OBJECTIVE To survey the status quo of hospital infection management and countermeasures in township health center. METHODS To adopt a unified examination and assessment survey,the township hospital infection management,including organization,personnel training,monitoring,disinfection and isolation,occupational protection,sterile disposable medical supplies and medical waste management was investigated in 15 Lanxi Town ship Health Centers. RESULTS Only 2 centers had management organizations (13.33%),5 (33.33%) to participate in personnel/training,no one carry out the monitoring of hospital infection,with fuzzy concept about cleaning disinfection and sterilization and poor awareness of occupational protection. CONCLUSIONS Realizing a sound organization improving hospital infection management staff and intensive training,increaseing the investment and strengthening th supervision and inspection are in accordance with the law and guide management of patients in rural areas to be assured of a secure medical establishment.

Objective:To explore the perioperative treatment principle for arteriovenous fistulas of hemodialysis,the related factors to the success of operations and the intervention measures.Methods:1820 cases in the 2 periods from 1992to 2000 and from 2001 to 2008 were selected,and the relation of the change of primary diseases,the difference of their blood vessel condition before operation,different operation methods and different treatment after operation to the successful rate of operation and fistulas blood flow was analyzed and statistical analysis was made to the related data.Results:The ratio of secondary renal disease in the second period was much bigger and of significant difference with that in the first period(P

Diffuse large B-cell lymphoma (DLBCL) is a heterogeneous group of non-Hodgkin's lymphoma.An uncommon subset with myc and either bcl-2 or bcl-6 rearrangement,also known as ‘double-hit’ lymphomas,is considered very aggressive clinical course and poor prognosis despite high-intensity chemotherapy.Recently,these lymphomas have received increased attention.This review explores the existing literatures for the involved genes with their functions,clinical features,diagnosis and treatment.

Objective:In order to improve operator’s cognitive level for standardized disinfection, this paper will focus on analyzing and interpreting the disinfection procedures for some common dialysis machines.Methods: This paper will interpret and compare the disinfection procedures for three brands of dialysis machines in the following aspects: the choice of the disinfectant, the disinfection method, the concentration of the disinfectant and the injected volume of the disinfectant, etc.Results: The procedures of hot disinfection with citric acid were used completely in those three brands of dialysis machine, and the procedure of sodium hypochlorite need been used periodically to remove the proteins and other organic matter.Conclusion:Although the dialysis machines provide almost complete and efficient disinfection procedures, but the operator should need to select the most suitable procedures according to their practical situation. If the operators cannot master the disinfection procedures and have not noticed the importance of it, the wrong operator will lead to incomplete disinfection, affect the normal operation of the dialysis machines and increase the risk of cross-infection.

Objective To investigate the effect of cognitive behavioral multi-level intervention on post-stroke depression. Methods 160 patients with post-stroke depression in our hospital from February 2013 to February 2015 were divided into control group (n=80) and obser-vation group (n=80). Both groups received conventional medical treatment and nursing care. The observation group received cognitive be-havioral multi-level intervention nursing care, including personal psychology, behaviour and joint relationship. Self-rating Depression Scale (SDS) was assessed, and the serum level of interleukin (IL)-1β, IL-6 and tumor necrosis factor-α(TNF-α) were mesured before and after treatment. Results After treatment, the score of SDS was lower (t=2.705, P<0.05), and the levels of IL-1β(t=8.182), IL-6 (t=2.883), TNF-α(t=2.604) were lower in the observation group than in the control group (P<0.05). The incidence of depression was also lower in the observa-tion group than in the control group ( χ 2=6.144, P<0.05) after 6 months follow-up. Conclusion Cognitive behavioral multi-level interven-tion could effectively prevent post-stroke depression.

Objective To study the clinical efficacy of low dose thyroxine combined with irbesartan hydrochlorothiazide in the treatment of elderly patients with severe heart failure.Methods 100 cases of elderly patients with severe heart failure treated in our hospital from January 2013 to December 2016 were selected as the research object in this study.They were randomly divided into control group and experimental group, with 50 cases in each group.Patients in the control group were treated with conventional therapy, while the experimental group was treated with low dose thyroxine combined with irbesartan and hydrochlorothiazide.The clinical efficacy of the two group were compared and analyzed.Results After the corresponding treatment, the total effective rate of the experimental group was 88.0%,significantly higher than that of the control group(70.0%), the difference was statistically significant(P<0.05).After treatment, the experimental group of patients with left ventricular ejection fraction index, four triiodothyronine and three triiodothyronine levels were significantly higher than those before treatment, the control group of patients with left ventricular ejection fraction were significantly higher than before treatment, the difference was statistically significant(P<0.05).Conclusion Low dose thyroxine combined with irbesartan hydrochlorothiazide in the treatment of elderly patients with severe heart failure has better clinical effect, can improve the therapeutic effect in a certain extent, with further clinical promotion and application significance.

OBJECTlVE To investigate the improvement effect of rosigIitazone(ROm)against cis-pIatin(DDP)-induced nephropathy in rats and its mechanim of resistance to oxidative stress. METHODS Invitro:the survivaI rate of HEK293 ceIIs was measured with mTT assay incubated with DDP 0.4 -100 μmoI·L-1 aIone or with DDP 25 μmoI·L-1 and ROm 0.01-1000 μmoI·L-1 for 48 h. Then the content of maIondiaIdehyde(mDA)and the activity of gIutathione(GSH)in HEK293 ceIIs co-incubated with DDP 25 μmoI·L-1 and ROm 100 μmoI·L-1 were assayed using chromatometry. In vivo:sixty maIe SD rats were randomIy divided into normaI controI group,modeI group(DDP 5 mg·kg-1 )and modeI+ROm 5,10 and 20 mg·kg-1 groups. The modeI of DDP-induced nephropathy was estabIished by taiI vein injection of DDP 5 mg·kg-1 ,once a week,for 3 times. After the first injection,the rats in modeI+ROm 5,10 and 20 mg·kg-1 groups were ig given ROm 5,10 and 20 mg·kg-1 ,once a week,for 8 weeks. The bIood urea nitrogen(BUN)and creatinine(Cr)were assessed with an automatic biochemicaI anaIyzer. Nitric oxide(NO)and mDA content,GSH and superoxide dismutase( SOD)activities in the kidney tissue were determined using chromatometry and histopathoIogicaI changes in renaI tissues were detected by hematoxyIin-eosin staining. RESULTS In vitro:IC50 of DDP to HEK293 ceII survivaI for 48 h was 21.0 μmoI·L-1 . Co-incubation with ROm 1-1000 μmoI·L-1 and DDP 25 μmoI·L-1 for 48 h couId signifi-cantIy increase the totaI ceII survivaI rate compared with DDP 25 μmoI·L-1 group(P﹤0.05,P﹤0.01), whiIe co-incubation with ROm 100 μmoI·L-1 and DDP 25 μmoI·L-1 for 48 h couId significantIy decrease the IeveI of mDA(P﹤0.01)and increase GSH activity(P﹤0.01),respectiveIy. In vivo:compared with normaI group,serum BUN and Cr content in modeI group were significantIy increased(P﹤0.01),renaI tissue GSH and SOD activities decreased(P﹤0.01),renaI tissue mDA content increased(P﹤0.01), and renaI tissue NO IeveI and NOS activity aIso decreased significantIy(P﹤0.05). Compared with modeI group,serum BUN content in modeI+ROm 5,10 and 20 mg·kg-1 decreased from(17.0±1.3)mmoI·L-1 to 14.0±4.1,11.2±1.8 and(6.1±1.0)mmoI·L-1(P﹤0.01),serum Cr content in modeI+ROm 10 and 20 mg·kg-1 decreased from(124.6±39.8)mmoI·L-1 to 49.0±5.2 and(47.1±2.9)mmoI·L-1(P﹤0.01), renaI tissue GSH and SOD activities in modeI+ROm 10 and 20 mg·kg-1 group increased significantIy (P﹤0.05,P ﹤ 0. 01),mDA IeveI decreased(P﹤0.05,P ﹤ 0. 01),NO IeveI and NOS activity aIso increased(P﹤0.05,P﹤0.01),and renaI pathoIogicaI tissue damage couId be improved. CONCLUSlON ROm pIays a protective roIe in rat kidney damage caused by DDP,which may be reIated to improving oxidative stress resistance of the kidney.

Objective This prospective study was performed to evaluate the role of oral glucose toler-ance test(OGTF) in evaluating the preoperative status and postoperative complications of patients with hepa-tocellular carcinoma. Methods One hundred and twenty-eight patients with primary hepatic carcinoma (PHC) were divided into 3 groups according to the resection, in which the resection of no more than 1 seg-ment called group A, the resection of 1-2 segments called group B, the resection of more than 2 segments called group C. OGTT, routine liver function tests and Child-Pugh classification were performed in these pa-tients preoperatively. The postoperative complications were also recorded. Results Blood glucose lever of 60 min and 120 min after glucose loading test in Child B (11.23 mmol/L ± 2. 78 mmol/L, 11.79 mmol/L± 3.48 mmol/L) were significantly higher than that in Child A (8.56 mmol/L±2. 36 mmol/L, 6. 78 mmol/L ±1.60 mmol/L,P <0.01) ,but the blood glucose lever of 0 min and 30 min showed no difference. The rate of diagonis of DM in Child B was 28. 30% ,which was higher than Child A(13.33% ,P =0. 035). The OG-TT results for the L-shaped curve showed that postoperative complications were significantly higher than that of type I and P in group A and B. I-shaped and L-shaped were found ascites in group C. The cases with jaun-dice all showed L-shaped curve. When the patients' OGTT curve was P -shaped, the ascites production rate was no significantly different in these three groups. With the increase of the removal in liver, ascites produc-tion rate increased evidently in I-type and L-type(P < 0. 05). Conclusions OGTT is worthwhile to assess hepatic function reserve and postoperative complications for patients with PHC. Combination of OGTT and Child-Pugh classification has higher predictive value on hepatic function reserve.

Objective To observe the predictive value of Alberta stroke program early CT score (ASPECTS) and hemorrhage after thrombolysis score (HAT score) for the hemorrhagic transformation (HT) of acute cerebral infarction (ACI) patients after thrombolysis with Alteplase.Methods One hundred and twenty-one patients with ACI admitted to the Department of Neurology of Tianjin Jinghai District Hospital from January 2015to March 2017 were enrolled, they were all treated by using Alteplase 0.6 mg/kg for thrombolysis, maximum dose being 90 mg, and 1/10 of the total dose was intravenously injected in 1 minute, and then the residual part dissolved in 100 mL normal saline was intravenously dripped continuously for 1 hour. The ASPECTS and HAT score were carried out before the start of thrombolysis, and then the HT incidence situations in patients with different ASPECTSs and HAT scores were compared, and logistic regression analysis was used to analyze the risk factors of HT after thrombolysis in patients with ACI; then the receiver operating characteristic (ROC) curve was drawn, and the clinical value of HAT score and ASPECTS in diagnosing HT occurrence was analyzed.Results In cases with ACI, it was discovered that the higher the ASPECTS, the lower the incidence of HT, indicating that the incidences of HT in patients with ASPECTSs 0-4, 5-7, 8-10 were 57.1% (4/7), 26.7% (8/30), 14.3% (12/84) respectively; Similarly, in such cases, the higher the HAT scores, the higher the incidence of HT, showing that the incidences of HT of patients with HAT scores 0, 1, 2, ≥ 3 were 7.1% (4/56), 21.0% (8/38), 33.3% (7/21), 83.3% (5/6) respectively. The single factor analysis showed that the risk factors influencing the HT incidence included the systolic blood pressure on admission, anti-platelet medicine taken in the past history, the sign of high density of middle cerebral artery shown in head CT film on admission, the time of interval between the onset of the disease and the beginning of thrombolysis, HAT store and ASPECTS [odds ratio (OR) values were 0.972, 0.279, 0.992, 0.311, 2.628, 2.625, respectively, 95% confidence intervals (95%CI) were 0.9352-1.012, 0.093-0.836, 0.983-1.000, 0.105-0.916, 1.362-5.071, 1.522-4.525,P values were 0.034, 0.023, 0.042, 0.034, 0.003, 0.045 respectively]; the multifactorial logistic regression analysis showed that the independent risk factors influencing HT incidence were as follows: the systolic blood pressure on admission, anti-platelet medicines taken in the past history, the sign of high density of the middle cerebral artery shown in the head CT film on admission, the time of interval between the onset of the disease and the beginning of thrombolysis, HAT score and ASPECTS (OR values were 1.766, 1.012, 1.574, 1.030, 2.155, 2.431, 95%CI were 1.233-2.103, 1.009-1.204, 1.186-2.091, 1.009-1.053, 1.237-4.907, 1.213-5.815,P values were 0.023, 0.004, 0.002, 0.005, 0.007, 0.047); HAT score and ASPECTS could predict the risk of HT incidence after venous thrombolytic therapy, sensitivity, specificity, area under ROC curve (AUC), 95%CI in ASPECTS were higher than thoes of HAT score (94.4% vs. 94.0%, 61.4 vs. 41.0%, 0.77 vs. 0.70, 0.710-0.830 vs. 0.650-0.800).Conclusions It is shown in this study that the higher the ASPECTS, the lower the incidence of HT, and the higher the HAT score, the higher the incidence of HT; both HAT score and ASPECTS can predict the risk of HT incidence after venous thrombolytic therapy, and the predictive value of ASPECTS system is higher than that of HAT score.

Objective:To evaluate the biological safety of commercial pure Ti (cpTi),Ti alloy Ti6Al4V and stainless steel 316L.Methods:According to the GB/T16886.5-2003 and YY/T0127.2-2009 standards,the extraction of the 3 materials was respectively prepared,cck-8 assay was used to test their cytotoxicity,single cell gel electrophoresis was used to test their genotoxicity,and in vivo test was used to test their acute systemic toxicity.Results:The cytotoxicity of 100％ extractions of 316L,Ti6Al4V and cpTi was graded to 2,1 and 0,the olive tal moment(OTM) 10.79 ±0.39,9.84 ± 1.78 and 0.92 ± 1.43,the percentage of tail DNA (1.22 ±0.06) ％,(0.92 ± 0.43) ％ and (0.43 ± 0.01) ％ respectively.No systemic toxicity and no body weight change was observed in the acute systemic toxicity test in mice.Conclusion:cpTi has better biologic safety than Ti6Al4V and 316L.