Objective To realize the bacterial contamination on uniforms of health care workers(HCWs)in a gen-eral hospital,and put forward the corresponding management measures.Methods In May-October 2012,a total of 360 specimens of 120 uniforms of HCWs in departments of respiratory internal medicine,general surgery,gynecolo-gy,and pediatrics were taken on the first,third and seventh day of wearing,bacterial counts on uniforms were mo-nitored,compared and analyzed.Results Bacterial counts of uniforms at different wearing time were statistically differ-ent.The longer time of uniforms were worn,the more bacteria could be detected.Bacterial contamination of nurses’uni-forms was more serious than doctors ([0.65±3.38]CFU/cm2 vs [7.68±2.99]CFU/cm2 ),contamination of uniforms of HCWs in surgical departments was more serious than non-surgical departments([10.43±4.12 ]CFU/cm2 vs [8.60± 3.01]CFU/cm2 )(U=5.06,2.78,respectively,both P<0.01),over standard rate of different sites of HCWs’uniforms were significantly different(χ2 =33.12,P<0.01));over standard rates of bacteria on the cuffs,abdomen and chest sites was 73.33%,58.33% and 36.67% respectively.Conclusion The management of cleaning system of HCWs’uniforms needs to be strengthened,the change cycle of uniforms is suggested twice a week,and the frequency needs to be increased in high contamination departments.

Purpose: To study the effect of personality on the mental adjustment of breast cancer patients during operation. Methods: Forty three breast cancer patients were examined by the Eysenck Personality Questionnaire (EPQ) for their personality before operation, and by the Mental Adjustment to Cancer Scale ( MAC) for their mental adjustment reaction before and after operation. Results: ANOVA repeated analysis revealed that the patients characterized by high Psychoticism showed higher scores on Fatalism, and the patients characterized by low Lie showed higher Hopelessness during operation. Conclusions: In the treatment of breast cancer patients, it is necessary to give appropriate psychological treatment according to the patients's individual characteristics.

Objective To analyze the risk factors for complications in elderly patients with cardiac surgery under cardiopulmonary bypass.Methods From July 2004 to June 2012,64 patients aged ≥ 60 years undergoing cardiac operations were selected.Clinical data were collected.The complications after cardiac operation and the risk factors were evaluated by single factor analysis and multivariate Logistic regression analysis with SPSS software.Results The postoperative complication rate in all patients was 34.4％ (22/64).The complications occurred in 42 subjects and operative mortality was 6.3％ (4/64).The single factor analysis showed that chronic obstructive pulmonary disease combined before operation (P=0.001),diabetes combined before operation (P=0.009),cardiopulmonary bypass time ≥2 h (P=0.000),aortic cross clamping time ≥90min (P=0.001),and blood transfusion volume ≥2000 ml (P =0.000) were the important risk factors for postoperative complications.Multivariate Logistic regression analysis revealed that chronic obstructive pulmonary disease (P=0.007) and diabetes combined before operation (P=0.028),cardiopulmonary bypass time ≥2 h (P=0.003),and blood transfusion volume ≥2000 ml (P=0.030) were the significant independent predictive risk factors for postoperative complications.Conclusions Chronic obstructive pulmonary disease,diabetes,cardiopulmonary bypass time ≥2 h,aortic cross clamping time ≥90 min,and blood transfusion volume ≥2000 ml are the independent predictive risk factors for postoperative complications in elderly patients with cardiac surgery under cardiopulmonary bypass.

Objective To evaluate the feasibility of transparent cap-fitted endoscopy in improving diagnostic yield of Barrett's esophagus(BE).Methods A total of 168 patients with endoscopieally suspected BE were randomly divided into cap group(n=60)and control group(n=108).A transparent cap-fitted endoscopy Was applied in cap group to take biopsy,while a routine one was used in control group,and 2 biopsies from suspected lesions were collected in each patient.BE was diagnosed in the presence of columnar epithelium and the diagnostic rate was compared between 2 groups.Results The diagnostic rates of BE were 83.3%(50/60)and 69.4%(75/108)in cap and control group,respectively(P＜0.05).Conclusion The lesions at cardia Call be exposed clearly with capped endoscopy,which facilitates localized biopsy and BE diagnosis.

Neuroendocrine tumors (NETs) is a rare and heterogeneous group of tumors with widely varying morphologies and behaviors. Due to their rarity and heterogeneity, progress in improving its treatment has been slow. Pancreatic neuroendocrine tumors (pNETs) is a subset of NETs, previously known as islet cell tumors, occupies 3% of the primary pancreatic tumors with the annual incidence rate of (1-2)/100 000. In recent years, it is very necessary to improve the diagnosis and treatment of pNETs.

Objective To evaluate the relevance of MSCT pulmonary function parameters and pulmonary function test (PFT) parameters, and to define the reference value of MSCT pulmonary function parameters. Methods Thirty male volunteers received clinical PFT and MSCT scan. MSCT scan was perfomed at the end of the maximum inspiratory and maximum expiratory. All data were analyzed with the lung analysis software of computer-aided inspection system correlatedly with pulmonary function parameters. Results The lung volume at full inspiratory volume (Vin) and full expiratory volume (Vex) in MSCT scan had good correlation with total lung capacity (TLC) and residual volume (RV) (r=0.90, P<0.01; r=0.74, P<0.01). Vex/Vin was correlated with RV/TLC (r=0.74, P<0.01), and Vin-Vex was correlated with MVC (r=0.85, P<0.01). In inspiration, the average lung density was (-879.51±32.82) HU, the density per unit volume was (0.12±0.03) g/cm3, while in expiratory they were (-688.14±62.38) HU and (0.31±0.06) g/cm3. Conclusion MSCT pulmonary function tests with the analysis software of computer-aided inspection system have good correlation with PFT.

The tumor multidrug resistance reversal effect of NPB304, a novel taxane, was studied. MTT assay was used to determine the IC50 of chemotherapy drugs. Western blotting assay was applied to analyze the expression of P-glycoprotein (P-gp). The effect of compounds on the P-gp function and P-gp ATPase activity was determined by rhodamine 123 (Rh123) accumulation assay and analysis kit, respectively. Molecular docking was employed to predict the binding force between compounds and P-gp. Transmembrane transport of NPB304 was analyzed using MDCK II and MDR1-MDCK II cell model. NPB304 displayed multidrug resistance reversal effect on KBV cells and MCF-7/paclitaxel cells, NPB304 collaborative with P-glycoprotein (P-gp) inhibitors verapamil enhanced the reversal activity, specifically, 10 μmol x L(-1) verapamil in combination with paclitaxel reversed resistance by 56.5-fold, while combined with NPB304 increased the reversal fold; NPB304 synergistically increased Rh123 accumulation in the resistant cells when combined with verapamil, and NPB304 at 0-1 μmol x L(-1) enhanced the ATPase activity activated by verapamil was observed. NPB304 existed the hydrophobic interactions with the TM regions of P-gp, and the binding force between NPB304 and the A chain of the TM region was stronger. P-gp ATPase activity assay demonstrated NPB304 at lower concentrations (0-1.5 μmol x L(-1)) could activate the P-gp ATPase, playing a role on inhibition of P-gp function. However, NPB304 did not have an obvious feature of P-gp substrate. NPB304 exerted itself and synergy with verapamil activity on reversing tumor resistance via inhibiting the P-gp function.

Objective To evaluate the reliability, validity and applicability of the family caregiver burden scale (CBS-CP) for cancer patients. Methods The family caregivers of patients with digestive system cancer were selected as the research subjects. The reliability was evaluated by applying the Cronbach alpha coefficient and the half confidence level. The validity was evaluated by using criterion related validity. Applicability evaluation included: to analyze the burden level of family caregivers of patients with digestive system cancer;and to explore the influencing factors of caregiver burden. Results Except for factor 5, the Cronbach's alpha coefficient and the half coefficient level of the total CBS-CP and the other 4 factors were all higher than 0.75. The total scores and factors of CBS-CP were positively correlated with depression and anxiety (all P<0.01,r=0.296-0.505), and negatively correlated with the quality of life [except for the relationship between factor 5 and physical component summary score (P<0.05), the remaining Ps<0.01, r=0.126-0.370]. The total caregiver burden score ranged from 0 to 109, with an average of 46.03 ± 22.96;multiple regression analysis showed that the possible predictor variables of the total caregiver burden included:anxiety/depression, the disturbed life of family caregivers, quality of life, family economic pressure, spouse caregivers and caregivers'health status. Conclusions The findings showed that both the reliability and validity of the CBS-CP were good. The burden of family caregivers in patients with digestive system cancer is generally at a mild level, and the factors affecting the caregiver burden included physical, psychological, social and economic aspects. It was proposed that the influencing factors of caregiver burden should be explored through the dyadic level of caregivers and patients in future research, so as to provide scientific basis for the development of relevant interventions.

OBJECTIVETo investigate the clinical epidemiology change trend of upper gastrointestinal bleeding (UGIB) over the past 15 years.

METHODSConsecutive patients who was diagnosed as continuous UGIB in the endoscopy center of The First Affiliated Hospital of Sun-Yat University during the period from 1 January 1997 to 31 December 1998 and the period from 1 January 2012 to 31 December 2013 were enrolled in this study. Their gender, age, etiology, ulcer classification, endoscopic treatment and hospitalization mortality were compared between two periods.

RESULTSIn periods from 1997 to 1998 and 2012 to 2013, the detection rate of UGIB was 9.99%(928/9 287) and 4.49%(1 092/24 318)(χ=360.089, P=0.000); the percentage of male patients was 73.28%(680/928) and 72.44% (791/1 092) (χ=0.179, P=0.672), and the onset age was (47.3±16.4) years and (51.4±18.2) years (t=9.214, P=0.002) respectively. From 1997 to 1998, the first etiology of UGIB was peptic ulcer bleeding, accounting for 65.2%(605/928)[duodenal ulcer 47.8%(444/928), gastric ulcer 8.3%(77/928), stomal ulcer 2.3%(21/928), compound ulcer 6.8%(63/928)],the second was cancer bleeding(7.0%,65/928), and the third was esophageal and gastric varices bleeding (6.4%,59/928). From 2012 to 2013, peptic ulcer still was the first cause of UGIB, but the ratio obviously decreased to 52.7%(575/1092)(χ=32.467, P=0.000)[duodenal ulcer 31.9%(348/1092), gastric ulcer 9.4%(103/1092), stomal ulcer 2.8%(30/1092), compound ulcer 8.6%(94/1092)]. The decreased ratio of duodenal ulcer bleeding was the main reason (χ=53.724, P=0.000). Esophageal and gastric varices bleeding became the second cause (15.1%,165/1 092, χ=38.976, P=0.000), and cancer was the third cause (9.2%,101/1 092, χ=3.352, P=0.067). The largest increasing amplitude of the onset age was peptic ulcer bleeding [(46.2±16.7) years vs. (51.9±18.9) years, t=-5.548, P=0.000), and the greatest contribution to the amplitude was duodenal ulcer bleeding [(43.4±15.9) years vs. (48.4±19.4) years, t=-3.935, P=0.000], while the onset age of esophageal and gastric varices bleeding [(49.8±14.1) years vs. (48.8±13.9) years, t=0.458, P=0.648] and cancer [(58.4±13.4) years vs. (58.9±16.7) years, t=-0.196, P=0.845] did not change significantly. Compared with the period from 1997 to 1998, the detection rate of high risk peptic ulcer rebleeding (Forrest stage I(a, I(b, II(a and II(b) increased (χ=39.958, P=0.000) in the period from 2012 to 2013. From 1997 to 1998, 54 patients underwent endoscopic treatment, and the achievement ratio of hemostasis was 79.6% (43/54). From 2012 to 2013, 261 patients underwent endoscopic treatment and the achievement ratio of hemostasis was 96.9%(253/261), which was significantly higher (χ=23.287, P=0.000). Compared to the period from 1997 to 1998, more patients with variceal bleeding or non-variceal bleeding received endoscopic treatment in time (39.0% vs. 70.3%, χ=51.930, P=0.000; 3.6% vs. 15.6%, χ=62.292, P=0.000, respectively), and higher ratio of patients staging Forrest stage I(a to II(b also received endoscopic treatment in the period from 2012 to 2013 [27.4%(26/95) vs. 68.5%(111/162), χ=40.739, P=0.000]. More qualified endoscopic hemostatic techniques were used, containing thermocoagulation (0 vs. 15.2%, χ=79.518, P=0.000), hemostatic clip (0 vs. 55.9%, χ=20.879, P=0.000), hemostatic clip combined with thermocoagulation (4.3% vs. 16.4%, χ=5.154, P=0.023), while less single injection was used (87.1% vs. 6.2%, χ=10.420, P=0.001), and single spraying for hemostasis was completely abandoned in the period from 2012 to 2013. The ratio of inpatients undergoing reoperation decreased obviously in the period from 2012 to 2013 [9.3%(86/928) vs. 6.0%(65/1092), χ=7.970, P=0.005], while no significant difference was found in mortality during hospitalization between two periods.

CONCLUSIONCompared with the period from 1997 to1998, the mean onset age of UGIB increased, and the ratio of peptic ulcer bleeding decreased due to the reduction of duodenal ulcer bleeding, the detection rate of high risk peptic ulcer rebleeding increased, the cure rate of endoscopic treatment for UGIB increased, more reasonable and immediate hemostatic methods were used, but overall mortality did not change obviously in the period from 2012 to 2013.

Adult ; Age of Onset ; Aged ; Electrocoagulation ; methods ; trends ; Endoscopy, Digestive System ; trends ; Esophageal and Gastric Varices ; pathology ; therapy ; Esophagus ; pathology ; Female ; Gastrointestinal Hemorrhage ; classification ; epidemiology ; etiology ; mortality ; Gastrointestinal Neoplasms ; pathology ; Hemostasis, Endoscopic ; methods ; trends ; Hemostatic Techniques ; trends ; Hemostatics ; therapeutic use ; Humans ; Male ; Middle Aged ; Peptic Ulcer ; pathology ; therapy ; Peptic Ulcer Hemorrhage ; pathology ; therapy ; Reoperation ; trends ; Stomach Ulcer ; pathology ; therapy ; Surgical Instruments ; trends ; Ulcer ; epidemiology ; therapy

BACKGROUND: The symptoms of allergic rhinitis (AR) greatly affect the quality of life (QoL) in the patients with AR. The correlations of nasal response to leukotriene D4 (LTD4) and histamine nasal provocation with health related QoL in AR are not clear. OBJECTIVE: To evaluate the correlations of nasal response to LTD4 and histamine nasal challenge with QoL in AR. METHODS: Patients randomly underwent LTD4 and histamine nasal challenge tests, completed the rhinoconjunctivitis quality of life questionnaire (RQoLQ), and rating the symptom severity score (total symptom score 4, TSS4) in the previous week. The correlations between nasal challenge tests induced nasal responses and QoL in RQoLQ were analyzed. RESULTS: A total of 25 eligible AR patients enrolled and finished both LTD4 and histamine nasal challenge and completed the questionnaire of RQoLQ. Histamine nasal challenge induced sneezing, increased nasal resistant were correlated with most of the dimensions (general, practical, nasal, eye problems, and quality of sleep, p < 0.05), while LTD4 nasal challenge induced sneeze, increased nasal resistant only correlated with nasal and ocular problems. On the contrary, the severity of the sneeze assessed by TSS4, was not correlated with QoL, while the severity of rhinorrhea, congestion, and nasal pruritus were correlated with nasal and practical problems, and nasal congestion was also correlated with ocular problems (r = 0.60, p = 0.01). CONCLUSION: LTD4 and histamine nasal challenge induced nasal responses were correlated with different clinical symptoms severity and QoL, which can be used as a good diagnosis and evaluation methods for the management of AR.
Diagnosis ; Estrogens, Conjugated (USP) ; Histamine ; Humans ; Leukotriene D4 ; Pruritus ; Quality of Life ; Rhinitis, Allergic ; Sneezing