OBJECTIVE To discuss etiological factors and control strategies of hospital infection,in order to reduce the occurrence of hospital infection in the outpatient department of stomatology.METHODS According to the etiological factors of the hospital infection in outpatient department of stomatology,the corresponding control measures were presented.RESULTS The occurrence of hospital infection could be cut down by steps such as establishing the perfect rules and regulations,executing technical operation rules strictly,strengthening knowledge training for the medical staff,occupational protection,environmental disinfection management of outpatient department of stomatology,equipment disinfection management,hand hygiene of medical staff and standardizing the classification of the collection of clinical waste.CONCLUSIONS Occurrence of hospital infection has been effectively cut down by management measures of hospital infection taken in the outpatient department of stomatology.

OBJECTIVE:To analyze the general patterns and characteristics of drug-induced lupus (DIL) induced by inflix-imab,and to provide reference for the safety of drug use. METHODS:Usinginfiximab,lupusas searching words,inflix-imab-induced DIL literatures included in CJFD,VIP and PubMed from Jan. 2002 to Jun. 2016 were retrieved and analyzed. RE-SULTS:Totally 30 effective literatures were retrieved,involving 31 DIL patients,there were 8 male cases (25.81%) and 23 fe-male cases(74.19%);17 patients aged more than 50(54.84%). 20 cases occurred within 5-24 weeks(64.51%). 16 patients re-ceived infliximab alone (51.61%). Main clinical manifestations were skin rash or photosensitivie enteritig (15 cases),joint pain (16 cases,multiple arthritis and synovitis)and fever(12 cases). 5 patients suffered from 3 above symptoms simultaneously. Labo-ratory examination mainly manifested as antinuclear antibody,double stranded DNA antibody and anti-histone antibody positive. Thirty patients with DIL received drug withdrawal or steroid hormones treatment,among which the symptoms of 26 patients disap-peared after drug withdrawal or treatment within 6 months,and 1 patient deteriorated. CONCLUSIONS:DIL-induced by inflix-imab invovle patients'age and gender,disease types,family history and other factors. Clinicians should be aware of rules and char-acteristics of DIL induced by infliximab,and tighten drug use monitoring to reduce ADR.

Objective To study the effect of endotracheal tube's resistance on the respiratory systolic variation test(RSVT).Methods The RSVT,a test to predict fluid responsiveness was performed in 20 patients.The test consisted of the delivery of three congecutive pressure-controlled breaths with incremental peak inspiratory pressures of 10,20 and 30 cm H2O(1 cm H2O=0.098 kPa).The minimal values of the systolic arterial pressure following each of these three breaths were measured and plotted against their respective airway pressures,producing the RSVT slope.RSVT slope were compared between normal airway resistance and increased resistance circumstances,and the latter was simulated by advancing a Cooperdech bronchial blocker into endotracheal tube.Results Under normal resistance,RSVT slope was(0.39±0.21) volumes were(461.5±95.9),(891.5±149.8)and(1207.5±159.1)ml,when peak inspiratory pressures of 10,20 and 30 cm H2O were dehvered.When bronchial blocker was advanced into endotrecheal tube, (0.27±0.17)mm Hg,cm H2O significantly(P<0.01),and tidal volumes decreased to(434.5±92.8), (796.5±96.6)and(1097.5±68.4)ml(P<0.05 or<0.01).Conclusion Changes in endotraeheal tube's resistance can distort the RSVT slope.

Objective To explore the difference between pressure-regulated volume controlled ventilation (PRVCV) and volume controlled ventilation (VCV) during videothoracoscopic bhb excision.Methods Consecutive 20 patients scheduled to undergo videothoracoscopic bleb excision were enrolled into the study.After induction, endotracheal blocker was advanced into endotracheal tube to establish one-lung ventilation,each patient was randomly assigned to receive successively PRVCV and VCV for 20 minutes.Ventilatory variables were kept constantly(tide volume 6 ml/kg, respiratory rate 15 breaths/min and I: E ratio 1: 2).Heart rate,blood pressure,peak airway pressure and blood gas parameters were compared.Results Peak airway pressure was significantly lower with PRVCV than that with VCV [(12.7±3.6 ) cmH_2O(1 cm H_2O =0.098 kPa) vs (18.2±4.3) cm H_2O,P < 0.01].However,there was no significant difference in arterial oxygen tension,arterlal partial pressure of carbon dioxide,heart rate and blood pressure between PRVCV and VCV.Conclusion During one-lung ventilation in videothoracoscopic bleb excision, PRVCV offers lower peak inspiratory airway pressures while maintaining equal oxygenation compared with VCV.

To identify the best inducing condition, we studied the expression of membrane protein HSP70 and mRNA of H22 cell at various temperature. Using MTT,RT-PCR, immunofluorescence and FCM techniques, we observed H22 cell survival rate, the expression of HSP70 mRNA and membrane HSP70. No effects of H22 cell survival rate under 42 ~ 43℃ was observed, but cell survival rate declined with increasing stress time at 44 ~ 45 ℃; the level of HSP70 mRNA decreased initially (0.5~4.0) hours but gradually resumed and increased from 8 to 12 hours at 42℃. Membrane HSP70 expressing cells were significently higher in heat shock treatment group than in a control group ( P

Objective To compare the effects of target-controlled infusion (TCI) of propofol and remifentanil and inhalation anesthesia on the stress response in patients undergoing laparoscopic cholecystectomy (LC). Methods Selective LC was performed on 60 cases. Before the surgery,the patients were randomly divided into experiment (TCI of propofol and remifentanil) and control (standard general anesthesia combined with inhalation of fluorinated alkane and laughing gas) groups with 30 cases in each. The serum levels of cortisol and IL-6 were detected before the induction (t1) and 20 minutes after pneumoperitoneum (t2). In addition,the MAP and HR of the two groups were monitored at seven time points. Results The serum levels of cortisol and IL-6 in the experiment group were similar to those in the control at t1 [Cortisol:(227.48?50.81) ?g/L vs (233.21?41.02) ?g/L,t=0.481,P=0.633; IL-6:(105.99?30.65) ng/L vs (111.20?34.80) ng/L,t=-0.615,P=0.541],but significantly lower at t2 [Cortisol:(241.00?69.11) ?g/L vs (354.70?37.55) ?g/L,t=7.918,P=0.000; IL-6:(116.06?30.89) ng/L vs (172.73?23.54) ng/L,t=-7.992,P=0.000]. The MAP and HR in the experiment group were significantly lower than those in the control at t2 to t5 (5,10,15,and 20 minutes after the pneumoperitoneum; P

Objective To explore a method for establishing the hamster model of Clostridium difficile-associated diarrhea (CDAD)and the indicators for its evaluation.Methods Clindamycin was administered to hamsters subcutaneously (day 1),and 24 h later infected with C.difficile clinical isolates KH1 (ribotype 027,106-108 CFU/mL)or SH9 (ribotype 001 ,108-1010 CFU/mL)by gavage.Animals were observed for CDAD symptoms such as diarrhea,weight loss and death.At the end of ob-servation period (day 7 or death),the cecum was collected from each animal for histological evaluation of inflammation.Results Following a single dose of 100 mg/kg clindamycin subcutaneously,all the animals challenged with KH1 (108 CFU/mL)devel-oped diarrhea and then died within 5 days.All the hamsters challenged with SH9 (1010 CFU/mL)developed diarrhea as well but only 66.7% died at the end of observation period.Among other groups,only one or none developed diarrhea and then died. The symptoms of hamsters with diarrhea included loose stool,wet tail and weight loss.On histological examination,conges-tion,hemorrhage and neutrophil infiltration of the mucosa were observed in the hamsters died of CDAD.Conclusions We have successfully established a hamster CDAD model that allows for future investigations.

Objective To compare volume-controlled ventilation (VCV) versus pressure-controlled ventilation (PCV) improved by PEEP during one-lung ventilation (OLV).Methods Fifty ASA physical status Ⅰ-Ⅲ patients,aged 25-64 yr,weighing 40-80 kg,undergoing elective thoracotomy,were randomly divided into 2 groups (n =25 each) using a random number table:VCV + PEEP group (group Ⅴ) and PCV + PEEP group (group P).Those in group Ⅴ underwent OLV initially with VCV for 20 min followed by 4cm H2O PEEP for 20 min and then PEEP was removed.Those in group P underwent OLV initially with PCV for 20 min followed by 4cm H2O PEEP for 20 min and then PEEP was removed.At the beginning of two-lung ventilation before chest opening (T1),at 20 min of OLV before PEEP (T2),and at 20 min of ventilation with PEEP (T3),arterial blood samples were collected for blood gas analysis and the peak airway pressure (Ppeak) and development of SpO2 ＜ 95 ％ from beginning of OLV to T3 were recorded.Results Compared with group P,Ppeak at T2,3 and PaO2 at T3 were significantly increased in group Ⅴ (P ＜ 0.05).Compared with the baseline value at T1,PaO2 was significantly decreased and Ppeak was increased at T2.3 in Ⅴ and P groups (P ＜ 0.05).The incidence of SpO2 ＜ 95％ was significantly decreased and PaO2 was increased at T3 than at T2 in Ⅴ and P groups (P ＜ 0.05).Conclusion 4 cm H2O PEEP can improve VCV and PCV during OLV and the improved efficacy is better for VCV in patients undergoing thoracotomy.

Objective To study the clinical characteristics, diagnosis, treatment and prognosis of cancer metastasis to the thyroid gland. Methods A restropective review was performed on 35 patients with cancer metastasis to the thyroid gland in our hospital from 1958 to 2010. Diagnosis was confirmed by fineneedle aspiration cytology or histopathology in all cases. Results Primary tumor origin was identified in all but three cases. The lung was the most common primary tumor site( n = 16), followed by esophagus( n =9),breast ( n = 2), kidney ( n = 2), hypopharynx ( n= 1 ), nasopharynx ( n = 1 ) and soft palate ( n = 1 ). Thyroid metastasis was found before the diagnosis of the primary tumor was established in 12 cases; in the other 23 cases, the time lapse from diagnosis of the primary tumor to metastasis to the thyroid gland ranged from 0- 168 months, median 24 months. In 6 patients, this interval was more than 36 months. Fine-needle aspiration cytology ( FNAC ) confirmed metastatic malignancy in 7 patients, histology in 24, combined application confirmed the diagnosis in 4. After the metastasis to the thyroid gland was established, the median survival time for the entire group was 11.5 months, the 1-, 3- and 5-year survival rate was 43.8%,27. 8% and 11.9%, respectively. 28 patients were treated surgically, and 7 received nonsurgical therapy.The overall survival rate in the surgical group was higher than that in the nonsurgical group (P ＜0. 01 ). In those patients with metastatic cervical lymph nodes, median survival time did not vary from patients undergoing thyroidectomy with neck dissection to those undergoing thyroidectomy alone (P ＞ 0. 05 ).Conclusions Metastasis of carcinoma to the thyroid gland has an occult occurrence, thyroid metastases can be detected conclusively with FNAC. Metastasis to the thyroid gland implies advanced malignant tumors,often with poor prognosis.

Objective To explore the safety and clinical effects of laparosepie splenectomy.Methods Clinical data of 24 cages of laparoscopic splenectomy in our hospital from 2002 to 2008 were retrospectively analvzed.Among these 24 cases,there were 6 cases with liver cirrhosis,10 cases with ITP,2 cases with hemolytic anemia(Evens syndmm),2 cases with spelenic rupture,and 4 cases optimum spleen ambuty.Results All the 24 cases were successfully underwent laparoscopic splenectomy.The mean operation time wag 146 minute.the mean volume of blood loss was 220 ml.the postoperative gastrointestinal peristalsis time Was from 24 to 48 hours.The mean hospitalization time was 9 days after operation.Conclusions Provided mastering operation indication and technique,Laparoscopie spleneetomy is a safe and minimally invasive surgery.