Objective To observe the effect of atmospheric pollution on workers'α1-antitrypsin concentrationb in petrochemical enterprises.Methods During health examination,the workers were indivded into 3 groups according tO the length of job experience.Ⅰ group(<10 years)included 291 cases,aged 22-35 years old,Ⅱ group(10-20 years)included 634 cases,aged 33-45 years old,and Ⅲgroup(>20 years)included 427 cases,aged 44-55 years old.The normal control were individed int different group according to the status of petrochemical workers.,all the serum samples were detected on automatic biochemical analyzer,α1-antitrypsin levels were analyzed between the different groups.Results In group Ⅰ,the α1-AT concentration was 2.58±0.38 g/L(P>0.05)without significant difference compared with control.In group Ⅱ and Ⅲ,the concentration α1-AT were 2.02±0.43 g/L and 1.72±0.41 g/L respectively with significant differences compared with control.And the significant difference existed among the three groups of petrochemical workers..But the sigficant difference did not exist between different group of control people.Conclusion During the process of oil refining,the plants exhausted the polluted gas of nitrogen dioxide,olefins,alkanes,alcohols,carbonyl and other harmful substances,it influenced theα-AT levels of body.It is a good suggestion to decreas the petrochemical pollution,and to monitor the serum concentration of α-AT content among petrochemical workers,it might to reduce the incidence of lung disease of great significance.

One of the most problems is the diagnosis of the borderline lesion and/or borderline tumor to pathologists. It is necessary to make the correct diagnosis of the gastrointestinal borderline lesion and/or borderline tumor and correlative lesion such as gastrointestinal stromal tumors, gastrointestinal lymphoid proliferation and MALT lymphoma, IPSID, gastrointestinal adenoma and appendix carcinoid.[

As China witnesses constant development of its market economy and gradual deepening of reform in its medical and health cause,the ability of domestic hospitals to adjust their operational management strategies in due course is crucially related to their survival and development amidst market competition.Hospital managers,while stressing quality and economic control,should attach special importance to the brand effect of their hospital and step up hospital brand building,the focus of which lies in patient satisfaction and loyalty and hospital popularity and reputation.Only in this way can they constantly create advantages,enhance core competitiveness and put their hospital in an invincible position amidst market competition.

The Eleventh Five-year Program period will be a very important period in the historical development of China;it will also be a key period for domestic hospitals to deepen reform and achieve steady growth.Doing a good job of the five years' work will be of great significance to promoting reform of the medical and health system,strengthening and developing the hard-won good situation,speeding up hospital construction and growth,and solving such problems facing the common citizens as "it is difficult and expensive to see a doctor".The authors offer suggestions and hope to arouse discussions as to how hospitals ought to formulate a Eleventh Five-year Program that will meet their own growth needs with the guidance of a scientific approach to development.

Adult ; Cell Separation ; methods ; Endothelial Cells ; cytology ; Humans ; Stem Cells ; cytology

Objective: To evaluate the effects of percutaneous balloon pulmonary valvuloplasty ( PBPV) for pulmonary valve stenosis (PS) by single-balloon, double-balloon and Inoue-balloon methods. Methods: PBPV was performed in 42 patients with PS. The systolic right ventricular pressure (SRVP) , systolic right ventricular outflow pressure and systolic pulmonary arterial pressure ( SPAP) were contrasted before and after the procedure. Systolic transpulmonary valve pressure gradient (TVPG) and total pressure gradient from right ventricular to pulmonary arterial after the procedure were compared among the three gropes. Results:SRVP, SRVOP were decreased from (14. 69?6. 01 )kPa, (12. 16?3. 48)kPa to (8.14?5.26)kPa, (5.39?2.21)kPa and PAP increased from (1.57?0.56)cm to (17. 16? 2.16)cm after PBPV, respectively. TVPGs were (2. 40?2. 05) kPa, (3. 29?2. 25 ) kPa, (2.52? 1.95)kPa and TPGs were (2. 40?2. 05)kPa, (4.98?4.26)kPa, (6.16?6.93)kPa, (5.65?4.75) kPa after PBPV by single balloon, double balloon and Inoue balloon methods, respectively. During the follow-up period (2. 5?1. 6) years, bloodflow velocity at pulmonary valve measured by supersonic Doppler decreased from (2. 38?1. 89) m/s immediately after PBPV to (2.22?1. 96) m/s, further TVPG decreasing was indicated. Conclusion: The short and long term results of PBPV for PS by each of the three methods were excellent. Inoue balloon may be the first choice for elder children and adults, while for younger children, single balloon method may be preferred. Double balloon method can be remained as the second choice when Inoue method failed.

Objective To analyze the effects of different age and gender on the efficacy and pharmacokinetics of the target controlled infusion of atracurium besylate on liver dysfunction.Methods 160 case of patients with liver dysfunction and undergoing elective general anesthesia operation were divided into four groups according to their age and gender, 40 cases in each group:group A (age≥65 years old, male), group B (age≥65 years old, female), group C (age<65 years old, male), group D (age<65 years old, female).The patients received one-time double dose ED95 atracurium besylate, pharmacodynamic indexes and pharmacokinetic parameters were compared.Results The four groups of patients with block onset time, block maintenance time, clinical duration of T25%, in vivo role time T95%, muscle relaxation recovery index were compared, the difference was not statistically significant.The preoperative and postoperative 24h, four groups of patients with liver function ( alanine aminotransferase, aspartate aminotransferase, albumin, bilirubin) and renal function ( creatinine, urea nitrogen) were compared, the difference was not statistically significant.There was no significant difference between the four groups in the plasma concentrations of the substance to be measured, the peak time, the area under the curve and the elimination half lives.Conclusion For the patients with liver dysfunction, the target controlled infusion of atracurium besylate in general anesthesia operation, gender and age were not considered.

Objective To evaluate characteristic clinical and imaging findings of pancreatic neuroendocrine tumors (NET) in dual-phase contrast enhancement MSCT.Methods The dual-phase contrast enhancement MSCT images of 23 lesions in 20 patients with histologically confirmed pancreatic NET were studied retrospectively.Their clinical presentations,imaging characters as well as the intensities of lesions and normal pancreas in each phase were measured,and the following indices were calculated.First,the absolute enhancement of lesions,including the increasing of CT value of the maximum enhancement area within a tumor in arterial phase,that was named A1 in short,and that of the minimum enhancement area was labeled as A2.The same ROI measured increasing CT values in portal venous phase was labeled as V1 and V2 respectively.Secondly,the relatively enhancement indices comparing with the normal pancreas in the same patient within the same phase were calculated.This included the differences between the maximum,as well as the minimum,enhancement areas of tumors and the normal pancreas in arterial phase,which was named as AP1 and AP2 respectively,and those differences in portal venous phase,which were labeled as VP1 and VP2 respectively.All of the tumors were graded as G1 to G3 according to the WHO classification in 2010.A Kruskal Wallis test were performed to compare differences of tumor diameters and the enhancement indices.The change trend of enhancement indices varying with pathology grading were described.Fisher exact test was used to find differences of clinical and imaging characters.Results Twenty-three lesions in 20 patients included 13 lesions in grade 1 (G1),8 in G2,and 2 in G3.Among the 10 patients with G1 NET,7 of them had no endocrine symptoms,while the other 3 had endocrine symptoms.Six of them had no abdominal pain,while 4 of them complained of it.All of the 10 patients with G1 NET had no hepatic metastasis.Among 8 patients with G2 NET,4 of them were with endocrine abnormality,and the other 4 were not.Five of them complained of abdominal pain while the other 3 did not.Six of them had no hepatic metastasis,and 2 of them had.Both of the 2 patients with NET in G3 did not have any endocrine abnormality,and one of them complained abdominal pain.Both of them were with hepatic metastasis.There was no difference between groups that whether or not endocrine syndrome and abdominal pain was presented (x2 =2.238,0.713,P =0.318,1.000),while hepatic metastasis was of significant differences (x2 =9.516,P =0.003).Tumor location,distinct outline,necrosis and/or calcification were not significantly different.Tumor enhancement showed a probable trend of decrease in group of higher grade.A1 decreased from (126.4 ± 45.7)HU to (38.7± 8.5)HU (x2 =7.254,P=0.027),A2 decreased from (94.1 ±31.1)HU to (22.8 ± 14.0) HU (x2 =7.323,P =0.026) and AP1 dropped from 80.6 HU(-21.8 — 169.7 HU) to -36.7 HU(-41.6—-31.7 HU) (x2 =6.778,P =0.034).All of the indices mentioned above were of significant difference and the other indices showed no significant difference (P ＞ 0.05).Conclusions Quantitative assessment of their enhancement patterns may provide useful information to preoperative grading of pancreatic NET,and tumors in a higher grade may show poorer enhancement.

Objective To evaluate the efficacy of midazolam combined with remifentanil for lower eyelid blephamoplasty.Methods In a double-blind study,200 patients undergoing lower eyelid blephamoplasty were randomly and equally divided into 2 groups (100 cases each):test group (midazolam 0.05 mg/kg and remifentanil 0.5 μg/kg followed by remifentanil 0.05 μg/(kg·min) and control group (midazolam 0.05 mg/kg).Heart rate (HR),mean arterial pressure (MAP),and pulse oxygen saturation (SpO2),respiratory rate (RR),SpO2 change,operation time,recovery time,the incidence of adverse reactions and the satisfactory rate of both patients and surgeons were monitored and recorded before the medication,3 min after the medication,at beginning of the surgery,during and immediately after the surgery,and 30 min after surgery.Results Two groups of patients had no obvious difference in intraoperative MAP,HR,RR,SpO2 and postoperative recovery time (P＞0.05);the incidence of postoperative nausea and vomiting in the test group was significantly higher than that in control group (P＜0.05); Patients and surgeons satisfaction in the test group was higher than that in control group (91.3±11.6)vs (52.7±10.4) (P＜0.05).Conclusions Midazolam combined with remifentanil for lower eyelid blephamoplasty has less inhibitory effect on circulatory and respiratory functions and the patients come round fast after surgery.But there are risks of respiratory inhibition in the induce phase and nausea and vomiting in the recovery stage.

Objective To explore the MRI appearances of heterotopic gray matter. Methods The appearances of MRI of heterotopic gray matter(n=12) confirmed were analyzed retrospectively. Results In the 12 cases,3 lesions were nodular,9 lesions were lamellar. MRI can clearly show the lesions. On T1-WIs and T2-WIs,these lesions appeared isointense to the normal gray matter. 2 lesions associated with arachnoid cyst,2 lesions with schizencephaly and 1 lesion with dysgenesis of the corpus callosum and lipoma of midline. During contrast on MRI(n=5) ,all lesions show unenhancement. Conclusion The MRI have characteristics in diagnosis of heterotopic gray matter and is the best method.