Bleeding Time ; Child, Preschool ; Female ; Hemorrhage ; diagnosis ; Humans ; von Willebrand Diseases ; diagnosis

Maintaining organ viability after donation until transplantation is critically important for optimal graft function and survival. To date, static cold storage is the moot widely used form of liver preservation in clinical practice. Although simple and effective, it is questionable whether this method is able to prevent deterioration of organ quality in the present with increasing numbers of organs retrieved from older, more marginal, and even non-heart-beating donors. This review describes the history and progress of liver preservation and preservation solution, including hypothermic machine perfusion. Despite the fact that hypothermic machine perfusion might be superior to static cold storage preservation, liver are still exposed to hypothermia induced damage. Therefore, recently some groups have pointed at the beneficial effects of normothermic machine perfusion as a new perspective in liver preservation and transplantation.

Medical rescue is the most important step in the rescue action during grave disasters. Prompt and effective medical intervention is the key to decrease the death and disable rates in the salvage of the wounded. The authors participated in the medical rescue after China Wenchuan earthquake. Ultrasonography discovered the symptoms such as pleural effusion, pyoperitoneum, hepatic rupture, cystorrhexis, and so on, which contributed to the quick and accurate classification of patients. More emphasis should be given to ultrasonography examination during the on-spot medical rescue action after grave disasters, so as to timely differentiate patients and allow them to have timely and proper treatment, which can not only save time, but also improve the rescue efficiency.

OBJECTIVE:To explore the clinical role of two-hour(C2)of CsA in allogeneic hematopoietic stem cell transplantation.METHODS:The whole blood CsA concentration of 9 patients of C0 and 12 of C2 were determined by FPIA method . RESULTS: The satisfactory immunosuppressive concentration was found as follow: C0 was 200～400 ?g?L-1and C2 was 500～700 ?g?L-1.Both C0 and C2 could predict the acute rejection and side-effects,but C2 is more effective.CONCLUSION:The factors that affect the whole blood concentration of CsA were complex. CsA blood concentration monitoring can be used to guide rational use of CsA,but C2 is more effective than C0.

OBJECTIVETo dynamically assess drug targeting of Yougui Pill (YP) and Zuogui Pill (ZP) using infrared thermography.

METHODSIn this self-control experiment, five healthy volunteers were recruited. By using infrared thermography 10 to 11 thermal images of different body locations were taken from each participant after they took warm water, YP, ZP, and their dissembled prescriptions at 30, 70, 100, 130, and 160 min, respectively. The heat values in the lower quadrant abdomen, uterus, Du channel, and Shenque (CV8) were statistically analyzed after scanning for 125 times.

RESULTSAdministration of YP and its disassembled prescriptions enhanced the heat value of the locations of the Du channel and Shenque (CV8), but did no enhance the heat value of the lower quadrant abdomen at 30 min. Administration of ZP and its disassembled prescriptions reduced the heat value in the locations of the lower quadrant abdomen, uterus, Du channel, and Shenque (CV8) at each time point.

CONCLUSIONThe drug targeting of ZP and YP focused on the locations of the Du channel and Shenque (CV8), not on the locations of the lower quadrant abdomen or uterus.

Adult ; Drug Delivery Systems ; Drugs, Chinese Herbal ; administration & dosage ; Female ; Humans ; Infrared Rays ; Thermography ; methods ; Young Adult

12E7 Antigen ; Adult ; Antigens, CD ; metabolism ; Cell Adhesion Molecules ; metabolism ; Chondrosarcoma, Mesenchymal ; metabolism ; pathology ; surgery ; Diagnosis, Differential ; Hemangiopericytoma ; pathology ; Humans ; Lymphoma ; pathology ; Male ; Nasal Cavity ; Neuroectodermal Tumors, Primitive ; pathology ; Nose Neoplasms ; metabolism ; pathology ; surgery ; Vimentin ; metabolism ; Young Adult

Objective To explore the effect of early goal-directed therapy (EGDT) according to pulse indicated continuous cardiac output (PiCCO) on septic shock patients.Methods Eighty-two septic shock patients in Subei People's Hospital of Jiangsu Province from January 2009 to December 2012 were enrolled and randomly divided into two groups using a random number table,standard surviving sepsis bundle group (n=40) and modified surviving sepsis bundles group (n =42).The patients received the standard EGDT bundles in standard surviving sepsis bundle group.PiCCO catheter was placed in modified surviving sepsis bundles group.Fluid resuscitation was guided by intrathoracic blood volume index (ITBVI) with the aim of 850-1 000 mL/m2.Dobutamine was used to improve the heart function according to left ventricular contractile index (dPmax) and stroke volume index (SVI).The mean arterial blood pressure (MAP) was maintained 65 mmHg (1 mmHg=0.133 kPa) or above with norepinephrine.Extra-vascular lung water was monitored for the titration of liquid and diuretics.The acute physiology and chronic health evaluation Ⅱ (APACHE Ⅱ) score,sequential organ failure assessment (SOFA) score,the number of patients needed vasopressor,serum procalcitonin (PCT),lactic acid and lactate extraction ratio,the amount of fluid resuscitation,duration of mechanical ventilation,duration of intensive care unit (ICU) stay,hospital mortality were recorded in both groups.Results After treatment,the APACHE Ⅱ score,SOFA score and the number of patients needed vasopressor were gradually reduced in both groups,and those in modified surviving sepsis bundle group were significantly lower than those of standard sepsis bundle group at 72 hours (APACHE Ⅱ score:13.1 ± 6.5 vs.20.9 ± 7.5,SOFA score:8.8 ± 4.3 vs.14.6 ± 4.9,the number of patients needed vasopressor:8 vs.17,all P＜0.05).Arterial blood lactate clearance rate was gradually increased after treatment in both groups.Lactate clearance rate in modified surviving sepsis bundle group was significantly higher than that of standard surviving sepsis bundle group [6 hours:(18.2 ± 8.3)％ vs.(10.8 ± 7.5)％,t=-6.036,P=0.001 ; 12 hours:(22.6 ± 7.3)％ vs.(12.4 ± 8.1)％,t=-4.536,P=0.001 ; 24 hours:(27.8 ± 5.6)％ vs.(16.4 ± 9.5)％,t=-5.882,P=0.000].The amount of fluid resuscitation within 6 hours in modified surviving sepsis bundle group increased significantly compared with standard surviving sepsis bundle group (mL:3 608 ± 715 vs.2 809 ± 795,t=-3.865,P=0.033).The amount of fluid resuscitation within 24,48 and 72 hours in modified surviving sepsis bundle group was significantly less than that of standard modified surviving sepsis bundle group with the nadir at 72 hours (mL:918 ± 351 vs.1 805 ± 420,t=5.907,P=0.037).Duration of mechanical ventilation (hours:98.4 ± 20.3 vs.143.3 ± 29.6,t=9.766,P=0.001) and ICU stay (days:7.1 ± 3.1 vs.9.5 ± 2.5,t=2.993,P=0.004) were significantly reduced in modified surviving sepsis bundle group compared with standard surviving sepsis bundle group.The hospital mortality in modified surviving sepsis bundle group was slightly lower than that in standard surviving sepsis bundle group [16.7％(7/42)比 17.5％(7/40),x2=0.010,P=0.920].Conclusions Modified surviving sepsis bundle treatment according PiCCO can reduce the severity of disease in patients with septic shock,can make more accurately guide fluid resuscitation,and can reduce lung water and duration of mechanical ventilation and ICU stay.It has great clinical significance.

Objective To examine the impact of C-reactive protein (CRP) on the expression of interleukin-6 (IL-6), inflammatory cytokine, in cultured human pulmonary artery smooth muscle cells (hPASMCs) in order to find out the cause of pulmonary artery hypertension (PAH). Method The hPASMCs were cultured and stimulated by different concerntrations of CRP (5 - 200 μg/ml) for different lengths of time. The activity of nuclear factor-κB (NF-κB) was evaluated by electrophoretic gel mobility shift assay (EMSA). The expression of IL-6 mRNA and the level of IL-6 protein were measured by using real-time PCR and ELISA, respectively. Results CRP increased IL-6 production in hPASMCs in a dose-dependent manner. The increase in IL-6 at concerntration of 200 μg/mL in the CRP group was as high as 2.8times that in the control group. CRP also significantly induced the activation of NF-κB in hPASMCs. The effect of CRP on the inflammatory cytokine, IL-6, was inhibited by the specific FcγⅡa receptor antibody.Conclusions In vitro, CRP increases the production of IL-6 in hPASMCs mediated by FcγⅡa receptor and NF-κB translocation. These data offer important insights into the role of CRP in the pathogenesis of PAH.

Objective To adjust the layout of secondary medicine shelves in hospital pharmacy for outpatient services and optimize the varieties of automated equipment to improve working process and promote human-machine cooperation.Methods This article discussed the adjustment of the layout of secondary medicine shelves in hospital pharmacy for outpatient services and the optimization of varieties of automated equipment for storing by analyzing actual problems in automated system and clinical drug uses and the requirements of the automated equipment for drug storage respectively to improve working process and to adapt to the operation of outpatient pharmacy automated system.Results Dispensing efficiency of outpatient pharmacy automated system was improved, patients′ waiting time was significantly shortened, and the workload of pharmacists was decreased.Conclusion Optimization of hospital pharmacy drug delivery system and its operation can obviously improve work efficiency, shorten patients′ waiting time and reduce dispensing error, thus ensuring the safety of medication.

Objective To investigate and evaluate the clinical effect of the direct popliteal artery perforator flap.Methods Thirty embalmed lower limbs of adult cadavers which perfused with red latex were used to dissection,major observations were the origin,perforators and anastomoses regulations of the direct popliteal artery.Based on the anatomical study,direct popliteal artery perforator flaps were designed and used clinically to 7 patients who had soft tissue defects in popliteal fossa.Results The direct popliteal artery perforator was direct started from lateral wall of the superior segment of popliteal artery,and about 7-11 cm above knee joint.Then it goes up along the middle line of posterior region of thigh,and pierced from the carvity between semitendinosus and biceps femoris and gave off several branches in superficial fascia.Finally,these branches anastomoses with many perforating branches which were gave off form deep femoral artery (the 1st to 3rd perforator artery),obturator artery and lateral circumflex femoral artery.Clinically,all flaps were survived eventually,and 6 of them were healed quickly,only 1 case needed to change dressings to healed its partial necrosis for the pedicle had too much soft tissues and too swelling to block its blood supply.After 2-12 months of following-up,the colors and appearances of these flaps were excellent,and the function of knees were nearly normal.Conclusion Direct popliteal artery perforator flap has relatively constant location and sufficient blood supply to use in clinical application,it is safe and easy to use for recovering soft tissue defects in popliteal fossa.