Objective: To optimize the hospital medical examination process, reduce the patient waiting time. Methods: Established a centralized examination appointment center at outpatient department. Development and implementation of medical examination appointment platform, integrated with the hospital HIS system, PACS systems and queue system. Results:Achieved the function of“one-stop booking, network distribution, multi-point examination”for all patients, a better solution to the disorder problem of medication examination. Conclusion:The implementation of the medication examination platform has played a positive role. Facilitate patient visits, rational use of equipment, improve work efficiency and improve the treatment environment.

Objective To explore the diagnostic value of HR -HPV combined with TCT in the diagnosis of cervical cancer and precancerous lesion.Methods 1 198 cervical specimens were selected for the study.The results of HR -HPV detection and TCT detection were analyzed,with the pathological results as the gold standard,the diag-nostic value of HR -HPV and TCT in the diagnosis of cervical cancer and precancerous lesion were discussed. Results With increasing pathological grade,TCT positive rate increased gradually,there was a correlation between them(r =0.629,P <0.05).With increasing pathological grade,HR -HPV positive rate increased gradually,there was a correlation between them(r =0.684,P <0.05).The sensitivity of HR -HPV combined with TCT in the differ-ential diagnosis of cervical cancer,precancerous lesions was 100.00%,specificity was 79.64%,missed diagnosis rate was 0.00%,the misdiagnosis rate was 20.36%.Conclusion HR -HPV combined with TCT examination has high clinical value in the diagnosis of cervical cancer and precancerous lesions.

Objective To evaluate the effect of propofol infusion on hepatic blood flow (HBF) and oxygen delivery and consumption in rabbit. Methods Thirty adult male rabbits weighing 1.6-2.4 kg were randomly allocated into 3 groups: group I high dose propofol (HP) ( n = 11); group II low dose propofol (LP) (n = 10) and group III control group (C) ( n = 9). The rabbits were anesthetized with intravenous 3 % pentobarbital 45 mg ?kg-1 and mechanically ventilated (VT = 10 ml?kg-1 RR = 40 bpm, I:E= 1:2) after tracheal intubation. ECG, urinary output and rectal temperature were continuously monitored. Portal vein and hepatic artery were dissected and exposed for measurement of blood flow using electromagnetic flowmeter. Catheters were inserted into carotid artery, portal vein and hepatic vein via the mesenteric vein and right femoral vein for collection of blood samples. After the circulation was stabilized for 30 min, propofol infusion was started at a rate of 1.2 mg ? kg-1 ? min-1 ( HP) or 0.4 mg?kg-1 ?min-1(LP). In control group normal saline was infused instead of propofol. Portal venous and hepatic arterial blood flow were continuously measured. Blood samples were obtained from carotid artery, portal vein and hepatic vein before ( baseline) and at 30, 50, 70 and 90 min of propofol infusion for determination of Hb, SO2, PO2 and PCO2. The hepatic O2 delivery (DO2 ) and consumption (VO2 ) were calculated. Results The three groups were comparable with respect to body weight, duration of operation, the volume of fluid infused and blood loss and urinary output. HBF was significantly higher at 30-90 min of propofol infusion in HP group than in C group, meanwhile DO2 and VO2 in HP group were significantly higher during propofol infusion than the baseline value before infusion and those in C group. However, there was no significant difference in DO2/VO2 ratio between HP and C group. Conclusion High dose propofol infusion improves liver blood flow and O2 delivery but it also increases hepatic O2 consumption. However the balance between hepatic O2 supply/demand remains unchanged.

With the wide development of intra-arterial thrombolysis,the risk factors and the occurrence mechanism of hemorrhagic transformation have drawn great attention.Hemorrhagic tramformation is the most dangerous complication of intra-arterial thrombolysis.The understanding of the occurrence mechanism of hemorrhagic transformation from macroscopic tO microscopic,it is attributed ultimately to the destruction of vascular wall structure or function.The related mechanisms include oxidative stress reaction,leukocyte infiltration and inflammatory reaction,vascular reaction,and extracellular proteolysis.

Objective To investigate the efficacy and safety of carvedilol in patients with chronic heart failure (CHF).Methods Forty-six patients with CHF were randomly divided into carvedilol group (n=26) and control group (n=20) on the basis of standard therapy including digitalis, diuretics and ACEI. Before and after treatment, NYHA class, echocardiography and adverse reaction were observed. Results The mean dose of carvedilol was titrated to 25.14?3.05mg/day. After treatment, NYHA class was improved in both groups. Left ventricular end-diastolic diameter (LVEDD) measured by echocardiography reduced [(58.79?8.99)mm vs (64.68?10.12) mm,P

Objective To evaluate the effect of single CVVH and HDF on endothelial system. Methods Group CVVH:20 patients with multiple organ dysfunction syndrome ( MODS) underwent CVVH for 12h.Vascular access was through two-lumen catheter in femoral vein;Group HDF:Twenty patients with end stage renal disease (ESRD) on maintenance hemodialysis underwent HDF for 4h.Vascular access was through internal arteriovenous fistula.Group control:Healthy people were examined at our hospital.The se-rum levels of sVCAM-1, sICAM-1, vWF and MMP-9 were measured by enzyme-linked immunosorbent assay ( ELISA) after centrifugation in treatment group before and after treatment.Four cytokines were also meas-ured in fasting healthy subjects in the morning.Results The levels of serum sVCAM-1, sICAM-1, vWF, MMP-9 were significantly higher in Group CVVH and HDF than control group before and after treatment( P<0.05).Group CVVH:The serum levels of sICAM-1 and sVCAM-1 were significantly lower in post-treat-ment than pre-treatment, But the serum levels of vWF and MMP-9 showed no obvious changes after CVVH;Group HDF:the levels of four cytokines showed no obvious changes after single HDF.Conclusions Endo-thelium becomes impaired in MODS and ESRD patients, Endothelium may be protected by CVVH through the partial removal of cytokines harmful to endothelium in MODS patients.Single HDF therapy does not pro-tect endothelial function obviously in MHD patients.

Objective To investigate the preoperative management and the clinical effeciency of Lichtenstein tension-free hernioplasty in adult patients with inguinal incarcerated hernia.Methods Clinical data of 86 patients with inguinal incarcerated hernia were analyzed retrospectively.Hernia was repaired with Lichtenstein tension free after reposition.Results There were 59 male patients and 27 female patients with median age of (63 ± 18) years.There were 8 patients with liver cirrhosis.The operation was performed successfully in all patients.Segmental bowel resection with end-to-end anastomosis was performed in 38 emergency cases.Operative time was 20-120 min,with an average time of 54 min.The postoperative hospitalization was 5-17 d,with an average of 8 d.There were 7 cases of skin ecchymosis at the scrotum,there were no intestinal perforation,hepatic encephalopathy and upper gastrointestinal hemorrhage after operation.In early series of 24 cases without drainage tube left in place,there were 10 cases of fat liquefaction,10 cases of hydrops of hernial sac,6 cases of seroma and 3 cases of wound infection after operation.After 12 to 48 months of follow-up,there was no mortality after 2 years,no hernia recurrence.Conclusions Tension free repair in the treatment of incarcerated inguinal hernia is safe and feasible.

Objective To develop a equipment of vehicular multifunctional water,and the problem of water in disaster medical rescue was solved. Methods According to the features of the field water in earthquakes,floods and other disasters,a kind of disaster relief in the wild integrated production,supplying softening water and water purification technology was created,and a system by the pretreatment system, ion exchange,reverse osmosis systems,and storage and transportation system and other parts of the small truck-mounted multifunctional water treatment equipment was developed. Results The vehicular prototypes of multifunctional water treatment machine was developed,the pond water and river water were tested to prove that the throughput of the equipment in production and supply in the land of disaster relief,the puri-fied water and softening water reached 2 080 L/day and 12 100 L/day,which could meet the conducted large-scale medical treatment de-mand. Conclusion The successful design of the vehicular multifunctional water processor carried out the medical rescue with water prob-lem,and provided a new method and new equipment,which was worthy of popularization and application.

Objective To explore the prognostic significance in monitoring minimal residual disease (MRD) in childhood acute lymphoblastic leukemia (ALL) by a simple method,and to detect cloned immunoglobulin H (IgH) and T cell receptor γ (TCRγ) gene rearrangements by using multiplex polymerase chain reaction (PCR) and automated fragment analysis.Methods Bone marrow samples were collected from 86 newly diagnosed cases of childhood ALL at the Department of Pediatrics,the First Affiliated Hospital of Sun Yat-Sen University,from May of 2009 to August of 2013.IgH and TCRγ gene rearrangements were amplified by qualitative multiplex PCR.The clonality of PCR production was analyzed by GENEMAPPERID software.Only those carried monoclonal IgH/TCRγ on diagnosis were arranged to monitor MRD.Detectable monoclonal IgH/TCRγby the end of induction was defined as MRD positive.All patients were treated with GD2008 ALL protocol.Clinical data of all newly-diagnosed ALL patients in the corresponding period were reviewed.The final follow-up on May 31,2014.Survival rates and event free survival (EFS) curves were estimated by the Kaplan-Meier,and compared by using the log-rank test.Results The percent age of 94.2 (81/86 cases) patients was at least 1 marker positive.Subsequent MRD was monitored in 79 cases.The median follow-up time was 20 months (9-61 months).By the end of induction,20 cases were MRD positive and 59 cases were M RD negative,and the 3-year EFS were 56.4％ ± 14.7％ and 94.0％ ± 3.4％ (x2 =8.563,P =0.003),respectively.According to the traditional prognostic stratification criteria,MRD was detected 65 cases in the non-high risk group:23 cases in standard risk group and 42 cases in intermediate risk group,and the difference of 3-year EFS had no statistical significance (95.3％ ±4.7％ vs 76.6％ ±9.0％,x2 =0.934,P =0.334).While using MRD by the end of induction as a risk stratification criterion,there was a statistical significant difference compared with the 3-year EFS for MRD-negative (n =52) group and MRD-positive (n =13) group (93.1％ ± 3.8％ and 59.5％ ± 16.2％,x2 =7.128,P =0.008).Conclusions It is a simple but feasible method to monitor MRD in childhood ALL by using this qualitative multiplex PCR with automated fragment analysis for monoclonal IgH/TCRγ gene rearrangements.MRD by the end of induction can be used as a more accurate risk stratification criterion than the traditional one.It is worth of further research.

Objective To evaluate the role of 1-phosphatidylinositol 3-kinase (PI3K) signaling pathway in nerve growth factor-beta (NGF-β)-produced mitigation of cell apoptosis induced by endoplasmic reticulum stress during hypoxia-reoxygenation (H/R) in rat cardiomyocytes.Methods H9c2 cells were seeded in 96-well plates at a density of 5× 105 cells/ml (100 μl/well).The wells were randomly divided into 5 groups (n =15 each) using a random number table: control group (group C);group H/R;NGF-β group (group N);NGF-β+NGF receptor trkA antagonist K252a group (group N+K);NGF-β+ PI3K inhibitor LY294002 group (group N+L).The cells were exposed to 95％ N2-5％ CO2 for 4 h in an anaerobic incubator, followed by reoxygenation in a standard incubator for 4 h in H/R, N, N+K and N+L groups.In addition, the cells in N, N + K and N + L groups were incubated in a standard incubator containing NGF-β, the mixture of NGF-β and K252a and the mixture of NGF-β and LY294002, respectively, during reoxygenation, and the final concentrations of NGF-β , K252a and LY294002 were 50 ng/ml, 100 nmol/L and 50 μmol/L, respectively.The cell viability was detected by using CCK-8 assay, and the cell survival rate was calculated.The cell apoptosis was examined by flow cytometry, and apoptosis rate was calculated.The expression of glucose-regulated protein 78 (GRP78), C/EBP homologous protein (CHOP), caspase-12, Akt and phosphorylated Akt (p-Akt) was detected by Western blot.The ratio of p-Akt to Akt was calculated.Results Compared with group C, the cell survival rate was significantly decreased, and the apoptosis rate was increased in H/R and N groups, and the expression of GRP78, CHOP and caspase-12 was significantly up-regulated in group H/R, and p-Akt/Akt was significantly increased in group N (P＜0.05).Compared with group H/R, the cell survival rate was significantly increased, the apoptosis rate was decreased, the expression of GRP78, CHOP and caspase-12 was up-regulated, and p-Akt/Akt was increased in group N (P＜0.05), and no significant change was found in the parameters mentioned above in N+K and N+L groups (P＞0.05).Compared with group N, the cell survival rate was significantly decreased, the apoptosis rate was increased, the expression of GRP78, CHOP and caspase-12 was up-regulated, and p-Akt/Akt was decreased in N+K and N+L groups (P＜0.05).Conclusion NGF-β can mitigate the cell apoptosis induced by endoplasmic reticulum stress during H/R, and activation of PI3K signaling pathway is involved in the mechanism.