OBJECTIVE:To improve the system of management and maintenance for the purification air-conditioning system in PIVAS,and to further strengthen the management of cleaning environment. METHODS:The cleanness monitoring project of purifi-cation air-conditioning system in PIVAS of our hospital was introduced in terms of temperature and humidity record,pressure differ-ence record,airborne particles detection,settling microbe monitoring report. And the monitoring results were analyzed. RESULTS:The temperature and humidity,pressure difference of clean area in PIVAS of our hospital are both in line with the standard of Phar-macy Intravenous Admixture Quality Management Specification (2010 edition),i.e. temperature at 18-26 ℃,relative humidity of 40%-65%;negative pressure difference between antibiotics,hazardous drug dispensing area and second dressing room are 5-10 Pa. The number of airborne particles (average static particle/m3) at various cleanness degrees in clean area are all in line with the standard of GMP(2010 edition),i.e. maximal allowable number of airborne particles(≥0.5 μm)were 3 520/m3(100 degree);352 000/m3 (10 000 degree);3 520 000/m3 (100 000 degree). The percentage of qualified static settling microbe detection reach 100%in clean area,which is in line with the standard of Settling Microbe Detection Method in Clean Room(Area) of Pharmaceu-tical Industry,i.e. criteria for settling microbe(90 mm)CFU/0.5 h≤1(100 degree);≤3(10 000 degree);≤10(100 000 degree). The percentage of qualified dynamic settling microbe detection is in low level,especially those of dispensing room and secondary dressing room only reaches 80%. CONCLUSIONS:It’s important for effective hospital infection control in PIVAS,the quality im-provement of intravenous injection,the safety guarantee of drug use in patients to further improve standard operation procedure of purification air-conditioning system management and maintenance,and manage and maintain the purification air-conditioning sys-tem completely and scientifically.

Objective To explore the role of endogenous and exogenous β-glucuronidase( β-G) in the development of primary common duct stones.Method Using modified Fishman method to test the activities of the endogenous and exogenous β -G in 35 patients with primary common duct stones(experimental group) and 11 patients with cystic polypus (control group) respectively.Results The activities of endogenous β -G in the bile of experimental group and control group were (7859.1 ± 738.5 ),(2174.9 ± 348.4 ) U/L(P ＜0.01).While the activities of exogenous β-G in experimental group and control group were (6786.1 ±544.3),(1504.7 ±655.7) U/L (P ＜0.01).In experimental group,there were significant statistical differences in the activities of the exogenous β -G in the sample obtained on the day of operation and 7 days after operation from 13 cases with the acute inflammation [(8935.7 ± 845.9),(2176.1 ± 956.7) U/L]and from 22 cases with the chronic inflammation [(5137.2 ±540.7),(1838.8 ±733.3) U/L],and there were significant higher in the activities of the exogenous β -G in the sample obtained on the day of operation from the acute inflammation compared to those from the chronic inflammation (P ＜ 0.05 ).Conclusions There is obvious correlation between either endogenous or exogenous β -G with primary common duct stones.And the endogenous β -G might be one of the fundamental cause in the development of primary common duct stones.

Objective To analyze retrospectively the clinical characteristics, pathogeny and therapy of traumatic interhemispheric subdural hematoma (ISH). Methods 31 ISH cases admitted since 1996 were reviewed and analyzed retrospectively concerning the clinical characteristics and therapies. Typically,ISH manifested itself with hemiplegia or monoplegia in the contralateral lower limb, called the falx syndrome, and unconsciousness was infrequent at the initial stage of the head injury. The pathogeny of ISH involved cracks of the bridging vein, hematomas in the interhemispheric small arteries and veins and probably coagulation dysfunction or anticoagulant therapy. Results In all 31 patients, 29 were cured and 2 died ofmultisystem organ failure (MSOF) and cerebral hernia respectively. The follow-up revealed that 6 cured patients developed interhemispheric subdural effusion. Conclusion CT scanning showing the interhemispheric hematoma exceeds 20 mL, or the interhemispheric hematoma is thicker than 1 cm can be referential to the diagnosis of ISH. For the ISH treatment, surgery and conservative management are suggested based on the functional disturbance or the stability of the disease. Patients with progressive neurologic deterioration should be operated without delay.

OBJECTIVETo evaluate the therapeutic effects of mitral valve repair for the treatment of the anterior leaflet prolapse of mitral valve.

METHODSFrom November 1998 to October 2007, 210 patients with severe anterior leaflet prolapse of mitral valve underwent valve repair. The condition of valve was preoperative, intraoperative, and postoperative assessed with echocardiography.

RESULTSEdge-to-edge repair technique was used in 134 cases (63.8%). The cardiac function was NYHA class I in 168 cases and class II in 40 cases after operation. Patients were followup for 1 - 150 (25.7 +/- 29.0) months, two patients (0.95%) died of postoperative low cardiac output syndrome. Echocardiography examination indicated that the mean JP2 postoperative left atrial diameter was (37.7 +/- 9.2) mm against the preoperative value of (47.5 +/- 12.7) mm (P < 0.05), the mean postoperative left ventricular end-diastolic diameter was (51.7 +/- 7.9) mm against the preoperative value of (67.7 +/- 10.3) mm (P < 0.05), the mean postoperative left ventricular ejection fraction was (62.2 +/- 3.2)% against the preoperative value of (52.2 +/- 6.4)% (P < 0.05), and the mean preoperative regurgitation area was (10.4 +/- 4.1) cm(2) against the postoperative value of (4.1 +/- 1.7) cm(2) (P < 0.01).

CONCLUSIONSOptimal outcome was achieved by appropriate edge-to-edge technique or other mitral valve repair techniques for anterior leaflet prolapse of mitral valve. Edge-to-edge technique is a reliable and efficient surgical technique.

Adult ; Cardiac Surgical Procedures ; Female ; Humans ; Male ; Middle Aged ; Mitral Valve Prolapse ; surgery ; Treatment Outcome ; Young Adult

OBJECTIVETo evaluate the diagnostic accuracy of the cone beam computed tomography (CBCT) in judging the relationship between the impacted mandibular third molar (IMTM) and the inferior alveolar canal (IAC).

METHODSSixty IMTM superimposing on the canal partially or touching the canal in line on panoramic radiograms were examined by CBCT. All CBCT images of these cases were observed by two dentists respectively. Then, all these IMTM were extracted by minimally invasive surgery, and the conditions of the IMTM sockets were observed. Two dentists observed the CBCT images independently and reached a consensus. Diagnosis test was performed in this study.

RESULTSEight IMTM sockets were bleeding during the extracted operation, and whether the IAC wall was broken could not be judged. The other 52 IMTM sockets were clear and the walls of IAC were broken in 29 IMTM extractions. The sensitivity, specificity, Youden index, positive predictive value and negative predictive value of CBCT were 82.8%, 87.0%, 88.9% and 80.0% respectively. The diagnostic accuracy judged by the two dentists and Kappa coefficient were calculated as 84.6% and 0.800.

CONCLUSIONSThe CBCT examination had good authenticity and reliability, and it was very helpful in predicting the actual relationship between the IMTM and IAC.

Adolescent ; Adult ; Alveolar Process ; diagnostic imaging ; innervation ; Cone-Beam Computed Tomography ; methods ; Female ; Humans ; Male ; Mandible ; diagnostic imaging ; innervation ; Mandibular Nerve ; diagnostic imaging ; Molar, Third ; diagnostic imaging ; surgery ; Pilot Projects ; Preoperative Care ; Tooth Extraction ; Tooth, Impacted ; diagnostic imaging ; surgery ; Young Adult

Objective To explore the activated brain region of acute epilepsy in cat model induced by pentylenetetrazol(FFZ)with manganese enhanced-functional MR imaging(ME-fMRI),and evaluate the application of ME-fMRI on localization of the activated brain.Methods Forty cats were divided into 4 groups by random number table method as epileptic A and B groups as well as control A and B groups. Cats of epileptic groups were injected with PTZ(55 mg/kg)intramuscularly,and those of control groups were injected with the saline at same dose.The behavior change in the epileptic and control group A was observed and electroencephalogram(EEG)was also undertaken.Cats of epileptic and control group B were performed ME-fMRI,and the percentage of the enhanced signal intensity was then calculated.Results After injection with PTZ(55 mg/kg)intramuscularly,epileptic seizure was all evoked,and then EEG recording showed spike-wave and polyspike-wave complexes.The neocortex of cats of epileptic group B was diffusely phanero-enhanced on ME-fMRI.The percent enhancement of signal intensity in cortex of frontal lobe,parietal lobe and occipital lobe was(34.6?5.7)% and that in cortex of temporal lobe with(22.9? 6.5)%,whereas those of control group B with(14.9?4.5)% and(11.6?3.2)% respectively.And there was significant difference between the above different localization of the brain in the two groups (t=-10.43,-5.46 respectively,P

AIMTo reconstruct of a tissue engineering skin in vitro for the study of the use of drug percutaneous penetration and metabolism.

METHODSDermal fibroblasts were embedded in collagen type I. HaCaT cells were seeded on the top of the gel. The skin was generated through air-liquid interface culture. Effects of various culture media on tissues morphology were investigated. Sections of the cultured skin were stained with hematoxylin and eosin and examined under microscope. Permeation and metabolism of ketoprofen and its isopropyl ester through the cultured skin were investigated.

RESULTSHaCaT cells initially developed a multilayer epithelium at the air-liquid interface, but it showed a parakeratotic stratum corneum. Vitamin C enhanced cell proliferation obviously. Vitamin D3 promoted cell differentiation. And estradiol showed little effect on the tissue engineering skin. Ketoprofen isopropyl ester was hydrolyzed into ketoprofen when penetrated through the cultured skin, which resembled in the skin cell homogenates metabolism.

CONCLUSIONCultured at the air-liquid interface, HaCaT cells developed a parakeratotic mutilayer epithelium. Enzyme activity was reserved. This cultured skin could serve as an appropriate model for drug percutaneous metabolism and skin irritation.

Administration, Cutaneous ; Anti-Inflammatory Agents, Non-Steroidal ; pharmacokinetics ; Esters ; administration & dosage ; chemistry ; pharmacokinetics ; HeLa Cells ; cytology ; Humans ; Ketoprofen ; administration & dosage ; chemistry ; pharmacokinetics ; Skin Absorption ; Skin, Artificial ; Tissue Engineering ; methods

OBJECTIVETo evaluate the application of traditional cytomorphology, telomerase activity analysis and immunocytochemistry in cytopathologic diagnosis of pleural effusion and bronchoalveolar lavage samples.

METHODSA total of 123 agar-paraffin double-embedded pleural effusion and bronchoalveolar lavage fluid samples were enrolled into study. The cytomorphologic features were reviewed and correlated with immunocytochemical findings and telomerase activity.

RESULTSTelomerase activity was detected in 53 specimens using the real-time telomeric repeat amplification protocol. Amongst the cases studied, 39 samples (31.7%) contained overtly malignant cells while 20 cases (16.0%) were equivocal by conventional cytology. After verification by immunocytochemistry and clinical follow-up data, the diagnostic accuracy of telomerase activity and cytology was 87.0% and 82.1%, respectively. The sensitivity (97.6%) and specificity (100.0%) of cytology examination, when combined with telomerase activity analysis, were greater than those of cytology examination or telomerase activity analysis alone.

CONCLUSIONSTelomerase activity analysis can be used as an adjunctive investigative tool in cytology assessment of pleural effusion and bronchoalveolar lavage samples. The diagnostic accuracy can be further improved with the application of immunocytochemistry on agar-paraffin double-embedded cell block tissues.

Breast Neoplasms ; diagnosis ; enzymology ; pathology ; Bronchoalveolar Lavage Fluid ; chemistry ; Female ; Follow-Up Studies ; Humans ; Immunohistochemistry ; Lung Neoplasms ; diagnosis ; enzymology ; pathology ; Pleural Effusion ; diagnosis ; enzymology ; pathology ; Pleural Effusion, Malignant ; diagnosis ; enzymology ; pathology ; Sensitivity and Specificity ; Telomerase ; metabolism

OBJECTIVETo evaluate the cardiovascular involvements in Chinese patients with hypereosinophilic syndrome.

METHODWe respectively reviewed 149 inpatients with hypereosinophilic syndrome admitted to Peking Union Medical College Hospital and analyzed the cardiovascular involvements in these patients.

RESULTSCardiac abnormalities was evidenced in 32.9% patients (49/149). The ratio of male vs female was 34:15. The average age of the patients was (41.3 ± 16.9) years and course of disease was (26.4 ± 72.3) months. Cardiovascular involvements included ST segment and/or T wave (ST-T) ischemic changes, arrhythmia, myocardial injury, cardiac thrombosis, pericardial effusion, pulmonary hypertension, valve disorder, vein or artery thrombosis. After glucocorticoid and/or chemotherapeutic agents and treatment for symptoms, 11 (22.4%) patients achieved remission but have recurrent attacks and 3 (6.1%) patients died from failure in treatment. The prognosis in patients with echocardiogram abnormalities were poorer than those only with electrocardiogram abnormalities (P < 0.05).

CONCLUSIONSCardiovascular involvements are common in patients with hypereosinophilic syndrome and the manifestation of these involvement is various. Cardiovascular complications of HES are a major source of morbidity and mortality in these disorders.

Adolescent ; Adult ; Aged ; Child ; Child, Preschool ; Female ; Heart Diseases ; diagnosis ; diagnostic imaging ; etiology ; Humans ; Hypereosinophilic Syndrome ; complications ; diagnostic imaging ; physiopathology ; Infant ; Male ; Middle Aged ; Prognosis ; Retrospective Studies ; Ultrasonography ; Young Adult

OBJECTIVETo investigate the actual relationship between the impacted mandibular third molars (IMTM) and the mandibular canals on panoramic radiographs and cone beam computed tomography (CBCT).

METHODSA cross-sectional study design was used and panoramic radiographs of 390 patients (645 sides developed IMTM) were included in the present study. The relationship between the IMTM and the mandibular canal on panoramic radiographs was defined in three types: 'untouched', 'touching in point', and 'superimposition or line touching'. The IMTM superimposing and line touching with mandibular canals on panoramic radiographs were examined by CBCT.

RESULTSThe relationship types on panoramic radiographs were as follows: 'untouched' type 441 IMTM (68.4%), the type of 'touching in point' 149 IMTM (23.1%) and the type of 'superimposition and line touching' 55 IMTM (8.5%). CBCT showed that 25 (50%) of 50 IMTM of superimposition and line touching type impinged on the mandibular canals.

CONCLUSIONSMore than 90% of IMTM which do not have intimate relationship with the mandibular canals can be screened out by panoramic radiographs. The IMTM which belong to the line touching and superposition type on panoramic radiographs should be examined by CBCT.

Cone-Beam Computed Tomography ; Cross-Sectional Studies ; Humans ; Molar, Third ; diagnostic imaging ; Radiography, Panoramic ; Tooth, Impacted ; diagnostic imaging