Objective To investigate the status of disinfection and sterilization quality of different levels of medical institu-tes in Xi’an,and improve the management level of disinfection and sterilization of medical institutes. Methods Disinfection and sterilization efficacy of 69 medical institutes were monitored and evaluated according to Standardization for Disinfec-tionTechniques (2002 edition)and Sanitary Standards for Hospital Disinfection (GB15982-1995). Results From 2011 to 2013,2 224 specimens were tested,1 766 (79.41% )were qualified.The qualified rate of tertiary medical institutes was higher than second and below medical institutes (83.67% vs 77.50% ,P= 0.001),the qualified rate between public medical institutes and private medical institutes was not statistically different (79 .64% vs 78 .20% , P= 0.532),the qualified rate of comprehensive medical institutes was higher than specialized medical institutes (80.18% vs 74.92% ,P= 0.030). Of different detected specimens,the qualified rates of disinfectant in use and pressure steam sterilizers (including test pack and process challenge device)were higher (98.46% ,100.00% ,and 98.06% respectively),while the hands of health care workers (HCWs)and glutaraldehyde were lower(58.48% and 43 .28% respectively).Conclusion Disinfection and sterilization quality in different medical institutes in Xi’an is dif-ferent,and different disinfected and sterilized objects are also varied .It is necessary to intensify the management of hand hygiene of HCWs and concentration of glutaraldehyde.

AIM: To investigate the possible impact of conductive keratoplasty(CK)on intraocular pressure( IOP ).METHODS: 36 eyes of 20 patients with hyperopia underwent IOP measurement with non-contact tonometer (NCT), Goldmann applanation tonometer (GAT) and Schiotz tonometer before and after CK.RESULTS: After CK, a significant decrease was observed by NCT, GAT and Schiotz measurements. The change in IOP readings was not correlated with age, sex,keratometric readings, or attempted correction.CONCLUSION: The applanation tonometer atend to underestimate the true IOP after CK.

OBJECTIVE: To investigate the instruction for drug use for pregnant and lactating women and to provide reference for standardizing drug package inserts. METHODS: Four hundred and ninty drug instructions sampled from the pharmacy in our hospital were investigated and analyzed on the part for pregnant and lactating women medication by Provisions for Drug Insert Sheets and Labels, Regulatory Guidelines for the chemicals non-prescription drug, Regulatory Guidelines for chemicals and living creature product and other references. RESULTS: In prescription medicines, The rate of pregnant and lactating women to use the medicine circumstance marked was 53.91%, and that of "not yet clear" or "still have no data" was 13.28%, and the other 32.81% have never carried on to mark. In non-prescription medicines, The rate of pregnant and lactating women to use the medicine circumstance marked was 46.23%, 53.77% have never carried on to mark. CONCLUSION: The contents of pregnant and lactating women medication are far from perfect, Which should draw attention to better management.

ObjectiveTo retrospectively analyze the relationship between clinicopathological,biological characteristics and the outcome of renal cell carcinoma(RCC) and evaluate the risk factors related to metastasis in young patients.MethodsThe data of 83 RCC patients younger than 40-year-old, treated from January 1986 to December 2007 in Tianjin Cancer Hospital,were analyzed retrospectively.The complete follow-up data of the 83 cases were collected.The operative methods included partial and radical surgery.Clinical staging were consistent with the 2004 UICC TNM classification criterion.The histological sections were reviewed.Various biological factors including VEGFR-1, VEGFR-2, VEGFR-3, PDGFR-α, PDGFR-β, c-kit and PCNA were tested by immunohistochemistry staining.The adjuvant radiation therapy, chemotherapy and immunotherapy after operation were carried out on the basis of pathological and biological features.The 83 cases were divided into two groups according to metastasis and non-metastasis status within 5 years.The prognosis related factors including clinical factors, pathological and biological factors were evaluated.Chi-square test was used for the analysis of 5-years metastasis status; and multivariate analysis was carried out using Cox proportional hazards models to assess the independent effect of the metastasis factors (the test standard α = 0.05).ResultsThe 5-year follow-up data showed that the metastasis rate in the 83 cases was 16.87％ (14/83).The Chi-square test results indicated that the patients with clinical stage Ⅲ and grade 3 had the highest metastasis rate (57.14％ and 78.57％respectively,x2 =38.042, x2 = 9.820; Ps ＜ 0.01) .The VEGFR-3 and PCNA positive expression rates were 92.86％ and 85.71％ respectively in metastasis group.The metastatic risk of early stage patients was 3.444 times as much as the advanced stage patients.ConclusionThe young patients with clinical advanced renal cell carcinoma had worse outcome.The stage,grade, VEGFR-3 and PCNA expression were the risk factors correlated with the metastasis risk for young RCC patients.TNM stage was an independent predictive risk factor of metastasis in young patients.

Objective To explore the effect of physical condition on autonomous social participation function in stroke patients. Meth-ods A survey was conducted on 283 cases of stroke patients from October, 2014 to September, 2015. They were tested with General Situa-tion Questionnaire, Disease Status Questionnaire, Impact on Participation and Autonomy Questionnaire (IPA), Chinese Stroke Scale (CSS), and Mini-Mental State Examination (MMSE). Results Multivariate regression analysis showed that age, scores of MMSE and CSS, and physical disabilities were the factors related with autonomous social participation function in stroke patients (t>2.513, P<0.05). Conclusion It is needed to prevent and treat the complications of stroke early, which may contribute to the improvement of autonomous social participa-tion in stroke patients.

Child ; Child, Preschool ; Humans ; Male ; Posterior Leukoencephalopathy Syndrome

Objective Currently, the effect of hydrogen peroxide solution( H2 O2 ) flush on the recovery of peripheral nerve injury are still undetermined. This study aims to explore the effects of different H2 O2 flushing time course on recovery of peripheral nerve injury during surgical debridement. Methods 18 New Zealand male white rabbits were randomly divided into isotonic saline group( isotonic saline flush) , H2 O21 min group ( hydrogen peroxide solution flush 1 min + isotonic saline flush) , H2 O23 min group ( H2 O2 flush 3 min + isotonic saline flush. Each group has 6 rabbits. We established rabbit sciatic nerve injury model. After 12 weeks, we executed the animals, drew materials at the suture nerve, detected motor nerve conduction velocity and observed pathological HE staining, as well as measuring the sciatic nerve function indexes( SFI) of rabbits at the 8th and 12th week, respectively. Results Nerve conduction velocity in H2O21min group and isotonic saline group[(25.89±1.42), (26.46±1.67) m/s] were higher than that in the H2O23min group[(23.80±2.91)m/s](P<0.05). Pathological section shows that the isotonic saline group has a better sheathstructure, nerve fibers structure damage is not obvious and myelin degeneration degree is mild in H2 O21 min group. blurred sheath structure and myelin axons obvious deformation in H2 O23 min group. 8 weeks and 12 weeks after operation, SFI in isotonic saline group [(-43.00±0.82), (-39.17±0.91) m/s] was significant higher than H2O21 min group [ (-49.79±1.47), (-46.60±0.79) m/s] and H2O23min group [(-51.66±1.27), (-46.39±0.94) m/s], thedifference was statistically significant (P<0.05). SFI in group of H2O21min [(-49.79±1.47)m/s] was higher than group og H2O23 min [(-51.66±1.27) m/s][P<0.05]. Conclusion H2O2 solution has side effect on the recovery of damaged peripheral nerve inju-ry and with prolonging the H2 O2 flushing time, the damage of peripheral nerve can be aggravated. So in the process of clinical surgical debridement, under the premise of guaranteed sterilization the time of H2 O2 flush should be shortened as far as possible.

An originate angiotensin Ⅱreceptor-neprilysin inhibitor sacubitril/valsartan with double effect and a new active mode can not only promote the protection of heart and neuroendocrine system , but also inhibit renin-angiotensin-aldosterone system .Sacubi-tril/valsartan is the first and only one conformed by clinical trials with better efficacy when compared with standard therapy drug enala -pril, and its safety is higher as well .Sacubitril-valsartan represents a promising new treatment option for heart failure patients with low-ered risk of cardiovascular death and hospitalization for heart failure .

4?Gy were significantly higher than in those

Objective To evaluate the treatment of advanced endometrial cancer with californium-252 brachytherapy. Methods 21 cases of endometrial cancers who had not received any treatment were diagnosed as in the stages Ⅰ～Ⅳ according to the criteria of FIGO. Treatment schedule included: 252Cf brachytherapy, 8～12Gy/fraction/week, the total dose of reference point A was 35～45 Gy and total dose of reference point F was 35～50Gy in three to four implant sessions. On the second day after 252Cf therapy, the whole pelvis was treated with 6MV X-ray external beam radiotherapy, 200 cGy per fraction, 4 times per week. The total dose of external beam radiotherapy was 45 to 50 Gy (the middle of pelvis was shielded with 4cm of lead), and the total treatment time was 5～6weeks. The recent therapeutic effect and complications were observed. Results The average time of complete tumor regression was 25 days, the local control rate was over 90%; the late radioactive complications of bladder and rectum was low during the 5-year follow-up period. Conclusions Combined californium-252 brachytherapy and high energy X-ray external beam radiotherapy may be safe and effective on advanced endometrial cancer.