OBJECTIVE To provide evidence to establish properly protocol for medical cosmetic institutions.METHODS Through investigation to analyze the current situation and problems of disinfection and isolation in the medical cosmetic institutions.RESULTS There were 86.7% medical cosmetic institutions located in commercial buildings.And there were 33.3% institutions with improper layout of therapeutic room,sterilizing room and dressing room resulting from insufficient space or less rooms.The illumination intensity of the ultraviolet lamp and the disinfection effect of air were not coincident with standards.CONCLUSIONS There are many problems of disinfection and isolation in the medical cosmetic institutions,the disinfection is insufficient,the ultraviolet light is in wild-using,people only focus on using,but ignore irradiation dose and distance.It is very important for strictly observing Hospital Infection Management Methods,Disinfection Technology Standards and Disinfection Management Methods,and strengthening the management of disinfection and isolation in the medical cosmetic institutions.

Objective To assess the feasibility of laryngeal mask anesthesia under spontaneous ventilation in pulmonary resection with uniportal video-assisted thoracoseopic.Methods Forty patients with pulmonary masses were randomized into two groups(n =20 in each group) to undergo pulmonary resection with uniportal videoassisted thoracoscopic,full implementation of thoracoscopic lobectomy and mediastinal lymph node dissection.Patients in two groups were induced by intravenous anesthesia,and the skin of the fifth intercostal space were infiltrated with ropivacaine.Patients in two both groups were maintained by intravenous ancsthesia and sevoflurane anesthesia.Muscle relaxants were administered in endotracheal inmbation group but not in the LMA group.Patients in the LMA group and tracheal intubation group underwent with spontaneous breathing and one-lung ventilation respectively.Results No significant differences were found in surgery time,intraoperative lowest SpO2,preoperative PaCO2,1-h postoperative blood gas analysis between the two groups.The anesthesia induction time,extubation time,and the stay time for the recovery of anesthesia and postoperative hospital stay were significantly shorter than those in the tracheal intubation group.The increments in MAP and HR after intubation operation were smaller than those in the LMA group.The total dosage of sulfentanyl and propofol per kg in the LMA group were significantly less than those in the control group.The PaCO2 after pulmonary resection and the intraoperative maximum level of PETCO2 in the former group were significantly higher than those in the tracheal intubation group,however the incidence of throat discomfort and the hospitalization cast were significantly decreased.Conclusion In view of patient rehabilitation and in hospitalization cast,laryngeal mask anesthesia under spontaneous ventilation in uniportal video-assisted thoracoscopic surgery was better than the procedure performed under intubation anesthesia.

Objective To evaluate the diagnostic value and limitation of MRI for chromophobe renal cell carcinoma.Methods MRI features of 5 cases with pathology proved chromophobe renal cell carcinoma were analyzed retrospectively.Results All tumors showed homogenous isoin-tensity or slightly hypointensity on T1 weighted images and isointensity or slightly hyperintensity on T2 weighted images.Slightly hyperintensity were showed on DWI images,the mean ADC value of tumors was 1.42×10-3 mm2/s.On the contrast enhanced images,all the mass showed slight to moderate enhancement ,1 case had spoke-wheel-like enhancement,1 case showed flowed out blood vessels in the tumor.Conclusion The preoperative diagnosis is difficult for chromophobe renal cell carcinoma,MRI is a valuable method which could provide useful information for qualitative diagnosis.

Objective Systemic analysis the effect of the application of continuity nursing in community diabetes.Methods Retrieve documents from the PubMed,Cochrane Library,EMBASE,Science Direct,CBM,WANFANG Data and CNKI.Dating from the dates of establishment to May,2014.Randomized controlled trials (RCTs) on continuity of patient care for patients with diabetes were included.Two reviewers independently screened the literature according to the inclusion and exclusion criteria,extracted the data and assessed the quality of the included studies,and then meta-analysis was performed by RevMan 5.1 software.Results 5 RCTs (156 cases with diabetes) were involved into this Meta-analysis.The experimental group was superior to the control group in FBG,2h PBG,HbA1c and the level of treatment compliance,with statistically significant differences,P＜0.05.The descriptive analysis showed that the differences in the score of diabetes knowledge and the quality of life were statistically significant,P＜0.05,because the data could not be converted.Conclusions The continuity nursing can improve the compliance and the quality of life of community diabetes,ameliorate certain biochemical indicators.Study of large sample and RCTs should be take because of the existence of some restraining factors.

Objective To evaluate the efficacy and safety of infliximab and traditional disease modifying antirheumatic drugs (DMARDs) in the treatment of ankylosing spondylitis (AS). Methods Sixty patients with definite AS were treated with infliximab 5 mg/kg infusion at 0, 2, 6, 12 weeks and were followed up for 12 weeks. The primary endpoint was proportion of ASAS 20 responders at week 12. The secondary endpoints were the proportion of ASAS 50, the change from baseline in Bath AS functional index (BASFI).The improvement of signs and symptoms of AS and physical function were evaluated. The statistical treatments were used t-test andA2 test. Results The proportion of ASAS 20 responders at 2, 6, 12 week was 70%, 83% and 93% respectively. The proportion of ASAS50 responders at patients at 2, 6, 12 week was 13%, 37% and 57% respectively. Results for other secondary efficacy endpoints showed that infliximab could provide substantial benefits to patients with AS by reducing clinical signs and symptoms and improving range of motion, physical function and quality of life. Ten percent of the subjects reported treatment- related adverse events. The most frequently occurred were upper respiratory tract infection, followed by gastrointestinal adverse events and infusion reaction. Most treatment-related adverse events were mild to moderate in severity and disappeared after drug withdrawal. Conclusion Infliximab has been demonstrated to be effective and is well tolerated in the treatment of AS.

Objective To evaluate the therapeutic value of minimally invasive excision of benign breast lesions using stereotactic mammotome minimally invasive surgery system.Methods Under ultrasonographic image monitoring,1160 breast masses of 310 patients were excised using mammotome minimally invasive stereotactic excision system and sent for pathologic examinations immediatly.Patients′condition was follow-ed up and recorded post-operative.Their clinical data were retrospectively analysed.Results Accurate and complete resection of all of the 1160 breast masses was achieved.The resected tissues were large enough to make pathologic diagnosis.The pathologic diagnoses were all found to be benign,and included: fibroadenoma(n=672),fibroadenosis(n=451),intraductal papilloma(n=12),cyst(n=6),cystic hyperplasia(n=17) and tubular adenoma(n=17).Regular follow up every 6-12 months was done.Postoperative surgical scars were unremarkable,the skin incisions were small and concealed,breast appearance and skin sensation were normal and ultrasonography did not reveal residual lesions or recurrences.Conclusions Complete resection of benign breast lesions can be done with mammotome technique.This technique is safe,accurate and effective.Moreover,there is little trauma,low complication rate,and the breast appearance is not affected.This minimally invasive excision technique for benign breast lesions is suitable for wide use.

Objective To analyze the clinical features of systemic lupus erythematosus (SLE) com-plicated by noncirrhotic portal hypertention (NCPH),and improve the recognition of NCPH.Methods Clinical data from SLE complicated by NCPH in our hospital were retrospectively analyzed and summarized,while the related literatures were reviewed.Results Four patients diagnosed as SLE complicated by NCPH were all women.NCPH presented with the clinical features of portal hypertension with normal or slightly elevated transaminase.Anticardiolipin (ACL) antibodies were positive in 2 patients.Two patients underwent liver needle biopsy,showing nodular regenerative hyperplasia,of which,one with liver portal fibrosis.The treatment strategy was managing the primary disorder and controling of portal hypertention in four patients.Twenty-two cases of SLE complicated by NCPH were reviewed and analyzed,including 18 cases from related literatures and our 4 cases.Among the 22 cases,the mean time between the diagnosis of SLE and NCPH was eight years,of which one patient with NCPH before SLE,one diagnosed at the same time and the rest with NCPH after SLE.19％ (4/21) of patients presented with Raynaud's phenomenon and 18％ (4/22) complicated by pulmonary hypertension.In serological tests,patients presented with positive ACL anti-bodies [33％(7/21)] and anti-dsDNA [48％(10/21)],as well as increased IgG and γ-Globulin [38％(8/21)].Liver needle biopsy showed nodular regenerative hyperplasia or liver portal fibrosis with the prevalence of 80％ (16/20) and 25％ (5/20),respectively.Conclusion SLE complicated by NCPH is very rare clinically and is easily being misdiagnosed without obvious symptoms and signs in the early stage.Positive ACL antibodies and Raynaud's phenomenon maybe be closely related to SLE complicated by NCPH.

Background and purpose:The incidence of esophageal cancer of Kazakh race is higher than that of Han people. EphA2, as a member of Eph protein family, is related to a variety of malignant tumors. This study used immunohistochemical method and enzyme-linked immunoassay to detect EphA2 in tissues and serums of Kazakh and Han patients. Therefore to analyze the expression differences of EphA2 in esophageal squamous cell carcinoma (ESCC) tissues and serum of Kazakh and Han patients in Xinjiang, and the relationship with pathological features. Methods:The expression of EphA2 protein was detected by immunohistochemistry method in 100 cases of ESCC tissues and adjacent normal esophageal tissues;Then was tested by ELISA in those cases’ serum and 60 healthy persons. Results:The positive expression rate of EphA2 protein in ESCC and corresponding adjacent tissues were 72.0%, 28.0% in Kazakh, and 62.0%, 26.0% in Han people, respectively, and the differences were statistically significant (P=0.000) in the 2 nations. EphA2 protein levels in serum of ESCC and healthy persons, and Kazakh were (58.36±12.60) and (29.39±7.34) pg/mL, Han Chinese were (58.79±13.29) and (29.39±7.34) pg/mL respectively, there were statistical signiifcance (P=0.000). In ESCC of Kazakh and Han people, EphA2 protein expression had relationship with lymph node metastasis, TNM stage and tumor depth of invasion (P<0.05). In the serum of Kazakh and Han ESCC patients, the expression of EphA2 protein was related to TNM stage (P<0.05), while in the Kazakh esophageal cancer, the expression level was also correlated with the depth of tumor invasion (P=0.001). The positive expression rates of EphA2 protein in Kazakh and Han ESCC specimens were 72.0%and 62.0%, respectively;the protein level in the serum of patients in the 2 nations were (58.36±12.60) and (58.79±13.29) pg/mL, respectively. The protein levels in tissues and serum of the 2 different nations has no statistical signiifcance (P>0.05). Conclusion:The high expression of EphA2 protein may contribute to the occurrence, invasion and metastasis of Kazakh and Han ESCC patients. EphA2 protein expression in tissues and serum of patients with ESCC may be related to the primary tumor invasion, lymph node metastasis and TNM stage. The expression of EphA2 protein in peripheral blood of patients with esophageal cancer in Kazakh may be related to depth the of invasion.

Objective To investigate the clinical characteristics of multisystem impairment of Sj(o)gren's syndrome (SS) to make quick and accurate diagnose and treatment to decrease the rate of misdiagnosis and mistreatment.Methods A case of thrombotic thrombocytopenic purpura with SS was reported and the related literatures were reviewed.The clinical manifestations,laboratory examinations,diagnostic criteria and therapy of thrombotic thrombocytopenic purpura with SS were analyzed.Results Purpura haemorrhagica,hemolytic anemia,central nervous systemic symptoms,kidney impairment and fever were the representative clinical manifestations of thrombotic thrombocytopenic purpura with SS.Plasmapheresis was the most effective therapy with the background treatment with glucocorticosteroid and immunosuppressive agents.Conclusion Thrombotic thrombocytopenic purpura with SS presents a complicated clinical manifestations,so misdiagnosis and mistreatment is very frequent.More attention should be paid to this specific situation because the disease is rare and has high mortality rate.

Objective To investigate the effect of oil with medium-long-chain triacylglycerols on blood lip- id and lipoproteins in hyperlipemic patients. Methods Totally, 112 patients with hypertriglyceridemia were en- rolled and randomly divided into MLCT group (consumed oil with medium-long-chain fatty acids) and LCT group (consumed oil with long-chain fatty acids) (both 25-30 g/d for 8 weeks). Patients in both two groups were also instructed to take exercises. Height and weight were measured at baseline and 8 weeks later. Blood glucose, serum levels of aspartate aminotransferase (AST), alanine aminotransferase (ALT), total cholesterols (TC), triglyc- erides (TG), high density lipoprotein cholesterol, low density lipoprotein cholesterol, apolipoprotein Al (ApoAl), ApoB, ApoA II , ApoC2, ApoC3, and ApoE were measured and compared. Results At the end of study, 101 subjects were included. There were 50 subjects left in LCT group and 51 subjects left in MLCT group, respectively. There was no significant difference in weight, ALT, AST, TC, and TG at baseline between two groups (P>0.05). Eight weeks later, weight, serum TG, ApoC2, and ApoC3 were significantly lower and ApoAl level was significantly higher than those at baseline in MLCT group (P < 0.05). At the end of study, the decreases in body weight and blood biochemical variables including TG, ApoB, ApoA II , ApoC2, ApoC3 were significantly much greater in MLCT groups than those in LCT group (P < 0. 05). Conclusion When the diet is reasonably controlled, oil of medium-long-chain triacylglycerols may reduce the concentration of TG and improve the levels of apolipoproteins.