Objective To explore using evidence-based medicine to establish infection control process of hospital supply room. Methods We determined problems in the practice through collecting relevant materials on infection control of hospital supply room. Then we searched the related literatures from the evidencebased medicine(EBM) websites(MEDLINE database, ere) and undertook comprehensive evaluation, established all the infection control processes of hospital supply department by applying a systematic method. Results All the monitoring indexes were compared between the control group and the observation group :disinfection and sterilization of instruments (P<0.01), management of aseptic materials (P<0.05), environmental hygiene monitoring (P<0.05) and handwashing compliance of medical staff met standard requirements(P<0.05).All the items were statistically different between the two groups. Conclusions The method of EBM applied in establishing of infection control process of hospital supply room provides scientific and systematic working method.

In this paper, the needs of community care for diabetic patients were studied, and the existing problems were summarized and analyzed. "Four drawbacks" on community care were pointed out, namely, lack of knowledge, insufficient service resources, deficiency of professional nursing staff, and inadequate management. There were also "four lacks" on diabetic patients, namely, lack of confidence, lack of attention, lack of knowledge and lack of compliance. Seven measures of community health care for diabetic patients were pointed out in this paper, which were to enhance the quality of personnel, to strengthen health education, to emphasize on psychological counseling, to enhance behavioral modification, to carry out medical consulting, and to implement the specific medical care and comprehensive intervention.

Objective To observe the dynamic changes of urotensionⅡ (U Ⅱ) content in plasma and bronchoalveolar lavage fluid (BALF) of rats with chronic hypoxic pulmonary hypertension and to investigate the effects of hypoxia on the synthesis and secretion of U Ⅱ and the correlation of U Ⅱ with the mean pulmonary artery pressure (mPAP) and the partial pressure of arterial oxygen (PaO 2). Methods Male Wistar rats were randomly divided into control group and hypoxic groups. Model of chronic hypoxic pulmonary hypertension was established by normal barometric and discontinuous hypoxia. mPAP and RVdp/dt max of each rat were measured using right cardiac catheterization. PaO 2 was detected by blood gas analysis. U Ⅱcontents in plasma and BALF were detected by radioimmunoassay. Results During hypoxia, mPAP, RVdp/dt max , U Ⅱ content in plasma, and BALF increased in rats (P

This paper discusses the design of a special digital manometer for air-pocket in manual air-way. Integrated silicon pressure sensor MPX5010 with high precision and sensitivity is adopted in the device. It can not only measure and display air pressure of air-pocket,but also give the alarm for excessive pressure,thus providing a timely and convenient way for clinician to control air-pocket pressure,which ensures the safety and precision for clinic.

Objective To observe the effect of ischemic postconditioning on myocyte apoptosis in hyperlipemia rats with myocardial ischemic reperfusion.Methods Total forty-eight hyperlipemia SD rats were randomly divided into the sham-operation group, ischemic reperfusion group and ischemic postconditioning group with 16 rats in each group. The myocardial ischemic reperfusion model of rat was made. Rats in the ischemic reperfusion group were ligated for 40 min ischemia, and then reperfused for 240 min. Rats in the ischemic postconditioning group were treated for 40 min ischemia, reperfused for 10 s and 10 s ischemia for three cycles, and then reperfused for 240 min. Rats in the sham-operation group were opened the chest to braid for ringer without deligation. The presence of apoptotic myocytes was detected by the method of terminal deoxynucleotidyl transferase-mediated dUTP nick end-labeling (TUNEL). Meanwhile, the serum creatine kinase activity and myocardial infarct size were measured.Results The creatine kinase activity was 734.86±25.48 U/L in the ischemic postconditioning group and 967.64±28.16 U/L in the ischemic reperfusion group after reperfusion, all significantly higher than that (274.28±16.94 U/L) in the sham-operation group ( P<0.05), and it was significantly lower in the ischemic postconditioning group than that in the ischemic reperfusion group ( P<0.05). There was no significant difference in ratio of myocardial ischemic size and left ventricle after reperfusion between the ischemic postconditioning group and the ischemic reperfusion group. But the ratio of myocardial necrotic size and ischemic size of the ischemic postconditioning group was 24.8%±6.7% and significantly lower than that (38.2%±7.1%) of the ischemic reperfusion group ( P<0.05). No apoptotic myocardial cells were found after the reperfusion in the sham-operation group. The apoptotic rate in the ischemic postconditioning group (12.7%±2.8%) was significantly lower than that (20.9%±3.7%) in the ischemic reperfusion group ( P<0.05).Conclusion Ischemic postconditioning can relieve the ischemic reperfusion injury in hyperlipemia rats, the mechanism of which may be related with decreased myocardial apoptosis.

Objective To explore the epidemiological characteristics of nonalcoholic fatty liver disease (NAFL)and relationship with main chronic diseases in Xuanwu district community of the elderly.Methods 6 779in the elderly physical examination,unified health questionnaire,physical examination,measurement of body mass index,blood pressure,fasting blood glucose,liver function,blood lipids,abdominal B-ultrasound to calculate prevalence of NAFL rate,and its related factors were analyzed.Results NAFL prealence was 38.7％,NAFL group of overweight and obesity,diabetes,high blood pressure,dyslipidemia was significantly higher than the control group.Conclusion NAFL rate was high,and it has close relationship with the metabolic syndrome,NAFL should be placed in community mainly chronic diseases of prevention and control category.

OBJECTIVE To investigate the microorganisms on the hands of nurses who are doing the intravenous infusion.METHODS Sampled the hands of nurses during the procedure of intravenous infusion randomly,and then sampled after monitoring the nurses washing their hands by the six steps hand-cleaning technique.Then cultured the samples and did the identification of bacteria.The distribution of microorganism on nurses' hands was analyzed.RESULTS During the procedure of intravenous infusion,before and after the intervention the microorganisms on the nurses' hands had evident difference and with the statistic meanings.CONCLUSIONS The handwashing compliance among nurses before working in our hospital is poor,and the hand hygiene status during the nursing procedure needs to be improved.

Objective To investigate the efficacy and safety of single-channel endoscopic nylon rope combined with hemostatic clip suture in the treatment of peptic ulcer and bleeding.Methods Patients in our hospital due to peptic ulcer bleeding and hospitalization emergency electronic endoscopy from January 1st,2001 to July 1st,2017 were enrolled in the study.They were treated the single-channel endoscopic nylon rope combined with hemostatic clip suture.The basic information,clinical data,surgical records combined and retrospective analysed.Results 16 patients were included in the study.Among all the patients,peptic ulcer was located in 6 cases of gastric angle,3 cases of gastric antrum,3 cases of gastric body,2 cases of duodenal bulb and stomach.Ulcer maximum 40 mm × 25 mm,an average of (23.0 ± 6.0) mm.All ulcer wounds in patients underwent single-channel endoscopic nylon rope combined with hemostatic clip pouch suture were completely closed,including 1 case of duodenal ulcer patients after bleeding,achieved hemostasis successfully when turned into our hospital intervention.The remaining 15 cases were no longer bleeding.1 cases of gastric antral and 1 cases of stomach were diagnosed as moderately differentiated adenocarcinoma and they received endoscopic resuscitation after successful elective surgery gastric antral cancer radical surgery.Conclusions Single channel endoscopic nylon rope combined with hemostatic clip sacking is a safe and effective method for the treatment of giant peptic ulcer and bleeding.It is worthy of clinical manifestation,especially for those with deep and perforated ulcer.

Objective To investigate the anatomical classification of left intrahepatic bile duct (LHD) and the pattern of bile duct reconstruction during pediatric split liver transplantation and their relationship with postoperative biliary complications. Methods Clinical data of 75 pediatric recipients undergoing split liver transplantation were analyzed retrospectively. Before splitting the donor liver, iopromide injection was used for retrograde cholangiography through the common bile duct. According to the patterns of intrahepatic bile ducts in the second, third and fourth segments, the anatomical classification of LHD of the donor liver was determined. The biliary reconstruction regimens for different classification types of LHD were summarized. The incidence and treatment of biliary complications after pediatric split liver transplantation were analyzed. Results Among 75 donor livers, the anatomical classification of LHD included 57 cases (76%) of type Ⅰ, 9 cases (12%) of type Ⅱ, 4 cases (5%) of type Ⅲ and 5 cases (7%) of type Ⅳ LHD, respectively. Among 75 pediatric recipients, 69 cases (53 cases of type Ⅰ, 8 type Ⅱ, 4 type Ⅲ and 4 type Ⅳ) underwent the left hepatic duct-jejunum Roux-en-Y anastomosis, 1 case received common bile duct-jejunum Roux-en-Y anastomosis (type Ⅳ), and 5 cases underwent the left hepatic duct-common bile duct end-to-end anastomosis (4 cases of type Ⅰ and 1 type Ⅱ). Postoperative biliary complications occurred in 6 cases (8%), including 3 cases of biliary anastomotic stenosis, 2 cases of biliary anastomotic leakage and 1 case of bile leakage on the hepatic resection surface. Among 6 recipients, 4 cases were classified as type Ⅰ and 2 cases of type Ⅲ LHD. No significant difference was observed in the incidence of biliary complications between typical type and anatomical variant type of LHD (all P > 0.05). Among 3 recipients with biliary anastomotic stenosis, 2 cases underwent percutaneous transhepatic cholangial and drainage (PTCD) and 1 case repeatedly received biliary-intestinal anastomosis. Two cases of biliary anastomotic leakage underwent PTCD and 1 case of bile leakage on the hepatic resection surface received local drainage. All 6 children survived after treatment. Conclusions Anatomical variation of LHD can be observed in 24% of donor livers, and type Ⅱ accounts for the highest proportion of 12%. Prior to donor liver splitting, routine cholangiography and fine biliary anastomosis may effectively lower the incidence of biliary complications. The incidence of postoperative biliary complications is not significantly associated with the anatomical classification of LHD.

AIM: To observe the effects of superoxide dismutase (SOD), glutathione peroxidase (GSH-Px), myeloperoxidase (MPO) and transforming growth factor-β1 (TGF-β1) of radiation-induced lung injury rats by Kiwi fruit essence (unsaturated fatty acid of actinidia chinesis planch seed oil). METHODS: According to random number table, 90 Sprague-Dawley rats were divided into the control group, model group, 60 mg/kg unsaturated fatty acid of actinidia chinesis planch seed oil intervention group, 120 mg/kg unsaturated fatty acid of actinidia chinesis planch seed oil intervention group, 240 mg/kg unsaturated fatty acid of actinidia chinesis planch seed oil intervention group, 18 animals were included in each group. Except for the control group, rats in the remaining groups were constructed by 6MV-X-ray 18Gy full chest radiation, one week before modeling, the rats in the last 3 groups were given (60, 120, 240) mg/kg unsaturated fatty acid of actinidia chinesis planch seed oil. The first two groups were given 0.9% sodium chloride solution by gavage, once a day in each rat. 14 days, 28 days, and 56 days after radiation, the rats were randomly sacrificed and their chests were cut, and ave lung tissue was saved. HE and Masson staining were performed to observe the pathological changes, and the content of SOD, GSH-Px, MPO was determined. The expression of TGF-β1 was analyzed by immunohistochemical staining. RESULTS: Compared with the model group, (60, 120, 240) mg/kg unsaturated fatty acid of actinidia chinesis planch seed oil significantly reduced the degree of lung alveolitis and radiation pulmonary fibrosis, reduced the content of hydroxyproline (HYP), MPO, increased the antioxidant enzymes SOD and GSH-Px content, down-regulated the expression of TGF-β1.There were significant differences in the above-mentioned indicators among the intervention groups of (60, 120, 240) mg/kg unsaturated fatty acid of actinidia chinesis planch seed oil group, and it was positively correlated with dosage. CONCLUSION: Unsaturated fatty acid of actinidia chinesis planch seed oil has a preventive effect on radiation-induced lung injury, and its mechanism may be related to the reduction of oxidative stress damage and down-regulation of TGF-β1 expression.