Background:Intestinal metaplasia(IM)and dysplasia in Barrett’s esophagus(BE)can be detected by endoscopic biopsy combined with pathological examination. Aims:To evaluate the efficacy of acetic acid stain-guided biopsies in detection of IM and dysplasia in BE under standard endoscopy. Methods:One hundred patients found to have columnar-lined esophagus by endoscopy from January 2012 to November 2014 at Shanghai Jing’an District Central Hospital were enrolled. Under standard endoscopy,acetic acid was sprayed and multi-point biopsies were performed in visible abnormal regions. This was followed by four-quadrant biopsies at every 1 to 2 cm of the remaining BE segments. Detection rates of columnar epithelium,IM and dysplasia were compared between acetic acid stain-guided biopsies and four-quadrant biopsies. Results:A total of 96 patients were diagnosed as BE. Detection rates of columnar epithelium by acetic acid stain-guided biopsies and four-quadrant biopsies were 96. 9%(93 / 96)and 90. 6% (87 / 96),respectively,no significant difference was found between the two methods(McNemar test,P = 0. 146),however,consistency of the two methods was poor(κ = 0. 340). A total of 32 patients were diagnosed as BE with IM. Detection rates of IM by acetic acid stain-guided biopsies and four-quadrant biopsies were 84. 4%(27 / 32)and 40. 6%(13 / 32),respectively,difference in detection rate between the two methods was significant(McNemar test,P = 0. 007),and consistency of the two methods was poor(κ =0. 266). Five cases of low-grade dysplasia were detected by acetic acid stain-guided biopsies only. Conclusions:Acetic acid stain-guided biopsies can detect BE with IM and dysplasia better than four-quadrant biopsies.

Objective To investigate the incidence and influencing factors for sharp injuries occurred in workers in central sterile supply departments (CSSDs).Methods In October-November 2012,a multicenter cross-sectional survey was conducted,a total of 95 workers in CSSDs of 16 hospitals in Hunan Province were surveyed through questionnaires.Results A total of 89 workers (93.68%)in CSSDs sustained sharp injuries,46 (48.42%)of whom sustained 1 -5 times of sharp injuries,22(23.16%)sustained 6-10 times of sharp injuries,and 11 (11 .58%)sus-tained for at least 10 times of sharp injuries.81 workers (85.26%)sustained at least one time of sharp injuries one year before survey,52 (54.73%)of whom were injured by contaminated needles or other sharps.Logistic regression analysis revealed that higher educational background was protective factor for sharp injuries(OR 90%CI :0.05-0.87);while poor sleep quality(OR 90%CI :1 .03-17.94),frequent touching sharps(OR 90%CI :1 .11 -12.15),and irrational placing of objects by the other medical stuff (surgeons and nurses in operating rooms)(OR 90%CI :1 .23-16.98)were the risk factors for sharp injuries.Conclusion The incidence of sharp injuries among workers in CSSDs is high,which is related to personal factors and environmental factors.It is suggested to strengthen staff training to enhance their awareness of precaution.

AIM: To investigate the action of testosterone on atherosclerosis in a rabbit model. METHODS: 37 male cholesterol-fed rabbits were divided into five groups: castration group: castrated rabbits without exogenous testosterone administration; testosterone Ⅰ group: castrated rabbits with exogenous testosterone 0.25 mg?kg -1?d -1; testosterone Ⅱ group: castrated rabbits with exogenous testosterone 2.5 mg?kg -1?d -1; testosterone Ⅲ group: castrated rabbits with exogenous testosterone 12.5 mg?kg -1?d -1. The sham operation group was also set. Three months later, the levels of testosterone, blood lipids (including TG, HDL-C, LDL-C), PAI activity, nitric oxide (NO) content, endothelin (ET), angiotensin Ⅱ (AngⅡ) in blood were detected. RESULTS: It showed that testosterone in castration group was the lowest. There was no significant difference of TG or LDL-C between castration group and the other four groups. HDL-C in castration group was lower than that in other four groups. NO content of castration group was lower than that in others, but PAI activity, ET and AngⅡ concentration were higher than that in other groups. CONCLUSION: Testosterone is a protective factor against atherosclerosis in male rabbits.

Objective To observe the effect of polyethylene terephthalates (PET) coated with 58S bioactive glass on graft-bone healing.Methods The PET coated with 58S bioactive glass was used in experimental group,and uncoated PET was used as a control.The coating solution was made of 20％ bioactive glass powder and 80％ gelatin powder (by weight).In our vitro study,4×104/ml MT3T3-E1 cells were cultured in 24-well plates with the coated or uncoated PET,and the MTT and ALP were tested at 1,3,5 days to show the proliferation and the activity of the cells.The SEM and the X-ray photoelectron spectrometer were adopted to analyze the surface characteristics of the fiber.In our vivo study,24 skeletally mature New Zealand white rabbits were randomly divided into two groups,the 58S-PET group and the PET group.Both groups underwent a surgical procedure to establish a tibia-articular tendon-bone healing model.Mechanical examination and histological assay were taken to verify the coating effect in vivo.Results The 58S-PET group showed significantly differences in both the MTT and ALP tests at each time point (3,5 days) compared with the PET group.In the animal experiments,the maximum load increased by time in both groups.At 6 weeks,the load-to-failure was significantly higher in the 58S-PET group [(61.70±6.95) N]than that of the PET group [(45.21±9.78) N].At 12 weeks,the load-to-failure was also significantly higher in the 58S-PET group [(89.25±9.50) N]than that of the PET group [(71.38±6.26) N].In the histological assay,it was found that there was new bone formation in the indistinct interface between the graft and the host bone in both groups at 6,12 weeks,and a stronger binding was seen in the 58S-PET group than in the PET group.Conclusion The 58S-PET could enhance the proliferation and activity of the osteoblast and therefore promote the new bone formation and subsequently leads to a positive effect on tendon-bone healing.

This paper summarizes the nursing care of a child with hand,food and mouth disease complicating multiple organ failure,such as use of ice-blanket and strategies of vessel protection. As a result,the child recovered well and was discharged after rehabilitation.

Objective: To investigate the lunch supply in primary and middle school dining rooms in Ningbo City, so as to provide the scientific evidence for guiding rational dietary supply and improving student health. Methods: A primary school and a junior high school were randomly sampled from each of 10 counties (districts) in Ningbo City. Food receipt and balance, dinner supply and number of students with meals were collected from school dining rooms with questionnaires formulated by Zhejiang Provincial Center for Disease Control and Prevention, and all foods in school dining rooms provided by enterprises were sorted and recorded. Daily mean lunch food, energy and nutrient supply was calculated per student, and evaluated with the Student Electronic Nutritionist platform, the 2013 revision of Chinese Dietary Reference Intakes and the national criteria of Nutrition Guidelines of Student Meals (WS/T 554-2017). Results: Six urban primary schools, six urban junior high schools, four rural primary schools and four rural junior high schools were enrolled, and there were two schools with meals provided by enterprises and eighteen schools with meals provided by their dining rooms. Appropriate supply of cereals and potatoes, excessive supply of livestock and poultry meat, vegetable oil and salt, and low supply of fruits, eggs, milk and soybean and nuts were found in primary and junior high school, and notably, milk and fruits were not provided by any rural junior high schools. Excessive energy supply was found in primary schools (excessive energy supply in rural primary schools and appropriate in urban primary schools), and appropriate energy supply was seen in junior high schools. High energy ratios of protein and fat, low energy ratio of carbohydrate, low supply of diatery fiber, vitamin A and calcium, appropriate supply of vitamin B1, B2 and C, and sufficient supply of iron and zinc were found in primary and junior high school. Conclusion Unreasonable dietary structure, excessive energy supply and nutrient imbalance are found in lunch supply by primary and junior high schools in Ningbo City.

Objective To analyze the reasons of discarding as useless of ?-Se direct conversion digital flat panel detector (?-Se FPD). Methods (1) E-COM DR-2000CTM chest system, with high frequency X-ray machine made by CPI company of Canada, the X-ray tube made by VARIAN company of America and Direct Ray-1000 ?-Se FPD made by DRC company of America. (2) 50 cases were collected rondomizedly, each had 4 pieces of chest image and were analyzed by two experienced radiologists and two technicians. Results After about 14 months with 30,000 times exposure efficacious, some damage lines and points appeared in the detector. After about 34 months with 70,000 times exposure efficacious, a damage region (area is 6.7in*0.95in ) existed, this reduced the images' quality and at the end the detector was discarded as useless. Conclusion The ?-Se FPD needs maintenance and monitoring working circumstance.

Objective To research the structure,imaging mechanism and quality of dry view laser imaging film. Methods We extracted 60 pieces of dry view laser imaging film,wet view laser imaging film and ordinary film respectively. Each tape of films was divided into 3 groups in 100 pieces each. They were observed in the same temperature and humidity. Results Group A was observed after 300 minutes,the dry view laser films image of 10 pieces without package,4 pieces packed with plastic and 1 piece packed with paper changed. After 120 minutes,group B was observed; the dry view laser imaging film in different packing had the different changes. To the contrast,the wet laser imaging film's images didn't change in the same humidity and temperature after 420 minutes test. Conclusion The imaging of dry laser imaging film with different temperature,humidity and package will easily affect the image quality.

Objective To explore the clinical value of thermal tomography (TT) in the diagnosis of breast diseases.Methods Totally 222 breast diseases patients underwent examinations by color Doppler ultrasound and TT.Some stable TT images were selected,and the TT curves of the lesions were analyzed according to the malignant tumor TT curve diagnosing standard,so that the benign and malignant tumors could be determined.Color Doppler ultrasound was used to describe the site,size and property of the lesion.Results Pathological examination found 95 cases of malignant tumors and 127 benign ones.TT had 198 results coincident with those by pathological examination while the remained 24 ones not,with 15 false positive results and 9 false negative ones.When compared with pathological examination,TT had the accuracy,sensitivity and specificity being 89.19％,90.43％ and 88.28％ respectively.Conclusion TT is non-invasive,accurate and sensitive when used to screen and diagnose breast diseases,and should be applied if possible in medical facilities.

?AlM: To evaluate the long - term effects of laser peripheral iridectomy ( LPl ) and trabeculectomy in treating early chronic angle-closure glaucoma.
?METHODS: Ninety-eight patients (102 eyes) with early chronic primary angle-closure glaucoma were randomly divided into two groups. Group A of 50 patients (54 eyes) was treated with LPl and group B of 48 patients (48 eyes) with trabeculectomy. After 3 - 8y of follow - up observation, comparison would be made from the perspectives of postoperative eyesight, intraocular pressure, anterior chamber angle, visual field and cup/disc ratio ( C/D) .
?RESULTS:ln group A, 24 eyes with eyesight declining, 22 eyes with theintraocular pressure>21mmHg (1mmHg=0. 133kPa), 21 eyes with chamber angle synechia >180o, 21 eyes with visual field narrowed, 21 eyes with C/D ratio enlarged. The results of group B for the same items were 10, 5, 4, 4, 4 eyes respectively. The comparative difference was statistically significant (P<0. 05).
?CONCLUSlON:Good effects will be achieved for early-stage chronic angle - closure glaucoma with surgical method. Trabeculectomy is obviously better than LPl for the long-term effects.