Objective To observe the application of alkaline cleaning agent in disinfection and supply room cleaning of medical devices, to evaluate the cleaning quality. Methods The 800 contaminated medical instruments collected from February 2016 to February 2017 in municipal maternal and child health hospital were divided into control group (February 2016 to August 2016) and study group (September 2016 to March 2017 ) according to different time periods,with 400 pieces in each group.In the reference group, the instrument was washed with multienzyme detergent, and the study group was cleaned with alkaline detergent. The cleaning of 2 groups of instruments was observed and compared. Results The total excellent and good rate of instrument cleaning in the study group was 97.25％ (389/400), in the reference group was 89.50％(358/400), the difference between the two groups was statistically significant (P<0.05); the cleaning safety, practicality, economy, comprehensive score difference of the study group was significantly better than the reference group (P<0.05). Conclusion The effect of alkaline cleaning agent used in disinfection supply room cleaning medical instruments is remarkable, and the equipment residue and microorganism can be effectively eliminated, and the utility model has the advantages of high safety and low economic cost, and has the important practical value.

Objective To identify differentially expressed proteins in keloid tissue and to explore the proteomic characteristics of keloid by utilizing capillary high-performance liquid chromatography (LC) and tandem mass spectrometry (MS).Methods Tissue specimens were obtained from the lesions of 5 patients with non-familial keloid and normal skin of 5 human controls.After extraction and in-solution digestion of proteins,the resultant peptides were separated and identified by LC-MS/MS.Label-free detection and quantitation of peptides were carried out by using the DeCyder MSTM software.Results A total of 570differentially expressed peptides were identified between non-familial keloid and normal tissue (all P ＜ 0.05),which correspond to 1221 proteins.A difference greater than 1.5 folds was observed in the expressions of 293 proteins,including 124 up-regulated and 169 down-regulated proteins in non-familial keloid tissue.Conclusion Differences exist in the expression of proteins between non-familial keloid and normal skin tissue.

Objective To know the advantages and disadvantages of problem-based learning from students'angle. Methods Interviewed 15 students by PBL scale and face to face interview,to know their ideas about problem-based learning,and then analyzed the results. Results PBL contributed to developing problem-solving skills,self-directed learning,team collaboration and extending professional knowl-edge. But it failed to show positive effect on students'learning motivation. Conclusions PBL has two sides on the outcomes of learning. Implementing PBL appropriately could gain the optimal effects.

AIM:To investigate whether minocycline postconditioning protects rat myocardium from ischemia-reperfusion ( I/R ) injury through attenuating poly ( ADP-ribose ) polymerase-1 ( PARP-1 ) excessive activation. METHODS:The left anterior descending coronary artery was ligated for 45 min and then reopened for 2 h to establish the rat model of myocardial ischemia-reperfusion injury.The male Wistar rats ( n =90 ) were randomly divided into sham group, I/R group, low-and high-dose minocycline groups, and 3-aminobenzamide (3-AB, PARP inhibitor) group.The myocardial infarct size was measured by Evans blue and 2,3,5-triphenyltetrazolium chloride ( TTC) staining.The morpho-logical changes of the myocardium were observed with HE staining.The cardiomyocyte apoptosis was detected using in situ TDT-mediated dUTP nick end labeling ( TUNEL) .The level of tumor necrosis factorα( TNF-α) and interleukin 1β( IL-1β) in the serum were measured by ELISA.The content of poly( ADP-ribose) ( PAR) in the reperfused myocardium and peripheral leukocytes were detected by Western blot.RESULTS: Compared with sham group, PAR expression, TNF-αcontent and IL-1βconcentration increased in all other groups.Compared with I/R group, treatment with low and high doses of minocycline and 3-AB significantly reduced the infarct size and myocardial apoptosis.PAR expression, TNF-αcontent and IL-1βconcentration in low-and high-dose minocycline groups and 3-AB group all decreased.No significant difference of the above parameters between high-dose minocycline group and 3-AB group was observed.CONCLUSION: Minocy-cline postconditioning may attenuate myocardial ischemia-reperfusion injury by depressing the activation of PARP-1 in car-diomyocytes and peripheral leukocytes in rats.

Sixty cases of pseudobulbar palsy were treated by puncturing Shuigou (GV 26), Lianquan (GV 23), Fengchi (GB 20), Wangu (GB12), Yifeng (TE 17),Tongli (HT 5), Neiguan (PC 6) and Fenglong (ST 40)with the needling technique to refresh mind and open orifice, and by puncturing the retropharyngeal wall and palatine arch, plus training of swallowing function, the total effective rate reached 95.0%.

Objective To investigate the status of community type 2 diabetic patients with peripheral arterial disease,analyze the influencing factors and put forward nursing countermeasures.Methods 210 type 2 diabetic patients living in a community in Shanghai were enrolled in the investigation.ABI and arterial peak velocity were measured using Doppler blood flow detector,symptoms and signs of foot were assessed and related laboratory examinations,including HbA1c,HDL-C,LDL-C were tested.Results There were 49 cases of ABI ＜ 0.9.The proportion of abnormal color of foot skin,edema,abnormal pulsation of dorsal artery of foot and sense of coldness in group of ABI ＜ 0.9 were larger than group of ABI≥0.9.There was no statistical significance between the two groups in the pain at rest and intermittent claudication.Logistic stepwise regression analysis showed that age and LDL-C not up to the standard were risk factors of PAD and the peak of foot dorsal artery flow was a protective factor of PAD.Conclusions It's important to early screen for PAD and to adopt corresponding nursing measures on the basis of treatment.We hope to further prevent the development of PAD and effectively prevent diabetic foot.

Objective To get a more comprehensive view of caregiving experiences, and describe the caregiver burden and the positive aspects of caregiving of family caregivers of senile dementia patients in community and to explore the relationship between the caregiver burden and the positive aspects of caregiving. Methods Totally 80 family community-dwelling caregivers of senile dementia patients in community were investigated by Caregiver Burden Inventory (CBI) and Positive Aspects of Caregiving (PAC) questionnaires. Results The score of CBI was 54.73 ± 13.15 and the score of PAC was 28.53 ± 5.37. The score of PAC was negatively correlated with the caregiver burden (r=-0.243, P<0.05). Conclusions The caregiver burden of the family community-dwelling caregivers of dementia patients is high and the positive aspects of caregiving is at middle level. Professional help and support should be provided to the family caregivers of dementia patients by the community health service centers on the premise that the caregiving experience is fully understood. Our aim is to reduce their burden, strengthen the caregiving skills and improve the positive aspects of caregiving simultaneously.

The national essential drug system is designed to solve the problem of covering hospital expenses with medicine revenue, and the problem of difficulty and high expense to see a doctor. This paper investigated whether the national essential drug system worked in three public community hospitals in Beijing. The result showed that the implementation of the program was now well underway, but left some problems. This paper put forward some suggestion for bidding of essential drug, improving the enthusiasm of the medical staff and improving the function of community hospitals.

Rheumatoid arthritis(RA) is very common in immune rheumatism, with high disease incidence and long course, hard to cure. The medicines and bio-preparation used in treating RA in modern medicine are difficult to spread and for long application owing to their unsatisfactory effect or much toxic or side effects. However, the acupuncture has definite effect without side effects. As the unique therapy in acupuncture field—abdominal acupuncture, can it bear the task of treating RA The article makes analysis and discussion on its availability.

Objective To develop a conductance-ion chromatography for simultaneous determination of 5 anions in drinking water. Methods The orthogonal experiment method L9(34) was used to select the optimum working conditions of IC-2000 ion chromatography. Under the founded chromatography condition, 5 anions in water samples were determined simultaneously after filtered with 0.45 ?m filter membrane. Results Both of the precision and accuracy of this method were desirable, all the relative standard deviation was less than 5.0%, the rates of recovery were 90%-106.7%, the correlation coefficient was more than 0.999 except NO2-(0.990 5). Conclusion This method is simple, accurate, quick and suitable for simultaneous determination of 5 anions in drinking water with no need of sample pretreatment.