Objective To explore the purifying effects of clean bottling workshop in jugged or bottled drinking water manufacturing enterprise in Wuhan. Methods 32 manufacturing enterprises were sampled to test the purifying levels of bottling workshops according to GB50073-2001 The Criterion for Purifying Workshop Design, GB/T16294-1996 Detecting Method for Suspended Particle in Clean Shop or Area of Medical Industry and GB/T16249-1996 Testing Method for Sedimentation Bacteria in Clean Room or Area of Medical Industry. The microorganism determination was based on GB17324-1998 The Hygiene Standard for Bottled Drinking Pure water and GB8537-1995 The Hygiene Standard for Drinking Natural Mineral water and CJ94-1999 The Hygiene Standard for Bottled Drinking Water. Results The qualified rate was 78.1% for the count of dust in air and 81.3% for the count of bacteria in air of bottling workshops of 32 manufacturing enterprises.Among 32 manufacturing enterprises, 25(78.2%) and 8(25%) enterprises accorded with the requirement of 10 000 and 1 000 purifying level of air in whole bottling workshop respectively,only 2 accorded with the requirement of 100 purifying level of air at product line in bottling workshop. The qualified rate was 84.4% for temperature,light,noise,87.5% for flow rate, 46.9% for relative humidity, 34.4% for air pressure difference between indoor and outdoor.After the performance of sanitary management, the qualified rate of microorganism in barrelled water increased from 61.1% in 2001 to 84.1% in 2002. Conclusion The application air cleaning facility in bottling workshop of jugged or bottled drinking water manufacturing enterprise can improve the sanitary quality of microorganism in barrelled water.

ObjectiveTo summarize the effect of staged operations strategy for delayed spontaneous rupture of esophagus with empyema.MethodsThree patients in the department of thoracic surgery of the second affiliated hospital of Guangzhou medical university underwent staged operative treatment for delayed spontaneous rupture of esophagus with empyema.The primary operative procedure consisted of removal of empyema sac,T-tube drainage and jejunostomies.The second operative procedure included alimentary reconstruction with thoracic esophageal resection and exclusion,or with esophageal resection and exclusion later.ResultsAll cases were cured with mean hospitalization of 78.7 days.None of them had any dysphagia at followup of 5-14 months.ConclusionDelayed spontaneous rupture of esophagus with empyema can be managed safely and effectively through staged operations strategy.

Female ; Humans ; Hypophosphatemia ; etiology ; Middle Aged ; Osteomalacia ; etiology ; Paranasal Sinus Neoplasms ; complications

Objective In this study,we investigate the influence on nurses professional ability by the hierarchical level training under the advanced mode.Methods By referring to advanced mode of clinical expertise,combined with impacts including the ability of nurses,seniority factors,professional titles and educational background,1 527 nurses of our hospital were divided into five ranks (including nine grades).We developed training plan,training forms and training purposes aiming at all level of training objectives.In addition,we developed a training effect questionnaire and promotion criteria.All the nurses must be evaluated and compared with the traditional nursing mode,which contained 1 486 nurses as the control.Results Within two years after the start of the experiment in the observation group,1 106 nurses had been promoted.Compared with the traditional platform-based training model,nursing assessment indicators were significantly improved by the hierarchical level of training.Quality control of care services was significantly improved and the score of patient satisfaction was significantly increased.Nurses acceptance of tiered training was improved compared to the control group,published research papers were significantly increased.Conclusions Detailed training on the layer classification of the nurses can improve the ability of nurses including specialist knowledge,interpersonal communication and humanistic care,teaching,scientific research,management and other professional skills,so as to improve nursing quality and work efficiency.

Objective To investigate the immunity effects of quorum sensing in the pulmonary infection in rats due to Pseudomonas aeruginosa.Method(1)300 healthy,clean Sprague-Dawley rats were divided into 3 groups randomly:two different Pseudomonas aeruginosa(the wide-type Pseudomonas aeruginosa PAO1 and its double mutant PAO-JP2,in which the quorum sensing systems were defective,embedded in minute seaweed algiante beads which was made by an ejection set with an acuminate hole were inoculated to Sprague-Dawley rats to establish animal model of chronic pulmonary infection.The control group were dealed with the same methods using the sterile brine instead.(2)The levels of antibody IgG,IgM,IgG1,IgG2a to Pseudomonas aeruginosa in sera and cytokines including interferon-?(IFN-?),Interleukin-4(IL-4)in lung homogenate was measured at 3,7,14,28 days after infection.Results(1)The mortality in the PAO1-JP2-infected group(11.0%)was significantly lower than that of the PAO1-infected group(29.7%)and the control group(4.21%).(2) Compared with the PAO-JP2 group,during the early stages of infection(3 days after infection),the IFN-?level in lung homogenates was significantly higher;during the middle stages of infection(7 days after infection),the levels of IFN-?and IL-4 of PAO1-infected rats were significantly higher;In the later stages of infection(14 to 28 days after infection),levles of IFN-?,IgG2a were lower,while levels of IL-4,IgG,IgG1 were higher persistantly in PAO1-infected rats.Conclusions Quorum sensing system play an important role in pathogenesis and immunity effects of pseudomonas aeruginosa infection via modulating the expression of virulence factors and interfering with the immune system of hosts.

The study aimed to establish a population pharmacokinetic/pharmacodynamic (PPK/PD) model of warfarin. PCR-RFLP technique was used to genotype the CYP2C9 and VKORC1 polymorphisms of 73 patients. RP-HPLC-UV method was used to determine the 190 plasma concentrations of warfarin. Application of NONMEM, the clinical information and 263 international normalized ratio (INR) monitoring data were used to investigate the effect of genetic, physiological, pathological factors, other medication on clearance and anticoagulant response. The final model of warfarin PPK/PD was described as follows: CL = θCL · (WT/60)θWT · θCYP · eηCL (if CYP2C9*1/*1, θCYP = 1; if *1/*3, θCYP = 0.708); EC50 = θEC50 · θVKOR · eηEC50 (if VKORC1- 1639AA, θVKOR = 1; if GA, θVKOR = 2.01; V = θV; K(E0) = θK(E0); Emax = θEmax; E0 = θE0 · eηE0. Among them, the body weight (WT), CYP2C9 and VKORC1 genotype had conspicuous effect on warfarin PK/PD parameters. The goodness diagnosis, Bootstrap, NPDE verification showed that the final model was stable, effective and predictable. It may provide a reference for opitimizing the dose regimen of warfarin.
Anticoagulants ; pharmacology ; Body Weight ; Cytochrome P-450 CYP2C9 ; genetics ; Genotype ; Humans ; International Normalized Ratio ; Nonlinear Dynamics ; Polymorphism, Genetic ; Vitamin K Epoxide Reductases ; genetics ; Warfarin ; pharmacokinetics

Objective To measure von Willebrand factor(vWF)concentrations and von Willebrand factor-cleaving protease(vWF-cp)activity in plasma of lung cancer patients and to evaluate their clinical significance.Methods The vWF:antigen(vWF:Ag)and vWF-cp activity were measured by using ELISA and residual-collagen binding assay(R-CBA),respectively in 78 patients with lung cancer.The serum and pleural fluid(PLF)of carcino-embryonic antigen(CEA)were measured by radioimmunity assay in 23 patients.Results (1)The level of vWF:Ag in lung cancer patients(107.7?43.7)%was significantly higher than that in benign diseases(71.3?49.5)% and normal controls(82.4?41.3)%(P

Objective To evaluate the value of high frequency color Doppler ultrasound in diagnosis of malignant tumor in the parotid gland.Methods High frequency ultrasound was used to observe shape and internal echo texture of tumor,color Doppler flow imaging(CDFI) was added to observe blood flow signal,peak systolic velocity(PSV) and resistance index(RI) were measured by pulsed wave Doppler, and lymphonodus around parotid gland were examined.Results The features of ultrasonography included round,lobulated and irregular shape.Three types of boundary were clear but not smooth,unclear,irregular and invasive.Internal echo texture included low and irregualr echo,cystic echo,spot like and intensive echo,honey comb like echo.CDFI showed spet like,stick like blood flow signal.PSV and RI were 4.6 17.5 cm/s,and 0.69 1.14 .Eight cases were misdiagnosed for benign tumor,the correspondent rate was 87.1% .Conclusions The high frequency ultrasonogram of malignant tumor in the parotid gland were similar and specific,adding the CDFI,PSV,RI and lymphonodus examination around the parotid gland may help to improve the diagnostic accuracy.

Objective To study the long-term outcome of cardiac resynchronization therapy (CRT) in drug refractory heart failure patients through retrospective analysis and to ivestigate the underline reasons of unsuccessful cases in the study. Methods The study comprised a total of 48 patients (mean age 70?18.5 years; 83% male) with New York Heart Association class Ⅲ (86%) or class Ⅳ (14%) heart failure and LVEF≤35%. All patients fulfilled the standard CRT indications with the QRS duration ≥130 and LVEDd≥60 mm. Only one of the 48 patients was implanted with a combination of automatic implantable cardioverter-defibrillator and CRT device. The outcome of CRT was evaluated in terms of QRS duration, LVEF through echocardiography, 6 minute hall walk and tissue doppler echocardiography. Results Within a mean clinical follow-up of 29.0?7.5 month, the QRS duration was significantly shortened by biventricular pacing compared with right ventricular or left ventricular pacing. [(169?26) ms vs (188?40) ms and (222?34) ms vs (212?42) ms, respectively]. The NYHA functional class was improved from class Ⅲ-Ⅳ before the operation to class Ⅰ-Ⅱ at 1 week and 1 month during the follow up period. LVEF increased gradually from (28.30?3.94)% to (37.80?3.98)% after one week and increased to (42.99?7.87)% at the end of the follow-up. There was significant difference in LVEF before and 1 week after the operation (P

In top-quality course construction of medical ethics,it is necessary to attach importance to practical operation as well as the consistency of theoretical logic.To well adapt to the current medical practice and medical technical advances,the idea of medical ethics should include virtue,harmony and value.Virtue is the prominent concept in top-quality course construction of medical ethics.Harmony is the core idea of medical ethics,and value is the innovative idea to solve the questions caused by life technologies.Therefore,in the top-quality course construction of medical ethics,coordination and unification of the above three ideas must be maintained in order to defend the demonstration significance of top-quality course of medical ethics.