Objective To improve the protective strategy of occupational risks for technicians in blood centers so as to ensure their health and safety.Methods The occupational risk factors were analyzed by the 5W1H method,and the corresponding protective measures were introduced.Then,the protective measures were verified dynamically by the PDCA circulation,and were standardized and further spread.The projects with poor effect were replanned and entered the PDCA recycling.Results The system of the 5W1H method combined with PDCA circulation could identify and control various occupational risks,and effectively prevent the occupational detriments.Condusion Combined application of the 5W1H method with PDCA circulation is an effective way to protect the health and safety of technicians in blood centers and an effective mode to improve the management of occupational risks.

Objective To investigate the influence of a combination of Chinese herbs,Astragalus membranaceus var.mongholicus and A ngelica sinensis (A&A)on the production and elimination of reactive oxygen species (ROS)and the underlying mechanism during the process of renal interstitial fibrosis in the obstructive kidneys of rats with unilateral ureteral obstruction(uuo).Method Male Wistar rats were randomly divided into control,sham,UUO and UAA (UUO+A&A)groups.The rats in UAA group were administered with A&A(14 g/kg)by oral gavage once daily:the ones in sham and UUO group were given with equal volumes of water.Three days after setting up models,pathological injury of renal tissue was evaluated.Level of total antioxidant capacity(T-AOC)and activity of CuZn superoxide dismutase(CuZn-SOD)in renal homogenates were measured bv spectrophotometry.Expression of NADPH oxidase subunits p47-phox,p22-phox and nintrotyrosine was analyzed by Western blot. Results Severe interstitial inflammatory cells infiltration, mild tubular atrophy and interstitial fibrosis were found in UUO group, which were alleviated by A&A administration. Compared to sham group, T-AOC of UUO group was not significantly changed, but the expression of the nitrotyrosine, NADPH oxidase subunits p47-phox and p22-phox was increased significantly (P<0.05). After A&A administration, T-AOC level was increased (2.5±1.1 vs 1.5±0.5, P<0.05) and the expression of nitrotyrosine was decreased (P< 0.05) in UAA group compared with UUO group. Additionally, the expression of p47-phox was reduced at day 3 (P<0.05), accompanied with a reduced expression of p22-phox (P< 0.05). CuZn-SOD activity was not significantly changed among the groups. Conclusion The inhibition of A&A in NADPH oxidase subunits p47-phox and p22-phox, which is responsible for reduction of oxidative stress, is associated with the alleviation of renal fibrosis in obstructive rat kidney.

ObjectiveTo investigate the unfavorable factors of intestinal mucosa repair after the intestinal epithelial injury in vivo in a mouse model of sepsis. MethodsThe method of cecal ligature and puncture (CLP) was used to induce sepsis and then the intestinal mucosa damage, epithelial cell apoptosis and the number of transformed goblet cells were observed, and the concentrations of serum TNF-αt, IL-1 and TGF-β1 and TFF3 ( trefoil factor 3) in small intestinal mucosa were determined. All above various laboratory examinations were made by different assays including H-E staining, western blot, ELISA and immunohistochemistry respectively. The experimental mice were divided into sepsis group and sham operation control group. The mice with sepsis were separately sacrificed 6 hours ( n = 7 ), 24 hours ( n = 7) and 48 hours ( n = 7) after CLP. Results In septic mice group, the injured intestinal mucosa was found 6 hours after CLP. The damage scores in mice 24 h and 48 h after CLP were higher than those 6 h after CLP, but there was no significant difference between those 24 h and 48 h after CLP. Moreover, a few goblet cells or other epithelial cells adjacent to the injured surface migrated onto the wound to cover the denuded area. The number of goblet cells was substantially decreased in mice of sepsis group 6 hours after CLP compared with sham operation control group. Compared with sham operation control group, levels of IL-1 and TNF-α significantly increased 3-4 times in mice of sepsis group at all intervals, and the phosphorylated caspase-3 increased 4 times. Although TFF3 assayed by using Western blot showed modest increase 6 h after CLP and it declined 24 h and 48 h later. A similar change was found in TGF-β1, it modestly increased 6h after CLP, but it didn't elevate 24 h and 48 h later. ConclusionsSevere sepsis keeps on the inflammatory reaction and epithelial cell apoptosis, preventing the repair of intestinal mucosa from injury.

Objective To relatively prolong the length of C7 nerve through microanatomical study and carry out direct anastomosis between the end of avulsed nerve and contralateral C7. Methods Fifteen cadaveric specimens and 30 sides of the adult brachial plexus was dissected. The C7 nerve was confirmed and measured by using electric vernier caliper. Parameters as follow: the length of C7 nerve from root to trunk; the length of C7 nerve from root to division(anterior and posterior division); transverse and longitudinal diameter of C7 nerve in root site, combination site between trunk and division, end site of anterior and posterior division. After dissected the nerve adventitia of binding site between division and cord and cut the distal end of anterior and posterior division, the length of C7 nerve from root to division (anterior and posterior division)was measured again. Results The measured result of the length C7 nerve: the length of C7 from root to trunk: (45.87 ± 10.43)mm; Before micro-dissected, the length of C7 from root to anterior division: (61.14 ±13.44)mm; the length of C7 from root to posterior division: (54.63 ± 11.35)mm after micro-dissected, the length of C7 from root to anterior division: (74.67±12.86)mm; the length of C7 from root to posterior division:(68.73± 11.86)mm; the prolonged length of anterior division: (13.15± 4.26)mm; the prolonged length of posterior division: (14.21 ± 6.98)mm. Conclusion Through dessecting the adventitia of binding site of division (anterior and posterior division) and cord of C7 nerve. The length of C7 nerve can be relatively prolonged.

Aim To investigate the effects of irbesartan on Wnt/β-catenin signaling pathway in tubular epithelial-mesenchymal transition(EMT)in HKCs induced by high-glucose.Methods Human kidney proximal tubular epithelial cell line(HKCs)cultured in vitro was divided into four groups:normal-glucose group,mannitol control group,high-glucose group and high-glucose plus irbesartan group.Immunocytochemistry staining was used to observe the expression of β-catenin;the protein expression of Wnt4,β-catenin,E-cadherin and α-SMA was assessed by Western blot;Wnt4 and β-catenin mRNA were detected by reverse transcription-polymerase chain reaction(RT-PCR).Results Compared with normal-glucose and mannitol control group,both the protein and the mRNA of Wnt4 were up-regulated in HKCs stimulated by high-glucose.α-SMA expression significantly increased but E-cadherin decreased in HG group.The cytoplastic and nuclear fraction of β-catenin enhanced with highglucose stimulation.But no difference of the total protein and mRNA of β-catenin was observed between highglucose-treatment and control groups.Highglucose induced Wnt4 and β-catenin expression in a time-dependent manner,both peaking at 24 h.Irbesartan reduced the promotional effect of HG on Wnt4 and α-SMA expression,and nuclear translocation of β-catenin.HG-mediated inhibition of E-cadherin was also restored by irbesartan.Conclusion These data supported a functional role for Wnt/β-catenin signaling pathway during epithelial-mesenchymal transition of HKCs induced by high glucose and suggested that irbesartan might reverse tubular EMT by regulating activity of Wnt/β-catenin pathway.

Objective To provide vascular feature of neurocutaneous vascular flap and anatomical details about how to design the flap.Methods Ten fresh human body sample with twenty limb were perfused.The clinical anatomy of lateral antebrachial cutaneous nerve,medial antebrachial cutaneous nerve,sural nerve,superficial peroneal nerve,saphenous nerve and their nutrient vessels were studied.The distribution of their nutrient perforators were observed.Results Neurocutaneous nutrient vessels or nutrition artery with large diameter were accompanying nervus cutaneus by a long distance; Or longitudinal vascular chains were formed by ramus communicans with the ascending branches and descending branches from multiple segmental vessels.Medial antebrachial cutaneous nerve,lateral antebrachial cutaneous nerve,sural nerve,superficial peroneal nerve,saphenous nerve has the ulnar artery perforating branches,radial artery perforating branches,anteriolateral supra malleolar perforating branches,posterolateral supra malleolar perforating branches,medial supra malleolar perforating branches,accompanied separately,and the occurrence rate were 100％,95％,80％,90％,100％ respectively.Conclusion Cutaneous branch from the main deep artery is the anatomical basis of neurocutaneous nutrient vessel.Its distribution also accord to pressure balance rule.Mostly nervus cutaneus had constant perforator attending to suply its nutrition.Actually neurocutaneous nutrient vessel is a predictable and reliable vascular chain.

1. 5 cm) sessile colorectal polyps referred for EMR. After submucosal injection of epinephrine, either en bloc or piecemeal snare polypectomy were performed. All resected specimens were retrieved for pathologic study. Follow-up colonoscopy was performed in all patients after EMR. Results All 157 polyps were removed completely. All lesions are larger than 1. 5cm, but 3 less than 1 cm on the submucosa of rectum. The largest one is 13 cm X 12 cm. No complication occurred. Histopathologic assessment of the resection specimens revealed the following: adenoma, 123; dysplasia, 80; mucosal carcinoma, 11; hyperplastic polyps, 20; rectal carcinoid, 3. Two patients who had rectal adenoma that was larger than 7cm recurrence happened at the resection site after 1 and 3 months follow-up respectively, than removed completely by hot biopsy forceps showed hyperplastic and villous adenoma on pathological study. No more residual tumor was detected for 6-12 months. Conclusion EMR with an intensive follow-up program is a safe and effective treatment for large sessile colorectal polyps and mucosal carcinoma.

Objective To evaluate the number of lymph node harvested during radical resection of invasive rectal carcinoma(stage Ⅰ toⅢ).Methods From January 2000 to June 2008,the pathological data of colorectal carcinoma patients who were operated on were retrospectively reviewed.Exclusion criteria included recurrent colorectal tumor,Tis tumor,R1 or R2 resection,tumor resection transanally or endoscopically,synchronous diseases affecting the surgical procedure for the reetal cancer(familial adenomatous polyposis.synchronous coloreetal carcinoma)and rectal cancer receiving perioperative neoadiuvant chemoradiation.Statistical analysis was performed using Mann-Whitney Test and Chi-Square Test (SPSS 15.0).Results were expressed as mean±SEM.Results A total of 2282 patients were identified.including 1216 cases in the rectal carcinoma group and 1066 cases in the colon carcinoma group.There were no significant difference in gender(719/1216 vs.593/1066,P=0.092)and overall TNM stage (P=0.067)between the two groups.But patients of rectal cancer were younger(58.6±0.4 vs.62.0±0.4.P=0.000).The lymph node retrieval in the rectal carcinoma group was significantly less than that of colon carcinoma group(9.4±0.1 vs.10.5±0.1,P=0.000).There were significantly less rectal cancer patients with a 1ymph node harvest equal to or more than 12 nodes(P=0.000).Patients in the low rectal cancer group(≤7 cm from the anal verge.n=834)had less lymph nodes harvested than the mid-high rectal cancer group(＞7 am and≤15 cm from the anal verge.n=382)(9.2±0.1 vs.9.9±0.2,P=0.009).Conclusion The lymph node harvest in the rectal carcinoma group was significantly less than that in the colon carcinoma group.A new standard may be necessary to define the adequate number of lymph nodes for rectal cancer.

Objective: To explore the peri-operative application of GLP-1 analogue and insulin on myocardial perfusion and clinical prognosis in patients of acute ST segment elevation myocardial infarction (STEMI) with stress-induced hyperglycemia. Methods: Our research was a prospective single center randomized control study. A total of 114 consecutive STEMI patients received percutaneous coronary intervention (PCI) within 12h of onset were enrolled, the patients had no diabetes while blood glucose ≥11.1mmol/L at immediate admission. Based on random number table, the patients were divided into 2 groups: Observation group, the patients received GLP-1 analogue, n=59 and Control group, the patients received insulin, n=55. The post-operative myocardial perfusion, indicators of myocardial damage and cardiac function, myocardial infarct area (MIA) and myocardial salvage index (MSI) were compared between 2 groups. The patients were followed-up for 6 months to record the incidence of major adverse cardiovascular events (MACE). Results: At peri-operative period, compared with Control group, Observation group had decreased peak values of creatine kinase isoenzyme (CK-MB) and troponin T (cTnT), P<0.05. At 6 months post-operation, compared with Control group, Observation group showed increased myocardial perfusion and left ventricular ejection fraction (LVEF), P<0.05, reduced MIA (15±12) g vs (20±14) g, P<0.05 and 12% elevated MSI as (0.64±0.13) vs (0.56±0.12), P<0.001. The MACE incidence was similar between 2 groups, P=0.217. Conclusion: In STEMI patients with stress-induced hyperglycemia, peri-operative application of GLP-1 analogue may safely regulate blood glucose, improve cardiac perfusion and function, reduce MIA; while it had no influence on myocardial perfusion at peri-operative period and no impact on MACE occurrence at 6 months post-operation.

Objective To explore the clinicopathologic factors impacting recurrence and survival in rectal cancer patients after radical resection.Methods Clinicopathologic data of 1 166 patients with rectal cancer in Changhai Hospital,were recruited between 2005 and 2010.Kaplan-Meier analysis and the logrank test were used to evaluate the effects of the pathology on patients' survival.Cox regression model was used to assess independent factors associated with clinical prognosis.Results The 1,3,5-year overall survival rates were 94.3％,81.2％ and 76.5％,median survival time was 53 months.328 patients had recurrence and metastases,with a median recurrence time of 18 months.The independent prognostic factors for overall survival time were CEA,CA19-9,tumor distance to dentate line,surgical modality,radical operation,tumor invasion,tumor differentiation,lymph node metastasis and postoperative treatment.Surgical treatment,radical operation or not,tumor invasion and lymph node metastasis were statistically significant associated with tumor recurrence and metastases.Conclusions The important factors inffuencing the prognosis of rectal cancer patients were CEA,CA19-9,tumor distance to dentate line,surgical modality,radial operation,tumor in vasion,tumor differentiation,lymph node metastasis,and post operative treatment.