Objective To discuss the disinfection effect of the wiping towel with microwave oven. Methods 200 wiping towels were chosen in class Ⅱ environment in our hospital. 100 wiping towels (the control group)were disinfected by soaking in the chlorine-containing disinfectant,the other (the observation group )by microwave. The disinfection effect, the disinfection time, and the economic cost in three months were compared between two groups. Results There was no significant difference between two groups in the disinfection effect. There was significant difference between two groups in the disinfection time,the economic cost in three months. Conclusions Adopting microwave oven for towel disinfeciton has reliable result and is convenient. It costs shorter time and lower cost. The new method has no chemical side effect and can replace traditional method. It is an ideal disinfection method and worthy of clinical application.

Objective To discuss task-based learning and team-based learning methods and lecture-based learning method in the class of ethnic medicine.Method 50 students in clinic medicine (general practice) of grade 2012 were selected as D-TBL group and 54 students in clinic medicine of grade 2013 were selected as LBL group.Both groups have teaching content,textbook,teachers,class hours in common.Effect of teaching was valued by tests,evaluation in students,questionnaires.SPSS was used to analyze scores of tests.T test was used.Results The correct answer rate?of subject items in D-TBL group was higher than that of LBL group and the difference had statistical significance [(94.56 ± 4.95)％ vs.(29.26 ± 12.15)％,t=36.382,P=0.000).There was no significant difference between the correct answer rate of personal test in D-TBL group and objective item in the LBL group[(75.20 ± 11.82)％ vs.(68.61 ± 14.65)％,t=2.512,P=0.374].There was no statistically significant difference between the correct answer rate of group test in D-TBL group and objective item in the LBL group[(84.25 ± 13.08)％ vs.(68.61 ± 14.65)％,t=5.727,P=0.961].In Score table for members in every division,41(85.42％) students got straight A,7(14.58％) students got B and nobody got C.Feedback questionnaire showed 40(83.33％) students like D-TBL while 26(50.00％) students like LBL.Conclusion Most of students in D-TBL group like D-TBL.D-TBL and LBL cannot take the place of each other.In the future teaching,both methods should be used in different teaching periods according to their merits.

ObjectiveTo summarizeand the law of lymph node metastases from adenocareinoma of esophagogastric junction ( AEG),analyses the extent of lymphadenectomy for AEG.Methods198 cases of AEG had been retrospectively analyzed from 2006.6.6 to 2010.12.31,and kept detailed record of the operation type、Siewert's type、TNM stage and group of metastatic lymph nodes.ResultsThe thoraco-abdominal two field lymph node dissection had been performed for 198 AEG,the total number of lymph nodes had been dissected was 3069,the average number was 15.50,the number of metastases lymph nodes was 859.In the 198 AEG,132 cases with lymph node positive,The metastatic rate and incidence was 66.67％ and 27.99％,respectively.The manner of the metastasis about 130 cases was station by station and 2 cases was skipping over station,accout for 98.48％ and 1.52％ of all nodes-positive cases,1 case skiped to left gastric and celiac axis and another case skiped to tracheal bifurcation.The location of positive lymph nodes about Siewert Ⅰ and Ⅱ were recorded:tracheal bifurcation(6.25％,3.33％ ) 、lower posterior mediastinum and paraoesophageai(25.00％,14.67％ ),right paracardiac (47.92％,52.00％ ),left paracardiac (31.25％,36.67％ ) 、lesser curvatura(43.75％,43.33％ ),greater curvatura( 27.08％,22.00％ ) 、left gastric and celiac axis( 27.08％,30.00％ ).The lymph nodes metastastic rate of stage T1 + T2 and T3 + T4 were 40.43％,74.83％,respectively,the difference were significantly.The lymph nodes metastastic rate of different tumor length were analyzed,≤ 3cm group were 40.74％,3 ～5cm group were 70.71％ and ≥5cm group were 88.89％,the difference were significantly;but there were no significant difference related to different differentiation grades and different Siewert types.The mediastinal lymph node metastase rates between Siewert Ⅰ (27.08％) and Siewert Ⅱ (14.67％) were significant difference,but the difference were not found in pericardiac lymph nodes.ConclusionSiewert Ⅰ 、Ⅱ AEG trend to metastasized to middle and low mediastinal and pericardiac,the modified left thansthoracic route and two field lymph node dissection maybe suitable to the lymphadenectomy for AEG.

Objective To evaluate the treatment effect of management by nursing objectives in the extracorporeal membrane oxygenation ( ECMO) treatment on the first case of avian influenza H7N9 infection patient with severe pneumonia .Methods The overall goal was to ensure ECMO machine running smoothly and without any nursing complications . According to the overall objective , eight specific sub-objectives were developed .Various care measures were implemented in accordance with the eight specific sub -objectives . Results During the 153 hours of ECMO treatment , the machine ran smoothly without the occurrence of detachment, embolism and hemolysis, thrombosis, pressure sores or any other nursing complications .The patient was successfully off-line.Conclusions Management by nursing objectives makes the nursing goal orientate clearly and effectively , which avoids the blindness and subjectivity during work .It is a strong guarantee for the success of ECMO treatment and should be widely applied .