OBJECTIVE To investigate the correlative factors in emergence of urinary infection(CI) among(inpatients) in order to prevent or decrease it.METHODS Totally 77 cases with UI from Jan 2001 to Dec 2004 were retrospectively analyzed.RESULTS There were significant differences in incidence of UI among inpatients between sexes,ages(before or after 60 years),and with or without catheterization.The longer the retention time of(catheters) the higher the incidence of UI was.There were 14 cases with UI without catheterization.(CONCLUSIONS) The UI is correlated not only with sexes,ages,with or without catheterization and the retention time of (catheters,) but also with the reasonable application of antibacterials.

Objective To study the effect of pharmacy intravenous admixture service(PIVAS)combined with mobile transfusion management system on the intravenous infusion for outpatients.Methods Six hundred patients hospitalized from January to December 2011 were set as the control group,and another 600 patients from January to December 2012 as observation group.The control group were managed with PIVAS management mode and the observation group with PIVAS combined with mobile transfusion management system management mode.The two groups were compared in terms of transfusion reaction,transfusion errors,nurse-patient disputes, transfusion check errors,no response from patients at call and patient’s satisfaction.Results There were no significant differences between the groups in transfusion reaction and transfusion error rate( P>0.05).The rates of nurse-patient disputes,transfusion check errors,no response from patients at call and patient's satisfaction in the observation group were significantly lower than those in the control group(all P<0.05).Conclusion PIVAS combined with mobile transfusion management system can not only provides pharmaceutical care safety quality for outpatient’s infusion,but also simplify the infusion process and improve the work efficiency and patient’s satisfaction with nurses.

Unplanned extubation (UEX) is defined as premature removal of the indwelling catheter tube by a patient (deliberate unplanned extubations) or by staff during nursing and medical care (accidental extubations). UEX, either deliberate or accidental, can cause severe damage of patients, with the increasing of hospital costs and medical disputes. Identifying high-risk patients is the key point of reducing UEX. This review conclude risk assessment tools reported for UEX.

Objective To detect the change of interleukin-18 (IL-18) level in the serum of patients with acute leukemia (AL) in children, and explore the clinical significance of IL-18. Methods The level of IL-18 was measured by sandwich enzyme-linked immuno-sorbent assay (ELISA) in 45 patients with AL in children. Results The leverof IL-18 in pre-treatment AL group was 719.35±358.21pg/mL and significantly higher than that of normal-control group [(311.80±146.64)pg/mL P <0.01]. Mter treatment, the level of IL-18 was 401.14±180.78 pg/mL in post-treatment complete remission group, which was significantly lower than that of pre-treatment group(P <0.01). The level of IL-18 in non-remission group was higher than those of normal control and CR group (P<0.01);while pre-treatment group the difference was not significant (P >0.05). According to the clinical sub-group with risk factors in pre-treatment AL, the level of IL-18 in high risk(HR) and middle risk(MR) group was significantly higher than low risk(LR) group (P<0.05). The level of IL-18 in T-ALL group was significantly higher than that in B-ALL group (P<0.05). The levels of IL-18 in pre-treatment AL were markedly correlated to the count of blast cells in bone marrow (r=0.411, P=0.005). Conclusion The level of IL-18 in the patients of childhood AL was in a high expression, and related to the clinical treating effect and the count of blast cells in bone marrow, which would be taken as an index of treating effect. The level of IL-18 was closely related to the clinical risk factors in pre-treatment AL.

ObjectiveTo assess the diagnostic performance of contrast-enhanced ultrasound(CEUS)in characterization of adnexal masses in comparison with baseline ultrasound.MethodsOne hundred and thirty-seven masses were examined by CEUS and baseline ultrasound.Two independent investigators reviewed the images before and after contrast agent administration.The diagnostic performances were evaluated using receiver operating characteristic (ROC) analysis and the interobserver agreement was analyzed.ResultsAfter review of CEUS,ROC analysis revealed significant improvement in differentiating between malignant and benign pelvic masses that the areas under the ROC curve were 0.731 and 0.738 at baseline ultrasound versus 0.891 and 0.903 at CEUS ( P ＜0.01 ).The accuracy for both investigators also improved significantly after reviewing CEUS.A better interobserver agreement was achieved after reviewing of CEUS (g =0.681 at baseline ultrasound versus κ =0.893 at CEUS) and a better result of specific diagnosis was obtained (73.2％ and 74.2％ at baseline ultrasound versus 90.7％ and 91.2％ at CEUS)(all P ＜ 0.01 ).Conclusions Real-time CEUS improves the diagnostic performance in adnexal masses for discrimination between malignancy and benignity and improves the capability in specific diagnosis compared with baseline ultrasound.

Objective To assess the diagnostic performance of contrast-enhanced ultrasound in characterization of pelvic masses.Methods Contrast-enhanced ultrasound was performed on 137 patients with pelvic masses.The results were compared to pathological diagnostic criteria.The diagnostic performance was evaluated by using diagnostic test.Results Sensitivity,specificity,positive predictive value,negative predictive value,accuracy and area under ROC curve in diagnosing complex pelvic masses by using contrast-enhanced ultrasound were as follows:85.3％ (29/34),93.2％ (96/103),80.6％ (29/36),95.0％ ( 99/101 ),91.2％ ( 125/137 ),0.892,respectively.Conclusions Contrast-enhanced ultrasound provides a simple and curate method for characterization of pelvic masses.

BACKGROUND: Hemorrhagic cystitis remains a common complication of hematopoietlc stem cell transplantation.Granulocyte-macrophage colony stimulating factor (GM-CSF) affects proliferation and differentiation of hematopoietic stem/progenitor cells, adjusts functions of monocytes, granulocytes, lymphocytes and endothelial cells.OBJECTIVE: To investigate the protective effects of GM-CSF bladder irrigation in hemorrhagic cystitis after allogeneic hematopoietic stem call transplantation.DESIGN: Case analysis.PARTICIPANTS: A total of 15 hematopathy patients undergoing allogenic hematopoietic stem cell transplantation at the Zhongshan Hospital of Sun Yat-sen University from January 2004 to August 2006 (routine treatment group). A total of 16 hematopathy patients undergoing allogenic hematopoietic stem cell transplantation from September 2006 to December 2008 (GM-CSF group).METHODS: In the routine treatment group, patients received mesna, hydration, alkalization and forced diuresis in the prevention of hemorrhagic cystitis. In the GM-CSF group, GM-CSF was infused into the bladder in addition to mesna,hydration, alkalization and forced diuresis in the prevention of hemorrhagic cystitis 24 hours before cyclophosphamide treatment. Catheter was extracted 3 days following cyclophosphamide withdraw. Following washing with saline, the bladder was emptied. 10 mL of saline and 5 mL of lidocaine were added into 300 μg of GM-CSF. The mixture was infused into the bladder for 60-120 minutes.MAIN OUTCOME MEASURES: The following parameters were measured: occurrence of hemorrhagic cystitis and its correlation to graft versus host disease, as well as the occurrence of cytomegalovirus infection and urinary system infection.RESULTS: Compared with routine treatment group, the occurrence rate of hemorrhagic cystitis was significantly decreased in the GM-CSF group (x2=4.39, P < 0.05), mean duration of hemorrhagic cystitis and duration of hospitalization were significantly shortened (t=3.97, P < 0.05; t=3.13, P < 0.05), and the occurrence rate of over grade HI hemorrhagic cystitis was significantly reduced (x2=5.04, P < 0.05). Cystitis degree was associated with degree and duration of graft-versus-host disease (r = 0.76).Compared with the routine treatment group, cytomegalovirus infection rate was slightly decreased in the GM-CSF group (x2=0.28, P> 0.05), and occurrence rate of over grade Ⅲ hemorrhagic cystitis was higher in patients with cytomegalovirus infection.Compared with the routine treatment group, the occurrence rate of urinary system infection was slightly reduced in the GM-CSF group (x2=0.28, P > 0.05).CONCLUSION: GM-CSF bladder irrigation is well tolerated and often effective, and should be considered as a preparative regimen of hemorrhagic cystitis after allogeneic hematopoietic stem call transplantation.

Objective To prepare the acellular carotid artery of adult pig using biotic enzymes for small-diameter vascular tissue-engineering scaffold.Methods Carotid artery of adult pig was removed cells by using Trypsin/EDTA,ribonuclease and desoxyribonuclease.Residual cellular composition was studied with quantitative DNA analysis and the Hematoxylin and Eosin(H&E)staining.Extracellular matrix composition was evaluated with elastin van Gieson's(VG)staining and scanning electron microscopy(SEM).Results Quantitative DNA analysis and H&E staining confirmed that carotid arteries were completely decellularized.Elastin van Gieson's staining demonstrated that elastin morphology appeared unchanged.Scanning electron microscopy examination of the acellular scaffolds revealed a well-oriented porous decellularized structure that maintained natural architecture of the aorta.Conclusion Carotid artery of adult pig rendered acellular with Trypsin/EDTA,ribonuclease and desoxyribonuclease has well-preserved extracellular matrix for vascular scaffold,which can be used as a scaffold for further small-diameter vascular tissue engineering.

Objective To prepare a completely biological hybrid scaffold for small-diameter vascular tissue engineering using porcine fibrin and decellularized canine carotid artery.MethodsPorcine fibrin was sprayed coating on the external surface of decellularized canine carotid artery to construct completely biological hybrid scaffold for small-diameter vascular tissue engineering. The completely biological hybrid scaffold was evaluated with Hematoxylin and Eosin (H&E) staining, scanning electron microscopy and biomechanics test.ResultsHistology examination revealed that the porcine fibrin was sprayed coating uniformly on the external surface of decellularized canine carotid artery. Scanning electron microscopy examination confirmed that the external surface of completely biological hybrid scaffold was smooth and uniformly. Compared with fresh canine carotid artery and decellularized artery, the biological hybrid scaffold had similar burst and breaking strength. Furthermore, compared with decellularized artery, the biological hybrid scaffold had higher compliance.ConclusionThe porcine fibrin was sprayed coating uniformly on the external surface of decellularized canine carotid artery to prepare a completely biological hybrid scaffold for small-diameter vascular tissue engineering. The biological hybrid scaffold had appropriate biomechanical properties and had potential to serve as scaffolds for small-diameter vascular tissue engineering.

Objective To prepare completely biological tissue-engineered small-diameter blood vessel based on a biological hybrid scaffold.MethodsEndothelial cells and smooth muscle cells were isolated from the porcine aorta and expanded in vitro. Mixture of smooth muscle cells and porcine fibrin was prayed coating on the decellularized canine carotid artery. Then, the inner surface of the decellularized artery was seeded with the endothelial cells to construction of completely biological tissue-engineered small-diameter blood vessel. The tissue-engineered blood vessel was evaluated with Hematoxylin and Eosin (H&E) staining and scanning electron microscopy.ResultsHistology examination revealed that the completely biological tissue-engineered small-diameter had intact media and intima. Scanning electron microscopy examination confirmed that the inner surface of tissue-engineered blood vessel was covered with intact monolayer endothelial cells and the external surface was covered with multilayer smooth muscle cells.ConclusionThe completely biological tissue-engineered small-diameter with intact media and intima was prepared using mixture of blood vessel cells and porcine fibrin on the decellularized canine carotid artery.