Objective To introduce three-dimensional management mode to manage the devices in the operating room so as to reduce the risks.Methods A three-dimensional quality control group was established to strengthen the devices management.From three dimensions of thinking,communication and action some measures were proposed including training for standardized operation and incident treatment,improving guidance,sticking warning signs,advocating active report of adverse events,preventive maintenance and etc.Efficacy inspection and continuous improvement were carried out.Results The examination scores,inspection results and active reports of adverse events were significantly different before and after the introduction of three-dimensional management mode.Conclusion Three-dimensional management mode,in which the three dimensions connect to and cycle through each other,makes nursing staffs progressively develop the habit of safe operation in an environment of safety culture.Three-dimensional management mode is a scientific and applicable management method to reduce risks in using the devices in the operating room.

Objective To explore the clinical efficacies of laparoscopic distal pancreatectomy (LDP) with laparoscopic splenectomy (LS) for the treatment of malignant tumors in the body and tail of pancreas.Methods The clinical data of 37 patients with malignant tumors in the body and tail of pancreas who were admitted to the Third Affiliated Hospital of Guangzhou Medical University from June 2009 to December 2014 were retrospectively analyzed.LDP with LS was performed on all the patients under general anesthesia.The operation time,volume of intraoperative blood loss,postoperative complications,removal time of postoperative drainage tube,duration of hospital stay and results of pathological examinations were recorded.All the patients were followed up via outpatient examination and telephone interview up to May 2015.Results Thirty-seven patients received successful surgery without conversion to open surgery and perioperative death.Of 37 patients,19 received splenectomy due to splenic artery and vein surrounded by masses of pancreatic body and tail,splenic ischemia after clamping or amputating of splenic artery and vein;11 received splenectomy due to splenic hilum invasion,dense adhesions,unclear boundary and difficulty in preserving spleen;7 received splenectomy due to splenic cystic occupying lesion.The operation time,volume of intraoperative blood loss and removal time of drainage tube were (232 ± 42) minutes,(330 ± 160)mL and (5.0 ± 2.0)days,respectively.Four patients were complicated with pancreatic leakage without obvious discomfort and discharged from hospital with a placement of drainage tube,and then drainage tubes were removed after 2 weeks.The mean duration of postoperative hospital stay was 7.5 days (range,5.0-10.0 days).The results of pathological examination showed that resection margin was negative,moderate and low malignant intraductal papillary mucinous neoplasm (IPMN) was detected in 12 patients,mucinous cystic carcinoma in 9 patients,moderate and low malignant solid pesudopapillary neoplasm (SPN) in 7 patients,pancreatic ductal adenocarcinoma in 4 patients,pancreatic neuroendocrine cancer in 3 patients and acinic cell carcinoma in 2 patients.The number of detecting lymph node was (9 ± 3).All the patients were followed up for a mean time of 9 months (range,3-12 months) without recurrence of tumors.The platelet (PLT) of 37 patients was different levels of increasing.Of 21 patients with PLT ＞ 500 × 109/L,PLT was returned to normal range after aspirin and/ or clopidogrel were taken orally.Conclusion LDP with LS is safe and feasible for malignant tumors in the body and tail of pancreas.

Objective To investigate the underlying mechanism of bone marrow mesenchymal stem cells (BMSC) modulating the inflammatory response during the multiple organ dysfunction syndrome (MODS), especially the expression of inflammatory cytokines, which will provide new theoretical and experimental basis of MODS in clinic. Methods BMSC of Sprague-Dawley (SD) rat (female, 4 weeks) was extracted and cultivated, and the 4th passage were used in experimental study. According to the random number table, 60 female SD rats were divided into three groups (n = 20 per group): sham group, MODS group, BMSC group. MODS model in rats was induced by lipopolysaccaride (LPS, 1 mg/kg) via femoral vein injection. Sham group was injected with the sterile phosphate buffer saline (PBS) in the same volume. BMSC group, in which BMSC infusion was started at 2 hours after 0.5 mL LPS stimulation (1×106/cells) through the tail vein. The survival rate was observed after 72 hours in each group. Abdominal aortic blood was collected for routine blood and biochemical examination at 72 hours after operation. Protein microarray was used to detect the related 34 inflammatory cytokines. Signal ratio was defined as the differentially expressed factors when it was more than 2.0 or less than 0.5. And enzyme linked immunosorbent assay (ELISA) was be applied to validate the significant inflammation factor. Meanwhile, the heart, kidney, intestine tissue was harvested, then their pathological changes were observed by hematoxylin eosin (HE) staining.Results 20, 12, 16 rats lived in sham group, MODS group and BMSC group respectively at 72 hours after operation. Compared with the sham group, the indicators (routine blood, liver and kidney function, myocardial enzyme) were apparently unusual, and the heart, kidney, intestine tissue were injured obviously in the MODS group. After BMSC administration, the organ function was improved and tissue damaged was alleviated significantly. Protein microarray showed that interleukin-4 (IL-4) and receptor for advanced glycation end products (RAGE) were significantly different in 34 goal cytokines. The signal ratio change of IL-4 was 0.397, 1.124, 2.826 respectively, and the signal ratio of RAGE was 6.197, 1.552, 0.250, respectively in MODS/sham group, BMSC/sham group, BMSC/MODS group. ELISA validated the result that the expression level of IL-4 decreased significantly (ng/L:3.59±1.21 vs. 29.10±5.78) and the expression level of RAGE increased significantly (ng/L: 1.09±0.04 vs. 0.11±0.03) in MODS group as compared with sham group (bothP < 0.05). Compared with the MODS group, the level of IL-4 was obviously higher than that in BMSC group (ng/L: 9.59±2.21 vs. 3.59±1.21,P < 0.01), and RAGE decreased significantly (ng/L: 0.29±0.07 vs. 1.09±0.04,P < 0.05).Conclusions BMSC administration can regulate the expression of IL-4 and RAGE in the rats subjected to MODS. Moreover, BMSC can promote the restoration of tissue and organ function, thus improve the survival rate. BMSC may be the target in cell therapy for the inflammatory disease.

Objective To investigate the effects of puerarin(Pur)on myocardial perfusion and ventricular wall motion in patients withacute coronary syndrome(ACS).Methods Thirty-seven patients with ACS were randomly divided into two groups:conventionaltreatment group(n=17,11 males,range of age:32-80 years,average age:60.9±4.9 years)and Purtreatment group(n=20,12 males,rangeof age:40-76 years.average age:62.7±3.5 years).Patients in the conventional treatment group received standard treatment according tothe current guidelines,while patients in the Pur treatment group received intravenous administration of Pur(500 mg/day)for 10 daysplus conventional treatment.Real-time myocardial contrast echocardiography (RT-MCE) was performed to evaluate the change inmyocardial perfusion index (MPI)and veiltricular wall motion index(VWMI)at admission and 10 days after treatment.Results At10 days after treatment,MPI was significantly higher(P＜0.01)and VWMI significantly lower(P＜0.01)in the Pur group comparingwith those in the conventional group.Conclusions Puerarin might improve myocardial microcirculation perfusion and ventricularwall motion in patients with ACS.

Objective To investigate the effect of femoral head replacement for the treatment of intertrochanteric frac -tures among elderly patients .Method There were 38 cases that received intertrochanteric fracture hemiarthroplasty and 35 patients were treated with open reduction and dynamic hip screw ( DHS) plate internal fixation .After follow-up, their opera-tion duration,blood loss, postoperative drainage flow , postoperative ambulation time , hospitalization time were compared according to the Harris score to assess the effect of postoperative follow-up.Results After the mean follow-up time of 18 months (12 to 36 months),the hemiarthroplasty group was superior to the open reduction and DHS plate fixation group ,as shown by the earlier postoperative ambulation time , fewer complications , and better fracture reduction , with an excellent rate of 94 .7%.Conclusion For patients with intertrochanteric fractures , hemiarthroplasty surgery is effective and can re-duce the incidence of postoperative complications .

Sixteen compounds have been isolated from the EtOAc fraction of 95% ethanolic extract of Sophora dunnii through silica gel, Sephadex LH-20 and semi-prerarative HPLC column chromatographies. Their structures were identified on the basis of NMR and MS spectra data as phaseollidin (1), L-maackiain (2), 2-(2',4'-dihidroxyphenyl)-5,6-methylenedioxy benzofuran (3), 8-demethyl-farrerol (4), liquiritigenin (5), genistein (6), 6-methylgenistein (7), 5-O-methyl genistein (8), 7,2',4'-trihydroxys-5-methoxy-isoflavanone (9), 7, 3', 4'-trihydroxy-isoflavanone (10), erythribyssin D (11), calycosin (12), trans-resveratrol (13), cis-resveratrol (14), stigmasterol (15), β-sitosterol (16). Among these, compounds 1-14 and 16 were isolated from this plant for the first time.
Chemical Fractionation ; Drugs, Chinese Herbal ; chemistry ; isolation & purification ; Molecular Structure ; Sophora ; chemistry ; Spectrometry, Mass, Electrospray Ionization

Objective To explore the effects and safety of hemoperfusion(HP) therapy on tetramine poisoning in infants.Methods Thirty-five infants with tetramine poisoning were divided into two groups: HP group(n=18) and non HP group(n=17).The changes of blood tetramine concentration and clinical symptom improving of both groups after the treatment were observed together with the adverse effects of HP group.Results The average blood tetramine concentration of HP group was higher than that of non HP group(342.2?333.4 vs 117.9?50.8 ?g/L,P

Objective: To establish a method for isolation and purification of fetal membrane derived adherent cells (FMDACs) , and investigate their biological characteristics. Method: FMDACs were isolated with trypsin inducing and cultured in vitro. FMDACs were induced to differentiate into osteoblasts and adipocytes. FACS and immunocytochemistry technique were used to examine the cell surface antigen. The genetic stability was verified by karyotype analysis. Results: FMDACs were successfully isolated and expanded in vitro. They had strong proliferative ability. FMDACs were positive for CD44 and CD29, but negative for CD34, CD14 and CD45. FMDACs were differentiated into osteoblasts and adipocytes after inducement. The karyotype was stable in the sixth-passaged FMDACs and the tumorigenicity was not found. Conclusion; FMDACs have the possibility of multipotent stem cells, which have strong capacities of self-renewal and multidirectional differentiation. The genetic background of FMDACs is stable. FMDACs may be used as a kind of novel seed cells for tissue engineering.

OBJECTIVETo study the clinical and pathological features of drug-induced liver injury (DILI).

METHODSLiver specimens were obtained through needle biopsies from 100 patients with DILI. The histological preparations of the specimens were stained with haematoxylin eosin, several histochemistry methods, and immunohistochemistry stains. The pathological changes of the livers were analyzed together with the patients's clinical data. The patients were divided into two groups, an acute DILI group (n=39) and a chronic DILI group (n=61), based on their clinical courses and histological changes in their livers. In the chronic DILI group, the clinical courses were longer than 6 months and/or fibrosis or cirrhosis occurred in their liver tissues.

RESULTSAmong our cases the leading cause of DILI was Chinese herb medicine, accounting for 21% of the 100 cases; steroids induced cases were 11% of the total. 78% of the patients presented elevated serum transaminases and/or jaundice. The degree of transaminases elevation and the frequency of jaundice happening in the acute group were significantly higher than those in the chronic group (P less than 0.05). The histopathological liver changes in these DILI cases included: (1) necrosis commonly occurred in acinar zone 3, (2) abundant neutrophil and/or eosinophil infiltrations, (3) hepatocytic and/or canalicular cholestasis with little or no inflammation, (4) microvesicular steatosis mixed with macrovesicular steatosis, and (5) presentation of epitheloid cell granuloma. There were no significant differences in liver histopathology between the acute and the chronic DILI groups, except that the fibrosis and the ductular proliferation were different.

CONCLUSIONDILI has become a notable liver disease in mainland China, and the use of Chinese herbal medicine must be improved, standardized and regulated more closely.

Adolescent ; Adult ; Aged ; Chemical and Drug Induced Liver Injury ; pathology ; Child ; Child, Preschool ; Female ; Humans ; Liver ; pathology ; Male ; Middle Aged ; Young Adult

OBJECTIVE: To identify the gene causing diffuse palmoplantar keratoderma in a Chinese pedigree. METHODS: Four normal individuals and 3 patients in a diffuse palmoplantar keratoderma family and 10 unrelated control samples were recruited. The hotspot of the mutations of keratin 9 gene was analyzed by polymerase chain reaction and direct sequencing. RESULTS: We found a G485A transition in ke ratin 9 gene, resulting in the substitution of glutamine for arginine at codon 162 in this diffuse palmoplantar keratoderma family. The mutation was not found in the 10 unrelated control samples and 4 normal individuals. CONCLUSION The mutation G485A found in keratin 9 gene is the disease-causing mutation in the diffuse palmoplantar keratoderma family.
Base Sequence ; DNA Mutational Analysis ; Female ; Heterozygote ; Humans ; Keratins ; genetics ; Keratoderma, Palmoplantar, Diffuse ; genetics ; Male ; Molecular Sequence Data ; Mutation ; Pedigree