Objective To explore the effective disinfection and management measures of standby aspirators. Methods Randomly sampled 17 standby aspirators in our hospital and examined whether their liquid storage bottles and covers were contaminated by pathogens.According to the situation,we developed appropriate measures to intervene.4 months after intervention,we sampled 17 standby aspirators which were tested again. Results 82.4% liquid storage bottles and 88.2% covers were contaminated. While the contamination rate after intervention was zero.The pathogens found were mainly Pseudomonas Aeruginosa, Klebsiella pneumoniae and other opportunistic pathogens.Conclusions To strengthen the disinfection management of standby aspirators can control the contamination of standby aspirators.

Objective To observe the effect of tongue-drawing at lateral position in nasogastric intubation for senile patients with conscious disorders. Methods One hundred senile patients with conscious disorders were randomly divided into observation group and control group with 50 cases in each group. The patients in the control group were given routine nasogastric intubation while those in the observation group were given nasogastric intubation by tongue drawing at the lateral position. The two groups were compared in terms of success rate of intubation, the rate of adverse reactions and intubation effects. Result Compared with the control group, the observation group showed significantly higher in one-time intubation success rate , comfort rate and lower rate of adverse reaction (all P<0.01). Conclusions The nasogastric intubation by tongue-drawing at lateral position is superior to the routine intubation. It can improve the success rate of one-time intubation, decrease the rate of adverse reactions and relieve the pains of patients.

AIM:Activin A,a member of transforming growth factor superfamily,is the negative regulator factor in liver regeneration. In this study,the effects of extract of Ginkgo Biloba on hepatic fibrosis and the expression of Activin A in rats with cirrhosis were investigated. METHODS:The experiment was performed at in the Central Laboratory of Wuhan First Hospital from September 2005 to December 2006. ①Thirty-six male SD rats of(160?20) g were randomized into 3 groups:control group,model group and treatment group. ② Except the rats in the control group,others were intraperitoneally injected with 500 mL/L CCl4 for 8 weeks to establish models of hepatic fibrosis. Meanwhile,the extract treatment group was infused with the extract of Ginkgo Biloba(Chinese drugs preparation laboratory of Wuhan First Hospital,detected by Hubeu Wushi Medicine Industry Co.,Ltd. No. 02-391) daily for 8 weeks. ③After administration,all anesthetized rats were sacrificed. Blood samples were collected for the determination of liver function biochemical indexes. Liver tissue samples were used for histopathological examinations. The expression of Activin A was determined by immunohistochemistry and RT-PCR. RESULTS:All 36 rats were involved in the final analysis. ①The liver function in extract treatment group was significantly improved compared with that in model group. ②The grade of fibrosis in extract treatment group were remarkably lower than that in model group under light microscope. ③The positive staining of Activin A in treatment group was significantly reduced compared with model group. ④The expression of Activin A mRNA in extract treatment group was significantly reduced compared with model group. CONCLUSION:Extract of Ginkgo Biloba can effectively decrease the expression of Activin A in rats with hepatic fibrosis caused by CCl4,and lessen the degree of hepatic fibrosis.

Objective To investigate the effects of continuous vennvenous haemodiafihration(CVVHDF)on major organ fimction and plasma cytokine levels in MODS dogs.Methods Fifteen Beagle dogs were subjected to hemorrhagic shock plus resuscitation and endotoxemia to establish MODS model,then dogs were randomly divided into 2 groups:CVVHDF group(n=8)and MODS group without CVVHDF (n=7).CVVHDF was performed for 12 hours after endotoxin injection in CVVHDF group dogs.Serum ALT,AST,Scr,BUN and blood gas were routinely measured,and plasma TNF-α,IL-6 and IL-10 coneentrations were measured by ELISA at different time points. Results Plasma levels of IL-6 and IL-10 were significantly decreased in the CVVHDF group at 3 h,6 h,9 h and 12 h after endotoxin injection as compared with MODS group (P＜0.01).TNF-α levels were similar in both groups(P＞0.05).IL-6 and TNF-α were detected in the ultrafihrate.The sieving coefficients (SC) for IL-6 and TNF-α were 0.27±0.13 and 0.1±0.1 respectively.IL-10 could not be detected in the ultrafiltrate.In CVVHDF group,function of major organs was improved.The beneficial effect of CVVHDF on the hypotension of MODS dogs was particularly striking at 6 h,9 h,and 12 h alter endotoxin injection(P＜0.01).Mean PaO2 in CVVHDF groups at 3 h,6 h,9 h,and 12 h after endotoxin injection was significantly higher than that in MODS group(P＜0.01). Conclusion CVVHDF effectively removes IL-6 and IL-10from the cireulation,attennates endotoxin-induced hypotension and improves arterial oxygenation in MODS dogs.

Objective To translate the Personal Diabetes Questionnaire(PDQ),and test the relia bility and validity of the Chinese version of PDQ.Methods Through forward translation,back translation,cultural adjustment,etc.,the Personal Diabetes Questionnaire (PDQ) was introduced to localize it.60 eligible patients with diabetes were selected in a tertiary hospital to make a preliminary investigation.The results were statistically analyzed in order to assess the reliability and validity of the Chinese version of PDQ.Results The Chinese version of PDQ had good reliability,whose total internal consistency coefficient was 0.831 and test-retest reliability was 0.801.The questionnaire has good validity.Total Content Validity Index was 0.938.I-CVI was between 0.800 and 1.000.The questionnaire's dimensions had good parallel validity with glycosylated hemoglobin (HbAlc) and body mass index (BMI).Conclusions The Chinese Version of the personal diabetes questionnaire has good reliability and validity,which can be widely used as the evaluation tool of diabetes self-management education.

Objective To analyse the DNA heterogeneity of 20 clinical isolates of Acinetobacteria using infrequet-restriction-site PCR (IRS-PCR ).Methods Strain-specific electrophoretic patterns from PCR products by amplifying DNA sequences flanking infrequent restriction of 20 strains of Acinetobacter were compared with the results of genotype with RAPD as well as the results of biotyping.Results Among the 20 bacteria, ten can be recognized as Acinetobacter haemolytius with biotyping, seven as Acinetobacter lwoffi, while the other 3 bacteria can not be recognized. Acinetobacter haemolytius isolates were divided into 5 gene types with IRS-PCR, isolates of Acinetobacter lwoffi were divided into 4 gene types, meanwhile, the last three bactria were divided into 2 gene types. With RAPD technique, Acinetobacter haemolytius, Acinetobacter lwoffi and the other 3 bacteria were divided into 6 gene types, 4 types, and 2 types by prime 1, respectively, the amplifying results of primer 2 divided Acinetobacter haemolytius into 9 gene types, the Acinetobacter lwoffi ,5 types and the other 3 bacteria,2 types. Conclusion IRS-PCR can be used for typing Acinetobacter and is more aceurate than biotyping. It has the same recogniton abili ty as RAPD while is of better stability and repeatability, so this method is capable of clinical application.

Objective To evaluate the effect of sufentanil postconditioning on renal ischemia-reperfusion (I/R) injury in rats and the relationship with autophagy.Methods Thirty pathogen-free healthy adult male Wistar rats,aged 6-8 weeks,weighing 180-220 g,were divided into 3 groups (n=10 each)using a random nunber table:sham operation group (group S),group I/R and sufentanil postconditioning group (group SP).The left renal pedicle was clamped for 45 mnin with an atraumatic vascular clamp followed by reperfusion,and the right kidney was removed immediately after onset of reperfusion in anesthetized rats to establish the model of renal I/R injury in I/R and SP groups.In group S,the left renal pedicle was only isolated,and the right kidney was removed.Sufentanil 1 μg/kg was injected via the tail vein at 5 min before reperfusion in group SP,while the equal volume of normal saline was given instead in S and I/R groups.At 24 h of reperfusion,blood samples were collected by cardiac puncture for measurement of serum creatinine (Cr) and blood urea nitrogen (BUN) concentrations.The animnals were then sacrificed,and the left renal specimens were obtained for examination of pathological changes (with light microscopes) and for determination of the expression of microtubule-associated protein 1 light chain 3 (LC3) and Beclin-1 in renal tissues (by immuno-histochemistry).Results Conpared with group S,the serum Cr and BUN concentrations were significantly increased,and the expression of LC3 and Beclin-1 in renal tissues was up-regulated (P＜0.05),and the pathological changes of kidneys were aggravated in I/R and SP groups.Compared with group I/R,the serum Cr and BUN concentrations were significantly decreased,the expression of LC3 and Beclin-1 in renal tissues was down-regulated (P＜0.05),and the pathological changes of kidneys were significantly attenuated in group SP.Conclusion Sufentanil postconditioning can attenuate renal I/R injury,and the mechanism may be related to inhibition of autophagy in rats.

With this retrospective study, we analyzed the negotiation subject, drug type, drug access mechanism, negotiation link and negotiation result of drug negotiation in typical regions at home and abroad.In foreign countries, drug negotiation mechanism has been implemented for many years, and many countries have established a relatively perfect negotiation system.We selected 8 typical countries and regions for which we statistically analyzed the negotiation subject, drug type, drug access mechanism, negotiation link and negotiation result of drug negotiation and these include the United States, Australia, Canada, France, Germany, Italy, South Korea and Taiwan.However, in recent years some Chinese medical insurance department carried out pilot works on drug negotiations, and they got some successful results of the implementation of practical experience.Eight typical Chinese regions were also selected for statistical analysis, and these include Zhejiang, Hunan, Jiangsu, Jiangxi, Chengdu and Qingdao.From the analysis of the comparison of drug negotiation mechanism in domestic and foreign typical regional, we found that foreign regional drug negotiation mechanism is more mature and perfect, while in the domestic areas the mechanism is still poor at a certain extent as compared to foreign countries.We should learn from the successful experience of foreign countries and also establish and improve the negotiation mechanism that is suitable for China''s national conditions.

Objective To evaluate the effects of dexmedetomidine on lung ischemia-reperfusion (I/R) injury in rats.Methods Ninety-six healthy SPF male Wistar rats,weighing 250-350 g,aged 8-12 weeks,were randomly divided into 4 groups (n =24 each):sham operation group (S group),I/R group,low dose dexmedetomidine group (DL group) and high dose dexmedetomidine group (DH group).In DL and DH groups,dexmedetomidine 100 and 500 μg· kg-1 · d-1 were injected intraperitoneally once a day for 2 consecutive days,while the equal volume of normal saline was given in S and I/R groups.Lung·I/R was induced by clamping the left hilum of lung for 45 min followed by reperfusion at 30 min after administration on 2nd day.At 45 min of ischemia,and 60 and 120 min of reperfusion,6 rats were sacrificed,and lungswere removed for determination of TNF-α (tumor necrosis factor-a) content and myeloperoxidase (MPO) activity in lung tissues.The percentage of damaged alveolar in lung tissues was detected at 120 min of reperfusion.Another 6 rats were lavaged and the broncho-alveolar lavage fluid (BALF) was colleted for determination of the total protein concentrations.Results Compared with S group,the TNF-α content,MPO activity,percentage of damaged alveolar,and total protein concentrations in BALF were significantly increased in I/R,DL and DH groups.Compared with I/R group,the TNF-α content,MPO activity,percentage of damaged alveolar,and total protein concentrations in BALF were significantly decreased in DL and DH groups.Conclusion Dexmedetomidine can alleviate the lung I/R injury in rats,and the mechanism is related to inhibiton of the inflammatory responses.