Objective:To investigate and explore the science management mode for high- value medical consumables in order to solve the problem of management deficiency in purchase and using of high-value medical consumables.Methods: To strengthen the management for high value consumables on 5 aspects: systematized institution, normalized processes, standardized operation, scientific evaluation and informationalized management.Results:The normalized, standardized and programmed management mode for high-value medical consumables has been established and improved throughout the whole process monitoring and management of total life cycle for the consumables. This research normalized the management for these consumables and formed a new science management mode.Conclusion: The exploration and implementation of new management method and path for medical high-value consumables can effectively improve the level of hospital material management, reduce management loopholes, decrease the cost of high-value consumables and increase work efficiency.

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Objective Through the determination of the insulin receptor and its signal transducers,we tried to find the defects in the common pathway of insulin signal transduction in type 2 DM and to lay a foundation to discover the pathogenesis and effective drugs.Methods Using 32 P-labeling method to determine the activity of TPK and MAPK.Using Fluo 3-AM as fluorescent probe to determine intracellular calcium of patients with type 2 DM.Using photometry to determine the concentration of NO.Results The activities of TPK,MAPK remarkably descended and the concentration of NO also greatly descended compared with healthy people.The concentration of intracellular calcium increased compared with healthy people.Conclusion The defects of the related signal molecule in insulin signal transduction of type 2 DM existed.

Objective To evaluate the effects of hemodialysis in aged patients with chronic renal failure,decrease complications,to improve their survival rate.Methods The clinical datas of aged patients suffering from CRF who received maintenance hemodialysis were summarized and analyzed about the survival,the cause of death and common complications.Results The commonest causes of death in aged patients with maintenance hemodialysis were cardiovascular events,infection and malnutrition.The common complications were cardiac insufficiency,infection.Conclusion Providing individual enough HD and treatment,improving nutritional situation,anemia and controlling infection may contribute to the reduction of the complications and the increasing of survival rate.

Objective To explore the causes of bile duct injury during laparoscopic cholecystectomy and its treatment.Methods From January 1998 to February 2007,totally 8600 cases of LC were performed in our hospital.Bile duct injury occurred in 36 of them,among which,the common hepatic duct was cut in 20 cases,the common bile duct was severed in 4 patients,the common hepatic duct was cut and freed in 4;incomplete clipping of the common hepatic duct or common bile duct occurred in 3 and 1 cases respectively;3 cases had injury to the conjunction of the cystic duct and common hepatic duct;electrical burn injury happened in 1 patient.Thirty one of the injured cases were detected during the laparoscopic surgery,while the other five were found because of jaundice or biliary leakage.The patients received bile duct repair and T tube drainage(24),T tube drainage(4),Roux-en-Y bowel biliary anastomosis(4),bile duct anastomosis(1),or removal of the titanium clips after the accidents.Results One of the patients who received bile duct anastomosis developed biliary stenosis after the T tube was withdrawn in 2 months after the surgery,Roux-en-Y bowel biliary anastomosis was thus performed 3 months later.Two patients who underwent Roux-en-Y anastomosis developed anastomotic stenosis after the operation,and thus received a second anastomosis in 11 months.These 3 patients who received totally 3 operations,were followed up for 2 to 3 years,none of them developed cholangitis or biliary stones.One patient in this series had refractory cholangitis,jaundice,and liver function impairment,and was cured after 1-year anti-inflammation and liver support therapy.In the other 32 patients,an 8-to 36-month follow-up(mean,16 months) was achieved,during which none of them showed any complications.Conclusions Bile duct injury can be due to lacking experience and knowledge of the complications of laparoscopic cholecystectomy,inappropriate enrollment of the patients,inaccurate operation,misuse of the surgical instruments,or being unable to discern the Calot's triangle.Strict indications for the operation,advanced training for young doctors,and appropriate timing for conversion to an open surgery are necessary to decrease the rate of bile duct injury.

Objective To assess the respective value and limitation of cardioangiography and ultrasonography in interventional therapy for congenital heart disease in children,and to discuss the clinical significance of the combined use of both examinations. Methods A total of 162 children with congenital heart disease,screened by ultrasonography,were enrolled in this study.The disorders included VSD(n=50),PDA(n=96)and PS(n=16).Before the interventional therapy all the cases accepted cardioangiography and ultrasonography examinations,and the diameter of the abnormal passage was measured.The difference in the diameter between two examinations was compared and statistically analyzed by using paired t test.All the cases accepted both examinations after the interventional therapy to check the location of the occluder and the result of balloon dilatation.Results Both cardiovascular angiography and ultrasonography could make a definite diagnosis of congenital bean disease in children,and could well display the location and shape of the abnormalities.The diameter of VSD(n=50)measured by cardioangiography and ultrasonography was(4.93±2.73)mm and(5.66±2.77)mm respectively,with no significant statistical difference existing between two methods(P＞0.05).The diameter at the narrowest site of PDA(n=96)measured by cardioangiography and ultrasonography was(3.22±1.45)mm and(3.96±1.42)mm respectively,with a significant difference existing between two methods(P＜0.05).In 16 PS cases,the diameter of valvular ring determined on cardioangiogram and on ultrasonogram wag(16.16±4.26)mm and(17.94±5.50)mm respectively,with no significant difference between two groups(P＞0.05).During the operation of VSD,the monitoring ultrasonography revealed that the valvular opening and closing was interfered by the occluder in 9 cases,so the occluder was re-adjusted till it was fixed to proper position. After the interventional therapy for VSD and PDA,cardioangiography detected a small residual shunt in 7 cases,which completely disappeared 24 hours later on ultrasonography.After balloon dilation in all 16 children with PS the right ventricle-pulmonary artery pressure difference was reduced by more than 50%and the pressure figure reached the standard of clinical Cure.The interventional procedure was successfully completed in all patients except for three cases. Conclusion In treating children of congenital heart disease with interventional procedures,the determination of the lesion's diameter and the selection of the occluder should be based on cardioangiographic measurement,although ultrasonography is more helpful in making preoperative screening and postoperative evaluation.

Objective To study the imaging findings, clinical and pathological characteristics of langerhans cell histiocytosis(LCH)in limbs of children, and to improve the imaging diagnostic accuracy of LCH . Methods Imaging findings and clinical data of 12 patients with limbs LCH were analyzed retrospectively. X-ray examination was performed in 10 cases, while 9 cases underwent CT and 7 cases underwent MRI examination. All imaging findings were analyzed. Results Seven lesions were solitary, including 4 lesions in the tibia, 2 in the radius and 1in the ulna. Five cases had limbs lesion in multiple sites, which included 12 bone lesions in total, with 6 lesions in the femur, 3 in the humerus (1 case involved the epiphysis), 2 in the tibia and 1in the radius. The X-ray or CT images of the lesions showed osteolytic destruction and swelling of the bone, which was commonly associated with the reaction of periosteum. Eleven cases were with peripheral soft tissue swelling, and one case had soft tissue mass. The lesions showed low signal on T1WI and high signal or mixed signal on T2WI. Six cases were diagnosed as LCH at the first time and the other 6 cases were diagnosed as infectious lesions. Twelve cases were regularly followed up after the treatment, and the prognosis of the patients with single lesion was better. Conclusions LCH of limbs usually involves diaphyseal and metaphyseal bone. The imaging features include osteolytic destruction and swelling of the bone, with peripheral soft tissue swelling or mass of the soft tissue. Although LCH of limbs has some specific imaging features, it is difficult to differentiate it from malignant bone tumors. Multi-imaging modalities such as radiography, CT and MRI imaging may suggest the diagnosis and provide important information for evaluating prognosis.

Objective: To establish capillary zone electrophoresis method for determination of sildenafil citrate (Viagra) content in its troche. Methods： Using tetrandrine as internal standard(IS), the electrophoretic separation was achieved with 25 mmol/L borate (pH=7.89) running buffer. And a voltage of 14 kV was applied to the 40 cm×75 μm(i.d) capillary. The analytes were introduced into capillary by siphon (1 s) and determined with on-column monitoring at 214 nm. Results：The determination could be completed within 4 min and the minimum concentration of detection was 5 μg/ml.The analytical results of sildenafil citrate samples demonstrated a good linear relationship within the range of 24-480 μg/ml.The relative standard deviations (RSD) of intra-day was less than 1.58% and that of inter-day was less than 2.46%.The present recoveries were between 95%-105％. Conclusion：The CZE method is accurate, simple, rapid and reliable, so it can be applied to the determination of sildenafil citrate content.

A simple, fast flow injection chemiluminescence (CL) method for the determination of methyl-parathion has been developed. It is based on the reaction of methyl parathion with luminol-H2O2 in the alkaline medium (pH：11.5～12.0), sensitized by water-soluble macromolecule Polyethylene glycol 400. Under the optimal conditions, the CL intensity was linear to the concentration in the range of 5.0×10-8～1.0×10-5　g/mL (r=0.9996), with a detection limit (3σ) of 2.0×10-8　g/mL. Relative standard deviation was less than 4% (n=11) and the recovery was between 82%～93%. This method has been successfully applied to the determination of trace residue of methyl-parathion in grain sample.

Objective To study and compare the protective effects of pmtease inhibitor and corticosteroid on endotoxin-indueed acute lung injury in order to guide the choice of appropriate drugs. Method Thirty-two New Zealand rabbits were randomly divided(random number) into four groups with 8 rabbits in each, namely normal controls(C) ; lipopolysaecharide(LPS) group(L) ; ulinastatin(UTI) group(U) and dexamcthasone(DEX) group (D) .Except group C, all rabbits were injected with a dose of LPS 600 μg/kg iv. Meanwhile the rabbits in group U,group D received UTI(100 000 μ/kg), DEX(5 mg/kg), respectively. The specimens were collected 4 hours later for detecting the levels of TNF-α and NO in serum, and blood gas analysis, histological manifestations, the lung wet/dry weight ratio, lung tissue MPO and SOD activity, lung tissue MDA. Data were analyzed by ANOVA (SNK- q test), and P < 0.05 was considered as significantly different. Results Compared with group C, the lungs of the rabbits in group L had inflammatory granulocyte infdtration, diffused alveolar septum thickening and hemorrhagic spots were observed in pathological examinations. The histological changes of group U and group D were much lessened than those in group L. As groups U and D were compared with group L, there were significant differences inmany biomarkers including lung wet/dry weight ratio[(5.02±0.11),(4.93±0.13) vs.(5.37 ±0.29)],lung tissue MPO activity[(0.51 ± 0.05),(0.54±0.07) vs.(0.82 ± 0.09)] and MDA[(0.82 ±0.05),(0.81 ±0.04) vs.(0.96±0.05)], NO[(296.2± 11.7),(291.7 ± 15.8) vs.(351.8±19.6)] and TNF-α[group D(2.021 ± 0.122) vs. group L(4.999 ± 0.139)],lung tissue SOD activity[(120.3 ± 6.1),(122.6±3.5) vs.(105.1 ± 8.5)] and blood gas analysis[pH(7.30±0.23),(7.30±0.17) vs.(7.22±0.45) and PaO_2( 101.9 ± 6.8).( 102.5 ± 4.7) vs.(80.3 ± 3.3)] ; but there were no differences of above mentioned biomarkers between group U and D( P > 0.05). And there were no significant differences in PaCO_2 betweeu group U and D and group L[(37.0 ± 3.3),(37.6 ± 3.0) vs.(34.8 ± 2.3)]( P > 0.05). Conclusions The protective effects of ulinastatin on endotoxin-induced acute lung injury is comparable to those of dexamethasone, thus the former may be a clinical substitute for the latter with less side effects.