OBJECTIVE To investigate the sterilizing effect of Avagard surgery wasting liquid.METHODS All the staff on operation were divided into two groups at random,each no less than 50 persons.Both groups were sterilized by 4% Avagard surgery washing liquid.In one group,hands and forearms were smeared by 0.5% Avagard fast surgery washing liquid(smearing group),the other group was not smeared by 0.5% Avagard fast surgery washing liquid(no-smearing group).In both groups the samples were derived from fingers and cultured right after sterilization and at intervals of 1h,2h,3h,4h,5h and 6h during operation,and to investigate the sterilization effect.RESULTS The bacteriological detections of both groups in all times showed that the number of colony was0.05).CONCLUSIONS The results of the experiment show that 4% Avagard surgery washing liquid is reliable for its sterilizing effect and easy to use.The duration of antibacterial effect is no less than 6 hours,this method could reduce the cost of the operation and improve the efficiency of work.

OBJECTIVE To discuss the practicality of using the nylon nets,which are derived from disposed used medical(suture-band).The nylon nets were attached to the filtering apparatus on original return-wind exit on the lateral wall of surgical operating room.METHODS The velocity of wind,concentration of bacteria and the total(particle) amount of dust were determined by contrasting the number determined before and after passing the nylon nets on the(filtering) apparatus return-wind exit.RESULTS There was no evidence to influence the cleaning and temperature(regulating) effects of air conditioner by binding the nylon nets on them.CONCLUSIONS This method appears to save time as well as energy to work more efficiently than cleaning air conditioners weekly.

To investigate the expression of mRNA and protein of telomerase reverse transcriptase(TERT) in guinea pig asthmatic lung tissues and human circulating lymphocytes and to discuss the role of TERT in the pathogenesis of asthma and the clinical significance of expression of TERT in human asthmatic circulating lymphocytes in monitoring the state of asthma.Methods: In 6 guinea pig asthmatic lung tissues, 6 guinea pig normal lung tissues, 16 samples of circulating lymphocytes of asthmatic patients and 14 normal circulating lymphocytes the expression of mRNA and protein of TERT were detected with nuclei acid in situ hybridization and immunostaining. The expression of TERT in circulating lymphocyte were compared with pulmonary function and serum IgE level. Results:The expression of mRNA and protein were up-regulated in asthmatic airway epithelium and lymph nodule germinal center in guinea pig. Compared with control group,high expression were also showed in human asthmatic circulating lymphocytes.The index of TERT expressive positive lymphocytes showed negative correlation with FEV1/ predictive value and MW/predicn've value,positive correlation with serum IgE level. Conclusion: (1 )TERT expression in asthmatic airway epithelium and lymph nodule germinal centers of guinea pig and human circulating lymphocytes were up-regulated; (2)Detection of TERT expression of asthmatic circulating lymphocytes may be useful to monitor the state of asthma.

Objective To study the changes of the rat's hearing threshold by long-term treatment with Vitamin-C and the reason of the changes. Methods Forty-two Wistar rats were randomly divided into two groups: the treatment group was treated with water added Vit-C and the placebo group was treated with drinking water.(1)Concentrations of malondialolehyde(MDA)of the cochlea with fluorescence chromatometry.(2) Auditory sensibilities with auditory brainstem response testing.(3) The frequency of the mtDNA~(4834)bp deletion in the cochlea with polymerase chain reaction technique. Results Hearing threshold of both groups become worse with aging,and the treatment group showed the better auditory sensitivities,the less concentrations of MDA and the less frequency of mtDNA~(4834)bp deletion compare with the placebo group. Conclusions Long-term treatment with Vitamin-C could reduce the degree of hearing loss of the rats and the concentrations of MDA of the cochlea and the frequency of mtDNA~(4834)bp deletion in the cochlea.The oxygen radicals theory should be the etiology of presbyacusis.

Objective To evaluate the accuracy of stroke volume variation (SVV) in monitoring blood volume during one-lung ventilation in patients undergoing thoracoscopy operation. Methods Twenty-two ASA Ⅰ or Ⅱ patients ( 12 male, 10 female) aged 18-60 yr undergoing thoracoscopy operation under general anesthesia were studied. Anesthesia was induced with midazolam, sufentanil, propofol and rocuronium and maintained with TCI of propofol and remifentanil and intermittent iv boluses of vecoronium. Robertshow double-lumen endobronchial tube was inserted. Correct position of the tube was verified by fiberoptic bronchoscopy. The patients were mechani40 mm Hg. Radial artery was cannulated and connected to FloTrac pressure transducer and Vigileo monitor. A loading dose of 6% HES 5 ml/kg was infused over 10 min. MAP, HR, CO and SVV were recorded before and at 3 min after loading dose. The change rate of SVV (SVV) and CI (△CI) were calculated. Increase in CI by 11% was considered effective volume expansion. The ROC curve for SVV in determining the volume expansion efficacy was plotted. The area under the curve for SVV and 95% confidence interval were calculated. Results (1) CO were significantly increased while SVV decreased after a loading dose of HES. (2) During two-lung ventilation 12 patients responded to the 6% HES loading dose.SVV correlated with△CI ( - 0.710, P ＜ 0.05). The volume expansion efficacy was determined by SVV 11.5 % (sensitivity = 82 %, specificity = 92 % ). The area under the curve for SVV and 95% confidance interval were 0.880 (0.580-0.987). (3) During one-lung ventilation 11 patients responded to the 6 % HES loading dose. SVV correlated with CI ( - 0.668 , P ＜ 0.05). The volume expansion efficacy was determined by SVV 9.5 % ( sensitivity = 77 %, specificity = 63 % ). The area under the curve for SVV and 95% confidance interval were 0.971 (0.917-1.024). Conclusion One-lung ventilation does not alter the ability of SVV in monitoring blood volume in patients undergoing thoracoscopy operation.

OBJECTIVE To analyze the caloric test findings of the unilateral primary horizontal and posterior semicircular canal benign paroxysmal positional vertigo(HSC-BPPV and PSC-BPPV).METHODS Caloric test were tested in 152 PSC-BPPV patients and 25 HSC-BPPV patients after Dix-Hallpike test and Roll test.RESULTS Of 152 PSC-BPPV patients 64 canal paresis(CP)were found in the abnormal side and 44 in the normal side;Of 25 HSC-BPPV patients 16 canal paresis were found in the abnormal side and 9 in the normal side.The incidence of CP in PSC-BPPV is 30.3% and the incidence of CP in HSC-BPPV is 52%.13 Patients with PSC-BPPV were found abnormal Directional Preponderance(DP)and 10 Patients with PSC-BPPV were found abnormal Directional Preponderance.CONCLUSION The incidence of CP in the abnormal side of HSC-BPPV and PSC-BPPV is more than that of the normal side.The incidence of CP in abnormal side of the HSC-BPPV is more than that of PSC-BPPV.The incidence of abnormal DP in HSC-BPPV is more than that of PSC-BPPV.

Objective To explore treatment of bile duct variation in Laparoscopic Cholecystectom.Methods The author retrospectively analyzed the clinical data of 7 cases with bile duct variation in 2 000 patients performing Laparoscopic Cholecystectomy.Among the 7 cases,2 cases had small hepatic duct openings in the gallbladder bed;2 cases had cystic duct openings in the right hepatic duct;2 cases had accessory right hepatic duct;and one case had rare variation whose right hepatic bile duct and the jejunum connect together.2 cases of the first variation had no bile leakage,adopting the suture method in LC.Among 2 cases of the second variation(all found in LC),one case had bile spillage in the junction of the cystic duct and the right hepatic duct,so the operator converses to laparotomy,cuts the gallbladder,sutures the break,and the patient had no bile leakage at last;The other one case was anatomized clearly under the cavity mirror.Among 2 cases of the third variation,one had no bile leakage,whose accessory hepatic duct was ligated in LC.The other one case had bile leakage after LC,so the operator converses to laparotomy,clips the accessory hepatic duct,and extract the drainage tube until there was no bile drainage.The last case was mistaken and cut it,the next day biliary peritonitis appeared,so the bile leakage was sewed up under the laparoscope.Results The seven cases were followed 1 ~3 years,they had no jaundice and their liver function was normal.Conclusion Careful-ly dissect Calot's triangle in LC,observe bile leakage after LC;improve the level of understanding and dealing bile duct variation in LC,don't cut the duct which is known to us.We should treat differently according to particular case.

Objective To study the effectiveness of intravenous Lidocaine on subjective tinnitus in the elderly, and analyze its correlation with the effectiveness of subsequently oral Carbamazepine.Methods A prospective case-control study was conducted in 120 elderly patients with subjective tinnitus, who were divided into two groups.The control group (n=60) was treated with oral Carbamazepine 0.1 g Bid for one month, and the treatment group (n=60) was treated with 2％ lidocaine by intravenous injection.Patients in the treatment group were observed on responses in tinnitus during the period with Lidocaine injections.The treatment group was further divided into the improvement subgroup and the no-improvement subgroup, according to responses to intravenous lidocaine.All the patients in the treatment group received oral carbamazepine 0.1 g Bid for one month following the intravenous lidocaine injection phase.Results In the control group, 5 patients showed marked improvement, 20 patients showed partial improvement, 33 patients showed no improvement, and 2 patients showed symptom deterioration, with an effectiveness rate of 41.7％ (25/60).In the treatment group, 6 patients showed marked improvement, 26 patients showed partial improvement, 24 patients showed no improvement, and 4 patients showed symptom deterioration, with an effectiveness rate of 53.3％ (32/60).Of the 32 patients in the improvement subgroup, 6 cases showed marked improvement, 16 cases showed partial improvement, 8 cases showed no improvement, and 2 cases showed symptom deterioration after subsequent oral Carbamazepine treatment, and the effectiveness rate was 68.8％ (22/32).Of the 28 patients in the no-improvement subgroup, 1 case showed marked improvement, 9 cases showed partial improvement, 16 cases showed no improvement, and 2 cases showed symptom deterioration, and the effectiveness rate was 35.7％ (10/28).The effectiveness rate in the improvement subgroup was higher than in the no-improvement subgroup (68.8％ vs.35.7％, x2 =6.55, P＜0.05).The effectiveness of lidocaine followed by carbamazepine was better than that of carbamazepine alone (68.8％ vs.53.3％, x2 =6.13, P＜0.05).Conclusions Oral Carbamazepine treatment following intravenous Lidocaine injection in elderly patients with subjective tinnitus has better therapeutic outcomes than treatment with oral Carbamazepine alone, but is not as effective in patients with negative responses to Lidocaine as in patients with positive responses.

Objective To assess the correlation of serum 25-hydroxyvitamin D (25-OHD) levels with vitamin D-binding protein (the group-specific component,GC) gene polymorphism in chronic obstructive pulmonary disease (COPD).Methods In a cross-sectional case-control study,250participants,including 116 COPD patients with smoking history and 134 healthy smokers,were investigated.A questionnaire about smoking history,vitamin D intake and comorbidities was collected.General pulmonary function was done by routine.Serum 25-OHD levels were detected by ELISA.The genetic variants (rs4588and rs7041) were genotyped by real time fluorescence polymerase chain reaction (RT-PCR) with TaqMan probe technology.Results The COPD patients had lower serum vitamin D level than the smoker subjects (36.58 nmol/L vs 43.80 nmol/L,P ＜0.001).In the COPD patients,vitamin D level was 39.43 nmol/L in those with percentage of predicted forced expiratory volume in 1 second (FEV1 ％ pred) greater than or equal to 80％.In other groups with FEV1 ％ pred 50％-80％,30％-50％ and lower than 30％,vitamin D levels were 35.32 nmol/L,32.21 nmol/L,26.25 nmol/L respectively (P ＜ 0.01).Moreover,there was a significant relevance of 25-OHD levels with FEV1 ％ pred in both COPD patients and healthy smokers (r2 =1.911; P ＜0.000 1).The mean 25-OHD concentration had a negative correlation with Global Initiative for Obstructive Lung Disease (GOLD) stages.Homozygous carriers of vitamin D-binding protein gene rs7041 T allele were independently related to 25-OHD levels and susceptibility of COPD (P ＜ 0.01 ; OR =2.140,95％ CI 1.157-3.959,P =0.015 respectively).Conclusions Patients with COPD are at high risk of vitamin D deficiency and the severity of COPD is inversely correlated with vitamin D levels.Furthermore,homozygous carrier of rs7041 T allele influences 25-OHD serum levels and is related to susceptibility of COPD,which may be a potential candidate gene for screening COPD.

Objective To investigate the expression of CD40 and CD40L on the surface of peripheral blood mononuclear cells(PBMCs)in asthmatic rats and the effect of anti-CD40L McAb on cytokines of it.Methods Flow cytometry and RT-PCR were used to detect the expression of CD40 and CD40L of PBMCs ih asthmatic rats.After the PBMCs Was treated with anti.CIMOL McAb.ELISA was used to detect the levels of IL-4 and IFN-γin the supematants of cultured cells.Results Compared with the normal control group.the expression of CD40 and CD40L of PBMCs in asthImatic rats increased(P＜0.05).Compared with the untreated group,the level of IL-4 and the ratio of IL4/IFN-γ decreased after the PBMCs were treated with anti-CD40L McAb(P＜0.05).Conclusion The expression of CD40 and CD40L on the surface of PBMCs in asthmatic rats Was unregulated.Anti-CD40L Mcab Can decrease the level of IL-4 and the ratio of IL_4/IFN-γ.