Objective To investigate the clinical efficacy of losartan combined with atorvastatin in the treatment of essential hypertension and its influence on the plasma high sensitive C reactive protein(hs-CRP),endothelin (ET) and the level of nitric oxide(NO).Methods According to the digital table,84 patients with primary hypertension were randomly divided into the two groups of 42 cases,the control group was given losartan for treatment,the observation group was treated with losartan combined with atorvastatin.The clinical curative effect and the changes of plasma hs-CRP,ET and the level of NO before and after treatment were compared between the two groups.Results The effective rate of the observation group was 92.86％,which was significantly higher than 80.95％ of the control group(x2 =7.85,P ＜ 0.05);The levels of plasma hs-CRP and ET of the observation group after treatment were (3.02 ± 0.29) mg/L and (34.44 ± 4.59) μg/L,which were significantly lower than (5.30 ± 0.38) mg/L and (58.30 ± 5.27) μg/L of pretreatment and (4.95 ± 0.36) mg/L and (55.93 ± 5.71) μg/L of the control group (t =7.43,8.10,7.89,8.56,all P ＜ 0.05);The NO level of the observation group after treatment was (70.47 ± 4.58)μmol/L,which were significantly higher than (44.43 ± 3.41)μ mol/L of pretreatment and (46.33 ± 3.81) μmol/L of the control group(t =8.69,9.04,all P＜0.05).Conclusion Atorvastatin combined with losartan has a definite effect in treatment of primary hypertension,which can significantly improve the inflammation and endothelial function of patients that has a good clinical application value.

OBJECTIVE To study the usage of antibiotics in aseptic operation,and strengthen the management of antibiotics usage. METHODS We investgated the usage of antibiotics in aseptic operation retrospectively,then statistically analyzed. RESULTS Among all the 347 cases,343 cases were used for prophylaxis,the usage rate was 98.85%.The mean time of antibiotic therapy was 7.22 days.90.96% of the patients were treated with antibiotics for 3 days or more,53.35% of the patients were treated beyond 7 days.Ninety one patients were given antibiotics 0.5-2 hours before the operation(26.53%).There were 7 kinds of drugs used in the operation,the cephalosporin class accounted for 70.26%,moreover was third generation cephalosporin. CONCLUSIONS The prophylactic application of antibiotics in the aseptic surgery has some unreasonable phenomenon and must be strengthened.Training the doctor to use the antibiotics reasonably,and the effective surveillance management mechanism be established.

Objective:Through the application of remote diagnosis system in medical equipment operation maintenance analysis, clarify the significance of the remote diagnosis technology.Methods:Combined with the actual case, from the breakdown maintenance, preventive maintenance, online training, and other aspects to explore remote diagnosis technology in the medical equipment application and expand operations.Results:Using the remote diagnosis technology can reduce the failure rate, monitor system operation state and environment parameter, improve the efficiency of management of medical equipment.Conclusion: remote diagnosis technology make full use of the manufacturers of professional and technical resources, early detection equipment problems, provide prospective judgment, ensure the equipment running in the best condition.

OBJECTIVE To search for available mode of oral apparatus′s disinfection and management.METHODS To use new ways of oral apparatus′s disinfection and management that are enhancement of recognition,normal disinfecting procedure,available disinfection room,enhancement of management,new management system,building digitizing management and so on.RESULTS To build effective system and decrease abrasion and uselessness of oral apparatus.CONCLUSIONS Effective disinfection and management are very important for prevention of the cross infection and ensuring of daily use of oral apparatus.

Objective:To explore the effect of continuous quality improvement theory on patients' satisfaction and nurses'perception of working environment.Methods:Quality nursing service satisfaction survey was conducted in 450 patients,at the same time,100 nurses were investigated for the situation of working environment.Patients' satisfaction and the status of nurses' perception of their own work environment were compared before and after the implementation of continuous quality improvement theory.Results:After the implementation of continuous quality improvement theory,both patients' satisfaction and nurses' perception of working environment were significantly improved (P ＜ 0.05).Gonclusions:Continuous quality improvement theory can improve the satisfaction of patients with high quality nursing service,and enhance the nurses' perception of their working environment.

OBJECTIVE To investigate the microorganisms on the hands of nurses who are doing the intravenous infusion.METHODS Sampled the hands of nurses during the procedure of intravenous infusion randomly,and then sampled after monitoring the nurses washing their hands by the six steps hand-cleaning technique.Then cultured the samples and did the identification of bacteria.The distribution of microorganism on nurses' hands was analyzed.RESULTS During the procedure of intravenous infusion,before and after the intervention the microorganisms on the nurses' hands had evident difference and with the statistic meanings.CONCLUSIONS The handwashing compliance among nurses before working in our hospital is poor,and the hand hygiene status during the nursing procedure needs to be improved.

BACKGROUND: Measuring the slope of proximal tibiofibular joint may elucidate the anatomical structure and type of proximal tibiofibular joint, and evaluate the stability of proximal tibiofibular joint. OBJECTIVE: To investigate the measurement methods and clinical significance of the joint slope by comparing the slope measurement of bilateral proximal tibiofibular joint surface on X-ray and 64-row spiral CT reconstruction.METHODS: One hundred normal adult volunteers, including 50 males and 50 females, aged 18-90 years, were photographed in double knees via internal rotation to 30°, 45° and 60°, respectively and scanned with 64-row spiral CT, tibiofibular bone (including knee joints) was reconstructed. The included angle between proximal tibiofibular articular surface and the longitudinal axis of the fibula shaft, between the proximal tibiofibular articular surface and the horizontal line, were measured using an angle square.RESULTS AND CONCLUSION: There were great variations of the data in the same proximal tibiofibular joint measured by X-ray and spiral CT. X-ray results are affected by the site of photograph position, and the slope of articular surface is estimated, so the 64-row spiral CT is an accurate and convenient method to reconstitute the slope of proximal tibiofibular joints. Spiral CT could be used to distinguish the dislocation and instability of the proximal tibiofibular joint, accordingly reduce the clinical misdiagnosis.

Objective To explore the potential of autologous dendritic cells (DC) pulsed with HLA-A201-binding peptide E613-21(KLPDLCTEL) and E786-94(TLGIVCPI)in inducing specific T cells respouse in vitro.Methods Cervical carcinoma patients with positive HLA-A201 were enrolled and their monocytes isolated and induced into dendritic cells and pulsed with HLA-A201-binding peptide E613-21 and E786-94.PBLs were primed by DCs every week for thee times.The cytokine level of supernatant of CTLs was tested by ELISA.The percentage of special CTLs was tested by flow cytometry.The specific killing effect of CTLs was tested by MTT.Results the numbers of DCs of eleven cervical carcinoma patients were (10.79±0.88) ×106(100 ml peripheral blood).CDllc+HLA-DR+(97.15±2.41)％,CD80+(84.28+5.39)％,CD83 +(85.17±5.06) ％,CD86 + (97.74+0.87) ％.Proliferation index of PBLs primed by DCs three times was 15.4± 1.5.Cytokine levels including IL-2,IL-12,IFN-γ and TNF-α were obviously higher than nonpriming PBLs[(2551.9+195.3) pg/ml,(554.9±64.0) pg/ml,(2416.9±281.7) pg/ml,(632.4 +71.1)pg/ml,respectively] (P＜0.05),but IL-10 was no significant difference between priming CTLs and nonpriming CTLs.The average percentage of special CTLs was obviously higher than control group[(6.32±1.54)％,P＜0.05].The killing effect of CTLs was obviously higher than control group(P＜0.05).Conclusion Dendritic cells pulsed with peptide E613-21 and E786-94 can induce special CTLs in vitro and stimulate CTLs secret cytokines.This will provide science basis for research of therapeutic HPV vaccine.

Objective To study the expression of PINCH and vascular endothelial growth factor C (VEGF-C) in cervical squamous cell carcinoma.Methods We detected the expression of PINCH and VEGF-C by immunohistochemistry SP in 58 cervical squamous cell carcinoma cases and 30 normal cervical epithelial tissue and analyzed their relationship to the clinical pathological features.Results The expression of PINCH and VEGF-C in 58 cervical squamous cell carcinoma(62.1％,36/58 ;67.2％,39/58 ) were higher than that in normal cervical epithelial tissue(0,0/30).The difference was significant( x2 =31.512,12.534,P ＜ 0.001 ).The expression of PINCH protein was not significantly associated with the age,tumor size and tumor differentiation grade ( P ＞ 0.05 ),but was associated with the lymph node metastasis and clinical stage ( x2 =9.090,8.236,P ＜ 0.001 ).The expression of VEGF-C had no significant correlationship with the age and tumor size( P ＞ 0.05 ) but had a correlationship with the lymph node metastasis,tumor differentiation grade and clinical stage( x2 =10.775,13.496,5.001,P ＜ 0.05 ).The expression of VEGF-C was correlated with the expression of PINCH protein( C =0.341,P ＜ 0.01 ).Conclusion It is possible that VEGF-C and PINCH take part in the development and progress of cervical squamous cell carcinoma and play an important role in the invasion and metastasis mechanism altogether.

Objective To investigate the clinical outcomes of surgical excision combined with recom binant interferon aipha-2b in the treatment of acral malignant melanoma (MM). Methods Fifteen patients with acral MM admitted to the department since 2004 were recruited into this study. The tumors varied from 1.8 mm to 3.9 mm in invasion depth. Thin tumors with an invasion depth of 1.8 - 2.0 mm were excised with a margin of lcm beyond the tumors, and those with an invasion depth of 2.0 - 3.9 mm were excised with a margin of 2 cm beyond the tumors. After excision, 4 cases of minor excision were sutured directly, 10 cases of large excision were repaired with adjacent skin grafts and flaps, 1 patient with the involvement of the first metatarsophalangeal joint underwent toe amputation followed by the repair of planta wound surface with the remaining skin on the dorsa of toes. Patients received intramuscular recombinant interferon alpha-2b for 3 months (3 million units daily for the first 3 days and 6 million units for the remaining days) following operation. Results There were 6 cases of MM in situ and 9 cases of invasive MM in this study. All the skin grafts and flaps survived. Within the 3-year follow up, relapse was observed only in 1 patient with invasive MM. Recovery was achieved in the functions of feet in all patients. Conclusion The excision of tumors with a margin determined by tumor thickness plus intramuscular interferon alpha-2h may improve the survival of patients with cutaneous MM in planta pedis with avoidance of amputation.