OBJECTIVE To cultivate central supply unit member's custom of watching detail and dealing with everything carefully. To enhance central supply unit work's quality and efficiency,and decrease the phenomenon of article sterilized overdue and nipping tool's scathe. METHODS To organize study and enhance the cognition. To constitute regulations,systems and operation rule. To investigate the condition of medical instrument utilized,and pay attention to detail service for packaging sterilization. RESULTS The rate of overdue sterilized article decreased from 0.008% to 0.001%. The number of nipping tool's injuries decreased from 18 in 24 to 2 in 22 when the detail management was actualized. The rate of injury decreased from 75.0% to 9.09%. CONCLUSIONS In order to ensure the quality of asepsis of articles,we need to alter our conceptions,strengthen our responsibility,servicing more initiatively and carefulness.

Objective To explore the synergistic effectiveness of hyperthermia and chemotherapy in the treatment of advanced gastric cancer.Methods Eighty-nine patients with advanced gastric cancer were randomly assigned to a study group which received a CapeOx chemotherapy regimen supplemented with hyperthermia or to a control group which received only the CapeOx regimen.The regimen consisted of capecitabine (1000 mg/m2,bid,orally for 14 consecutive days) plus oxalipaltin (130 mg/m2) on day 1.The hyperthermia was at 43℃ for 60 min in the tumor area on day 1 and twice a week thereafter.One cycle was 21 days.After 2 treatment cycles,efficacy was evaluated according to RECIST standards,improvements in the quality of life were assessed according to Karnofsky's performance status (KPS) and the side-effects of therapy were recorded.Results The response rate was 68.9％ in the study group and 36.4％ in the control group,showing a significant difference between the groups after two treatment cycles.The median progress-free survival (PFS) was 8.3 months in the study group vs 5.2 months for the controls.The 1-year survival rate was 66.4％ vs 45.5％ and the rate of improvement in KPS was 77.8％ vs 45.5％.All these differences were statistically significant.The common adverse effects were gastrointestinal toxicity,marrow depression and peripheral nerve abnormalities,but these adverse effects were all mild and similar in the two groups.Conclusion Hyperthermia when combined with the CapeOx chemotherapy regimen might improve the therapeutic effect in advanced gastric cancer without obviously increasing the adverse effects.

Objective To learn the exposure levels and health hazards of long-term exposure to hexavalent chromium (Cr6+) through drinking water in a west county,and to provide a scientific basis for making preventive measures.Methods Five water points were selected to test the Cr6+ concentration of drinking water in the county in 2015,data of 3 water points with water Cr6+ concentrations exceeded the standard (Cr6+ ＞ 0.05 mg/L) were selected from 12 drinking water points in some west counties in the recent six years (2009-2014) as the exposed group,2water points that drinking water Cr6+ concentrations not exceeded the standard (Cr6+ ≤0.05 mg/L) in the county and adjacent to the exposed group were selected as the control group.Sixty villagers were selected as the investigation objects in each water point to conduct internal medicine,ears,nose,throat (ENT),dermatology and health examination,urinary chromium content,routine blood and urine test were done.Determination of hexavalent chromium concentration in drinking water was done according to The Drinking Water Standard Examination Method 1,5-diphenylcarbazide Spectrophotometry (GB/T 5750-2006);routine urine was tested using the 10 urine analyzer test;urinary chromium was tested using graphite furnace atomic absorption spectrometer;routine blood five classification was tested using automatic blood analyzer;determination of drinking water hexavalent chromium concentration was done according to The Hygienic Standard for Drinking Water (GB 5749-2006).Higher than 0.05 mg/L was judged as exceeded the standard;physical examination was done according to The Diagnostic Criteria of Occupational Chromium Nasal Disease (GB Z12-2002) and The Diagnostic Standard of Occupational Contact Dermatitis (GB Z20-2002).Results There were 184 and 109 people in the exposed group and the control group,respectively.The average concentration of Cr6+ exceeding the standard ratio was 2.82-3.22 in drinking water,the nasal septum nucosa perforation,skin erythema edema,skin ulcers were 4.9％ (9/184),4.3％ (8/184) and 4.3％ (8/184) in the exposed group,and the urinary chromium level (0.31 μg/L) in the exposed group was significantly higher than that of the control group (0.27 μg/L,Z =-4.078,P ＜ 0.05).Routine blood test result of mean corpuscular haemaglobin (MCH) was (29.56 ± 2.07) pg,platelet counts (PLT) was (222.38 ± 47.53) × 109/L and plateletcrit (PCT) was (0.25 ± 0.05)％ in the exposed group,it was all higher than those of the control group [(29.03 ±2.95) pg,(211.74 ±75.27)× 109/L,(0.24 ± 0.08)％,t =1,940,2.318,2.079,all P ＜ 0.05];standard difference coefficient of variation of red blood cell distribution width (RDW-CV) was (13.14 ± 1.05)％,lymphocyte number (LYMPH) was (2.01 ± 0.64) × 109/L in the exposed group,it was all lower than those of the control group [(13.38 ±1.54)％,(2.21 ± 1.02) × 109/L,t =-1.989,-1.956,all P ＜ 0.05].The positive rate of glycosuria,uric bravery red,and urine nitrite in routine urine test of exposed group was 17.39％ (32/184),23.36％ (43/184),7.61％ (14/184);it was all higher than those of the control group [(8.25％ (9/109),11.93％ (13/109),0.91％ (1/109),x2 =4.746,5.798,6.309,all P ＜ 0.05].Conclusions Urine chromium accumulation has been found in populations long-term exposed to 2.82-3.22 times excessive Cr6+ through drinking water,which has affected the population's health to some extent.Therefore,it is necessary to speed up the local drinking water improvement project.

Objective To detect the change of exoression level of plasma microRNA‐21(miR‐21) and TGF‐β1 in cardiac remode‐lin affer acute myocardial infarction(AMI) of the pateins .Methods 200 pateints with AMI and 100 normal controls(age ,sex matched) were enrolled .Blood samples were obtained from the normal controls and patients with AMI on the 3 days ,7 days and 14 days .Real‐time PCR was developed to detect the expression of miR‐21 and TGF‐β1 in plasma .Results The expression of miR‐21 was significantly up‐regulation in the 3 days ,7 days and 14 days in MI group than that cntrol group ,0 .74 ± 0 .21 vs .2 .62 ± 0 .23 , vs .3 .67 ± 0 .25 ,vs .4 .13 ± 0 .27 up‐regulation in the 3 days ,7 days and 14 days in MI group than that cntrol group ,0 .98 ± 0 .18 vs .2 .35 ± 0 .24 ,vs .3 .67 ± 0 .25 ,vs .4 .13 ± 0 .27 ,P<0 .05 ,respectively .The expression of miR‐21 and TGF‐β1 were up‐regulation with the change of cardiac function .Positive relationship between miRNA‐21 expression and LVDd (r=0 .757 ,P<0 .05);Positive relationship between TGF‐β1 mRNA expression and LVDd(r=0 .701 ,P<0 .05) .Conclusion The expression of miR‐21 and TGF‐β1 were up‐regulation in cardiac remodelin affer AMI of the pateins ,which involved in regulation in cardiac remodelin affer AMI .

Objective:To study the clinical value of serum adenosine deaminase (ADA) combined with whole blood microRNA (miR)-197-3p in the diagnosis of human brucellosis.Methods:From January 2020 to September 2023, 120 patients with brucellosis were selected from the Department of Pulmonary and Critical Care Medicine, Affiliated Hospital of Jining Medical University (referred to as this hospital) and assigned to the brucellosis group, including 89 patients in the acute stage, 19 patients in the chronic stage, and 12 patients in the latent infection. In addition, 60 healthy volunteers from the animal husbandry industry were selected as the control group from the physical examination population in this hospital during the same period; sixty critically ill patients with community-acquired pneumonia were selected from the Department of Pulmonary and Critical Care Medicine of this hospital as the infection control group. Patients in the brucellosis group and infection control group were given standardized treatment. Fasting elbow venous blood samples were collected in the morning before and after treatment in the brucellosis group and infection control group, at enrollment in the control group, and serum ADA and whole blood miR-197-3p levels were tested. Multivariate logistic regression analysis was used to study the risk factors affecting the occurrence of brucellosis. Receiver operating characteristic (ROC) curve was used to evaluate the diagnostic efficacy of ADA, miR-197-3p, and their combination for brucellosis.Results:Before treatment, the levels of serum ADA (U/L: 12.35 ± 2.89, 18.33 ± 4.57, 29.75 ± 6.46, 22.20 ± 4.78, 14.15 ± 3.03) and whole blood miR-197-3p (1.09 ± 0.33, 2.25 ± 0.41, 2.68 ± 0.59, 2.43 ± 0.51, 1.18 ± 0.40) in the control, infection control, acute stage, chronic stage, and latent infection groups were compared, and the differences were statistically significant ( F = 4.38, 4.02, P = 0.014, 0.019). Compared with the control group, the serum ADA and whole blood miR-197-3p levels in the other 4 groups were higher ( P < 0.05). Compared with the infection control group, the serum ADA level in the acute stage and chronic stage groups was higher, and the serum ADA level in the latent infection group was lower ( P < 0.05); the level of whole blood miR-197-3p was higher in the acute stage group, but lower in the latent infection group ( P < 0.05). Compared with before treatment, the levels of serum ADA and whole blood miR-197-3p in the infection control, acute stage and chronic stage groups were lower after treatment ( P < 0.05). Multivariate logistic regression analysis showed that increased levels of serum ADA and whole blood miR-197-3p were risk factors for brucellosis [odds ratio ( OR) = 2.235, 3.404, 95% confidence intervals ( CI): 1.491 - 3.362, 1.623 - 7.605, P < 0.001]. ROC curve results showed that serum ADA and whole blood miR-197-3p had auxiliary significance in the diagnosis of brucellosis ( P < 0.001). The area under curve (AUC) of serum ADA combined with whole blood miR-197-3p was 0.933, which was superior to the diagnostic efficacy of serum ADA and whole blood miR-197-3p alone (AUC = 0.823, 0.840). Conclusion:The combination of serum ADA and whole blood miR-197-3p has high clinical value in the diagnosis of human brucellosis, and can provide an important reference for the clinical diagnosis and efficacy evaluation of brucellosis.

Theories of classified management which are based on risk governance are introduced into the newly revised , but the punishments on the manufacturers of unconformity products are not classified based on the severity and risks caused by the test items. This article analysed the disadvantages of current punishment measures on the manufacturers of unconformity products and the theoretical basis of classified punishments. The feasibility of classified punishments had also been studied and some basis of discretionary punishments was provided under the current regulations.
Equipment Failure ; Equipment and Supplies ; standards ; Punishment

UNLABELLEDBackround N-terminal pro-brain natriuretic peptide (NT-proBNP) is a reliable predictor in acute coronary artery disease (CAD). Little is known about patients with stable CAD, especially Chinese patients with CAD. The aim of the present study was to investigate the association of NT-proBNP levels with the severity of CAD in patients with normal left ventricular ejection fraction.

METHODSA total of 658 consecutive patients were divided into two groups based on angiograms: CAD group (n = 484) and angiographic normal control group (n = 174). The severity of CAD was evaluated by modified Gensini score, and its relationship with NT-proBNP was analyzed.

RESULTSThe prevalence of risk factors such as age, male gender, diabetes mellitus (DM), dyslipidemia, smoking, and family history of CAD in the CAD group were higher than that in the control group. In multivariate regression model analysis, age, gender, and DM were determinants of the presence of CAD. NT-pro BNP was found to be an independent predictor for CAD (OR:1.66 (95% CI: 1.06-2.61), P < 0.05). In a receiver operating characteristic (ROC) curve analysis, an NT-proBNP value of 641.15 pmol/L was identified as a cut-off value in the diagnosis or exclusion of CAD (area under curve (AUC) = 0.56, 95% CI: 0.51-0.61). Furthermore, NT-proBNP was positively correlated with Gensini score (r = 0.14, P < 0.001) in patients with CAD.

CONCLUSIONNT-proBNP was an independent predictor for Chinese patients with CAD, suggesting that the NT-proBNP level might be associated with the presence and the severity of CAD.

Coronary Disease ; blood ; physiopathology ; Female ; Humans ; Male ; Middle Aged ; Natriuretic Peptide, Brain ; blood ; Peptide Fragments ; blood ; Prospective Studies ; Risk Factors ; Severity of Illness Index ; Stroke Volume