Objective The paper analyzes the operating patterns of the outpatient process and identifies the links needing reengineering so as to provide scientific basis for the optimal allocation of outpatient resources and process reengineering and prove the rationality and feasibility of using the queuing theory. Methods Using the methods of the queuing theory, the service time and the patients' arrival time at such service links as registration, billing and accounting, internal medicine, and gynecology in the outpatient department of a certain hospital were measured and the operational indexes at various links such as service intensity, average queuing length, average queuing time, average stay, probability of the service desks being idle, and the probability of the patients having to wait were calculated so as to estimate the rational number of service desks and the optimal value of the sum of the cost of waiting and the cost of service. Results Registration, billing and accounting , service intensity in internal medicine, personnel allocation, and queuing time were basically rational in the outpatient department of the hospital surveyed. One more physician should be added to the gynecology department so as to improve efficiency and reduce patients' waiting time and queuing length. There was currently a shortage of medical staff in the hospital. The cost of hospital input was moderate while the cost of waiting was on the high side. Conclusion It is rational and feasible to evaluate the efficiency of the outpatient process with the methods of the queuing theory. The method deserves to be spread.

AIM: To investigate the effect of ischemic preconditioning(IPC) on expression of nitric oxide synthase(NOS) in rat smallfor-size liver graft and its significance.METHODS: Sixty SD rats were randomly divided into 3 groups(n=10 pairs/group): nonwarm ischemia group(NWI);warm ischemic group(WI);and ischemic preconditioning group(IPC).The models of rat small-for-size liver transplantation were set up by two-cuff technique.Expression of eNOS mRNA and iNOS mRNA in hepatic tissue were detected by fluorescence-quantitating-PCR.RESULTS: Heptic expression of eNOS mRNA post-IPC was higher than that pre-IPC(P0.05).It was higher in IPC group than that in NWI and WI group(P

To develop a real-time FQ-PCR method for quantifying human ermap, a set of primers and a fluorescent probe were designed by primer express 2.0. pBluescriptSK(+) plasmid contained ermap cDNA was transcribed to generate calibration standards for quantification. A real time FQ-PCR method was established. The results showed that when the concentrations of DNA to be amplified were ranged from 1.725 x 10(7) to 1.725 x 10(10) cps/ml, there was a good correlation between template concentration and cycle threshold, and the correlation coefficient reached to -0.999376. In conclusion, real time FQ-PCR which is specific, sensitive and accurate can be used to further research on human ermap.
Blood Group Antigens ; genetics ; Butyrophilins ; DNA, Complementary ; chemistry ; genetics ; Fluorescent Dyes ; chemistry ; Fluorometry ; methods ; Humans ; Polymerase Chain Reaction ; methods ; Reproducibility of Results

OBJECTIVETo investigate the methods of culturing and identifying mouse myeloid semimature dendritic cell (smDC) in vitro.

METHODSMyeloid monocytes derived from 6-week-old C57 BL/6 mice were cultured in RPMI-1640 medium containing 10% fetal bovine serum, 2 ng/ml recombinant murine granulocyte macrophage-colony stimulating factor (GM-CSF), and 20 ng/ml recombinant murine interleukin (IL)-4 for 9 days. Then cells were incubated with 40 ng/ml tumor necrosis factor-alpha (TNF-alpha) for 24 hours to obtain smDC. Meanwhile, smDC was differentiated into mature dendritic cell (mDC) or immature dendritic cell (iDC) by treatment with 1 micro/m1 lipopolysaccharide (LPS) or without LPS. The morphological features of smDC were assayed by inverted microscopy and scanning electron microscopy. Surface markers such as CD11c, CD4O, CD8O, CD86, and MHC-II were tested by flow cytometry. IL-1beta, IL-6, IL-12, and IL-10 in the supernatant were tested by ELISA. The activation of allogene lymphocyte (BALB/c mice) stimulated by C57BL/6 myeloid smDC in mixed lymphocyte reaction was examined by Cell Counting Kit-8 in vitro.

RESULTSThe shape of smDC was round or oval-shaped, and the diameter of smDC was about 15 microm. The length of smDC dendrite was between 5 to 10 microm. smDC, iDC, and mDC all expressed high level of CD11 c. The expressions of MHC-II, CD40, CD80, and CD86 on smDC were higher than those of iDC and lower than those of mDC. IL-1beta, IL-6, and IL-12 secretion of smDC was significantly lower than that of mDC (P < 0.01), and IL-12 was significantly lower than that of iDC (P < 0.05), while no significant difference of IL-1beta and IL-6 secretion was found between smDC and iDC (P > 0.05). Furthermore, IL-10 secretion was not significantly different among these three kinds of DCs (P > 0.05). The effect of allogene lymphocytes activation on smDC was significantly lower than that of mDC and positive control (P < 0.01), but had no significant difference when compared with that of iDC and negative control (P > 0.05).

CONCLUSIONSsmDC may be a relatively independent dendritic cell sub-population in terms of function and morphology. It is a feasible way to induce myeloid monocytes to differentiate into smDC using GM-CSF, IL-4, and TNF-alpha in vitro.

Animals ; Cell Culture Techniques ; Cell Differentiation ; Cells, Cultured ; Cytokines ; immunology ; Dendritic Cells ; cytology ; immunology ; Male ; Mice ; Mice, Inbred BALB C ; Mice, Inbred C57BL ; Monocytes ; cytology ; immunology

AIMTo study the pharmacokinetics of genistein in Beagle dogs.

METHODSGenistein, suspended in 0.5% CMC-Na solution, was orally administered to Beagle dogs at the dose of 5.34 mg.kg-1. At various time intervals, 1.5 mL of blood was drawn from the vein of dogs in their front legs. At the same time, urine and feces were collected. After the collection, the feces were homogenized with physiological saline (to 1 g feces, 10 mL physiological saline were added). The genistein in plasma, urine and homogenized feces was extracted twice by vortexing with 2.0 mL mixture of methyl tert-butyl ether and pentane (8:2). The organic phase was transferred into tubes and evaporated in ventilation cabinet. The residue was dissolved in 50 microL of methanol and 20 microL of the solution was drawn and detected by high-performance liquid chromatography. The pharmacokinetic parameter was calculated by 3P97 software.

RESULTSThe plasma concentration-time curve was fitted to a one-open-compartment model. The peak time was 0.29 h, and the elimination half-life was 0.52 h. After genistein was administered, 10.79% of genistein were excreted from urine and 21.55% from feces within 24 h. It was also found that 13.00% genistein were excreted from urine and 52.46% from feces within 60 h.

CONCLUSIONIt showed that the speed of absorption and elimination of genistein was high in Beagle dog, and genistein was mainly excreted in the form of parent compound in urine and feces.

Animals ; Anticarcinogenic Agents ; blood ; pharmacokinetics ; urine ; Area Under Curve ; Chromatography, High Pressure Liquid ; Dogs ; Feces ; chemistry ; Genistein ; blood ; pharmacokinetics ; urine

OBJECTIVETo investigate the operative method and effect of the reversed sural neurocutaneous flap in repairing soft tissue defects of the anterior foot and the ankle.

METHODSFrom March 1999 to November 2004, 19 cases (17 male, 2 female) of soft tissue defects of the anterior foot and the ankle were repaired with the reversed sural neurocutaneous flaps. The flap sizes range from 18 cm x 9 cm to 30 cm x 18 cm.

RESULTSAll flaps survived well, while 1 flap had distal partial necrosis and healed after dressing change. The follow-up from 6 months to 2 years showed that all flaps were satisfactory.

CONCLUSIONSural neurocutaneous flap is easy to get and to survive. It is an effective method to repair the soft tissue defects of the anterior foot and the ankle.

Adolescent ; Adult ; Ankle ; blood supply ; surgery ; Female ; Foot ; blood supply ; surgery ; Humans ; Male ; Middle Aged ; Reconstructive Surgical Procedures ; Soft Tissue Injuries ; surgery ; Surgical Flaps

OBJECTIVETo observe the incidence, causes and deviation angle of axial offset in patients with fracture ununited treated by Ilizarov bone transport technology.

METHODSFrom January 2007 to December 2012, 10 patients with fracture ununited were treated by Ilizarov bone transport including 8 males and 2 females with an average age of (30.3 ± 10.6) years old ranging from 18 to 49 years old. The segment of bone defect involved upper tibial in 2 cases, medial tibia in 2 cases, lower tibial in 5 cases, upper femoral in 1 case. For Paley type of bone defect, 6 cases were type B1, 4 cases were B3. The incidence and deviation angle of axial offset after Ilizarov bone transport technology were observed and evaluated on bone result by Paley assessment.

RESULTSAll patients were followed up from 19 to 32 months with an average of (22.0 ± 5.6) months. Three cases were natural healed at fracture ends, the other 7 cases were healed after bone graft. The time of external fixator was 16 to 28 months. At the last follow-up, there were 3 cases occurred coronal angulation of angle 5° to 11° with an average of (8.7 ± 3.2). Sagittal angulation was in 4 cases, angle 6° to 9° with an average of (8.5 ± 2.1)°. There were 4 cases occurred axial offset. In the last follow-up, according to Paley evaluation criteria, osseous results were excellent in 7 cases, good in 3 cases; functional results were excellent in 6 cases, good in 4 cases.

CONCLUSIONAxial deviation after the Ilizarov bone transport treatment is relatively common, which will result in delayed healing of bone and poor limb alignment. In order to improve the bone healing, corresponding measurements should be taken to avoid or reduce the incidence of axial deviation during and after the operation.

Adolescent ; Adult ; Female ; Fracture Healing ; Fractures, Ununited ; surgery ; Humans ; Ilizarov Technique ; adverse effects ; Male ; Middle Aged

Objective To investigate the long-term follow-up results of patients treated with radical nephrectomy for small renal carcinoma.Methods Between January 1992 and June 2004,a total of 56 pa- tients(41 men and 15 women;mean age,54 years;age range,19-71 years)underwent radical nephrectomy for small renal carcinoma.The clinical data and long-term follow-up results of the 56 cases were analyzed ret- rospectively.All the patients were followed by questionnaire;and the 5-and 10-year survival rates were calcu- lated by Kaplan-Meier method.Results None of the patients was found to have metastasis preoperatively. Postoperative pathology showed renal clear cell carcinoma in 44 cases,granular cell carcinoma in 7,and mixed cell carcinoma in 5.Among these cases,ipsilateral adrenal metastasis was found in 1 case,local lymph- aden metastasis in 2,and perirenal fat metastasis in 4.Postoperatively,49 of the 56 patients(87.5%)were followed for 11-155 months with a mean of 71 months.The 5-and 10-year survival rates were 81.7% and 66.9%,respectively.Five patients died of metastasis from renal carcinoma.Conclusions Radical ne- phrectomy for small renal carcinoma has favorable long-term effects,therefore it is an optimal surgical proce- dure for small renal carcinoma.

BACKGROUNDThe key components of metabolic syndrome (MS) are waist circumference, blood pressure, fast blood glucose, high density lipoprotein cholesterol (HDL-c) and triglycerides (TG). These components have, separately and jointly, been associated with an increased risk of cardiovascular diseases. In this study, we aimed to explore the association between MS components and cancer risk in a population-based cohort in China.

METHODSWe established a population-based cohort with 17 779 individuals aged 35 and above at baseline in 2004 and 2005 in Changzhou, Jiangsu Province, China. All participants were face-to-face interviewed to complete a questionnaire and were accepted physical examinations including blood tests for glucose and lipids and physical measurements for obesity and blood pressure. In 2009, a total of 16 284 subjects (6886 men and 9398 women, 91.6%) attended the flow-up interviews and the participants or their family members reported all the hospitalizations and diseases including cancer occurred during the follow-up period. Multivariate Cox regression was used to estimate the hazard ratios (HRs) of metabolic syndrome components and cancer incidence.

RESULTSThere was a dose-response association between cancer risk and the number of MS components presented at baseline (P for trend = 0.012) and the HR (95% confidence interval (CI)) was 2.63 (1.27 - 5.45) for subjects carrying 3 or more metabolic syndrome components after adjustment for possible confounding factors. Specifically, the multivariate-adjusted HRs (95%CIs) for cancer risk in subjects with central obesity, high fasting glucose, low HDL-c were 1.94 (1.01 - 3.74), 2.04 (1.10 - 3.77) and 2.05 (1.09 - 3.88), respectively.

CONCLUSIONSIn this population-based, prospective cohort study in China, we found MS components, e.g., central obesity, high fasting glucose, low HDL-c were risk factors for cancer development. Early intervention of MS components may be also beneficial to reduce cancer burden.

Adult ; Asian Continental Ancestry Group ; Blood Glucose ; physiology ; China ; Female ; Humans ; Male ; Metabolic Syndrome ; epidemiology ; Middle Aged ; Multivariate Analysis ; Neoplasms ; epidemiology ; Prospective Studies ; Triglycerides ; blood ; Waist Circumference ; physiology

OBJECTIVETo investigate the efficacy of conversion from calcineurin-inhibitor (CNI) to rapamycin in liver recipients with CNI-associated renal insufficiency.

METHODSThis retrospective study examined the liver transplant recipients who had switched from CNI to rapamycin between January 2004 and June 2008 in the first affiliated hospital of Sun Yat-sen University. The data of renal function before and after the conversion were analyzed by Wilcoxon sum rank test, and rapamycin-related adverse effects were also observed.

RESULTSCompared with that before conversion, the renal funtion 4 months after the conversion improved significantly (P<0.05). The blood lipid level 3 months after the conversion increased significantly (P<0.05) but were well controlled.

CONCLUSIONRapamycin can be used safely as a good alternative in liver transplant recipients with CNI-related renal insufficiency.

Adult ; Aged ; Calcineurin Inhibitors ; Female ; Humans ; Immunosuppressive Agents ; therapeutic use ; Liver Transplantation ; adverse effects ; Male ; Middle Aged ; Renal Insufficiency ; drug therapy ; etiology ; Retrospective Studies ; Sirolimus ; therapeutic use ; Young Adult