Catheterization ; methods ; Humans ; Needles ; Pneumothorax ; nursing ; surgery ; Silicosis ; nursing ; surgery ; Thoracic Cavity

Adult ; Chronic Disease ; Female ; Humans ; Lead Poisoning ; nursing ; Male ; Mercury Poisoning ; nursing ; Middle Aged ; Young Adult

Objective To establish an influencing factors system for the implementation effect of the vertical integration of services between the hospitals and community health service institutions.Methods Primary data related to influencing indicators were collected by literature review,questionnaire method and in-depth interview,and then the analytic hierarchy process (AHP) and Delphi method were used for the construction of final influencing factors indicator system.Results An influencing factors indicator system which coincides with the status of the vertical integration between hospitals and community health service institutions in Nanjing,Wuhan and Zhenjiang was established,including 4 firstlevel indicators,10 second-level indicators and 36 third-level indicators.Conclusion This study can provide a basis for hospitals and community health centers to improve the integration service system,and fill the gap of research on the influencing factors of the vertical integration of the domestic health care system,which are meaningful for the vertical integration of health care system in other districts and patterns.

Objective To explore the effect of lysolecithin choline (LPC) on blood-brain barrier(BBB) permeability in rats with acute pancreatitis. Methods Acute pancreatitis rat model was produced and rats were randomly divided into:(1)Test group-AP, rats received LPC by tail vein injection; (2)control group I, AP rats were given normal saline by tail vein injection; (3)control group II, sham operation without AP, but LPC was given by tail vein injection.Horseradish peroxidase(HRP) was used as a tracer to determine BBB permeability 7~10 days later.Results The test group showed local extravascular effusion of HRP, indicating that BBB permeability was markedly increased,while both control groups showed no apparent increase of BBB permeability,which were statistically significant(P

Radical resection is one of the important factors for improving the prognosis of patients with resectable carcinoma of head of the pancreas,carcinoma of the distal bile duct and periampullary carcinoma.In order to proceed with a R0 resection,there are many types of pancreaticoduodenectomy (PD) for pancreatic,biliary and periampullary carcinoma such as PD with lymphadenectomy.In this report,we described a PD with extended retroperitoneal lymphadenectomy (D2 +) for the adenocarcinoma of the distal bile duct.The case presented underscores the feasibility and safety of PD with D2 + lymphadenectomy.

OBJECTIVE:To assess the stability of the quality control of FPIA for monitoring of CsA and MEIA for monitoring of FK506.METHODS:The quality control on the blood samples of patients receiving therapeutic drug monitoring of CsA and FK506 from June to August in 2007 were subjected to a continual assessment and analysis to investigate the stability and accuracy of the quality control.RESULTS:The mean recoveries of the low,middle and high concentrations of CsA and FK506 were 93.14%～97.65% and 97.70%～103.09% respectively,with RSD at 4.41%～5.37% and 10.44%～14.23% respectively,which accorded with the requirement for biological sample determination stated in the Chinese Pharmacopoeia.CONCLUSION:The methods of FPIA for monitoring of CsA and MEIA for monitoring of FK506 were accurate,and worth to be applied in clinical to guide individualized medication.

Objective: To discuss the treatment of pancreatic encephalopathy(PE).Methods: Recombinant human growth hormone (rhGH)(Saizen)were applied in patients of severe acute pancreatitis(SAP) with suspicious early PE that presented with mental disorders. rhGH was also used in combination with somatostatin as the therapeutic method for SAP and its complication.Dosage and administration: Saizen 4U was injected intramuscularly twice a day for 5～7 days.Results: In 7 patients of this group, all of them showed improvement in the aspect of mental dysfunction and the symptoms disappeared after 48～72 hours. In 13 SAP cases underwent combined application of rhGH and somatostatin, no PE was observed.Conclusion: Application of rhGH showed therapeutic effect on the early manifestations of PE. It also suggested that combined use of rhGH and somatostatin could decrease the occurance of PE.

Objective To analyze the etiology and clinical feature of pi t uitary apoplexy.Methods The clinical data from 18 cases of pitui tary apoplexy were analyzed retrospectively.Results Main symptom s were headache in 12 cases and decreased visual acuity in 12 cases.Positive si ghs were temporal hemianopisia in 6 cases,unequal pupil in 3 cases,oculomotor ne rve(Ⅲ) paralysis in 2 cases and abducent nerve (Ⅵ) paralysis in 2 cases.Imagin g examinations showed CT positive finding in 4 cases and MRI positive finding in 6 cases.Tumor diameter was longer than 2 cm in 13 cases and less than 2 cm in 5 cases.Chromophobe pituitary tumor was found in 11 cases.All cases received surg ical operation.Conclusion Clinical features of pituitary tumor a poplexy are atypical,of which headache and visual acuity decrease are the main s ymptoms.Most cases occur suddenly or primary symptoms are deteriorated suddenly. CT and MRI positive findings are helpful for diagnosis.

BACKGROUND: Bone bone bone marrow derived mesenchymal stem cells (MSCs) has the capacities of self-renewal and multi-directional differentiation, which can differentiate into osteoblasts after induction. Combined with basal hydroxyapatite materials, MSCs can repair the bone defect with satisfactory shape and function.OBJECTIVE: To observe the bone formation performance of segmental bone defect repaired by autologous transplantation after combination of MSCs and basal hydroxyapatite materials.DESIGN: Open experiment.SETTING: Department of Cells, Third People' s Hospital of Wuxi.MATERIALS: The experiment was conducted in the Department of Cells,Third People's Hospital of Wuxi between May 2004 and March 2005.Eighteen New Zealand rabbits of clean grade, aged 6 months were selected and randomly divided into cytoskeleton group, simple scaffold group and blank control group with 6 rabbits in each group. Nano-collagen basal hydroxyapatite bone were provided by the Department of Material, Tsinghua University, which is characteristic of natural-bone microstructure. Composition: about 57% were hydroxyapatite,and 30% were collagen and 13%were polylactic acid.METHODS: ①bone bone marrow derived MSCs of rabbits were isolated and cultured. Well-grown cells of the second generation were inspected of the expression of cell surface antigen (CSA) with EPICS-ALTRA flow cytometry. ②Scaffold materials were cut into blocks with the size of 6 mm ×6 mm×4 mm, sterilized by 60Co irradiance and infiltrated with DMEM-LG before using. Cells of the 2nd and 3rd generations were collected, cultured,the concentration of which was regulated to 109 L-1. Cells were co-cultured with nano-collagen basal hydroxyapatite in vitro. ③Model of segmental defects in radial of rabbits were established in all groups. The prepared compounds in the cytoskeleton compound group were embedded in the bone defect according to autograft principle, and blank scaffold materials were embedded in the bone defects of simple scaffold group. Nothing was transplanted in the blank control group. Rabbits in all groups received no internal or external fixation, whose soft tissues and skins were closely sutured.④The surface structure of materials and cell adherence in all groups were observed under scanning electron microscope (SEM).⑤Bone formation was studied by general observation, histological analysis and X-rays at 4, 8 and 16 weeks after operation respectively.MAIN OUTCOME MEASURES: ①The isolated culture and identification of MSCs.②Observation of all groups under SEM.③Results of radiological inspection of all groups. ④General morphous of cells in each group after operation.⑤Results of histological inspection of all groups after operation.RESULTS: A total of 18 enrolled New Zealand rabbits were involved in the analysis of results.①There were adherent cells at 4 hours after primary culture, which were like cloned at 48 hours after static culture. Cells were in irregular scale-shape with large cell body and the nucleus was in middle. Inspection with flow cytometer showed that CD29,CD44, CD-105 were positive, and the ratios of three positive cells were 97.4% ,98.1% and 86.2% respectively. ②The surface of simple scaffold group was irregular with many ventages. There were cells adherent to the surface of materials as well as the inside of ventage in the cytoskeleton compound group. ③The absorbance of X-rays at 4, 8 and 16 weeks after operation were higher in the cytoskeleton compound group than blank control group and simple scaffold group, moreover, bone union could be seen at the 16th week in the cytoskeleton compound group. ④The implants was embedded in the osteotylus at 16 weeks after operation in the cytoskeleton compound group,while parts of the middle segment of implants in the simple scaffold group was not covered by bone tissues. No porosis was found in the blank control group.⑤The ossifying capacity at each time point after operation was better in the cytoskeleton compound group than simple scaffold group, moreover,there was bone trabecula formed at the 16th week, and the osteoblasts were arranged in order. The bone tissues in the simple scaffold group mainly concentrated on the surface of materials, which sucked little. There were some bony tissues formed in the proximal end of defects in the blank control group, while none was seen in the middle parts.CONCLUSION: Rabbit MSCs can greatly proliferate in vitro, which has strong osteogenesis by being co-cultured with nano-collagen basal hydroxyapatite. It is a good kind of seed cells in tissue engineering.

Objective To investigate the effect of different forbidden drink schemes on anesthesia induction and postoperative nausea and vomiting during pediatric interventional heart surgery.Methods One hundred and twenty pediatric patients underwent cardiac interventional procedures under general anesthesia were randomized into group A,B and C,with 40 patients in each group.Patients in cach group were fasted for 8 h preoperatively.Water was prohibited for patients in group A for 6 h preoperatively.Patients in groups B and C orally took 10％ glucose solution and a multivitamin drink (Outfast) at 2 h preoperatively,respectively.Nausea and vomiting after anesthesia induction were recorded for 24 h postoperatively.Results The sedation and mask acceptance scores were significantly higher in group B and C than those in group A,and were significantly higher in group C than those in group B (P ＜ 0.05,resoectively).Following anesthesia induction,MAP was significantly higher in group B and C than that in group A (P ＜ 0.05,resoectively).Both the severity and incidence of postoperative nausea and vomiting were higher in group B and C than those in group A,and was lower in group C than that in group B (P ＜ 0.05,resoectively).Conclusions Taking clear water orally 2 hours before surgery can decrease the restlessness of pediatric interventional heart surgery during anesthesia induction period,with stable smooth hemodynamics,reducing the degree of PONV.