OBJECTIVE:To provide reference for rational use of human serum albumin for surgical inpatients. METHODS:The utilization of human serum albumin for surgical inpatients in a hospital during Jan.-Mar. 2014 was analyzed and evaluated by UHC Guidelines for the Use of Album,Nonprotein Colloid,and Crystalloid Solutions(2010 edition)and European Immune Globu-lin and Albumin Use Recommendation. RESULTS:Among the 556 patients,totally 895 human serum albumin application were con-ducted,mainly involving development of gastrointestinal surgery(29.7%),hepatobiliary surgery(25.9%)and cardiothoracic sur-gery(13.1%). The main reasons were correcting hypoalbuminemia(62.9%),followed by albumin supplemented during major sur-gery(7.9%)and alleviating ascites in patients with cirrhosis(4.4%);only 95 applications(10.6%)were considered appropriate. The most prevalent inappropriate reason was for correcting hypoalbuminemia. CONCLUSIONS:Human serum albumin in the surgi-cal inpatients in the hospital shows a large amount,and low consistent rate between indications and guidelines. The rational stan-dardized utilization of human serum albumin should be strengthened.

OBJECTIVE:To systematically review the efficacy and safety of pirfenidone in the treatment of idiopathic pulmo-nary fibrosis (IPF),and provide evidence-based reference for clinical treatment. METHODS:Retrieved from Cochrane Library, PubMed,EMBase,CJFD,CBM,VIP Database and Wanfang Database,randomized controlled trials (RCT) about the efficacy and safety of pirfenidone (test group) versus placebo (control group) in the treatment of IPF were collected,and Meta-analysis was performed by using Rev Man 5.1.7 software after data extracting and quality evaluating by modified Jadad. RESULTS:Totally 4 RCTs were enrolled,involving 1 153 patients. Results of Meta-analysis showed the decrease value of lung capacity [WMD=0.39,95%CI(0.16,0.61), P<0.001] and decrease value of the percentage of forced vital capacity to expected value [RR=0.68, 95%CI(0.53,0.87),P=0.002] in test group were lower than control group,there was significant difference between 2 groups;there was no significant difference in the lowest oxygen saturation [WMD=0.53,95%CI(-0.78,1.84),P=0.43] between 2 groups,however,the results of subgroup analysis showed the remission degree of 1 200 mg/d PFD for the decrease of lowest oxy-gen saturation was superior to placebo group,there was significant difference between 2 groups [WMD=1.72,95%CI(1.33,2.10), P<0.001],but therewas no significant difference between the remission degree of 1800 mg/d and placebo;and there was no signifi-cant difference in the incidence of adverse reactions between 2 groups [RR=1.70,95%CI(0.46,6.31),P=0.43],but the incidence of photosensitivity veactions in test group was significantly higher than that of control group,there was significant difference [RR=9.35,95%CI(4.23,20.67),P<0.001]. CONCLUSIONS:The efficacy of pirfenidone in the treatment of IPF is good,but the inci-dence of photosensitivity reactions should be noticed.

Objective To establish an assay for the detection of Torque teno sus virus ( TTSuV) strains and to analyze its preliminary application to biologics.Methods Primers and probe were designed according to the conserved sequences.A fluorescent PCR assay for the detection of TTSuV strains was estab-lished.Several parameters including the specificity, linearity, accuracy, sensitivity and anti-interference of the established assay were verified.The fluorescent PCR assay was performed to detect the samples of por-cine blood, cell substrate and rotavirus vaccine.The porcine blood samples positive for TTSuV strains were further genotyped.Results The established fluorescent PCR assay was confirmed to have high specificity as no cross-reactions with parvovirus virus of various species, SV40 and porcine circovirus strains were detec-ted.The linear range of the assay was 1×109-1×103 copies/μl for TTSuV1 genotype and 1×109-1×102 cop-ies/μl for TTSuV2 genotype with a R2 value more than 0.993.The sensitivity of the fluorescent PCR assay was 1×103 copies/μl for TTSuV1 genotype and 1×102 copies/μl for TTSuV2 genotype.The intra-and inter-CVs were both less than 7%in Ct values and less than 25% and 45% respectively in copies.No interfer-ence was found in the detection of TTSuV nucleic acids from cell samples.8 out of 20 porcine blood samples were positive for TTSuV strains, among which one sample was positive for TTSuV1 genotype, four samples were positive for TTSuV2 genotype and the rest were positive for both TTSuV1 and TTSuV2 genotypes.Com-pared with the reference strain, strains genotyped as TTSuV1 and TTSuV2 were respectively shared 98%-99%and 98%homologies in sequences.All of the cell substrate and rotavirus vaccine samples detected by the fluorescent PCR assay were negative for TTSuV strains.Conclusion The fluorescent PCR assay for the detection of TTSuV was established successfully, the application of which would further improve the safety of biologics.

Objective To analyze the case of inezolid in effectively treating hospital-acquired methicillin-resistant staphylo-coccus aureus (MRSA) pneumonia after ineffective glycopeptide antibiotics treatment in order to provide opinions for the clinical use .Methods The antibacterial drugs analysis was performed on 1 case of hospital-acquired MRSA pneumonia after acute subdural hematoma removal operation in this hospital ,and the curative effects and economic indicators of glycopeptide antibacterial drugs and inezolid were conducted the evidence-based evaluation .Results Using glycopeptide antibacterial drugs in this patient had poor cura-tive effect ,and then changing to inezolid anti-infection treatment obtained the success .This patient used vancomycin 2 g ,generic teicoplanin 400 mg and inezolid 1200 mg per day ;the average daily costs were 497 ,341 ,788 Yuan respectively .Conclusion Lin-ezolid can be selected for treating hospital-acquired MRSA pneumonia patient after ineffective glycopeptide antibacterial drugs treat-ment .

Objective: To investigate the relation between ser um hyaluronic acid (HA) concentration and cryopreservation-reperfusion injury. Methods: The animals were randomly assigned to 3 groups: (1 ) group A: the control; (2) group B: liver allografts were stored in lactated R inger's solution (0℃) for 2 h before implantation; (3) group C:liver allografts were stored in lactated Ringer's solution (0℃) for 4 h before implantation. Th e serum sample and liver specimen were taken up at 2 h and 4 h after transplanta tion to detect the concentration of HA, AST and LDH, and to get pathologic obser vation. Results: Serum HA increased earlier and decreased more s hortly than AST and LDH after transplantation in group A. Serum HA increased sig nificantly in group B and C, much higher than that in group A(P<0.01). The i njury of vascular endothelium and the disorder of hepatic sinuses and hepatic lo b ules were observed in group B and C. In the specimen of 4 h in group C, evident infiltration of inflammatory cell was present. Conclusion: Cryopreservation leads to injury of endothelial cell and reperfusion aggravat es this injury. The serum HA concentration indicates the degree of cold ischemia -reperfusion injury.

Objective To explore the clinical application and effect of the transplantation of the cutaneous fibular flap combined with anterolateral thigh flap for the repair of complex tissue defect of the leg. Methods The cutaneous fibular flap combined with anterolateral thigh flap in series connection or parallel connection transfer were applied to repair complex tissue defect of the leg in 36 cases. 10 cases were fresh non-infectious wound 26 cases were delayed infectious wound. The area of wound ranged from 25 cm × 18 cm to 45 cm × 13 cm (36 cm × 16 cm on average). The area of anterolateral thigh flap ranged from 12 cm × 13 cm to 32 cm × 18 cm. The area of the cutaneous fibular flap ranged from 2.0 cm × 1.5 cm to 18.0 cm × 16.0 era. The length of fibular transplantation ranged from 10 cm to 24 cm. 30 cases were combined in parallel connection transfer, 6 cases were combined in series connection transfer, 5 cases were repaired in emergency, 5 cases were repaired in subemergency, 26 cases were repaired in delay. Results All cases were successfully repaired in 36 cases.35 cases were followed up. A mean follow-up was 29 months. Arterial crisis occurred in 1 case, venous crisis occurred in 2 cases 34 flaps survived completely and 2 cutaneous fibular flap survived partially in parallel connection which were later healed by skin transplantation.32 cases were healed in first stage, 4 cases were healed in second stage, (healing time ranged from 12 to 18 days), Bone healing time ranged from 3 to 6 months in fibula transplantation. The Enneking score system was applied to evaluate the leg function. Of the 35 cases, the mean scores was 26 (their scores ranged from 23 to 28).The functions of all supplied regions were not found malfunctional. Conclusion Transplantation of the cutaneous fibular flap combined with anterolateral thigh flap is an optimal method to repair the complex tissue defect of the leg.

OBJECTIVETo investigate the effects and methods of intracranial-extracranial (IC-EC) bypass surgery in the treatment of intracranial aneurysms.

METHODSThe clinical material of 9 cases, who performed IC-EC bypass surgery before occlusion of the parental arteries of intracranial aneurysms, was studied retrospectively, especially how to evaluate the co-lateral circulation of the parental arteries and how to select the different methods of IC-EC bypass surgery.

RESULTSThe co-lateral circulation in 9 cases was not enough to meet the need of the cerebral blood flow after occlusion of the parental arteries of the aneurysms. Revascularization by different methods of IC-EC bypass surgery and then occlusion of the parental arteries, ischemia in the brain area feeding by occluded parental arteries of the aneurysms did not occurred.

CONCLUSIONWhen the co-lateral circulation of the parental arteries of intracranial aneurysm is not enough, the revascularization by different methods of IC-EC bypass surgery is needed before occlusion of these arteries.

Adolescent ; Adult ; Cerebral Revascularization ; methods ; Female ; Follow-Up Studies ; Humans ; Intracranial Aneurysm ; surgery ; Male ; Middle Aged ; Retrospective Studies

Adult ; Aged ; Central Nervous System Vascular Malformations ; diagnostic imaging ; surgery ; Female ; Humans ; Laminectomy ; methods ; Male ; Middle Aged ; Radiography ; Retrospective Studies ; Treatment Outcome

OBJECTIVETo investigate the role of genetic polymorphisms of epoxide hydrolase 1 (EPHX1) in the metabolism of styrene in vivo.

METHODSFifty-six styrene-exposed workers, who worked in the painting workshop of an enterprise for manufacturing glass fiber-reinforced plastic yachts in Shandong Province, China for over one year and were protected in approximately the same way, were selected as study subjects. The 8-hour time-weighted average concentration (8 h-TWA) of styrene and the concentrations of mandelic acid (MA) and phenyl glyoxylic acid (PGA) as urinary metabolites were measured. The genetic polymorphisms of EPHX1 were detected by polymerase chain reaction-restriction fragment length polymorphism analysis.

RESULTSThe urinary concentrations of MA and PGA were 177.25±82.36 mg/g Cr and 145.91±69.73 mg/g Cr, respectively, and the 8 h-TWA of styrene was 133.28±95.81 mg/m3. Urinary concentrations of MA and PGA were positively correlated with 8 h-TWA of styrene (R=0.861, P < 0.05; R=0.868, P < 0.05). The subjects were divided into high-exposure group (8 h-TWA >50 mg/m(3)) and low-exposure group (8 h-TWA ≤ 50 mg/m(3), and in the two groups, the urinary concentrations of MA and PGA were significantly higher in the individuals carrying high-activity genotypes of EPHX1 than in those carrying low-activity genotypes of EPHX1 (P < 0.05).

CONCLUSIONGenetic polymorphisms of EPHX1 play an important role in the metabolic process of styrene in vivo.

Adult ; Air Pollutants, Occupational ; pharmacokinetics ; China ; Epoxide Hydrolases ; genetics ; Glyoxylates ; urine ; Humans ; Male ; Mandelic Acids ; urine ; Occupational Exposure ; Polymorphism, Genetic ; Styrene ; pharmacokinetics

China ; Humans ; Maximum Allowable Concentration ; Occupational Exposure ; prevention & control