Objective To realize the current status of central sterile supply departments(CSSDs)in hospitals,and provide the basis for making improvement measures.Methods Field investigation was adopted to study the resource distribution,personnel structure,and the quality of medical instrument cleaning in 78 hospitals in Chongqing.Re-sults Qualified results of 78 hospitals was 24.36% (19/78),basically qualified rate 52.56% (41/78),unqualified rate 23.08% (18/78);inspection results of different types of hospitals were significantly different(Hc= 16.643,P=0.002),qualified hospitals mainly concentrated on city- and county-level hospitals.Unqualified rate of CSSD con-struction area was 78.21% (n= 61),unqualified rate of personal allocation was 75.64% (n= 59),concentrated man-agement of operating rooms and CSSDs was 52.56% (n= 41),mainly concentrated on city- and county-level hospi-tals;decentralized management accounted for 47.44% (n= 37),58(74.36% )hospitals used repeated cleaning stain-less steel tables for receiving,50% didn’t install automated cleaning machine and drying cabinet,42.31% (33/78) performed manual cleaning,40(51.28% )didn’t equip with water treatment system;12(15.38% )hospitals used patched or worn clothing for packing,47 didn’t equip with hard metal container,37(47.44% )had no heat sealing machine,21(26.92% )had no detection equipment for cleaning quality,41(52.56% )had no low temperature sterili-zation instruments;52(66.67% )hospitals performed biological monitoring on high pressure steam sterilizer.Conclu-sion Clean and disinfection equipments in CSSDs in city- and county-level hospitals are well-appointed,procedures of clean and disinfection are standard,and can achieve the standard of clean quality;while hospitals affiliated to fac-tories and private hospitals are not well-appointed,procedures of clean and disinfection are not standard. Construc-tion of CSSD should be standard,so as to ensure the effectiveness of clean,disinfection and sterilization of surgical instruments.

BACKGROUND:For patients with lumbar spondylolisthesis combined with osteoporosis, appropriate fixation system for effective reset and good fixation stability is currently a hot issue of clinical concern. Pedicle screw screw-rod system after bone cement perfusion can achieve the effective fixation between pedicle screw system and the vertebral bone. OBJECTIVE:To observe the therapeutic effect of bone cement-augmented pedicle screw on patients with lumbar spondylolisthesis combined with osteoporosis. METHODS:17 cases of lumbar spondylolisthesis combined with osteoporosis were identified by bone density test. They received the posterior open reduction and internal fixation, and implanted with 68 bone cement-augmented pedicle screws. Their repair effects were observed by short-term fol ow-up. Patients were evaluated using low back pain Visual Analog Scale and lower limb Oswestry Disability Index before treatment, 1 week, 3 months and 1 year after treatment. Vertebral height, intervertebral height, screw loosening and bone cement leakage were observed using imaging.
RESULTS AND CONCLUSION:Compared with pre-treatment, low back pain Visual Analog Scale score and lower limb Oswestry Disability Index were significantly improved at 1 week, 3 months and 1 year after treatment (P<0.05). No significant difference was detected between post-treatment and fol ow-up (P>0.05), which indicated that clinical repair effect could be effectively maintained. At 3 months of fol ow-up, one screw loosening occurred in two patients. During fixation, mild bone cement leakage appeared in seven vertebral bodies with screw fixation, no symptoms or subsequent complications were observed. There were no significant differences in vertebral height and intervertebral height before and after treatment and during fol ow-up (P>0.05). These results suggest that bone cement-augmented pedicle screw for patients with lumbar spondylolisthesis combined with osteoporosis can effectively reset vertebral slippage, effectively provide good anti-pul-out force for a long term, and the effect was stable. Bone cement augmentation can perfectly strengthen fixation, shows good biocompatibility, and avoids osteoporosis around the screw-induced failure fixation.

Objective:To explore the clinical efficacy of Paishi granules on promoting stone expulsion after extracorporeal shock wave lithotripsy ( ESWL) . Methods:A retrospective study method was adopted. Totally 510 cases of lithangiuria patients were divided into the treatment group and the control group with 255 cases in each. The control group was treated by ESWL, and the treatment group was treated by Paishi granules after ESWL. The stone expulsion rate,clinical efficacy and adverse reactions in the two groups were stud-ied and compared. Results:The stone expulsion rate of the observation group was 78. 8%,which was significantly higher than that of the control group (51. 0%, P<0. 05). The curative rate of the observation group was 72. 9% with the total effective rate of 92. 5%, that of the control group was 43. 9% with the total efficiency of 82. 4%,and the differences between the two groups were statistically significant (P<0. 05). There was no statistically significant difference in the incidence of adverse reactions between the two groups (P>0. 05). Conclusion:Using Paishi granules after ESWL can promote stone expulsion with high efficacy and slight adverse reactions.

Objective To analyse the effect of repaglinide combined with Zhenqi Jiangtang Capsules on βcell function in elderly patients with type 2 diabetes mellitus.Methods 60 elderly patients were collected from harbour branch of Hainan provincial People's hospital, who were diagnosed with type 2 diabetes mellitus .All patients were randomly divided into experimental group and control group, 30 cases in each group, 2 groups of patients were given control diet, moderate exercise, and other conventional adjuvant therapy.Control group was treated with repaglinide orally on the basis of routine adjuvant treatment, 1 mg/times, three times per day,experimental group were given Zhenqi Jiangtang Capsules based on the treatment in control group,4 grains/times,three times per day.Both groups were treated for 4 weeks, after the end of treatment, blood glucose levels,serum insulin levels,βcell function and serum lipids in all patients were detected.ResuIts After treatment, compared with control group, the levels of blood glucose, HbA1c and AUCg in experimental group were significantly lower ( P<0.05 );the insulin levels 30 min,60 min, 120 min after meal were significantly higher (P<0.05);the HOMA-IR of patients was significantly lower(P<0.05);IRG, AUCi and AUCi/AUCg were significantly higher (P<0.05);the serum TC, TG, LDL levels were significantly lower, serum HDL levels were significantly higher(P<0.05).ConcIusion Repaglinide combined with Zhenqi Jiangtang Capsules can significantly reduce the blood glucose and lipid levels in elderly patients with type 2 diabetes, improve the function of pancreatic beta cells, promote postprandial insulin secretion and improve insulin resistance.

Objective To investigate the effects of ursolic acid (UA) on oxidative stress and apoptosis in focal cerebral ischemia reperfusion in rats. Methods One hundred and twenty SD rats were randomly divided into 6 groups:sham operation group, model group, and groups of 20, 40, 80 120 mg/kg UA, with 20 rats in each group. A model of focal cerebral ischemic reperfusion was induced using the intraluminal thread method. Drugs were administrated immediately via tail vein injection when the suture was inserted. At 6h later, the total antioxidative capacity (T-AOC), malondialdehyde (MDA) level, and the activity of creatine kinase (CK), lactate dehydrogenase (LDH) in the serum, and the activity of superoxide dismutase (SOD), catalase (CAT), glutathione peroxidase (GSH-Px) in the ischemic cortex were measured. Apoptosis in the ischemic cortex was detected by TUNEL staining. Results Compared with the model group, the activity of CK (301.2 ± 86.8 U/L, 258.5 ± 58.4 U/L, 228.7 ± 49.2 U/L vs. 352.6 ± 88.1 U/L), LDH (327.5 ± 87.1 U/L, 288.6 ± 69.5 U/L, 243.7 ± 74.9 U/L vs. 395.4 ± 98.6 U/L) in the serum in the groups of 40, 80 120 mg/kg UA were significantly decreased (P<0.05 or P<0.01), MDA (5.5 ± 1.4 mmol/L, 4.8 ± 1.1 mmol/L, 4.4 ± 1.3 mmol/L vs. 7.8 ± 2.0 mmol/L) and T-AOC (9.4 ± 2.2 U/L, 10.5 ± 2.9 U/L, 11.8 ± 3.1 U/L vs. 8.0 ± 2.1 U/L) were significantly increased (P<0.05 or P<0.01); the activity of SOD (10.1 ± 2.7 U/mg, 11.6 ± 2.5 U/mg vs. 6.9 ± 2.6 U/mg),GSH-Px (12.9 ± 2.9 U/mg, 14.2 ± 3.2 U/mg vs. 9.5 ± 2.3 U/mg), CAT (3.3 ± 1.3 U/mg, 3.9 ± 1.2 U/mg vs. 2.3 ± 0.9 U/mg) in the ischemic cortex in the groups of 80 120 mg/kg UA were significantly increased (P<0.05 or P<0.01). TUNEL staining showed that apoptosis in the ischemic cortex in all the UA groups were significantly decreased compared with the model group. Conclusion UA could effectively enhance the activity of antioxidant enzymes and free radical scavenging capacity, ameliorate oxidative stress and inhibit apoptosis in focal cerebral ischemia reperfusion in rats.

With continued ozone deletion and increased ultraviolet application,ultraviolet (UV) induced eye injury receives more attention,especially for astronauts,residents on high elevation plateaus and other people exposed to intense beams of UV.Continuous exposure to UV can lead to damage of conjunctiva,cornea,crystalline lens and retina,which are correlated with conjunctivitis,keratitis,ocular tumor,climatic droplet keratopathy,and pterygium.This paper focuses on the effect of UV on eyes,with a systematic elaboration of UV-induced eye injury.

Objective To investigate the protective effects of ursolic acid (UA) on global cerebral ischemic-reperfusion injury in rats.MethodsThe experimental rats were divided into the sham operation group, the model group, the UA low, medium and high dose groups, 20 in each group. Except the rats in the sham operation group, the rats in other groups were dealed by four arteries occlusion to made global cerebral ischemia-reperfusion model. The rats in the UA low, medium, high dose groups were given UA as 40, 80, 120 mg/kg immediately after the occlusion line was inserted; the rats in the sham operation group and the model group were given equal-volume saline. And 6 hours later, the recovery time of righting reflex and electrical activity of brain were recorded, water content of the brain were evaluated, and the activity of LDH, MDA, SOD, CAT in brain tissue were determined; the inflammatory cytokines content of TNF-α, IL-1β, IL-6 were determined by ELISA. Results Compared with the model group, the recovery time of righting reflex (20.6 ± 7.2 min, 18.2 ± 6.9 min vs. 27.3 ± 8.8 min) and electrical activity of brain (16.2 ± 5.8 min, 14.9 ± 5.6 min vs.24.1 ± 7.2 min) of the UA medium and high dose groups were shortened (P<0.05 orP<0.01); the water content were significantly decreased (79.0% ± 0.7%, 78.6% ± 0.5%vs. 80.7% ± 0.9%;P<0.05 orP<0.01); the activity of SOD (158.5 ± 8.4 U/mg, 165.4 ± 9.0 U/mgvs. 143.0 ± 7.1 U/mg), CAT (3.3 ± 1.4 U/mg, 3.9 ± 1.5 U/mgvs. 2.4 ± 0.9 U/mg) in brain tissue of the UA medium and the high dose groups were significantly improved; the content of LDH (16.0 ± 2.6 mmol/g, 18.4 ± 2.8 mmol/gvs. 12.4 ± 1.9 mmol/g) were significantly increased; the content of MDA (18.6 ± 2.8μmol/g, 17.2 ± 2.4μmol/gvs. 24.9 ± 3.4μmol/g), TNF-α (45.8 ± 6.3 nmol/L, 40.1 ± 5.6 nmol/Lvs. 56.3 ± 7.2 nmol/L), IL-6 (187.2 ± 18.5 nmol/L, 136.8 ± 15.7 nmol/Lvs. 238.4 ± 22.9 nmol/L) were significantly decreased, and the content of IL-1β in UA 120 mg/kg treated group was significantly decreased (713.6 ± 56.3 nmol/L vs. 915.7 ± 70.5 nmol/L;P<0.05 orP<0.01).Conclusion UA can effectively promote righting reflex and EEG recovery, reduce brain water content, which perhaps related with its pharmacological effects of enhanceing the activity of antioxidant enzymes, lower oxidative stress, and inhibit inflammation.

Objective To survey the clinical application of glycopeptide antibiotics in hospitalized patients, and evaluate the rationality of drug use, so as to provide reference for rational clinical drug use.Methods A retrospective study was conducted to investigate the application of glycopeptide antibiotics among inpatients in a hospital from January to December in 2014, relevant clinical data were recorded.Results A total of 727 cases were included , 471 (64.79%) of which were infected cases.Respiratory tract infection was the main site of both healthcare-associated infection and community-associated infection (39.17% and 45.98%, respectively).The average days of glycopeptide antibiotic use were 6.06 day (4 403/727).Patients who used glycopeptide antibiotics were mainly from intensive care unit, department of oncology, and department of neurosurgery, accounting for 20.36%(n=148) , 12.10%(n=88), and 11.14%(n=81) respectively.Glycopeptide was used in 338 patients(46.49%),the average types of combined use was 4.43, triple and above was used in 99 patients(13.62%),combination of the second generation cephalosporins was the highest(20.48%).450(61.90%) patients used vancomycin, 260(35.76%)used teicoplanin,17(2.34%)used both vancomycin and teicoplanin.A total of 847 pathogenic strains were isolated, the major were Acinetobacter baumannii (n=111, 13.10%), Klebsiella pneumoniae (n=80, 9.45%), Pseudomonas aeruginosa (n=68, 8.03%), and Staphylococcus aureus (n=54 , 6.37%), methicillin-resistant Staphylococcus aureus was 50 strains.490 (67.40%) patients treated with glycopeptide antibiotics were effective.Of 727 patients, 86 (11.83%) used antibiotics rationally, 315(43.33%) basically rational,and 326 (44.84%) irrationally.Conclusion Application of glycopeptide antibiotics in this hospital is basically rational, but indications should be paid attention.

Objective To explore the intervention in patients with advanced lung cancer in chemotherapy effect in psychology. Methods According to the routine nursing care of 40 cases of patients with advanced lung cancer chemotherapy, and classified as the control group, the other 40 patients in the control group based on the nursing for patients with psychological intervention, and classified as the observation group, two groups of patients in our hospital from January 2015 to January 2017. Results The intervention of patients before, there were no significant difference between the two groups of patients' quality of life and life ability score, after grouping after intervention in observation group were significantly better than the control group patients were compared between the two groups; for the intervention of the satisfaction rate of visible, The proportion of patients in the observation group 97.5% was significantly higher than the control group of 72.5% patients, showed significant differences between the two groups (P<0.05). Conclusion The psychological intervention analysis find application in patients with advanced lung cancer in chemotherapy, the chemotherapy effect can help to reflect, consolidate the therapeutic effect, improve the quality of life of patients, improve the patients for nursing recognition, therefore it is worthy of reference.

5-Fluorouracil(5-FU)has been widely used to treat gastrointestinal,head,neck,chest and ovarian malignant tu-mors since 1957. As an analogue of pyrimidine,5-FU plays anti-cancer roles by inhibiting thymioylate synthase and integrating its me-tabolites into DNA and RNA. Although 5-FU is one of the first-line therapeutic compounds for gastrointestinal malignant tumor as a sin-gle drug or in combination with other drugs,its effectiveness is hindered by its low efficiency,which may be due to chemotherapy re-sistance. 5-FU chemotherapy resistance may stem from enzyme abnormality,genetic abnormality and tumor microenvironment. In this paper,we make a review about 5-FU actions and the mechanisms underlying chemotherapy resistance.