OBJECTIVE To strengthen the hospital infection management in community health service centers,in order to reduce the onset of hospital infection.METHODS According to Hospital infection administration regnltions and Shenzhen medical service hospital infection control quality evaluation management demands we had investigated and evaluated the hospital infection management in 9 community health service centers.RESULTS The monitoring,surveillance and management of hospital infection in community health service centers as a quality evaluation index of hospital medical service still had many problems,it should further enhance the quality in the field of administration management,sterilization and disinfection,surveillance and sevage treatment.CONCLUSIONS The hospital infection management in community health service centers is a part of whole hospital medical service,but their quality at present is weak.To strengthen the hospital infection management is important to guarantee the medical service quality and medical care safety.

BACKGROUND:Different mechanical stimulations may have an effect on the level of metabolism of chondrocytes, but the effect is not clear.
OBJECTIVE:To investigate expression level changes in metabolic genes that participate in cartilage cel decomposition and synthesis under compressive stress and tensile stress conditions.
METHODS:We obtained articular chondrocytes from 2-week-old Sprague-Dawley rats. Primary cultured chondrocytes were identified. Passage one chondrocytes received cyclic tensile stress and cyclic compressive stress of 3%and 7%, respectively, so as to measure articular changes in chondrocytes-related genes.
RESULTS AND CONCLUSION:When chondrocytes were subjected to cyclic tensile stress of 3%, synthetic metabolic gene col agen types I and II and proteoglycan mRNA expression levels were decreased. If 3%cyclic compressive stress was applied, proteoglycan mRNA expression levels were increased, and type I col agen mRNA expression levels were decreased (P<0.001), and matrix metal oproteinase-13 mRNA expression levels were reduced (P<0.01). When strain reached 7%, cyclic tensile stress and compressive stress could lead to a general decrease in anabolism-related genes. The former could also make matrix metal oproteinase-13 mRNA expression levels increased (P<0.05). 3%cyclic compression ratio and 3%cyclic stretch made cytoskeleton become oval. These results indicated that in vitro, proper cyclic compressive stress is beneficial to maintain the growth characteristics of articular chondrocytes in rats. Smal tensile stress can decrease the synthesis ability of chondrocytes. The effect of stress may be caused by changing the cytoskeleton.

Under normal conditions,insulin secreted by the pancreas enters the liver through the portal vein,forming a difference in insulin concentration above the peripheral circulation.Subcutaneous administration of insulin forms a portal-peripheral concentration gradient of insulin above the liver,which is inconsistent with normal physiological conditions.Intraperitoneal insulin administration has been extensively investigated because that is closer to physiological state.In this paper,the pharmacokinetic and pharmacodynamic studies of insulin intraperitoneal administration were reviewed.Compared with the conventional subcutaneous delivery,intraperitoneal insulin administration can not only reduce the incidence of hypoglycemia,but also has the advantage of correcting abnormal lipid metabolism.This means that intraperitoneal administration of insulin has a positive effect on the prevention and treatment of diabetic complications.Therefore,it is necessary and feasible to develop a safe,low-cost,and easy-to-use percutaneous intraperitoneal insulin delivery device.

This article reported a case of kaposiform lymphangiomatosis (KLA) identified in the fetal stage and diagnosed at the neonatal stage. A routine ultrasound examination at 19 weeks of gestation showed multiple masses in the whole body of the fetus (involving neck, chest wall and armpit) complicated by pleural and peritoneal effusion. Shunting was performed to drain pleural effusion from the right chest in another hospital at 26 +5 weeks of gestation. The patient was born at 34 +3 weeks of gestation by cesarean section due to "intrauterine distress" and required invasive ventilator assisted ventilation support after birth because of respiratory distress. A large amount of hemorrhagic effusion was drained out during the shunting. Coagulation dysfunction and thrombocytopenia occurred on the 3rd day after birth and KLA was suspected. Empirical treatment with sirolimus turned out to be ineffective. Biopsy was taken on postnatal day 7. However, the patient died on the 12th day after birth due to respiratory and circulatory failure. Pathological findings obtained the day after death were consistent with the features of KLA. The diagnosis of KLA was confirmed based on the clinical manifestations and pathological results.

Objective:To investigate the application value of Overlap guiding tube (OGT) in Overlap esophagojejunostomy of laparoscopic total gastrectomy.Methods:The retrospective and descriptive study was conducted. The clinicopathological data of 5 patients with gastric cancer who were admitted to Nanfang Hospital of Southern Medical University from June to July in 2021 were collected. There were 3 males and 2 females, aged from 48 to 61 years, with a median age of 54 years. Patients underwent laparoscopic total gastrectomy combined with OGT-assisted Overlap esophagojejunostomy. Observation indicators: (1) surgical situations; (2) postoperative situations; (3) follow-up. Follow-up was conducted by outpatient examination and telephone interview to detect postoperative anastomotic stenosis and esophageal reflux up to September 2021. Measurement data with normal distribution were represented as Mean± SD, and measurement data with skewed distribution were represented as M(IQR) or M(range). Count data were represented as absolute numbers. Results:(1) Surgical situations: 5 patients underwent laparoscopic total gastrectomy combined with OGT-assisted Overlap esophagojejunostomy and D 2 lymph node dissection success-fully, achieving R 0 resection. There was no combined organ resection, intraoperative conversion to laparotomy or combined thoracotomy. There was no intraoperative conversion to other esophagoje-junostomy method either. The tumor diameter, length of surgical incision, the number of lymph nodes dissected, time of esophagojejunal anastomosis, time of digestive reconstruction, operation time, volume of intraoperative blood loss of 5 patients were 3.0(2.8)cm, 5.0(2.0)cm, 47.0(21.0), 21.0(5.0)minutes, 62.0(23.0)minutes, 295.0(75.0)minutes, and 50.0(60.0)mL, respectively. The anvil fork of linear stapler was successfully inserted into esophageal lumen by once operation in 4 cases of 5 patients and by twice operation in 1 case to complete the esophagojejunostomy. (2) Post-operative situations: the time to first out-of-bed activities, time to postoperative first anal flatus, time to postoperative initial liquid diet intake, time to postoperative initial semi-liquid diet intake, time to abdominal drainage tube removal, duration of postoperative hospital stay of 5 patients were 2.0(1.0)days, 3.0(2.0)days, 4.0(3.0)days, 6.0(3.0)days, 7.0(4.0)days, and 9.0(6.0)days, respectively. Results of postoperative pathological examination of 5 patients showed gastric adenocar-cinoma in all the 5 patients, with the TNM staging as stage pT2-4aN0M0. The esophageal surgical margin was negative in all cases, and the length of proximal margin from esophagus was 5.0(4.0)cm. None of the 5 patients developed anastomotic leakage, anastomotic bleeding or anastomotic stenosis. Two cases with mild pneumonia (Clavien-Dindo grade Ⅱ) were cured by conservative treatment such as anti-infection and expectoration promotion. There was no unplanned secondary surgery or perioperative death occurred to the 5 patients. (3) Follow-up: 5 patients were followed up for 3 months. None of the 5 patients developed anastomotic stenosis or esophageal reflux during the follow-up. Conclusion:OGT-assisted Overlap esophagojejunostomy of laparoscopic total gas-trectomy is safe and feasible, with good short-term effects.

Objective To explore the resistance of neural stem cells (NSCs) in β-amyloid (Aβ) toxicity after being transfected with brain-derived neurotrophic factor (BDNF) and its mechenism.Methods NSCs in the C57 mice were transfected with BDNF gene by using lipofectamine technique; the BDNF gene expression in transfected NSCs and their differentiated cells were detected by immune-fluorescent staining and ELISA.Rat neurons were cultured in vitro and divided into 3 groups:neurons group,neurons co-cultured with NSCs group,neurons co-cultured with BDNF transfected NSCs group; two-parallel group design was adopted.Three d after the group culturing,cells from each parallel group were added Aβ40 protein.Neuron survival of each group was recorded 24 and 48 h after adding Aβ40 by ELISA.The Aβ,tau,and phosphorylating tau (ptau) levels were detected by Western blotting.Results BDNF-transfected NSCs could continuously express BDNF gene products during the first 1.5 weeks.Both transfected NSCs and their progenies expressed BDNF gene products.Using neurons group as reference,the mean survival rates of neurons plus Aβ40 group,neurons co-cultured with NSCs plus Aβ40 group,neurons co-cultured with BDNFtransfected NSCs plus Aβ40 group were 51.86％±0.03％,73.68％±0.04％ and 85.34％±0.01％ at 24 h after adding Aβ40,and 38.76 ％±0.01％,59.65 ％±0.04％,75.61％± 0.07％ at 48 h after adding Aβ40; the survival rate in the neurons plus Aβ40 group and neurons co-cultured with NSCs plus Aβ40 group was significantly lower than the other groups (P＜0.05).High level of Aβ protein was noted in the neurons plus Aβ40 group,neurons co-cultured with NSCs plus Aβ40 group and neurons co-cultured with BDNF transfected NSCs plus Aβ40 group,without significant differences between each two groups (P＞0.05).The tau protein level showed no significant differences between each two groups (P＞0.05),while the p-tau protein level was significantly different (that in the neurons co-cultured with NSCs plus Aβ40 group and neurons co-cultured with BDNF transfected NSCs plus Aβ40 group was significantly higher than that in the other groups,P＜0.05).Conclusion BDNF-transfected NSCs express BDNF gene products during the early time,which alleviate the toxicity of Aβ to NSCs and reduce the p-tau protein level,leading to increased survival rate of neurons.

According to the pathological characteristics of symptomatic chronic thoracic and lumbar osteoporotic vertebral fracture (SCOVF), the different clinical treatment methods are selected, including vertebral augmentation, anterior-posterior fixation and fusion, posterior decompression fixation and fusion, and posterior correction osteotomy. However, there is still a lack of a unified understanding on how to choose appropriate treatment method for SCOVF. In order to reflect the new treatment concept and the evidence-based medicine progress of SCOVF in a timely manner and standardize its treatment, the clinical guideline for surgical treatment of SCOVF is formulated in compliance with the principle of scientificity, practicability and advancement and based on the level of evidence-based medicine.