OBJECTIVE To transfer the dispersing management non-disposable medical instrument packages into the centralized management by the supply department,to improve its quality and save the medical cost.METHODS The centralized management adopted the step by step implementation strategy,standardized recycling,cleaning,and packaging procedure for key instruments.The cleanliness and integrity of the packaging sheet,the in-packet indicator cards and the out-packet label,and instrument and their human and material resources consumption were compared each other.RESULTS Under the centralized management,the cleanliness and integrity of packaging sheet,the wholeness indicator cards in packet and outside packet of instrument label were obviously better than dispersing management(P

OBJECTIVE To analyze the incidence and relevant factors of hospital infection of newborn baby in a mother with own baby room,to put forward the corresponding nursing countermeasures,as a result,and to probe into the nursing ways for decreasing the incidence of hospital infection of newborn baby in the same conditions.METHODS A retrospective analysis was made on the monitoring material concerning the hospital infection of newborn babies,who were born in our hospital from 2001 to 2005,in a mother with own baby room.RESULTS The average sick rate of hospital infection of newborn baby in the same conditions was 1.12%.Among them,3.10% was in 2001,1.62% in 2002,1.09% in 2003,0.32% in 2004 and 0.05% was in 2005.And the most was respiratory tract infection,in which the key pathogen causing the infection was Staphylococcus epidermidis.CONCLUSIONS In order to decline the sick rate of hospital infection of newborn baby living in a mother with own baby room,room conditions should be carried out by air disinfection,using disinfected nursing articles and simultaneously doing well the respiratory tract nursing and basic nursing.

Objective:To observe autophagy in human peripheral blood T lymphocyte.Methods:Peripheral blood T lymphocytes of healthy adults were separated with Percoll(1.073 g/ml) and harvested by using nylon column. The cultured cells were divided into control and dexamethasone(DXM) group, and cell morphology was observed through light microscope, electron microscope and fluorescent microscope at 0 and 72 h. And incidence rate of autophagy was analyzed by flow cytometry.Results:①The natural cultured T lymphocytes showed typical morphology of autophagy. ②There was significant statistic difference between 0 and 72 h incidence rate of autophagic T lymphocyte in both control and DXM group. ③There was significant statistic difference in 72 h incidence rate of autophagic T lymphocyte between control and DXM group.Conclusion:Autophagy can be seen in human peripheral blood T lymphocytes, and DXM could induce autophagy.

Accidents, Occupational ; prevention & control ; Humans ; Metals ; poisoning

ObjectiveTo study streptococcus pneumonia capsular polysaccharide antibodies of patients with chronic obstructive pulmonary disease(COPD) in acute exacerbation and the feasibility of vaccination for patients with COPD.MethodsThe COPD in acute exacerbation without respiratory failure (RF)(COPD without RF group),COPD in acute exacerbation with RF (COPD with RF group),asthma (asthma group),healthy elderly examination(elderly examination group) and healthy youth examination (youth examination group) were selected,and each group had 15 cases.The levels of streptococcus pneumonia capsular polysaccharide antibodies IgG,IgM and IgA were measured in all groups.Results There was no significant difference in IgG among the five groups (P ＞ 0.05 ).The levels of IgM in COPD without RF group and elderly examination group were significantly lower than those in COPD with RF group,asthma group and youth examination group (0.554 ± 0.309 and 0.538 ± 0.327 vs.0.810 ± 0.387,0.887 ± 0.278 and 0.852 ± 0.305,P ＜ 0.05 ).Although the level of IgA in COPD without RF group was significantly lower than that in youth examination group(0.532 ±0.297 vs.0.930 ±0.502,P ＜0.05),there was no significant difference among the five groups.Conclusion Patients with COPD should inoculate pneumococcal vaccination.

Objective To characterize clinical features,antimicrobial susceptibility and the outcome of nosocomial Acinetobacter baumannii meningitis.Methods All patients with nosocomial meningitis due to Acinetobacter baumannii in 2nd Affiliated Hospital Medical School of Zhejiang University between January 2010 and October 2011 were retrospectively reviewed.Results During the study period,40 patients of this nosocomial infection were identified,who came from neurosurgery ward (19 cases,47.5％),neurosurgieal intensive care unit (18 cases,45.0％),emergency intensive care unit (2 cases,5.0％) or intensive care unit (1 case,2.5％).All the patients had a history of recent neurosurgical procedures. Fever and disturbance of consciousness were the major manifestations,and cerebrospinal fluid examination showed elevated white blood ceil count and protein,and reduced glucose.All isolated pathogens were resistant to the first line antibiotics.The fatality rate was high. Conclusions The most common risk factor for nosocomial Acinetobacter baumannii meningitis is neurosurgery. Resistance to the first line antibiotics is common among all pathogens isolated.The prognosis of the meningitis is poor.

Polyglandular autoimmune syndromes (PAS) comprises a wide spectrum of autoimmune disorders for autoimmune inflammatory to invade.According to age of presentation,characteristic patterns of disease combinations,and different modes of inheritance,PAS are classified into four subtypes.Actual diagnosis of PAS involves clinical syndromes,serological measurement of organ-specific autoantibodies and subsequent functional testing.Principles of treatment included comprehensive assessment,hormone replacement,general consideration.

ObjectiveTo compare the sensitivity among three diagnostic criteria for multiple myeloma.MethodsA total of 220 patients with multiple myeloma were studied retrospectively to compare thesensitivity, aswellastheirclinicalmanifestations, cellmorphologyinbonemarrowand immunophenotype.Results (1) The sensitivity of domestic diagnostic criterion in 1975 was 79.1％ (174/220) and there were some drawbacks in type identify.The sensitivity of WHO diagnostic criterion in 2001 was 97.3％ (214/220) and the sensitivity of domestic diagnostic criteria in 2011 was 100％. (2) Immunoglobulin level in 12.7％ (28/220) patients was ＜ 30 g/L,plasma cells count in bone marrow in 13.6％ (30/220) was ＜ 10％ ; 2.7％ (6/220) patients had not met the standard in immunity globulin and bone marrow plasma cells count.(3) The immunophenotype was CD38 positive ( 100％ ),restricted light chain (kappa/lambda) and CD19 100％,CD138 (98.2％,216/220) negative.ConclusionsAmong the three diagnostic criteria,the highest was 2011 domestic diagnostic criteria.Comprehensive analysis include clinical manifestations,cell morphology,immunophenotype will contribute to the diagnosis for multiple myeloma.

Objective:To analyze the clinical therapeutic effect and safety of large dosage of valsartan on chronic heart failure (CHF).Methods:A total of 106 CHF patients hospitalized in our department were chosen and ran-domly divided into routine dose group (n=53,received routine dosage of valsartan,80mg,once/d)and large dose group (n=53,received large dosage of valsartan,80mg,twice/d)accerding to number table.Both groups received anti-heart failure treatment for six months according to the guidelines.After treatment,plasma N terminal pro brain natriuretic peptide (NT-proBNP)level was measured,left ventricular end-systolic diameter (LVESd),left ventricu-lar end-diastolic diameter (LVEDd),interventricular septal thickness (IVST)and left ventricular posterior wall thickness (LVPWT)were measured by color Doppler echocardiography,and all patients received 6min walking test. Therapeutic effect and incidence rates of adverse reactions were compared and analyzed between two groups after treatment.Results: Compared with routine dose group,there were significant reductions in NT-proBNP level [(3042.6±116.3)pmol/L vs.(2565.8±98.2)pmol/L],LVESd [(34.5±2.2)mm vs.(29.4± 2.0)mm], LVEDd [(55.1±2.9)mm vs.(50.2±2.5)mm],IVST [(12.9±1.8)mm vs.(10.7±1.2)mm]and LVPWT [(11.8±1.1)mm vs.(10.9±0.9)mm];significant rise in 6min walking distance [(271.2±24.9)m vs.(367.7 ±22.3)m]and total effective rate (43.40% vs.62.26%)in large dose group,P <0.05 all.There was no signifi-cant difference in incidence rates of major adverse reactions between two groups (P >0.05).Conclusion:Large dos-age of valsartan is more effective and is safe in treatment of chronic heart failure.

Objective To explore the clinical significance of C-reaction protein ( CRP ) and D-Dimer levels in patients with acute exacerbation of chronic obstructive pulmonary disease ( AECOPD ) complicated by pulmonary hypertension (PH) and their association with HP. Methods Arterial blood gas and levels of CRP and D-Dimer were detected in 150 patients with AECOPD. Results Levels of CRP, D-Dimer, and PaCO2 were higher but PO2 level was lower in patients with moderate to severe PH than those with mild PH and the control subjects. Levels of CRP and D-Dimer were higher in patients with mild PH than the control subjects. Levels of CRP, D-Dimer, and PCO2 levels had a linear relationship with PASP, while PO2 was negatively correlated with PASP. Levels of CRP and D-Dimer were positively related with PCO2, while were negatively correlated with PO2. Conclusions Levels of CRP and D-Dimer can be used as an indicator for estimating the severity of pulmonary hypertension in patients with AECOPD.