Objective To study and summarizes the methods ofthe standardized hospital infection manage -ment technology in order to prevent and control hospital infection scientifically .Methods Taking the chance of im-provingthe execution of the standardized hospital infection management issued by the Ministry of Health ,we realized organizational execution by enhancing the responsibility decomposition , mechanism implementation by standardized completion,ideological implementation by education and training ,the implementation of standards by inspection and monitoring and finally form a team by enhanced communication .Results The technicalstandards of hospital infection management was implemented and the quality of hospital infection control was improved progressively .Conclusion It is an effective way to guarantee medical security to improve the execution of the technical standard of hospital infec -tion management .

Objective Pulmonary sequestration (PS) is a rare disease,and its clinical symptoms are usually related to subsequent pulmonary infections.We analyzed the clinical characteristics of PS complicated by aspergillosis,and reviewed related literature,so as to disclose the association between these two diseases.Methods Sixty-nine patients with surgery-confirmed PS in Peking Union Medical College Hospital between January 1990 and December 2013 were retrospectively analyzed,including seven cases complicated by aspergillosis.Clinical manifestation,imaging and surgery of these patients were analyzed.Literature focusing on PS complicated by aspergillosis in pubmed data base was reviewed.Results In these seven patients,four cases were male,and three cases were female.Age at diagnosis ranged from 29 to 58 years old.The interval from onset to definite diagnosis ranged from two weeks to 20 years.Clinical symptoms included productive cough in seven cases,hemoptysis in three cases,chest pain in two cases,and fever in one case.All cases were intralobar PS with four in the left lower lobe and three in the right lower lobe.Consolidation in chest CT was noted in six cases.Cavitation was positive in three cases.Surgery of lung lobe resection was performed in all patients.Aberrant arteries were found during operation with the origin from aortic artery in four cases,phrenic artery in two cases,and intercostal artery in one case.Aspergillosis was diagnosed by pathology in six cases and by lung tissue culture in one case.Conclusions PS complicated by aspergillosis is extremely rare,but the trend of an increase in recent years has been noted.Strict and cautious examinations for microorganisms and pathology will help find relatively insidious aspergillosis.

Neurology is a relatively difficult subject in all medical subjects, to which medical students, interns and low qualification residents generally have a kind of fear, called neurophobia. Through such teaching methods as bedside teaching, problem and case oriented group discussions, mini-lectures and net-work communication, and combined with the specific case and imaging data, our teaching and research section helps students consolidate the basic knowledge of neuroanatomy, grasp the physical examination of the nervous system, and cultivate their thinking of positioning and qualitative diagnosis, so as to enable them to achieve better learning effect in the shortest practice time when they are in clinical neurological depart-ment, and help them to overcome neurophobia.

Objective To evaluate the risk factors for early rebleeding (ERB) after elective endoscopic variceal ligation (EVL) in cirrhotic patients and the influence of ERB on the long-term survival.Methods A total of 198 cirrhotic patients who received elective EVL were retrospectively evaluated.Twenty-six patients rebleeded within 6 weeks after initial EVL and were assigned to the ERB group.One hundred and seventy-two other cirrhotic patients were assigned to the control group.Multivariate analysis was used to define the high risk factors of ERB.A Kaplan-Meier analysis was performed to evaluate the cumulative survival rates between two groups.Results The Child-Pugh classification (P =0.016),Child-Pugh scores (P=0.012),and the total bilirubin (P =0.001) were significantly different between ERB and control group.Multivariate analysis showed total bilirubin was the only independent risk factor of ERB (OR =2.02,95％CI:1.04-4.04,P =0.008).The proportional mortality indicator of bleeding-related deaths was 66.7％ (10/15) in ERB group and 13.6％ (6/44) in control group (P ＜0.01).The five-year curmulative survival rate of the control-group was significantly higher than that of the rebleeding group (67.8％ vs.25.3％,P ＜ 0.01).Conclusion Cirrhotic patients with ERB after elective EVL have a poor prognosis.High level of total bilirubin may predict ERB.

Objective To discuss Buyang-huanwu decoction preventing the formation of lower limb deep vein thrombosis (DVT) after major orthopedic surgery.Methods 60 patients were randomly divided into a treatment group and a control group.The treatment group was treated with oral liquid of Buyang-huanwu,twice a day; while the control group was treated with 5000IU of low molecular heparin through subcutaneous injection,once daily.Prothrombin time (PT),activated partial thromboplatin time (APTT),fibrinogen (FIB),D-dimer,lower limb deep vein color B ultrasonic and the wound flow changes after 48 hours were observed at 1st,7th,and 14th day after medication.Results ①)Comparison on the incidence of DVT:The incidence of DVT in the treatment group was higher than the control group at 7th day after medication,this incidence turn to equal in the two groups at the 14th day after medication,while at the end of therapy,the incidence of DVT in the treatment group was lower than the control group with significant difference (P＜0.05).②Comparison on D-dimer changes:D-dimer at the 1st and 14th day were (0.782 ± 0.472) mg/1 and (0.320 ± 0.102) mg/1 in the treatment group and (0.720±0.421)mg/1 and (0.417 ± 0.217) mg/l in the control group.Comparing with the same group before treatment [the treatment group was(0.548±0.245)mg/1; the control group was (0.560±0.195) mg/l],D-dimer was increased at the 1 st day with obvious difference (P＜ 0.05),but reduced at the 14th day,without statistical difference (P＞0.05).Conclusion Buyang-huanwu decoction did not show good effects as low molecular heparin at the beginning of the treatment,but the its whole therapeutic effects and safety was better in treating lower limb deep vein thrombosis after major orthopedic surgery.

Objective Taking methyl nonyl ketone as index to establish pharmacokinetic compartment model for study volatile oil from the whole herb of Houttuynia cordata by pharmacokinetic parameters in rabbits in vivo. Methods Using GC to determine the blood concentrations of methyl nonyl ketone in the volatile oil from whole herbs of H. cordata in rabbit plasma. The GC system used a capillary SPB-5 column and helium as carrier gas; the initial temperature was at 90 ℃, then raised to 190 ℃ by 10 ℃/min and kept for 5 min; the injector temperature was 250 ℃ and the FID detector temperature was 300 ℃; the injection volume was 5.0 ?L with splitless injection mode; n-hexane was used as solvent and n-pentadecane as interior standard substance. The blood concentration value of methyl nonyl ketone was fitted with 3P97 procedure. Results A capillary GC method was established for the detemination of methyl nonyl ketone in the volatile oil from whole herbs of H. cordata in rabbit plasma. Methyl nonyl ketone linearity was good (r=0.987 0) within 0.04—60.0 ?g/mL.The blood concentration-time course of precision in rabbit plasma conformed to two compartment model. Conclusion The experiment provides pharmacokinetic evidence for the rational administration and the further development of H. cordata and some methods for pharmacokinetic study of volatile oils from traditional Chinese medicinal materials.

Objective To study the method of development of PHT PB resistant amygdala kindled rats. Methods By examining the effects of the antiepileptic drugs PHT and PB in a group of rapidly kindled rats,the 40 animals with different sensitivity to these drugs were selected. Then using immunohistochemistry method to determinate the expression of PGP in the brain of the rats. Results Using determination of the after discharge threshold for evaluation of PHT′s and PB′s anticonvulsant effects, 6 animals showed no increase in their ADT at repeated test trials with PHT or PB (from PHT PB resistant rats), and 6 animals exhibited reproducible increase in ADT about 100% after injection of PHT or PB (from PHT PB nonresistant rats). The immunohisto chemistry for P glycoprotein showed increased staining in capillary endothelium in the samples from PHT PB resistant rats as compared with staining in PHT PB nonresistant rats,in extensive fields of bilateral cerebral hemispheres ( P

Objective To summarize experiences in surgical treatments of 18 patients suffered from Ebstein's anomaly with intracardiac repair and bi-directional cavopulmonary shunt from January 1999 to June 2003. Methods Of 18 patients, 10 male (55.6%) and 8 female (44.4%), mean age was (18.47?13.85) years old (range from 9 months～54 years old),and mean weight of body (36.09?19.78) kg (range from 8.5～80.0 kg). All patients were in type II of Ebstein's anomaly according to WANG (Zenwei's) classification, while 15 (83.3%) were in type B, and 3 (16.7%) in type C according to Carpentier's classification. Danielson repair of Ebstein's malformation and other intracardiac repair were performed on all patients, followed by bi-directional cavopulmonary anastomosis, on pump with heart beating. Results There was no death, and no severe heart dysfunction and refractory low cardiac output in all patients postoperatively. No reoperation for residual or recurrent tricuspid incompetence was required in all patients. At follow-up of 13 (72.2%) patients ranging from 1 to 53 months, 12 patients were in New York Heart Association ((NYHA)) class I, 1 in class II. Four were with 1 grade, 2 with 2 grades tricuspid regurgitation. The patency of bi-directional cavopulmonary anastomoses was verified by echocardiography. Conclusion Ventricular unloading added to intracardiac repair appears to be effective to improve left and right ventricular function and tricuspid valve performance in Ebstein's anomaly with moderate or massive tricuspid dysfunction and physiological right ventricular outlet tract obstruction.

Objective To study the potential effect of verapamil for the early changes of L-type calcium channel ?1c and potassium channel Kv4.3 in a rapid paced primary cultured atrial myocyte model for atrial fibrillation. Methods Primary rat atrial myocytes were cultured and established a rapid paced primary cultured atrial myocyte model. Atrial cells were divided into four groups: control group, rapid pacing group, verapamil with rapid pacing group and verapamil without rapid pacing group. Durations of rapid pacing were 24 h. The mRNA and protein expressions of L-type calcium channel ?1c and potassium channel Kv4.3 were measured by RT-PCR and Western blotting respectively. Results It was found that 24 h pacing significantly reduced mRNA and protein expressions of L-type calcium channel ?1c and potassium channel Kv4.3 as compared to controls (P0.05). Conclusion Expressions of L-type calcium channel ?1c and potassium channel Kv4.3 were reduced in the rapid pacing atrial myocytes, suggesting ion channel remodeling of atrial myocytes. However, verapamil can attenuate the progression of ion channel remodeling of atrial myocytes at least in early phase.

BACKGROUND:On-pump coronary artery bypass grafting(CABG)is replaced by off-pump coronary artery bypass grafting step by step.Effects of the two operations on liver and renal function deserve further studies.OBJECTIVE:To analyze the postoperative changes in liver and renal function between off-pump and on-pump CABG.DESIGN.TIME AND SETTING:Controlled study.The experiment was conducted at the Department of Cardiovascular Surgery.General Hospital of Chinese PLA.Beijing between June and November 2005.PARTICIPANTS:Fifty patients undergoing elective CABG at General hospital of PLA from June to November 2005 were enrolled in the study.All patients had normal liver and renal function before surgery.None of them developed severe acute liver and renal function.METHODS:All patients were allocated to either off-pump coronary bypass(OPCAB)(n=30)or on-pump conventional CABG (CCABG)(n=20)group according to patient's intention and condition.No significant difference was detected in age,gender,body mass index,preoperative ejection fraction,preoperative liver and renal function and operation risk factors between both groups(P>0.05).MAIN OUTCOME MEASURES:Alanine aminotransferase(ALT),aspartate aminotransferase(AST),blood urea nitrogen (BUN)and creatinine(Cr)were respectively measured in patients of both groups before surgery,1 day,1 week and 2 weeks after surgery.RESULTS:A total of 50 patients were involved in the final analysis.Changes in liver function:Serum ALT and AST Ievels in the OPCAB group were significantly lower than those in the CCABG group at 1 day after surgery(P<0.05).The level of two parameters recovered to the baseline at 2 week after surgery in both group.Changes in renal function:Serum BUN and Cr levels in the OPCAB group were significantly lower compared to the CCABG group at the first postoperative day(P<0.05).BUN and Cr levels recovered to the preoperative levels at 2 weeks after surgery in bOth group.CONCLUSl0N:CABG has an adverse effect on liver and renal function.which can recover in the early postoperative period.OPCAB has the less adverse effect on liver and renal function and offers a better liver and renal protection compared to CCABG.