Described in this paper are the JCI accredited domestic hospitals, what should be learned from the JCI accreditation standards by domestic hospital accreditation standards, enlightenments of JCI accreditation standards on improving domestic library service such as establishment of library management systems, provision of network reference service, predictive information service, first-asked responsibility system reference service, library mobile service, and prolongation of library open time.

Objective To explore the effect of bone marrow stromal cells (BMSC) transferred by Nell-1 gene combined with biomaterial fibrin glue (FG) to enhance segmental bone defect healing in dog mandible. Methods Nell-1 gene vector was reconstructed in retroviral vector and then transfected BMSC. The protein of Nell-1 gene in transferred cells was determined by immunohistochemistry. Segmental defects were created surgically in the dog’s mandible. The defect was repaired with BMSC transfected by Nell-1 retroviral granules in presence of FG,untransfected BMSC in combination with FG,and FG alone. The control group was left untreated. The defect-repairing capability for each treatment were assessed by gross observation,radiography,and histology at 8th week and 16th week. Results Cells transfected by Nell-1 retroviral granules expressed abundant Nell-1 mRNA and protein in the cytoplasm. Positive results were not found in those cells that were not transferred. The use of BMSC transferred by Nell-1 retroviral granules combined with FG materials exhibited the strongest defect-repairing ability. Gross observation,radiographical and histomorphometric analyses revealed a significantly greater total area of bone formation,increased amount of the new bone in the defects than in those treated with the untransfected BMSC. Conclusion Nell-1 gene transfection may be used to promote the osteogenic ability of BMSC.

Objective To evaluate the efficiency and safety of Percusurge guardwire distal protection system in coronary intervention in patients with acute myocardial infarction. Methods Three male patients with acute myocardial infarction were enrolled in the study. Primary angioplasty was performed for 2 of them, 2 and 7 hours after onset of the infarction symptom, respectively. Selective angioplasty was performed 17 days after infarction for the third case. Percusurge guardwire system was used during the procedure. Results Procedure success was achieved for all of the 3 cases. Lot of thrombus was sucked out. The infarct-related arteries had TIMI 3 flow at the end of the procedures. The patients′ symptoms were resolved soon after the procedure. Minor dissection was seen in one case which did not obstruct the distal flow and was left alone. Conclusion Percusurge guardwire system can be used safely and effectively in coronary intervention in the thrombus-laden arteries such as acute myocardial infarction.

Objective To summarize the effect and safety of percutaneous coronary intervention (PCI) for CHD in patients with single patent coronary artery. Methods We collected the data of CHD in 10 patients with single patent coronary artery who underwent PCI and analyzed them retrospectively. Results All patients with single patent coronary artery had successful PCI. Symptoms of all the CHD patients had been significantly relieved after PCI. No major adverse cadiac events occurred in hospitalization. Conclusion The data suggest that the patients with single patent coronary artery might be treated with PCI effectively and safely.

Objective To compare between conventional and endoscope-assisted greater saphenous vein harvesting and to invest if endoscope-assisted greater saphenous vein harvesting can reduce post-operative leg incision complications.Methods Minimally invasive endoscopic saphenous vein harsvesting technique has been used in 36 isolated CABG patients and this is compaired with 50 conventional saphenous vein harsvesting group. There is no significant difference in sex structure, age, hypertension, diabetes mellitum (DM), myocardial infarction (MI) et al in two groups. Results The incidence of post-operative leg complications with minimally invasive greater saphenous vein harvesting group (2.8% ) was remarkably lower than that in conventional group (28%), and the hospital-stay time was much shorter in minimally invasive group. Conclusion Endoscope-assisted saphenous vein harvesting is a effective method in reducing post-operative leg incision complications.

Objective To study the validity of continuous positive airway pressure(CPAP)curing overlap syndrome.Methods Comparisons were made in the respiratory disturbance index(RDI)the longest apnea time the longest hypopnea time etc between before and after-treatment.Results The respiratory disturbance index(RDI)、the longest apnea time、the longest hypopnea time were signifi- candy different(P＜0.05).Conclusion Continuous positive airway pressure is an effective method to treat overlap syndrome.

ObjectiveTo explore the long-term fluctuation of fasting plasma glucose (FPG) and its effect on prognosis in patients surviving for more than 1 year after renal transplantation.MethodsFour hundred and forty-six patients underwent kidney transplantation from January,1993 to December,2008.According to preoperative FPG levels,patients were divided into diabetic,impaired fasting glucose (IFG),and normal fasting glucose (NFG)groups. The changing trend of FPG level was observed and analyzed. For 428 non-diabetic patients before transplantation,the prevalence and different outcomes of post-transplantation diabetes( PTDM ) according to FPG after transplantation were analyzed.The characteristics of the patients with persistent PTDM ( P-PTDM ) and transient PTDM (T-PTDM) were compared.The incidence of complications and patient survival between the PTDM group and non-PTDM groups were also compared.ResultsFPG level was increased early and then decreased in patients after renal transplantation.Of the 428 patients,87 developed into PTDM ( 20.3％ ) including 15 T-PTDM patients ( 17.2％ of total PTDM ),who eventually recovered to NFG or IFG.Compared with P-PTDM group,the incidence of acute rejection episodes was higher for T-PTDM ( P =0.043 ).The incidence of infections,hypertension,and dyslipidemia within the first year,was higher in PTDM group compared with non-PTDM group but patient survival was not different within a mean follow-up of ( 5.65 ± 3.68 ) years.ConclusionPTDM will not be permanent and may recover to NFG or IFG in the course of the disease.Acute rejections are associated with the onset of T-PTDM.The overall patient survival is not affected by PTDM,although complications,such as infections,hypertention,and hyperlipidemia are more frequently encountered in PTDM patients.

Objective To conduct a descriptive epidemiological study on thyroid cancer incidence in the urbanarea of Tianjin during 2002 - 2006 and to analyze the secular trend of incidences based on previous data of 26 years and those from Shanghai and the United States. Methods Annual percent change (APC%) of thyroid cancer incidence and the rank of all-site cancer profiles were estimated. The secular trend of different histological incidences and the proportion changes were analyzed. Results The incidence of female thyroid cancer was 6. 55/100000 in 2006, ranking the eighth in the female cancer profile. The incidence of thyroid cancer showed an increased secular trend in recent 26 years, especially a 5.7-fold increase in the papillary thyroid cancer (PTC). The incidence for female increased by 267% in 2006 compared to that in 1981, APC% was 3. 1%. The variation ranked second among all the female tumors. The incidences of thyroid cancer in Shanghai and the United States also elevated with time.Conclusions Thyroid cancer has been one of female common tumors from a once less common tumor,especially the proportion of PTC is expanding. It suggests that further study on the risk factors and preventive efforts should be made.

ObjectiveTo evaluate the safety and efficacy of tirofiba in the treatment of patients with acute ST-elevation myocardial infarction (STEMI) undergoing emergency percutaneous coronary intervention (PCI). MethodsA total of 158 patients with acute STEMI were randomly divided into tirofiban group 1 (59 cases, received tirofiban before PCI), tirofiban group 2 (56 cases, received tirofiban when PCI) and control group(43 cases, only received PCI). The coronary reperfusion flow(TIMI grade) of infarct related artery (IRA) after PCI, the resolution of the sum of ST segment elevation(sum STR) at 90 min after the procedure, the changes of myocardial enzyme at 6 h and 12 h afterwards, the left ventricular ejection fraction (LVEF) 1 week later, the major adverse cardiac events(MACE) within 30 d, bleeding and thrombocytopenia complications were analyzed and compared among the three groups. ResultsTIMI reperfusion grades in tirofiban group 1[98.3％(58/59 )]and tirofiban group 2[92.9％(52/56)]were higher than those in control group[60.5％(26/43)](P ＜0.05). The resolution of sum STR at 90 min after PCI in tirofiban group 1 [(89.3 ± 6.9)％]and tirofiban group 2[(82.4 + 7.3)％]was higher than that in control group[(65.6 +8.1 )％](P＜ 0.01 ),and there was significant difference between tirofiban group I and tirofiban group 2 (P＜0.05 ). The occurrence of MACE within 30 d was lower in tirofiban group 1 and tirofiban group 2 than that in control group (P＜ 0.05). The level of CK-MB at 6 h and 12 h afterwards was lower in tirofiban group 1 than that in tirofiban group 2,and tirofiban group 2 was lower than control group (P＜ 0.05). LVEF 1 week later in tirofiban group 1[(56.2 + 6.4)％]was higher than that in tirofiban group 2[(51.1 + 4.9)％]and control group[(49.8 + 5.7)％](P ＜ 0.05),but there was no significant difference between tirofiban group 2 and control group (P ＞ 0.05). Although bleeding incidence in tirofiban group 1 and tirofiban group 2 was higher than that in control group, no severe bleeding and thrombocytopenia was observed. Conclusion Tirofiban can safely and effectively reduce the incidence of the ischemic events in the patients with acute STEM1 during preoperative of emergency PCI.

Objective:To explore the diagnosis and treatment of ketamine-associated urinary system dysfunction. Methods:Total-ly 56 cases of urinary tract symptoms with the history of ketamine abuse in recent years were retrospectively analyzed. The routine ex-amination and the examination related to the urinary system were given, and individual treatment was undertaken according to different situation. Results: The main symptom of ketamine-asscociated urinary tract dysfunction was lower urinary tract symptom (LUTS). Bladder pathologic biopsy showed different degree of inflammatory change. Imaging examination showed various degree of pathological changes, including reduced bladder capacity, thickened bladder wall, bladder contracture, ureteral stricture and hydronephrosis. Three patients had increased serum creatinine level. Conclusion: Ketamine-asscociated urinary system dysfunction is a disease with LUTS as the main clinical symptom. At the early stage, the disease is reversible with promising treatment outcome. In the progression of the disease, some patients develop irreversible histological changes in the urinary tract, which should be brought to the forefront.