Objective This study compared the cleaning effect of gastroscope by different cleaning mehtods and discuss practical and reliable evaluation method for the cleaning degree of gastroscope.Methods Three cleaning methods were selected and used in the cleaning of gastroscope.The Endocheck lumen was used to examine the cleaning degree of gastroscope and the effects of different methods were compared. Results The qualification rate by using ordinary cleaning method was 50.0%and it reached 60.0%and 73.3%by elevation of polyenzyme concentration and adding bedside pre-washing.which Was statistically different from that by using ordinary cleaning method(P＜0.05).Conclusions Bedside pre-washing could increase the cleaning degree of gastroscope;Endocheck lumen could be regarded as an evaluation method for the cleaning degree of gastroscope.

OBJECTIVE To investigate a case of nosocomial infection incident in a hospital,analyze the reasons and put forward preventive measures.METHODS Investigation was carried out on the related people and environment in the department where the incident occurred.Analysis was made on the reasons and processing.RESULTS The nosocomial infection incident was caused by Norovirus;fecal-oral transmission and contact transmission were 2 main pathways of Norovirus.There were 7 persons who had been contaminated by Norovirus,included 5 old inpatients,1 doctor and 1 nurse.CONCLUSIONS Many people should work to prevent and control the infections in hospital,such as doctors,nurses,inpatients,hospital works etc.Hand-washing and disinfection isolation should be enhanced among the hospital staffs in the normal works.

Objective:To evaluate the value of pretreatment 18F-fluorodeoxyglucose (FDG) PET/CT-based heterogeneity for early prediction of targeted therapy outcome in patients with human epidermal growth factor receptor 2 (HER2) positive metastatic breast cancer. Methods:From May 2012 to April 2018, 29 patients (all females, median age: 52 (32-69) years) who had HER2 positive metastatic breast cancer and underwent pretreatment 18F-FDG PET/CT in Fudan University Shanghai Cancer Center were retrospectively enrolled. All patients received trastuzumab as first-line treatment and were followed up for 6-87 (median time: 35) months. The relations between clinicopathologic parameters or PET/CT-based parameters and progression-free survival (PFS)/overall survival (OS) were analyzed with Cox univariate analysis. The parameters with P≤0.01 were further analyzed with Cox multivariate analysis. Optimal cut-off values were determined by time-dependent receiver operating characteristic (ROC) curve analysis. The survival analyses were estimated by Kaplan-Meier method and log-rank test. Results:The median OS of the 29 patients was 30 (6-83) months, and the median PFS was 10 (2-29) months. The PET/CT-based heterogeneity index(HI), including the maximum standardized uptake value (SUV max) ratio (SUV max-R; hazard ratio ( HR)=8.6, 95% CI: 2.7-27.8, P<0.001), the mean standardized uptake value (SUV mean)-2.5 (the cut-off value of standardized uptake value (SUV)=2.5) ratio (SUV mean-2.5-R; HR=2.6, 95% CI: 1.2-5.9, P=0.020), the metabolic tumor volume(MTV)-2.5 ratio(MTV-2.5-R; HR=2.4, 95% CI: 1.1-5.2, P=0.030), and the total lesion glycolysis(TLG)-2.5 ratio(TLG-2.5-R; HR=3.2, 95% CI: 1.4-7.4, P=0.008) of the lesion with the highest SUV max to that with the lowest SUV max, were significantly associated with PFS. None of the parameters was significantly associated with OS (all P>0.05). Multivariate analysis showed that the SUV max-R was the only independent predictor for PFS ( HR=6.8, 95% CI: 1.8-26.1, P<0.01). Area under the ROC curve for SUV max-R was 0.747. With a cut-off value of 1.8, SUV max-R could effectively distinguish the benefit from non-benefit population treated with trastuzumab (15.0 vs 7.0 months; χ2=18.68, P<0.01). Conclusion:Pretreatment 18F-FDG PET/CT-based HI has potential value for early prediction of first-line trastuzumab treatment outcome in patients with HER2 positive metastatic breast cancer.

Objective To study the adriamycin nephrosis model in different development pathological stages. Methods The rat adriamycin nephrosis model was established by injecting adriamycin into tail-vein twice every two weeks to detect blood and urina biochemical indicators and to observe the pathological changes of the renal tissues. Results The model showed serious edema,proteinuria,hypoproteinemia,and hyperlipidemia. Podocytes were swollen and mesangial cells developed mild hyperplasia at the end of the fourth week. The nephric tubule atrophied at the end of the eighth week accompanied with adhesion between glomeruli and Bowman's capsule. Glomeruli sclerosis of mild or medium degree was observed at the end of the twelfth week with obvious lymphocyte infiltration in the renal interstitium as well as the formation of collagen fibers. Conclusion The adriamycin nephrosis model was successfully developed by injecting adriamycin 4 mg/kg into tail-vein twice every two weeks. The acute model is similar to human minimal change disease,and the chronic model is similar to human focal segmental glomerulosclerosis.

OBJECTIVE To understand the situation of the nosocomial infection among the hospital inpatients in a grade-A hospital in Beijing.METHODS Surveillance on nosocomial infection was performed among the hospital inpatients from Jan 2005 to Dec 2007.RESULTS From Sept 2006 to Aug 2007,803 cases were infected,the incidence was 1.99%.The lower respiratory tract ranked the first place(38.97%)and the highest infected rate was in ICU(16.16%).The species were predominated by Gram-negatives.The main pathogenic microorganisms were Pseudomonas aeruginosa,Staphylococcus aureus,Escherichia coli,Acinetobacter baumannii,Klebsiella pneumoniae and Candida albicans,etc.From 2005 to 2007,the infections caused by P.aeruginosa increased gradually,and the infections caused by C.albicans reduced gradually.CONCLUSIONS Many people should work to prevent and control the infections in hospital,such as doctors,nurses,inpatients,management workers,etc.

OBJECTIVE To investigate the distribution and drug resistance of nosocomial infection pathogens.METHODS The data of pathogen′s origin and antibacterial resistance of Intensive Care Unit(ICU) inpatients from Apr 2008 to Mar 2009 in a Hospital were analyzed.RESULTS There were 226 strains pathogens isolated from 116 nosocomial infection cases,from which the Gram-negative bacteria were predominate(63.27%).The resistance rates of Acinetobacter baumannii was the highest in Gram-negative bacteria,more than 70% isolates resistant to almost antibacterial.The main Gram-positive bacteria were Staphylococcus aureus,and the rate of meticillin-resistant S.aureus(MRSA) was 41.3%.All S.aureus were sensitive to vancomycin and Linezolid.CONCLUSIONS To control the antibacterial resistance of pathogens and decrease the nosocomial infection,it is important to strengthen the appropriate use of antibiotics.

Objective To explore the effect of comprehensive intervention measure on antimicrobial use and incidence of healthcare-associated infection(HAI)in patients in sports medicine department.Methods Antimicrobial use and incidence of HAI in hospitalized patients in the surgical departments (sports medicine department and other surgical departments)of a hospital between January 2006 and December 2010 were analyzed retrospectively(before intervention),from January 2011, comprehensive intervention based on clinical-centered multi-department cooperation was adopted by sports medicine depart-ment,the other surgical departments over the same period were not comprehensively intervened;antimicrobial use and inci-dence of HAI in patients in surgical departments between January 2012 and December 2013 were monitored prospectively (after intervention ),effectiveness of intervention was evaluated.Results Antimicrobial use and incidence of HAI in pa-tients in sports medicine department after intervention were both lower than before intervention (55.75% vs 95.26%,χ2=753.42;0.10% vs 0.32% ,χ2 =15.13,both P <0.01).Antimicrobial use in patients in other surgical departments after intervention was lower than that before intervention(65.63% vs 73.79% ,χ2 =251.57,P <0.01 );incidence of HAI was higher than that before intervention(0.55% vs 0.42% ,χ2 =19.04,P <0.01).Conclusion Comprehensive in-tervention measure based on clinical-centered multi-department cooperation is safe and effective,it can reduce antimicrobial use and incidence of HAI in patients in sports medicine department.

Objective To observe the morphological changes of corneal nerve in experimental herpes simplex keratitis (HSK) in rabbit eyes. Methods Inoculation of the scarified cornea with herpes simplex virus-Ⅰ(HSV-Ⅰ)leads to herpetic infection of cornea. The HSK was detected by slit lamp and polymerase chain reaction(PCR), and the changes of corneal nerves in various periods with methylene blue vital staining and ultrastructure of corneal nerve were studied. Results Under light microscope, fewer corneal nerve bundles were observed, scattered with lower density of nerve fiber at center of cornea on the 4th day after the infection. At days 7 and 14, the seriously damaged nerve fiber was intermittent. The neuraxon became shorter with little polarity and the density of nerve fiber was extremely low. At day 30, the density was still low while the nerve fiber was approximately normal. Under electromicroscope, at day 4, the lamellar sheath of nerve fiber in the epitheliums appeared intermittent, and the neuroplasm of endings was partly lysed. During day 7 to day 14,neuroplasm was damaged and became vacuolar. The mitochondria swelled with vacuolar crest, and then were destroyed and lysed. The nerves in stroma were also injured. On day 30, neurilemma sheath was still intermittent with the decrease of microfilament and racuole. Conclusion HSK leads to the damage of nerve and the decrease of nerval density, and the damage of corneal nerve repairs very slowly.

Objective To study the performance verification of lactate dehydrogenase(LDH) in the Johnson Vitros 5 .1 FS bio‐chemical analyzer .Methods According to CLSI instrumentation evaluation standard and referring to the validation scheme provided by the Johnson company ,the precision ,accuracy ,linear range of LDH ,maximum dilution degree ,biological reference range were verified .Results The LDH intra‐batch and inter‐batch precision experiments were≤3 .30% ;the accuracy experiment≤4 .00% ;the determination coefficient of the linear experiment was 0 .997 2 ;the LDH maximum dilution degree was 8 times with saline solution dilution;the biological reference range experiment verified that the reference range 313-618 U/L provided by the VITROS Meth‐odology Manual could be quote .Conclusion The performance verification of LDH detected by the Johnson Vitros 5 .1 FS biochemi‐cal analyzer basically conforms to the requirements of the quality objectives and manufacturer′s instructions ,and meets the needs of clinical test .

Prospective payment rates based on diagnosis related groups (DRGs)have been established as the basis of Medicare' s hospital reimbursement system.The purpose of the DRGs is to relate a hospital's case mix to the resource demands and associated costs experienced.The patient characteristics included in the definition of each DRG relate to a common organ system or etiology,and each DRG should contain patients,who are similar from a clinical perspective,with a similar pattern of resource intensity.DRGs were divided by principle diagnosis,major surgery,major complication and/or comorbidity,age,sex,birth weight etc.Using a grouping software(version 18)by DRG definitions used in the United Stated,we encoded the hospital discharge data of all secondary and senior hospitals in Beijing.After analyzing the DRG grouping,as well as rationality and weighting of these DRG groups,we concluded that it was feasible to encode Chinese data using US DRG definitions with specific adjustments accommodating to relevant conditions in China.