Objective To study the application of intraoperative drug administration in simultaneous pancreas-kidney transplantation(SPK), in order to achieve favorable postoperative results. Methods In the 19 cases of SPK,we primarily administered albumin 1.5~2.0g/kg to increase blood volume. Intraoperative electrocyte fluid dosage was 30~50mL/kg. Isoptin, 5mg/12h and prostaglandin E1(PGE1) 100?g/12h was given to lessen preservation injury and somatostatin(3mg/12h) to inhibit exocrine secretion of the transplanted pancreas. Results After reperfusion,the 19 transplanted pancreas grafts secreted amylase averaging 20 800U/L,and the transplanted kidneys produced urine,through the ureters,in 2~10min.In the 19cases,exogeneous insulin was withdrawn within 1.5h~9d and kidney function returned to normal within 2~4d. Conclusions In the SPK recipients, the rational use of albumin, vasodilators and somatostatin plays an important role in obtaining better function of transplanted pancreas and kidney.

Objective To investigate the maternal attitude and demands for Institute of Postpartum Care in order to provide targeted services.Methods 285 women were a investigated about maternal attitude and demands towards Institute of Postpartum Care with self-designed questionnaire.Results 97.9％ (279/285) women thought sitting the month (puerperal period) was very important,50.2％ (143/285)women were interested in Institute of Postpartum Care.They thought the main three advantages were energy saving,medical expertise and technology and avoidance of family conflicts;The three major issues were high price,lack of monitoring mechanism and unfamiliar environment and less family company;33 items of services demands over four points accounted for 78.6％,the three modules with highest scores were cleaning services scored 4.64±0.47,newborn services scored 4.45±0.41,consultation service scored 4.41:±0.53.Conclusions Professional postnatal care services have been a trend and social need,and a large proportion of women have great interest and demand on Institute of Postpartum Care which should make full use of its concentrate resources,and provide specific services according to maternal demands for services.It is urgent to build unified service standards and evaluation indicators to improve service quality.

BACKGROUND:Sunshine time in northem region is short in winter,the infants and young children are vulnerable to lack of vitamin D. Up-to-date textbooks and the guidelines formulated by Chinese Medical Association account that glass block ultraviolet and indoor exposure to human is meaningless. Early studies have shown that sunlight exposure through glass had meaning in rats,but it was difficult to accurately quantify,while outdoor exposure in rats is difficult to continue. This expedment uses B-band ultraviolet rays,which has the impact on vitamin D metabolism in some wavelengths,to facilitate further study.OBJECTIVE:To study the effect of ultraviolet B exposure in laboratory on 25-hydroxy vitamin D(25-OHD)level and bone metabolism in the serum of growing rats.DESIGN,TIME AND SETTING:A randomized controlled animal experiment was performed in June 2007 in the ExperimantalAnimal Center of Chinese PLA General Hospital.MATERIALS:Forty male 21-day-old Wistar rats were employed in this study. Ultraviolet waves were sourced from an artificial UV light instrument(wavelength 280-350 μm,irradiation intensity 5.5μW/cm~2).METHODS:Forty Wistar rats were divided into four groups by random sampling table,exposed to different doses of ultraviolet Bwave. Direct exposure group:direct exposure for 20 minutes at an irradiation dose of 4.2 mJ/(cm~2·d);Indirect exposure 60 and 120 min groups:exposure through a single pane of glass for 60 and 120 minutes at an irradiation dose of 0.36 and 0.72 mJ/(cm~2·d).Control group:no exposure was given. For the direct exposure group,the lamp was placed above the cage. A 3-mm-thick pane of glass(common window glass) was placed underneath the lamp in the indirect exposure groups. Exposure groups were given irradiation for successive 20 days.MAIN OUTCOME MEASURES:Serum 25-OHD,bone alkaline phosphatase (BALP),and bone mineral density (BMD) were measured on day 21.RESULTS:25-OHD was significantly higher in all exposure groups compared with the control group (P＜0.001),but there was no difference between the direct exposure group and two indirect exposure groups. BALP was significantly lower in the exposure groups than control group (P＜0.001),it was also significantly lower in the 120-min indirect group than in the 60-min indirect group (P=0.022). There was a positive correlation between exposure dose and 25-OHD (r=0.555,P=0.002) and a negative correlation between exposure dose and BALP (r=0.595,P=0.001),also a negative correlation between 25-OHD and BALP (r=0.569,P=0.002),but there were no differences between groups for BMD. Exposure dose exhibited a threshold,serum 25-OHD and BALP no longer increased or decreased when it was 0.36 mJ/(cm~2·d).CONCLUSION:Midwave ultraviolet rays might affect serum 25-OHD and BALP levels in the growing rats through glass exposure,with no significant difference compared to direct exposure. The B-band ultraviolet exposure dose may play an important role in serum 25-OHD synthesis,but there is a threshold dose for the synthesis. Low-dose and prolonged exposure time also achieve threshold exposure.

OBJECTIVE:To provide reference for the improvement of pharmacy management in primary hospital.METHODS:Some problems about pharmacy management and its operation process in primary hospital were introduced briefly.Reasons of above problems were investigated and analyzed,and relevant countermeasures were put forward.RESULTS & CONCLUSION:Pharmacy management of primary hospital should be strengthened,standardized and improved.More efforts should be put into the pharmacy work of primary hospital in order to make primary hospital become a great contributor for primary medical care.

Objective　To observe the effects of residual perfluorocarbon liquid(PFCL) droplets in the anterior chamber in patients after vitreoretinal(VR) surgery for complicated retinal detachments.Methods　The study group consisted of nine patients(nine eyes)aged 16～64 in whom droplets of perfluorodeclin liquid(PFDL) appeared in the anterior chamber subsequent to VR surgery for complicated retinal detachments involving scleral bucking, vitrectomy and/or lensectomy, the peeling of pre-retinal membrane, perfluorodecalin injection, and perfluorodeclin liquid-silicone oil or fluid-air exchange. Mean follow-up was 10.3 months.Results　Three to 30 droplets of perfluorodeclin liquid were found in the anterior chambers in 9 eyes. There was no corneal complication or inflammatory reactions or blood vessel invasion into the corneal stroma or increased intraocular pressure.Conclusion　Residual perfluorodeclin liquid droplets in the anterior chamber are well tolerated and do not induce corneal damage or ocular inflammation.

Objective Pancreas perfusion is an essential step in human islet isolation.To develop the new methods for introductal canulation,collagenase infusion and to observe their effects on islets isolation.Methods A total of 17 pancreases were digested from March 2005 to April 2010.The pancreases were distended by three methods:the standard method (n =3),the one-cannula method (n =11) and three-cannula method (n =3).In the standard group,the pancreases were completely cut into half at the mid-body.Two catheters were inserted into the main duct:one directed toward the tail and the other to the head.In the one-cannula method group,a long tube was inserted into the duct at the head,advancing to the tail In the three-cannula method group,pancreatic parenchyma was then minimally cut at the mid-body and three catheters were inserted into the main pancreatic duct:one at the head (the first catheter) and two at the mid-body,one toward the tail (the second catheter) and the other toward the head (the third catheter).The pancreases were digested by improved Ricordi technique.Ficoll continuous density/grads centrifuge method was performed to purify the islets.DTZ staining was adopted to identify islets and count islet equivalent (IEQ). AO/EB fluorescence examination was used to count active islet percentage.Static glucose stimulating test (SGS) in vitro was designed to estimate islet function and calculate SI.Results The distension volume of the threecannula method group was 1.24 rnl/g pancreas,and higher than the other groups (for the standard group:0.71 ml/g pancreas; for one-cannula method group:0.96 ml/g pancreas,P＜0.05).The yield of islet in the three-cannula method group and the one-cannula method group was 2514 and 2270 IEQ/g,which was significantly more than that in the standard group (1914 IEQ/g pancreas,P＜0.05).The purity and viability of the islets were 74 ％/79.3 ％,75.6 ％/79.4 ％ and 78.3 ％/84.0 ％ respectively in the three groups with the difference being not significant among the groups.SI in the one cannula method group (4.74) and the three-cannula method group (5.27) was significantly higher than that in the standard group (3.46).ConclusionThe three-cannula method improved collagenase infusion and the islet yields.

Objective To compare the advantages and disadvantages of botulinum toxin A (BTX-A) and phenol block in the treatment of spasticity in children with cerebral palsy. Methods Four hundred and twenty children with spastic cerebral palsy were divided into an experimental group (375 cases) and a control group (45 cases).The children were aged from 1 to 22 years ( average age 6 years).The children in the experimental group were treated with BTX-A block at a dosage of 55 to 350 IU (average 130.5 IU).The children in the control group were treated with a 5％ phenol solution block at a dosage of 0.5 to 4.6 ml ( average 2.2 ml).Children of both groups were given systematic functional rehabilitation training. All the children were evaluated with a physician rating scale (PRS) and the modified Ashworth scale (MAS) before and after the blocking.Effectiveness rates,effectiveness durations and side effects rates were calculated. Results Before treatment there was no significant difference in terms of motor disorder or spasticity between the 2 groups.After treatment,spasticity had been significantly reduced in both groups.The effectiveness rate was 98.4％ in the experimental group and 95.6％ in the control group,a difference which was not significant.The average effectiveness duration was ( 24.9 ± 5.76 ) weeks in the experimental group and ( 69.2 ± 13.76) weeks in the control group,significantly longer.The side effects rate was 5.33 ％ in the experimental group and 15.56％ in the control group,also a significant difference. Conclusion BTX-A could be more widely used because of its safety and credibility.

ObjectiveTo investigate the methods of hepatic arterial reconstruction in orthotopic liver (transplantation)(OLT), and the prevention and management of associated complications, so as to improve the therapeatic results and donor survival rate of OLT.MethodsThe clinical data of 85 cases of orthotopic liver transplantation performed in our institute from May 1995 to May 2004 were retrospectively analysed. Hepatic artery reconstruction was made by use of Carrels patch of donor celiac artery or bifurcation of donor common hepatic artery and splenic artery anastoniosed to left and right hepatic artery of recipient in 16 cases((18.82)%), to bifurcation of gastroduodenal and proper hepatic arteries of recipient in 61 cases((71.76)%), or use of donor iliac artery interposition graft to abdominal aorta in 8 cases(9.42%). Regular heparin or low-molecular-weight heparin as a prophylactic anticoagulation therapy was maintained during and after (operation) as indicated by prothrombin time. Intra-and postoperative Doppler ultrasonography was used to (monitor) hepatic arterial blood supply.ResultsHepatic artery thrombosis(HAT) was observed in 1 case (intraoperatively)(overall incidence 1.2%).Thrombectomy and reconstruction of the arterial anastomosis were performed immediately.This patient currently has a survival time of 13 months without HAT. HAT was not observed in any of the other 84 cases during the follow up of 2 to 52 months.Conclusions Hepatic artery thrombosis may be minimized by proper selection of anastomotic site of hepatic artery reconstruction and (effective) use of postoperative anticoagulation.Close follow-up by Doppler ultrasonography may make a prompt diagnosis of HAT, salvage grafts and avoid re-transplantation.

Objective To investigate whether the curative effect of Botulinum Toxic A(BTX-A) block increased and prolonged when the dose calculated according to certain formula.Methods 15 children with cerebral palsy(CP) were appointed as the trial group and the dose of BTX-A was calculated according to the designed formula.The other 58 CP children were appointed as the control group and the BTX-A dose was determined by routine method.Results After treatment,the motor function of the children in trial group was superior to that in the control group(P<0.05) and the duration of therapeutic effect of the trial group was significantly longer than the control group(P<0.001).Conclusion BTX-A dose calculated according to the formula can increase effect and prolong the duration.

Objective To investigate the long-term efficacy of Botulinum toxin type A (BTX-A) on spasticity in cerebral palsy, and theeffect of rehabilitation on it. Methods 230 children with spastic cerebral palsy were treated with BTX-A block. The dose of BTX-A wasidentified with the weight of the children and the Modified Ashworth Scale (MAS). They were divided into group A who exercised morethan 2 h/d, and group B who exercised less than 2 h/d or not. They were assessed with Gross Motor Function Measure (GMFM) 1 year aftertreatment. Results There was no significant difference between group A and B with ages, weight, MAS, GMFM before block (P>0.05), norwith BTX-A effect time (P>0.05). The GMFM improved significantly in both group A and B 1 year after block (P<0.05), and it improvedmore in group A than group B (P<0.01). Conclusion The long-term efficacy of BTX-A block is positive. The rehabilitation training afterblock can help children to improve their gross motor function.