Objective:To explore and analyze application of the activity of quality control circle (QCC) in the management of disinfection for laparoscopic instruments.Methods: 1000 non-disinfected laparoscopic instruments of operating room were randomly divided into control group (n=500) and observation group (n=500). The laparoscopic instruments of control group received routine disinfection while that of observation group was implemented activity of QCC during they received routine disinfection. The occurrence rate of damage for instruments and special small component, qualified rate of disinfection, occurrence rate of adverse event and the problem solving ability of paramedic were compared after all of laparoscopic instruments were disinfected.Results:After received the activity of QCC, the damage rate of instruments, miss rate of special small components, loose rate of packaging and error rate of relative record of observation group were significantly lower than that of control group (x2=52.31,x2=64.49,x2=34.51, x2=79.00;P<0.05), and the qualified rate of disinfection in observation group was significantly higher than that of control group (x2=37.70,P<0.05). Besides, the occurrence rate of adverse event of observation group was significantly lower than that of control group (x2=1857.28,P<0.05).Conclusion:The activity of QCC is implemented in the management of disinfection for laparoscopic instruments can efficiently enhance the qualities of disinfection and care, and can enhance the working enthusiasm, responsibility and problem resolving ability of paramedic.

Objective To evaluate the effects and side effects of three different recruitment maneuvers (RM) in acute respiratory distress syndrome (ARDS) caused by extrapulmonary disease.Methods Forty-four patients of extrapulmonary ARDS, according to crossover design methods, were undergone three RM in different periods, including sustained inflation (SI), increase progressively positive end expiratory pressure (IP), pressure control ventilation (PCV). Heart rate (HR), mean arterial blood pressure (MAP), central venous pressure (CVP), oxygenation index, lung compliance were recorded before and after RM, and were analyzed for statistical analysis. Results Oxygenation index and lung compliance were increased obviously in a short time after RM, improvement of IP method were better more obviously than the other two methods [1 h oxygenation index after RM:227 ± 42 vs 190 ± 19,186 ± 21; lung compliance:(59.4±12.5 ) ml/cm H2O(1 cm H2O = 0.098 kPa) vs (50.1 ± 9.3 ), (49.7 ± 10.6) ml/cm H2O;P＜ 0.05], 2h after RM,there were no statistical difference among the three methods (P＞0.05). After RM,HR and CVPwere increased, MAP was decreased in a short time, changes of SI method were smaller than the other two inethods [10 min HR after RM: (94.0±10.3 ) beats/min vs (116.0 ± 14.8 ), ( 107.0 ± 5.7 ) beats/min; CVP:(13.7±3.1 )cm H2O vs ( 18.4 ± 6.7 ), ( 15.4 ± 2.7 )cm H2O; MAP: ( 87.0 ± 12.1 ) mm Hg( 1 mm Hg = 0.133 kPa) vs (73.0 ± 4.8), (81.0 ± 6.6) mm Hg;P＜ 0.05), 20 min after RM, there were no statistical difference among the three methods (P＞ 0.05). Conclusion When extrapulmonary ARDS undergo RM ,IP method is the most effective on increasing oxygenation index and lung compliance, SI method has the smallest side effect on hemodynamics.

Objective To investigate the effect of reformative ventilation method (head-high leg-low 30°-declivate prone position ) in the ventilation of acute respiratory distress syndrome ( ARDS ) patients, and compared with normal prone position ventilation. Methods Forty-four patients of ARDS underwent ventilation were divided into prone position group (22 cases) and reformative prone position group (22cases) by random digits talle. Continuous 30° semireclining position was kept in normal time. The patients of the two groups underwent different prone position ventilation 4 hours every day,and indexes of hemodynamics and respiration before,during and after prone position ventilation were recorded and analyzed. Results After prone position ventilation, oxygenation index of two groups improved similarly (P ＞ 0.05 ). In prone position group, lung compliance decreased [2 h, ( 25.6 ± 5.8 ) ml/cm H2O ( 1 cm H2O = 0.098 kPa) vs. ( 37.2 ± 20.5 )ml/cm H2O] ,average airway pressure increased [2 h, ( 18.5 ± 3.9) cm H2O vs. ( 15.6 ± 5.3 )cm H2O] ,heart rate increased [2 h, ( 112.0 ± 16.2 ) beats/min vs. ( 102.0 ± 11.3 ) beats/min], mean arterial blood pressure decreased [2 h, (86.0 ± 6.7) mm Hg ( 1 mm Hg = 0.133 kPa) vs. (93.5 ± 7.5 ) mm Hg] ,central venous pressure increased[2 h, ( 15.5 ± 3.3 ) cm H2O vs. ( 12.6 ± 4.3 ) cm H2O]. These changes persistently existed during prone position ventilation (P ＜ 0.05 ),and they disappeared in 1 hour when recovered to 30 °semireclining position. Conclusion Reformative prone position ventilation not only has same effect on improving oxygenation index, but also obviates adverse effect on lung compliance and hemodynamics.

To observe the therapeutic efficacy of electric stimulation on points for children's amblyopia.Method:Ninety children amblyopia cases with ametropia upon correction were randomized into three groups:point electric stimulation,comprehensive conventional therapy and integrative therapy of the above two.And then visual function changes of kids in the three groups were observed.Results:Among the above three therapies,the recovery rates of point electric stimulation,comprehensive conventional therapy and integrative therapy of the two were 83.9%,82.6%and 94.25 respectively,showing no significant difierence(P＞0.05) among the three groups.Conclusion:Point electric stimulation has similar action with comprehensive conventional therapy in the treatment of children's amblyopia,and the combination of the two therapies has better effect,indicating point electric stimulation can speed up recovery of visual function of kids with amblyopia.

Objective To compare the clinical efficacy of three kinds of replacement fluid for continuous hemofiltration in severe sepsis,and to develop a more rational composition.Methods Fifty severe sepsis patients with continuous hemofiltration were divided into four groups randomly.The configuration of the replacement fluid in accordance with the random number table,randomly selected from four different formulations:group A (13 cases):Ports composition provided by Nanjing general hospital;group B (12 cases):Zhongshan hospital composition; group C (11 cases):an improved composition; group D (14 cases):an improved composition by Donghua hospital affiliated to SUN Yat-sen university.Blood electrolytes,blood gas analysis,renal function,blood glucose(highest and lowest serum glucose in treatment period),high sensitive C-reactive protein(hs-CRP) concentration,calcium concentration in filter were tested before and after every treatment period.Results The concentration of blood electrolytes during treatment had no significant change (P ＞ 0.05).Renal function were improved significantly after treatment among four groups (P ＜ 0.05).The level of hs-CRP decreased significantly after treatment (P ＜ 0.05) and there was no significant difference among four groups (P ＞ 0.05).The change of serum glucose during treatment was the smallest in group D than that in group A,B,C [(3.0 + 0.9) mmol/L vs.(11.2 + 2.0),(3.8 + 1.1),(5.5 +1.3) mmol/L](P ＜ 0.05).Calcium concentration in filter was the lowest in group D than that in group A,B,C [(1.5 + 0.5) mmol/L vs.(2.0 + 0.7),(2.3 + 0.5),(2.1 + 0.4) mmol/L] (P ＜ 0.05).The dosage of heparin was the least during treatment in group D than that in group A,B,C[(6.5 ± 2.8) U/(kg·h) vs.(8.9 ± 3.4),(7.9 ± 3.0),(8.7 ± 3.1) U/ (kg· h)] (P ＜ 0.05).Conclusions Improved composition by Donghua hospital affiliated to SUN Yat-sen university hospital compared to other compositions can better maintain a stable blood glucose levels,have a better anticoagulant effect,reducing the application of heparin,maintain a stable homeostasis.It is worthy of using in clinic.

OBJECTIVE: To observe the physiological and biochemical effects of intermittent fasting combined with hunger-resistant food on mice, and to evaluate the safety and beneficial effects of this regimen. METHODS: One hundred and forty-four adult ICR mice were divided into 4 groups: standard feed AL group (ad libitum intake of standard feed), hunger-resistant food AL group (ad libitum intake of hunger-resistant food), standard feed IF group (feeding standard feed and fasting on alternate days), and hunger-resistant food IF group (feeding hunger-resistant food and fasting on alternate days). The experiment lasted for 4-8 weeks and all mice drank water freely. The quality of life, body weight, fasting blood glucose, serum lipid, blood routine test, liver and kidney functions as well as the viscera indexes were examined. RESULTS: Compared to the standard feed AL group, the caloric taking and the increment of body-weight were reduced (P<0.01), and the viscera indexes of the liver and kidney were elevated (P<0.05) in the hunger-resistant food AL group and the hunger-resistant food IF group, the values of fasting blood glucose were reduced in standard feed IF group and hunger-resistant food IF group (P<0.01), the value of triglycerides was reduced in hunger-resistant food IF group (P<0.05), while the quality of life, blood routine test as well as the liver and kidney functions were not obviously affected in the hunger-resistant food AL group, standard feed IF group and hunger-resistant food IF group. CONCLUSION: The regimen of intermittent fasting combined with hunger-resistant food is safe and beneficial to metabolic regulation, such as controlling body-weight and adjusting blood glucose and serum lipid. It is expected that development of this regimen will be helpful to the control of obesity and diabetes, etc.

OBJECTIVE: To examine the effect of different reduced caloric intake on mice transplanted with S180 ascitic tumor. METHODS: The institute for cancer research (ICR) mice were randomly divided into control group, 3.0 standard feed (SF) group, 2.0 SF group and 1.3 SF group. The mice in control group were fed enough (about 5 g/d) dietary intake, while the amounts of dietary intake in the latter three groups were scaled down in the proportion of 65%, which were 3.0 g, 2.0 g and 1.3 g standard feed respectively. Meanwhile the essential vitamins were added to the latter three groups to keep the amount of intake the same as that of the control's. RESULTS: For most of the mice, the caloric intake obviously prolonged the mean survival days and improved the life quality was 7.14 kcal/d, and the fasting blood glucose level was 2-3 mmol/L. CONCLUSION: Properly reduced caloric intake and keeping lower blood glucose level is beneficial to prolonging the survival time of mice transplanted with S180 ascitic cancer.

Objective To investigate the expression of Twist,E-cadherin and N-cadherin in bladder urothelial carcinoma and evaluate their relationships with tumor.Methods From January 1998 to June 2007,the expression of Twist,E-cadherin and N-cadherin protein were detected in 180 bladder urothelial carcinoma tissue specimens in paraffin blocks and 60 normal bladder tissue specimens by tissue microarray and immunohistochemistry.Results Compared with normal hladder tissues,the expression of Twist and N-cadherin was up-regulated in bladder carcinoma tissues and the positive percentage was 63.9％ and 47.8％ respectively.The percentage of high E-cadherin expression in bladder carcinoma tissues was only 27.8％,which was significantly lower than that in normal bladder tissues.The expression of Twist was significantly related with age,tumor number,vessel invasion,distant metastasis and lymph node metastasis (P＜0.05).The expression of E-cadherin was significantly related with distant metastasis and lymph node metastasis (P＜ 0.05).The expression of N-cadherin was significantly related with distant metastasis and lymphnode metastasis (P＜0.05).There was significant positive correlation between Twist and E-cadherin expression (P＜ 0.05).There was significant positive correlation between Twist anl N-cadherin expression (P＜0.05).There was negative correlation between E-cadherin and N-cadherin expression.All the 180 bladder carcinoma patients were followed up after the surgery,and the mean follow-up time was (35.2±9.1) months.The 5-year survival rates of patients with low and high Twist expressions were 67.7％ and 46.1％ respectively,and there was significant difference between the two groups (P＜0.05).The multivariate analysis indicated that the Twist expression was an independent prognostic factor of bladder carcinoma.Conclusions The high expression of Twist,E-cadherin and N-cadherin are involved in the processes of invasion and metastasis of bladder urothelial carcinoma.The Twist expression was one of the independent prognostic factors of bladder urothelial carcinoma.

potential use in clinical therapy and prognosis estimation of the tumor.

Objective To clear, amplify and detect the activity of the recombinant adeno-assoeiated virus vector with adiponectin( rAAV2/1-Aerp30 ). Methods Recombinant plasmid pSNAV2.0-Acrp30 was obtained. The recombinant plasmid was then transfected into BHK21 cells using LipofectAMINETM 2000. The G418 resistant cells were obtained consequently. These cells were infected with HSVI-rc/△UL2 which has the function of packaging and copying recombinant AAV. After purification, the construction of recombinant rAAV2/1-Aerp30 was collected. Results The construction of recombinant pSNAV2.0-Acrp30 was confirmed by PCR electrophoresis and digestion with restriction enzyme. The gene sequencing showed that the recombinant pSNAV2.0-Acrp30 was correct. The virus titer was about 1.0×1012 μg/ml. The purity f the recombinant AAV2/1 was fairly high using the SDS-PAGE method. Conclusion With this method, rAAV2/-Aerp30 with high virus titers and purity can be acquired successfully and it can meet the demands of the experimental study of Acrp30 gene therapy of GK rats.