OBJECTIVE To apply course management in disinfection and sterilization in hospital.METHODS The key points of disinfection and sterilization were investigated and found out.The flow of disinfection and sterilization was reconstructed,and the course management was actualized.RESULTS The hardware of disinfection and sterilization was improved,and the work efficiency and the percentage of pass were increased.CONCLUSIONS Course management is propitious to normal disinfection and sterilization in hospitial.

Objective To investigate the attitude of career in undergraduates of rehabilitation therapy. Methods 41 undergraduate students were investigated with questionnaire. Results 14.6% of the students preferred rehabilitative therapeutist, 53.7% knew little about the profession, 31.7% selected this profession for employment, 22.0% loved rehabilitation work, 41.4% would take rehabilitation work for life.Conclusion It is important for school to help the students understanding the profession of rehabilitative therapeutist correctly.

OBJECTIVE Passing through the investigation of disposable syringes use condition, to determine amount of syringes used in the hospital and extent of their contact with blood and body fluids, and to assess their waste polluted condition. METHODS By our hospital computer charge system, from May 1, 2006 to Apr 30, 2007 The used syringes were calculated. RESULTS A total of 923 676 plastic disposable syringes were used; from them 6 801 (0.74%) were contaminated by blood, an other body fluids (urine, gastric secretion, cerebrospinal fluid, and wound drainage) or cells, 16 892 (1.83%) were by anticancer drugs and 160 461(17.37%) were with different injections or contrasts. 739 522(80.06%)were utilized for dilute medicine in i.v. drip. CONCLUSIONS Eighty percent of syringes waste is without pollution, it can be used to regard as recycled resources.

OBJECTIVE To explore the efficientcy of washing and sterilization methods for the endoscopic cell brush. METHODS The contaminated cell brush with the mixture of Bacillus subtilis var.niger spore and blood was washed by four methods:manually washing,multienzyme plus manually washing,ultrasonic cleaner washing,and multienzyme plus ultrasonic cleaner washing,and then dipped in glutaraldehyde for 5 h or 10 h,fumigated with glutaraldehyde for 5 h,and sterilized with 3M ethylene oxide box.The positive rates of occult blood test(OB test),the cleaning rates of B.subtilis var.niger spore and the sterilization eligibility ratio of four serilization methods were compared. RESULTS The washing method that multienzyme plus ultrasonic cleaner washing could clear effectively the contaminated cell brush that the positive rates of OB test was 0 and the cleaning rates of B.subtilis var.niger spore was 99.90%.The positive rates of OB test and the cleaning rates of B.subtilis var.niger spore of manually washing was 56.67% and 90.87%.Fumigated in 3M ethylene oxide box or dipped in glutaraldehyde for 10 h could kill all the spores,but dipped in glutaraldehyde for 5 h or fumigated with glutaraldehyde for 5 h could not. CONCLUSIONS The mixed contaminated endoscopic cell brush should be washed effectively by multienzyme+ ultrasonic cleaner washing,and should be sterilized by fumigated in ethylene oxide box or dipped in glutaraldehyde for 10 h.

Objective To investigate the incidence and high risk factors of brain injury in very low birth weight infants(VLBWI),to reduce the morbidity of brain injury,and improve the developmental outcome of VLBWI. Methods Data of 181 VLBWI admitted in the neonatal intensive care unit(NICU)between October 2008 and September 2009 were retrospectively analyzed. The difference in basic information,maternity diseases,treatment and complication were analyzed between two groups(brain injury group and normal newborn group),and Logistic regression analysis was adopted to analyze the risk factors for brain injury. Results Seventy-eight of the 181 neonates(43.09%)were found to have brain injury,including 67 neonates(37.01% )with periventricular/intraventricular hemorrhage(43 with intraventricular hemorrhage(IVH)gradeⅠ,12 with IVH grade Ⅱ,10 with IVH grade Ⅲ,and 2 with IVH grade Ⅳ)and 12 neonates(6.63%,one complicated with IVH grade Ⅲ)with periventricular leukomalacia. The younger the gestational age,the higher the brain injury rate was observed. Concerning the brain injury rate,there were no differences in gender,single birth/plural births,birth weight,the mode of delivery,fetal distress,premature rupture of membrane,hypertension during pregnancy,placenta abruption,and intrauterine growth restriction(IUGR)between these two groups(P ＞ 0.05). The difference in therapeutic measures such as pulmonary surfactant therapy,nasal continuous positive airway pressure(nCPAP),conventional mechanical ventilation,and high-frequency oscillatory ventilation was significant(P ＜ 0.05),except aminophylline therapy(P ＞ 0.05). As to the complication,there were significant differences in the incidences of asphyxia,neonatal respiratory distress syndrome(NRDS),hypercapnia,metabolic acidosis,hyperglycemia,anemia,and personal digital assistant(PDA)(P < 0.05). However,there was no difference in the incidences of hypoglycemia,sepsis,thrombocytopenia,apnea,pulmonary hemorrhage,and hyperbilirubinemia between these two groups(P ＞ 0.05). Further Logistic regression analysis showed that NRDS,high-frequency oscillatory ventilation,and PDA were the main risk factors for brain injury in VLBWI. Conclusions VLBWI is the high-risk population of brain injury. Pulmonary surfactant therapy,nCPAP,conventional mechanical ventilation,high-frequency oscillatory ventilation,asphyxia,NRDS,hypercapnia,metabolic acidosis,hyperglycemia,anemia,and PDA were confirmed to be the high-risk factors for brain injury in VLBWI. And,NRDS,high-frequency oscillatory ventilation and PDA were main risk factors.

Objective To investigate the epidemic status of endemic fluorosis in Shandong Province,Jining City,and to provide a basis for prevention and control of the disease.Methods Based on Shandong Provincial Project Technical Solutions for Endemic Fluorosis,Rencheng,Jinxiang,Yutai,Jiaxiang and Liangshan Counties in Jining were selected as monitoring sites.According to the illness situation of mild,moderate or serious districts,one village was selected as a major survey site from each county(district).There were a total of 15 such villages selected.Survey content included drinking water fluorine level; dental fluorosis of children,adults' clinical skeletal fluorosis and urinary fluorine levels; water and urinary fluoride content were determined by the method of fluoride ion selective electrode; dental fluorosis of children was diagnosed by Deans method and clinical diagnosis was based on the Diagnostic Criteria of Endemic Skeletal Fluorosis (WS 192-2008).Results Sixty-one water samples from 15 villages of five counties (districts) were tested.Fluoride levels of 9 out of the 61 samples were exceeded the national standard (＞ 1.0 mg/L),and the rate was 14.75％; 1 sample ＞ 2.0 mg/L,and the maximum water fluoride was 2.25 mg/L.Seven hundred and seventeen people's real time urinary fluoride was detected in the 15 villages,including 420 children and 297 adults,and the geometric mean were 1.53 and 1.69 mg/L,respectively.Clinical examination of 755 children aged 8 to 12 showed that the detection rate of dental fluorosis was 26.89％ (203/755); defect rate was 9.12％(29/755) and dental fluorosis index weres 0.65.The detection rate of clinical skeletal fluorosis of 11 565 adults was 4.76％(550/11 565),including 303 moderate or serious cases.Conclusions The situation of excessive water fluorine in outside environment in Jining City has been controlled at a certain degree; groups urinary fluoride level is closed to the normal upper limit; the prevalence of dental fluorosis or skeletal fluorosis has been suppressed at a certain degree,therefore,the results of control should be further consolidated and expanded,in order to completely eliminate the fluoride hazard.

Objective To analyze the assessment results of external quality control and network operation of urinary iodine in local laboratories of Shandong Province,to evaluate the ability of consistent analysis; and to provide a reliable laboratory quality assurance for epidemiological surveillance and control of iodine deficiency disorders (IDD) and reliable decision-making.Methods Z-scores of the assessment results of external quality control of urinary iodine in local laboratories of Shandong Province were analyzed from 2000-2013.Results The feedback rate of urinary iodine in local laboratories of ShandongProvince was 100.0％ from 2000-2013; the qualified rate was 100.0％(14/14),100.0％(14/14),92.9％(13/14),100.0％(14/14),92.9％(13/14),100.0％ (14/14),100.0％ (14/14),100.0％ (14/14),92.9％ (13/14),100.0％ (17/17),100.0％ (17/17),94.1％ (16/17),100.0％ (17/17),and 100.0％ (17/17),respectively.The total qualified rate of Z-scores between Zs in local laboratories was 100.0％ (214/214)and within Zs was 98.6％ (211/214).Conclusion The test abilities of urinary iodine in local laboratories of Shandong Province are steady; the overall results are satisfactory,but some laboratories need to improve.

Objective To survey the working situation of community nurses and care needs of the residents in a prefecture-level city.Method One hundred and thirty-five community nurses and 338 residents were selected and investigated by self-designed questionnaire.Results Community nurses still focused on the area of nursing and treatment rather than prevention,rehabilitation, health care,health education and family planning,which need to be paid more attention to.The needs of residents on community nursing service shift from disease treatment to disease prevention and health promotion.The current community nursing service cannot satisfy residents’care needs.Conclusion Community nurses should provide demand-oriented community care to the residents, strengthen the concept of disease prevention and health promotion,and set up community health centers to be a blend of prevention, health care,rehabilitation,health education and family planning as soon as possible.

Objective To investigate the feasibility of using low Kv,low iodine contrast Agent concentration (dual low)CT scan techniques in Coronary CTA (CCTA).Methods Seventy-six patients undergoing CCTA were divided into Group A and Group B , randomly.Group A (38 patients)was the dual-low group,which was scanned with tube voltage of 100 kVp,and injected with iso-osmolarity contrast agent visipaque 270 (270 mg I/mL),with iterative reconstruction technique (ASIR 40%).Group B (38 pa-tients)was scanned with 120 kVp,and low osmolarity contrast agent omnipaque 350 (350 mg I/mL)and FBP reconstruction,The images are assessed double-blindly by two experienced radiologists.Five ROIs were placed onto the ascending root of aorta (AO), left main artery(LM),left anterior descending (LAD),left circumflex artery(LCX),right coronary artery (RCA),and the image qualities are evaluated objectively using CT values,noise,signal noise ratio (SNR),contrast noise ratio (CNR),and compared sta-tistically using Paired t-test.The radiation dosages,such as CTDIvol,DLP and ED were also recorded and compared with Paired t-test.Results CTDIvol,DLP and ED of Group A (dual low)decreased 35.7%,38.6% and 38.6% respectively compared with Group B,the iodine intake decreased 22.9%.While the image qualities of the two groups were not significantly different,all images are good enough for diagnosis,with Group A slightly better than Group B in radiologists’scores.Conclusion Voltage 100 kVp, combined with low contrast agent concentration of 270 mg I/mL can fully satisfy the diagnostics need in CCTA,and significantly lower both the radiation dosage and iodine intake.

Objective: To determine the distribution characteristics of waist circumference (WC), waist height ratio (WHtR) of 6–18 years olds in Guangzhou, and to put forward the WC and WHtR appropriate boundary values for 6–18 years olds on the basis of cardiovascular disease (CVD) risk factor assessment. Methods: We analyzed the height, weight, WC and its metabolic indication data (blood pressure, fasting blood glucose, and blood lipids) of 15 000 children in Guangzhou, aged 6–18, with the receiver-operating characteristic curve (ROC), and explored the best value point of WC and WHtRfor the prediction of cardiovascular diseases. Results: When the WC percent reached P85, and WHtR reached 0.48, the cardiovascular risk factors of fasting blood-glucose, blood pressure, and blood fat were signiifcantly higher. Conclusion: The 85th percentile value of WC and 0.48 of WHtR are the appropriate boundary values in increasing the cardiovascular disease risk factors in Chinese children and teenagers. WC and WHtR as a relatively simple inspection method, can well predict cardiovascular diseases, and be used in the conventional measuring items among students.