Objective To understand the change of transient bacteria on surface in clinical ward before and after terminal disin‐fection ,provide the basis for controlling of hospital infection .Methods Surface samples were collected before and after terminal dis‐infection in infected patch of our hospital ,and then bacterial in the samples were cultured and identified .Compared changes about number and type of samples bacterial ,distribution of common clinical pathogenic bacteria before and after of the terminal disinfec‐tion .Results The surface colony number < 10 CFU /cm2 accounted for 63 .54% after terminal disinfection ,compared with the dis‐infection before 56 .29% ,increased 7 .25 percentage points .Surface sampling microorganism detecting rate decreased by 6 .74% . Surface average bacteria colony had different degree decreased before and after disinfection ,except the bed frame and quilt cover . Water tap ,which was the largest amount of bacteria surface ,followed by the bedside table .Before and after disinfection ,the mainly common microorganism was environment bacteria in infected patch ,including coagulase negative staphylococcus ,gram positive ba‐cilli ,Micrococcus ,Acinetobacter spp .Clinical common pathogenic bacteria mainly isolated from the department of brain surgery (9 .49% ) ,department of hepatology(8 .76% ) ,department of dermatology (8 .76% ) ,department of pediatrics (8 .03% ) ,emergency department (7 .30% ) .Pathogenic bacteria living areas were mainly the bedside table (21 .17 % ) ,water tap (18 .25% ) ,bed rest (12 .41% ) .Conclusion Terminal disinfection could effectively reduce the number of bacteria in the infected patch ,improve the ward environmental sanitation quality ,it have an important significance in the prevention of hospital infection control .

Objective To study sex differences,in common risk factors,subtypes and outcomes in stroke.Methods 2912 patients hospitalized for stroke were evaluated for common risk factors,subtypes and outcomes data.Results Mean age was higher in women than in men(P

Objective To understand the homology of clinical isolates from patients with carbapenem-resistant Klebsiella pneumoniae(CRKP)infection and isolates from environment in a medical institution.Methods One CRKP strain isolated from a patient in this hospital and 4 strains of Klebsiella pneumoniae(K.pneumoniae)isolated from patient's surroundings were collected,susceptibility of 5 strains to commonly used antimicrobial agents was detected,production of carbapenems in 5 strains were detected by modified Hodge testing and carbapenem inactivation method(CIM),homology analysis was performed by pulsed-field gel electrophoresis(PFGE).Results Antimicrobial susceptibility testing results showed that 5 strains of K.pneumoniae(1 from patient,4 from the patient's ward surroundings,including hands of nursing aides,solution bottle opening,handle for lifting and dropping bed,and bedrail)were all resistant to other antimicrobial agents except to cephamycin and aminoglycosides.The modified Hodge testing and CIM confirmed that 5 strains all produced carbapenemases;PFGE results showed that electrophoretogram of CRKP isolated from solution bottle opening of ward,bedrail,and handle for lifting and dropping bed were the same as CRKP isolated from patient,while electrophoretogram of CRKP isolated from hands of nursing aides had 2 different bands,there was a close relationship between the strains.Conclusion The same type of CRKP were isolated from patient and his surroundings,it is necessary to implement healthcare-associated infection(HAI)control system,isolate infected patient,and strengthen environmental cleaning and disinfection,so as to avoid the outbreak of HAI.

Objective To assess the feasibility of applying intensity-modulated radiotherapy(IMRT)simultaneous integrated boost(SIB)to replace conventional radiotherapy(CR)plus brachytherapy of whole pelvis in locally advanced cervical eaneer(LACC).Methods Five LACC patients based difference position of uterus were chosen and worked out CR and IMRT SIB plans respectively.Dose distributions were compared between IMRT SIB and CR.Results When uterus was in ante-,neutral-,retro-pnsition and deviation respectively,IMRT SIB could provide enough and homogeneous dose distribution for target volume and reduce irradiated volumes and doses for organs at risk(recta,bladder and small intestine)than CR.The doses of the A,B,and fundus of uterus were higher in IMRT SIB than CR.However,in ease of small intestine was close to or encircled the uterus,the targets volume dose would be inadequacy.Conclusions LACC IMRT SIB's dose distribution is better than CR(except excess ante-position)and may help to treat those patients who couldn't be suitable with brachytherapy.

Objective To summarize the application of ATP bioluminescence assay in surveillance of terminal disinfection of effects ,so as to provide the basis for intervention of disinfected effects .Methods ATP bioluminescence assay were employed to randomly test the surfaces of operating objects in therapeutic rooms and beside tables in wards ,total 144 object surfaces ,of each clinical departments in the whole hospital .The values of ATP bioluminescence assay were read on‐site ,0-250 RLU was recognized as qualification ,while disqualification when >250 RLU .The disqualified object surfaces were performed on‐site intervention that all of them were re‐disinfected ,the results were compared .Results Both the surfaces of operating objects and beside tables were dis‐qualified before disinfection ,and the values of ATP bioluminescence assay were 780 ± 10 .34 RL and 853 ± 13 .29 RLU respectively . The pass rates of ATP bioluminescence assay was 61 .97% of operating surfaces and 79 .45% of beside table surfaces the first dis‐infection .The disqualified sites were retested following on‐site intervention .The values of ATP bioluminescence assay were 431 .02 ± 0 .53 before intervention and 1 .43 ± 0 .59 after intervention ,and the difference was statistically significant .Conclusion ATP bi‐oluminescence assay can get more immediately ,simple and timesaving in evaluating the effect of disinfection and estimate the effi‐ciency of disinfection timely ,which can also provide the scientific basis on on‐site intervention so as to improve the execution power of hospital infection management .

The mechanism of sudden cardiac death caused by variation in SCN5A is still unclear. Recently, the converging evidences suggest that the dysfunction of regulation mediated by transforming growth factor-β1 in cardiac fibration and reconstruction of cardiac iron channel could be main reason of SUNDS caused by variation of SCN5A. The resent progress of the mechanism of transforming growth factor-β1 in sudden cardiac death caused by variation of SCN5A gene is reviewed in this paper, hoping to provide reference for the research and practice of sudden cardiac death in forensic medicine.

OBJECTIVETo explore rest, cold compress and elevate (RICE) with rest, compress and elevate (RCE) without cold for the treatment of acute ankle sprain, in order to clear mid-term clinical effects.

METHODSEighty-nine patients with acute ankle sprains were collected from January 2013 to March 2014,including 30 males and 59 females aged from 18 to 60 years old with an average of 36 years old; the time from injury to hospital ranged from 3 to 24 h with an average of 9 h. All patients were divided into two groups according to visiting sequence. There were 45 patients in RICE group, and 45 patients in RCE groups. The main therapeutic effect index was evaluated by Karlsson scoring, and secondary therapeutic effect index was pain and satisfactory VAS scores. Safety index evaluated by adverse event.

RESULTSOn the 2nd weeks after injury, Karlsson score in RICE group was 44.66 ± 11.58, and 46.67 ± 8.52 in RCE group, while there was no statistical significance between two groups in Karlsson scores (P > 0.05). Karlsson score of two groups after treatment were higher than before treatment. There was no significantly meaning in pain and satisfactory VAS scores between two groups (P > 0.05). No adverse reaction were occurred between two groups.

CONCLUSIONCold compress did not receive much more final gains, and no evidence showed cold compress could affect recovery of joint function.

Acute Disease ; Adolescent ; Adult ; Ankle Injuries ; physiopathology ; therapy ; Case-Control Studies ; Cold Temperature ; Female ; Humans ; Male ; Middle Aged ; Sprains and Strains ; physiopathology ; therapy

A method was developed for analyzing the stable carbon isotope ratio of five volatile components ( Ethanol, Glycerol, Acetic acid, Ethyl lactate, 2-methyl-butanol ) in wine using gas chromatography-combustion-isotope ratio mass spectrometer ( GC-C-IRMS ) . The sample injection volume was less than 0. 5 μL, and the analytical time of each run was less than 14 min. The precision of this method was 0. 08‰-0. 25‰ for analyzing standards, while 0. 09‰-0. 36‰ for wine samples. Compared to element analysis-isotope ratio mass spectrometry ( EA-IRMS) results, the deviations were lower than 0. 5‰. Fifty-four wine samples from France, Australia, America and China were considered. The δ13 C of five volatile components were measured using GC-C-IRMS. Discriminant analysis ( DA) was employed for analyzing the geographical origin traceability of selected wine. The result indicated that δ13 C of volatile components could be used to distinguish the origin of wines. The method was shown to be effective in improving detection of the origin traceability of wine.

OBJECTIVE:To establish a method for simultaneous determination of residual methylparaben,ethylparaben,nipa-sol and benzalkonium chloride in marketed eye drops. METHODS:HPLC method was adopted. The determination was performed on Hypersil GOLD C18 column with mobile phase consisted of 0.005 mol/L ammonium acetate(10 mL triehtylamine in 1 L solu-tion,pH adjusted to 5.0±0.5 with glacial acetic acid)-acetonitrile(45:55,V/V)at the flow rate of 1.0 mL/min. The detection wave-length was 262 nm(methylparaben,ethylparaben,nipasol)and 214 nm(benzalkonium chloride),respectively. The column tem-perature was 30 ℃ and sample size was 20 μL. RESULTS:The linear range were 1.2350-15.4380 μg/mL for methylparaben(r=0.9999),1.3170-16.3836 μ g/mL for ethylparaben (r=0.9997),1.2072-15.0894 μ g/mL for nipasol (r=0.9996) and 17.776-222.0 μg/mL for benzalkonium chloride(r=0.9999),respectively. Limits of quantitation were 2.0,2.0,2.0,1.11 μg,re-spectively;limits of determination were 0.375,0.375,0.375,0.333 μg,respectively. RSDs of precision,stability and reproducibili-ty tests were all lower than 2.0%. The average recoveries were 98.14%-102.48%(RSD=1.6%,n=9),98.79%-102.42%(RSD=1.3%,n=9),98.19%-102.49%(RSD=1.5%,n=9)and 98.76%-100.53%(RSD=0.6%,n=9),respectively. CONCLUSIONS:The method is accurate,reproducible,simple and suitable for the determination of residual methylparaben,ethylparaben,nipasol and benzalkonium chloride in marketed eye drops.

Pancreatic cancer is a highly lethal disease in gastrointestinal malignant tumors.The mortality of pancreatic cancer closely parallels its incidence.Most patients with pancreatic cancer remain asymptomatic until the disease reaches an advanced stage.There is no program for screening patients at high risk of pancreatic cancer.Although CT,MRI,positron emission tomography,endoscopic ultrasonography,and endoscopic ultrasonography-guided fine-needle aspiration offer high diagnostic ability for pancreatic cancer,it cannot be found at the early stage easily.Surgical resection is regarded as the only potentially curative treatment and adjuvant chemotherapy is given after surgery.This article reviews epidemiology,risk factors,diagnosis and treatment for pancreatic cancer by summarizing relevant literature.