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Objective To estimate the hand dose of occupational staff in five procedures of interventional radiology.Methods The thermoluminescence ring dosimeter(TLD,LiF:Mg,Ti)calibrated in dose equivalent Hp(0.07) was used to monitor the radiation dose to the both hands in five procedures of interventional radiology in four hospitals.Meanwhile,the tube voltage and current and the fluoroscopy time,accumulated doses,DAPs (Dosed-Area Product) and photographic frames were also recorded for statistical analysis(SPSS 18.0).Results In this study,five interventional procedures were monitored in 119 cases.The doses to the left and right hands of occupational personnel in the five interventional procedures were analyzed,and the difference was statistically significant (t =1.99,P＜ 0.05).The differences in the dose to the left hand and the right hand of the first operator with different interventional procedures were statistically significant (F =455.83,116.45,P＜0.01).Tube voltage,current,fluoroscopy time,and photographic frames in influence factor analysis were statistically significant (r =0.570,0.712,0.564,0.711,P＜ 0.05),indicating that four factors might affect the operator's hand doses.In addition,increasing these four factors directly led to increase in the operator's hand doses.The variables with statistical significance in the above single factor analysis were introduced into the multiple linear regression equation and the stepwise regression method was used to fit the equation.The fitting equation was y=225.763+ 1.862x1-98.125x2 (F=22.726,P＜0.05).Where,x1 was the fluoroscopy time and x2 was the photographic frames which showed that they were the main factors affecting the hand dose.Conclusions The dose to the hands of the primary operator was the highest,followed by the second operator,the assistant or nurses.The order of average doses to the hands of the primary operator was PM＞RFA＞CA＞ PTCA+PCI ＞ ITCA in the five procedures.The annual equivalent dose to primary operator's hands may exceed the dose limit for hands in practicing large amount of the PM procedures.
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Objective To measure the peak skin dose (PSD) in two cardiovascular interventional procedures,including coronary angiography (CA) and percutaneous transluminal coronary angioplasty (PTCA) using radiochromic film.Methods Gafchromic XR-RV3 film was selected to measure PSD in two hospitals.The films were placed on the table underneath the patient during interventional surgery.The kV,mA,fluoroscopy time,dose-area product (DAP),and cumulative dose at reference point and other relevant information were recorded for all cases.Using the Epson V750 flatbed scanner for scanning and analyzing film,FilmQA software was chosen to analyze the pixel value of red,green and blue color channels.The PSD was determined using red channel data.The correlation and linear regression analysis between PSD and device-displayed parameters was carried out.Results PSD were measured using XR-RV3 film for 26 CA and 19 CA + PTCA procedures.For CA procedures,maximum fluoroscopy time,cumulative dose and DAP were 17.62 min,1 498.50 mGy and 109.68 Gy · cm2,respectively.The maximum PSD was 361.20 mGy.However,for CA + PTCA procedures,maximum fluoroscopy time,cumulative dose and DAP were 64.48 min,6 976.20 mGy and 5 336.00 Gy· cm2,respectively.One patient with CA + PTCA procedures was found to have received the PSD value more than 2 Gy,up to 2 195.70 mGy.DAP was found to be a good indicator (R2 =0.815,P ＜0.05) of PSD for CA procedure,and correlated with cumulative dose (R2 =0.916,P ＜ 0.05) for CA + PTCA procedures.Conclusions The PSD value of some patients in cardiac interventional procedures would exceed 2 Gy,the threshold of deterministic effects recommended by ICRP.The dose-related parameters value showed on DSA device can only used to estimate PSD roughly.Using XR-RV3 film accurate measurement of the PSD in interventional projects is a very fast and effective method.
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Objective To explore the effect of relative warm ischemia (RWI) on bile nature and component in rats self-liver transplantation.Methods Thirty two rats were randomly divided into group Ⅰ (control group),group Ⅱ (RWI 0 min),group Ⅲ (RWI 30 min),and group Ⅳ (RWI 60 min).The levels of bile phospholipids (PL),total bile acids (TBA),and PL/TBA ratio were detected early after self-liver transplantation.The concentration changes of hydrophilic and hydrophobic bile acids were examined.Results Only PL concentration of group Ⅱ seemed to be lower than that of group Ⅰ (P ＜ 0.05),without any change for other indexes.Compared with group Ⅱ,only the PL and TBA concentrations of the group Ⅲ were decreased significantly (P ＜ 0.05),and no significant difference was found between two groups on PL/TBA ratio and mole fractions of bile acids (P ＞ 0.05).Compared to group Ⅱ,the concentrations of PL and TBA,PL/TBA ratio,and the mole fraction of taurocholic-β-mouse acid (T-β-MC) were much lower in group Ⅳ (P ＜ 0.05),and the mole fraction of taurocholic acid (TC) were higher in group Ⅳ (P ＜ 0.05).Conclusions RWI caused changes of PL/TBA ratio,hydrophilicity and hydrophobicity of bile early after liver transplantation,and the changes were directly proportional to the RWI time.The property of bile in early transplantation seemed not to be changed when the relative warm ischemia time was less than 30 min.When the RWI time was longer than 60 min,the bile component was changed obviously and the toxicity was increased.In liver transplantation,arterial anastomosis should be completed as soon as possible,and the RWI time should be less than 30 min.
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Objective To investigate the appropriate low tube current of abdominal CT on a 64-slice spiral CT. Methods (1) Phantom study:The phantom Catphan500R was scanned with a fixed 120 kVp,and 450,400,380,360,340,320,300,280 mA, respectively. 15, 9, 8, 7, 6 mm diameter low-contrast objects with 1% contrast were scanned for evaluating image quality. CT images were graded in terms of lowcontrast conspicuity by using a five-point scale. Statistical analyses were performed to determine the appropriate tube current and the interval leading to the qualitative change. (2) Clinical study: 3 groups of 45 patients who had 2 examinations of non-enhanced abdominal CT within 3 months were enrolled. All patients were scanned with 450 mA at first scanning. For the second scanning, group-1 was scanned with optimal tube current, group-2 was scanned with optimal tube current plus interval, group-3 was scanned with optimal tube current sinus interval. CT images were graded in terms of the diagnostic acceptability at three anatomic levels including porta hepatis, pancreas and the upper pole kidney, and the image noises of eight organs including abdominal aorta, portal vein, liver, spleen, gallbladder, pancreas, renal cortex, renal medulla were graded by using a five-point scale. The image quality was compared with non-parametric rank sum test,and the individual factors of the patients were compared with the A VONA. Results (1) The optimal tube current and interval leading to the qualitative change were 340 mA and 40 mA respectively. (2) There were no significant differences in image quality between 340 mA and 450 mA in group-1, between 380 mA and 450 mA in group-2 (P ＞ 0. 05). There was significant difference in image quality between 300 mA and 450 mA in group-3 (the mean scores for 300 mA were 2. 92 ± 0. 62,2.92 ± 0. 62,2.64 ± 0. 84,2. 72 ±0.82,2.63 ±0.71,2.51 ±0.84,3.04 ±0.72,3.04 ±0.72,2.63 ±0.71,2.52 ±0.73,2.93 ±0.81respectively; for 450 mA were 3.93 ± 0. 72,3.94 ± 0. 72,3.41 ± 0. 64,3.43 ± 0. 61,3.62 ± 0. 93,3.63 ±0.71,3.93 ±0.81,3.93 ±0.81,3.43 ±0.61,3.52 ±0.92,3.84 ±0.82 respectively) (Z = -2.449 to - 2. 236, P ＜ 0. 05). Conclusion Radiation dose can be effectively reduced by using an appropriate and lower current of 340 mA.
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Objective To comparatively study the ischemia-reperfusion injuries caused by heterogeneity of different positions of the biliary system and different construction patterns of the peribiliary vascular plexus. Methods Thirty rats were randomly divided into 3 groups: Group Ⅰ , sham operated; Group Ⅱ , 1h ischemia in biliary tract followed by 1h reperfusion; Group Ⅲ, 1h ischemia in biliary tract followed by 2h reperfusion. TUNEL assay, pathomorphology score determination and ultrastructural quantitative analysis were performed on epithelium of the hilar bile duct, proximal common bile duct and interlobular bile duct. Results In groupⅡ , TUNEL assay and pathomorphology score showed no statistical difference between proximal common bile duct and interlobular bile duct (P＞0.05) but showed significant differences in the hilar bile duct(P＜0.05). Mean volume (V) of mitochondria and area density of microvilli were obviously serious in the hilar bile duct but obviously slight in the proximal common bile duct(P＜0. 05). In group Ⅲ, the results of the above detections showed that the most severe was in hilar bile duct, followed by the interlobular bile duct and proximal common bile duct(P＜0. 05). Conclusion Different injuries in various parts of the biliary system are caused by heterogeneity of biliary epithelial cells and construction patterns of the peribiliary vascular plexus. It also provides the experimental basis to explain the higher incidences of hilar bile duct stricture. It could be taken as the best position when the bile duct is anastomosed.
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BACKGROUND: Studieshave shown that long time of warm ischemia or cold preservation would injury the biliary tract in liver transplantation. However, whether relative warm ischemia (RWI) of biliary tract would result in bile component changes is unclearly. OBJECTIVE: To establish auto-liver transplantation bile ducts RWI models, observe the effects of RWI on the bile salts and phospholipid concentration secreted by the donor liver, and to study the correlation between the total bile salt/phosphoUpid ratio (TBA, PL ratio) and billary tract injury. METHODS: A total of 32 SD rats were selected for auto-liver transplantation models with bile ducts RWI, and the rats were randomly divided into 4 groups (n=8). In Group Ⅰ (sham operation group), rats only received liver dissociation without any cold reperfusion. The RWI time of Group Ⅱ,Ⅲ, and Ⅳ were 0 minutes, 30 minutes and 60 minutes, respectively. The concentration of TBA in bile was measured with enzymatic cycling assay, andPL with enzymic colorimetric. Pathological observation with light microscope and ultrastructural observation with transmission electron microscope were performed on the hilar bile duct. The endothelial cell apoptosis was detected with TUNEL assay. The correlation between TBA, PL ratio and biliary injury was analyzed. RESULTS AND CONCLUSION: One rat died, the other 31 rats were included in the final analysis. RWI could change the composition of bile secreted by donor liver, raise the TBA/PL ratio, and increase the bile toxicity. These changes had a positive correlation to RWI time, and the changes were obviously with time prolonged. In addition, the changes are closely related to the biliary tract injury. This study shows an important mechanism of the biliary tract injury caused by RWI-injury.
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，and 17.47%.Conclusions Xylitol can lower the blood glucose a littte but without significant difference.It has little effect on blood glucose variability of patients with type 2 diabetes mellitus and can be safely used for rehydration.
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OBJECTIVE To investigate the rate of the clinical isolation of ESBLs positive Escherichia coli and the resistance in intensive care units(ICU).METHODS We isolated E.coli from 2003 to 2004 in our hospital ICU,phenotypic confirmatory test was applied to detect ESBLs.Bacterial drug susceptibility test was performed by standard Kirby-Bauer method.RESULTS The isolation rate of ESBLs positive E.coli was 74.36% in 2003 and 81.58% in 2004.ESBLs positive bacteria had high resistance to antibacterial drugs,but the resistance rate did not rise.ESBLs negative bacteria were more susceptible to antibacterial drugs(P=0.001);but ESBLs negative bacteria in 2004 had higher resistance than in 2003(?2=84.511,P=0.001).CONCLUSIONS It is very important for ICU to use ESBLs detection test in time,and antibacterial drugs in reason.
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0.05),but the injury was more serious in hilar bile duct compared with those of the proximal and distal common bile ducts(P
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Object To study the chemical constituents of the extracts S 1 and S 7 in GINSENG SINI TANG, which has the effect of antihemorrhagic shock Methods The constituents of S 1 and S 7 were isolated and purified by silica gel column chromatographic methods and analyzed by ESI/MS n, MALDI TOF/MS Results The 12 compounds were identified as ginsenosides Ra 1, Ra 2, Rb 1, Rb 2, Rb 3, Rc, Rd, Re, Rg 1, Rg 2, Rg 3, Rf from constituent S 7 in GINSENG SINI TANG The six compounds of diterpenoid alkaloid were identified as 14 benzoylhypaconine 8 linoleate (HAL), 14 benzoyldeoxyaconine 8 oleate (HAO), 14 benzoylhypaconine 8 palmitate (HAP), benzoylmesaconitine (BM), benzoylaconitine (BA), benzoylhypaconitine (BH) from constituent S 1 in GINSENG SINI TANG Conclusion All these compounds were obtained from GINSENG SINI TANG and identified for the first time
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Object To study the chemical constituents of GINSENG SINI TANG Methods The active constituents were isolated and purified by chromatographic methods and their structures were identified by physicochemical properties and spectral data Results Seven compounds were obtained and they are ginsenoside Rb 1, Rb 2, Rc, Rd, Re, Rg 1 and uracil respectively Conclusion All these compounds were first obtained from GINSENG SINI TANG
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Objective:To establish an orthotopic autologous liver transplantation model with bile duct ischemia-reperfusion injury in rats,so as to make it easy for the operation.Methods: Eighty SD rats were used to establish the models.The method used for this model was the same as the one for orthotopic liver transplantation,except for the blood vessel anastomosis and the constant pressure perfusion of portal vein and abdominal aorta.The portal vein and the hepatic artery reperfusion were controlled by artery clamp.Results: The successful rate of the operation for establishing the model was 95%(76/80) and the anhepatic phase was(16?2) min.The periods of hot and cold ischemia and reperfusion could be accurately controlled and the effect of double constant pressure perfusion was good.There was no erythrocyte in the capillary of bile ductal wall under the light microscope after the reperfusion.Conclusion: This technique,simulating the whole process of liver transplantation,is simple and has high successful rate.Besides,it rules out the influence of immune agent on bile ducts impairment,and better reflects the pathophysiological process of bile ducts ischemia and reperfusion injury,providing a novel approach for investigation of bile ducts injury during liver transplantation.