OBJECTIVE To find standard for the management of the medical waste through the plan,do,check and action(PDCA) loop method. METHODS Four steps of PDCA were done to treat the medical wastes. RESULTS Establishment of the effective management of organization and the feasible rules and regulations was an important pledge.Training,propaganda and education for enhancing every-one′s management consciousness were a considerable element.Matching institutions for treating medical waste was the most important basis.Examinations according to the formulated quality specification were the artifice. CONCLUSIONS PDCA loop method is one of the scientific management for treating the medical wastes.

Objective To investigate the agitation effect of dexmedetomidine in the operation of radical hysterectomy by general anesthesia in patients.Methods 68 cases in this study who were under the operation of radical hysterectomy by general anesthesia in our hospital were selected, and randomly divided into the group A and the group B, 34 cases in each group.Group A received dexmedetomidine after tracheal intubation, and group B received physiological saline as the measurement of group A, hemodynamic and inflammatory factors were measured at different time points in anesthesia, the corresponding indexes and the degree of emergence delirium were compared.Results Compared with T1 , levels of HR and MAP increased, levels of SpO2 decreased at T3 and T4 in group B, levels of CRP, TNF-αincreased at T2 , T3 , T4 , T5 in group B, levels of CRP, TNF-αincreased at T3 , T4 , T5 in group A(P<0.05), and compared with the group A, levels of HR and MAP were higher at T3 and T4, levels of SpO2 were lower,levels of CRP, TNF-αwere higher at T2, T3, T4, T5in group B(P<0.05).The cough response score and agitation score in group B were higher than group A, and sedation score was lower than group A ( P <0.05 ) , the grade of emergence delirium in group A was better than group B ( P <0.05 ) . Conclusion Dexmedetomidine in the operation of radical hysterectomy by general anesthesia could reduce the emergence of agitation occurred, inhibit extubation reaction, but would not extend the anesthesia recovery time.

OBJECTIVE To analyze the status quo of pathogenic bacteria distribution and drug resistance of hospital infection in intensive care unit,to provide evidence for the guidance of clinical rational administration and to decrease the hospital infection. METHODS Pathogenic bacteria were isolated from patients who suffered from hospital infection in intensive care unit from 2001 to 2004.K-B slip diffusion method was taken to carry out the sensitive test.Rate of drug resistance of the pathogenic bacteria was analyzed. RESULTS As the bacteria distribution,the highest isolated rate was 60.77%,which was isolated from the sample of respiratory tract.The main pathogenic bacteria were the Gram-negative bacilli(47.69%).And the second pathogenic bacteria were the mycetes(37.69%).The Gram-positive cocci(14.62%) occupied the third.The monitoring of the drug resistance showed that rate of the drug fast was rather higher.The detection rate of the meticillin-resistant staphylococci was 81.82%.The detection rate of the ESBLs from the Escherichia coli and the Klebsiella pneumoniae was 75.00% and 57.14%,respectively. CONCLUSIONS Intensive care unit is one of the highest risk departments for the hospital infection.Generally,the pathogenic bacteria are the multidrug-resistant ones.Enhanced monitoring on pathogenic bacteria distribution and drug resistance analyses of hospital infection in intensive care unit could benefit for the guide of clinical rational administration,the depression of multidrug-resistant bacteria,and the decrease in hospital infection.

Objective To investigate the changes of drug resistance related genes and drug resistance of Acinetobacter Bau-mannii in hospital,and provide evidence for rational use of antibiotics in clinic.Methods A retrospective analysis of Shaanxi Corps Hospital of Chinese Peoples’s Armed Police Forces from 2011 to 2015 from clinical samples of 11 521 specimens were isolated and cultured 1 861 strains of Acinetobacter Baumannii,drug susceptibility test by K-B method.The antimicrobial minimum inhibitory concentration (MIC)according to the 2014 edition of the CLSI judgment criteria of judgment.Results 1 861 strains of Acinetobacter Baumannii were detected drug resistance genes gyrA,parC,OXA-51,OXA-23,int on the 1,I TEM,AAC (6’)-1,AAC (3’)-1,ant (3)-1,ant (2)-1 and Caro gene detection rates were 50.4%,72.1%,70.9%,55.7%, 56.2%,65.6%,12.9% and 89.9% respectively,and SHV,IMP and VIM genes were not detected.The sequencing results showed that gyrA and parC gene mutation was the main cause of quinolone resistance.The antibiotic resistance of Acineto-bacterBaumannii was an increasing trend year by year,and 1 861 strains has 1 419 strains showed multiple drug resistance, all strains were sensitive to polymyxin.In 2015,quinolones aminoglycosides resistance rate was more than 65%.To imipen-em,meropenem and Cefoperazone/sulbactam were 35.17%,36.01% and 42.40%.Conclusion The detection rate of Acine-tobacter Baumannii is increasing year by year,and the drug resistance and multi drug resistance is increasing year by year.It is necessary to strengthen the clinical rational drug use andcontrol the hospital infection.

Objective:To investigate the application value of ultrasound-guided selective pudendal nerve block during vestibular gland resection.Methods:Ninety patients who underwent vestibular gland resection in Lishui Maternal and Child Health Hospital from January 2017 to January 2020 were included in this study. These patients were divided into a control group and an observation group ( n = 45/group) according to the order of admission. Patients in the control group underwent blind nerve block and those in the observation group underwent ultrasound-guided selective pudendal nerve block. Hemodynamics before and after anesthesia, anesthetic effects, pain severity, and the incidence of complications were compared between the control and observation groups. Results:There were no significant differences in hemodynamics and pain severity between the control and observation groups (both P > 0.05). Systolic blood pressure [(124.37 ± 8.12) mmHg], diastolic blood pressure [(91.68 ± 5.44) mmHg] and heart rate [(74.62 ± 3.56) beats/min] were significantly lower than those in the control group [(128.62 ± 9.27) mmHg, (95.24 ± 6.17) mmHg, (76.12 ± 3.32) beats/min, t = 2.248, 2.903, 2.067, all P < 0.05]. In the observation group, pain scores at 2 and 24 hours after surgery were (3.06 ± 0.25) points and (4.21 ± 0.52) points, respectively, which were significantly lower than those in the control group [(3.28 ± 0.24) points and (4.54 ± 0.48) points, t = 2.618, 3.128, both P < 0.05). Anesthetic effect in the observation group was superior to that in the control group, and incidence of complications in the observation group was significantly lower than that in the control group ( χ2 = 12.869, 4.285, 4.864, 3.920, all P < 0.05). Conclusion:Ultrasound-guided selective pudendal nerve block in vestibular gland resection exhibits better anesthetic effect, has no obvious effect on hemodynamics, and has good analgesic effect with low incidence of complications. Therefore, it deserves clinical popularization.

This study was aimed to explore the clinical efficiency of modified Xiao-Y ao (XY) powder and acupuncture in the treatment of diarrhea-predominant irritable bowel syndrome (D-IBS). A total of 90 D-IBS patients were randomly divided into the treatment group and control group, with 45 patients in each group. Patients in the treatment group received acupuncture combined with modified XY powder. Patients in the control group received oral administration of montmorillonite powder, compound glutamine enteric-coated capsules, compound azintamide enteric coated tablet. Four weeks were one treatment course. After two treatment courses, the pretreatment and posttreatment symptom score, the score of Hamilton Depression Rating Scale (HAMD)/(HAMA), and the overall efficacy were compared. The results showed that compared with pretreatment, clinical symptoms were improved in varying degrees after treatment in both groups (P < 0.05 or P < 0.01). HAMD and HAMA were significantly decreased (P < 0.05). The treatment group had obvious advantages compared to the control group (P < 0.05). The overall efficacy of the treatment group was 91.11%, which was significantly higher than the control group of 68.89%(P < 0.05). It was concluded that modified XY powder and acupuncture can quickly relieve gastrointestinal symptoms, improve anxiety and depression. It is an effective treatment method for D-IBS.

Shanyao (Dioscorea opposita Thunb.) is the one of the conventional herbs in the clinical practice, which is good at nourishing yin, and entering the lung, spleen and kidney meridian. Through analysis on all formulae contain-ing Shanyao in past dynasties, we found out the top 30 kinds of traditional Chinese medicine (TCM) herbs for the highest frequency in combination with Shanyao, among which there were 28 herbs recorded in the Shen Nong Ben Cao Jing (Shen Nong's Classic of the Materia Medica) and 23 herbs were considered as the top grade medicinals. This article was focused on the analysis of the compatibility meaning and rules of Shanyao and supplementing medic-inals in order to provide scientific basis for clinical formulae and daily health cultivation so as to make good use of Shanyao.

AIM: The purpose is to study the stability of ferulic acid and develop a method for determining the content of ferulic acid in angelica sinensis by HPLC. METHODS: The solvent of reference ferulic acid was HCOOH H 2O(5∶95), but the solvent of the sample was HCCOH CH 3OH(5∶95). The separation was performed on Shimpack CLC -ODS column with acetonitrile (containing 0.2% methanol) 0.1% triethylamine (containing 0.1% phosphate)(20∶80) as mobile phase. Ferulic acid was detected at 324nm with flowing rate as 1.0mL?min -1 . RESULTS: The calibration curve was linear ( r =0.9998) in the range of 0.704 17.6 ?g?mL -1 for ferulic acid. The average recovery was 99.33% and RSD 0.60%, respectively. CONCLUSION: The method is quick and convenient for determination of ferulic acid.

Purpose Cortex is one of the frequently involved sites of multiple sclerosis (MS),and the cortex and corpus callosum lesions of MS are gradually concerned.The study aims to observe the changes of cerebral cortex and corpus callosum of MS in experimental autoimmune encephalomyelitis (EAE) model by using 7.0T MRI diffusion tensor imaging (DTI).Materials and Methods Twenty female C57BL/6 mice of 6-8 week old were enrolled in the study,10 of which were induced by MOG35-55 to make EAE models and the rest 10 of which were taken as control group.On the 20 days after model establishment,the head T2WI and DTI were performed on both control and EAE mice.DTI quantitative indicators such as fractional anisotropy (FA),mean diffusivity (MD),axial dispersion coefficient λ//,and radial dispersion coefficient λ ⊥ in region of interest including bilateral prefrontal cortex,bilateral cingulate cortex and corpus callosum were compared between the two groups.Results No obvious lesions were observed on the T2WI in both control and EAE groups.In the experimental group,the FA mapping suggested the integrity of the left side of the corpus callosum was destroyed.The FA,MD,λ// λ ⊥ of bilateral prefrontal cortex and corpus callosum showed significant difference between experimental group and control group (P＜0.05);the increase of λ ⊥ in bilateral cingulate was significantly different from that in the control group.Meanwhile,HE staining in the experimental group showed that inflammatory cells gathered around the cortical and subcortical vessels.The LFB staining in experimental group showed a bit paler than that in the control group,and the corpus callosum showed patchy demyelination.Conclusion The technique of 7.0T MRI DTI sequence can detect cortex and corpus callosum lesions which cannot be found by conventional MRI,so that it provides radiological evidence for the study of MS with cortex and corpus callosum lesions.

Objectives:To investigate the nutritional status of the maintenance hemodialysis(MHD) patients. Methods:The dietary investigation, anthropometry and biochemical tests were conducted in 46 MHD patients,including weight,triceps skinfold(TSF), arm muscle circumference(AMC), serum total protein(TP), albumin(Alb), prealbumin(PA), transferrin(TF) and ideal weight rate(IBW%).Then nutritional status was evaluated. Results:①The energy intake of most MHD patients was lower than 125.4 kJ/(kg?d) and the mean protein intake was nearly 1.0 g/(kg?d).②According to each single index,the incidence of malnutrition was:39.13% by IBW%, 71.74% by TSF, 58.70% by AMC, 30.43 % by Alb and 82.61% by TF respectively.Only 6.52% patients had all normal paremeters. Conclusions:Malnutrition incidence of MHD patients was as high as 93.48% in our study. The regular nutritional assessment and the nutritional advice are very important for the better clinical outcome in the MHD patients.