Objective To prospectively investigate superselective renal arterial embolization (SRAE) in the treatment of iatrogenic renal hemorrhage MethodsFrom November 2005 to November 2010,19 patients with iatrogenic renal hemorrhage in the Affiliated Hospital of Hangzhou Normal University underwent diagnostic renoarteriography to reveal the site and degree of renal artery rupture,then superselective embolization by coins,or coins combined with spongia gelatinosa were performed for these patients.Results Renal arteriography showed hemorrhage was located at the renal segmental arteries and/ or their branches ( 9 cases at segmental renal artery,6 cases at interlobar artery and 4 cases at arciform artery),two cases were found with simple hemorrhage of segmental renal artery ( SRA ),9 cases with pseudoaneurysm,5 cases with arterio- venous fistula (AVF),3 cases with pseudoaneurysm combined with AVF.Seventeen cases received embolization with coins,while 2 cases with pseudoaneurysmes received embolization with coins and spongia gelatinosa at the same time.Bleeding was successfully ceased immediately and did not recur in all cases.Conclusions Superselective renal arterial embolization could be considered as a safe and effective method to treat hemorrhage of iatrogenic renal vascular injuries..

Objective To investigate the evaluation of femoral neck anteversion using the digital three-dimensional model induced determination method.Methods Ten healthy volunteers,including five men and five women,aged 18-60 years (mean,43 years) were recruited.Bilateral femur CT scan was taken and processed with Mimics 17.0 software to build the three-dimensional model of the femur.Traditional Photoshop and three-dimensional reconstruction techniques were separately applied to determine the femoral neck anteversion.Anteversion angle and measurement time determined with the two methods were compared.Results Anteversion angle was (17.0 ± 4.2) ° based on the Photoshop method and was (17.0 ± 4.2) ° based on the three-dimensional method (P ＞ 0.05).Measuring time was (1,231.5 ± 152.8) sec with the Photoshop method and (590.0 ± 37.2) sec with the three-dimensional method (P ＜ 0.01).Conclusion Both methods provide accurate measuring of the femoral neck anteversion,but three-dimensional measurement spends far less time resulting in improved measure efficiency.

Objective To investigate the effect of combined antiplatelet drugs on clinic and aggregation activity of platelet in patient with aucte myocardial infarction(AMI).Methods Consecutive 97 cases with AMI were redomized to receive clopidogrel plus aspirin(treated group,n=48) or aspirin alone(placebo group,n=49) for 30 days.Before and after treatment,the clinical recurrent angina,improvement of heart function,death,ST segment changes of electrocardiogram and the rate of maximun aggregation of paltelet were tested and analysed.Results Recurrent angina occurred in 10.0%(5 cases) in the treated group and 20%(10 cases) in the placebo group.The total frequency of improvement of heart function occurred in 36.7%(18 cases) in the treated group and 22.4%(11 cases) in the placebo group(?~2=3.638,P=0.045).Death occurred in 4%(2 cases) in the treated group and 8%(4 cases) in the placebo group.ST segment of electrocardiogram decreased from (0.36?0.13)mV to (0.13?0.08)mV,compared with placebo from (0.35?0.14)mV to (0.16?0.90)mV(t=3.012,P=0.04).The rate of maximum aggregation of platelet induced by ADP reduced from (74.54?8.99)% to (34.09?9.23)%,the placebo from (72.30?7.78)% to (56.54?6.92)%(t=13.42,P

To improve the pharmaceutical care ability of adult students,and ensure the safety in clinical medication. According to the requirement of the Ministry of Education of China, the new training scheme for adult Pharmaceutical undergraduates were drawn up by research and practice to meet the development needs of market economy and licensed pharmacist system in China.

Objective To investigate the methodology and feasibility of bedside temporary cardiac pacing with balloon-tipped floating catheter by femoral vein approach.Methods 86 patients in this study were treated with bedside temporary cardiac pacing by femoral vein for arrhythmias.A balloon-tipped floating catheter was inserted through the femoral vein in right ventricle,guided by the length of catheter in body and the QRS morphology of pacing electrocardiogram(ECG).After that,the pacing site was identified by X-ray fluoroscopy.Then,the feasibility and successful rate of this bedside temporary cardiac pacing,and the causes for failure were analyzed.Results Guided by the length of catheter and the QRS morphology of pacing ECG,the succesful rate of balloon-tipped floating catheter putted into right ventricle was 98.8%.The most successful pacing sites were located at the right ventricular apex(RVA) and right ventricular out-flow tract(RVOT).The lengths of catheter from the puncture sites to RVA and RVOT were (57.2?3.2)cm and (54.3?3.1)cm,respectively.Incidence of undersensing in RVOT pacing group was significantly higher than that in RVA pacing group(P

Objective To study antimicrobial resistance of clinically isolated Escherichia coli (E.coli),the preva-lence of integrons in E.coli,and relation of integron with antimicrobial resistance of E.coli.Methods E.coli isola-ted from three hospitals of Guangdong Province from 2010 to 2012 were collected,and antimicrobial susceptibility testing was performed by Kirby-Bauer method;integrons were detected by polymerase chain reaction (PCR),and gene cassette was analyzed by sequencing.Results A total of 156 E.coli isolates were collected,antimicrobial sus-ceptibility testing showed that resistance rate of E.coli to most penicillins,cephalosporins,fluoroquinolones,amin-oglycosides and sulfonamides were over 50%;the resistance rate to antimicrobials < 10% included cefoperazone/sulbactam(0),imipenem(3.85%),cefotetan(4.35%),ertapenem(7.69%)and piperacillin /tazobactam (8.97%);The positive rate of class I integron was 57.69%(90/156);the positive rate of class I integron in multidrug-resist-ant and non-multidrug-resistant E.coli was 66.00% (66/100)and 64.71 % (22/34)respectively,the difference was not statistically different (P >0.05),but compared with sensitive E.coli (9.09%,2/22),the difference was statisti-cally different (P<0.01 ).There were nine types of integron-drug resistant gene cassettes in the variable regions, most of which contained aadA and dfrA.Conclusion Antimicrobial resistance of E.coli is serious;high incidence of class I integrons are widely found in E.coli,and is closely related with drug resistance of E.coli,class I integrons mainly mediated aminoglycosides,sulfonamides and beta-lactams resistance.

Objective To study the risk factors of lymph node metastasis in the central neck compartment of thyroid carcinoma,and to explore the reasonable range of lymph node dissection in central neck dissection for clinically node-negative papillary thyroid microcarcinoma patients.Methods From Dec.2015 to Dec.2016,a total of 200 patients with CN0 papillary thyroid carcinoma were randomly divided into two groups according to the registration number:unilateral central neck dissection group and bilateral central neck dissection group in Department of Thyroid Surgery,Fujian Medical University Union Hospital.The risk factors of lymph node metastasis and value of bilateral central neck dissection were analyzed.Results The risk factors of lymph node metastasis in the central papillary thyroid carcinoma were ≥0.7 cm in diameter and older than 45 years in age and gender in male.Further analysis found that contralateral central lymph node metastasis occurred in patients with tumor diameter ≥0.5 cm.The positive rate was 22％.The number of lymph nodes detected in the unilateral and bilateral central areas was 9.53±6.04 and 12.19±7.18,P=0.035,respectively.The positive numbers of lymph nodes were 1.17±1.47 and 2.11±2.75,P=0,022 respectively.Conclusion In patients with tumor diameter ≥0.5 cm,bilateral central neck dissection is conducive to improving the thoroughness of tumor dissection and does not increase the risk of complications.

Objective To investigate the clinical efficacy of domestic porous tantalum rod in treatment of early avascular necrosis of femoral head (ANFH).Methods A prospective study was made on 18 cases (19 hips) diagnosed as early ANFH treated by domestic porous tantalum rod from July 2014 to December 2015.There were 14 males and four females, with a mean age of 44.2 years (range, 30-62 years).According to the modified Ficat staging, four cases were identified as stage Ⅱa and 14 stageⅡb.Efficacy of the treatment was evaluated by Harris score, Womac score, radiological images of the hip, complications and bone growth.Results All cases were followed up for 8-24 months (mean, 16 months).No complications such as infection, wound healing problems, immunological rejection, tantalum rod breakage, loosening or displacement were observed at last follow-up.Harris score was (82.7±9.0)points, (84.5±10.8)points and (87.2±10.0)points at postoperative 3, 6 and 12 months respectively, significantly higher than that pre-operation [(75.5±11.9)points] (P<0.05).Harris score was rated excellent in 10 cases, good in three, fair in five and poor in one at the last follow-up, with the excellent and good rate of 68%.Womac score was (17.4±9.4)points, (12.4±7.3)points, and (11.1±8.4)points at postoperative 3, 6 and 12 months respectively, significantly lower than that pre-operation [(28.3±13.1)points] (P<0.05).Seventeen cases (18 hips) showed no obvious deterioration in femoral head necrosis, with femoral head survival rate of 95%.One case underwent total hip arthroplasty after operation because of progressive hip pain and collapsed femoral head.Bone ingrowth was detected in the porous tantalum biomaterial after operation.Conclusion Domestic porous tantalum rod can effectively promote bone ingrowth, relieve pain, prevent the collapse of the femoral head, delay total hip arthroplasty time and finally improve hip function in treatment of early avascular necrosis of femoral head.

The authors reviewed the practice of integrated health care delivery system( IDS) at home and abroad, and based on experiences of collaborations between medical service institutions in Zhejiang province,proposed the strategic positioning,responsibilities and service innovation of urban public hospitals in a regional medical service system. It is held that the direction of China′s health care reform should move towards IDS in the future,and such hospitals should play an active role in the process via integration of its own resource and provide multi-level,diversified services for the regional health care system.

OBJECTIVE:To establish a method for the 5 main components (original syringin,chlorogenic acid,eleutheroside E,isofraxidin and quercetin-3-rhamnoside) in the fruits and roots of wild Acanthopanax senticosus. METHODS:UPLC was per-formed on the column of Waters ACQUITY UPLC HSS T3 with mobile phase of acetonitrile-0.3% phosphoric acid (gradient elu-tion)at a flow rate of 0.2 ml/min. Detection wavelength was 300 nm,column temperature was 30 ℃,and injection volume was 10μl. RESULTS:The linear range was 24.56-184.2 μg/ml for syringin(r=0.9993),18.454-138.405 μg/ml for chlorogenic acid(r=0.9993),8.416-63.12 μg/ml for eleutheroside E (r=0.9997),3.286-24.645 μg/ml for isofraxidin (r=0.9993) and 2.522-18.915μg/ml for quercetin-3-rhamnoside(r=0.9998);RSDs of precision,stability and reproducibility tests were lower than 1%;recover-ies were 99.14%-100.50%(RSD=0.48%,n=6)for syringing in the fruits of A. senticosus、99.03%-100.45%(RSD=0.50%,n=6) for chlorogenic acid in the fruits of A. senticosus、99.22%-100.44%(RSD=0.44%,n=6)for eleutheroside E in the fruits of A. sen-ticosus、99.80%-100.80%(RDS=0.44%,n=6)for isofraxidin in the fruits of A. senticosus、99.76%-101.10%(RSD=0.51%,n=6) for quercetin-3-rhamnoside in the fruits of A. senticosus;99.21%-101.20%(RSD=0.73%,n=6)for syringing in the root of A. senti-cosus、99.81%-101.20%(RSD=0.52%,n=6)for chlorogenic acid in the root of A. senticosus、100.00%-101.50%(RSD=0.62%, n=6)for eleutheroside E in the root of A. senticosus、99.22%-100.40%(RSD=0.47%,n=6)for isofraxidin in the root of A. senti-cosus. CONCLUSIONS:The method is simple and stable with good reproducibility,and can be used for the simultaneous determi-nation of original syringin,chlorogenic acid,eleutheroside E,isofraxidin and quercetin-3-rhamnoside in the fruits and root of wild A. senticosus.