Objective:To explore and analyze application of the activity of quality control circle (QCC) in the management of disinfection for laparoscopic instruments.Methods: 1000 non-disinfected laparoscopic instruments of operating room were randomly divided into control group (n=500) and observation group (n=500). The laparoscopic instruments of control group received routine disinfection while that of observation group was implemented activity of QCC during they received routine disinfection. The occurrence rate of damage for instruments and special small component, qualified rate of disinfection, occurrence rate of adverse event and the problem solving ability of paramedic were compared after all of laparoscopic instruments were disinfected.Results:After received the activity of QCC, the damage rate of instruments, miss rate of special small components, loose rate of packaging and error rate of relative record of observation group were significantly lower than that of control group (x2=52.31,x2=64.49,x2=34.51, x2=79.00;P<0.05), and the qualified rate of disinfection in observation group was significantly higher than that of control group (x2=37.70,P<0.05). Besides, the occurrence rate of adverse event of observation group was significantly lower than that of control group (x2=1857.28,P<0.05).Conclusion:The activity of QCC is implemented in the management of disinfection for laparoscopic instruments can efficiently enhance the qualities of disinfection and care, and can enhance the working enthusiasm, responsibility and problem resolving ability of paramedic.

BACKGROUND: Micro-nano-sized modification of the material surface provides an effective way to enhance the endothelialization of cardiovascular implants. Shear stress plays an important role in the endothelialization of cardiovascular implants.OBJECTIVE: To review the effects of flow shear stress on endothelial cell cytoskeleton alignment, migration, adhesion and apoptosis on the micropatterned substrates.METHODS: The author performed a retrieval of PubMed and CNKI databases from 2002 to 2017 to search literatures about the effects of shear stress on endothelial cells on the micropatterned substrates. The keywords were micrometer topology, micropattern, flow shear stress, endothelial cells in English and Chinese, respectively.RESULTS AND CONCLUSION: The shear stress parallel to the long axis of the micropattern which is applied to the endothelial cells on micropatterned substrates promotes endothelial cell microfilaments alignment along the long axis direction of micropattern, strengthens endothelial cell migration along the flow direction, increases the level of FAK phosphorylation, enhances endothelial cell adhesion, and improves endothelial cell activity. However, there are some controversies on the effects of parallel shear stress on the microtubule arrangement of endothelial cells on micropatterned substrates. Some studies have reported that parallel shear stress promotes endothelial cell microtubules alignment along the long axis of micropatterns. But others have found that parallel shear stress has no effect on endothelial cell microtubule arrangement. There are different conclusions about the effects of shear stress perpendicular to the long axis of the micropattern on endothelial cells on the micropatterned substrates. Some literatures have found vertical shear stress destroys the structure of endothelial cell microfilaments and microtubules,weakens the degree of microfilaments and microtubules arranged along the long axis of micropatterns, and attenuates endothelial cell adhesion and cell activity. But some have found vertical shear stress does not destroy the structure and alignment of endothelial cell microfilaments and microtubules, and still can promote endothelial cell migration along the flow direction. The magnitude of shear force affects endothelial cell migration, and the number of endothelial cells on the micropatterned substrates migrating along the flow direction increases with the increasing intensity of shear stress.

Objective: To investigate the biological phenotype and cell cycle distribution characteristics of nasal and/or nasopharyngeal epithelia of TgN(p53mt-LMP1)/HT mice.Methods: The biological phenotype changes(mainly the incidence of precancerous lesion) in nasal and nasopharyngeal epithelial tissues of the generation G4 of TgN(p53mt-LMP1)/HT mice aged 5,11,15 and 18 months were determined by H-E staining,and the cell cycle characteristics of nasal and nasopharyngeal epithelia detected by flow cytometry(FCM).Results: The incidences of precancerous lesion in the nasal and nasopharyngeal epithelia were 0,50%,60% and 75% respectively in the 5,11,15 and 18 mos groups of the positively expressed transgenic mice,and 0 in the four age groups of the negatively expressed ones.Compared with the negatively expressed transgenic mice,the number of nasal or nasopharyngeal epithelial cells was markedly decreased in the G0/G1 phase,but obviously increased in the S and G2/M phases,with the proliferation index(PI) significantly enhanced(P

Objective To retrospectively explore the incidence and causes of apnea after operation for retinopathy of prematurity(ROP). Methods The clinical data of 17 premature infants with operation for ROP(ROP group)and the other 23 premature infants without ROP(control group)were collected.The occurrence of apnea(time of onset and remission and original diseases) was recorded after operation in ROP group and at adjusted 37 weeks of gestational age in control group.Follow-up was conducted for 4 weeks,and the prevalences of apnea were compared between these two groups.Results There was significant difference in prevalenees of apnea between ROP group and control group ( 52.9%vs 21.7%,P<0.05).In ROP group,time of occurrence of apnea was (38±40)h after operation,and time of remission was (126±145)h after onset.Among the infants with apnea,there were 3 cases of pneumonia(33.3%),1 case of hypoglycemia(11.1%)and 5 cases with unexplained causes(55.5%). Conclusion Infants after operation for ROP are more prone to apnea,and pediatricians and ophthalmologists are required to collaborate in the perioperative care.

Objective To analyze the change in the concentration of IL-17 and IL-10 inflammatory factors among the deadaptation personnel who returned from the plateau.Methods A total 21 healthy males were investigated who averaged 25 years in age, lived permanently in the plains (200 m), and once stayed to the plateau (Lasha) for 6 months.Their venous blood was collected at three time points:the day before ascending to the plateau(control), the second day after return to the plains(d2) and the 30th day(d30), respectively.Their serum was seperated from the whole blood and the level of IL-17A and IL-10 was detected by ELISA method.Results The concentration of IL-17A and the IL-17A/IL-10 ratio were significant increased at d2 and d30, respectively, compared with control (P<0.05).Compared with d2, IL-17A and the IL-17A/IL-10 ratio were decreased obviously at d30(P <0.05).The level of IL-10 at d2 and d30 was significantly reduced compared with control ( P <0.05), but increased at d30 compared with d2.Correlative analysis showed that there was a negative correlation in the levels of IL-10 and IL-17A between control, d2 and d30, respectively (r1=0.948, P<0.05;r2=0.969, P<0.05;r3=0.972, P<0.05).A significant negative correlation was observed in the alteration levels of IL-10 and IL-17A between the three groups(r4=-0.793, P<0.05; r5=-0.756, P<0.05). Conclusion The concentration of inflammatory factors among the plateau deadaptation patients is imbalanced, but it is gradually reduced with time.The mechanism is still not clear.

Objective To understand the dynamic changes of snail situation and wild faeces pollution in marshlands in the pilot areas after leveling embankment for flood running and moving people from outside embankment to town for providing the scientific basis of schistosomiasis control in the same type areas. Methods Shishou City,Jiangxia District,Tuanfeng County and Huangzhou District were selected as the pilot areas. Snails were surveyed by the systematic and environmental sampling. Wild faeces were also investigated. The data were processed by Excel. Results Snail areas in Huangzhou Yeluzhou increased by 12.71%,in the others it did not change. For the snail density,there was a decline trend in Jiangxia Sanjiaozhou from 1999 to 2001,but it increased in 2002 obviously;in Huangzhou Yeluzhou it decreased in 2000,but increased again from 2001 to 2002;in Tuanfeng Luohuozhou it was fluctuation;it did not change in Shishou Fuxingzhou. Except Shishou City,the other three sites had infected snails distribution. The densities of wild faeces in the pilot areas were 1.14～15.60/hm~2. The positive rates of wild faeces were 1.35%～37.21%. Conclusion The marshlands in pilot areas were seriously polluted by wild faeces. There seemed to be an increase trend in the snail density. Snail areas did not change significantly in the last few years. However,the high transmission areas will expand. So the snail survey and snail control should be strengthened.

Aim To study the antitumor and immunological regulation effects of ardipusilloside-Ⅰ(ADS-Ⅰ) on tumor-bearing mice of S180, H22, EAC and L1210. Methods The tumor-bearing mouse model was made through injecting cancer cells in the right limb oxter(or in abdominal cavity), and the mice were administrated orally with ADS-Ⅰfor 8 days. Then we detached the tumor and counted the inhibition rate of tumor growth. Incorporation of ()~3H-TdR was used to assess the proliferation of T spleen lymphocyte cells; phagocytosis of abdominal cavity macrophage was measured with the method of chicken red blood cells. Results ADS-Ⅰ was proved to be effective on the tumor-bearing mice of S180, H22 and EAC, and the maximal inhibition rate of the dose of 100 mg?kg~(-1) was 38.7%, 48.6% and 50.0%, respectively;ADS-Ⅰ promoted the proliferation of T spleen lymphocyte cells,and strengthened the phagocytosis of macrophage in the tumor-bearing mice significantly. Conclusion ADS-Ⅰ can inhibit the growth of transplanted tumor,and improve the immunological function of tumor-bearing mice.

OBJECTIVETo observe the preventive effects of multi-glycoside of Tripterygium wilfordii (GTW) on glomerular lesions in experimental diabetic nephropathy (DN).

METHODThe DN model of rats was established with streptozotocin (STZ) and intervened with GTW. In the same time, normal, benazepril, and vehicle control groups were set up. After 8 weeks of oral treatment with GTW (50 mg x kg(-1) BW), benazepril (6 mg x kg(-1) BW), and vehicle (physiological saline), the changes of body weight, urine albumin (UA1b), blood glucose (BG), serum creatinine (Scr), blood urea nitrogen (BUN) and glomerular morphology were examined. In addition, the level of protein expression of alpha-smooth muscle actin (alpha-SMA) and collagen type I in glomeruli was determined by immunofluorescence.

RESULTBoth GTW and benazepril reduced UA1b. GTW ameliorated glomerular injury, such as mesangial cell proliferation, alpha-SMA and collagen type I over-expression, in DN model. Compared with benazepril, beneficial effects of GTW on glomerulusclerosis were more significant (total cell number: GTW group 54.44 +/- 2.41, benazepril group microg/67.83 +/- 4.41, P < 0.05; alpha-SMA score: GTW group 1.98 +/- 0.52, benazepril group 2.27 +/- 0.46, P < 0.05; collagen type I score: GTW group 2.11 +/- 0.37, benazepril group 2.88 +/- 0.58, P < 0.05).

CONCLUSIONPreventive effects of GTW on glomerular lesion in DN model are related to decreasing UA1b and ameliorating glomerulusclerosis.

Animals ; Diabetic Nephropathies ; drug therapy ; metabolism ; prevention & control ; Disease Models, Animal ; Glycosides ; administration & dosage ; Humans ; Kidney Glomerulus ; drug effects ; injuries ; metabolism ; Male ; Plant Extracts ; administration & dosage ; Random Allocation ; Rats ; Tripterygium ; chemistry

Objective To study the clinical features and risk factors of acute pulmonary reperfusion injury after operation in neonates with severe pulmonary stenosis or pulmonary atresia.Method From February 2014 to February 2018,a retrospective analysis was performed in patients with critical pulmonary stenosis or pulmonary atresia who received percutaneous balloon pulmonary valvuloplasty (PBPV) in the neonatal intensive care unit of our hospital.Clinical characteristics,perioperative cardiac structure,hemodynamic data and biochemical results were collected.The neonates were assigned into injury group if they had acute lung reperfusion injury,and non-injury group if not.The risk factors of acute lung reperfusion injury were analyzed using multi-variate Logistic regression model.Result A total of 32 patients (24 prenatal diagnosis and 8 postnatal diagnosis) with severe pulmonary stenosis or pulmonary atresia with intact ventricular septum were enrolled.The main manifestations were dyspnea and cyanosis.Intravenous prostaglandin E was administered to keep the ductus arteriosus open.The age of operation ranged from 1 to 52 days and the median age was 7.5 days.Postoperative acute lung reperfusion injury occurred in 7 cases (21.9％).Preoperative and intraoperative pulmonary valve annulus diameter,balloon diameter,preoperative hemoglobin,hematocrit and blood albumin were significantly lower in the injury group.The operation duration,total length of hospital stay and postoperative duration were longer than in the non-injury group,the differences were statistically significant (P ＜ 0.05).Multi-variate Logistic regression analysis showed that the diameter of pulmonary valve annulus (OR =5.814,95％CI 1.106 ～30.568),preoperative blood albumin (OR =1.361,95％ CI 1.063 ～ 1.742),and hematocrit (OR =1.173,95％ CI 1.010 ～ 1.363) were risk factors of acute lung reperfusion injury,with statistically significant differences (P ＜ 0.05).Conclusion Acute lung reperfusion injury is one of the common complications after the operation of severe pulmonary stenosis or pulmonary atresia.The severity of pulmonary valve annulus stenosis,preoperative hematocrit and blood albumin level may be the risk factors of postoperative acute lung reperfusion injury.

Objective:To assess the value of acoustic radiation force impulse (ARFI) elastography in the diagnosis of children with biliary atresia.Methods:A prospective survey of infants with hepatitis syndrome and hyperbi-lirubinemia in Xinhua Hospital Affiliated to Shanghai Jiaotong University School of Medicine from January 2017 to December 2018 was performed.The children with hepatitis syndrome were divided into the biliary atresia group( n=45) and non- biliary atresia group( n=30). Thirty children with hyperbilirubinemia were selected as the control group.Shear wave speed (SWS) of all infants was collected by ARFI ultrasound and compared among 3 groups.Receiver ope-rating characteristic curve(ROC curve) was used to analyze the optimal threshold value for SWS in the diagnosis of biliary atresia. Results:The mean SWS values in the biliary atresia group, non-biliary atresia group and the control group were (1.79±0.29) m/s, (1.26±0.12) m/s and (1.08±0.06) m/s, respectively.Compared with the control group, the mean SWS values in the biliary atresia group and non-biliary atresia group were significantly higher ( t=165.43, 15.75, all P<0.05). The mean SWS value in the non-biliary atresia group was significantly lower than that in the biliary atresia group ( t=90.27, P<0.05). With the non-biliary atresia group as reference, the area under the ROC curve of SWS for diagnosis of biliary atresia was 0.98(95% CI: 0.95-1.00), the optimal threshold was 1.45 m/s, and the sensitivity and specificity were 88.9% and 96.7%, respectively. Conclusions:Rapid non-invasive ARFI elastography is effective in the diagnosis of biliary atresia, and thus has important value for early diagnosis and treatment in clinical practice.