Objective To evaluate the effectiveness of hospital environmental cleaning practice by fluorescence labeling method.Methods From January to February 2015,312 ward rooms in 7 hospitals were chosen,high touch object surface were labeled with fluorescence,after object surface being cleaned by cleaners,clearance rates of fluorescence labeling were calculated (as baseline survey data),training and on-site guidance for cleaners were performed(intervention measures),fluorescence labeling clearance effect before and after intervention was compared.Results A total of 110 ward rooms were performed baseline survey,the fluorescence labeling clearance rate of 2 856 touched clean surface was only 50.81％,the quantitative evaluation value was 45.70;after intervention,202 rooms were surveyed,fluorescence labeling clearance rate of 3 992 touched clean surface enhanced to 79.23 ％,the quantitative evaluation value was 76.30;there was significant difference in fluorescence labeling clearance rate between before and after intervention (x2 =612.14,P＜0.05).In the baseline survey,the clearance rates of fluorescence labeling on touched surface of medical instruments,hospital beds,and toilets were 46.07％,37.80％,and 25.20％ respectively;after intervention,the clearance rates were 80.59％,75.90％,and 51.70％,respectively.After intervention,fluorescence labeling clearance rates of beepers,toilet seat covers,toilet electrical switches,and chairs were low,the clearance rates of these touched surface in baseline survey were＜ 30％,after intervention were 47.03 ％-68.32％;the clearance rates of other high touch surface were all＞75 ％.Conclusion Fluorescence labeling method can directly reflect the operation quality of cleaners,and improve the cleanliness of ward environment,it is a simple,inexpensive and objective globally popular method for evaluating hospital environment cleanliness.

Objective Preparing platelet rich gel through two-times centrifugal technique and co-culturing chondrocytes with PRG, then observing the proliferation and gene expression of chondrocytes, in order to provide a favorable way to prepare tissue engineering cartilage. Methods Centrifugating venous blood of rabbit through two-times centrifugal technique to obtain platelet rich plasma( PRP) ,then detecting the concentration of various growth factor in PRP. Admixing PRP with chondrocytes of rabbit and activating them with activator. After co-culti-vation,the proliferation of chondrocytes through MTT method and expression of ACAN,CollagenⅡand SOX-9 through realtime-PCR were ob-served,and compared with common cultured chondrocytes. Results The concentrations of PDGF-AB,TGF-β1,IGF-1 and VEGF in PRG were significantly higher than those in blood(P<0. 05). After co-cultivation, the proliferation rate of chondrocytes and the expression of ACAN,Collagen Ⅱ and SOX-9 were significantly higher than that of common cultured chondrocytes(P<0. 05). Conclusion Co-culturing chondrocytes with PRG is able to promote the proliferation and gene expression of chondrocytes. We considered that it is a excellent method to construct tissue engineering cartilage.

Objective To investigate the asseciation of 1188A/C polyrnorphism of Interlenkin-12B gene (IL-12B) with remit-relapse multiple sclerosis (RRMS) in the southern Chinese population.Methods Ninety-four patients with RRMS and 145 age- and-sex-matched normal controls were recnfited in this study.The polymorphism was detected by using polymerase chain reaction and restriction fragment length polymorphism (PCR-RFLP) assay in these subjects.The frequencies of the alleles in each group were statistically analyzed.Results The frequency of the allele A increased significantly in RRMS patients (64.4%) compared with that in healthy controls (53.8%, χ2=5.228, P=0.022).An increased risk for MS was suggested in carriers of the A allele (OR=1.551, 95% CI=1.064-2.262).Conclusions The A allele in 1188A/C polymorphism of IL-12B gene may be a risk factor for RRMS in southern Chinese population.

Objective To compare the efficiency of original neuromyelitis optica(NMO)-IgG assay of detecting NMO-IgG with a new anti-aquaporin-4(AQP4)assay of detecting AQP4,and to explore the accuracy of the method in the diagnosis of NMO and multiple sclerosis(MS).Methods The sera were obtained from 44 patients with NMO and 46 patients with MS and were tested by both NMO-IgG and antiAOP4 assays.NMO-IgG was identified by original NMO-IgG assay with a substrate from mouse brain.AntiAQIP4 was detected by anti-AQP4 antibody assay.The results from the two assays were statistically analyzed to compare accuracy and specificity of the methods.Results The results of the two assays were concordant in 45 testing negative cases and 36 positive cases(Kappa=0.798.P=0.000).The McNemar test showed that the positive rate of the two assays were not significantly different(P=1.000).The NMO-IgG assay showed 77.3% sensitivity,87% specificity,82.2% diagnosis accuracy,85%positive predictive value,87% negative predictive value.and 74.3%Younden index. The anti-AOP4 antibody assay showed 88.6% sensitivity,95.7%specificity,92.2% diagnosis accuracy,98.1% positive predictive value,89.8% negative predictive value.and 84.3% Younden index.Conclusions This study demonstrated that NMO-IgG and AQP4 antibody detection have high sensitivity and specificity to detect NMO and MS.Anti-AQP4 detected by anti-AQP4 antibody assay may be more useful for NMO diagnosis.

Objective To investigate the distribution characteristics and risk factors of intracranial atherosclerotic stenosis ischemic stroke. Methods We retrospectively collected 342 consecutive patients with first-ever ischemic stroke. Clinical data was collected including demographics, the presence of risk factors,MRI with MRA and other routine admis?sion laboratory tests. Results Intracranial atherosclerotic stenosis (ICAS) was located most frequently in MCA (47.0%), Extracranial internal carotid artery was the most common affected artery (65.0%) among extracranial atherosclerotic steno? sis (ECAS). MetS (OR=1.586,95%CI:1.232~2.268), ApoB/ApoA1 ratio (OR=1.926,95%CI:1.051~4.288), were as?sociated with ICAS (vs ECAS), whereas hypertension (OR=3.603,95%CI:1.675~12.485), MetS (OR=2.268,95%CI:1.274~6.103), HbA1c (OR=2.015,95%CI:1.182~5.613) and ApoB/ ApoA I ratio (OR=1.948,95%CI:1.157~4.285) were related to ICAS (vs NCAS). Hypertension (OR=2.437,95%CI:1.492~3.505,P=0.005), Hcy (OR=2.437,95%CI:1.492~3.505,P=0.005) and HbA1c (OR=1.769,95%CI:1.034~3.121, P=0.005) were the independent risk factors re?lated to posterior circulation strokes (vs anterior circulation strokes ) in ICAS strokes. Conclusions The occurrence of ICAS may be more frequent than that of ECAS in ischemic stroke. Posterior circulation ICAS strokes seems to be close?ly associated with metabolic derangement.

Objective To establish the anti-infective tissue engineered bones (TEBs) and evaluate the anti-infective and osteogenic effects of the infection-prevention TEBs on femoral large bone defects in goats.Methods Based on the controlledrelease antibiotic system fibrin gel-coated vancomycin alginate beads (FG-Vanco-AB),the infection-prevention TEBs were established and evaluated.They were transplanted into the critical-size defects in the right femurs of goats.TEBs without the controlled-release antibiotic system were used as controls and transplanted into the left femoral defects.The breakpoint sensitivity of vancomycin (5 mg/mL) for S.aureus was used as a standard concentration.Postoperatively,the vancomycin concentrations in the lesion site,in the adjacent site and in the circulation,as well as the anti-infective effects of the infection-prevention TEBs were evaluated by High-performance liquid chromatography (HPLC).Bone hcaling was assessed by histology,CT and ECT.The results were used to evaluate the osteogenic effect of the infection-prevention TEBs.Results Results from ESM,CLSM and in vivo tracing showed that the in vitro and in vivo survival conditions of seeded cells were analogous to those of TEBs.The effective concentration (over the bactericidal concentration) of vancomycin in bilateral defects and in blood lasted for 28 days,2 days and 7 days,respectively.The concentration of vancomycin in the femur decreased gradually from the grafted site to both ends.At 28 and 56 days postoperatively,the ECT results showed no significant difference between the right and left femurs.CT and histology demonstrated that at 14,28 and 112 days after surgery,bone defects in the bilateral femurs were repaired synchronously,and were completely covered by new bone tissue after 112 days.Conclusion The anti-infective TEBs were successfully established.FG-Vanco -AB in the transplanted sites provided the local bone tissues with anti-infective capability whilst not interfered the process of bone reconstnction and wound healing.

Objective To evaluate the detection of serum pepsinogen (PG) in screening of gastric cancer. Methods (1) To calculate the detection rate of gastric cancer in PG Positive patients from northeastern, noah-western and northern China. (2) To determine the PG positive rate in patients with chronic superficial and atrophic gastritis. (3) To calculate the detection rate of gastric cancer, H. pylori infection and esophageal cancer in PG positive patients from gastric cancer high risk areas. Results (1) The detection rate of gastric cancer in PC, positive patients from Changchun (northeastern China), Xihing (northwestern China) and Beijing ( northern China) was 22. 58%, 25. 2% and 0, respectively. The sensitivity of PG to seeen gastric cancer in Changchun and Xihing was 50. 9% and 35.6%, and the specificity was 82. 56% and 85.69%, respectively. (2) Only 25% of patients with chronic atrophic gastritis were PG positive. (3) The serum PG level was measured in 2346 cases from gastric cancer high risk areas, and PG positive rate was 27.02% (634/2346), in which 496 patients (76. 65%, 496/634) received endoscopy, and gastric cancer was detected in 10 (2. 02%, 10/496), including 9 cases of early gastric caner. The prevalence of gastric cancer was 0. 43% in common population and 1.58% in PG positive population. The infection rate of H. pylori was 70. 73% in 2346 subjects and 2 cases of esophageal cancer, including 1 case of early cancer was diagnosed. Conclusion Serum PG level cannot be used as a marker for gastric cancer or atrophic gastritis, while it may be of value for gastric cancer screening in high risk areas.

Objective To describe the clinical features,ancillary tests,treatments and outcomes of adult male patients with anti-N-methyl-D-aspartate receptor (anti-NMDAR) encephalitis.Methods Observational study of clinical data,ancillary tests,treatments and outcomes of 5 adult male patients,admitted to our hospital from August 2014 to May 2016 and diagnosed as having anti-NMDAR encephalitis,was carried out.And the pathologic mechanism was discussed combining with literature review.Results All of the 5 adult male patients were not associated with treatoma,4 patients had significant relevant past medical histories,including purulent meningitis,drug abuse,colon descendens adenocarcinoma after radical resection and idiopathic inflammatory demyelinating disease (IIDD).For ancillary tests,positive virus antibodies were detected in two patients,and one of them presented positive EBV-DNA in CSF sample;one patient presented elevated thyroid autoantibodies in sera sample;four patients presented atypical abnormal brain contrast enhancement MRI,and three of them exhibited punctiform and/or patchy enhancement in brain parenchyma;one of them showed gliacyte proliferation after necrosis and another one presented demyelination.All patients had favorable outcomes after timely immune therapies.Conclusion Adult male patients who are rarely associated with teratomas may trigger by virus infection,other autoimmune or demyelinating diseases;the earlier application of immune therapies,the better the prognosis.

Objective The purpose of this study was to analyze the distribution,temporal and spatial clustering characteristics and changes of severe hand,foot,and mouth disease (HFMD) in order to provide evidence-based decision making strategy for control and prevention of severe HFMD cases.Methods Severe HFMD cares were extracted from the National Diseases Reporting System of Chinese Center for Disease Control and Prevention (CDC) between 2008 and 2013.Definition and clinical diagnostic criteria of severe HFMD cases were set up by China CDC in the Hand,Foot,and Mouth Disease Control and Prevention Guideline,version 2010.Spatial scan unit was under the district/county of 2 900 in mainland China with temporal scan unit as month and time span as from May 2008 to August 2013.Kulldorff scan statistics was applied and analyses were conducted by SaTScanTM 9.1.Mapping and visualizing the results were carried out with ArcGIS 10.0.Results Data related to the monitoring program on severe HFMD from 2008 to 2013 demonstrated that above 96％ of the severe HFMD cases occurred under 5 years old,mostly males,with the ratio of males to females as 1.73-1.80 and over 84％ of the children were ‘scattered'.Results from SaTScan illustrated that the temporal and spatial clustering existed among severe HFMD cases.The temporal dimension of severe HFMD was from May to July each year.Spatial dimension was located in south-east coastal area and middle-east area.With respect to the changes of temporal and spatial clustering phenomena,Class 1 clustering area was located in south-east coastal region in 2008 and in middle-east region in 2009 and was shifting to the west from middle-east region in 2010.It moved to the north-east from middle-east region in 2011 and to the north-west and south-west from middle-east region in 2012.Class 1 clustering area covered districts/countries from 18 provinces in 2012.The same pattem of Class 1 clustering area was observed as in the previous year-2013,but with less districts/countries from the 13 provinces.Conclusion Temporal and spatial clustering areas of severe HFMD were presented in this report,and the yearly changing pattern of the clustering areas was noted.Findings from this study provided evidence-based data to the decision-making authorities so as to prevent deaths from severe HFMD cases under reasonable prevention and control strategies.

Objective To investigate electroencephalographic (EEG) characteristics of anti-N-methyl-D-aspartate (anti-NMDA) receptor encephalitis during different courses of the disease. Methods This study enrolled 30 cases of anti-NMDA receptor encephalitis patients. A total of 58 EEG monitoring reports and their clinical data were retrospectively analyzed based on different disease courses and severity of disease. According to the clinical stages, EEG data was divided into 4 phases: the initial stage (4), the peak stage (23), the improvement stage (16) and the recovery stage(15). Based on severity of disease during the peak stage, patients were divided into mild group(10 cases) and severe group (13 cases). Results Occipital background activity of the EEG was presented in all patients (100%) in the initial stage and in the recovery stage, in 39.1%(9/23)in the peak stage and in 13/16 (81.2%)in the improvement stage. Generalized rhythmic delta activity (GRDA) pattern could only be detected in the peak stage and the improvement stage. In the peak stage, the main presentation of abnormal EEG was diffuse slow-wave (9 cases, 90%) in mild group. GRDA and extreme delta brush(EDB) were more common in severe group than in mild group(P<0.05). Three focal epilepsy including one status epilepticus were detected in three patients in the peak stage. Focal epileptiform discharges in EEG existed in the whole course. Conclusion Occipital background activity and GRDA pattern are evolved and gradually recovered during the course of the disease. The EEG patterns of GRDA and EDB are common in severe anti- NMDA receptor encephalitis patients in the peak stage. Focal epileptiform discharges in EEG can be detected during the whole course.