OBJECTIVE:To study the safety of percutaneous administration of Hongzhi gutong cataplasm. METHODS:Rab-bits were taken for single dose in complete skin irritation test(n=4),single dose in damaged skin irritation test(n=4)and multi-ple doses in complete skin irritation test(n=4). The left and right sides of the skin respectively paste 3 cm×3 cm blank matrix and Hongzhi gutong cataplasm for 24 h(calculated by crude drug of 0.14 g). After removing tape 1,24,48,72 h,the erythema and edema in hair removal site of rabbits in the former 2 tests were observed;after 24 h of administration,the rabbits in the last group were administrated again after exposing the administration area for 1 h,repeated 3 times,the erythema and edema in hair removal site after removing tape the first,second time and 1,24,48,72 h in the third time were respectively observed. RESULTS:In the 3 experiments,the scores of erythema and edema of all rabbits were 0,and skin irritation was evaluated as no irritation. CONCLU-SIONS:Hongzhi gutong cataplasm has no skin irritation in rabbits.

Objective To investigate the effect of nursing interventions on the quality of life after radiotherapy in nasopharyngeal cancer. Methods 56 patients with nasopharyngeal cancer who received radiotherapy were randomly divided into control group and intervention group. All the patients were given conventional nursing interventions, and those in the intervention group were given accurate evaluation, enhanced psychological guide, reasonable dietary guide, and special nursing for preventing and treating complications. All the patients were evaluated by using quality of life questionnaire core 30 items(QOL-C30). Results The scores of the dimensions of somatic function,psychological function, social function and material life after interventions in the intervention group were significantly higher than those in the control group (P＜0.05 ). Conclusion Nursing interventions can improve the quality of life, and the therapy can be completed smoothly.

Objective To observe the pathologic changes of corneal lesions in rabbits induced by mustard gas and changes of lymphocytes in the pathologic development so as to discuss the role of lymphocytes in the pathogenic process.Methods Thirty-five New Zealand white rabbits were randomly divided into experiment group and control group according to the random number table.In experiment group,rabbits were exposed to 0.2 ml of mustard gas liquid (400 μl/L) for a period of 4 minutes and were divided into 6 subgroups at 15 min,2 h,1 w,3 w,4 w,and 8 w after injury.Corneal tissue from each group was collected to detect changes of lymphocytes with aid of HE and immunohistochemical stainings.Results In experiment group,corneal epithelium was dropped totally,basement membrane was exposed,swelling was thickened,matrix layer was loosened and swelled,and collagen fibre was ranged loosely at 15 minutes and two hours ; corneal epithelium appeared multi-layer hyperplastic change in acute restoration period at 1 week; basal corneal epithelium cells appeared irregular column arrangement in chronic inflammation period at 3 and 4 weeks; around 10％ of toxic corneas had delayed reaction with partial corneal epithelium resloughed,fundus membrane appeared,edema thickened,and stroma collagens loosened and swelled at eight weeks.Immunohistochemical Envision staining showed positive expression of plymphomonocytes (CD20,CD45RO,and LCA) inside matrix layer at corneoscleral junction.Conclusions Ocular exposure to 400 μ/L mustard gas for a period of four minutes leads to direct and delayed lesions to cornea,which presents at one week and eight weeks respectively.The lymphocyte-mediated cellular and humoral immunity responses may be involved in the pathogenic process.

Objective To investigate current status and problems of coagulation factor Ⅷ and Ⅸ assay in domestic laboratories so as to provide the reference for implementing the standardization and quality improvement.Methods A questionnaire survey was carried out in 76 laboratories,and quality control materials were distributed to 54 laboratories for activity assay.The questionnaire information was analyzed statistically.Test results of quality control materials were classified into three groups according to the reagents and the ranked grading analysis were used to evaluate the performance.Results This research was investigative study.The amount of sample was less than 30 per month in 72％ (52/72)of laboratories.The frequencies of calibration were different,and 33％ (24/72) of laboratories did not perform calibration in a different assay batch.39％ (28/72)of laboratories did not run internal quality control,and about 21％ (15/ 72) of laboratories just performed the normal level quality control.Individual laboratories showed a high cumulative CV (＞ 30％) of intemal quality control.For normal FⅧ and FⅨ control materials,the CV of results were 11.3％-18.2％ and 11.3％-17.9％ respectively as well as 15.3％-20.3％ and 19.5％-21％ for abnormal.Of the three groups,the proportions of laboratories which the FⅧ test results out with consensus were18％,24％ and 22％ as well as 20％,24％ and 28％ for FⅨ.Conclusions The key requirements for quality control of coagulation factors active assay remain to be addressed and implemented.The repeatability and comparability in some laboratories are not satisfactory to meet the clinical needs.With the purpose of promoting quality improvement,we need to develop guidelines,organize related training and establish a national external quality assessment scheme.

[Summary] A total of 352 pregnant women were selected in Affiliated Hospital of Qingdao University. Serum levels of TSH and FT4 were determined and pregnancy outcome were observed in all subjects. According to the standard of American Thyroid Association(ATA) published in 2011 and the Chinese Guideline of Gestation Thyroid Disease published in 2012, the subjects were grouped into control(0. 1≤TSH≤2. 5 mIU/ L), observation(2. 55. 17 mIU/ L)during first-trimester(T1)and control(0. 2≤TSH≤3. 0 mIU/ L), observation(3. 05. 22 mIU/ L) during second-trimester(T2). The results showed that the rupture of membranes, preterm labor, and total obstetrical adverse events in the observation group were significantly higher than those in control group during T1(all P<0. 05), no statistical significance between control group and treatment group. The rupture of membrances in the observation group was significantly higher compared with control group during T2 ( P < 0. 05), no significant difference in other adverse pregnancy outcomes between these two groups. Compared with control group during T1, the proportion of adverse pregnancy outcomes in observation group during T1 was significantly increased(P<0. 05). The elevated TSH is one of the risk factors for the increased incidence of adverse pregnancy outcomes at the first half of pregnancy, especially during T1. L-T4 treatment reduces the incidence of adverse pregnancy outcomes.

Objective To investigate the correlation between the remnants of extrahepatic bilie duct with the prognosis of biliary atresia after Kasai operation.Methods From Sep.2005 to Sep.2011,93 cases of biliary atresia [51 boys and 42 girls,ages at operation:61 days(40-121 days)] in Tongji Hospital Affiliated of Tongji Medical College of Huazhong University of Science and Technology were operated with Kasai procedure,and the diagnosis of type Ⅲ biliary atresia was based on the cholangiography and the intraoperative findings.According to whether there was fibrotic remnant plates of porta hepatis or not,type Ⅲ biliary atresia cases were grouped into 2 subtypes:subtype A,in which there was fibrotic remnant plates of porta hepatis (n =80) ; subtype B,in which there was no fibrotic remnant plates,but solid cords structure like hepatic duct was observed(n =13).Specimens of the remnants were colleted in operation and pathologic section detected the degree of bile ductular proliferation in the remnants.Postoperatively,all of the patients were followed up.The contents included the cholangitis occurrence rate,the jaundice disappearance rate and survival rate during postoperative 2 years.Results The patients had more bile ductular proliferation in subtype A (x2 =18.49,P ＜0.05).There was no significant difference in incidence of cholangitis in postoperative 1 month between the 2 groups (x2 =0.01,P ＞ 0.05).The jaundice disappearance rate in postoperative 6 months of subtype A was higher than the rate of subtype B(x2 =9.19,P ＜ 0.05).The survival rate during postoperative 2 years of subtype A was higher than the rate of subtype B(x2 =4.49,P ＜ 0.05).Conclusions There are higher jaundice disappearance rate and 2 years survival rate in type Ⅲ biliary atresia with the fibrotic remnant plates of porta hepatis,which suggest that there is more bile ductular proliferation in the extrahepatic remnants which is good for biliary drainage in subtype A after Kasai operation,and it can slow down hepatic injury and have a long-term good life quality.

Objective To evaluate the association between bradycardia and neurological sequel in patients with restoration of spontaneous circulation (ROSC) after cardiopulmonary resuscitation (CPR) during targeted body temperature management (TTM).Methods Forty-three unconscious patients with ROSC after CPR were treated with TTP.The patients were cooled with therapeutic hypothermia to body temperature target range (32-34°C) after cardiac arrest and divided into bradycardia and control groups depending on the lowest heart rate less than 50 beats/min and more than or equal to 50 beats/min respcetively at that time.The bispectral index (BIS) and the neuron-specific enolase (NSE) values were respectively recorded at the following intervals,0h (h0)、24h (h24)、48h (h48)、72h (h72) after ICU admission.Neurological outcome was defined according to the Pittsburgh cerebral performance category (CPC) at 3 months after ICU discharge.Results Compared with the control group,during TTM the bispectral index levels were significantly higher in the bradycardia group at h0,h48,h72 after admission,(h0 bradycardia group 73.0 ± 12.3;control group 58.0 ± 18.6,P ＜0.01)、(h48 bradycardia group 71.4 ± 21.2;control group 46.3 ± 18.9,P ＜ 0.01)、(h72 bradycardia group 78.6 ± 24.6;control group 51.8 ± 24.1,P =0.01).The neuron-specific enolase level in bradycardia group was significantly lower than that in control group on day3 (118.8 ± 118.8 ng/mL vs.248.3 ± 191.9 ng/mL,P =0.02).The level of CPC in the bradycardia group was significantly higher than that in the control group (P =0.046).Conclusions Patients with bradycardia during TTM had favorable neurological outcome,which could provide evidence for clinical treatment and prognostic evaluation of the patients.

Objective To explore clinical features and antimicrobial resistance of Klebsiella pneumoniae (K.pneumoniae) lower respiratory tract infection(LRTI) in children.Methods Clinical data of 107 children with K.pneumoniae LRTI confirmed by sputum culture from January to December 2015 were analyzed retrospectively.Results 62.62% of children with LRTI were aged less than 6 months and 64.49% episodes occurred in autumn and winter.All cases had cough and 39 had fever, the main complications were type I respiratory failure, type Ⅱ respiratory failure, cardiac insufficiency, and electrolyte disturbance, 39 cases(36.45%) had complications involving two systems, 5 cases(4.67%)had complications involving three systems,47 cases (43.93%) met the diagnostic criteria of severe pneumonia.43 cases (40.19%) had primary underlying diseases, the major were congenital heart disease, preterm and low birth weight, and malnutrition.Children with imipenem-resistant bacteria infection were more prone to develop extrapulmonary complications than those with non-resistant pathogenic infection.The resistance rate of K.pneumoniae to amikacin was the lowest(9.35%).90 cases were recovered and markedly effective, 11 cases were effective, 4 cases were not healed and voluntarily discharged from hospital, and 2 cases died.Conclusion Children aged less than 6 months and with underlying diseases are prone to develop LRTI, and complications are more.

AIM:To understand the effects and approach the mechanisms of matrix metalloproteinase-9(MMP-9)and cystoskeleton actin on the permeability increasing of blood-brain barrier(BBB)model which was induced by hypoxia/ischemia status in vitro.METHODS:The BBB model was build by the co-culture of cell ECV304 and astrocytes in vitro,then divided randomly into control group,hypoxia/ischemia group and BB-1101 pretreatment group.The permeability of BBB was determined by [125I]-BSA.The expression and the disposition of actin were detected by direct-immunofluorescence and Western blotting.BB-1101,the MMPs inhibitor,was used to investigate if MMP-9 participate the process of the increasing of BBB models' permeability in hypoxia/ischemia status.RESULTS:Post-stimulation of hypoxia/ischemia for 5 h,the permeability of [125I]-BSA and amount expression of MMP-9 in hypoxia-ischemia group was increased compared with control group(P

Objective To analyze complications of carotid artery stenting (CAS) and preventions.Methods Clinical data and treatment outcomes of 72 consecutive patients ( 80 stents ) from July 2006 to January 2012 with carotid stenosis were analyzed.Asprin 100 mg and clopedigrel 75 mg were given orally 5 days before CAS.Distal embolic protection device were implanted in all patients,pre-dilatation was done for those with carotid stenosis ＞ 90％ and post-dilatation was done for those of residual stenesis ＞ 30％.Severe complications of CAS mean death,myocardial infarction (MI) and stroke.Other minom included transient ischemic attack ( TIA ),hyperperfusion and intracranial hemorrhage ( ICH ),bradycardia and/or hypotension,hypertension,access hematoma or bleeding.Results In 72 patients a total of 80 self-expandable bare stents were successfully implanted.Distal embolic protection devices were used in all cases.Combined procedure was taken in 5 cases including OPCABG in 2 cases,left subclavain artery stenting in 2 cases and renal artery stenting in 1 case.The overall in-hospital complications was 37.5％ (27 of 72).Of these events,1 case had minor strokes defined as a modified Rankin Scale score less than 3 at 1-year follow-up,2 patients (2.78％ ) experienced a hemispheric TIA (neurological symptoms that resolved within 24 hours),1 patient experienced hyperperfusion syndrome.The overall mortality rate was 0,21 cases (29.2％ ) experienced hemodynamic instability (hypotension in 15 cases,bradycardia in 5 cases and hypertension in 1 case) and 2 others had access hematoms.The 30-day death/stroke/myocardial infarction risk was 1.39％ (1 minor stroke).Conclusions Hemedynamic instability (hypotension and bredycardia) is main complications of carotid artery stenting in patients with carotid artery stenosis,severe complications are rare.