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.

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 effects of dexmedetomidine on serum inflammatory factor and oxidative stress response in septic rats.Methods Thirty healthy male SD rats,aged 10-14 weeks,weighing 250-300 g,were randomly divided into 3 groups( n =10 each): sham operation group (group S),sepsis group (group CLP) and sepsis + dexmedetomidine group (group CLP + D).Sepsis was induced by cecal ligation and puncture in groups CLP and CLP + D.Group CLP + D received intravenous infusion of dexmedetomidine at 10 μg· kg- 1 ·h- 1 from the end of operation until dead or 12 h after operation.Groups S and CLP received equal volume of normal saline at 1 ml·kg-1 ·h-1.Arterial blood samples were taken from 5 rats in each group before (basline) and at 1,6 and 12 h after operation for determination of serum IL-6,IL-10,SOD and MDA levels.The survival rate within 12 h after operation was recorded.Results Compared with group S,serum IL-6,IL-10 and MDA concentrations at 1,6 and 12 h after operation were increased,while serum SOD activity at 1,6 and 12 h after operation and survival rate were decreased in group CLP ( P ＜ 0.05 ).Compared with group CLP,serum IL-6 and MDA concentrations at 6 and 12 h after operation were decreased,while serum SOD activity at 12 h after operation and survival rate were increased in group CLP + D ( P ＜ 0.05 ).Conclusion Dexmedetomidine can increase the survival rate of septic rats by inhibiting inflammatory factor release and oxidative stress response.

This review article compared the antiviral therapies recommended by major international and national guidelines for management of chronic hepatitis B(CHB)issued by American Association for the Study of Liver Diseases, Asian-Pacific Association for the Study of the Liver,Chinese Society of Hepatology & Chinese Society of Infectious Diseases,China Medical Association,and World Health Organization in 2015. The essentials and highlights of guidelines were compared,focusing on goals of therapy,indications of therapy,choices of drugs,endpoints and duration of therapy, management of treatment failure,treatment of CHB in pregnancy.

Objective To explore the effect of budesonide(BUD) on dendritic cell(DC) and airway inflammation in the asthmatic mice.Methods Forty female Kunming mice were divided into 4 groups:asthmatic model group,therapeutic control group,BUD treated group,and normal control group,with 10 mice in each group.Mice were sensitized by an intraperitoneal injection of 50 ?g ovalbumin(OVA) adsorbed to 1 mg aluminum hydroxide dissolved in 0.2 mL saline.Animals were boosted on the 14th day in the same way.From the 21th to 35th days,and mice were challenged with 10 g/L aerosolized OVA for 30 min a day to establish a murine model of asthma.To evaluate the effect of BUD,60 minutes prior to OVA exposure,the mice were treated with 1 mg aerosolized BUD or placebo(saline).Control animals were sensitized intraperitoneally with saline and challenged with aerosolized saline alone.Eosinophil(EOS) count,degree of mucus secretion and DC count around the airways were measured by haematoxylin and eosin staining,periodic acid schiff's staining,immunochemistry technique and computerized image analysis system.Results In asthmatic model group,EOS count,DC count and the degree of mucus secretion around the airways were increased compared with nomal control group(P_a0.05).In BUD treated group,EOS count,DC count and the degree of mucus secretion around the airways were decreased compared with the asthmatic model group(P_a