Objective To investigate the influence of participation of healthcare-associated infection (HAI)man-agement department in ward round presided over by hospital director on hand hygiene compliance of health care workers (HCWs)in a basic-level hospital.Methods Implementation of hand hygiene in January-June 2012 (control group :HAI management department didn’t participate ward round)and January-June 2013 (trial group :HAI management department participated ward round)were investigated,the compliance of hand hygiene of two groups of HCWs and consumption of hand hygiene products of each department were compared.Results HAI case rate in trail group was significantly lower than control group (1.49% vs 2.01% )(χ2= 4.31,P<0.05);HCWs’hand hy-giene compliance rate was significantly higher than control group (71 . 56% [3 249/4 540 ]vs 44. 00% [1 914/4 350]),hand hygiene compliance rates in nurses were higher than doctors of both groups(χ2= 151.30,179.92, respectively,bothP<0.001),hand hygiene compliance rate in trial group from high to low was department of pedi-atrics,obstetrics and gynecology,surgery,and internal medicine. The consumption of rapid hand disinfectant of trail group and control group was 5.38mL/bed-day and 1.88 mL/bed-day respectively,the consumption of hand sanitizer was 11.51 mL/bed-day and 7.03 mL/bed-day respectively.Conclusion Hand hygiene checked during the ward round presided over by hospital director can improve HCWs’hand hygiene compliance,reduce the incidence of HAI,and ensure medical safety.

Objective　To explore the significance of dynamic determination of arterial blood gas for early diagnosis, treatment and prognosis of patients with acute respiratory stress syndrome(ARDS). Methods　The results of 655 times arterial blood gas assayed in 113 patients with ARDS were analysed retrospectively.Results　(1)Types of acid-basic disturbance:The simple acid-base disturbances were 44 cases,in which respiratory alkalosis were 20 cases, respiratory acidosis 11 cases, metabolic acidosis 10 cases, metabolic alkalosis 3 cases. Complex acid-base disturbances were 53 cases,in which respiratory alkalosis with metabolic acidosis were12 cases, respiratory alkalosis with metabolic alkalosis 14 cases, respiratory acidosis with metabolic acidosis 21 cases, respiratory alkalosis with metabolic alkalosis 6 cases. Triple acid-base disturbances (TABD) were 16 cases, in which the type of respiratory alkalosis were 11 cases, the type of respiratory acidosis 5 cases. the types of acid-base disturbances in cured patients mainly were respiratory alkalosis (17 cases) and respiratory alkalosis with metabolic alkalosis (12 cases). The types of acid-base disturbances in dead patients were mainly respiratory acidosis with metabolic acidosis (19 cases),TABD (14 cases) and respiratory acidosis (9 cases).(2)The oxygenation indexes(PaO2/FiO2) of all 113 patients were less than 26.7kPa.(3)The cured rate in 113cases was 53/113(46.0%)and the mortality was 61/113(54.0%).Conclusion　Dynamic determination of arterial blood gas and calculation of index of oxygenation were of important clinical value in diagnosis and treatment of ARDS.

Objective To evaluate the accuracy of prediction equations in calculating energy expenditure in elderly patients with type 2 diabetes mellitus (T2DM).Methods In 75 elderly T2DM patients hospitalized in our hospital between August 2014 and August 2015,the resting energy expenditure (REE)measured with indirect calorimetry was compared with those calculated with six different prediction equations.Statistical analysis was performed with paired t-test,the percentage of individual coincidence,and BlandAltman method.Results The measured REE of the patients was (1 513.2 ± 240.6) kcal/d.There were statistically significant differences between the measured REE and the values predicted with Harris-Benedict,Owen,Mifflin,and Liu equations (all P ＜ 0.05),while no statistically significant differences were observed between the measured REE and the values predicted with FAO/WHO/UNU and Schofield equations (both P ＞0.05).FAO/WHO/UNU equation showed the smallest average difference from the measured value (-18.9 kcal/d),but the 95％ consistency limit (-363.3 kcal/d,325.5 kcal/d) was still beyond the acceptable clinical range.Conclusion The accuracy of prediction equations in estimating REE in elderly patients with T2DM may be dissatisfactory.

Objective To investigate the effect of multi-channel minimally invasive percutaneous nephrolithotomy in combination with Yag laser in complex renal calculi operation. Methods Eighty six complex renal calculi patients were divided into two groups, study group (46 cases) was treated with multi-channel minimally invasive percutaneous nephrolithotomy combined with Yag laser, control group was treated with single-channel minimally invasive percutaneous nephrolithotomy combinated with extracorporeal shock wave treatment. Comparison of gravel removed time, stone clearance rate,postoperative hemoglobin decreasing rate, blood transfusion rate of surgery,length of stay time and operative complications were done between the two groups, the results were analysed statistically. Result The gravel removed time was (102±23) min in study group, and ( 121 ± 28) min in control group, there was no significant difference between the two groups(P ＞ 0.05 ). In study group, postoperative hemoglobin decreasing rate was 6.5%(3/46), blood transfusion rate of surgery was 17.4% (8/46), stone clearance rate was 82.6%( 38/46 ), length of stay time was (5.6 ± 1.7) d,while those in control group was 12.5%(5/40),22.5%(9/40),72.5%(29/40), (7.4 ± 1.8) d,respectively. There was statistical significance between the two groups(P＜ 0.05 ). Conclusion Multi-channel minimally invasive percutaneous nephrolithotomy in combination with Yag laser in the treatment of complex renal calculi has the shorter operation time, less blood loss,less complications and higher stone clearance rate, and is worthy of promotion.

Objective To observe the inhibition of asON phosphorothioate to the TIMP-1 gene and protein expression in the liver tissue of immune- induced hepatic fibrosis rats. Methods According to the analysis of modulator, structure protein, encoding sequence of TIMP-1 genome, we designed four different groups of asONs. These asONs were injected into the hepatic fibrosis rat models through coccygeal vein. The results were observed by RT-PCR, immunohistochemistry and in situ hybridization with collagen Ⅰ、Ⅲ, special staining of collagen fiber, electron microscope. Results The asON phosphorothioate of TIMP-1 could be expressed in vivo, and could block the TIMP-1 gene and protein expression in the liver of immune- induced hepatic fibrosis rats on the level of mRNA, which could promote the degradation of collagen Ⅰ、Ⅲ(P

Objective To study the expression and distribution of TIMP 1 and TIMP 2 in liver tissue of cirrhosis patient and to investigate the roles and pathogenesis of TIMP 1 and TIMP 2 in liver cirrhosis. Methods TIMP 1 and TIMP 2 proteins and mRNA were detected with immunohistochemistry and in situ hybridization methods using monoclonal antibodies and cDNA probes. Results mRNA and proteins of TIMP 1 and TIMP 2 were detected in all the liver tissues from 40 liver cirrhosis patients, all in cytoplasm but not nucleus. TIMP 1 and TIMP 2 were found co exist in all samples, while TIMP 1 concentration was higher. Conclusions mRNA and protein of TIMP 1 and TIMP 2 are found in all the cirrhosis patient samples. Liver TIMP 1 and TIMP 2 concentrations increase with the progression of liver cirrhosis, decrease the degradation of extracellular matrix proteins, resulting in the initiation and the development of liver fibrosis and liver cirrhosis.

The Union Youth Science & Research Fund was set up by the Peking Union Medical College (PUMC) using the Fundamental Research Funds for the central universities.Education Ministry's National College Special Fund for Basic Science& and Research drafted and implemented its own management rules.The rules standardize the fund's various aspects including its system construction,project classification,implementation terms,outlay management,and project management.In consequence,the rules promoted the young teachers' research on funded-subjects and improved the management level on scientific research projects.

An experimental immunity hepatic fibrosis rat model was prepared by means of immunologic assault with human serum albumin, and normal rats served as a control group. The immunohistochemistry methods and in situ hybridization were respectively used to detect TIMP 2 mRNA and related antigens in the liver,and to investigate the localization and expression of TIMP 2 in the liver of both normal and experimental hepatic fibrosis rats. The results showed that TIMP 2 mRNA and related antigens in the livers of experimental group were expressed in myofibroblasts and fibroblasts, especially in the portal area and fibrous septum. The positive signal was located in the cytoplasm, but not in the nucleus. On the other hand, there was a high level of expression of TIMP 2 in the liver of the experimental group.It is suggested that in the process of hepatic fibrosis, fibroblasts and myofibroblasts are the major cells expressing TIMP 2. The severer the hepatic fibrosis in the injured liver is, the higher the levels of TIMP 2 related antigens and gene expression are.

Objective To explore the clinical therapeutic effectiveness,safety and feasibility clinical of leflunomide and cyclophosphamide on lupus nephritis.Methods 34 cases with lupus nephritis were randomly divided into control group and observation group according to the time of admission during January 2013 to July 2014 in Shangdong Jining NO.1 People’s Hospital.17 cases in observation group were given leflunomide;17 cases in control group were given cyclophosphamide,six months was a period of treatment.Two groups were in the process of therapy observed and recorded changes in liver and lidney function indexes,serum albumin 24-hour urinary protein,anti-double stranded DNA antibody titers before and after treatment.At the end of a course, the basic activities of the two groups of lupus index were evaluation.Results The total effective rate in control group was 70.5%, and that was 88.2% in the observation group, there was no difference significant.Compared with the other indexes before and after treatment were statistically significance (P<0.05); the incidence of adverse events in the control group was 42.9%, the incidence of adverse events in the observation group was 14.3%, the difference was statistically significant (P<0.05).Conclusion Leflunomide in treatment of lupus nephritis has significant effect, less side effects and high safety.

BACKGROUND: Effects of Pericarpium aurantiin water extract on sleeping and spontaneous activity in Kunming mice has been investigated in three experiments, that is, the experiments of sleeping time due to supraliminal and subliminal dosage of sodium pentobarbital, and shaking cage for energy transducer, respectively.OBJECTIVE: To observe the influence of Pericarpium aurantiin water extract on sleeping and spontaneous activity of Kunming mice.DESIGN:Randomized controlled trial.SETTING: The Staff Rooms of Pathology, Physiology and Pharmacology in Gannan Medical College.MATERIALS: The experiment was conducted in the Central Laboratory of Science Research, Gannan Medical College from January through February 2005. Ninety adult Kunming mice, grade of clearness, were enrolled and randomly divided into three groups with 30 mice for each experiment:10 in control group, 10 in large-dosage group and 10 in small-dosage group.METHODS: ① In energy transforming trial, spontaneous activity of mice was recorded, small wave with wave amplitude ＜ 5 mm was considered as the waveform of gentle activity in mice, such as fur licking and tickling; middle wave with wave amplitude of 5-10 mm as the waveform of moderate activity, such as walking, standing, climbing up and down;large wave with wave amplitude ＞ 10 mm as the waveform of intensive activity, such as running, jumping up and down. Mice in the small-dosage group, large-dosage group and control group were respectively given intraperitoneal injection of 5 mg/g, 10 mg/g Pericarpium aurantiin water extract and equal volume of normal saline, and placed into the cage after 15 minutes. Then, 3 minutes later, waveforms of mice within 15 s was recorded. ② In the experiments on duration of sleep in mice due to supraliminal or subliminal dosage sodium pentobarbital, 0.02 mL/g or 0.01 mL/g sodium pentobarbital (2.5 g/L) were administrated intraperitoneally into mice in the small-dosage, large-dosage and control group 15 minutes after intraperitoneal injection of 5 mg/g, 10 mg/g Pericarpium aurantiin water extract and equal volume of normal saline were given to the three groups, respectively. Subsequently, comparisons of the number of sleeping mice, time to falling asleep, and sleeping time were carried out among the three groups.MAIN OUTCOME MEASURFS: ① Times of spontaneous activity, ②Sleeping time due to supraliminal dosage of sodium pentobarbital, ③ Duration of sleep due to subliminal dosage of sodium pentobarbital.RESULTS: All the mice were involved in the result analysis without loss.① There were fewer middle and large waves in the small-dosage and largedosage groups as compared with that in the control group (90.5±14.7,58.3±12.5, 45.6±10.1, t=2.341-3.215; P ＜0.05 or P ＜0.01), indicating that Pericarpium aurantiin water extract can evidently inhibit spontaneous activities in mice. ② In comparison with the control group, the time to falling asleep and the duration of sleep due to supraliminal dosage of sodium pentobarbital were shortened and prolonged significantly, respectively,in the small-dosage and large-dosage groups. ③ In comparison with the control group, the time to falling asleep and duration of sleep due to subliminal dosage of sodium pentobarbital were shortened and prolonged significantly, respectively, in the small-dosage and large-dosage groups.CONCLUSION: Pericarpium aurantiin water extract can prolong the duration of sleep and inhibit the spontaneous activities of Kunming mice,which is in cooperation with sodium pentobarbital in central inhibition.