Construction and application of subject evaluation system in public hospitals / 中华医院管理杂志

Discipline evaluation is an important measure to promote the virtuous circle of discipline construction, and is an indispensable link in the process of discipline development in public hospitals. After becoming a directly affiliated hospital of a " double first-class" university, in order to improve the comprehensive strength and influence, a hospital built and applied a disciplinary evaluation system in four directions: talent construction, clinical medicine, scientific research ability, and teaching work. According to the evaluation results, the hospital′s disciplines were divided into three categories, namely, advantageous disciplines, cultivating disciplines and potential disciplines, and development strategies were established at different levels, providing policy support and financial support, especially in the field of scientific research and teaching, to accelerate to make up for shortcomings. Through exploration and practice, the talent team, scientific research and teaching level, discipline reputation, and comprehensive strength of the hospital had been significantly improved, providing effective support for the high-quality development of the hospital.

Bladder pressure expansion with drug perfusion for the treatment of ketaminea ssociated cystitis: long-term results / 中华泌尿外科杂志

Objective To study the long-term efficacy of bladder pressure expansion and perfusion therapy by bladder hydraulic expansion with alkalify lidocaine,heparin,dexamethasone for the treatment of ketamine correlation cystitis Methods From January 2008 to September 2011,the data from 19 male and 3 female patients,who were diagnosed as ketamine-associated cystitis was retrospectively analyzed.The mean age was (26 ± 5)years old.All patients accepted bladder pressure expansion under the spinal and epidural anesthesia.After expansion,the silicon three-channel catheters were left in those patients.2％ lidocaine (20 ml) and 5％ bicarbonate (10 ml) was perfused into the bladder.Meanwhile,the heparin (2.5 U) and dexamethasone (10 mg) were added into the solution,as well.After perfusion,the catheter was clamped until the patient could not tolerate.The perfusion was performed three times every day for 5 days.The volume of urine was recorded each time.The OABSS score,urine volume,maximum urine flow rate,day and night urination frequency were followed within 5 years.And the data was compared with those preoperative and postoperative 1 week,1 month,3 months,6 months.Results 22 patients accepted the procedure successfully.No complications,such as fever or bladder rupture,occurred.At the end of 5 years,the bladder volume daily urinating frequency,night urinating frequency,maximal flow rate,OABSS score were (238.3 ± 37.3) ml,9.2 ± 2.3,2.1-± 1.3,(18.2 ± 8.3) ml/s,4.4-± 2.4,respectively.Compared to the one week and one month after the operation,those results have significant difference (P ＜ 0.01).Compared to the 3 months after the procedure,the bladder volume has significant difference [(238.3-± 37.3) ml vs.(158.3-± 18.3) ml,P ＜ 0.01].No significant differences were noticed in those items 6 months after the procedure (P ＞ 0.05).Conclusion The long-term efficacy of bladder pressure expansion with alkaline lidocaine,heparin and dexamethasone the anesthesia in the treatment of ketamine associated cystitis is good.The outcome is stable,and no obvious complications.

Real-time quantitative PCR monitoring of minimal residual disease in CML after treatment / 白血病·淋巴瘤

Objective To set up a real-time quantitative PCR approach for detection and quantification for bcr-abl transcripts in CML patients,and detect minimal residual disease (MRD) in CML by real-time quantitative PCR (RQ-PCR)and evaluate the significance of MRD detection.Methods The ber-abl.fusion gene expression in 80 patients with CML was analyzed by RQ-PCR. The patients were divided into three groups according to the different treatment, allogeneic hematopoietic stem cell transplantation group,imatinib group and hydroxyurea group. The change of bcr-abl fusion gene was monitored in CML patients before and after treatment.Results The average of RQ-PCR detection on newly diagnosed patients with CML in chronic phase was 6847.67 copies / 104 cells,the accelerated phase was 306 176.08 copies / 104 cells,and the average results were 944.33, 2.37, 0.29, 0 copies / 104 cells after allogeneic hematopoietic stem cell transplantation one month,6 months,12 months or 24 months respectively.The average of RQ-PCR detection after use imatinib mesylate 3 months was 3720.23 copies / 104 cells and not be detected after one year. The average was 7290.11 and 3143.24 copies / 104 cells after hydroxyurea treatment 0 and 9 months respectively.The difference in first two groups was not significant (t=1.74,P=0.17), but the difference between the third group and the first two groups was significant (t=3.74,P=0.01.t=2.97,P=0.02). The upregulation of bcr-abl transcript levels could be detected when disease progression. The transcripts level in accelerated phase was significantly higher than that in chronic phase. Conclusion RQ-PCR can be used to detect the MRD,monitor the treatment outcome,predict disease recurrence and give early intervention.

Clinical study on modified GMALL protocol for adult acute lymphoblastic leukemia / 白血病·淋巴瘤

Objective To analyze the treatment efficacy and safety of a modified GMALL protocol for adult acute lymphoblastic leukemia (ALL). Methods Data of 37 patients with newly diagnosed adult ALL treated with a modified GMALL protocol from January 2005 to December 2009 were retrospectively analyzed,and compared with that of 44 patients treated with an in-house conventional protocol at the same period.Results The complete remission (CR) rate was 89.2 %(33/37) treated with modified GMALL protocol. The cumulative overall survival (OS) rates at 1 year, 2 years, 3 years and 4 years were 77.5 %, 48.0 %, 40.0 %and 40.0 %, respectively. The main adverse events were grade 3 or grade 4 hematological toxicities and infections which were easily managed, and the treatment-related mortality rate was low. The OS of modified GMALL protocol was superior to that of the conventional protocol. Conclusion The modified GMALL protocol has a satisfying effect and the adverse events can be tolerated for adult ALL, so its clinical application can be encouraged.

Study on chromosomal aberrations in patients with multiple myeloma by fluorescence in situhybridization / 白血病·淋巴瘤

ObjectiveTo explore the genetic abnormalities of multiple myeloma (MM)patients by fluorescence in situ hybridization (FISH).MethodsWith the application of FISH,sequence specific DNA probes (IGH,DI3S319/p53 and 1q21/RB1) were applied to detect 14q32 rearrangement,del(13q14),del (17p13)and gain of lq21.Forty-four MM patients were enrolled in this study.ResultsThirty-two cases (72.7 ％) detected by FISH had genetic abnormality in 44 cases,lq21 amplification was observed in 11 cases (25.0 ％),while RB1 deletion in 17 cases (38.6 ％),D13S319 deletion in 16 cases (36.4 ％),p53 deletion in 6 cases(13.6 ％)and 14q32 translocation in 19 cases(43.2 ％).The patients with one abnormality was detected in 10 cases(22.7 ％),two abnormalities in 11 cases(25.0 ％),three abnormalities in 8 cases (18.2 ％),4 abnormalities in 3 cases(6.8 ％).28 were found to undergo split-phase by conventional cytogenetic in 44 patients.The patients with genetic abnormalities detected by conventional G-banding was 2 cases (7.14 ％),the difference with that in FISH was significant (P ＜0.05).Genetic abnormalities compared with clinical parameters showed that β2-MG in IGH gene abnormal patients were significantly higher than those without such abnormalities (P ＜0.05).Patients with bone marrow plasma cells of lq21 amplification were higher than those with normal karotypes(P ＜0.05),CRE was significantly higher among lq21 amplification and p53 deletion patients (P ＜0.05),CRP was significantly higher among p53 deletion patients (P ＜0.05).No significant difference was oberserved in relationship of the chromosome aberration and age,the chromosome aberration and stage.ConclusionThe most common genetic abnormalities in MM is IGH rearrangement and absence of RB1 and D13S319,followed by lq21 amplification,the least is p53 deletion.FISH is a rapid and sensitive technique to refine chromosome aberrations in MM.The specific detection for genomic features of MM is proved to be correlative with its clinicopathologic characteristics and the prognosis.

Nitrous Oxide Inhalant Combined with Sublingual Administration of Misoprostol Preoperatively versus Transvenous Anaesthesia with Propofol for Induced Abortion / 中国药房

0.05).Some side reactions such as respiratory depression and postoperative loss of orientation were seen in Group B,and the duration of free action was significantly longer than in Group A and Group C(P