Objective To realize the current status of central sterile supply departments(CSSDs)in hospitals,and provide the basis for making improvement measures.Methods Field investigation was adopted to study the resource distribution,personnel structure,and the quality of medical instrument cleaning in 78 hospitals in Chongqing.Re-sults Qualified results of 78 hospitals was 24.36% (19/78),basically qualified rate 52.56% (41/78),unqualified rate 23.08% (18/78);inspection results of different types of hospitals were significantly different(Hc= 16.643,P=0.002),qualified hospitals mainly concentrated on city- and county-level hospitals.Unqualified rate of CSSD con-struction area was 78.21% (n= 61),unqualified rate of personal allocation was 75.64% (n= 59),concentrated man-agement of operating rooms and CSSDs was 52.56% (n= 41),mainly concentrated on city- and county-level hospi-tals;decentralized management accounted for 47.44% (n= 37),58(74.36% )hospitals used repeated cleaning stain-less steel tables for receiving,50% didn’t install automated cleaning machine and drying cabinet,42.31% (33/78) performed manual cleaning,40(51.28% )didn’t equip with water treatment system;12(15.38% )hospitals used patched or worn clothing for packing,47 didn’t equip with hard metal container,37(47.44% )had no heat sealing machine,21(26.92% )had no detection equipment for cleaning quality,41(52.56% )had no low temperature sterili-zation instruments;52(66.67% )hospitals performed biological monitoring on high pressure steam sterilizer.Conclu-sion Clean and disinfection equipments in CSSDs in city- and county-level hospitals are well-appointed,procedures of clean and disinfection are standard,and can achieve the standard of clean quality;while hospitals affiliated to fac-tories and private hospitals are not well-appointed,procedures of clean and disinfection are not standard. Construc-tion of CSSD should be standard,so as to ensure the effectiveness of clean,disinfection and sterilization of surgical instruments.

Objective To investigate the effects of ursolic acid (UA) on oxidative stress and apoptosis in focal cerebral ischemia reperfusion in rats. Methods One hundred and twenty SD rats were randomly divided into 6 groups:sham operation group, model group, and groups of 20, 40, 80 120 mg/kg UA, with 20 rats in each group. A model of focal cerebral ischemic reperfusion was induced using the intraluminal thread method. Drugs were administrated immediately via tail vein injection when the suture was inserted. At 6h later, the total antioxidative capacity (T-AOC), malondialdehyde (MDA) level, and the activity of creatine kinase (CK), lactate dehydrogenase (LDH) in the serum, and the activity of superoxide dismutase (SOD), catalase (CAT), glutathione peroxidase (GSH-Px) in the ischemic cortex were measured. Apoptosis in the ischemic cortex was detected by TUNEL staining. Results Compared with the model group, the activity of CK (301.2 ± 86.8 U/L, 258.5 ± 58.4 U/L, 228.7 ± 49.2 U/L vs. 352.6 ± 88.1 U/L), LDH (327.5 ± 87.1 U/L, 288.6 ± 69.5 U/L, 243.7 ± 74.9 U/L vs. 395.4 ± 98.6 U/L) in the serum in the groups of 40, 80 120 mg/kg UA were significantly decreased (P<0.05 or P<0.01), MDA (5.5 ± 1.4 mmol/L, 4.8 ± 1.1 mmol/L, 4.4 ± 1.3 mmol/L vs. 7.8 ± 2.0 mmol/L) and T-AOC (9.4 ± 2.2 U/L, 10.5 ± 2.9 U/L, 11.8 ± 3.1 U/L vs. 8.0 ± 2.1 U/L) were significantly increased (P<0.05 or P<0.01); the activity of SOD (10.1 ± 2.7 U/mg, 11.6 ± 2.5 U/mg vs. 6.9 ± 2.6 U/mg),GSH-Px (12.9 ± 2.9 U/mg, 14.2 ± 3.2 U/mg vs. 9.5 ± 2.3 U/mg), CAT (3.3 ± 1.3 U/mg, 3.9 ± 1.2 U/mg vs. 2.3 ± 0.9 U/mg) in the ischemic cortex in the groups of 80 120 mg/kg UA were significantly increased (P<0.05 or P<0.01). TUNEL staining showed that apoptosis in the ischemic cortex in all the UA groups were significantly decreased compared with the model group. Conclusion UA could effectively enhance the activity of antioxidant enzymes and free radical scavenging capacity, ameliorate oxidative stress and inhibit apoptosis in focal cerebral ischemia reperfusion in rats.

Objective To evaluate the effects of gender on the median effective target plasma concentration (EC50) of propofol inhibiting responses to laryngeal mask airway (LMA) insertion in patients.Methods Fiftyfive ASA physical status Ⅰ or Ⅱ patients,aged 20-60 yr,with body mass index 18-25 kg/m2,requiring LAM insertion,undergoing elective surgery,were divided into 2 groups according to the gender:male group (group M,n =27) and female group (group F,n =28).Propofol was given by target-controlled infusion.Anesthesia was induced with target-controlled infusion of propofol.The concentration of propofol was determined by using modified Dixon's up-and-down method.The initial target plasma concentration of propofol was 3.0 μg/ml (group M) or 2.7μg/ml (group F) and the ratio between the 2 successive concentrations was 1.1.Fentanyl 1 μg/kg was injected intravenously at about 10 min of propofol target-controlled infusion.LMA was inserted after the effect-site and plasma concentrations were balanced.The positive response to LMA insertion was defined as development of swallowing,coughing,biting LMA,body movement and laryngospasm during insertion.When the response to LMA insertion was positive,the concentration of propofol was increased in the next patient and when the response was negative,the concentration was decreased in the next patient.The EC50 and 95 ％ confidence interval of propofol inhibiting responses to LMA insertion were calculated.Results The EC50 (95 ％ confidence interval) of propofol was 3.11 (2.92-3.30) μg/ml in group F and 2.70 (2.55-2.85) μg/ml in group M (/ ＜ 0.05).Conclusion The EC50 of propofol inhibiting responses to LMA insertion is higher in female patients than in male patients.

Objective To test the hypothesis that if oxidized low density lipoprotein (ox-LDL) were associated with target organ damage(TOD) in patients with essential hypertension.Methods A total of 182 patients with primary hypertension[102 males and 80 females,age (52.8?18.4) years] were enrolled in this study in our department between October 2006 and June 2009.Patients were classified as with TOD(n=85) or without TOD (n=97).Left ventricular mass index (LVMI) and intima-media thickness(IMT) was determined using echocardiography;24 hours urine microalbumin and retinal changes were measured.Cerebral hemorrhage,ischemic infarction,transient ischemic attack (TIA) were evaluated by CT or MRI.Serum ox-LDL was measured by sandwich ELISA.Results Mean ox-LDL level were (114.6?24.3)U/L in without target organ damage patients which was significantly lower than that in target organ damage group[(164.2?27.6)U/L,P

Objective To survey the clinical application of glycopeptide antibiotics in hospitalized patients, and evaluate the rationality of drug use, so as to provide reference for rational clinical drug use.Methods A retrospective study was conducted to investigate the application of glycopeptide antibiotics among inpatients in a hospital from January to December in 2014, relevant clinical data were recorded.Results A total of 727 cases were included , 471 (64.79%) of which were infected cases.Respiratory tract infection was the main site of both healthcare-associated infection and community-associated infection (39.17% and 45.98%, respectively).The average days of glycopeptide antibiotic use were 6.06 day (4 403/727).Patients who used glycopeptide antibiotics were mainly from intensive care unit, department of oncology, and department of neurosurgery, accounting for 20.36%(n=148) , 12.10%(n=88), and 11.14%(n=81) respectively.Glycopeptide was used in 338 patients(46.49%),the average types of combined use was 4.43, triple and above was used in 99 patients(13.62%),combination of the second generation cephalosporins was the highest(20.48%).450(61.90%) patients used vancomycin, 260(35.76%)used teicoplanin,17(2.34%)used both vancomycin and teicoplanin.A total of 847 pathogenic strains were isolated, the major were Acinetobacter baumannii (n=111, 13.10%), Klebsiella pneumoniae (n=80, 9.45%), Pseudomonas aeruginosa (n=68, 8.03%), and Staphylococcus aureus (n=54 , 6.37%), methicillin-resistant Staphylococcus aureus was 50 strains.490 (67.40%) patients treated with glycopeptide antibiotics were effective.Of 727 patients, 86 (11.83%) used antibiotics rationally, 315(43.33%) basically rational,and 326 (44.84%) irrationally.Conclusion Application of glycopeptide antibiotics in this hospital is basically rational, but indications should be paid attention.

Objective To explore the intervention in patients with advanced lung cancer in chemotherapy effect in psychology. Methods According to the routine nursing care of 40 cases of patients with advanced lung cancer chemotherapy, and classified as the control group, the other 40 patients in the control group based on the nursing for patients with psychological intervention, and classified as the observation group, two groups of patients in our hospital from January 2015 to January 2017. Results The intervention of patients before, there were no significant difference between the two groups of patients' quality of life and life ability score, after grouping after intervention in observation group were significantly better than the control group patients were compared between the two groups; for the intervention of the satisfaction rate of visible, The proportion of patients in the observation group 97.5% was significantly higher than the control group of 72.5% patients, showed significant differences between the two groups (P<0.05). Conclusion The psychological intervention analysis find application in patients with advanced lung cancer in chemotherapy, the chemotherapy effect can help to reflect, consolidate the therapeutic effect, improve the quality of life of patients, improve the patients for nursing recognition, therefore it is worthy of reference.

Objective To analyse the effect of repaglinide combined with Zhenqi Jiangtang Capsules on βcell function in elderly patients with type 2 diabetes mellitus.Methods 60 elderly patients were collected from harbour branch of Hainan provincial People's hospital, who were diagnosed with type 2 diabetes mellitus .All patients were randomly divided into experimental group and control group, 30 cases in each group, 2 groups of patients were given control diet, moderate exercise, and other conventional adjuvant therapy.Control group was treated with repaglinide orally on the basis of routine adjuvant treatment, 1 mg/times, three times per day,experimental group were given Zhenqi Jiangtang Capsules based on the treatment in control group,4 grains/times,three times per day.Both groups were treated for 4 weeks, after the end of treatment, blood glucose levels,serum insulin levels,βcell function and serum lipids in all patients were detected.ResuIts After treatment, compared with control group, the levels of blood glucose, HbA1c and AUCg in experimental group were significantly lower ( P<0.05 );the insulin levels 30 min,60 min, 120 min after meal were significantly higher (P<0.05);the HOMA-IR of patients was significantly lower(P<0.05);IRG, AUCi and AUCi/AUCg were significantly higher (P<0.05);the serum TC, TG, LDL levels were significantly lower, serum HDL levels were significantly higher(P<0.05).ConcIusion Repaglinide combined with Zhenqi Jiangtang Capsules can significantly reduce the blood glucose and lipid levels in elderly patients with type 2 diabetes, improve the function of pancreatic beta cells, promote postprandial insulin secretion and improve insulin resistance.

OBJECTIVE:To investigate the effect of insulin use intervention and self management of blood glucose in the treat-ment of cystic fibrosis related diabetes. METHODS:In prospective cohort study,during Apr. 2007-Apr. 2013,1 295 CFRD inpa-tients selected from 14 hospitals of Shanghai were randomly divided into trial group (743 cases) and control group (552 cases). Control group maintained the dose of insulin,and trial group adjusted the dose of insulin every week and received patient education about self management of blood glucose. Blood glucose,blood lipid,quality of life,the ability of self management and other in-dex were detected,recorded and compared between 2 groups 1 year after intervention. RESULTS:1 year after intervention,fasting blood glucose,postprandial 2 h blood glucose and HbA1c of trial group were significantly lower than those of control gorup,with statistical significance(P<0.05). The time of blood glucose reaching the standard,the dose of insulin,the number of hyperglycemia and hypoglycemia in trial group were all significantly shorter or lower than control group,with statistical significance (P<0.05). There was statistically significant difference in the rate of standard blood glucose between trial group [93.5%(695/743)] and control group [59.6%(329/552)]. TG of trial group decreased while HDL increased,there was statistically significant difference between 2 groups (P<0.05). There was statistically significant difference in the quality of life score between trial group (196.24 ± 15.80) and control group(180.33±16.29)(P<0.05). The ability of self management in trial group was significantly higher than control group, with statistical significance(P<0.05). CONCLUSIONS:Insulin use intervention and self management of blood glucose can control the level of blood glucose in CFRD patients,and improve the quality of life,medication compliance and therapeutic effect.

BACKGROUND:Bionic structure is one of the most important goals of scaffold design in tissue engineering. However, the majority of the bionic scaffolds do not have the capacity of sustained release of growth factors.
OBJECTIVE:To fabricate a novel biomimetic nanofibrous heparin/gelatin scaffold and investigate the characterization of the scaffolds including the microstructure, the mechanical strength andin vitro recombinant human bone morphogenetic protein-2 (rhBMP-2) release.
METHODS:Heparin-conjugated gelatin was prepared by chemical crosslinking and mixed with gelatin at different ratios. Nanofibrous composite scaffolds with different ratios of heparin-conjugated gelatin (0, 20% and 40%) were fabricated by using a thermaly induced phase separation combined with particle leaching technique. The amount of conjugated heparin in the scaffolds, scaffold microstructures and mechanical strength were detected and observed. The release kinetics of rhBMP-2 from the scaffolds with different concentrations of heparin conjugated gelatin was detected using ELISA method.
RESULTS AND CONCLUSION:The composite scaffolds possessed abundant porosities, good mechanical properties, and biomimetic nano-structures. The macroporous size was 250-420 μm. When the ratio of heparin-conjugated gelatin was 0, 20% and 40%, the content of heparin in the scaffolds was 0, (12.82±2.49) and (25.08±3.69) mg/g, respectively, with significant differences; the elastic modulus of the composite scaffolds was (299±38), (286±40) and (236±33) kPa, respectively, with insignificant differences (P > 0.05). With the increase in the content of heparin-conjugated gelatin, the rhBMP-2 adsorption capacity of the nanofibrous heparin/gelatin scaffold is improved, thereby significantly reducing the burst release of rhBMP-2 and prolonging the releasing time.

Objective To investigate the protective effects of ursolic acid (UA) on global cerebral ischemic-reperfusion injury in rats.MethodsThe experimental rats were divided into the sham operation group, the model group, the UA low, medium and high dose groups, 20 in each group. Except the rats in the sham operation group, the rats in other groups were dealed by four arteries occlusion to made global cerebral ischemia-reperfusion model. The rats in the UA low, medium, high dose groups were given UA as 40, 80, 120 mg/kg immediately after the occlusion line was inserted; the rats in the sham operation group and the model group were given equal-volume saline. And 6 hours later, the recovery time of righting reflex and electrical activity of brain were recorded, water content of the brain were evaluated, and the activity of LDH, MDA, SOD, CAT in brain tissue were determined; the inflammatory cytokines content of TNF-α, IL-1β, IL-6 were determined by ELISA. Results Compared with the model group, the recovery time of righting reflex (20.6 ± 7.2 min, 18.2 ± 6.9 min vs. 27.3 ± 8.8 min) and electrical activity of brain (16.2 ± 5.8 min, 14.9 ± 5.6 min vs.24.1 ± 7.2 min) of the UA medium and high dose groups were shortened (P<0.05 orP<0.01); the water content were significantly decreased (79.0% ± 0.7%, 78.6% ± 0.5%vs. 80.7% ± 0.9%;P<0.05 orP<0.01); the activity of SOD (158.5 ± 8.4 U/mg, 165.4 ± 9.0 U/mgvs. 143.0 ± 7.1 U/mg), CAT (3.3 ± 1.4 U/mg, 3.9 ± 1.5 U/mgvs. 2.4 ± 0.9 U/mg) in brain tissue of the UA medium and the high dose groups were significantly improved; the content of LDH (16.0 ± 2.6 mmol/g, 18.4 ± 2.8 mmol/gvs. 12.4 ± 1.9 mmol/g) were significantly increased; the content of MDA (18.6 ± 2.8μmol/g, 17.2 ± 2.4μmol/gvs. 24.9 ± 3.4μmol/g), TNF-α (45.8 ± 6.3 nmol/L, 40.1 ± 5.6 nmol/Lvs. 56.3 ± 7.2 nmol/L), IL-6 (187.2 ± 18.5 nmol/L, 136.8 ± 15.7 nmol/Lvs. 238.4 ± 22.9 nmol/L) were significantly decreased, and the content of IL-1β in UA 120 mg/kg treated group was significantly decreased (713.6 ± 56.3 nmol/L vs. 915.7 ± 70.5 nmol/L;P<0.05 orP<0.01).Conclusion UA can effectively promote righting reflex and EEG recovery, reduce brain water content, which perhaps related with its pharmacological effects of enhanceing the activity of antioxidant enzymes, lower oxidative stress, and inhibit inflammation.