OBJECTIVE To find out the problem of hospital infection management,and establish measurement for improving medical quality.METHODS The problems of hospital infection management were investigated according to Measurement of Management on Hospital Infection,the Regnlations of Anti-septic Technology,and the Regulations of Management on Hospital Infection.RESULTS Hospital infection could be controlled effectively by reinforcing the inspection and education among medical staff about hospital infection.CONCLUSIONS Enhancement of hospital infection managementis an important method for improving medical quality.

Objective To determine the influence of stellate ganglion block on myocardial ischemial reperfusion arrhythmia.Methods Sixteen rabbits were divided randomly into two groups : group A(control group), group B (experimental group) was left lateral stellate ganglion blocks. Myocardial ischemia reperfusion model in vivo was carried out routinely. Blood samplies were taken from coronary sinus for the determination of neuropeptide(NPY) and noradrenaline(NE) at the following time point before LAD crossclamping , 5min, 30min after reperfusion.The occurrence of RA was measured in 1～5min during reperfusion.Results The level of plasma NPY and NE were significantly reduced at 5min, 30min after reperfusion (P

OBJECTIVETo observe clinical therapeutic effect of electric heat needle therapy on senile gonarthritis.

METHODSSixty-five patients were divided into a treatment group and a control group. The treatment group of 35 cases were treated by electric heat needling at Dubi (ST 35), Neixiyang (EX-LE 4), Yanglingquan (GB 34) and Yin-lingquan (SP 9), and the control group of 30 cases by simple acupuncture at the same acupoints as in the treatment group. In the two groups, the treatment was given once every other day, 10 sessions constituting one therapeutic course. After treatment of 2 courses, their therapeutic effects were compared.

RESULTSThere was a very significant difference between the two groups in the total effective rate (P < 0.01).

CONCLUSIONElectric heat needle therapy has a better clinical therapeutic effect on senile gonarthritis, better than simple acupuncture therapy.

Objective:To evaluate the outcome of implant-supported all-ceramic fixed partial prostheses (FPPs)in posterior area. Methods:The clinical data of 1 20 implants-supported 53 fixed dentures in 47 patients were collected from July 201 1 to June 201 2 and prospectively studied.Complication and failure of implants and /or prosthesis,biological and technical complications were evaluated. Results:43 restorations with 1 00 implants in 37 cases were followed up for 1 2 -24 months.Veneering ceramic chipping was observed in 9(20.9%)prostheses.Inflamed marginal gingivitis was found around 3(7.0%)prostheses.No implant was involved in technical complication.Cumulative survival rate was 1 00% for implant-based analysis and 1 00% for prostheses-based analysis.Conclusion:Implant-supported all-ceramic fixed partial dentures may be a feasible treatment modality for posterior dental restoration.

Objective To discuss the effects of implants of different thread face angles on the primary stability of immediately loaded implant using the 3-dimensional finite element analysis with the models of the immediately loaded implants. Methods Using the commercial code of Pro/E software, Hypermesh software, and ABAQUS software we created 3-dimensional finite element models. The micromotions of the finite element models with different screw face angles (V-shape, buttress, square-shape and inverse buttress) were computed with the ABAQUS software. Results Concerning different thread face angles, the micromotion of buttress implant was the minimum and the micromotion of inverse buttress implant was the maximum with vertically loading; the micromotion of inverse buttress implant was the minimum and the micromotion of buttress implant was the maximum with horizontal loading. Conclusions Different screw-types have great influence on vertical interfacial micromotions but little influence on horizontal interfacial micromotions. There are two angles which are formed by top /bottom edge and the implants. The larger are the angles, the smaller are the vertical interfacial micromotions, but the weaker of the strength. Thus in designing the screw-type implants, we should consider the angles of thread faces and the strength.

[Objective]This study was designed to discover the expression of histamine H4 receptor in allergic rhinitis(AR)and its clinical significance.[Methods]Seventy-three patients with allergic rhinitis and 30 volunteers were recruited in our study.Western blot and Real-time fluorescent quantification PCR were used to detect the protein and mRNA expression of H4R on peripheral blood monocytes(PBMC).To analyze the relationship between the H4R and allergic rhinitis,the level of serum interleukin 4(IL-4)and interleukin 12(IL-12)were determined by enzyme linked immunosorbnent assay(ELISA)in the AR group.[Results]The protein and mRNA expression of H4R in the AR group were significantly higher than that in the NAR group.Person correlation analysis revealed that H4R was positively correlated with IL-4(r=0.71,P＜0.01)and negatively correlated with IL-12(r=-0.50,P＜0.01).The expression of H4R also had positive relationship with IL-4/IL-12 ratio(r=0.75,P＜0.01).[Conclusion]These results indicate that histamine H4 receptor is closely related with allergic rhinitis and is important in the pathogenesis of AR.The elevated expression of H4R in AR patients' PBMC may be closely correlated with Th1/Th2 balance.

BACKGROUND:Previous studies have reported the cause and treatment of biliary complication. However, how to improve operative technique for preventing the complication is rarely reported.
OBJECTIVE:To explore the effect of operational skil s during liver transplantation on biliary complications.
METHODS:Biliary complications in 475 patients who underwent liver transplantation were retrospectively analyzed. The relationship between operational skil s and biliary complications after liver transplantation was observed. The potential risk factors about operative technique were summarized. Some preventive interventions for biliary complications were suggested.
RESULTS AND CONCLUSION:Biliary complication was diagnosed in 36 (7.6%) of 475 patients who underwent liver transplantation. They were nonanastomotic biliary stricture (n=19, 4.0%), anastomotic biliary stricture (n=7, 1.5%), biliary leakage (n=3, 0.6%), twisted common biliary duct (n=3, 0.6%), residual common duct stone (n=1, 0.2%), and neoformative common duct stone (n=3, 0.6%). There was no difference in the incidence of nonanastomotic biliary stricture among the three biliary anastomotic styles. The possibility of anastomotic biliary stricture in placing T-drainage tube group was lower than the other two groups according to clinical data. Nevertheless, there was no statistical difference between these three groups. Infusing UW into the liver from cranial mesenteric vein and douching the biliary duct immediately while taking the donor could decrease the incidence of biliary complication after liver transplantation (P=0.013 and P=0.018, OR=0.26 and OR=0.28), the later factor could also decrease the incidence of nonanastomotic biliary stricture (P=0.001, OR=0.09). Meanwhile, some operational skil s also decrease the incidence of biliary complications, such as protecting the artery around the biliary duct, and elevating the liver when suturing the common biliary duct.

Objective To evaluate the efficacy and security of splenic artery ligation for severe hypersplenism during liver transplantation.Method Thirty-two liver transplant patients with preoperative hypersplenism were selected,including 17 cases (ligation group) treated by splenic artery ligation during liver transplantation,and rest 15 patients as non-ligation group.The fluctuation of white blood cells,platelets and volume of spleen were compared between these two groups.At the same time,splenic infarction,postoperative infection,recurrent gastrointestinal bleeding,splenic artery steal syndrome and other complications were observed in these two groups.Result All recipients were followed up for over 6 months.One recipient in ligation group died of multiple organ dysfunction caused by delayed recovery of liver donor with the survival rate being 94.1％ (16/17).The survival rate in non-ligation group was 93.3 ％ (14/15) (one recipient died of respiratory failure caused by pulmonary infection).There was no statistically significant difference in survival rate between these two groups (P＞0.05).Splenic necrosis wasn't detected in the ligation group.The splenic volume in ligation group was significantly less than that in non-ligation group (P＜0.01).The products of splenic maximum length and wide diameter shrunk 33.17-± 8.26 cm2 and 22.47 ± 7.25 cm2 in ligation group and non-ligation group,respectively.The platelet counts of ligation group were significantly greater than those of non-ligation group in all the observation points within 6 postoperative months (P＜0.01).The white blood cell counts of ligation group were greater than those of non-ligation group at the first week postoperatively (P＜0.01),whereas,there was no statistically significant difference between these two groups from then on (P＞0.05).The infection incidence of ligation group was lower than that of non-ligation group within 6 postoperative months (P ＜0.05).Statistically significant differences in recurrent gastrointestinal bleeding and splenic artery steal syndrome weren't found between these two groups (P＞0.05).Conclusion Splenic artery ligation in liver transplantation is safe and effective.It can rapidly increase the counts of platelet and white blood cell in the earlier postoperative time,which is beneficial to patient's recovery.Besides,it adds no correlative complication.

ObjectiveTo assess the feasibility and clinical efficacy of minimally invasive esophagectomy for esophageal cancer.MethodsFrom July 2007 to December 2009,eighty-one patients with esophageal cancer received combined thoracoscopic and laparoscopic esophagectomy with anastomosis in the neck.All clinical data were retrospectively reviewed.ResultsThe median operative time was 270.5 min (range 196-315 min).The median time of gastric mobilization and abdominal lymph node dissection was 64.5 min,and the median time of esophageal dissection and mediastinall lymph node dissection was 81.2 min.The median blood loss was 121.5 ml for the thoracic phase and 42.4 ml for abdomen phase.The mean number of disected lymph nodes was 20.4 (range 5-41) with metastastic rate of 30.9% (25/81).The mean harvest lymph node was 12.5 in chest and 7.3 in abdomen.Perioperative complications rate was 27.2%,including respiratory failure in 1 case,pulmonary infection in 10,anastomotic leak in 3,chylothorax in 2,gastric tube dilatation in 1,gastric tube leak in 1.And recurrent laryneal nerve injury in 5 .Seventy-nine patients were followed up withmMean follow up time of 14.2 months( range 2-31 months).The overall one-year survival rate was 91.1%.Postoperative complications included anastomotic stenosis in 5 cases (6.3%),reflux esophagitis in 12 (15.2%) and recurrence or metastasis in 6 (7.6%).ConclusionMinimally invasive esophagectomy for esophageal cancer can mimimus trauma,reduce post-operative complications,improve the quality of life,which is feasible and effective from the point of the clinical efficacy and the purpose of tumor therapy.

Objective To find out current distribution of Oncomelania snails and Schistosoma infection in snails in Zhejiang Province, so as to improve the project of schistosomiasis control. Methods Investigation spots were selected by stratified cluster sampling method, 100 villages of 34 counties were selected from 7 106 villages of 55 counties as survey spots. Synchronously systematic and environmental samplings were used for the survey. Snails were dissected to determine the infection status and spots with sham snails were set to assess the quality of the survey. Results The result showed that snails were found in 223 strips, 1 572 frames and 73 300 m 2 area in 32 villages of 21 counties. Snails were found in an area covering 72 640 m 2 in 29 villages of 18 counties in hilly region, which accounted for 99.1% of total snail habitats. The significantly larger area with snails was revealed in hilly region than that in water network region (t=3.04, P