OBJECTIVE To standardize the classification,collection and transportation of the medical wastes in our hospital. METHODS A Manual of Administrative Measures for Medical Wastes was set according to the Regulations on Medical Waste Management stipulated by State Council.Field investigation,supervision,management and adjustment had been carried out.RESULTS The medical waste was strictly collected and separated in clinical departments.The dispensable sharp wastes should be collected in a special container.We adopted medical wastes preservation management in our hospital and records should be made when the staff exchange.The mixed medical wastes have been solved.While transporting the medical wastes,closed vans should be used in order to avoid wastes left on the road.After our measures were put in place good achievement was made.CONCLUSIONS Standardized training on separation,collection,transportation,preservation and settlement of medical wastes should be carried out among medical staff at all levels.The facilities for medical wastes settlement should be improved.Investigation,supervision and adjustment in this regard should be strengthened.

Objective To analyze the clinical characteristics of acute hematogenous pulmonary tuberculosis and tuberculous meningitis in pregnant women after in vitro fertilization and embryo transfer (IVF-ET).Methods Clinical data of 11 cases of hematogenous pulmonary tuberculosis and tuberculous meningitis in women after IVF-ET admitted in Hangzhou Red Cross Hospital from January 2003 to October 2012 were retrospectively analyzed.Results The clinical manifestations of acute hematogenous pulmonary tuberculosis and tuberculous meningitis were non-specific.All cases presented with fever,and some were accompanied by headache,but no typical respiratory manifestation was observed.Chest X-ray showed typical military lesions.Miscarriage occurred in 11 patients within 2 to 5 weeks after the onset of fever,including 3 received artificial abortion.Conclusions The outcome of hematogenous pulmonary tuberculosis in pregnant women after IVF-ET is less favorable.Physicians should be aware of tuberculosis in pregnant women after IVF-ET,especially for those with long-term fever and not responding to anti-inflammatory treatment.

Objective To investigate the pathogens inducing a posto perative nosocomial infection. Methods Specimens was collected fro m exudates or air for bacteria culture and identification. Re sults The postoperative infection was induced by staphylococcus x ylosus. Conclusions The relevant factors affecting the po stoperative nosocomial infection include incomplete sterilization of operative r oom and operative tools. Thus strict control measures must be put into effect.

Objective To study the characteristics of the serum free light chain ( sFLC ) and cytokines levels and the effects of cyclophosphamide (CTX) on patients with primary Sj(0)gren's syndrome (pSS) complicated with amyloidosis.Methods Nine patients of pSS with amyloidosis who were admitted to Department of Rheumatology of the hospital from Jan 2005 to Mar 2011 were selected.The serum levels of sFLC and cytokines TNF-α,TGF-β1,IL-4 were measured before and 3,6,12 months after the treatment respectively.Meanwhile,Twelve patients with pSS without complications were selected as controls.Repeated measures analysis of variance was used for data analysis.Results The sFLC in serum of pSS patients with amyloidosis was λ type,the κ type was not found.The level of serum sFLC after 12 months treatment [(22±42) mg/L]was significantly lower than before treatment [(180±15) mg/L].The levels of TNF-α,TGF-β1,IL-4 after 12months treatment [(24.0±1A),(58±5),(38.8±3.2) ng/L,respectively] were significantly lower than before treatment [(31.1±L0),(65±5),(61.2±3.8) ng/L,respectively].Conclusion The levels of serum sFLC and eytokines are abnormally increased in patients of pSS with amyloidosis.After treatment,the levels of cytokines are decreased initially which indicates that these cytokines may play a key role in the pathogenesis of pSS.CTX therapy may lead to better efficacy and more favorable prognosis.

OBJECTIVE To study the application of APACHE Ⅲ in ICU targeted surveillance to assess the standards for clinical illness grading and scoring.METHODS From Sep 2006 to Feb 2007,nosocomial infection was monitored among the patients in a comprehensive ICU and the APACHE Ⅲ was used in assessing the standards for clinical illness grading and scoring in comparison with the previous method.RESULTS Among 972 ICU patients over that time,264 cases were selected as the supervision targets,84 patient-times with nosocomial infection were found out with a daily incidence of 8.642%.Two clinical doctors assessed and graded patients′ conditions.There was significant difference in the results between the methods by the clinical doctors and APACHE Ⅲ(P

ObjectiveTo evaluate the clinical effects of early pain intervention provided by an acute pain service team on the efficacy of postoperative patient-controlled analgesia ( PCA).MethodsOne thousand four hundred and sixty-seven patients receiving postoperative PCA in November and December 2011 were enrolled in this study.Patients were excluded from the study if they were ＜ 12 yr,unconscious or uncoorperative.The patients were divided into control group (group C,n =725) and intervention group (group 1,n =742).Group 1 received preoperative systematic pain education on the significance and conect use of PCA including pharmacology of analgesic (sufentanil 100 μg in normal saline 100 ml) by an acute pain service team made up of anesthesiologists and nurses specializing in pain management.The education was repeated immediately before operation and when the patients were discharged from recovery room.While in grup C the correct use of PCA was explained routinely before operation by anesthesiologists and nurses taking care of the patients.The incidence of incomplete analgesia and adverse reactions and patient' s satisfaction were rated.ResultsThe incidence of incomplete analgesia was significantly lower and the patient's satisfaction higher in group 1 than in control group.There was no significant difference in adverse reactions between the two groups.ConclusionEarly pain intervention provided by an acute pain service team is effective in improving the efficacy of postoperative PCA and patient's satisfaction.

AIM: To observe the expression of HIF-1? mRNA, HIF-1?, VEGF and iNOS proteins and to investigate their relationship in h ypoxia-treated SW480 cells. METHODS: HIF-1?, VEGF and iNOS proteins were measured by immuno cytochemistry. Western-blot was used to detect HIF-1? protein. HIF-1? mRNA wa s measured by in situ hybridization. RESULTS: Under hypoxic condition, SW480 cells expressed proteins of HIF-1?, VEGF and iNOS more strongly than that under normoxia condition. How e ver, under hypoxia condition, these three proteins expressed weakly or negativel y when the cells treated with genistein, the inhibitor of HIF-1?. Expressions o f HIF-1? and VEGF proteins in cultured SW480 cells under hypoxic condition were completely or partially inhibited by the addition of SNP but the expression of iNOS was unaffected. Another NO donor NOC5, however, induced the expression of t hese three proteins. L-NAME, a non-specific inhibitor of NOS, inhibited the expr ession of HIF-1?, VEGF and iNOS. The levels of HIF-1? mRNA changed slightly i n different oxygen condition or addition of genistein, NO donor or iNOS inhibitor . CONCLUSIONS: Hypoxia induces the expression of HIF-1?, therefor e upregulates the production of VEGF and iNOS. During hypoxia, SNP inhibits but N OC5 promotes HIF-1? expression, indicating that different NO donor acts on the cells through different mechanisms.

Objective To establish a mouse model of systemic C. albicans infection by oral inoculation of the pathogen and observe the proliferation and distribution of C. albicans in vivo tissues. Methods Male ICR mice(n=46) were used as the experiment group(n=40) and blank group (n=6). Cotton swabs with C. albicans were used to infect the mice (7 × 106 CFU/mL), and the blank group with saline. The mice of the experiment group were randomly divided into two groups:model group A for clinical assessment (n=20) and model group B for tissue fungal burden detection (n=20). Clinical score, survival and autopsy were carried out among the model group A. Five mice were randomly killed from the model group B at 3 d, 5 d and7 d after infection, respectively ( blank group killed 2 mice each time) . Microbial load tablet method was used to detect the tissue fungal burdens in different tissues, meanwhile samples of tongue, esophagus, stomach, liver, kidney, lung of infected mice were taken for pathological examination. Results White spot appeared on the surface of tongue since 3 d postinfection and increased with time and finally caused death. The mortality reached over 50% at 5 d. C. albicans was not only detected from the tongue (87?5%), stomach (87?5%), liver (54?5%), kidney (50?5%), lung (20%) and heart (4%), but also was microscopically seen mycelia proliferation in the tongue, stomach, liver, and kidney , yet not seen in the control group, showing that C. albicans caused disseminated systemic infection through mucosal infection in mice. Conclusions C. albicans can induce opportunistic systemic infection by breakthrough the mucosal immune barrier, so as to increase the infection to death.

Objective:To investigate the effect, safety and compliance of micro-implant anchorage in adolescent orthodontic treatment.Methods:A total of 50 adolescent patients who underwent orthodontic treatment from March 2017 to March 2019 in the Department of Stomatology, Li Huili Hospital of Ningbo Medical Center were selected and randomly divided into control group and observation group according to the digital table, with 25 cases in each group.The control group received conventional corrective treatment, and the observation group received micro-implant anchorage therapy.The treatment efficacy, upper incisor dip angle and tooth convexity difference, molar displacement, safety, adverse reactions and compliance were compared between the two groups.Results:There were no statistically significant differences in gender, age, etc.between the two groups(all P>0.05). The improvement of the incisor angle difference, tooth crown distance difference and molar displacement difference in the observation group were significantly better than those in the control group, the differences were statistically significant( t=11.328, 20.011, 17.336, all P<0.05). The incidence of adverse reactions such as soft tissue edema, oral inflammation and discomfort of correction in the observation group (8%) was lower than that in the control group(28%), the difference was statistically significant(χ 2=10.225, P<0.05). The compliance of patients in the observation group (96%) was significantly higher than that in the control group (80%), the difference was statistically significant(χ 2=19.316, P<0.05). Conclusion:The micro-implant anchorage is effective in the clinical treatment of adolescent orthodontics, with high safety and high patients’ compliance.It is worthy of clinical promotion.

Objective:To investigate the correlation between different degrees of white matter hyperintensities (WMHs) and outcome after intravenous thrombolysis (IVT) in patients with acute ischemic stroke.Methods:Patients with AIS received intravenous thrombolytic therapy with standard dose of alteplase in the First Hospital of Putian City from January 2019 to June 2022 were retrospectively included. The Fazekas scale was used to score the WMHs shown on MRI, and the patients were divided into without or mild WMH group and moderate-to-severe WMH group. The clinical baseline data and the clinical outcome after 3 months of the two groups were compared. The poor outcome was defined as the modified Rankin scale score >2. Multivariate logistic regression analysis was used to determine the influence of the severity of WMHs on the outcome after intravenous thrombolysis. Results:A total of 103 patients with AIS were included. Their age was 64.85±10.89 years old, and 66 (64.1%) were men. There were 60 patients (58.3%) in the without or mild WMH group, and 43 (41.7%) in the moderate-to-severe WMH group. There were significant differences in age, body mass index, systolic blood pressure, baseline National Institutes of Health Stroke Scale (NIHSS) scores, as well as the proportion of patients with hypertension, smoking, hemorrhagic transformation and poor functional outcome at 3 months after onset in different degrees of WMH groups (all P<0.05). There were 73 patients (70.9%) in the good outcome group and 30 (29.1%) in the poor outcome group. There were significant differences in age, body mass index, baseline NIHSS score, WMH score, as well as the proportion of patients with hypertension, large atherosclerotic stroke and symptomatic intracranial hemorrhage between the two groups ( P<0.05). Multivariate logistic regression analysis showed that after adjusting for confounding factors, moderate-to-severe WMHs were the independent risk factors for the poor outcome at 3 months after intravenous thrombolysis (odds ratio 3.810, 95% confidence interval 1.298-1.124; P=0.015). Conclusion:Moderate-to-severe WMHs are associated with the poor outcome in patients with AIS at 3 months after intravenous thrombolysis.