Objective To summarize the previous work experience and loss of function in the development process of hospital modernization of sterile supply room,and discuss the model of centralized treatment and unified supply.Methods Through investigation in the clinical departments,various roles and regulations of sterile supply room were established,especially the various job responsibilities,operating procedures,disinfection and isolation system,the quality management system,testing system,equipment and apparatus management systems,traceability systems,continuous quality improvement process and goods recall system.The system had performance appraisal,workilow management and other methods to enhance the staff's self-discipline,to strengthen humanities education for sterile supply room staff,strict execution of the standards and norms of Health Ministry,to enhance the legal awareness,establish and improve the sterile supply room management systems and service system.Results Implementation of centralized treatment can effectively prevent nosocomial infection,reduce the spread of pollution to ensure medical safety,reduce staff input that help ensure the professional quality and reduce the economic costs,and promote the professional development of sterile supply.Conclusions Centralized treatment of multiplexing medical apparatus and instruments promotes the all-dimensional development of sterile supply room,which is worthy of wide application.

Objective To investigate whether gemcitabine (GEM) could enhance radiosensitivity of human non-small cell lung cancer cells and its related mechanism.Methods Clonogenic assay was used to analyze radiosensitivity enhancement by GEM on p53 mutant human lung adenocarcinoma cell line 973.Alterations of cell cycle distribution and apoptosis were measured by flow cytometry.Results Mild radiosesitizing effect was observed when 10 nmol/L GEM was administrated before or after irradiation.Marked radiosesitizing effect was demonstrated when 100 nmol/L GEM was administrated before or after irradiation, with much stronger effect of pre-irradiation GEM treatment.Mutation of p53 gene affected cell cycle redistribution and cell apoptosis, but had no relationship with radiosensitivity enhancement of GEM.Conclusions 100 nmol/L GEM could significantly enhance radiosensitivity of human lung cancer cells.However, this effect may not be associated with p53 gene mutation, cell cycle redistribution or cell apoptosis.

BACKGROUND: The middle ear is a little aerated cavity with a complex anatomy and a deep location. Computed tomagraphy virtual endoscopy (CTVE) can be used to reconstruct the stereoscopic images of internal surface of hollow organs using spiral CT volumetric data, providing findings similar to fiberendoscope.OBJECTIVE: To vedfy the ability to show the normal middle ear and the clinical application of virtual endoscopy based on 64-detector CT data.DESIGN, TIME AND SETTING: A confirmatory controlled observation was performed at Department of Radiology, First Affiliated Hospital of Sun Yat-sen University between October 2005 and March 2006.PARTICIPANTS: A total of 33 patients (66 ears) with suspected middle ear disease who underwent spiral CT examination were included in this study. Among included ears, 35 were normal, and 31 were impaired, including 24 ears presenting with chronic suppurative otitis media (10 simple otitis media, 5 granulomatous otitis media, and 9 middle ear cholesteatoma), 2 ears with post-operative recurred suppurative otitis media, 2 ears with carcinoma of middle ear, and 2 ears with temporal bone fracture, and lear with foreign body granuloma.METHODS: CT images of the temporal bone were obtained using 0.5 mm thick axis slices with a soft reconstruction kemel at 0.3 mm intervals. Virtual endoscopic images of middle ear on CT were generated from volumetric data using the Navigator software. CTVE images were observed from multiple directions using the Fly Through software, and compared with the axial and coronal images and surgery findings.MAIN OUTCOME MEASURES: The following structures were observed: auditory ossicle and joints, superior, middle, and inferior tympanum, sinus tympani, external acoustic meatus, tympanum, facial recess, tegmental wall, anterior and superior ligaments of malleus, posterior ligament of incus, and retrotympanum.RESULTS: A series of images were acquired as the virtual endoscope moved from the extemal auditory canal to the middle ear cavity. CTVE displayed the structures of normal middle ear with high details in 100%, except the anterior and posterior limbs of stapes in 68.6% (24/35) and 74.3 %(26/35), respectively. In the ears with supperative otitis media, the destruction of bone of handle, head of malleus, long and short limbs of incus, and limbs of stapes was found on CTVE in 91.7%(22/24), 95.8%(23/24), 95.8%(23124), 100%(24/24), and 87.5%(21/24), respectively. CTVE clearly showed the destruction of promontory, tegmental wall and facial nerve tube in one ear with carcinoma. CTVE showed the dislocation of incudomallear joint in one ear with temporal bone fracture. It took about 10-15 minutes to perform CTVE.CONCLUSION: CTVE can be used as a noninvasive and reliable method in displaying normal and pathologic middle ears. In cases of suspected bony destruction and confirmed trauma, it is helpful for diagnosis and surgical planning. CTVE of the middle ear can currently be considered as a complementary technique to conventional CT, and it is time-saving and reserves clinical generalization.

Objective:To prepare mesalazineβ-cyclodextrin inclusion compound and observe its properties. Methods:The struc-ture was characterized by UV, IR and DSC. The inclusion process of mesalazine andβ-cyclodextrin was simulated using molecular doc-king technique. The solubility and dissolution of inclusion compound were determined. Results:UV, IR and DSC were used to deter-mine the formation of inclusion complex. The inclusion ratio was 1: 1 and the phase solubility diagram was AL type. The solubility of inclusion compound in deionized water (25 ℃, pH 7. 0) was 7. 8 mg·ml-1 . The preparation of mesalazine β-cyclodextrin inclusion compound could significantly increase the dissolution rate and solubility of mesalazine. Conclusion:The prepared mesalazineβ-cyclo-dextrin inclusion compound can obviously improve the poor water solubility and dissolution of mesalazine.

Objective To study efficacy and prognostic analysis of metoprolol combined with trimetazidine in treating 86 patients with ischemic heart failure.Methods A total of 172 patients with ischemic heart failure in our hospital were randomly divided into experimental group (n =86) and control group (n =86).On the basis of conventional symptomatic treatment,the control group was treated with trimetazidine,while the observation group was combined with metoprolol,continuous treatment was lasted for 12 weeks.The systolic blood pressure (SBP),diastolic blood pressure (DBP),heart rate (HR),ultrasonic cardiogram and clinical efficacy between the two groups were-compared.After 1 year of follow-up,the incidence of cerebral infarction was recorded.Results The results of SBP,DBP,HR and ultrasonic cardiogram in the two groups were significantly improved compared with treatment before (P ＜ 0.05);The SBP,DBP and HR in the experimental group were significantly lower than that of the control group (P ＜ 0.05);The ultrasonic cardiogram,the left ventricular fractional shortening (FS),stroke volume (SV),cardiac output (CO),left ventricular end diastolic volume (LVEDV),left ventricular end systolic volume (LVESV),left ventricular ejection fraction (LEVF) were significantly better than that of the control group,the differences were statistically significant (P ＜ 0.05);The total effective rate in the observation group was significantly higher than that of the control group (P ＜ 0.0 5),the follow-up showed that the incidence of cerebral infarction in the observation group was significantly lower than that of the control group (P ＜ 0.05).Conclusion The effect of metoprolol combined with trimetazidine is significant for ischemic heart failure,and it's helpful for prevention of cerebral infarction.

Objective To study efficacy and prognostic analysis of metoprolol combined with trimetazidine in treating 86 patients with ischemic heart failure.Methods A total of 172 patients with ischemic heart failure in our hospital were randomly divided into experimental group (n =86) and control group (n =86).On the basis of conventional symptomatic treatment,the control group was treated with trimetazidine,while the observation group was combined with metoprolol,continuous treatment was lasted for 12 weeks.The systolic blood pressure (SBP),diastolic blood pressure (DBP),heart rate (HR),ultrasonic cardiogram and clinical efficacy between the two groups were-compared.After 1 year of follow-up,the incidence of cerebral infarction was recorded.Results The results of SBP,DBP,HR and ultrasonic cardiogram in the two groups were significantly improved compared with treatment before (P ＜ 0.05);The SBP,DBP and HR in the experimental group were significantly lower than that of the control group (P ＜ 0.05);The ultrasonic cardiogram,the left ventricular fractional shortening (FS),stroke volume (SV),cardiac output (CO),left ventricular end diastolic volume (LVEDV),left ventricular end systolic volume (LVESV),left ventricular ejection fraction (LEVF) were significantly better than that of the control group,the differences were statistically significant (P ＜ 0.05);The total effective rate in the observation group was significantly higher than that of the control group (P ＜ 0.0 5),the follow-up showed that the incidence of cerebral infarction in the observation group was significantly lower than that of the control group (P ＜ 0.05).Conclusion The effect of metoprolol combined with trimetazidine is significant for ischemic heart failure,and it's helpful for prevention of cerebral infarction.

Objective To investigate the value of interleukin-6(IL-6),procalcitonin(PCT)and immuno-globulin G(IgG)in evaluating the susceptibility and recurrence of bacterial pneumonia in children with hor-mone-sensitive primary nephrotic syndrome(PNS).Methods A total of 150 children with hormone-sensitive PNS admitted to the hospital from January 2019 to March 2023 were selected as the study objects.The pa-tients were divided into concurrent group and non-concurrent group according to whether bacterial pneumonia was complicated or not within 3 months.The baseline IL-6,PCT and IgG levels of the two groups were com-pared,and the factors affecting susceptibility to bacterial pneumonia were analyzed by Logistic regression.Re-ceiver operating characteristic curve(ROC)was drawn to analyze the value of IL-6,PCT and IgG in assessing susceptibility to PNS bacterial pneumonia and the risk of PNS recurrence.Results IL-6[(7.84±2.49)pg/mL]and PCT[(0.39±0.11)ng/mL]in concurrent group were higher than those in non-concurrent group[(4.75±1.56)pg/mL,(0.29±0.09)ng/mL].IgG[(3.82±1.25)g/L]was lower than that of non-concurrent group[(5.92±1.97)g/L],and the differences were statistically significant(P＜0.05).Logistic regression e-quation showed that with the increase of IL-6 and PCT and the decrease of IgG,the susceptibility to bacterial pneumonia gradually increased,and the difference was statistically significant(P＜0.05).The AUC of IL-6,PCT and IgG for PNS bacterial pneumonia susceptibility was 0.792,0.744 and 0.677,respectively.The AUC of IL-6 and PCT combined IgG for PNS bacterial pneumonia susceptibility was 0.929,which was higher than that of IL-6,PCT and IgG alone(P＜0.05).The risk of PNS recurrence in patients with high IL-6 level was 7.054 times that of low IL-6 level,the risk of PNS recurrence in patients with high PCT level was 6.750 times that of low PCT level,and the risk of PNS recurrence in patients with high IgG level was 0.079 times that of low level,the differences were statistically significant(P＜0.05).Conclusion IL-6,PCT and IgG are the influencing factors of hormone-sensitive PNS bacterial pneumonia in children,and they are related to the recurrence of PNS.Clinically,IL-6,PCT and IgG levels can be used to evaluate the susceptibility and recur-rence risk of bacterial pneumonia in children,so as to provide guidance for preventive clinical intervention.

Objective To deeply analyze the problems of public hospitals in medical service satisfaction,construct a more applicable and explanatory service satisfaction evaluation model,and provide reference for the improvement path of patients'medical service satisfaction.Methods Based on the ESCI model,this paper puts forward a research hypothesis,compiles the"Medical Service Satisfaction Evaluation Scale of Public Hospitals in S City",selects S public hospitals as the research object,and evaluates medical service satisfaction from the perspective of patients.Results At present,the main problems affecting the improvement of patients'satisfaction with medical service management in public hospitals in S city are as follows:it is urgent to improve the diagnosis and treatment technology in terms of hardware quality and optimize the environmental hygiene of public hos-pitals,and it is an urgent task to shorten the waiting time for medical treatment in software quality.The score of medical service satisfaction evaluation of S public hospitals was 3.76,and the satisfaction of patients in S public hospitals with their medical serv-ices was at a moderately low level.Conclusion In view of the above problems,it is recommended to strengthen the construction of key specialties,strengthen the construction of talent team,optimize the medical process,open digital linkage services,and strengthen service management,so as to promote the improvement of patients'satisfaction with medical services.

The quality of clinical practice teaching is an important factor affecting the quality of intensive care unit (ICU) specialist nurse training. We investigated the current situation of ICU specialist nurse training and teaching quality evaluation in China and around the world. There are several aspects that can be improved in the evaluation of the quality of clinical practice teaching for ICU specialist nurses in China. Result-oriented summative evaluation is mainly used in China, and there are few studies on the quality evaluation of clinical practice teaching process. Effective feedback mechanism has not been established for teaching quality evaluation. There is a lack of systematic theoretical guidance and few studies have been conducted on the formation of the quality of clinical practice teaching and the affecting factors. Therefore, there is an urgent need to construct a set of scientific and practical clinical practice teaching quality evaluation system for ICU specialist nurses under the guidance of systematic theory and in line with China's national conditions. We should formulate reasonable and uniform quality evaluation standards for clinical practice teaching, strengthen the quality evaluation of the training process on the basis of result-oriented quality evaluation. Moreover, the needs of all parties in the evaluation system should be comprehensively evaluated to improve the quality of clinical practice teaching.

In addition to the essential pharmacologi-cal effects of opioids,situational cues associated with drug addiction memory are key triggers for drug seeking.CircRNAs,an emerging hotspot regulator in crown genet-ics-play an important role in central nervous system-relat-ed diseases.However,the internal mediating mechanism of circRNA in the field of drug reward and addiction mem-ory remains unknown.Here,we trained mice on a condi-tional place preference(CPP)model and collected nucle-us accumbens(NAc)tissues from day 1(T0)and day 8(T1)for high-throughput RNA sequencing.qRT-PCR revealed that circTmeff-1 was highly expressed in the NAc core but not in the NAc shell,suggesting that it plays a role in addiction memory formation.Meanwhile,the reverse regulation of circTmeff-1 by adeno-associated viruses could both inhibit the formation of addiction mem-ory in the NAc core or shell.Subsequently,the GO and KEGG analyses indicated 21 that circTmeff-1 might regu-late the addiction memory via the MAPK and AMPK path-ways.These findings suggest that circTmeff-1 in NAc plays a crucial role in morphine-dependent memory for-mation.