OBJECTIVE To analyze the factors influencing endoscope disinfection,in order to take the effective measure,improve endoscope disinfection work and prevent nosocomial infection.METHODS According to Instructions for Technical Procedures of Endoscope Cleaning and Disinfection published by Ministry of Health,42 samples of disinfected endoscopes from 18 000 were randomly selected.RESULTS The work for rinse and disinfection of endoscope in our hospital came to be standardized procedure gradually.We already achieved qualified by 100 percent according to Instructions.CONCLUSIONS The standardized management for rinse and disinfection of endoscope is the assurance for preventing nosocomial infection.

Objective To evaluate the clinical effect of levocarnitine in the treatment of continuous blood purification and its effect on matrix metalloproteinase-2(MMP-2),interleukin-18(IL-18)and heart function.Methods 118 patients with continuous blood purification were randomly divided into the control group(n=59)and treatment group group(n=59).Two groups were treated with hemodialysis treatment.Control group was given folic acid,vitamin B and alpha keto acid,treatment group intravenous given levocarnitine injection 20mg/kg+0.9％NaCl 20mL on the basis of control group.A cycle of treatment was 28 days,and treated for 3 cycles.Serum levels of MMP-2 and IL-18,heart function,clinical effect and adverse drug reaction were compared between the two groups.Results After treatment,the total effective rate in control group was 84.74％,lower than 94.92％in treatment group(P<0.05).After treatment,serum MMP-2,IL-18,left atrial diameter(LAD),left ventricular end diastolic diameter(LVDd),left ventricular posterior wall thickness(LVPWT),ventricular septal thickness(IVST),left ventricular volume index(LVMI)in two groups were lower than pre-treatment(P<0.05),and the indexes in treatment group were more lower than control group(P<0.05).The E/A and left ventricular ejection fraction(LVEF)in two groups were all increased after treatment,and those in treatment group were higher than control group,the differences were significant(P<0.05).There was no significant in the incidence rate of adverse drug reactions between two groups.Conclusion Levocarnitine in the treatment of continuous blood purification was effective,and significantly reduce the serum MMP-2,IL-18 level and improve the heart function.

Objective To investigate the effect of surgical treatment for giant primary liver cancer.Methods One hundred and forty-six cases of giant primary liver cancer received surgical treatment in recent 11 years ware analyzed retrospectively. Of them, 99 cases underwent irregular hepatectomy ,28 hemihepatectomy and 4 right hepatic trisegmentectomy .Including 19 cases received secondary resection after preoperative TACE, meanwhile 6 cases were underwent portal venous cancer thrombus extraction, 15 cases received biopsies and DDS only, Interoprative DDS were performed in 105 cases. Result The postoperative complications was 10.3 %, the postoperative mortality was 1.4%.The 1-,3-,5- and 10year survival rates were 56.6 %, 30.2% ,14.4% and 2.1% respectively. Conclusions The main treatment of giant liver cancer is hepatcctomy.Combination with TACE,portal thrombus extraction and DDS can improve the long-term survival.

[Objective]To explore the anatomical structures,depth and direction of needling at Chengqi (ST1).[Methods] Forty-eight adult orbital specimens were observed by dissection.[Results] When a needle was vertically inserted into Chengqi (ST1),the needle tip would pass through the skin,subcutaneous tissue,orbicularis muscle,orbital adipose body,inferior obliges and inferior rectus.[Conclusion] The acupuncture of the Chengqi (ST1) should select straight sting needling back-upwards.The depth should not exceed 25.0mm.

Objective To analyze the clinical and pathological characteristics of thyroid carcinoma in patients from Qilu Hospital of Shandong University in last 7 years,and to explore the changes in disease spectrum.Methods Records of 772 patients with thyroid carcinoma,who underwent thyroidectomy and pathological examination,were reviewed from January 2005 to December 2011.Results (1) Individuals suffering from thyroid carcinoma have increased rapidly during these 7 years.(2) The high incidence of the disease resided in the age group of 30-59 for both men and women,with a male-to-female ratio of 1 ∶ 2.73.(3) The proportion of papillary microcarcinoma showed a growing trend,the rising trends were also apparent in papillary thyroid cancer (PTC) coexisting with nodular goiter or Hashimoto's thyroiditis (HT).Papillary microcarcinoma accounted for27.27％ of all PTC in 2005 and reached 54.22％ in 2011.Coexistence of PTC and HT accounted for 12.38％ of the cases with a male-to-female ratio of 1 ∶ 6.Conclusion The occurrence of thyroid carcinoma,especially papillary microcarcinoma has been increasing in recent years.The coexistence of PTC with nodular goiter or HT showed a trend to increase.

Objective:To explore the therapeutic effect of monoclonal anti EGFR antibody leading chemotherapy to human tumors.Methods:To prepare immunoconjugate of chemotherapy drugs with anti EGFR antibody and apply to clinic,and to observe it′s therapeutic effect and side effect. Results: This conjugated method could relief clinic symptoms and reduce side effect of tissues and organs significantly.Conclusion:Conjugates of monoclonal therapy of anti EGFR antibody and drug attached chemotherapy is a new and effective way for treatment of human tumors, and it can reduce side effect of the drugs meanwhile.

Objective To explore the inner relationship between the humanistic care of nursing and the four elements of benevolence, rites, confidence, harmony, and construct a theoretical model of nursing humanistic care based on Confucian thought. Methods Using semi-structured focus interview with 13 experts, the data was sorted, analyzed, encoded and refined, seeking to enrich the modern humanistic nursing care ideas and factors from the Confucian ideology by using grounded theory research method, make the theory research and clinical practice of nursing humanities phenomenon was closely related to the construction of nursing the theory of humanistic care model based on Confucianism. Results Obtained the cognition, feelings and ideas of the experts in nursing, humanistic care and Confucianism, and extracted four classification subjects:benevolence ritesconfidenceharmony as the spiritual core, carrier, code of conduct, value orientation of nursing humanistic care, and constructing a theoretical model of nursing humanistic care based on Confucianism. Conclusions The construction of nursing humanistic care theory model based on Confucianism enriches the connotation of nursing humanistic care, and provides references for the further study of nursing humanistic care theory, and instructs clinical nursing practice by nursing humanistic care theory based on Confucianism.

Objective To compare the success rate, operation time, complication rate and the degree of tolerance of two kinds of endoscopic placement of small intestine decompression tube. Method 68 intestinal obstruction patients treated with transnasal ileus tube were randomly divided into 2 groups, group A and group B, 34 cases in each. Patients in group A were treated by endoscopic placement, while in group B placement was guided by nasal endoscope. Results The catheterization success rate and complications between the two groups have no statistical significance (P > 0.05) while the differences of catheter operation time (P < 0.05) and placement tolerance (P < 0.01) have statistical significance. Conclusion Endoscopic placement of small intestinal decompression tube has clinical application value while placement guided by nasal endoscope has certain advantages.

Objective To study the therapeutic effect of EUS-guided biliary drainage (EUS-BD) on patients with malignant obstructive jaundice when ERCP failed.Methods From January 2014 to January 2016,all patients with malignant obstructive jaundice during hospitalization underwent EUS-guided biliary drainage (group A,36 cases) or PTCD treatment (group B,30 cases) by draw after failed ERCP.Operation success rate,liver function recovery time,complication rates,length of hospital stay and hospital costs were observed and compared.Results There was no significant difference in the operation success rates between two groups [94.44％ (34/36) VS 86.67％ (26/30),P＞0 05)].And there were significant differences in liver function recovery time (25.79± 6.48 d VS 30.24 ± 8.49 d),incidence of complications [5.56％ (2/36) VS 23.33％ (7/30)],length of hospital stay (21.54±4.73 d VS 25.68 ± 8.56 d) and hospitalization costs (23.5±8.4 thousand yuan VS 32.8±6.5 thousand yuan,P＜0.05).Conclusion EUS-guided biliary drainage could be the first option for its noninvasiveness and efficacy,when ERCP failed in patients with malignant obstructive jaundice.

BACKGROUND:Bone marrow mesenchymal stem cells (BMSCs) can differentiate into renal paranchymal cells including renal intercapillary cells.BMSCs can repair kidney structure and function after damage.OBJECTIVE:To investigate renal histology and function changes following BMSC transplantation in a rat model of radiation-inducad damage.DESIGN,TIME AND SETTING:The cytological in vitro study was performed at the Laboratory of the Department of Hematology,Zhujiang Hospital from January to October 2009.MATERIALS:A total of 35 clean male Sprague Dawley rats were selected.Of them,20 were used to prepare BMSCs.The remaining was randomly assigned to a normal control,model and cell transplantation groups,with 5 in each group.METHODS:Rat BMSCs were incubated by the whole bone marrow method.When 90% cells were confluent,BMSCs were digested in trypsin for subculture.In the model and cell transplantation groups,rats were used to establish radiation-induced models,and then underwent X-ray general irradiation,at a dose of 500 cGy/min,100 cm from the target,6 Gy each,once per week,for consecutively 3 weeks.24 hours following irradiation,BMSCs of 3 passage were collected at logarithmic phase.In the cell transplantation group,1 mL cell suspension was infused into the rat caudal vein,containing 3×10~6 cells,totally three times.In the normal control and model groups,rat caudal vein received an equal volume of saline.MAIN OUTCOME MEASURES:The following parameters were measured:results of hematoxylin-eosin staining;serum and kidney malondialdehyde (MDA) content and superoxide dismutase (SOD) activity;serum creatinine and urea nitrogen levels.RESULTS:Kidney histopathology demonstrated thin renal cortex,increased number of mesenchyme,uneven renal corpuscle,and disordered structure of renal glomerulus,narrow renal glomerular vessel,partial disappeared capsular space,and degeneration and sclerosis of some glomerulus in the model group.In the cell transplantation group,renal cortex became thick,with clear structure;interstitial hyperemia and edema was significantly relieved;many complete renal corpuscles were observed;partial renal glomerulus presented degeneration and sclerosis;significant capsular space could be seen.Oxygen free radical examination results showed that compared with the model group,SOD activity was significantly higher (P ＜ 0.05),MDA levels were significantly lower (P ＜0.05) in the cell transplantation group.Renal function examination results demonstrated that compared with the model group,serum creatinine and urea nitrogen levels were significantly reduced in the cell transplantation group (P ＜ 0.05).CONCLUSION:BMSC transplantation can effectively treat renal radiation injury and improve renal function.