Objective To identify the fungi isolated from two acute radiation sickness(ARS)patients as a result of an accidental 60Co irradiation,and to observe the sensitivity of the fungi to antifungal agents.Methods The pathogenic fungi were morphologically examined and identified with the VITEK 2 automatic microorganism analyzer and API 20C AUX yeast identifying card.The susceptibility of fungi to antifungal agents was tested with broth microdilution method.Results Candida parapsilosis and Sporothrix schenckii were identified from case A in the samples of blood,bone marrow,urine and stool etc.Most of pathogenic fungi were sensitive to the antifungal drugs in vitro.In case B,Candida parapsilosis,Candida tropicalis,Trichosporon asahii and Aspergillus terreus were identified in the samples of sputum,urine or stool etc.Accompanying with the prolongation of antifungal treatment,the sensitivity of fungi to the antifungal drugs were decreased remarkably.Conclusion Multiple infections in different organs could be caused by pathogenic fungi,such as Trichosporon asahii and Sporothrix schenckii.Although most of pathogenic fungi were sensitive to the antifungal drugs in vitro,the effects of antifungal treatment were not satisfactory owing to poor general conditions of 2 acute radiation sickness(ARS)patients and marked compromise of the immune system.Because of antibiotic and antifungal drugs were used early for preventive purpose,the clinical samples should be specially treated in order to raise the positive rate of fungal identification.

Objective To explore the effect of clinical pharmacist on clinical rational use of antineoplastic drugs after participating in treatment group.Methods Retrospective research was used.According to whether there was a clinical pharmacist directly or indirectly involved in,all medical teams of the oncology department were divided into intervention group,advisory group and control group in our hospital.Intervention group was the medical team that had a specialist clinical pharmacist who could intervene irrational use of antineoplastic drug in the treatment on the spot.Advisory group was in the same area with the intervention group,and didn't have a specialist clinical pharmacist, but used to communicate with clinical pharmacist and take his medication advice,where clinical pharmacist indirectly involved in treatment.The control group was the medical group in the other area without clinical pharmacists of oncology department.The control group one and two were with the most beds among the control group.Randomly selected lung cancer,breast cancer,esophageal cancer,gastric cancer,colorectal cancer,gynecological cancer,liver/gallbladder/pancreatic cancer and other tumors patients from intervention group,advisory group,control group one and control group two,from January 2015 to December 2015,10 copies of each case,80 copies of each group.And antineoplastic drugs were commented specially.The information such as sex,age,clinical diagnosis,irrational antineoplastic drug use,adverse reaction and unexpected events and hospitalization time were recorded.Results The rate of irrational antineoplastic drug use of the intervention group (41.25%)was lower than the advisory group(80%),and was significantly lower than two control groups(147.50%,161.25%),advisory group was also lower than two control groups,but no significant differences between the two control groups(χ2 =0.193,P>0.05).Irrational chemotherapy, inappropriate usage and dosage and inappropriate indications were prominent problems in intervention group and advisory group.In addition,there were more improper solvent and contraindicated or adverse interaction problems in two control groups.Adverse events and incidence of unexpected events in intervention group (46.25%,12.50%) were significantly lower than those in two control groups[(73.75%,22.50%),(23.75%,18.75%)].Furthermore, the length of stay of intervention group patients was shortest in four groups (F=8.766,P<0.05).Conclusion By participating in the treatment group,clinical pharmacists can discover the irrational drug use and security risks in treatment,can provide medication guidance,consultation,publicity and other pharmaceutical service for specialist medical staff and patients.They will be more and more prominent in the treatment of cancer.

Objective To investigate the application of blood purification for critical disease with non-renal indications in PICU. Methods We retrospectively analyzed the clinical data of 10 critical disease cases with non-renal indications in PICU admitted from Jan to Dec 2009. Five cases were with acute liver failure,2 with autoimmune disease (1 with Guillaln-Barre syndrome, 1 with systemic juvenile rheumatoid arthritis with macrophage activation syndrome) ,2 with severe sepsis,one with metabolic diseases. Results Four cases were treated with plasma exchange combined with continuous veno-venous hemmofiltration. Three cases were treated with continuous veno-venous hemmofiltration. Three cases were treated with plasma exchange.Conclusion CBP is an effective and safe method in the treatment of critical diseases with non-renal indications in PICU.

Objective To investigate the application of continuous blood purification in the children with critical diseases. Methods Eighteen critical patients aged 1 ～ 15 years in PICU underwent continuous blood purification(CBP). Fourteen with acute renal failure (ARF) were treated with continuous veno-venous hemmofiltration(CVVH) ,2 with Guillain-Barre syndrome and 2 with Raye's syndrome were treated with plasma exchange(PE). The changes of clinical symptoms, blood biochemistry , blood gas, and oxygenation were analyzed before and after CBP. Results After CVVH treatment, the BUN and creatinine of 14 patients with ARF were decreased from (48.6 ± 14. 8) mmol/L to(28. 9 ±5.4) mmol/L and (634. 3 ±258. 2) μ mol/L to (318.4 ± 143.5) μmol/L,K+ and pH of serum were maintained in the normal range,oxygenation was significantly improved. Breathing difficulties and muscle strength in 2 patients with GBS were ameliorated and successfully weaned from ventilator after PE. Serum ALT,AST and ammonia of 2 cases with Raye's syndrome decreased significantly and they discharged after comprehensive treatment including PE. Bleeding in puncture region were found in 3 patients, hypothermia in 2 patients. During the treatment, vital signs of patients were stable,blood pressure and pulse were not fluctuated. Conclusion CBP is an effective and safe method in the treatment of critical diseases in children.

Chinese herbal pieces are a key factor to protecting the quality of the clinical efficacy of traditional Chinese medicine (TCM), and it is one of the basic elements of ensuring the quality of TCM and people's usage safety. However, Chinese herbal pieces has massive problem such as adulteration and counterfeit, dyeing and weighting, pesticide residues, heavy metals in excess of the standards, and all the issues are repeated excessive in the clinic treatment. These issues impacted sound development of production, management and use of TCM, but also brings common people hidden trouble for the clinical safety of medication. Protect and improve the quality of the Chinese herbal pieces demand that continue improve quality system, in-depth scientific research, and strengthen self-discipline and other factors. So it is fundamentally to ensure good quality of Chinese herbal pieces with the color, taste and shape by systematic supervision to it from the source, production, management and research, with strengthened implementation and en- forcement of the "3G".
Drug Contamination ; prevention & control ; Drugs, Chinese Herbal ; adverse effects ; Medicine, Chinese Traditional ; adverse effects ; Total Quality Management ; methods

Objective To determine the optimal volume proportion of iodize d oil (Lipiodol)-ethanol mixture by comparing the clinical efficacy of transhepatic arterial embolization-ablation therapy using different volume proportion of Lipiodol-ethanol mixture in treating experimental rabbit models with VX 2 liver cancer. Methods VX2 tumor was implanted in eighteen adult male New Zealand white rabbits. The 18 VX 2 rabbit models were randomly and equally divided into the following six groups according to the Lipiodol-ethanol volume ratio ∶ group A (3 ∶ 1), group B (2 ∶ 1), group C (1 ∶ 1), group D (1 ∶ 2), group E (1 ∶ 3) and group F (1 ∶ 4). One week after the treatment, all the rabbits were sacrificed and their livers were removed and sent for pathologic examination. The tumor growth rate, the microvascular density, the apoptosis index (AI) of tumor tissues and the injury of the hepatic tissue adjacent to the tumor were evaluated. Results After the treatment, the tumor’s size was increased in group A, E and F. The tumor growth rate of group A was significantly higher than that of the other five groups , and the difference was statistically significant (P<0.05). The tumor’s size of groups B, C and D was decreased, although the difference was not significant when compared with the tumor’s size of groups E and F (P > 0.05). The proportion of ethanol in Lipiodol ∶ethanol mixture bore a negative relationship to the microvascular density counts (R2= 0.840, F = 89.432, P < 0.001). AI of group A was strikingly lower than that of groups C, D, E and F (P < 0.05). The difference in AI between group A and group B was not significant (P > 0.05), while the difference in AI between group B and group C or between group B and group F was statistically significant (P<0.05), and no significant difference in AI existed between each other among other groups (P > 0.05). The injury extent of the hepatic tissue adjacent to the tumor in group A and B was remarkably milder than that of other groups (P < 0.05). Conclusion When considered in terms of safety, the optimal volume proportion of Lipiodol-ethanol mixture should be 2 ∶ 1. Successful super-selective catheterization of the tumor feeding artery, strict and close fluoroscopic monitoring of the injection and proper increase in the proportion of ethanol can definitely improve the therapeutic efficacy.

The feasibility of anterior lumbar intervertebral fusion with artificial bone in place of autogenous bone was investigated. Porous hydroxyapatite (HA)/ZrO2 ceramics loading bone morphogenetic protein (BMP) were implanted after removal of lumbar vertebral disc in rabbits. The adjacent intervertebral discs were also removed by the same way and autogenous illic bone was implanted. SEM observation and biomechanical test were carried out. Compound bone had a bit lower osteoinductive activity than autogenous bone by SEM (Osteoinductive activity of artificial bone in 12 weeks was the same as that of autogenous bone in 9 weeks). Biomechanical test revealed that compound bone had lower anti-pull strength than autogenous bone (P < 0.001), but there was no significant difference in anti-pull strength between compound bone at 12th week and autogenous bone at 9th week (P > 0.05). It was concluded that compound bone could be applied for anterior spinal fusion, especially for those patients who can't use autogenous bone.
Biocompatible Materials/therapeutic use ; Bone Morphogenetic Proteins/*therapeutic use ; Calcium Phosphates ; Durapatite ; Hydroxyapatites ; Implants, Experimental ; Intervertebral Disk/surgery ; Lumbar Vertebrae/*surgery ; Spinal Fusion/*methods ; Spinal Injuries/*surgery

The effects of E-cadherin-transfected neural stem cells (NSCs) transplantation for spinal cord injury (SCI) in rats were investigated. Sixty SD rats were randomly divided into model control group, NSCs group, empty plasmid group and E-cadherin overexpression group (n=15 each). The animal SCI model was established by using the modified Allen's method. NSCs were cultured. Rats in NSCs group were subjected to NSCs transplantation. E-cadherin gene eucaryotic expression vector and pcDNA3.1-E-cadherin were respectively transfected into cultured NSCs, serving as empty plasmid group and E-cadherin overexpression group respectively. At 7th day after transplantation, neurological function of all rats was assessed by Tarlov score. After rats were sacrificed in each group, the number of BrdU and Nestin positive cells was counted by immunohistochemistry. Immumofluorescence method was used to detect the expression of neurofilament protein (NF) and glial fibrillary acidic protein (GFAP). As compared with model control group, the Tarlov score and the number of of BrdU and Nestin positive cells, and the expression of NF and GFAP in NSCs group, empty plasmid group, and E-cadherin overexpression group were increased significantly (P<0.05), and those in the E-cadherin overexpression group were increased more significantly than the other transplantation groups (P<0.05). It was suggested that E-cadherin could be conductive to nerve regeneration and repair probably by promoting the proliferation and differentiation of NSCs.

Objective To investigate whether arsenic trioxide(As2O3)with different density is capable of affecting the invasiveness of neuroblastoma(NB)cells,and to give grounds for NB therapy with As2O3.Methods 1.Well-developed NB cells were selected and exposed to 0.75 ?mol/L,1.50 ?mol/L,3.0 ?mol/L As2O3 for 24 h;2.Collect the adherence cells,count the number and float them in nutrient medium again,add them into the transwell polycarbonate membrane plate that was covered by matrigel,there were 2?104 NB cells in each well;3.After 24 h,take off the membrane,fix the cells which cross the membrane with mehanol and dye them with hematoxylin;4.Observe the NB cells and count them,so the capability of invasion of LA-N-5 was evaluated by transwell chamber assay.Results After 24 h with the different density As2O3,the number of invading LA-N-5 cells was significantly lower in As2O3 group than that in control group(the number of invading cells of the As2O3 group was 28.0?4.0,19.33?4.16,6.33?1.53,respectively,the cell number of the control group was 46.33?6.11)(P=0.013,0.003,0);among the experiment groups,there was no difference between 0.75 ?mol/L and 1.50 ?mol/L(P=0.06),and it was significantly different between 0.75 ?mol/L and 3.0 ?mol/L,1.50 ?mol/L and 3.0 ?mol/L(P=0,0.007),the number of invading LA-N-5 cells of 3.0 ?mol/L As2O3 was the least.Conclusions As2O3 could inhibit the invasive potential of NB cells;the inhibitory action of 3.0 ?mol/L As2O3 is the most.

According to the characteristics of the Laboratory Medicine and our twenty years' medical educational experience ,we explore to improve the quality of education and cultivate the students' practical ability and creative ability. And we construct an educational mode for clinical practice, laboratory medical practice and research project.