OBJECTIVE:To observe the effects of dexmedetomidine on hemodynamics of patients underwent cardiac valve re-placement in the anesthesia induction. METHODS:92 patients underwent cardiac valve replacement were randomly divided into ob-servation group and control group,with 46 patients in each group. Both groups received routine anesthesia induction regimen of midazolam 1-2 mg/kg+ fentanyl 0.05 mg/kg+ propofol 1-2 mg/kg+ cis-atracurium 0.15 mg/kg. Observation group was additionally given dexmedetomidine 0.5 μg/kg,within 10 min with pumps,and then maintained with 0.4 μg/(kg·h)till the end of operation;control group was additionally given constant volume of normal saline with pumps. SBP,DBP,MAP,HR,cardiac output(CO), cardiac index(CI),stroke volume(SV),stroke volume variation(SVV)before anesthesia induction(T0),5 min after medication (T1),2 min after anesthesia induction (T2),1 min after intubation (T3),3 min after intubation (T4) and 5 min after intubation (T5)were recorded in 2 groups as well as OAA/S at T0 and 5 min after pumping dexmedetomidine(T1). ADR of 2 groups during anesthesia was also recorded. RESULTS:There was no significantly difference in SVV of 2 groups at T0-T5 (P>0.05);SBP, DBP,MAP,HR,CO,CI and SV of observation group at T0-T5 were all better than those of control group,with statistical signifi-cance(P<0.01);there was no statistically significant difference in OAA/S of 2 groups at T0(P>0.05),and OAA/S of observa-tion group at T1 was decreased significantly and lower than control group,with statistical significance(P<0.01). There was no sta-tistically significant difference in the incidence of ADR as cardiac arrhythmia and hypotension between 2 groups(P>0.05). CON-CLUSIONS:Dexmedetomidine can reduce the influence of anesthesia on the hemodynamics of patients underwent cardiac valve re-placement with good safety.

OBJECTIVE To explore countermeasures to improve the quality of hospital infection control. METHODS The hospital control problems were analyzed through clinical practice. RESULTS Hospital infection control management was restricted by the inadequate understanding of the importance,the lack of related knowledge,the medical treatment cost and economic performance. CONCLUSIONS To establish an effective mechanism dealing with hospital infection control,education of the importance of infection control and training and to implement the target responsibility system are the keys to improve the quality of hospital infection control.

Objective To observe the protective effect of Racecadotril combined with Succinate Injection on myocardial injury in children with rotavirus enteritis and explore its clinical significance.Methods Totally 116 cases of children with rotavirus enteritis from Huangshi Traditional Chinese Medicine ofEdong Healthcare Group were selected in this study.Patients were randomly divided into Racecadotril control group (n =58) and Racecadotril combined with Succinate Injection observation group (n =58).The levels of CK,CK-MB,LDH,IL-17,IL-6,and TNF-α were detected by ELISA analysis.The rates of clinic effects and adverse reaction were compared.Results There was no significant difference of CK,CK-MB,LDH,IL-17,IL-6,and TNF-α between two groups before treatment.After treatment,they were all decreased in two groups (P ＜ 0.05,0.01).However,they were all lower in observation group than those in control group after treatment (P＜0.05).The rate of clinic effects was 94.8％ in observation group,which was higher than 81.0％ in control group (P ＜ 0.05).The rate of adverse reaction was 8.6％ in observation group and 6.9％ in control group.There was no significant difference between two groups.Conclusion Racecadotril combined with Succinate Injection inhibits the inflammatory response to protect myocardial injury in RVE children,with significantly clinical efficacy and safety.

Objective To study the nursing effect of evidence-based nursing in perioperativc period of gynecological laparoscopy operation and prevention of postoperative complications.Methods 238 cases of patients undergoing laparoscopic operation were setas the study group,the evidence-based nursing method was used in this group.Another 212 cases of patients undergoing laparoscopic operation were named as the control group,they were given conventional nursing care.The improvement of complications and anxiety emotion were compared between the two groups.Results The complication rate was 10.92% in the study group,and 29.24% in the control group,the difference between the two groups was significant.The decreased degree of total score of HAMA and psychic anxiety,somatic anxiety score in the study group was higher than those of the control group at discharge.The difference had statistical significance.Conclusions Evidence-based nursing plays an important role in decreasing the postoperative complications and improving the anxiety emotion of patients,which is worthy of clinical popularization.

Objective To discuss the value of CT prognosis on the Masaoka staging system of thymic epithelial tumors(TET) before surgical resection.Methods The CT images of 102 patients with TET proved by surgery and pathology were reviewed retrospectively.The TET were reclassified according to Masaoka stage system.The size,homogeneity,sharp,contour,infiltration of surrounding tissue,and metastasis on CT were analyzed with Logistic analysis.The diagnostic value was also evaluated with a ROC curve.Results Masaoka pathologic stages were stage Ⅰ for 36 (35.3 ％),stage Ⅱ for 27 (26.5 ％),stage Ⅲ for 30 (29.4 ％),and stage Ⅳ for 9 (8.8 ％).A multivariable Logistic regression model showed that TET with larger size of tumor (20/35,P =0.0371,OR =4.539),irregular or lobulated tumor contour (26/42,P =0.0230,OR =4.870),heterogeneous (21/33,P =0.0154,OR =6.020),infiltration of surrounding fat (25/32,P =0.0019,OR =14.005),and pleural seeding (11/11,P =0.0032,OR =36.153)were more likely to have stage Ⅲ or Ⅳ disease.The area under ROC curve was 0.940.Conclusions The tumor CT imaging features can differentiate between stage Ⅰ,Ⅱ and stage Ⅲ,Ⅳ disease.This helps identified patients more likely to benefit from neoadjuvant therapy.

Objective To find out the defects existing in the rinsing and sterilizing process of the automatic bottle washer and to put forward an improvement measure and efficiency assessment.Methods To make the washer more effective,an automatic brush pre-washing process and a rotary spraying device were designed and used.The total bacteria amount,the total coliform group and the disinfectant (ClO2) residual level were employed as the assessment parameters.Results An external automatic pre-washing machine was installed on the bottle washer;the bottle washer was innovated so that its spray nozzle could be in directions and the rinsing and sterilizing process could be enhanced.The results showed that the improved machine ran well in treating the polluted and recycled bottles and all the assessment indexes were better than that of before improvement.Conclusion The improved automatic bottle washer is considered effective in cleanout and sterilization of bottles with a satisfactory result.

BACKGROUND:Bone marrow mesenchymal stem cels have the ability to differentiate into a variety of non-hematopoietic tissue cels. Effects of magnetic fields on the differentiation of bone marrow mesenchymal stem cels have attracted a lot of attention in recent years. OBJECTIVE:To summarize the effects of magnetic fields on the differentiation of bone marrow mesenchymal stem cels towards osteoblasts, chondrocytes, adipocytes, nerve cels and cardiomyocytes, which provide references for the research and application of tissue engineering seed cels as wel as the clinical applications of magnetic fields. METHODS:The first author performed a data retrieval of PubMed and CNKI databases from 2000 to 2015 to search the articles addressing the effects of magnetic fields on the differentiation of bone marrow mesenchymal stem cels, and reviewed the literatures systematicaly. Finaly, 40 articles were chosen for further analysis. RESULTS AND CONCLUSION:Magnetic fields can promote the differentiation of bone marrow mesenchymal stem cels towards osteoblasts, chondrocytes, nerve cels and cardiomyocytes, and inhibit the differentiation of bone marrow mesenchymal stem cels towards adipocytes. There are optimal frequency and intensity in the induction of magnetic fields on the differentiation of bone marrow mesenchymal stem cels. In general, low-intensity and low-frequency magnetic fields have more obvious effects on bone marrow mesenchymal stem cels. The facilitation of magnetic fields on the differentiation of bone marrow mesenchymal stem cels is also a time-dependent behavior.

Objective:To investigate the use of simple pooling and bivariate model in meta-analyses of diagnostic test accuracy (DTA) published in Chinese journals (January to November, 2014), compare the differences of results from these two models, and explore the impact of between-study variability of sensitivity and specificity on the differences. Methods:DTA meta-analyses were searched through Chi-nese Biomedical Literature Database (January to November, 2014). Details in models and data for four-fold table were extracted. Descriptive analysis was conducted to investigate the prevalence of the use of simple pooling method and bivariate model in the included literature. Data were re-analyzed with the two models respectively. Differences in the results were examined by Wilcoxon signed rank test. How the re-sults differences were affected by between-study variability of sensitivity and specificity, expressed by I2 , was explored. Results:The 55 systematic reviews, containing 58 DTA meta-analyses, were included and 25 DTA meta-analyses were eligible for re-analysis. Simple pooling was used in 50 (90. 9%) systematic reviews and bivariate model in 1 (1. 8%). The remaining 4 (7. 3%) articles used other models pooling sensitivity and specificity or pooled neither of them. Of the reviews simply pooling sensitivity and specificity, 41(82. 0%) were at the risk of wrongly using Meta-disc software. The differences in medians of sensitivity and specificity between two models were both 0. 011( P<0. 001, P=0. 031 respectively). Greater differences could be found as I2 of sensitivity or specificity became larger, especially when I2 >75%. Conclusion:Most DTA meta-analyses published in Chinese journals(January to November, 2014) combine the sensitivity and specificity by simple pooling. Meta-disc software can pool the sensitivity and specificity only through fixed-effect model, but a high proportion of authors think it can implement random-effect model. Simple pooling tends to underestimate the results compared with bivariate model. The greater the between-study variance is, the more likely the simple pooling has larger deviation. It is necessary to increase the knowledge level of statistical methods and software for meta-analyses of DTA data.

Objective To investigate the clinical efficacy of abdominal acupuncture plus pricking bloodletting in treating diabetes-associated herpes zoster. Methods One hundred diabetes patients were randomly allocated to treatment and control groups, 50 cases each. Both groups took oral hypoglycemics and acyclovir. In addition, the treatment group received abdominal acupuncture plus pricking bloodletting and control group, electroacupuncture plus local surround needling. The time for blister disappearance, the time for pain relief and the time for scabbing were observed in the two groups before and after treatment. The clinical therapeutic effects were compared between the two groups. Results The total efficacy rate was 92.0%in the treatment group and 86.0%in the control group;there were statistically significant differences between the two groups (P<0.05). There were statistically significant differences in the time for blister disappearance, the time for pain relief and the time for scabbing between the two groups (P<0.01, P<0.05). Conclusion Abdominal acupuncture plus pricking bloodletting is an effective way to treat diabetes-associated herpes zoster.

OBJECTIVE To study the washing effect of different methods to keep the surgical instruments moist. METHODS The instruments which were selected from the routine surgical instruments within a week were washed after three different methods to keep moist. The washing effect was compared by eyes, without equipment and with 5 times magnifying glass. RESULTS The multienzymatic detergent was the best one to keep moist, the next was the water, and the chlorine releasing agent was the worst. CONCLUSIONS Hospitals should select the suitable method to keep moist by considering the actuality.