Objective To ensure the quality of disinfection and sterilization of the fiberbronchoscope in the sterilesupply center through the implementation of whole life cycle management.Methods Using the historical comparative method,the fiberbronchoscopes managed by the departments were enrolled into a control group from February 2013 to March 2014,and the ones undergoing life-cycle management in the sterile supply center were involved in an observation group from April 2014 to May 2015.The two groups were divided according to the management subject and mode,and compared from the aspects of treatment flow,process quality control and record tracing validity.All the data were input with Excel sheet,andanalyzed statistically with SPSS 17.0.Results The observation group and the control group had the numbers of positive results in internal cavities,positive results in external surface,damaged or irrationally-placed package,invalid data tracing and non-standardized storage being(0,1.11±0.15),(0,1.09±0.20),(1.07±0.13,2.75±0.22),(0.57±0.03,1.53±0.31) and (0.13±0.07,0.95±0.21) respectively,and the differences between the two groups were significant (P＜0.05).The turnover of the fiberbronchoscope was enhanced significantly in the observation group when compared with that in the control group.Conclusion Life cycle management contributes to strengthening quality control of the treatment of polluted fiberbronchoscope,and decreases the incidences for hospital infection.

Objective To observe the clinical effect of anterior capsule relaxing incisions with Nd:YAG laser in treating postop-erative anterior capsule contraction in high-risk cataract patients.Methods 120 high-risk cataract patients with postoperative ante-rior capsule contraction collected from December 2010 to November 2012 were divided into experimental group(performed the ante-rior capsule relaxing incisions on postoperative 3 d)and control group.The anterior capsule opening area was measured immediately after laser operation(baseline),in postoperative 1,3,6 months by using the Scheimpflug video photogeaphy system,and the descent rate of the opening area was simultaneously calculated.The decentration degree and tilt of intraocular lens(IOL),posterior capsule opacification and other complications were also assessed.Results Of the observed 120 cases,40 cases were pseudo posterior capsule stripping syndrome,40 cases were primary angle closure and 40 cases were diabetic retinopathy.There was no statistically signifi-cant difference in the baseline value of the opening area between the experimental group and the control group(P>0.05).In the ca-ses of primary angle closure 1,3,6 months after operation,the anterior capsule opening area in the experimental group was signifi-cantly increased compared with the control group(P<0.05)and the descent rate of the opening area was significantly diminished (P<0.05).In the cases of pseudo posterior capsule stripping syndrome or diabetic retinopathy,although there was no statistically significant difference in anterior capsule opening area between the experimental group and the control group(P>0.05),the descent rate of the opening area was significantly diminished(P<0.05).No significant differences were found in the aspects of IOL decen-tration and tilt,posterior capsule opacity,or other complications.Conclusion YAG laser anterior capsule relaxing incisions in the early period after cataract surgery is safe and effective in preventing anterior capsule contraction in high-risk patients.

OBJECTIVETo analyze the change in drug resistance of Staphylococcus aureus (SAU) in the PLA general hospital from January 2008 to December 2012, and to provide solid evidence to support the rational use of antibiotics for clinical applications.

METHODSThe SAU strains isolated from clinical samples in the hospital were collected and subjected to the Kirby-Bauer disk diffusion test. The results were assessed based on the 2002 American National Committee for Clinical Laboratory Standards (NCCLS) guidelines.

RESULTSSAU strains were mainly isolated from sputum, urine, blood and wound excreta and distributed in penology, neurology wards, orthopedics and surgery ICU wards. Except for glycopeptide drugs, methicillin-resistant Staphylococcus aureus (MRSA) had a higher drug resistance rate than those of the other drugs and had significantly more resistance than methicillin-sensitive Staphylococcus aureus (MSSA) (P < 0.05). In the dynamic observation of drug resistance, we discovered a gradual increase in drug resistance to fourteen test drugs during the last five years.

CONCLUSIONDrug resistance rate of SAU stayed at a higher level over the last five years; moreover, the detection ratio of MRSA keeps rising year by year. It is crucial for physicians to use antibiotics rationally and monitor the change in drug resistance in a dynamic way.

Anti-Bacterial Agents ; pharmacology ; Drug Resistance, Multiple, Bacterial ; Humans ; Methicillin-Resistant Staphylococcus aureus ; drug effects ; Staphylococcal Infections ; drug therapy ; Staphylococcus aureus ; drug effects

Child ; Child, Preschool ; Female ; Forkhead Transcription Factors ; genetics ; metabolism ; Humans ; Immune System Diseases ; immunology ; Male ; Purpura, Thrombocytopenic, Idiopathic ; genetics ; immunology ; metabolism ; T-Lymphocytes, Regulatory ; immunology

Objective To investigate the effect of dexmedetomidine ( Dex) combined with ropivacaine in brachial plexus block ( BPB) on serum basic fibroblast growth factor ( bFGF) levels of upper limb fracture patients in the perioperative period. Methods 80 patients ( ASA gradeⅠ~Ⅱ) scheduled for selective upper extremity surgery were randomly divided into the dexmedetomidine combined with ropiva-caine group ( RD group) and the ropivacaine group ( R group) with 40 patients in each group. BPB was performed at the point of 2 cm below coracoid directed by nerve stimulator. Ropivacaine (200 mg) was diluted into 40 mL in group R and ropivacaine (200 mg) +1 μg/kg dexmedetomidine were diluted into 40 mL in group RD. Drew 5 mL blood at T0~T4 points respectively,and serum bFGF concentration were determined. Results Compared with group R,MAP and HR at T1~T3 points were significantly lower in group RD (P<0. 05). SpO2 in the two groups at each point had no statistical significance (P>0. 05). Compared with T0 points,bFGF concentration were increased in two groups at T1~T4 points (P<0. 05),and it was higher in group RD compared with group R (P<0. 05). Conclusion Dex combined bra-chial plexus block promote the secretion of bFGF more than simple brachial plexus block,which is conducive to fracture healing after opera-tion,but it should be cautious to apply for patients with bradyarrhythmia.

patients received thoracic surgery. Methods Fifty patients underwent radical resection of pulmonary carcinoma were divided into DP group ( dexmedetomidine infusion by micro pumo and parecoxib 40 mg through intravenous injection) and DN group ( dexmedetomidine infusion by micro pumo and nomal saline 5mL through intravenous injection). The time for spontaneous breath,eye opening and extubation after the oper-ation were recorded. The mimi-mental state examination ( MMSE) was used to assess the cognitive function. The concentration of protein S100β and IL-6,TNF-α were determined at 1 d before operation and 1 h,24 h after the operation. Results The difference of time for spon-taneous breath,eye opening,extubation and preoperative values of MMSE between two groups were not statistically significant(P>0. 05). MMSE scores at 1 d,3 d and 5 d after operation in group DN were lower than those in group DP (P<0. 05). The values of S100β、IL-6、TNF-α at 1 h and 24 h after operation in group DN were higher than that in group DP (P< 0. 05). Conclusion Dexmedetomidine com-bined with parecoxib can decrease the incidence of postoperative cognitive dysfunction in elderly patients underwent thoracic surgery,and the mechanism of which may be related to the downregulation of serum inflammatory factors.

Objective To investigate the effect of the serum of patients with hepatopulmonary syndrome on the myogenic differentiation,proliferation and migration of human lung fibroblasts.Methods The human lung fibroblasts were seeded in plates or flasks and randomly divided into 2 groups (n =31each) using a random number table:serum of patients with hepato-pulmonary syndrome group and serum of healthy volunteer group.The human lung fibroblasts were incubated in the DMEM culture medium containing 10％ serum of patients with hepatopulmonary syndrome or in the DMEM culture medium containing 10％ serum of healthy volunteers.At 24,48 and 72 h of incubation (T1-T3),the expression of smooth muscle-α-actin (SM-α-actin) and smooth muscle myosin heavy chain (SM-MHC) in human lung fibroblasts was determined by Western blot,the proliferation of the human lung fibroblasts was determined using 3H-TDR incorporation assay,and the migration of the human lung fibroblasts was determined by Transwell chamber assay.Results Compared with serum of healthy volunteer group,the expression of SM-α-actin and SM-MHC in human lung fibroblasts was significantly up-regulated at each time point,and the proliferation and migration of the cells were significantly enhanced at T2,3 in serum of patients with hepatopulmonary syndrome group (P＜0.05).Compared with the value at T1,the expression of SM-α-actin and SM-MHC in human lung fibroblasts was significantly up-regulated,and the proliferation and migration of the cells were significantly enhanced at T2,3in serum of patients with hepatopulmonary syndrome group (P＜0.05).Compared with the value at T2,the expression of SM-α-actin and SM-MHC in human lung fibroblasts was significantly up-regulated,and the proliferation and migration of the cells were significantly enhanced at T3 in serum of patients with hepatopulmonary syndrome group (P＜0.05).Conclusion The serum of patients with hepatopulmonary syndrome can promote the myogenic differentiation,proliferation and migration of human lung fibroblasts.

Objective To investigate the clinical effect of digital multifunction trauma rinser(DMTR) on wound cleaning .Meth-ods 278 trauma patients from 6 hospitals were divided into groups by hand washing and DMTR .The cleaning time ,the amount of cleaning fluid and the effects of wound cleaning and bacterial clearance and healing were compared between the two groups .Results DMTR save time ,reduced the amount of cleaning fluid ,reduced residual bacteria ,and had better wound healing in patients with large wound area .Conclusion DMTR ,which is worthy of clinical application ,has better effect on cleaning large wounds than the traditional manual debridement w ay .

Objective:To study the epidemiology of attention-deficit hyperactivity disorder(ADHD) in pupils of Zhenjiang urban districts. Methods: Questionnaire was designed and employed for parents of 3 698 pupils at schools in Zhenjiang urban districts. ADHD was diagnosed according to the international DSM-Ⅳ scale. Differences were determined by Qi-square test and multiple regression analysis. Results: Prevalence of ADHD was 6.54% in pupils of Zhenjiang urban districts, and was 9.14% in male pupils and 4.01% in female. There was significant difference between 2 gender groups (? 2=34.933,P

Objective To explore the role of protein kinase C(PKC) to regulate the activation of nuclear factor-?B(NF-?B)in T lymphocyte in children with acute idiopathic thrombocytopenic purpura(ITP).Methods Sterility peripheral blood was collected from acute ITP children(n=30)and healthy children(n=30).T lymphocytes were isolated and purified,and divided into 3 groups:control group,PMA group stimulated with PMA,PMA plus H-7 group stimulated with PMA and H-7.The expression of NF-?B and inhibitor protein-?B(I-?B)was detected by immunohistochemical staining and Western blot,respectively.Results The percentage of cells with active NF-?B was significantly higher and the expression level of I-?B was significantly lower in acute ITP PMA group than that in acute ITP control group and normal PMA group,respectively(all P