OBJECTIVE To explore the effect of managing the rent surgical instruments with cycle management method of PDCA.METHODS The managing of the rent surgical instruments used two methods in our central supply room from Jun 2006 to Jun 2008 was reviewed in the control group and experimental group.RESULTS The rate of effective screening compared with the control group was improved from 59.9% to 100%.The rate of clear direction of instruments compared with the control group was improved from 85.9% to 99.8%(P

AIM:To investigate the effects of budesonide on expression of basic fibroblast growth factor and mRNA in asthmatic rats.METHODS: Thirty six male Sprague-Dawley rats were randomly divided into three equal groups,including asthma group,control group and budesonide treatment group.In this experiment,the rat model of asthma was established by the ovalbumin challenge methods.The concentration of basic fibroblast growth factor in bronchoalveolar lavage fluid(BALF)was measured by ELISA,the expression of the protein of basic fibroblast growth factor and mRNA were detected with immunohistochemistry methods and in situ hybridization methods.RESULTS: The concentration of basic fibroblast growth factor in bronchoalveolar lavage fluid,the protein and mRNA expression of basic fibroblast growth factor in lung tissue were significantly higher in the asthma group than those of control group(P

Esophageal cancer is one of the most common malignancies in the world.Surgical treatment is the first choice for the treatment of esophageal cancer because it could radically resect the tumor and significantly improve the patients'condition.Minimally invasive esophagectomy (MIE) was rapidly developed because of its advantages of minimal invasion,small volume of blood loss,slight pain,low complication rate and quick recovery of patients.The extent of lymphadectomy and postoperative survival rate of MIE were comparable to those of traditional thoracotomy.MIE has become the treatment of choice for benign esophageal diseases and early esophageal cancer in some medical centers.However,debate still exists regarding the role of MIE in the treatment of esophageal cancer,particularly given the limitations in the widespread implementation of this technically challenging operation.This review summarized the current status of the use of minimally invasive surgery for the treatment of esophageal cancer and some thoughts on the development of MIE were provoked.

[Objective] The paper tries to demonstrate the reasonableness and legality of Doctors ’Right of Intervention. [Methods]By comparing life divine principle and patient autonomy principle to analyze the value ranking. By data col ection, study the relevant provisions of Doctors ’Right of Intervention at home and abroad. [Results] Life divine principle demonstrates the reasonableness of the Doctors ’Right of Intervention, and the right to life and health in Constitution demonstrates the legality of the Doctors’Right of Intervention. [Conclusions] Doctors’Right of Intervention is reasonable and legal, so when patients or their family members make wrong or harmful choice in treatment, doctors should exercise the Doctors ’Right of Intervention without hesitation to help them to choose the right way or make decisions for them.

Objective To investigate the diagnostic value of adrenal tumors by MRI.Methods The MRI features of adrenal tumors proved pathologically in 26 patients were reviewed,and were comparatively studied with the results of operation and pathology.All patients received pre-and post-contrast MRI scans,the morphology,size,margin,signal intensity and enhancement pattern of the lesion were observed.Results Of 26 adrenal tumors,8 were pheochromocytoma which were encapsulated mass with long T 1 heterogeneous T 2 signal and heterogeneous enhancement,the characteristic manifestations were prominent high signal on T 2WI,heterogeneous signals were showed in haemorrhagia,necrosis,cystic formation.5 cases were metastatic tumors from pulmonary cancers,the shape and signal of tumons were regular or irregular.6 cases were adenomas which were showed as round mass with distinct margin and iso-signal without necrosis and cystic formation.Adenocarcinoma was seen in 4 cases and was manifested as irregular long T 1 heterogeneous T 2 signal and heterogeneous enhancement, the surrounding tissues and blood vessel were involved. Myelolipoma was found in 3 cases and presented as short T 1 and short T 2 signal intensity.Conclusion MRI is valuable in diagnosis and differentiated diagnosis of adrenal tumors, and is important in the delineation of tumor extent and surgical planning.

OBJECTIVE To study the washing effect of three different methods with the multienzymatic detergent to keep the surgical instruments moist.METHODS The surgical instruments which were selected within five days were washed by three different methods with the multienzymatic detergent to keep moist.The washing effect was compared by eyes and with 5 times magnifying glass and with OB test paper.RESULTS There were prominent difference to washing effect among three methods to keep the surgical instruments moist(P

Objective: To compare the root filling results of 2 thermoplasticized gutta-percha filling techniques (Ultrafil 3D and Obtura II) with cold lateral condensation of gutta-percha. Methods: Sixty freshly extracted maxillary mandibular single-rooted teeth were instrumented and randomly divided into 3 groups: Ultrafil 3D, Obtura II and cold lateral condensation groups. The root canal was routinely prepared and the obturation time was recorded. Three days later, 10 teeth of each group were randomly stained and the micro effusion length was subsequently measured. The micro-chink between filling materials and the wall of root canal were measured with scanning electron microscope in the other 10 teeth of each group. The data were analyzed using unpaired Student's t-test. Results: The longest obturation time was in cold lateral condensation group, then Obtura II and Ultrafil 3D group in order, with significant difference found between the cold lateral condensation group and the latter 2 groups (P<0.01). The lengths of micro effusion and micro-chink in lateral condensation group were significantly larger than those in the other 2 groups (P<0.05); however, there was no significant difference between the 2 injection thermoplasticized gutta-percha technique groups. Conclusion: Under in vitro condition, the 2 injection thermoplasticized gutta-percha techniques have better adaptation to the canal wall, better root filling results, and less obturation time compared with cold lateral condensation.

OBJECTIVE To investigate the significance of Epworth sleepiness scale(ESS)and modified Epworth sleepiness scale(MESS),and evaluate the feasibility of MESS in assessment of obstructive sleep apnea hypopnea syndrome(OSAHS).METHODS The ESS and MESS of 232 patients with OSAHS was recorded in their first visiting.The scores of ESS and MESS were analyzed with the parameters of polysomnography(PSG). RESULTS Both ESS and MESS can reflect the degree of sleepiness and anoxemia in OSAHS patients,but the MESS was more efficient than ESS.The difference of MESS score between normal group and severe OSAHS group was greater than that of ESS score.CONCLUSION MESS is concerned the living habit of Chinese,and can partly reflect the station of patient with OSAHS.MESS can also be a primary screening method for suspected patients with severe OSAHS.

Objective To investigate the influence of coix seed triglyceride combined with transcatheter arterial chemoembolization (TACE) therapy on AFP, CD4﹢CD25﹢regulatory T (Treg) cells and cellular immune function in patients with advanced primary hepatocellular carcinoma (HCC). Methods A total of 50 patients with inoperable HCC, whose imaging examination showed no distant metastasis, were divided into the study group (n=25) and the control group (n=25). Coix seed triglyceride together with TACE was employed for the patients of the study group, while only TACE was adopted for the patients of the control group. For the patients of the study group, transcatheter hepatic artery infusion of 100 ml coix seed triglyceride was carried out during the performance of TACE, and postoperative intravenous drip of coix seed triglyceride (200 ml/d) was used for 5 days. The peripheral blood samples were collected one week before and one month after the treatment to detect the changes of AFP and T lymphocyte subsets (CD3﹢, CD4﹢, CD8﹢,CD4﹢/CD8﹢ and Treg) levels. One month after the treatment, enhanced CT, MRI or PET-CT was performed to evaluate the necrosis degree of the tumor. Results After the treatment, AFP levels was decreased in both groups, when compared the preoperative data the differences were statistically significant (P<0.01); the tumor necrosis rate of the study group was (57.7 ±8.2)%, which was slightly higher than (57.7±8.2)% of the control group, however, the difference was not statistically significant (P>0.05). In the study group, the percentage of Treg cells decreased from preoperative (8.27±6.65)%to postoperative (4.22± 1.59)%, the difference was statistically significant (P<0.01). The percentages of CD3﹢ and CD4﹢ and the ratio of CD4﹢/CD8﹢ increased from preoperative (55.78 ±13.66)%, (43.98 ±14.00)% and 1.22 ±0.64 to postoperative (62.29±10.78)%(P<0.01),(51.82±16.32)% (P<0.05) and 1.54±0.80 (P<0.05) respectively, while the percentage of CD8﹢decreased from preoperative (45.71±12.94)%to postoperative (39.70±12.41)%(P<0.05). In the control group, no statistically significant differences in the above mentioned indexes existed between preoperative data and postoperative ones (P>0.05). Conclusion In treating advanced primary HCC, coix seed triglyceride combined with TACE can reduce the percentage of Treg cells, thus, influence the patient’s cellular immune status and possibly decrease the recurrence rate of HCC after TACE therapy.

Neovascular glaucoma is a rare and severe complication of hypoperfusion retinopathy.The appearance of hypoperfu- sion retinopathy complicating neovascular glaucoma in ophthalmolscopy and fundus fluorescein angiography shows a special feature. Neovascular glaucoma occurs when new fibrovascular tissues proliferate onto the chamber angle and obstruct the trabecular meshwork. The stenosis or occlusion of internal carotid artery is the most common reason of hypoperfusion retinopathy in elder people.Early recog- nition and treatment of patients with carotid occlusive diseases may prevent more serious complications.