OBJECTIVE To probe into the effect with the same cleansing method between dismountable and undismountable endoscopes in operating rooms,in order to finally improve the cleansing quality of surgical instruments.METHODS A total of 300 pieces of endoscopes with moderate pollution selected from operating rooms,were equally divided into dismountable and undismountable groups.They were all cleansed according the criteria by Ministry of Health.RESULTS After cleansing,the cleanliness and the occult blood test positive rate were 94.7% and 5.3%,respectively,for dismountable endoscopes vs 49.3% and 69.3%,respectively.It was obvious that the former superior(P

The application of robotic surgery can provide solutions to the many drawbacks of traditional laparoscopic surgery.Robotic surgery is a feasible and safe procedure for patients with gastrointestinal tumor.It can harvest adequate lymph node with low postoperative morbidity.Longer follow-up and further raudomized clinical trials are needed to validate the utility and efficacy of this technology in the field of gastrointestinal surgery.

Objective To understand the natural lighting in houses in constructed in different times island city and the influential factors in Dinghai, Zhoushan. Methods 3 districts, 92 families living in the buildings with 4-6 floors were chosen in Dinghai, Zhoushan, the daylight factor and the ratio of the window and the floor were determined, the subjective evaluation such as good, common, worse, the worst was done among 323 person according to the Code of Housing Design,GB50096-1999, Daylight Code of Building Design, GB50033-2001, Design Code for Planning City Residential Areas, GB50180-1993. Results The daylight in all the investigated houses met the requirement in GB50180-1993. The ratio of the window and the floor in the living room, bedroom, kitchen was larger than 1/7, that of the dinning room was more than 1/10, which met the requirement in GB50096-1999, in addition, the ratio of the newly buildings was higher than that of the old. The total qualified rate of the lowest daylight factor was 58.2, the main bedroom ranked the best, the living room ranked the worst, significant different results were seen in the houses constructed in different times, in 1980s, 1990s and 2000, it was 43.3%, 54.7% and 76.7% respectively. 91.9 percent of people who living in the first floor think the natural lighting worse, even the worst. Conclusion All the natural lighting designs for the involved houses in the island city can meet the requirements in the national standard of China, some people still complained the bad natural lighting, especially those who living in the lower floors.

Objective To investigate the effects of acupuncture on morphology and apoptosis related gene expression of lacrimal gland in dry eye model rabbit,and explore the possible mechanism of acupuncture on dry eye.Methods Eighteen healthy New Zealand white rabbits were randomly divided into three groups:blank group,model group,acupuncture group,6 rabbits in each group.Blank group did not accept any treatment.Model group and acupuncture group were treated with subcutaneous injections of scopolamine hydrobromide,4 times a day with the dose of 2.0 mg · kg-1,when the acupuncture group was also treated with acupuncture,once a day for fourteen days.Three groups were examined Schirmer Ⅰ test (S Ⅰt) at different stages,and morphological changes of lacrimal gland under light and electron microscope were observed.The immunohistochemical method was used to detect the protein levels of apoptosis related gene in lacrimal gland of all rabbits.Results Between the acupuncture group and model group,the S Ⅰt was significantly different on day 4,7,14 (all P ＜ 0.05).At the same time,compared with that before experiment,S Ⅰt had no significant difference on day 14 in acupuncture group (P ＞ 0.05).Optical and electron microscope showed the lacrimal gland epithelial cells of acupuncture group closely arranged with abundant cytoplasm,closed to that of the blank group.Meanwhile,the number of lacrimal epithelium cells with Bax,Fas and FasL positive expression was significantly less than that in the model group (all P ＜ 0.05).But when it compared with blank group,there was no significant difference of Bax/Bcl-2 and Fas/FasL positive expression in acupuncture group (all P ＞ 0.05).Conclusion Acupuncture can restrain the apoptosis and gland atrophy of lacrimal gland tissue of dry eye rabbit,and promote metabolism,thereby increase the tear secretion.

The dynamic changes about vasoactive intestinal peptide (VIP), angiotension Ⅰ (AⅠ)and angiotension Ⅱ (A Ⅱ)concentrations in plasma, cerebral spinal fluid (CSF) and brain extracts were studied in the experimental high-velocity missile wound models, which were produced on both hind legs of dogs. The findings were as follows: (1) Plasma VIP, AⅠ and AⅡ concentrations started to increase from 30 rain after the wound and the elevation had been continuing at 4 h after the wound. Their highest points of post-trauma were 2,9, 11.5 and 4.9 times as much as that of pre-trauma. (2) CSF VIP elevated at 4 h after the wound, but AⅠ and AⅡ concentrations reduced tempo tarily at 1 h and 2 h after the wound respectively. (3) The changes of VIP, AⅡ concentrations in the brain extracts tented to be consistent with that of the CSF. The signifcance and machanism of these changes of VIP and AⅡ concentration remain to be clarified.

Objective To detect the effect of Rhubarb retention enema on patients with acute pancreatitis(AP).MethodsA total of 84 AP patients were enrolled in this study. Patients were divided into the control group(n=42) and Rhubarb enema observation group(n=42). Control group was treated with fasting, continuous gastrointestinal decompression, correcting water electrolyte and acid-base imbalance, with the oral administration of octreotide and gabexatemesilate to inhibit pancreatic secretion and enzyme activity. On the basis of the control group, the observation group was treated with rhubarb retention enema. IL-17, IL-10, and IL-6 expression was detected by ELISA analysis. The clinical effect was compared.Results The clinical effect rate (85.7%vs.71.4%,χ2=2.366,P=0.043) in observation group was significantly higher than that in control group. After treatment of 7 days, IL-17 (13.53 ± 3.16 ng/mlvs. 20.63 ± 4.83 ng/ml,t=2.416) and IL-6 (22.82 ± 4.56 ng/mlvs. 31.59 ± 6.63 ng/ml,t=2.421) expression was significantly lower and IL-10 (16.32 ± 4.15 ng/mlvs. 12.17 ± 3.22 ng/ml,t=2.326) expression was significantly higher in observation group than those in control group(P<0.05). The reduction of blood amylase (125.69 ± 32.47 U/Lvs. 259.26 ± 51.44 U/L,t=7.451) and urine amylase (204.73 ± 43.83 U/Lvs. 334.25 ± 60.18 U/L,t=7.323) in the observation group was significantly higher than those in the control group(P<0.01). Abdominal pain and abdominal distension recovery time (4.24 ±1.06 dvs. 3.02 ± 0.62 d,t=2.521), exhaust gas and defecation recovery time (5.42 ± 1.25 dvs. 3.26 ± 0.73 d,t=5.124), temperature recovery time (5.63 ± 1.46 dvs. 4.58 ± 0.92 d,t=2.418), and hospitalization time (18.65 ± 4.16 dvs. 13.78 ± 3.15 d,t=2.386) were higher in control group than those in observation group (P<0.05 orP<0.01). Conclusion Rhubarb enema can regulate the IL-17/ IL-10, and inhibit the inflammatory reaction.

How to cultivate oral medical graduate students with solid general medical founda-tion is still under exploration. There are some systematic, comprehensive and relatively weak limita-tions for different departments' rotations in training general clinical skills for professional degree post-graduates in stomatology. With the establishment of a comprehensive teacher group of oral medicine, prosthodontics and oral & maxillofacial surgery in department of general dentistry, students can be trained for general clinical thinking and skills, and the students' ability of general clinical practice has been strengthened via these programs. On the basis of postgraduate students' analysis of structures and learning interests and under the premise of upholding the uniform requirements, the individualized and hierarchical teaching has been conducted to the students, paying attention to stimulating their interest in learning. Besides, by way of a comprehensive assessment, students' academic performance has been objectively evaluated.

Covered in the paper is the practice of an information platform of a medical alliance centering on Wuxi People′s Hospital,and its application in 1 6 member hospitals.Thanks to the overall standardization,planning, construction, regulation and synergy of the members in tiered medical services,such a platform contributes positively in sharing management,technology and medical resources among the members.

BACKGROUND:Radial head re-dislocation is one of the alarming complications of old Monteggia fracture. Many treatment methods have described the necessary of fracture and annual ligament reconstruction during treatment, but stil unclear.
OBJECTIVE:To emphasize the practicality of annular ligament reconstruction through comparing the children’s treatment in two groups.
METHODS:Twelve patients with children’s old Monteggia fracture were included for retrospective analysis. Al the patients were treated with radial head open reduction and internal fixation. Among them, five cases received ulna extending osteotomy and annual ligament reconstruction, and seven cases received ulna extending
osteotomy without annual ligament reconstruction. The course was 3-18 months from damage to the clinical
manifestations (an average of 9 months). Ten cases with Bado type Ⅰ and two cases were Bado type Ⅱ andⅢ. The reliability of ligament reconstruction was evaluated before and after treatment with Kim standard.
RESULTS AND CONCLUSION:Al the 12 cases were fol owed-up for 22 months (8-26 months). Evaluation
according to the Kim standard after treatment showed excel ent in 10 cases without abnormalities and pain, the range of motion>250 °, and no elbow was limited, the activities of daily living was 25 points;good in two cases with mild deformity and mild or intermittent pain, the range of motion was 200°-250° with elbow limited, activities of daily living was 15 points;no poor (serious deformity, pain, range of motion<200°, elbow severely limited, activities of daily living was 0 points). Fol owed-up lasted for 22 months and found that the average healing time of ulnar
osteotomy was 8 weeks (6-14 weeks). The wounds were healed primarily without infection and nonunion. The
results indicate that ulna extending osteotomy has great significance in keeping stability of radial head, and annular ligament reconstruction is determined by the time of injury, surgical procedures and intraoperative radial head stability.

β-arrestins are involved in the insulin signaling pathway, affecting peripheral insulin resistance,also affecting insulin secretion and lipid metabolism. To clarify β-arrestins mediated signaling pathways is an approach to the pathogenesis and effective treatment of diabetes.