Adenocarcinoma ; pathology ; secondary ; surgery ; Adult ; Bone Marrow Neoplasms ; diagnosis ; secondary ; Female ; Humans ; Postoperative Period ; Stomach Neoplasms ; pathology ; surgery

OBJECTIVE:To discuss the way to improve the service quality of outpatient pharmacy.METHODS:The pharmaceutical work in the outpatient pharmacy was optimized applying the theory of system engineering.RESULTS:The working efficiency and service quality of outpatient pharmacy were improved significantly.CONCLUSIONS:The theory of system engineering lay a focus on the optimal holistic effect of the system.Excellent results were achieved on the same objective conditions,when the stable quality of drugs,intensive scientific management,coordinating the exterior and interior relationships and reasonable usage of workers were considered as the elements of the system.

Objective To establish a new method for inducing the primordial germ cells to differentiate into hepatocyte-like in vitro.Methods The primordial germ cells(PGCs) from the gonadal ridges of the mouse embryos of 13 days postcoitum from Kunming pregnant mice were cultured in vitro.Then embryonic hepatocytes enclosed in microcapsule and liver tissue extract of newborn mice were added into medium to co-culture with PGCs for committed differentiation.Albumin(ALB) and ?-1-antitrypsin(AAT) were assayed by immunocytochemistry.Results The morphology of cells differentiated from PGCs likes star or ovum,the ALB and AAT immune positive expression were detected in those differentiated cells.The ratio of positive cells was above 70% in 2 weeks.Conclusion Microenvironment of embryonic hepatocyte microcapsules and liver tissue extract could effectively induce PGCs to differentiate into hepatocytes.

Arterial steal syndrome(ASS),a scarce complication after liver transplantation,is charac-terized by hepatic arterial hypoperfusion of the graft caused by a shifting of blood flow into the splenic,left gastric,or gastroduodenal arteries. It can lead to stricture formation of biliary system and transplanted liver function exhaustion. The early diagnosis and treatment are important for protecting the transplanted liver function. Dynamic CDFI after liver transplantation as a routine is necessary to find out the suspected lesions,and transcatheter angiography as the gold standardization can give clear dignosis. Embolization of splenic artery is minimally invasive,successful and less complication treatment for ASS and especially the coil embolization of middle segment of splenic artery is the best choice.

The insufficient blood supply to the portal vein after liver transplantation, mainly caused by portal vein stenosis (PVS)or portal vein thrombosis(PVT), occurs low in incidence but would be serious enough to lead to graft failure. Prompt diagnosis and treatment is critical to allow graft salvage. The color Doppler flow image (CDFI) could be the first choice for testing portal venous flow, and angiography is reliable for further accurate diagnosis on meaningful functional change of the stenosis. The interventional therapy , including percutaneous balloon angioplasty and stent placement, is safe and effective in lowering the portal venous pressure after hepatic transplantation with portal vein stenosis. Thrombolysis, percutaneous mechanical fragmentation and stent placement ,as the treatments of early portal vein thrombosis, are effective therapeutic methods, and TIPS is also a proper management if necessary.

The occurrence rate of the obstruction of the hepatic vein or the inferior vena cava is very low. Obstruction can develop acutely as a result of technical problems or can present itself much later after the transplantation due to intimal hyperplasia or perianastomotic fibrosis. Clinically, the common presentations include hepatic dysfunction, liver engorgement, ascites, abdominal pain, etc. Percutaneous endovascular treatment with balloon dilation or stent placement is a safe and effective alternative treatment, which can keep the vessels open for a long period of time. Angioplasty can achieve technical success in restoring anastomotic patency almost to 100% of cases, but, unfortunately, restenosis occurs frequently. For adult patients or pediatric patients with adult-sized hepatic veins, stenting seems to be the optimal choice.

Objective To study the factors affecting preverbal communication skill in prelingually deaf children with cochlear implants.Methods A total of 31 prelingually deaf children with cochlear implantation participated in the study.They received cochlear implantation the age of 12 months with a mean of 46.71 months.The video analysis were applied to assess the preverbal communication skill including rurn-taking,autonomy,eye contact and auditory awareness.According to the implant age,preoperative use of hearing aids,preoperative speech rehabilitation training,preoperative surgerg ear averrage residual hearing.Wilcoxon signed-rank test was used to evaluate the differences among the groups.The implant age distribution:16 cases in ≤36 months group;15 cases in >36 months group.Preoperative speech rehabilitation training (recovery time more than 3 months) : 14 cases in rehabilitation group, 17 case in no rehabilitation group.Preoperative surgerg ear averrage residual hearing:6 cases in ≤80 dB HL group;25 cases in >80 dB HL group.Preoperative use of hearing aids (use time more than 3 months) distribution: 21 cases in use group, 10 cases in no use group.Results There was statistical signifficance in preoperative use of hearing aids,preoperative speech rehabilitation training,preoperative surgerg ear averrage residual hearing(P<0.05)and there was no statistics significance group of implant age(P>0.05).Conclusion Preoperative use of hearing aids,preoperative speech rehabilitation training,preoperative surgerg ear averrage residual hearing in prelingually deaf children with cochlear implants relate with better preverbal communication still.

Objective To compare the clinical effect of different percutaneous endoscopic removal of nucleus pulposus vertebral plate gap into the road in the treatment of L5 and S1 lumbar intervertebral disc protrusion.Methods 120 cases with lumbar intervertebral disc protrusion in our hospital were randomly divided into group A and group B,60 cases in each group.Group A was given the intervertebral foramen mirror vertebral plate gap into the way,group B was given the posterior intervertebral disc mirror reserves the yellow ligament treatment.The operation time,number of perspective,intraoperative blood loss,length of incision,visual analogue scale (VAS),hospitalization days,Oswestey disability index (ODI) before and after surgery were compared between two groups.The curative effect was evaluated by the Macnab criteria.Results The operation time,number of perspectives,intraoperative blood loss,surgical incision length,VAS score,hospitalization days in group A were (58.69±5.26)min,(2.56±0.52)times,(80.23±20.45)mL,(1.63±0.33)cm,(2.95±0.77)points,(4.98±0.84)d,respectively,those in group B were (60.36±5.31)min,(2.55±0.48)times,(75.69±2.96)mL,(1.56±0.21)cm,(2.98±0.69)points,(5.01±0.86)d,the differences between the two groups were not significant (all P＞0.05).Immediate postoperation and postoperative 3 months,the ODI scores of group A were (36.96±10.58)points,(9.26±0.23)points,(6.35±0.44)points,respectively,and those of group B were (37.02±9.85)points,(9.42±0.65)points,(6.30±0.39)points,immediately after operation,postoperative 3 months,the ODI scores of the two groups were lower than before operation,compared with immediate postoperation,the ODI scores of postoperative 3 months were significantly reduced,the difference was statistically significant (P＜0.05).At immediately after operation,postoperative 3 months,the ODI score between the two groups had no significant difference (P＞0.05).The excellent rate of group A was 90.00％,which of group B was 91.67％,the difference between the two groups was not obvious (P＞0.05).Conclusion Intervertebral foramen mirror the vertebral plate gap into the road and posterior intervertebral disc mirror reserves are yellow ligament in treatment of L5 and S1 lumbar intervertebral disc protrusion will achieve good operation effect,no obvious difference was found between the two methods,before undergoing surgery for the patients'' individual condition and indications for judgment,and to choose appropriate surgical method.

Objective: To study the bonding interface characteristic of five wet bonding systems while bonding on different dentin bonding surfaces. Methods: Rhodamine B was used to label five adhesives(OptiBond Sol o,Single Bond,Gluma One-Bond,Bond-1 and One-Step) in consistency of 0.1%, an d the bonding interface of the 5 wet bonding systems on dry or wet dentin surfa ces was observed with laser scanning confocal microscope. Results: All five bonding systems could infiltrate well into dentin bonding interface when bonding on wet dentin surface. The fluorescence confocal images gave eviden ce of the adhesives penetrated into the widened tubules, lateral tubules and dem ineralized peritubular dentin. Little discontinuity in dentin tubular was observ ed in the images, especially in those of alcohol-water-based adhesives. When b onded in dry dentin surface, the hybrid thickness of acetone-based adhesives de creased significantly. Conclusion: The penetration ability of ad hesives may be reduced significantly on dry dentin surface.

Neonatal mortality has been significantly decreased because of the development of neo-natal respiratory support techniques. Nevertheless,constant and high frequency ventilators have some limita-tions to solve all problems in neonatal respiratory failure. Special mechanical ventilation,mainly including he-liox and partial liquid ventilation,provides new respiratory support for newborn infants. The clinical signifi-cance of heliox and partial liquid ventilation need further investigation.