Objective To explore the necessity of inferior vena cava(IVC) filter implantation during catheter directed thrombolysis (CDT) for acute deep vein thrombosis (DVT). Method Ninety-three patients with acute DVT were reviewed from Nov. 2006 to Dec. 2008. There were 35 men and 58 women, age averaging at (60 ±29) year old, treated with CDT followed by percutaneous transluminal angioplasty ( PTA). The course of DVT was from 5 h ～ 15 d (6. 28 ±7.08) d with 80 left lower limbs and 13 right lower limbs involved. Results There were 30 patients with prior IVC filter implanted compared with 63 patients without filters (67. 7% ,63/93). Among the patients without filter, there were 93. 6% (59/63) left lower limbs. DSA was redone after thrombolysis. Seventy-seven iliacfemoral thrombosis was resolved completely and stenosis or occlusion of the iliac vein were found in 90. 9% (70/77) cases. Endovascular treatment was performed in 57 patients. There was no patients suffering from symptomatic pulmonary embolism (PE). PE was found in 3 cases with a filter and 1 case without filter was suspected of PE on pulmonary CTA after treatment. Conclusion It is not necessary to routinely place an IVC filter during CDT for treating DVT on left lower limb when the thrombosis is not involing the IVC.

Orange peel was used as lowcost adsorbent in binding of Methylene Blue.The effects of equilibrium time,pH,dye concentration have been studied.Carboxyl,amine and phosphonate functional groups were present in the orange peel.The equilibrium time was 1 hour,the maximum adsorption capacities of the orange peel was 370.3?31.0 mg/g at pH 10.The Langmuir and Freundlich isotherms were well fitted in this biosorption system.Results showed relatively higher rate constant and biosorption capacities.These adsorption performance indicate the orange peel as a potentially economical adsorbent for dye removal.

Objective A novel Active Pharmaceutical Ingredient (API) pituitrin efficacy component content analysis method was explored, and the method is conformed to the requirements of the pharmaceutical production enterprise testing standard. Methods The reverse phase high performance liquid chromatography (RP-HPLC) was performed on a Zorbax Eclipse XDB-C18(250mm×4.6mm, 5 μm) (P/N 993967-902/ 5063-6600) Column, the column temperature was 25℃, the wavelength of detector was set at 220 nm, flow rate was 1.2 mL/min, 50% Acetonitrile- 0.13mol/L sodium dihydrogen phosphate aqueous solution was used as mobile phase for gradient elution. 20 μL sample solution was injected in each perform. Results The content of oxytocin and vasopressin as pituitrin efficacy components were analyzed by this method with advantage of simple and easy operation, good reliability and high precision. Different biological extraction technology process A and B was used on pituitrin injection production, the content of medicinal ingredients in the product: oxytocin and vasopressin is slightly different, but concentration level is different, which process B concentration is higher than that of A. Conclusion In this study, an effective determination the levels of oxytocin and vasopressin in pituitrin API method was established for a pharmaceutical production enterprise, can provide API pituitrin purification process control. Relevant technical information can be provided in the above, which worked on the biological API pituitrin research and development.

Objective To explore the strategy of repairing penile defect after necrosis caused by shortwave diathermy.Methods Between January 2004 and June 2012,18 cases with penile defect after necrosis caused by shortwave diathermy were admitted in our hospital.The age of those patients ranged from 18 to 55 years old (mean 34 years old).Among them,15 cases have been married.All patients have the history of penile shortwave diathermy therapy after surgery.After debridement,penile complete defect was found in 6 cases,incomplete defect was found in 10 cases and corpus cavernosum and corpus spongiosum partly defect was found in 2 cases.Under general anesthesia,we applied penis extent in 10 cases with incomplete defect,forearm free flap in 2 cases with penile complete defect,abdominal artery perforators flap in other 4 cases with penile complete defect.In 2 cases with corpus cavernosum and corpus spongiosum partly defect,the scrotal septal skin flap and fascia pedicle flap was used for 1-stage urethral reconstruction and costicartilage was implanted for 2-stage cavernosum reconstruction.Results 18 patients were followed up for 0.5-10.0 years (mean 2.3 years).16 cases with penile complete defect or incomplete defect had normal length after operation,ranged from 6.3 to 9.2cm.During erectile phase,the length of their penis ranged from 8.7 to 11.5 cm.No feeling abnormality or erectile dysfunction was complained.All patients exhibited the excellent morphology and felling of penis with minor scar in donor site.Early (half a month) complications included distant flap necrosis in 1 case and disruption of the wound in 1 case,which were cured after debridement and conventional treatment.After one year,we did not see the flap atrophy.One case had tumid which influenced penile beautiful and sexual intercourse.It was improved by local liposuction.One month after surgery,two patients with corpora cavernosa and corpus spongiosum partial defect had normal voiding.No feeling and erectile dysfunction were complained during the following-up.Conclusions According to the characteristics of the penile defect due to the shortwave diathermy,selecting the optimal skin flap and individual repair strategy are the keys to successful treatment.

Objective To investigate the correlation of possible risk factors with acute renal injury (AKI) after coronary artery bypass surgery (CABG) and explore if the incidence of AKI could be lower by off-pump CABG for kidney protection.Methods Two hundred and nine patients who underwent coronary artery bypass surgery in Nanjing First Hospital from September 2010 to November 2013 were recruited.The patients were divided into AKI group (fifty-five cases) and non-AKI group (one hundred and fifty-four cases) according to the AKI criteria and compared the possible risk factors between two the groups by univariate analysis and multivariate analysis.Results The index of female gender,body mass index,age,hypertension,basic serum creatinine,ejection fraction,the number of coronary atherosclerosis,cardiopulmonary bypass,IABP for circulatory support,postoperative low cardiac output,lactate in AKI group were higher than that in non-AKI group by univariate analysis (P ＜ 0.05).And basic serum creatinine,ejection fraction,cardiopulmonary bypass,postoperative low cardiac output showed a significantly statistical difference between two group by multivariate analysis.Conclusions Cardiopulmonary bypass,basic serum creatinine,ejection fraction,postoperative low cardiac output were independent risk factors.Off-pump CABG could benefit for kidney protection.

Objective To establish an assessment model of financial risk exposure for the county-levelpublic hospitals in Inner Mongolia Autonomous Region,which can be used to assess the risk exposure of the hospital in question,and as decision making reference for their financial management and risk prevention and control.Methods Using indicators standardized methods and entropy method to process 1 5 financial indicators (quantitative indicators and qualitative indicators )for the 20 public hospitals,and using the gray clustering method to assess financial risk exposure.Results 70% of the county-level public hospitals are faced with less financial risks,while four of them need to pay close attention,and two have large loopholes pending solution.Conclusions Entropy-Gray clustering methods can complement each other,as found in the study.This study proves its significance,and health authorities should establish their long-term financial risk control mechanisms.

BACKGROUND:In order to overcome the shortcomings of single materials, antibiotics-loaded hydroxyapatite/titanium composites have attracted people’s attentions.
OBJECTIVE:To evaluate the biocompatibility of vancomycin/hydroxyapatite/titanium nanotubes.
METHODS:Mouse osteoblasts, MC-3T3-E1, were co-cultured with titanium (Cp-T), TiO2nanotubes, and vancomycin/hydroxyapatite/titanium nanotubes, respectively. Cel morphology and growth were observed after 1, 3 and 5 days of co-culture under inverted microscope and scanning electron microscope. The cel proliferation was detected by AO-EB method. The total protein, calcium and alkaline phosphatase levels were detected at 7 and 14 days of co-culture.
RESULTSAND CONCLUSION:The MC-3T3-E1 cels with good viability and morphology adhered wel on the surface of vancomycin/hydroxyapatite/titanium nanotubes compared with those on the surface of pure titanium and TiO2nanotubes under the scanning electron miscroscope. Moreover, there were a large amount of pseudopodia on the surface of composite nanotubes. Compared with the other two groups, the cel number on the surface and the levels of intracelular calcium and alkaline phosphatase were al higher in the vancomycin/hydroxyapatite/titanium nanotubes group. These findings suggest that the vancomycin/hydroxyapatite/titanium nanotubes have good biocompatibility and no cytotoxicity.

Objective To discuss the value of color Doppler ultrasonography in the diagnosis and differential diagnosis of urinary tract urothelial carcinoma (UTUC).Methods Color Doppler ultrasonography exam was practiced in 84 UTUC patients preoperatively.According to ultrasound characteristics,lesions was classified into nodular type,wall thickening type and solid mass type,which were confirmed by pathology in all cases postoperatively.Results In the total of 84 cases (76 transitional-cell carcinoma,5 adenocarcinoma and 3 epidermoid carcinoma),lesions infiltrated laminae propria and surrounding tissue in 65 cases.In the nodular type of UTUC,there were nodules raising into lumen.Wall thickening type of UTUC was characterized by irregularly wall thickening,lumen narrowing,truncating and breaking.Similarly,obstruction broke off the ureteral lumen suddenly in solid mass type of UTUC.A clear demarcation could be found between the pipe wall and surrounding tissue in nodular type.However,such clear demarcation could not be found in wall thickening type and solid mass type.The accordance rate of ultrasonographic located diagnosis were 92.9 ％ (78/84),with 6 missed diagnosis cases.The accordance rate of qualitative diagnosis were 89.7％ (70/78).Conclusions As result of color Doppler ultrasonography,there were different relationship between lesion and the peripheral tissue in different types of UTUC.In types of wall thickening and solid mass,the demarcation was unclear and it is easier to violate the surrounding tissue.Color Doppler ultrasonography can provide more effective information for diagnosis and therapy UTUC.

BACKGROUND: Present studies have proved that titanium coating nanotubes cannot only promote the biological activity of the material itself, but also be used as a drug carrier loading antibiotics and growth factors. OBJECTIVE: To investigate the antibacterial properties of vancomycin/hydroxyapatite/titanium dioxide nanotubes in vitro and in vivo. METHODS: The releasing property in vitro of vancomycin/hydroxyapatite/titanium dioxide nanotubes and vancomycin/titanium dioxide nanotubes were detected. And 1010/L Staphylococcus aureus dilution was put onto the commercial titanium, titanium dioxide nanotube and vancomycin/hydroxyapatite/titanium dioxide nanotube, respectively. Twenty-four hours later, the bacterial growth and activity was observed by scanning electron microscope and confocus scanning electron microscope, respectively. RESULTS AND CONCLUSION: Scanning electron microscope showed: the number of Staphylococcus aureus was the least on the vancomycin/hydroxyapatite/titanium dioxide nanotube, and the bacterial morphology was destroyed. Confocus scanning electron microscope observed: the number of bacteria and viable bacteria was the least on the vancomycin/hydroxyapatite/titanium dioxide nanotube, and the most on the commercial titanium. Besides, the releasing time of vancomycin from the hydroxyapatite/titaniumdioxide nanotube was up to 18 days, but the releasing time of vancomycin was only 4 hours from the titanium dioxide nanotube. In conclusion, the vancomycin/hydroxyapatite/titanium dioxide nanotube has good antibacterial property and slow-releasing performance.

Objective: To evaluate the feasibility,the safety and the effect of early postoperative enteral nutrition in patients with esophageal cancer.Methods: On the first postoperative day,40 patients were randomly divided into two groups.One group was given isocaloric total parenteral nutrition through central vein(TPN group) and the other group was fed with enteral nutrition through nasoenteric tubes or jejunostomy tubes which were inserted during the operation(EEN group).All variables were measured before operation and on postoperative day 1 and 8.Blood was drawn at different time points to assess albumin,prealbumin and transferrin.Immune response was determined by immunoglobins,total lymphocytes,T-lymphocyte subsets and NK cells. Inflammatory response were determined by C-reactive protein,IL-6 and TNF-?.Morbidity,mortality and length of hospital stay were also evaluated. Results: Tolerance of enteral nutrition was excellent.Neither mortality nor serious morbidity occurred in all patients during the period of study.After the study,the levels of serum prealbumin,total lymphocytes,CD3,CD4 and CD4/CD8 ratio in the EEN group were significantly higher than the levels in the TPN group.The concentrations of IL-6 and the length of hospital stay in the EEN group were significantly lower than in the TPN group.Conclusion: Early postoperative enteral nutrition in patients with esophageal cancer is safe,and also has the benefit effects of enhancing the body status of nutrition and immune function,and reducing the inflammatory response and the length of hospital stay.