Subclavian artery occlusion is a common peripheral artery occlusion disease of various causes,with incidence of 1.9％.The most common symptoms are dizziness,ataxia,and hemiplegia that are caused by subclavian steal syndrome.Surgery is the only therapeutic method for symptomatic patients.Open surgery remains an important role despite of the rapid progress in endovascular surgery.Main surgical method includes carotid-subclavian transposition (CST),carotid-subclavian bypass (CSB) and axillary-axillary bypass.Each one is suitable for different lesions and anatomies.Both the effectiveness and safety have been testified.

A better understanding of the function of spleen has been gained recently,owing to the in-depth studies on the structure,cellular function,secretion and innervation of spleen.It is generally accepted that the spleen is the important part of the regulation network between immune,nerve and endocrine system.The spleen has much more functions besides blood filtering and storing,haematogenesis,and immunization,and its immune function has characteristics of two-way and phase.But further study is still needed for the precise evaluation of function of the spleen,especially the spleen on the pathologic state,clarification of the pathogenesis of hypersplenism,and the relationship between spleen and other organs.Here we introduced the progress of fundamental research of the spleen from multiple perspectives.

Objective To explore the role of Joint Commission International(JCI) standards on the improvement of pharmaceutical care in pharmacy intravenous admixture service (PIVAS) during the JCI accreditation.Methods The changes of PIVAS in Huangshi Central Hospital were analyzed and compared during JCI accreditation in respect of facilities,software management,service processes,safety awareness of the PIVAS staff and pharmacy management,service evaluation,error rate,etc.Results After JCI accreditation,the process of PIVAS were optimized,the software were updated ,and the safety awareness of PIVAS staff was improved;the management of high alert drugs was implemented more strictly;more importance was attached to the details of pharmaceutical care;the satisfaction degree of the clinic units to PIVAS was increased from 87.0% in 2014 to 98.0% in 2015;error rate was decreased from 0.40‰ in 2014 to 0.15‰ in 2015.The incidence rate of defective product was decreased from 0.32‰ in 2014 to 0.07‰ in March 2015.The correct rate of medical waste classification treatment was increased from about 85.5% in 2014 to 100.0% in 2015.Hand hygiene compliance rate and correct rate were increased up to 100.0%.6S site management activity participation rate was increased up to 100.0%.Conclusion The application of JCI standards and the process of JCI accreditation improve the quality of pharmaceutical care in hospital PIVAS.It can improve the medical safety in hospital.

Carcinoma, Papillary ; surgery ; Carotid Arteries ; surgery ; Diffusion of Innovation ; Humans ; Knowledge ; Laryngeal Neoplasms ; surgery ; Laryngectomy ; methods ; Reconstructive Surgical Procedures ; methods ; Surgical Flaps ; Thyroid Neoplasms ; surgery ; Thyroidectomy ; methods ; Voice Disorders ; etiology ; surgery

Animals ; Depression ; etiology ; metabolism ; Frontal Lobe ; metabolism ; Glutamic Acid ; metabolism ; Male ; Nitric Oxide ; metabolism ; Rats ; Rats, Sprague-Dawley ; Serotonin ; metabolism ; Stress, Physiological ; physiology ; Swimming

The county health service planning is a very important link in county health reform, the planning process involves many professional problems, such as the setting of total bed number and proportional allocation. To solve these problems, it is needed to find a feasible method. Methods:Using operational research theory and method of linear programming to estimate whether the resource amount could satisfy the needs, and further explore the problem of the health resources in county-township-village. Results:(1) Operational research method could be used to judge whether the total bed amount and rate in county and township are suitable;(2) but linear programming to allocate capital budget model still exist some defects. The blind expansion and the pursuit of institution beds scale expansion are the phenomenon at present stage, the linear programming method could effectively help to determine whether these resources is really insufficient or excess. The method could be expanded to urban areas so as to supervision whether health resources are over expanded.

Reconstructing the three-dimensional finite element model of compression fracture of T_(12) based on the 210-layer consecutive CT DICOM format images from one patient of compression fracture of T_(12) to simulate the hyperextending. Bound the lower of T_(12), a vertical traction at the top of T_(11)and a 3.0 cm-displacement toward the vertebra by three steps at the top of spinous process of T_(11), T_(12) and L_1 was provided. The procedure began computing to reed the results about dynamic biomechanical characteristics of anterior longitudinal ligament. A realistic appearance and full biomechanical properties 3D finite element model of thoracolumbar spine compression fracture was established. The anterior longitudinal ligament was changed from relaxation to tension after hyperextending. The stresses of anterior longitudinal ligament were different when the hyperextending fulcrum was different. The treatment effect of thoracalumbar spine compression fracture by hyperextending is exact. The anterior longitudinal ligament plays an important role in the treatment. Finite element analysis of mechanism of traditional practices has many advantages, such as reliable experimental results, direct displaying results, saving resources and accurate simulation.

OBJECTIVE: To recognize the research status on the mechanism of reactive oxygen species (ROS) and NADPH oxidases in cell growth and death,and explore the effects of ROS and NADPH oxidases on cardiomyocyte differentiation.DATA SOURCES: A computer-based online search of Medline was undertaken for the articles about the action mechanism of reactive oxygen and NADPH oxidases in cell growth and death published in English between January 1997 and December 2003 with the key words of "Reactive oxygen species, NADPH oxidase, Cardiomyocytes, Differentiation, Signal transduction".STUDY SELECTION: Inclusive criteria: ①Articles on ROS production and structure and activation of NADPH oxidase and their action mechanism in cell growth and death; ②Research about the molecule mechanism of cardiomyocytes differentiation. The repetitive research and review articles were excluded.DATA EXTRACTION: Totally 132 articles about the action mechanism of ROS and NADPH oxidase and cardiomyocytes differentiation were collected, and 78 ones met the inclusive criteria.DATA SYNTHESIS: ①ROS involved in pathogenesis of many diseases were mainly from intramitochondrial electron transport chains, and NADPH oxidase was closely related with ROS production; NADPH oxidase firstly found in phagocyte was a kind of multienzyme complex, and its activity was regulated by the concentration of Ca2+ in cells and mRNA expression of its subunits. ②At present, many researchers presumed that oxidative stress was a double-edged sword, and it two-ways regulated the cell proliferation and death, in which ROS served as the second messenger in the signal transduction. Recent data showed that ROS and NADPH oxidase played important roles in cardiomyocytes differentiation; however, it was not identified which subunit of NADPH oxidase expressed in myocardial cells and its detail regulative pathway. Those problems were important for further study in the molecule mechanism of cardiomyocytes differentiation.CONCLUSION: ROS including superoxide anion (O2-), hydrogen peroxide (H2O2) and hydroxyl radical (OH-), are generated in cardiomyocytes mainly by a membrane-bound NADPH oxidase (NOX). The NOX-derived ROS, as the second passenger, play important roles in various intracellular signaling pathways. In cardiomyocytes, ROS have the potential to alter the balance between cell growth and death through these signaling pathways. Recently,ROS have been demonstrated to play a critical role in regulation of cardiomyocyte differentiation from embryonic stem cells. Research in the regulation mechanisms of ROS will contribute to our better understanding of he role of ROS and NADPH oxidase in cardicomyocyte differentiation and will lead to the identification of factors able to promote cardiac differentiation.

Pharmacokinetic-pharmacodynamic(PK/PD)modeling,as an available tool accounting for the interrelated dynamic connection between the dosage and efficiency of drugs,plays an important role in the field of studying the mechanism and optimizing the clinical administration of traditional Chinese medicine(TCM).Based on the general illustration on the foregoing application of PK/PD modeling,the present work investigates the involving challenges in the field,such as the selection of the target chemical composition and effect mark.In accordance with the unique properties of TCM,further,the related suggestions,mainly focusing on determining the substances based on the effect and establishing the multi-index appraise system,are put forward as reference for the following research work.

Barrett's esophagus is known the only precancerous lesions of esophageal adenocarcinoma.Besides conventional endoscopy and pathologic biopsy,drugs and surgical treatment of the Barrett's esophagus,in recent years,some new endoscopic diagnosis and treatment technology were obtained.The progress of endoscopic diagnosis and therapy technique in Barrett's esophagus are reviewed in this paper.