Objective:To analyze the clinical application of navigation bronchoscopy system, and improve the accuracy during routine use.Methods:Through discussing ENB, System composition, clinical application and environment, the paper presents the clinical application standard and working environment standard of the navigation bronchoscopy system.Results:Electromagnetic navigation bronchoscopy(ENB) combined with the advantages of electromagnetic technology, virtual bronchoscopy and 3D CT reconstruction, which can perform the accurate localization of peripheral pulmonary lesion and mediastinal lymph node to acquire tissue samples for pathological diagnosis. ENB-guided localization can be used in interventional therapy(local injection or radioactive seed implantation).Conclusion:Navigation bronchoscopy system shows the merit of minimally invasive technique and medical visualization. It is a great progress in interventional pulmonology history.

Objective In order to investigate and evaluate the heating-ventilating-air conditioning (HVAC) systems in the public areas and therefore provide the support for the hygiene management. Methods According to Hygiene Criterion of HVAC System, 10 HVAC systems in 10 star grade hotels in Nanchang were selected and PM10 and the total count of aerobic bacterial in the air condition systems, the collected dust weight and the total count of aerobic bacterial in the dust in the inner surface of ventilation vessels, the legionella bacteria in cooling tower water were determined. Results The HVAC systems in the 10 hotels, 90.1% for the PM10 and 73.3% for the total count of aerobic bacterial in the air condition systems, 8.9% for the collected dust weight and 86.7% for the total count of aerobic bacterial in the dust in the inner surface of ventilation vessels were over the standard limits, the legionella bacteria were detected in two of the investigated HVAC systems cooling tower water. Conclusion The hygienic problems are existed in the ventilated systems in the air conditioners in the pubic places.The health supervision and monitoring must go on enhancing.

Objective:To have a research and application on management system of cold chain facilities temperature control in the hospital and real-time monitor the temperature and humidity changes of cold-chain facilities.Methods: Based on RFID radio frequency, Internet of things and computer technology to realize the construction of the system hardware and software platform, through commissioning and case analysis for system improvement, the system was popularized and applied comprehensively.Results: After one year’s trial run, it showed that the system could accurately and effectively monitor the abnormal temperature and humidity of the hospital’s cold chain facilities and give the acousto-optic hint and remote alarm in time, effectively improving the management level of cold chain temperature control.Conclusion: The system could guarantee the fine management of the cold chain facilities temperature control, provide safe and traceable historical data, and put forward a new solution for building the quality and safety of cold chain facilities temperature control system.

Annexin A5 is a member of Ca 2+-dependent phospholipid binding proteins family .It exists in histocytes . And because of its unique structure , Annexin A5 plays an important role in many critical functions such as cell in-side/outside anticoagulation and pro-apoptosis .Moreover , Annexin A5 has certain relevance with many diseases such as systemic lupus erythematosus ,tumour and other diseases .

Objective To establish the method for quality standard of Fangzhi Biyan Tablet. Methods Radix Angelicae Dahuricae, Radix Paeoniae Alba, Radix Saposhnikiviae and Radix Glycyrrhizae in the tablet were identified by TLC. The content of Imperatorin in this medicine was determined by HPLC. The Agilent Eclipse XDB-C18 (4.6 mm?250 mm, 5 ?m) was used, mobile phase was methanol-0.1%phosphoric acid solution (65∶35), flow rate was 1.0 mL/min, detection wavelength was 248 nm. Results The TLC spots developed were fairly and simply identical. HPLC was accurate and reproducible. Imperatorin show a good liner relationship at range of 0.076～0.684 ?g, the recovery was 98.63% (RSD=1.52%). Conclusion These methods can be used to control the quality of Fangzhi Biyan Tablet effectively.

Objective To investigate the feasibility and clinical effect of hip joint arthrodesis with the application of Kirschner wire and reconstruction plate in the treatment of advanced tuberculosis in total hip joint.Methods A total of 30 patients with advanced tuberculosis of the hip in our hospital from March 2014 to April 2016 were divided as Kirschner wire group and reconstruction plate according to different surgical methods,with 15 cases in each group.The operation time,bleeding volume during operation (intraoperative and postoperative),fusion time,postoperative complications of two groups were observed and compared.Results Patients of two groups reached bony fusion.Compared with reconstruction plate group,Kirschner wire group had less blood loss,shorter operative time,longer fusion time,the differences were statistically significant (P ＜ 0.05).Conclusion Both Kirschner wire fixation and reconstruction plate arthrodesis are effective for patients with advanced tuberculosis of total hip joint,but the clinical efficacy of Kirschner wire fixation in hip arthrodesis was significantly better than the reconstruction plate.

ObjectiveTo investigate serum lipopolysaccharide (LPS) level in people with different glucose tolerances and to explore the relationship between LPS and insulin resistance/β-cell secretory function.Methods Sixty-seven subjects were recruited,including 23 with newly diagnosed type 2 diabetes ( T2DM),21 impaired glucose tolerance ( IGT),and 23 normal glucose tolerance (NGT).Serum LPS was assayed by limulus amebocyte lysate test ;expression of LPS toll-like receptor 4 (TLR4) on surface of plasma monocytes was measured by flow cytometric assays,and the changes of LPS levels by 0.5 hours and 2 hours after a high-fat diet were detected.Insulin resistance was evaluated by homeostasis model assessment for insulin resistance (HOMA-IR); β-cell secretory function was evaluated by homeostasis model assessment for β3 cell function ( HOMA-β )/HOMA-IR,increment in insulin in the first 30 minutes/increment in glucose in the first 30 minutes ( AIns30/ΔG30)/HOMA-IR,AUCIns120min/HOMA-IR.Results2 h LPS levels after a high-fat diet were significantly higher than fasting LPS levels [ NGT:0.96(0.33,0.99)vs 0.62 (0.22,0.64),IGT:1.08(0.53,1.22)vs 0.71 (0.39,0.82),T2DM:1.23 (0.62,1.43)vs 0.86( 0.45,0.94 ),EU/ml,all P＜0.01 ].Fasting,0.5 h,and 2 h LPS levels and fasting TLR4 levels of T2 DM group and IGT group were respectively higher than those of NGT group [ fasting LPS:0.86( 0.45,0.94 ),0.71 ( 0.39,0.82 ) vs 0.62(0.22,0.64),EU/ml;0.5 h LPS:1.10(0.55,1.18),0.84(0.50,1.07) vs 0.73(0.31,0.76),EU/ml;2 h LPS:1.23(0.62,1.43),1.08(0.53,1.22)vs 0.96(0.33,0.99),EU/ml; fasting TLR4:36.96( 17.22,55.19),30.34 ( 15.00,45.18 )vs 15.66 (6.09,9.76),MIF/105 cells,all P＜0.01 ].Fasting LPS,AUCLPS 120 min,and fasting TLR4 were positively correlated with insulin resistance index and negatively correlated with β-cell secretory function index ( P＜0.05 ).Multiple linear regression analysis showed that fasting LPS was an independent correlative factor of HOMA-IR and 0.5 h LPS was an independent correlative factor of (AIns30/AG30)/HOMA-IR and AUCIns Ins120min/HOMA-IR.ConclusionPeople with different glucose tolerances show differed LPS levels and its receptor TLR4 levcls,both of which are correlated with insulin resistance and β-cell secretory function,suggesting that LPS is associated with the pathogenesis of abnormal glucose regulation.

Objective To evaluate the therapeutic effects,acute and late side-effects of cisplatin plus 5-fluorouracil (PF) schemed chronomodulated chemotherapy combined with concurrent intensitymodulated radiotherapy(IMRT) for nasopharyngeal carcinoma.Methods A total of 48 nasopharyngeal carcinoma patients treated with chronomodulated chemotherapy plus concurrent IMRT were retrospectively studied.The radiation doses prescribed to the gross target volume GTVnx of nasopharyngeal,to the positive neck lymphnodes GTVnd,to the clinical target volume CTV1,and to CTV2 were 73.92-77.88,69.96,60.06-66.00 and 50.96-56.00 Gy respectively.The Kaplan-Meier survival analysis was used to calculate the local-regional progression-free rate.The acute and late side-effects were graded according to RTOG radiation morbidity scoring criteria.Results The complete remission (CR) rate was 41.6％(20/48) ; the partial remission (PR) rate was 47.9％ (23/48) ; the stable disease (SD) rate was 4.2％(2/48) ; and the local tumor control rate was 89.6％.Most of the patients had grade 1 to 2 acute side effects and grade 0 to 1 late side-effects.No grade 4 acute and late toxicity was observed.1,2,4-year survival rates were 93.8％,79.2％ and 64.5％,respectively.The DVH analysis showed that IMRT improved the total dose and dose per-fraction to the target volume with considerable dose reduction of the normal structures at the same time.Conclusions PF chronomodulated chemotherapy plus concurrent intensity-modulated radiotherapy for NPC could improve therapeutic effects with satisfactory tolerance of the side effects.

Objective: To investigate the best extracting conditions of Polygonatum sibiricum polysaccharides by single and compound enzymatic methods, and to study on the change content of polysaccharide in processing of P. sibiricum by steamed and shined for nine times, which provide theoretical basis for processing of P. sibiricum and other Chinese herbal medicines. Methods: Response surface method (RSM) was used to optimize the extraction of polysaccharides in P. sibiricum. PMP precolumn derivatization and HPLC characteristic map technology were used to identify and analyze the changes of polysaccharide of P. sibiricum being steamed and shined for nine times and establish polysaccharide characteristic map of P. sibiricum by ancient processing and distillate. The effect of different enzymes on the extraction efficacy of P. sibiricum polysaccharides was also compared. Results: The extracting effect of cellulase in single enzyme was the best. Moreover, cellulose and pectinase were also the most significant factor for extracting polysaccharides from P. sibiricum in four complex enzymes. The best extracting conditions for polysaccharide obtaining by RSM as follows: Cellulase temperature was 51 ℃, cellulase dosage was 2%, and the total polysaccharide content was (675.34 ± 0.10) mg/g when the pH value of enzymolysis was 5.40. PMP-HPLC was used to detect four processed P. sibiricum, which contained mannose, ribose, rhamnose, glucose, and galactose. Glucose had a high proportion in P. odoratum, P. cyrtonema, and P. sibiricum polysaccharide, and P. filipes polysaccharide mainly composed of mannose. With the increase of processed times, the content of each monosaccharide increased first, then decreased, then increased and then tended to be stable. The content of mannose and galactose varied greatly. The content of monosaccharides in the distillate increased first and then stabilized, and the content changes of mannose and glucose were obvious. Conclusion: The extraction efficiency and purity of P. sibiricum polysaccharides can be improved by single and compound enzymatic extraction with cellulase, and the extraction yield of polysaccharide in P. sibiricum could be affected by steamed and shined for nine times. PMP-HPLC characteristic map technology can be used to determine the content of the polysaccharide in processing of P. sibiricum accurately and reproducibly, which can be used for the quality evaluation of P. sibiricum and other Chinese herbal medicines.

Objective:To study the application value of WeChat video teaching mode in clinical teaching of digestive endoscopy nurses.Methods:The study selected 126 nursing trainees taking an internship in the Department of Gastroenterology in our hospital from January 2018 to June 2020 as the teaching objects, and they were randomized into two groups, Control Group and Experimental group, with 63 cases in each group. The control group adopted traditional teaching and the experimental group took traditional teaching combined with WeChat video teaching. The internship time of both groups was 4 weeks. The scores of comprehensive ability assessment after practice were compared between the two groups, and the critical thinking ability scale and nursing students' clinical practice satisfaction scale were used to evaluate the critical thinking ability and satisfaction of practice nurses of the two groups before and after teaching. SPSS 19.0 was used for statistical analysis of the research data. Continuous variables were expressed as (mean ± standard deviation), t test was performed, categorical variables were expressed as percentage, four-grid test was conducted, and the test level was α=0.05. Results:The scores of comprehensive ability, theoretical knowledge and operation skills of the experimental group were significantly higher than those of the control group ( P<0.05). After teaching, the scores of seeking truth, opening mind, systematization ability, analytical ability, curiosity, cognitive maturity and total scale score of the two groups were significantly higher than those before teaching ( P<0.05), and there was no significant difference in the score of thinking self-confidence before and after the teaching ( P>0.05). The scores of seeking truth, opening mind, systematization ability, analytical ability, curiosity, cognitive maturity and total scale score of the experimental group were significantly higher than those of the control group ( P<0.05), and there was no significant difference in the score of thinking self-confidence between the two groups ( P>0.05). The experimental group's practice management, practice environment, teaching content, practice effect score and total scale score were significantly higher than those of the control group ( P<0.05), and compared with the control group, the score of teaching quality was poorer, without significant differences ( P>0.05). Conclusion:The application of WeChat video teaching mode in clinical teaching of digestive endoscopy nurses can improve the performance and satisfaction of comprehensive ability assessment of practice nurses, and enhance their ability of critical thinking.