Objective To analyze result of the external quality assessment for laboratories of toxicological pathology diagnosis in organizations in China. Methods A total of 86 organizations that participated in the 2020-2021 external quality assessment in laboratory of toxicological pathology diagnosis (hereinafter referred to as "reference units") were selected as research subjects using convenient sampling method, and the assessment results were analyzed. Results The median of total score was 92, and the 0-100 percentiles were 64-100 in these 86 reference units. Among these reference units, 76 were rated as excellent, 10 as qualified, with the excellent and the qualified rate of 88.4% and 11.6%, respectively. No reference unit was rated as unqualified. The rates of excellence of the reference units in public health institutions, pharmaceutical research institutions, drug safety evaluation centers and testing companies were 95.7%, 84.2%, 85.7% and 86.7%, and the qualified rates were 4.3%, 15.8%, 14.3% and 13.3%, respectively. The distribution of excellence and qualification among the four types of reference units showed no statistical difference (P>0.05). The distribution of sample scores according to the three grades of poor, good, and excellent were 4.9%, 20.7%, and 74.5% in public health institutions, 8.6%, 23.7%, and 67.8% in pharmaceutical research institutions, 12.5%, 25.0%, and 62.5% in drug safety evaluation centers, and 5.4%, 17.5%, and 77.1% in testing companies. The proportion of excellence unit in public health institutions was higher than that in pharmaceutical research institutions (P<0.05). Conclusion The overall toxicological pathology diagnostic capabilities in China are good, and various types of reference units demonstrate comparable technical capabilities. However, there is a need for standardization of diagnostic terminology.

OBJECTIVE: To evaluate the diagnostic ability of toxicity pathology in patho-toxicological testing institutions in China. METHODS: The institutions participated in the 2018 Interlaboratory Comparison Activity of Toxicity Pathology Testing(hereinafter referred to as reference unit) were selected as the research subjects. The heart, spleen, skin, soft tissue, liver and mammary gland of SD rats of different groups in the 2-year carcinogenesis test were selected. The femur, knee joint and nose of Beagle dogs in the 4-week toxicity test and a total of 10 pathological tissues were selected as the comparison samples. The pathological diagnosis was carried out by the pathological diagnostic personnel of the reference unit, and the diagnostic results were reported. The expert appointed by the Toxicology and Pathology Committee of Chinese Toxicology Association compared the diagnostic results with the appointed value. RESULTS: A total of 167 pathological diagnostic personnel from 75 reference units in 24 provinces and municipalities participated in the comparison activity. The reference units were mainly distributed in East China, South China and North China, accounting for 77.3%(58/75). Totally 75 reference units fed back 750 effective diagnostic results. The qualified rates of diagnosis on heart, spleen, skin, soft tissue and breast samples were higher than 60.0%. The qualified rates of diagnosis on femur and knee joint, and nose samples were low(30.7% and 6.7%, respectively). There were 1(1.3%), 46(61.4%) and 28(37.3%) reference units rated as unqualified, qualified and excellent, respectively. CONCLUSION: Most of the testing institutions in China have a high level of patho-toxicological diagnostic ability, that can provide reliable diagnostic results for toxicology safety evaluation tests.

Objective To investigate the effects of hydrogen (H2) on myocardium injury post-cardiac arrest (CA) in rabbits.Methods Sixty New Zealand rabbits were randomly divided into H2 treatment group (n = 30) and control group (n = 30) by random number table. The rabbit CA model was established by means of electrical stimulation of external membrane, both groups were mechanically ventilated. Cardiopulmonary resuscitation (CPR) was performed after 6 minutes of nonintervention, and stopped after restoration of spontaneous circulation (ROSC). Inhalation of 2％ H2 gas was conferred to rabbits immediately at the end of CA modeling for 72 hours in H2 treatment group. Air was given to rabbits in control group instead. The survival rate of rabbits was analyzed. Heart rate, ventricular premature beat frequency, and the levels of blood samples cardiac troponin I (cTnI), left ventricular ejection fraction (LVEF), B-type natriuretic peptide (BNP), and blood lactic acid (Lac) were collected before CA and after ROSC in all rabbits. Rabbits were sacrificed and microstructure injury was observed by electric microscope after ROSC 72 hours.Results There were 28 animals ROSC in both groups; the survival number in H2 treatment group was higher than that in control group at 72 hours after ROSC (number: 15 vs. 7,χ2 = 4.791,P = 0.029). In the early stage of ROSC, the heart rate of two groups slowed down, the number of premature ventricular increased, and then gradually recovered; the heart rate in H2 treatment group was returning to normal more quickly than that in control group at 48 hours after ROSC (bpm: 319±63 vs. 362±40,P < 0.05); the ventricular premature beat frequency was lower than that in control group at 72 hours after ROSC (times per minutes: 9.1±4.3 vs. 15.0±8.0,P < 0.05). The animals of two groups had different degrees of myocardial damage and cardiac insufficiency after ROSC, and restored with the extension of time. Compared with control group, the level of BNP in H2 treatment group was significant decreased at 24 hours after ROSC (ng/L: 385±98 vs. 488±174,P < 0.05), the levels of cTnI and Lac were significant decreased at 48 hours after ROSC [cTnI (μg/L:1.83±0.68 vs. 2.83±0.98, Lac (mmol/L): 5.5±1.6 vs. 7.9±2.6, bothP < 0.01], the LVEF was slightly higher than that at 72 hours after ROSC (0.690±0.040 vs. 0.650±0.041,P = 0.051). Compared with control group, less damage to myocardial ultra structure was found in H2 treatment group at 72 hours after ROSC.Conclusion Inhalation of H2 alleviates cardiac dysfunction and myocardial injury after CPR.

Objective:To analyze and summarize the causes of unscheduled suspension of knee and hip arthroplasty and to provide the method for optimizing the patient's pre-operative management and improving the efficiency of medical resources as well as the patient's satisfaction.Methods: The data for this report was retrospectively collected from September 2013 to August 2014 in our hospital,from cases of knee and hip arthroplasty that were suspended before the scheduled operation time.Acquisition data from the collected cases including the patients' gender,age and the surgical procedure.At the same time,the suspension reasons were recorded and analyzed.All the decisions of suspension was made by the surgeons and the anesthesiologists according to the abnormal result of preoperative examinations,after communicating with the patients and their families and obtaining their understandings.Results: In the collecting period,our department scheduled 1 146 cases of knee and hip arthroplasty,among which 1 003 were completed,143 suspended (12.5％ suspension rate).Among the causes of suspension,the top four common causes were cardiovascular disease (44/143,31％),other infections (20/143,14％),bacteriuria (18/143,13％) and inappropriate surgical indication (16/143,11％).Other causes include surgeon's reason,Blood system abnormalities,high inflammatory index,deep vein thrombosis,other diseases uncontrolled,abnormal liver function and poor diabetes mellitus control,etc.For the rate of suspension,there was no significant difference between the patients with different genders (male: 15.0％,and female: 11.7％,P=0.149),or age (≤50 years: 13.0％;51-65 years: 11.6％;66-80 years 13.3％;>80 years 11.1％;P=0.864).However compared with knee arthroplasty,hip arthroplasty had a higher suspension rate (knee arthroplasry 11.1％,hip arthroplasry 16.1％,P=0.021).Conclusion: It is important to educate and manage the patients before their knee and hip arthroplasty.Through clear diagnosis,detailed medical history analysis careful physical examination,and targeted outpatient examinations and tests for which priority was focused on cardiovascular or other system diseases we could minimize the occurrence of operative suspension post hospitalization,therefore improving the efficiency of the use of medical resources.

OBJECTIVE: To explore the non-neoplastic hepatic lesions in SD rats at different ages. METHODS: The specificpathogen free SD rats were collected from the blank control groups used in subacute toxicity tests,subchronic toxicity tests and chronic toxicity combined with carcinogenic tests for safety evaluation. At the end of each experiment,i. e. week 10,19,56 and 108(assigned into four groups: 10,19,56 and 108 weeks,each contained 100 rats with each sex),rats were executed. The liver organ coefficient was calculated,the pathological examination was performed,and the non-tumorous lesions in the liver were analyzed. RESULTS: The liver organ coefficients at the age of 19,56,108 weeks were lower than that of 10 weeks(P < 0. 05); those at the age of 56 and 108 weeks were lower than that of 19 weeks(P < 0. 05),and that of 108 weeks was greater than of 56 weeks(P < 0. 05). Among the 10-week-old,19-week-old,56-week-old and 108-week-old groups,the types of non-neoplastic hepatic lesions detected in the female rats were 6,6,13 and 15 respectively,meanwhile those in the male rats were 6,6,13 and 15 respectively. Both male and female rats,the incidences of hepatocyte fatty degeneration,edema and hepatic infiltration of inflammatory cells were significantly increased with the increase of age in each group(P < 0. 05). The incidences of intrahepatic bile duct proliferation and intrahepatic bile duct fibrosis in rats at the age of 56 and 108 weeks were higher than those at the age of 10 and 19 weeks(P < 0. 008).Moreover,the frequency of hepatic sinus expansion lesions in rats at the age of 108 weeks was higher than those of 19 weeks(P < 0. 008). CONCLUSION: Spontaneous non-neoplastic lesions in the liver of SD rats were common,primarily demonstrated as hepatocyte fatty degeneration,edema and infiltration of inflammatory cells. The incidences of lesions increased with the increase of age.

OBJECTIVE: To explore the spontaneous non-tumor lesion of kidney and its correlation with different age and sex in SD rats. METHODS: Eight hundred specific pathogen free SD rats were collected from the blank control groups used in subacute toxicity tests,subchronic toxicity tests and 1 or 2 years of chronic toxicity combined with carcinogenic tests. Rats were randomly divided into 4 groups with 10,19,56 or 108 weeks of experimental periods. Each group consisted of 100 female and 100 male rats. The renal tissues were collected at the end of each experiment,and the renal organ coefficients were calculated. The pathological non-tumor changes of the kidneys were analyzed. RESULTS: The renal organ coefficients in female rats at the age of 56 and 108 weeks were both lower than that of 10 and 19 weeks( P < 0. 008). The renal organ coefficient of male rats at the age of 56 weeks was lower than that of 10 and 19 weeks( P < 0. 008). The renal organ coefficient of male rats at the age of 108 weeks was higher than that of 56 weeks( P < 0. 008). The renal organ coefficient of male rats at the age of 108 weeks was higher than that of female rats of 108 weeks( P < 0. 008). The incidence of renal tubular calcium salt deposition,interstitial inflammatory cell infiltration and renal tubular dilatation in the female rats at the age of 108 weeks were higher than those in the male rats at the age of 108 weeks( P < 0. 05). The chronic progressive nephropathy incidence of female rats at the age of 108 weeks was lower than that of male rats aged 108 weeks( P < 0. 01).The renal tubular calcium salt deposition incidence of female rats aged 56 weeks was higher than that of male rats aged 56weeks( P < 0. 01). CONCLUSION: The spontaneous non-tumor lesions in the kidney of SD rats were common. The incidence of some lesions was different in the same age group with different sex.

OBJECTIVE: To observe the diagnostic capacity and its influencing factors in the toxicologic pathology diagnostic laboratories in China. METHODS: Inter-laboratory comparison of toxicologic pathology diagnosis was cosponsored by Chinese Society of Toxicology-Toxicologic Pathology Specialty Section and Guangdong Province Hospital for Occupational Disease Prevention and Treatment. Nine digital slices of digestive system lesions were screened as comparison samples,and the reference institution with toxicologic pathology diagnostic laboratories completed the diagnosis within the prescribed time. According to the three grades of “excellent”,“satisfaction”and “dissatisfaction”,the evaluation was carried out.RESULTS: A total of 74 reference institution participated in this comparison,which distributed in 20 provinces and 4 municipalities and 156 pathologists. The reference institutions were mainly distributed in North China,Southern China and East China. There was an average of 2 pathologists per laboratory,and in the quantity of academic title,the junior,intermediate,and senior was 15,70 and 46 persons respectively. Parasitic hepatocyte cysts( 97. 3%),adenocarcinoma of small intestine( 95. 9%) and polyarteritis nodosa of the pancreas( 89. 2%) had the highest rate of “excellent”grade,while the duodenal gland inflammation( 67. 6%),foam cell aggregation in colonic propria( 40. 5%) and hepatoma adenoma( 32. 4%) had the highest rate of dissatisfaction grade in the evaluation of single case. In the overall evaluation,reference laboratories reached the “excellent”grade and the “satisfaction”grade were 78. 4% and 21. 6% respectively.The number of pathologists provided by each reference laboratory had impacts on the overall evaluation level and the single case evaluation( neoplastic lesions) in the evaluation of single case( P < 0. 05). The types of the reference laboratory,the regional distribution and the grade of the academic title had no effect on the diagnostic ability( P > 0. 05). CONCLUSION: The reference laboratory is superior in diagnosing the digestive system lesions in the inter-laboratory comparison activity.The number of pathologists in the reference laboratory is one of the influencing factors of its diagnostic ability.

A retrospective analysis was performed among 8 patients with unilateral intraarticular calcaneal fracture, who were selected from the Department of Orthopaedics in Yangpu District Central Hospital of Shanghai. They were treated with the injectable bone graft MIIG[R] X3 combined with percutaneous reduction by leverage and axial fixation from June 2005 to November 2006. After treatment, the function of affected feet was evaluated according to the ankle-hindfoot score of the American Orthopaedic Foot & Ankle Society (totally 100 points). All the patients were rechecked with X-ray films periodically to observe the reaction between the materials and the host, the healing of fracture, the pain of limbs and joint motion. Eight patients were all followed up, the complication rate reached 12.5% (1/8), the improvement of Bohler angle excelled 18° to 25°, and that of Gissane angle exceeded 30° to 35°. Among the included patients, 6 cases achieved excellent effect and 2 cases good. All developed the bone union. None of all had complications, such as necrosis of skin, hematoma and deep infection.

[Objective]To explore the clinical value of discography followed by computed tomography for the treatment of multi-level lumbar disc degeneration. [Methods]Twenty-eight cases were enrolled from January 2005 to January 2008.There were 12 males and 16 females with average age of 38.2 years,ranging from 30 to 56 years.The level of degenerated disc included L3、4 and L4、5(9 cases),L4、5 and L5S1(15 cases),L3、4,L4、5 and L5S1(4 cases).The level of discography included L2、3(10 cases),L3、4(28 cases),L4、5(28 cases),and L5S1(26 cases) with a total of 92 discs.The painful discs(or responsible discs) were screened according to diagnostic criteria of provocative discography and treated with interbody fusion.[Results]Thirty-two responsible discs were screened in total of 92 discs.ODI scores between pre and post operation were significantly different(P

[Objective]To explore the short-term outcome and surgical technique of minimally invasive unicondylar knee arthroplasty(MIS-UKA) for medial compartmental osteoarthritis of the knee. [Methods]Forty-five patients(48 knees) with medial compartmental osteoarthritis of knee treated by MIS-UKA from May 2005 to December 2008 were reviewed and analyzed.The pain and range of motion(ROM) of the knees were evaluated by HSS score system before and after MIS-UKA.Pre-and postoperative alignment of the lower limbs was measured and compared.Surgery indications and surgical technique of MIS-UKA were also summarized.[Results]Forty-three knees in 40 patients were followed up for a mean time of 24 months(12-40 months).The pain over medial compartment of the knees was subsided or relieved in all cases.The post-operative ROM of the knees was 0?~135?(mean 120?),and alignment was 2? varus on the average(0?~6? varus).HSS score increased from 70(60~82) to 90(75~95).The good-to-excellent rate was 92%.[Conclusion]MIS-UKA is an effective method for medial compartmental osteoarthritis of the knee.Surgery indications and surgical technique are the key factors for the final results.