Objective To establish a safety culture evaluation model to conduct empirical research with regard to the assessment of both the radiation safety culture and management at different levels of health institutions.Methods Delphi method is used to develop a model to define the effectiveness and operational practice of safety culture system in hospitals.Results The research had achieved good reliability assessment,with Cronbach coefficient α of all indicators higher than 0.60.There were 16 hospitals with scores less than 75 (61.54％),at the primary stage of radiation safety culture,and 9 hospitals among 75-95 (34.62％),at the middle stage,only 1 hospital with score of 95.48 (3.85％),at the high grade stage.Conclusions At present,the level of radiation safety culture in medical institutions is lower as a whole.The evaluation model established in the present research is practicable to some extent and can provide reference for strengthening radiation safety management.

Objective To evaluate the effects of a single IV lidocaine bolus dose on the minimal alveolar concentration (MAC)of sevoflurane. Methods Patients (n=90), aged 25-65 years whose Anesthesiologists (ASA) classification wasⅠorⅡand underwent elective surgery on trunk under general anesthesia, were randomly divided into 3 groups with 30 cases in each group:high-dose lidocaine group (group H), low-dose lidocaine group (group L) and control group (group C). They were induced by sevoflurane inhalation, and ventilated by LMA (laryngeal mask airway). After a 15 minutes equilibration period with the above sevoflurane concentration , the medication to be studied (2%lidocaine 1.5 mg/kg for group H , 2%lidocaine 0.75 mg/kg for group L, 0.9%saline 5mL for group C) was administered for 3 minutes before the skin incision. The response to skin incision (movement versus no movement) was recorded in the first minute after skin incision. The MAC for sevoflu?rane was determined using the Dixon′s up and down method. Values of mean arterial pressure (MAP), heart rate (HR), and BIS were recorded at 1 minute and 5 minutes after being monitored (average values were noted as T0), immediately before the administration of medication (T1), immediately before the skin incision (T2) and 1 minute after the skin incision(T3). Results MAC in group H (2.00%± 0.17%) was lower than that in group C (2.22%± 0.18%) by approximately 0.22%,and which was lower than that of group L ( 2.21%± 0.14%) by approximately 0.21%(F=7.054,P<0.05). No significant differ?ence in the MAC of sevoflurane was noted between group L and group C. The values of HR, MAP and BIS all decreased at T 2 and increased at T3 in all 3 groups (all P<0.05). No significant difference in HR, MAP or BIS was observed between T0 and T1 in all three groups. The values of HR and BIS were lower in group H than those in group C and group L at T2 and T3. The values of MAP were lower in group L and group H than those in group C at T2 and T3. The value of MAP were lower in group H than that in group L at T2(all P<0.05). Conclusion A singleⅣ1.5 mg/kg lidocaine decreases MAC of sevoflurane, but the decreased amplitude (11%) does not reach expectation.

Objective To explore the expression of mismatch repair gene (MMR) (MLH1,MSH2,PMS2 and MSH6) in endometrioid adenocarcinoma,and to analyze its clinical pathological significance.Methods Inmunohistochemical EnVision method was used to detect the expressions of DNA mismatch repair proteins (MLH1,MSH2,PMS2 and MSH6) in 101 cases of endometrial adenocarcinoma.The phenotypes of tumor microsatellite instability (MSI) and microsatellite stable were determined,and its relationship with onset age,differentiation,depth of myometrial invasion,lymphatic metastasis and prognosis of tumor were analyzed.Results There were 67 cases of hysterectomy and 34 cases of endometrial biopsy in 101 cases of endometrial adenocarcinoma.52 cases of surgical specimens and 14 cases of biopsy specimens were included in 66 cases that had complete follow-up data.Rates of negative expression were as follows:MLH1 31.6 ％ (32/101),MSH228.7 ％ (29/101),PMS2 16.8 ％ (17/101),MSH6 8.9 ％ (9/101).MSI phenotype 53.5 ％ (54/101),MSS phenotype 46.5 ％ (47/101).Univariate analysis showed that prognoses of MSI-L&MSS group (34 cases) were better than those of MSI-H group (18 cases) in hysterectomy organization (P =0.041).The differences between depth of myometrial invasion,degree of differentiation,age and prognosis of endometrial adenocarcinoma were statistically significant (P ＜0.05).Cox multivariate analysis showed that differences between depth of myometrial invasion,age and prognosis of endometrial adenocarcinoma were statistically significant (P =0.034,P =0.009),while there was no significant difference between MSI-L&MSS group and MSI-H group in prognosis (P ＞ 0.05).Conclusions MSI is one of the molecular events that occur in the endometrioid adenocarcinoma.Age and depth of tumor invasion are independent prognostic factors of endometrioid adenocarcinoma.In view of inconsistency between univariate analysis and multivariate analysis,whether MSI can be used as deterministic accordance for endometrioid adenocarcinoma prognostic evaluation requires further verification.

Objective To investigate the relationship between ambulatory arterial stiffness index (AASI) derived from blood pressure monitoring and early signs of renal damage in patients with primary hypertension． Methods 74 primary hypertensive outpatients were divided into two groups according to their AASI values: normal AASI group (AASI≤0.51, n=40) and high AASI group (AASI>0.51, n=32). The urinary micro-albumin, glomerular filtration rates (GFR) were measured and compared. The relationship between AASI and micro-albumin, GFR were tested with Pearson correlation and multiple Logistic regression. Results Compared with those in the normal AASI group, the patients in high AASI group showed a higher level of urinary microalbumin (P<0.05) and a reduction in GFR (P<0.01). AASI was positively correlated with urinary microalbumin （r=0.32, P<0.001）, and negatively correlated with GFR （r=0.44, P<0.001）. After adjusting the potentially confounding variables, the odd ratio (OR) of AASI to renal damage was 2.18 （P=0.008，95%CI：1.76～4.34）. Conclusion The increase of AASI is associated with early signs of renal damage in patients with primary hypertension.

Objective To observe the clinical efficacy and adverse reactions of high-dose methylprednisolone pulse treatment on peritumoral edema induced by supratentorial brain tumors.Methods Thirty-five patients with supratentorial brain tumors and peritumoral edema were treated with methylprednisolone pulse therapy before surgery and the edema index of every patient was calculated by MRI examinations before and after methylprednisolone treatment.Results After methylprednisolone pulse therapy, the edema indexes of the light, medium and severe edema patients reduced by 1.79%, 8.81% and 12.02% respectively. The edema indexes of the medium and serious patients were significantly lower than that before treatment ( P<0.01). But the edema index of the light edema patients was not significantly different with that before treatment ( P>0.05).Conclusion High-dose methylprednisolone pulse therapy has an obvious effect on medium and serious peritumoral edema induced by supratentorial brain tumors and has no serious adverse reactions.

Cell Line, Tumor ; Humans ; Matrix Metalloproteinase 2 ; analysis ; Matrix Metalloproteinase 9 ; analysis ; Melanoma ; enzymology ; Skin Neoplasms ; enzymology

Objective To explore the clinical efficacy of reduced glutathione in the treatment of druginduced liver injury of elder.Methods Seventy-two cases of diagnosed drug-induced liver injury were randomly divided into regular treatment group (n =34) and reduced glutathione treatment group (n =38).Both groups were given conventional liver protection therapy including energy mixture,diammonium glycyrrhizinate and potassium magnesium aspartate.Patients with the reduced glutathione treatment group were additionally treated with reduced glutathione 1.8 g,iv for 4 weeks.Results The total effective rate were 84.2％ for reduced glutathione treatment group and 61.8％ for regular treatment group.There was significant difference between two groups (x2 =4.6541,P ＜ 0.05).Conclusion Reduced glutathione can significantly improve drug-induced liver injury of the elder.

Objective To investigate the clinical efficacy and safety of 5-aminolaevulinic acid-photodynamic therapy(ALA-PDT) in treatment of anorectal condyloma acuminatum.Methods 95 cases who suffered from male multiple condyloma acuminatum were randomly divided into two groups.There were 50 cases in the treatment group and 45 cases in the control group.There were no statistically significant between two groups in age,sex,course of disease,skin lesions,the size and the distribution.The treatment group was treated by photodynamic therapy combined with recombinant human interferon α-2b Gel while the control group was treated only by photodynamic therapy.The treatment time lasted 7-10 days later if the Lesion was not completely removed.Totally,1-4 treatment sessions were given.Then the rate of recovery and recurernce of the two groups were compared.Results The recovery rate in treatment group was 94.0％ (47/50) and 88.9％ (40/45) were found in control group.There were no significant difference in the two groups (x2 =0.290,P ＞ 0.05) ;The recurernce rate of the treatment group was 2.0％ (1/50) and the control group was 13.3％ (6/45),the two groups had significant differences (x2 =4.457,P =0.035).Conclusion ALA-PDT combined with recombinant human interferon α-2b Gel in the topical treatment of anorectal condyloma acuminatum is safe and effective,whcih may serve a therapeutic option for anorectal condyloma acuminatum.

Objective To prepare recombinant human bone morphogenetic protein-2(rhBMP-2)loaded chitosan nanospheres and to evaluate their ectopic bone formation activity in vivo. Methods The rhBMP-2 loaded chitosan nanospheres were prepaid using the ionic crosslinking method with TPP as a crosslinking agent.The morphological properties and particle size distribution were evaluated by transmission electron microcopy(TEM) and particle size analyzer.An intramuscular ectopic bone formation test was carried out to compare the ectopic bone formation activity in 24 SD rabbits that were randomized into 4 even groups.rhBMP-2 loaded chitosan nanospheres (1 mg),rhBMP-2 (1 mg),chitosan nanospheres and nothing were implanted into the muscle pouch at the left thigh,respectively,in groups A,B,C and D. Results The rhBMP-2 loaded chitosan nanospheres were well distributed and spherical in shape.The average particle diameter was 230.0 nm,the entrapment efficiency was 66.87％ ± 4.58％,and the loading rate was 33.44 ± 2.29 μg/mg.The mean ALP activity was respectively 1.94 ± 0.35 kat/g,1.48 ± 0.56 kat/g,0.20 ±0.07 kat/g and 0.18 ±0.06 kat/g in groups A,B,C and D,with a significant difference between the 4 groups( F =42.959,P =0.000).The mean Ca2 + content was respectively 5.20 ± 1.42 μg/mg,3.80 ± 1.40 μg/mg,0.19 ± 0.08 μg/mgand 0.20 ± 0.08 μg/mg in groups A,B,C and D,with a significant difference between the 4 groups ( F =39.242,P =0.000).Groups A and B were obviously higher than groups C and D and group A was obviously higher than group B in terms of ALP activity and Ca2+ content. Conclusion The rhBMP-2 loaded chitosan nanospheres prepared by ionic crosslinking method show a good property and obvious ectopic bone formation activity.

An 18-year-old woman was admitted to the hospital for swelling of the right lower limb and vulva with milky-white vesicles for 3 years.Skin examination revealed swollen and enlarged right lower limb and labium,numerous clustered or scattered pinhead-to millet-sized whitish thick-walled vesicles over the right labium majus,bilateral labium minus,vaginal orifice,and right thigh,with milky-white chylous fluid draining from the vagina.Magnetic resonance imaging revealed obvious lymphangiectasia in the lower abdominal cavity and right side of the pelvis,dilation and distortion of lymphatic vessels in the skin and subcutaneous tissue of the right inner thigh,the vaginal wall and at the medial side of the right labium majus,but no abnormality in the uterus.Histopathological examination of the milky-white vesicles showed cystic dilation of lymphatic vessels in the superficial dermis,and fibrous hyperplasia of the middle and lower dermis.A diagnosis of primary chylous reflux syndrome Ⅰ was made.