OBJECTIVE To observe the efficiency of new low-temperature sterilization method using(hydrogen) peroxide gas plasma sterilization system.METHODS The hydrogen peroxide gas plasma sterilization system of STERRAD 100S was monitored for 157 sterilization cycles.RESULTS From them 134 cycles were(completed,) 23 cycles were(cancelled.) All cycles were completed with negative results either in biological culture or in chemical indicators.CONCLUSIONS The STERRAD Sterilization System involves the combined use of hydrogen peroxide and low-temperature gas plasma to sterilize most medical devices and materials rapidly and safely without leaving any toxic residues.As nursing develops,the new sterilization system is efficient and convenient.However,it also has own limitations.Therefore,it is desirable to fully understand the normal procedure of system according to the operation instruction.

Objective To investigate the value of Kugel patch for elderly patients with recurrent inguinal hernia.Methods From February 2004 to February 2007,37 elderly patients with recurrent inguinal hernia received surgical treatment in our hospital.The patients were divided into two groups according to the surgical methods.Twenty-one patients,including 17 cases of unilateral indirect inguinal hernia,1 bilateral indirect hernia,1 direct hernia,1 indirect hernia complicated with femoral hernia,and 1 indirect hernia complicated with direct hernia,received hernia repair with Kugel patch via the posterior approach.The other 16 patients,including 15 cases of unilateral indirect hernia and 1 case of direct hernia,were treated with TAPP.Results The operation time in the Kugel group was significantly shorter than that in the TAPP group [(23.2?5.8) min vs(40.5?5.2) min,t=-9.392,P=0.000].In the TAPP group,2 patients complained of surgical-site pain or tension,while no patient in the Kugel group had the symptoms(?2=0.869,P=0.351).The mean hospital stay in the Kugel group was shorter than that in the TAPP group [(5.7?0.7)d vs(6.3?0.8) d;t=-2.429,P=0.020].The patients were followed up for 3-36 months,none of them had recurrence.Conclusions As an new,non-tension,safe,and minimally invasive method,hernia repair using Kugel patch through the posterior approach is of great advantage to elderly patients.The method is worth being used widely.

The metabolic syndrome leading to cerebrovascular disease attracts more and more attention by the medical circle,and its exact nosogenesis is not clear.There is no effective therapeutic method for this disease either.The author believes phlegm and blood stasis being the key factors for metaboric syndrome.Clinically,the author got good effects by treating the disease according to the different nosogenesis and stages of disease.

Objective To explore the puerperal mode of muliparas re-pregnancy, accumulate the clinical experience. Methods 490 multiparas' puerperal mode were analyzed as study group,and compared with 1600 prima-ry pregnancy at the same stage; compared the puerperal mode, the cesarean section rate and the rate of maerosoma. Results Re-pregnancy mtthiparas' vaginal delivery 385 examples, CS 105 examples,CS rate 21.4%, meanwhile the primary pregnancy's vaginal delivery 1200 examples,CS 400 examples,CS rate 25% ,no statistical difference(P>0.05). CS rate was directly proportional to the away time from last delivery. Conclusion CS rate had no remarkable difference between multiparas and primary pregnancy. Mainly CS indication is fetal distress, CS rate directly response to the time interval to last delivery. Macrosoma rate is high in muhiparas by well-fed. Multiparas had low CS rate with macrosoma.

Objective To explore the morbidity, risk factors and nursing of ventilator-associated pneumonia (VAP) in comprehensive ICU. Methods It was a retrospective survey. 98 mechanical ventilation (＞ 48 h) patients from Jan to Dec, 2009 in comprehensive ICU were reviewed using questionnaires to collect the clinical data. They were divided into the VAP and the non-VAP group. Several statistically significant risk factors were screened out with univarite analysis, then independent risk factors were determined with multiple Logistic regression. Results The morbidity of VAP was 35.7%. Univariate analysis showed that the level of APACHE Ⅱ score, duration of mechanical ventilation, whether primary lung disease, whether acid-suppressing agents, whether the semi-supine, whether accidental tube removal, oral care approach, whether attracted to subglottic were statistically significant risk factors of VAP. While multivariate Logistic regression analysis showed that the duration of mechanical ventilation, whether the semi- supine,whether attracted to subglottic were the major risk factors of VAP. Conclusions The occurrence of VAP is related with multiple factors. Application of comprehensive prevention strategies in accordance with these risk factors of VAP can reduce the morbidity of VAP effectively.

AIM: To find safe and effective bio-antimutagenic resources for the prevention of tumor. METHODS: The antimutagenic effect of PME on benzo-(a)-pyrene (B(a)P) was studied by the revised Ames test. RESULTS: PME could significantly inhibit the mutagenicity of B(a)P (P

36 mm?Hg. No permanent cardiac pacemaker was implanted. Transit trifascicular was seen in 3 cases, of whom, 2 disappeared with 1 hour after the procedure and, 1 trifascicular disappeared with 3 days. Permanent branch blocks were demonstrated in 36% patients. Conclusion PTSMA was feasible for HOCM with controllable complications. Precise position was the key point to prevent the alcohol leakage which will induce large area myocardial infarction and cardiac shock. Further study was needed to appreciate the more long-term follow-up.

Objective To use the new technique of seeding cells labeled with fluorescent protein for monitoring the construction process of tissue-engineering bone in vitro.Methods Human bone marrow stromal cells(BMSCs)were isolated and culture-expanded from femoral marrow.BMSCs were transfected with the recombinant retrovirus pLEGFP-Nl containing enhanced green fluorescent protein(EGFP).Those expressing EGFP were cultured in the experiment groups,and the unmarked BMSCs were in the control groups.The cell-scaffold complexes were constructed with BMSCs and hydroxyapatite in vitro.Some complexes were used to assess the adhesion efficiency and the others were cultured and observed under fluorescence microscope for four weeks.Results EGFP was successfully expressed after BMSCs were transfected with the retroviral vector pLEGFP-N1.The labeled cells were easy to observe while the cell-scaffold complexes were constructed and cultured.The adhesion efficiency was(90.3?2.1)%for the group of labeled BMSCs and(92.0?1.5)%for the control group,so there was no significant difference between the two groups(P=0.236).Conclusions After BMSCs are transfected with the recombinant retrovirus containing EGFP,the adhesion of cells will hardly be affected so that seeding cells labeled with fluorescent protein can well be used for monitoring the construction and culture of tissue-engineering bone in vitro.

Objective To investigate the factors in association with colorectal disorders in adult recipients of liver allograft. Methods A retrospective cohort study was carried out with clinical, microbiological and management data regarding diarrhea in 218 adult recipients of liver allograft from Jan. 2003 to Dec. 2006. Results Of the 218 patients, 68(31.2%) of them, who did not history of ulcerative colitis, were found to have diarrhea after orthotopic liver transplantation. Among these 68 patients, diarrhea was probably caused by administration of immunosuppressive agents in 35 cases (51.4%), in 12 cases (17.6%) diarrhea was antibiotics associated, and in 5 cases (7.4%) it was due to intraperitoneal infection. The other pathogenic factors included fungal infection in 3 cases (4.4%), cytomegalovirus infection in 3 cases (4.4%), Roux-en-Y choledochojejunostomy in 8 cases (11.8%) and some other unknown problem related in 2 cases (2.9%). Diarrhea occurred soon after transplantation in most cases. Of the 68 patients, the symptom of diarrhea occurred in the first 2 months in 45 cases (66.2%), and in the next 4 months in 23 cases (33.8%), i.e. the symptoms occurred 5-180 days after transplantation. Conclusion Immunosuppressive agents, antibiotics, fungal infection and cytomegalovirus infection are the top four common causes of diarrhea after orthotopic liver transplantation. The outcome is good with appropriate conservative management.