Objective Due to poor effects of sterilization,low efficiency and inconvenience of field emergency transportation for portable exhaust pressure steam sterilizer,we aimed to design and develop a portable pulse vacuum pressure steam sterilizer in order to effectively improve quality and efficiency of sterilization for sterile medical equipment in disaster and emergency medical treatment.Methods From the beginning of February 2013,we focused on the features of small size,light weight,reliable sterilizing effect and fast speed of sterilization,and conducted series of technology researches,and finally developed portable pulse vacuum pressure steam sterilizer which was suitable for individual carrying or air delivery.Results We performed outdoor sterilization tests for portable vacuum pressure steam sterilizer and portable exhaust pressure steam sterilizer under the same condition.Portable pulse vacuum pressure steam sterilizer achieved a 100％ qualification rate,average sterilization cycle was 28.6min per time,sterilization by weight was 48L/h,average water consumption was 0.4L/boiler,average power consumption was 0.7kw/h per time,and sterilization operation index,maneuverability and transportability were significantly better than those of portable exhaust pressure steam sterilizer.Conclusion The developed 4 portable pulse vacuum pressure steam sterilizer have higher cost performance,and have been successfully applied for medical service training and non-war medical treatment activities in our hospital.

Aim To investigate the effect of genistein ( GEN) against Aβ( 25 -35 )-induced PC12 cells in regulation of Fas pathway through the activation of JNK. Methods Aβ( 25 -35 )-induced PC12 cells model was established. MTT and fluorescence activated cell sorting to analyze cell viability and apoptotic rate. Fluorescence quantitative PCR was used to detect Fas apoptotic pathways related gene Fas, FasL, caspase-3 and caspase-8 mRNA relative expression. Spectropho-tometry was used to detect caspase-3 and caspase-8 en-zyme activity. Western blot was adopted to detect JNK and p-JNK protein expression level changes. Results GEN attenuated Aβ( 25-35 )-induced upregulation of Fas and FasL, caspase-3 and caspase-8 mRNA lev-el, caspase-3 and caspase-8 enzyme activity, and sig-nificantly reduced Aβ(25-35) induced JNK phospho-rylation level. Conclusion GEN can protect PC12 cells from Aβ(25-35)-induced apoptosis via reducing Aβ( 25 -35 )-induced phosphorylation of JNK activa-tion, and then inhibit the JNK dependent Fas apoptotic pathway.

BACKGROUND:Pain is the significant cause for patients with early rehabilitation after total knee arthroplasty. Continuous epidural analgesia and continuous femoral nerve block are effective analgesic methods after total knee arthroplasty, however, which method has better effects and less complications remains controversial. OBJECTIVE:To compare the efficacy and safety of countious femoral nerve block and continuous epidural analgesia after total knee arthroplasty. METHODS:We searched Cochrane Library, PubMed, EMBASE, Web of Science, CBM, CNKI, VIP, and WangFang. Meanwhile, we also searched conference papers and academic dissertation. The retrieval time was from database establishment to October 1, 2014. Studies of randomized control ed trials on countious femoral nerve block and continuous epidural analgesia after total knee arthroplasty were included. We evaluated the quality of these included studies and analyzed data by Cochrane Col aboration’s RevMan 5.0 software. RESULTS AND CONCLUSION:A total of 12 randomized control ed trials (4 English articles and 8 Chinese articles) involving 680 patients were included. There were 343 patients with countious femoral nerve block and 337 patients with continuous epidural analgesia. Meta-analysis results revealed that no significant differences in visual analog scale scores were detected between the countious femoral nerve block and continuous epidural analgesia groups at 6, 12, 24 and 48 hours after total knee arthroplasty. However, compared with the continuous epidural analgesia group, countious femoral nerve block could decrease the incidences of nausea/vomiting (RR=0.36, 95%CI:0.21-0.63, P=0.003), urine retention (RR=0.08, 95%CI:0.04-0.16, P<0.001) and dizziness (RR=0.24, 95%CI:0.06-0.99, P=0.05). These results indicate that compared with epidural analgesia, countious femoral nerve block after total knee arthroplasty provided a strong analgesia effect, contributed to early functional training, had less adverse reactions, and was a safe and effective analgesic method.

Objective To study the prevalence of HIV-1 drug-resistant strains in antiretroviral therapy-naive HIV-1 infectors,and provide background information for HIV-1 drug resistance survey and clin-ical antiretroviral therapy in Beijing in 2008. Methods Referring to the guidelines for HIV drug resistance threshold survey(HIVDR-TS) of WHO, collecting 60-70 plasma samples of HIV-1 infectors who were detec-ted in 6 months and not more than 25 years,we detected HIV-1 pol genotype and genetic mutations associated with drug resistance,counted the prevalence of drug-resistant strains, and evaluated the prevalent level. Re-Sults Of 61 plasma samples answering for the standards, 50 were successfully sequenced and genotyped pol sequence. The major infection route was homosex, which accounted for 62%. B, CRF01_AE, and CRF07_ BC were major genetic subtype, which accounted for 42%, 28% and 26%, respectively. One Pl-resistant strain was found, the incidence of which was 2% (1/50). One NRTI-resistant strain was found, the inci-dence of which was 2% (1/50). No NRTI-resistant strain was found, the incidence of which was 0. The in-cidence of drug-resistant strains in the protease (PR) region was 2%, and the incidence of reverse tran-scriptase (RT) region was also 2%. Both of the prevalence were classified as low level ( <5% ). Conclu-sion PR, RT-resistant HIV-1 strains were found in drug-naive infectors, and the prevalence was low in Beijing. Current antiretrovirai therapy regiments were still feasible. Most of the AIDS patients did not need to test drug resistance before antiretroviral therapy.

To screen antitumor active compounds, drug-like or leading compounds from Chinese traditional and herbal drugs.

Objective: To compare the effects of laparoscope and open complete mesocolic excision (CME) in the treatment of right colon cancer. Methods: The retrospective case-control study was adopted.The clinical data of 139 patients with right colon cancer who underwent CME at the Second People's Hospital of Lianyungang from January 2014 to November 2017 were collected.The patients were divided into laparoscopy group(55 cases) and open group(84 cases). The postoperative recovery and oncology efficacy were compared. Results: The operation time in the laparoscopy group[(172.8±25.9)min]was longer than that in the open group[(142.3±20.6)min](t=7.387, P<0.05), but the blood loss of the laparoscopy group[(111.6±36.7)mL] was less than that in the open group[(150.1±61.1)mL](t=4.017, P<0.05). There was no statistically significant difference in numbers of lymph nodes harvested.Compared with open group, there were advantages in the laparoscopy group such as less anal exhaust time, less postoperative eating liquid diet time and shorter hospitalization time, the differences were statistically significant (t=4.695, 5.517, 4.642, all P<0.05). There was no statistically significant difference in postoperative complication rate (P>0.05). There were no statistically significant differences in the cumulative recurrence rate, cumulative survival rate and cumulative survival rate between the two groups after 3 years (all P>0.05). Conclusion Laparoscopic CME is minimally invasive and quick recovery, and laparoscopic CME has the same oncologic clearance effects, and is worthy of clinical application.

OBJECTIVE: To explore application of endoscope assisting in retrosigmoid approach vestibular schwannoma resection and its signification. METHOD: Through retrosigmoid approach with endoscope assisting, vestibular schwannoma in the cerebellopontine angle was removed in 12 cases. Assessment of function of facial nerve and auditory was made for all patients preoperative and postoperative. RESULT: Vestibular schwannoma in 12 patients were removed completely, then the facial nerve and the acoustic nerve were preserved after tumor removal. No complication was found in six months. We observed the hearing loss in postoperative patients, and there is no difference in facial nerve function between preoperative and postoperative. The alteration of auditory and facial nerves functions is no difference between two retrosigmoid approach groups with or without endoscope assisting. CONCLUSION Application of endoscope assisting in retrosigmoid approach can be helpful for totally resection of vestibular schwannoma in inner acoustic meatus without lesion of canalis semicircularis and glomus jugulare. Application of the endoscope assisting in retrosigmoid approach is helpful to provide the precise information of CPA anatomic structure and decrease the incidence rate of complication.
Adult ; Aged ; Cerebellopontine Angle ; surgery ; Endoscopy ; methods ; Female ; Humans ; Male ; Middle Aged ; Neuroma, Acoustic ; surgery

OBJECTIVE: To study the characteristic of hearing loss and the changes of the auditory brainstem response and distortion product otoacoustic emission in diabetics. METHOD: General information of 136 diabetics were investigated whether had the complication of capillary vessel and hearing loss with self-made questionnaire at random. 136 cases (272 ears) were tested with ABR and DPOAE. They were divided into A, B, C, D four groups according to the age of per ten years (30-70 years). Other 120 (240 ears) matched healthy adult were enrolled in the control group. The pure tone threshold (PTT), acoustic impedance, ABR and DPOAE results were compared between the four groups and the control group, and then made statistical analysis. RESULT: When comparing to the control group, the interpeak latency I-V and ABR response were no significant difference between patients at the stage of 30 years. Not only the threshold of wave V was elevated with aging in patients over 40 years, but the amplitude of the peak latencies of waves III and V were lessening, and the interpeak latency III-V and I-V were prolonged between patients at the stage of 60 years, which had significant difference compared with age-matched patients (P < 0.05). The inducing rate of DPOAE were 100% in the test and control group, but the amplitude of DPOAE declined ranged from 1 to 8 kHz in patients with early diabetes mellitus and were significantly reduced at 4 kHz, which had significant difference compared with age-matched patients (P < 0.05). CONCLUSION The majority of patients with diabetes mellitus had slight and moderate hearing loss gradually. The ABR and the threshold of ABR response were varied with the age and sex of patients, and whether had the complication of capillary vessel, but were not related to its type and disease course. The DPOAE can comprehend the cochlear disorder in patients with early diabetes mellitus.
Adult ; Aged ; Case-Control Studies ; Diabetes Mellitus ; physiopathology ; Evoked Potentials, Auditory, Brain Stem ; Female ; Hearing Loss ; diagnosis ; etiology ; Humans ; Male ; Middle Aged ; Otoacoustic Emissions, Spontaneous

Objective: To explore the application effect of preoperative administration of immunomodulating enteral nutrition for gastric cancer. Methods: From January 2016 to December 2017, 90 cases with gastric cancer in the Second People′s Hospital of Lianyungang were selected and randomly divided into observation group, control group A and control group B, with 30 cases in each group.The observation group was given enteral nutrition emulsion(TPFT, Ruineng) before and after operation, the control group A was given Ruineng before operation and the enteral nutrition emulsion(TP, Ruisu) after operation, the control group B was given Ruisu before operation and Ruineng after operation.The recovery, serum markers of nutritional status and immune function were evaluated and compared, and the postoperative situations were observed. Results: There were no statistically significant differences in the total protein, albumin, prealbumin and transferrin among the three groups during admission, 1 day before operation and 5 days after operation(all P>0.05). There was no statistically significant difference in immune indicators among the three groups during admission and 1 day before operation(all P>0.05). At 5 days after operation, IgA, IgM, IgG, CD₄⁺ and CD4/CD8 in the observation group were (2.9±0.6)g/L, (1.4±0.4)g/L, (12.4±0.9)g/L, (37.4±5.1)%, (2.2±0.7), respectively, which were significantly higher than those in the control group A[(2.3±0.8)g/L, (1.1±0.6)g/L, (10.8±0.8)g/L, (34.2±4.8)%, (1.7±0.8), respectively, t=3.324, 2.250, 7.100, 2.506, 2.660, all P<0.05], the IgA and CD4/CD8 in the observation group were higher than those in the control group B[(2.6±0.8)g/L, (1.9±0.7), t=2.021, 2.127, all P<0.05]. The postoperative exhaust time of the observation group, control group A and control group B were (56.4±7.8)h, (78.6±10.4)h, (60.7±10.6)h, respectively, and the postoperative exhaust time of the observation group was significantly shorter than that of the control group A(t=9.323, P<0.05). There was no statistically significant difference in the gastrointestinal symptoms and postoperative complications among the three groups (P>0.05). Conclusion In perioperative period, immunomodulating enteral nutrition has little effect on the nutritional indicators of patients with gastric cancer and the incidence of postoperative complications, but it can improve the immune function.