Objective To explore the effect of quality control circle(QCC)on reducing adverse event incidence of the instrument management.Methods QCC group of 7 nurses in the central sterile supply department was set up for QCC training and then analyze the causes of adverse events in the instrument management and finally make countermeasures to apply continuous quality improvement.Result The adverse incidents were significantly decreased from 69 before QCC to 24 after QCC.(χ2=33.694;P<0.01).Conclusion QCC is effective in the reduction of the adverse events in instrument management and improvement of surgical safety.

Objective To evaluate the value of CT scan in diagnosing non-intestinal lesions on the right lower abdomen.Methods CT scan was performed in 70 patients with clinically supected non-intestinal lesions in the right lower abdomen.The diagnosis was confirmed by surgery or biospy in all cases,except 1 case of nephroptosis.Results 41 cases were benign lesions,which appeared as cystic or solid masses with definite bound on plain CT scans and were slight or middle enhanced on contrast enhanced CT scans,but abscess and tuberculosis were showed peripheral or multilocular enhancement with indistinct bound.The remaining 29 cases were malignant masses which presented as large irregular soft tissue mass and inhomogenous enhancement.Conclusion CT scan of certain is value in diagnosis and differential diagnosis of non-intestinal lesions of right lower abdomen.

Objective To evaluate the effect of sucralfate and acid-suppressive drugs on preventing ventilator-associated pneumonia (VAP) in mechanically ventilated patients.Methods All randomized controlled trials (RCTs),which studied the effect of sucralfate and acid-suppressive drugs on the incidence of VAP in mechanically ventilated patients,were searched from PubMed,Embase and the Cochrane Library during January 1966 to March 2013 via manual and computer retrieval.All related data were extracted.Meta analysis was conducted using the statistical software RevMan 5.2 and the quality of the RCTs was strictly evaluated with the methods recommended by the Cochrane Collaboration.Results A total of 15 RCTs involving 1315 patients in the sucralfate group and 1568 patients in the acid-suppressive drug group were included in this study.The incidence of VAP was significantly reduced in the sucralfate group (RR =0.81,95％ CI 0.7-0.95,P =0.008),while no difference was found between the two groups in the incidence of stress-related gastrointestinal bleeding (RR =0.96,95％ CI 0.59-1.58,P =0.88).No statistical difference was found in the days on ventilator,duration of ICU stay and ICU mortality in the two groups (all P values ＞ 0.05).Conclusion In patients with mechanical ventilation,sucralfate could decrease the incidence of VAP,while has no such effect on the stress-related gastrointestinal bleeding,the days on ventilator,duration of ICU stay and ICU mortality.

rse effect when compared with tibolone.

Objective With density in healthy people pharyngeal flora of the reference[1],study the respiratory tract infection and the treatment process of the change of density and pharyngeal flora infection treatment of correlation analysis,by using the density of the pharyngeal flora changes to evaluate the treatment of patients with respiratory tract infection and progno-sis.Methods Collected 102 cases of patients with upper respiratory tract infection and 219 cases of lower respiratory tract infection in patients with pharyngeal swab for bacterial culture,study clinical symptom change with the change of pharyngeal bacteria density of correlation.Results 62 cases of upper respiratory tract infection and the treatment group patients with pharyngeal flora normal no treatment group on the symptoms improved and recovered,no statistical difference (P >0.05), and 60 patients with upper respiratory tract infection and pharyngeal abnormal bacterium group the treatment group and treatment group in pharyngeal flora and CPIS score was statistically difference (P <0.05).For 219 patients with lower re-spiratory tract,including 121 cases of bacterial pneumonia,74 cases of severe pneumonia,and 24 cases of patients with lung abscess treatment observation,found that when back to normal pharyngeal flora,the accuracy of clinical pathological changes were 92.6%,86.5% and 87.5%,respectively.Conclmion Pharyngeal bacteria density between healthy people maintained a certain bacteria species and the number of stable,but when respiratory infections bacteria can disorders with the application of broad-spectrum antibiotics can lead to serious result in pharyngeal dysbacteriosis should be combined with pharyngeal bacteria in respiratory anti-infection treatment density changes to evaluate the clinical treatment,can reduce the number of days with antibiotics,patients with avoid induce drug-resistant bacteria and respiratory dysbacteriosis.

Objective To investigate the serum homocysteine (HCY)levels of patients with various liver diseases,and discuss the clinical value of combined detection of HCY and other liver function indicators in liver disease diagnosis.Methods Se-lected 123 cases of inpatients with different liver diseases (79 cases of male,44 cases of female),including 39 cases of chronic active hepatitis,52 cases of cirrhosis and 32 cases of primary hepatic cancer from Department of Gastroenterology,and 90 ca-ses of healthy persons as control group from Out-patient Health Examination Center of Shaanxi Provincial People’s Hospi-tal.Detected serum HCY and some indicators of liver function (TBIL,ALT,GGT and TBA)in different liver disease groups and normal control group with Roche MODUALR automatic biochemical analyzer,and did statistic analysis.Results The serum HCY levels of chronic active hepatitis,liver cirrhosis and primary hepatic cancer were 16.25± 3.98μmol/L,20.89± 4.26μmol/L and 22.92 ± 6.08μmol/L respectively,and significantly higher than those in normal control group (8.16 ± 4.03μmol/L,t=5.352~9.021,P<0.01).The serum HCY levels of liver cirrhosis and primary hepatic cancer group were higher than that of chronic active hepatitis group (P<0.05).Serum levels of HCY were obviously lower after treatment than that before treatment (P<0.05)for three groups of liver diseases.The positive rate of HCY was higher than those of other liver function indicators (P<0.05).Conclusion Serum homocysteine may be as one of the most important indexes of liver damage,and the combined detection of other liver function indicators may have important clinical value for liver disease diagnosis,differential diagnosis,treatment and prognosis.

Objective To analyze the distribution and pulsed-field gel electrophoresis (PFGE)of pathogenic bacteria causing infectious diarrhea in a district of Beijing from 2011 to 2013,and provide basis for tracing infection sources.Methods A total of 1 179 stool specimens of infectious diarrhea from patients in a diarrhea outpatient department from January 2011 to December 2013 were collected,all isolated pathogens were identified by serotyping and PFGE analysis.Results 330 enteric pathogens were isolated from 1 179 specimens,the top 4 bacteria were Shi-gella spp .(28.18%,n=93),Salmonella spp .(20.91 %,n=69),Vibrio parahaemolyticus (13.33%,n =44),and diarrheagenic Escherichia coli (3.33%,n = 11 ).18 Shigella sonnei isolates were identified as 8 PFGE patterns, clustering similarity was close to 88%;69 Salmonella spp .strains belonged to 18 serotypes and 41 PFGE patterns, Salmonella senftenberg and Salmonella enteritidis had dominant patterns;no dominant PFGE patterns were obviously identified among 23 strains ofVibrio parahaemolyticus .Conclusion The serotypes and PFGE patterns of pathogenic bacteria in infectious diarrhea in past three years showed a wide distribution characteristics,the dominant PFGE patterns of Salmonella spp .and Shigella spp .need to be paid more attention,and outbreak of infectious diarrhea caused by Salmonella spp .and Shigella spp .should be alerted.

Infant hair is a good medium to assess the cumulative exposure level of infant in the mother ' s body. Chlorinated persistent organic pollutants were ubiquitous and with the highest volume concentration in the human body. In this experiment, 20 infant hairs were collected from Beijing. The sample was overnight incubated in HCl, extracted with the mixture of hexane and dichloromethane, and cleaned up by a cartridge filled with alumina and acidified silica. The final eluate was concentrated, and 16 kinds of typical chlorinated persistent organic pollutants were detected with gas chromatography_high resolution mass spectrometry ( HRGC_MS). The results showed that the detection limit of the target compounds in sample was 1. 00-2. 50 μg/kg, the recovery of surrogate in all samples was more than 67 . 6%, and the range of recoveries for target compounds in spiked sample was 62. 5%-92. 3%. The positive rate is 100% for hexachlorobenzene,β_HCH and p, pˊ_DDE, 85% for γ_HCH, 50% for PCB28, and 40% for PCB52. The concentrations of Hexachlorobenzene, HCHs, DDTs and PCBs were 5. 48-8. 40 μg/kg, 3. 86-27. 1 μg/kg, 1. 16-18. 3 μg/kg and 2. 20-22. 1 μg/kg, respectively. The average concentrations were 7. 84 μg/kg for hexachlorobenzene, 6. 93 μg/kg for HCHs, 5. 53 μg/kg for DDTs, and 3. 44 μg/kg for PCBs. The method and the analysis results can be used to evaluate the accumulation level and cumulative exposure level of 16 target compounds for fetal in motherˊs body.

Objective To find out the iodine content in drinking water in Yi County,and to provide a scientific basis for prevention of iodine deficiency disorders.Methods An administrative village was taken as a unit in Yi County,Hebei Province.One drinking water sample was randomly selected from each village with centralized water supply.For villages with decentralized water supply,five drinking water samples were randomly selected according to directions (east,west,south,north and center) if there were more than five water sources in the village ; all the water source samples were taken if there were less than five water sources.Water iodine content of all of the water samples was tested; geomorphological feature,water type and well depth were surveyed.Water iodine content was determined through arsenic cerium catalytic spectrophotometric method.Results The range of water iodine content was 0.00-18.39 μg/L,and water iodine median was 2.08 μg/L in 1 024 water samples in the county.Water samples of 490,505 and 29 copies were collected in the hills,plains and mountains,and water iodine median was 1.74,2.26,3.15 μg/L,respectively.Concerning water iodine medians in drinking water,mountains were less than hills and plains(x2 =37.36,34.25,all P＜ 0.01),hills were less than (x2=15.27,P ＜ 0.01).Water samples of 742,228,54 copies were collected,respectively,in household well water,tap water and mountain spring water,and water iodine median was 2.08,2.24 and 0.73 μg/L,respectively.There was no significant difference between the water iodine median in tap water and household well water (x2 =2.97,P ＞ 0.05),and the iodine in mountain spring water was less than that of tap water and household well water (x2 =38.23,43.82,P ＜ 0.01).Water samples of 583 and 441 copies were collected,respectively,in the well depth ＜ 40 m and well depth ≥40 m,and water iodine median was 1.81 and 2.24 μg/L,respectively,and there was no significant difference between the water iodine median in the well depth ＜ 40 m and well depth ≥40 m(x2 =2.32,P ＞ 0.05).Conclusions Residents iodine content of drinking water in Yi County is lower; the natural environment is seriously iodine deficiency,and iodine supplementation should be strengthened.

Objective To establish serum NGAL reference range of healthy populations in Xi'an Area.Methods 2 665 cases (aged 6 to 95 years old,male 1 370,female 1 295) of health-check people were collected from March 2014 to October 2016 in Medical Examination Center of Shaanxi Provincial People's Hospital,and 682 cases (aged 0 to 6 years old,male 356,female 326) were collected from preschool children of prevention.Serum NGAL concentration of them were analysed by immunoturbidimetry method with the Automatic Biochemical Analysis Assembly Line of Beckman-AU5800,and the detection data for statistical analysis.Then established the reference range of serum NGAL population of different age and different sex in Xi'an.Results The serum NGAL levels in healthy subjects showed a skewed distribution,which were preschool children under 6 years of age 37.66±23.12 ng/ml,6～15 years 39.25±25.34 ng/ml,16～49 years 46.68±27.06 ng/ml,and 50～ 69 years 57.82±29.13 ng/ml.Compared the first two with the latter,there was a significant difference (t=0.589,P＜ 0.05).The serum NGAL levels of over 70 years were 61.87 ± 32.64 ng/ml,and there was a significant difference between the ages of 15 and 49 and over 70 years (t=8.529,P＜0.01).At the same time,the serum NGAL was closely correlated with age (r=0.298,P＜0.01).But there was no significant difference in serum NGAL level between male and female (t=0.263～0.542,all P＞0.05).87ng/ml was the upper limit of the reference value for the age of 50 years.Conclusion The level of serum NGAL was related to age and increased with age,but not with gender.