Objective To study the detail of quality control method during the implementing the new CSSD guideline in the district level hospitals. Methods The quality control was divided into 5 steps:Wrote the hospital' s CSSD quality system documents and comply them into a booklet. Set up reasonable quality control positions and staff and designed relative record files. Record the problems in the dynamic patrol handbook in time. Summary and discuss the problem by period. Made flow charts to improve the quality control details. All the above 5 steps formed the frame of the detail quality control. Results It had distinctly difference for inspection on quality efficiency ( Lumen clean, 175 vs 290, χ2 = 25.29, P ＜ 0. 01 ), and thescores of nursing inspection of( satisfaction ,94.26 ± 1.22 vs 98.46 ± 1.67 ,t =42. 10,P ＜0. 05 ), after the detail quality control.Conclusions It can solve the anti-guideline problems, improve work quality and efficiency and low down cost for the implementation of the CSSD guideline of the district level hospital by detail quality control method.

Objective To establish the management moved forward mechanism of detail problem in disinfection supply room,so as to achieve the purpose of the process control.Methods Management moved forward mechanism was established,such as finding problem,recording detail problem,discussing details problem,and tracing back to the effect in disinfection supply room.Deviation situation,efficiency targets of job quality,clinic satisfaction were compared before and after the management mechanism implemented.Results Compared before and after the management moved forward mechanism implemented in disinfection supply room,decontamination area deviation were cases (78 vs 12),qualified cleaning were ( 175 vs 290 cases),satisfaction survey scores were (94.26 ± 1.22 vs 98.46 ± 1.67),the difference was statistically significance ( P ＜ 0.05 ).Conclusions Management moved forward mechanism established in disinfection supply room can ensure the process coritrol on the details.

OBJECTIVETo explore the relationship between TCM syndrome type and gastric mucosa cell proliferation related controlling gene protein in chronic atrophic gastritis (CAG).

METHODSExpressions of cell proliferation related controlling gene protein, including proliferative cell nuclear antigen (PCNA), epidermal growth factor receptor (EGFR) and c-myc, from gastric mucosa of CAG model rats with different syndrome types were measured by immunohistochemistry and the changes of them before and after TCM intervention were also analyzed by image analysis.

RESULTSProtein expressions of PCNA, EGFR and c-myc in gastric mucosa of CAG model rats with different syndrome types (Pi-deficiency type, Gan-stagnation type and dampness-heat type) were different to some extent, and all of them reduced significantly after TCM intervention in the model rats of all syndrome types.

CONCLUSIONExpressions of cell proliferation related controlling gene protein in gastric mucosa of CAG model rats of different syndrome types were different to some extent, which provides a certain experimental evidence for revealing the essence of TCM syndrome type of CAG and judging the prognosis of various types.

Animals ; Diagnosis, Differential ; Drugs, Chinese Herbal ; therapeutic use ; Gastric Mucosa ; drug effects ; metabolism ; pathology ; Gastritis, Atrophic ; diagnosis ; drug therapy ; metabolism ; Immunohistochemistry ; Male ; Medicine, Chinese Traditional ; Phytotherapy ; Proliferating Cell Nuclear Antigen ; biosynthesis ; Proto-Oncogene Proteins c-myc ; biosynthesis ; Random Allocation ; Rats ; Rats, Wistar ; Receptor, Epidermal Growth Factor ; biosynthesis ; Syndrome

Objective To study the effect of fluoride on the expression of bcl-2 and Bax in chondrocyte in vitro, and investigate the mechanism of action of chondrocyte apoptosis induced by fluoride. Methods Articular chondrocytes of neonate rat were cultured in vitro and treated with 0(control),5,20,40 mg/L of fluoride,respectively, for 10 days. Then observed the u]trastructure of chondrocytes under eletronicmicroscope, and tested the expression of bcl-2 and Bax in chondrocyte in different groups by Western blotting. Results Abundant rough endoplasmic reticulums (RERs) and complete structure of mitochondria membranes were presented in globular chondrocytes in the control group and 5 mg/L group; but more lipid droplets and vacuoles were seen in the cytoplasm, and the structure of intracellular membranes became incomplete, and some shrieked chromatin and pyknosis were seen in the chondrocytes of the 20,40 mg/L groups. The expression of bcl-2 markedly decreased in 20 mg/L group(0.626 ± 0.042) and 40 mg/L group(0.531± 0.039) compared to the control group(0.876 ± 0.035,all P ＜ 0.01 ). And the expression of Bax significantly increased in 20 mg/L group(0.966 ± 0.047) and 40 mg/Lgroup ( 1 .289 ± 0.156) compared to the control group(0.642 ± 0.050, all P ＜ 0.01). But there was no statistical significant difference of the expression of bcl-2 or Bax between 5 mg/L group(0.885 ± 0.065,0.657 ± 0.045) and control group (all P ＞ 0.05 ). However there were statistical differences of expressions of bcl-2 and Bax between 20 and 40 mg/L groups(all P ＜ 0.01 ). Conclusions Twenty and 40 mg/L fluoride can cause damage to the ultrastructure of chondrocyte, and fluoride possibly promotes chondrocyte apoptosis by reducing the expression of antiapoptotic factor bcl-2 and increasing the expression of Bax.

Objective To analyze the drug resistance profile and risk factors for extensively drug resistant tuberculosis (XDR-TB) patients. Methods XDR-TB cases were identified by sixteen anti-TB drug susceptibility kits among inpatients with a diagnosis of laboratory-confirmed mycobacterium tuberculosis. Single-factor and Logistic analysis were used to analyze the risk factors for drug resistant of the first and second-line anti-TB drugs in XDR-TB patients. Results Resistant rate of rifampin, isoniazid and rifampicin were 100%, Resistant rate of streptomycin, rifampicin and dean, b sulfur isoniazid, levofloxacin and capreomycin were from 90% to 100%, resistant rate of kanamycin and amino salicylic acid were from 70% to 80%, resistant rate of amikacin from 60% to 70%, resistant rate of sulfur isoniazid was from 50% to 60%, resistant rate of ethambutol and moxifloxacin were from 40% to 50%, resistant rate of clarithromycin was from 10% to 20%, resistant rate of clofazimine 5.2%. 92.1% of XDR-TB patients were resistant to more than 10 anti-TB drugs, and the least of the patients were resistant to 6 anti-TB drugs.Logistic regression analysis showed the risk factors for XDR-TB first-and second-line anti-tb drugs included age ［20-40 year (OR=6.318, 95% CI:1.204-33.15, P=0.029;40-60 year (OR=4.772, 95% CI:0.973-23.392, P=0.054); 60 year (OR=41.366, 95% CI:2.909-588.265, P=0.006)］and anti-TB treatment history was retreatment(OR=28.013, 95% CI:3.357-233.766, P=0.002). Conclusions XDR-TB patients have serious drug resistance, but there were some drug treatable drug resistance types, and the risk factors mainly come from age and anti-TB treatment history.

Objective To analyze the practicability of using ELISA kit for the detection of hepati-tis E virus antigen ( HEV-Ag) in plasma donations and Biomex HEV seroconversion panels. Methods The HEV-Ag positive samples were screened out from 36 340 donated blood plasma samples. Real-time fluores-cent PCR was performed for the detection of HEV RNA in HEV-Ag positive samples. The open reading frame 2 (ORF2) in HEV RNA was amplified by nested RT-PCR and the amplified products were confirmed by sequencing analysis. Phylogenetic tree was constructed for HEV genotyping. Five Biomex HEV serocon-version panels were used in this study for the detection of HEV-Ag, anti-HEV antibody and HEV RNA as well as the correlation analysis between HEV-Ag and HEV RNA. Results Twenty-six out of 36 340 plasma samples (0. 07%) were positive for HEV-Ag. Of the 26 samples, 25 samples were positive for HEV RNA as indicated by the results of nested RT-PCR and 23 positive samples were confirmed by sequencing analysis. The positive rate of HEV RNA in blood plasma donators was 1 ∶ 1 580 (0. 06%). There were 17 samples of genotype 1 (74%) and 6 samples of genotype 4 (26%) according to the phylogenetic tree analysis. All of the HEV-Ag positive samples were also positive for HEV RNA as indicated by the analysis of Biomex sero-conversion panels. HEV-Ag was consistent with the peak of the HEV RNA concentration. Conclusion A close relationship between HEV-Ag and HEV RNA was observed. HEV-Ag screening could be used as a measure to reduce the risk of HEV transmission by blood transfusion.

Bacterial N-Acyl-L-homoserine lactones (AHLs)-mediated quorum sensing is involved in the regulation of diverse biological functions. As the bacterial pathogen population density increases, AHLs concentration secreted by pathogen reaches a threshold and then interacts with their intercellular receptor and triggers expression of virulence genes. It is a promising approach to biologically control bacterial disease in plants and animals by manipulating bacterial AHL-quorum sensing with AHLs-degrading enzyme and AHL analogue.

Ralstonia metallidurans CH34 was isolated from the deposit of a znic factory .The degradation of phenol by R .metallidurans CH34 was investigated. The results showed that R . metallidurans CH34 possesses high ability to degrade phenol with the biodegradation rate constant of 0.33 . The optimal pH , temperature and volume of medium for phenol degradation are pH 7.0 , 30℃ , and 20%(v/v), respectively . In addition , this strain retains its ability to degrade phenol in the presence of high concentration of heavy metal ion .The sodium citrate , sodium succinate can enhance the degradation of phenol.

Objective To compare the clinical efficacy and safety of ti-cagrelor and clopidogrelin the treatment of acute myocardial infarction in patients with percutaneous coronary intervention ( PCI ) after thrombolytic therapy.Methods A total of 130 ST -segment myocardial infarction (STEM) patients were randomly divided into control group (n=64) and treatment group ( n=66 ).The patients of control group were given clopi-dogrel 300 mg, maintenance dose 75 mg qd.The patients of treatment group were given ticagrelor 180 mg, maintenance dose 90 mg bid.All the patients of two groups received selective PCI successfully after 8-10 d treatment.The change of thrombolysis in myocardial infarction ( TIMI ) flow grades after operation , left ventricular ejection fraction ( LVEF) and left ventricular end -diastolic dimension ( LVEDD ) , the incidence of no-reflow/slow flow and adverse drug reactions after operation were compared between two groups.Results After operation, the TIMI flow grades and LVEF in treatment group were significantly higher than those in control group ( P<0.01 ).After operation , the LVEDD in treatment group was lower than that in control group , with significant difference ( P<0.01 ).The incidences of no -reflow/slow flow in treatment group and control group were 3.03%and 14.06%respectively , there was statistically significant difference in two groups ( P<0.05 ).Only some minor bleeding events happened in the two groups , there was no statistically significant difference in two groups after operation 6 months ( P>0.05 ).Conclusion Ticagrelor could support better clinical efficacy than clopidogre in selective PCI after thrombolytic therapy for acute myocardial infarction , which has a stronger anti -platelet aggregation function without increasing the incidence of bleeding events.

Objective To establish the mechanism of management-pass antedisplacement of detail problem and improve the effects of the quality control.Methods Made the former management-model of finding,noting and improving detail problems more fine and more material,established the platform of the management-pass antedisplacement of detail problem,and encouraged all staffs participating in management of detail problems and casting back effects of improving.Results After the implementation of the managementpass antedisplacement model of detail problem,the indexes of working quality were improved significantly.And comprehensive scores in various areas increased significantly such as removing dirt zone [(96.9 ± 1.7) vs(91.6 ± 1.8)],packing-check sterilization zone [(97.2 ± 1.6) vs (93.7 ± 2.4)],asepsis-goods storing zone [(98.8 ± 1.7) vs (94.5 ± 1.1)],skill-knowledge competition[(97.9 ± 1.5) vs(93.9 ± 1.7)],and clinical satisfaction degree [(98.2 ± 1.8) vs (93.5 ± 1.7)] were significantly higher than those before (t =-7.22,-4.79,-3.54,-6.26,-7.29,respectively;P ＜ 0.01).Conclusions The management-pass antedisplacement of detail problem can effectively improve the effects of quality control in sterilization-supply unit.