Objective To ensure the quality of disinfection and sterilization of the fiberbronchoscope in the sterilesupply center through the implementation of whole life cycle management.Methods Using the historical comparative method,the fiberbronchoscopes managed by the departments were enrolled into a control group from February 2013 to March 2014,and the ones undergoing life-cycle management in the sterile supply center were involved in an observation group from April 2014 to May 2015.The two groups were divided according to the management subject and mode,and compared from the aspects of treatment flow,process quality control and record tracing validity.All the data were input with Excel sheet,andanalyzed statistically with SPSS 17.0.Results The observation group and the control group had the numbers of positive results in internal cavities,positive results in external surface,damaged or irrationally-placed package,invalid data tracing and non-standardized storage being(0,1.11±0.15),(0,1.09±0.20),(1.07±0.13,2.75±0.22),(0.57±0.03,1.53±0.31) and (0.13±0.07,0.95±0.21) respectively,and the differences between the two groups were significant (P＜0.05).The turnover of the fiberbronchoscope was enhanced significantly in the observation group when compared with that in the control group.Conclusion Life cycle management contributes to strengthening quality control of the treatment of polluted fiberbronchoscope,and decreases the incidences for hospital infection.

OBJECTIVE:To investigate the bacteriological characteristics of nasal secretions of chronic rhinosinusitis(CRS)in our hospital,and conduct drug sensitivity test in order to provide theoretic reference for clinical treatment. METHODS:87 CRS patients underwent nasal endoscopic surgery were selected and the nasal secretions of patients were taken for bacterial culture. Automatic microbial analyzer was used to identify the bacteriological characteristics,and disk diffusion test was adopted for drug sensitivity test. RESULTS:Of 87 patients,bacterial strains were detected from 77 cases of nasal secretions,with positive rate of 88.5%. 112 strains were detected,including 81 strains of aerobic bacterium and 31 strains of anaerobic bacterium,and the most common bacterium were Staphylococcus aureus (20.54%). Antibiotics with the highest sensitivity was moxifloxacin (89.29%), followed by ciprofloxacin(87.50%),vancomycin(87.50%). CONCLUSIONS:The bacterial in nasal secretions of CRS patients has high positive detection rate and mainly are aerobic bacterium. Antibiotics should be used rationally according to the results of drug sensitivity test.

Objective To discuss the changes of serum Th1/Th2 cytokine levels of allergic rhinitis patients and the intervention effect of montelukast.Methods 40 cases of allergic rhinitis patients were selected as treatment group,who were given montelukast tablets (10mg) through the mouth one time daily for 8 weeks.The changes of interferon-γ (IFN-γ) and interleukin-4 (IL-4) in peripheral blood (PB) before and after medical treatment were observed,as well as the clinical curative effect and security.Accordingly 30 cases of healthy people were also selected as the control group.Results The IFN-γlevel in culture supernatant of patients in the treatment group [(8.74 ± 1.37) ng/mL] was lower than that in the control group before the medical treatment [(15.13 ± 3.16)ng/mL],while the IL-4 level of patients in the treatment group [(1.64 ± 0.47) ng/mL] was higher than that in the control group [(0.72 ± 0.21) ng/mL] (t =2..93,3.52,all P ＜ 0.01).After 8 weeks' medical treatment,the IFN-γ level in culture supernatant of patients [(12.36 ± 2.56) ng/mL] increased obviously than that of before [(8.74 ± 1.37) ng/mL],while the IL-4 level [(1.21 ± 0.28) ng/mL] declined obviously than that of before [(1.64 ± 0.47) ng/mL] (t =2.36,2.31,all P ＜ 0.05).The total clinical efficiency of patients in the treatment group was 92.5 ％ (37/40).No serious drug adverse reaction (DAR) appeared during the medical treatment.Conclusion The Th1/Th2 cytokine unbalances in peripheral blood (PB) of allergic rhinitis patients.Montelukast has reliable curative effect with high security,whose mechanism of action has close effect on lowering the IL-4 in peripheral blood (PB),increasing the IFN-γ level in peripheral blood (PB),correcting the balance disorders of Th1/Th2 cytokine,and the transformation of immunity reaction from Th2 to Th1.

Objective Compare the efifcacy and safety of drug eluting stent (DES) for treatment of in stent restenosis (ISR) and coronary de novo lesions. Methods Patients treated with DES for ISR and de novo lesions in Beijing Anzhen Hospital between October 2008 and December 2011 were followed up for 1 year. All lesions were divided into ISR and de novo group. Major adverse cardiovascular events (MACE) including all-cause death, myocardial infarction (MI) and clinical target lesion revascularization (TLR) were the primary endpoints. Results The study population consisted of 204 patients in the ISR group and 494 patients in the de novo group. Baseline clinical and angiographic parameters were comparable between the two groups. The rate of diabetic was higher in the ISR group than that in the de novo group (36.6%to 27.1%, P < 0.05). The diameter of coronary artery was smaller in the ISR group than that in the de novo group (2.72±0.36 to 3.08±0.54, P<0.01). The rate of TLR in the ISR group was higher than that in the de novo group (10.7%to 17.2%, P<0.05;14.2%to 21.1%, P<0.05),contributing to higher MACE in ISR group. Conclusions DES implantation is safe and effective for treatment of ISR lesions, but the rate of TLR is higher compared to treatment of de novo lesions.

By observations of the features of ultrastructure changes in the tissue engineered artificial tendon of vitreous cryopreservation, we investigated the repairing effect of tendon after an in-vivo implantation and hence we provided an important theoretical and experimental basis for the vitreous cryopreservation and application of tissue engineered artificial tendon. After vitreous cryopreservation, the implantation materials of tissue engineered artificial tendon dynamically constructed in vitro were implanted in rats for reparation of the tendon defect. A scanning electron microscope was used. At the 2nd week, the materials presented a reticular formation and there were juvenile tendon cells among materials. At the 6th week, materials were already degraded and absorbed, and then were substituted by neonatal tendon cells and collagen fibers. At the 8th week, dense tendon tissues containing uniform tendon cells and collagen fibers were found already formed; the density of collagen fibers significantly increased with time. Using a transmission electron microscope at the 2nd week, we found active proliferation of tendon cells; most of them were immature cells with a complete nuclear membrane, clear nucleolus and little collagen fibers. At the 6th week, tendon cells were more mature with a little-sized, deep-stained nucleolus surrounded by plenty of collagen fibers with complete fiber structure and clear cross striation. There was no significant difference between the two groups. Using an electron microscope, we found a very good agreement in observation of the tissue engineered artificial tendon after the in-vivo implantation in two groups. Neonatal tendon cells and collagen fiber tissues grew well and are in a similar form and order when compared versus normal tendon tissues. This proved that vitreous cryopreservation has no significant influence on the function of tendon cells. The neonatal tissue-engineered tendon exerts good function of growth and repair.
Achilles Tendon ; injuries ; surgery ; ultrastructure ; Animals ; Cryopreservation ; Female ; Male ; Random Allocation ; Rats ; Rats, Sprague-Dawley ; Tendons ; cytology ; transplantation ; Tissue Engineering ; methods ; Tissue Preservation ; methods ; Tissue Scaffolds ; Vitrification

Objective To evaluate the safety and efficiency of domestic snare applied during retrograde percutaneous coronary intervention (PCI) for chronic total occlusion (CTO) lesions.Methods A total of 27 patients who underwent retrograde PCI for CTO and used domestic snare during the procedure were enrolled in our study from March 2012 to November 2016.Clinical data, angiographic characteristics and PCI details were collected.Clinical data, characteristics of CTO lesion, effect of the domestic snare and snaring time were retrospectively analyzed.Special complications related to the domestic snare and major adverse cardiovascular events (MACE) were also documented.Results Domestic snare was used in all the procedures, which included facillitating the micro-catheter to pass through the CTO lesions in 6 patients and assisting the RG3/rotational guide-wire externalization in all the 27 patients.Mean snaring time was 3.5±5.4 minutes.Stents were successfully implanted in 26 patients except in 1 patient who failed to receive stent implantation for severe coronary calcification.No complications including coronary dissection, fracture of guide-wire and unreleased snare happened during the procedures and no MACE occurred during hospitalization.Conclusions Domestic snare facilitates retrograde micro-catheter crossing CTO lesions and retrograde guide-wire entering the guiding catheter and externalization.It is a simple, safe and efficient method.

Objective:To investigate the correlation between chronic periodontitis and pulmonary ventilation function.Methods:A total of 135 patients with chronic periodontitis who received treatment in Yuyao People's Hospital of Zhejiang Province between June 2014 and December 2019 were included in this study. They were divided into group A (stage I, initial lesion, n = 45), group B (stage II, early lesion, n = 45), group C (stage III, confirmed lesion, n = 45) according to the severity of periodontal lesion. Lung ventilation function indexes and serum levels of interleukin-6 (IL-6), IL-8 and tumor necrosis factor-alpha (TNF-α) were compared among the three groups. The correlation between periodontal condition and lung ventilation function indexes was analyzed. Results:Probing depth (PD), clinical attachment loss (CAL), number of missing teeth, alveolar bone resorption level were (1.67 ± 0.65) mm, (2.48 ± 0.44) mm, 0 pieces, and (1.38 ± 0.23) mm in group A, (2.05 ± 0.30) mm, (4.04 ± 0.97) mm, 1 piece, (3.37± 0.73) mm in group B, and (2.23 ± 0.47) mm, (5.17 ± 0.75) mm, 3 pieces, (6.48 ± 0.62) mm in group C. With the worsening of the disease, PD, CAL, number of missing teeth, and alveolar bone resorption level were gradually increased. PD, CAL and alveolar bone resorption level in group C were significantly higher than those in group A ( t = 4.68, 20.75, 51.74, all P < 0.001) and group B ( t = 2.17, 6.18, 21.78, P = 0.033, < 0.001, < 0.001). PD, CAL and alveolar bone resorption level in group B were significantly higher than those in group A ( t = 3.56, 9.82, 17.44, all P < 0.001). There was no significant difference in the number of missing teeth ( P > 0.05). Serum IL-6, IL-8 and TNF-α levels were (11.28 ± 4.26) ng/L, (7.48 ± 1.97) ng/L, (14.59 ± 2.11) ng/L in group A, (17.09 ± 4.91) ng/L, (10.82 ± 2.10) ng/L, (19.95 ± 4.48) ng/L in group B, and (26.47 ± 5.86) ng/L, (15.06 ± 2.75) ng/L, (33.76 ± 6.30) ng/L] in group C. With the worsening of the disease, serum IL-6, IL-8 and TNF-α levels were gradually increased. Serum IL-6, IL-8 and TNF-α levels in group C were significantly higher than those in group A ( t = 14.06, 15.03, 19.36, P < 0.001) and group B ( t = 8.23, 8.22, 11.98, all P < 0.001). Serum IL-6, IL-8 and TNF-α levels in group B were significantly higher than those in group A ( t = 6.00, 7.78, 7.26, P < 0.001). The percentage of the maximum expiratory volume in the first second to the predicted value (FEV 1%pre) and the ratio of the maximum expiratory volume in the first second to the forced vital capacity (FEV 1/FVC) were (81.53 ± 6.30)% and (68.73 ± 4.65)% in group A, (70.47 ± 5.25)% and (60.86 ± 3.42)% in group B, and (59.02 ± 3.41)% and (56.93 ± 4.21)% in group C. With the worsening of the disease, FEV 1%pre and FEV 1/FVC were gradually decreased. FEV 1%pre and FEV 1/FVC in group C were significantly lower than those in group A ( t = 21.08, 12.62, both P < 0.001) and group B ( t = 12.27, 4.86, both P < 0.001). FEV 1%pre and FEV 1/FVC in group B were significantly lower than those in group A ( t = 9.05, 9.25, both P < 0.001). Spearman correlation analysis showed that serum IL-6, IL-8 and TNF-α levels were negatively correlated with FEV1%pre and FEV 1/FVC ( r = -0.50, -0.28, -0.42, -0.61, -0.34, -0.51, all P < 0.05). Conclusion:There is a correlation between chronic periodontitis and pulmonary ventilation function. Inflammatory mediators may be involved in chronic periodontitis as internal systemic factors.

Objective To evaluate the impact of cardiovascular risk factors on index of microvascular resistance (IMR)and coronary flow reserve (CFR) and to explore the characteristics of IMR and CFR and the relationship between IMR and angiographic features in patients with intermediate coronary stenosis and chest pain.Methods Fractional flow reserve (FFR),CFR,and IMR were measured in patients who underwent invasive coronary angiography with 40％-70％ stenosis by visual assessment.All patients with FFR＞0.75 were enrolled and grouped with the cut-off points of IMR≥25 and CFR≤2.0.Patients with IMR≥25 were group H,including two sub-groups (high IMR-low CFR,group H1 and high IMR-high CFR,group H2),while those with IMR＜25 were group N.The thrombolysis in myocardial infarction (TIMI) frame were counted.Results A total of 34 patients with FFR＞0.75 were enrolled with 61.8％(21 cases) of males and 38.2％ (13 cases) of females.The mean age was (57.3±8.1) years old.High IMR accounted for 47.1％ of all cases.There was significant difference between group H and N in TIMI frame (33.0 vs.20.8,P=0.031).There were significant differences between group H1 and H2 in homocysteine (17.8 μmol/L vs.12.0 μmol/L,P=0.005) and IMRcorr (58.0 vs.36.1,P=0.002).IMRcorrwas correlated to TIMI frame (r=0.40,P=0.012) for all cases.The sensitivity and specificity of inferring IMR≥35.3 by TIMI frame were 0.75 and 0.65 (P=0.049) with TIMI frame over 40.5.Conclusions High IMR may be one of the reasons for chest pain in patients with intermediate coronary stenosis.There is no correlation between vascular risk factors and IMR or CFR,while there is positive correlation between TIMI frame and IMR.The specificity is 65％ for inferring IMR rise with TIMI frame over 40.5.

Objective:To explore the surgical outcomes of focal cortical dysplasia (FCD) patients with "difficult to locate" intractable epilepsy and their influencing factors.Methods:Thirty-five FCD patients with "difficult to locate" intractable epilepsy, underwent surgical treatment after intracranial electroencephalogram (iEEG) evaluation in our hospital from January 2011 to December 2018, were chosen in our study. Engel grading was used to evaluate the surgical efficacies of these patients, and they were divided into a satisfied efficacy group (Engel grading I) and an incomplete satisfied efficacy group (Engel grading II-IV). The clinical data of patients from the 2 groups were compared. Multivariate Logistic regression analysis was performed to explore the influencing factors for surgical outcomes of FCD patients with "difficult to locate" intractable epilepsy.Results:Of these 35 patients, 26 patients (74.3%) achieved satisfied efficacy, and 4 had incomplete satisfied efficacy. As compared with those in the satisfied efficacy group, patients in the incomplete satisfied efficacy group had significantly lower total resection rate of epileptogenic foci ( P<0.05). Multivariate Logistic regression analysis showed that incomplete resection of epileptogenic foci was the influencing factor for surgical outcomes of FCD patients with "difficult to locate" intractable epilepsy ( P=0.014, OR=0.050, 95%CI: 0.005-0.547). Conclusion:The FCD patients with "difficult to locate" intractable epilepsy can achieve satisfactory results by surgical resection of epileptogenic zones after iEEG monitoring; these FCD patients with "difficult to locate" intractable epilepsy with incomplete resection of epileptogenic foci often have poor surgical outcomes.

Objective To explore the mechanisms of ligament of Marshall (LOM) initiat and sustain atrial fibrillation (AF).Methods The electrophysiologic properties of canine LOM were investigated using multipolar catheter mapping(normal canines,n =4,group A;AF canines,n =5,group B).The programmed stimulation were performed in the LOM,PV-left atrium(LA)junction and LA,respectively.Activations maps of LOM were analyzed from episodes of spontaneous onset of AF and initiation of induced AF by a single extrastimulus.The effectives refractory period of each part was compared and statistically analyzed among three parts in each group and between the two groups.LOM were cutted with surgical incision technology.The inducing rate of AF and the mapping rate of double potential and fragmented electrocardiogram were compared and statistically analyzed pro and post isolation of LOM.Results The incidence of abnormal potential of LOM in the two groups was significantly different(P ＜0.01),re-entry cycle(group A 25％ vs.B group 80％),tachycardia(group A 25％ vs.B 100％),double potential(group A 25％ vs.group B 80％),fragmentation potential(group A 25％ vs.group 80％).There was a significant difference in the rate of LOM tachycardia induction before and after LOM intervention in group B (P ＜ 0.05,before 100％ vs.after 20％).Conclusion There are two possible mechanisms of LOM involved in the occurrence and maintenance of AF:one is that LOM induces AF through spontaneous excitation,the other is that LOM participates in the reentry of left atrium and pulmonary vein in the form of bypass to induce and maintain AF.