OBJECTIVE To strengthen the infection management in the public and private town hospitals.METHODS We investigated the infection management in the public and private hospitals which are below Grade 2 in our city.RESULTS The problems existing in the infection management in these hostpitals were obvious and severe,mainly including the leaders′ ignorance of the importance of infection management,incomplete organization and regulation,medical workers′ lacking of the related knowledge about infection management,behindhand hospital infection management, monitoring and prevention,and incorrect sterilization.CONCLUSIONS The infection mangement in public and private town hospitals is weak and needed to be strengthened.

Objective:To investigate the clinical pharmaceutical care methods and promote rational drug use. Methods:The diag-nosis and treatment process of one patient with chronic obstructive pulmonary disease were used as the examples, the pharmacists par-ticipated in selecting drugs, adjusting dosage and making individual regimen to carry out the pharmaceutical care in the whole treatment process, including observing curative effect, monitoring adverse reactions, implementing patient education,nutritional support, immu-notherapy and the effect evaluation. Results:Clinical pharmacists together with clinicians developed the treatment regimens for the pa-tient with the full implementation of pharmaceutical care, the effect was promising, and the patient recovered and discharged from hos-pital. Conclusion:Clinical pharmacists should implement pharmaceutical care for patients with chronic obstructive pulmonary disease in the whole treatment process, which can reduce drug adverse reactions and interactions effectively, and play an important role in ra-tional and safe drug use.

OBJECTIVE To reinforce the management of occupational risks among cleaner employec to lower the occurrence of job related exposure.METHODS Set up a survey to estimate the level of the awareness and knowledge among the cleaner employec about job related exposure and protective procedures in the three medical facilities of Yueqing City.RESULTS From 183 cleaner employec,sharp object cuts accounted for 89.6% per year;45.4% of them only had elementary education or less;39.3% of them wore protective gloves voluntarily during daily work.No one followed the hand hygeine procedures.It showed that the contracted cleaning workers had a huge potential occupational risks.CONCLUSIONS Cleaner employec are the weaker point of occupational exposure protection in the hospitals.Enforceing the mandatory immunization and monitoring their occupational risks and exposures can prevent incidence.

Objective To examine the cellular distribution and expression,activation of nuclear factor ?B(NF-?B) in the tissuses of chorion of early spontaneous abortion,and explore the relationship between early spontaneous abortion and NF-?B.Methods The NF-?B expression on the chorionic villi was analyzed by S-P immunohistochemistry.The nucleoplasmic ratio of NF-?B was detected by laser scanning confocal microscope.Results The expression intensity of NF-?B in the syncytiotrophoblasts was significantly weaker in women with early spontaneous abortion than in the normal early pregnancy(P

BACKGROUND: It is discovered that trace elements in Chinese patent medicine play an important role in pharmaceutical efficacy and structural analysis. A new topic has been formed gradually in a further research on pharmaceutical efficacy and effective components of Chinese patent medicine in the view of inorganic trace elements. The fuzzy classified study on the interrelationship between trace and constant elements of Chinese herbs and therapeutic effects is to discuss the trace-element action of drugs in the holistic aspect of trace elenent and research rather scientifically the holistic coordination among trace elements in Chinese herbs.OBJECTIVE: To determine the contents of 21 kinds of trace and constant elements in Chinese patent medicines in the treatment of cardio-cerebral vascular disease. To study with fuzzy classified method the interdependence between trace, constant elements of drugs and therapeutic effects so as to provide a new approach for the quality evaluation of Chinese patent medicine.DESIGN: Testified observed study based on various Chinese patent medicines.SETTING: Chemistry teaching-research room in a university and department of cardiology in a general hospital of a chemical industrial group corporation.MATERIALS: Twenty-one kinds of common Chinese patent medicines for the treatment of cardio-cerebral vascular diseases in clinic, namely di' ao xinxuekang capsule(DXK), xueshuan xinmaining capsule(XMN), shan haidan capsule(SHD), buchang naoxintong capsule(NXT), linaoxin capsule(LNX), xinnaosu capsule(XNS), lixin wan(LXW), suxiao jiuxin wan (SJX), xinbao wan(XBW), yinxingye pian(YXY), fufang danshen pian (DSP), niuhuang jiangya wan(NHJY), naosaitong pian(NST), qiangli tianma duzhong wan ( TD W ) , tongsaimai pian ( TSM ) , tongmai ningxin infusion(TMNX), maitong capsule(MTC), fufang yinxing wan ( YXW ) , da huoluo dan(DHL), guanxin suhe capsule(GXSH) and xiaoshuan tongluo capsule (XSTL).METHODS: Wet digestion was used to manage samples, atomic absorption spectrophotometric method(AAS) method was used to determine the contents of 10 kinds of trace and constant elements in 21 Chinese patent medicines,namely Na, Ca, Mg, K, Fe, Cr, Ni, Cu, Zn and Mn. Data range method was applied for the standardized management of statistical indexes of various element contents in relevant drugs, dotprod(U, V) method was used to measure correlation coefficient(r) among the classified objects so as to determine fuzzy matrixes in universe. The interrelationship was analyzed between the contents of trace elements of various Chinese medicines and pharmaceutical efficacy. By the analysis of fuzzy matrixes in universe, it was to evaluate firmly on the efficacy similarity of various kinds of Chinese patent medicines with quantitative indexes.MAIN OUTCOME MEASURES: ① Results of element contents; ② Results of fuzzy cluster analysis on elements.RESULTS: The standardized management of statistical indexes was carried on the contents of Na, Ca, Mg, K, Fe, Cr, Ni, Cu, Zn and Mn in various drugs to determine correlation coefficient(r) among the classified objects so as to determine fuzzy matrixes in universe. When(r) = 0.55, there were 9 kinds of drugs similar in cluster, namely xueshuan xinmaining capsule, buchang naoxintong capsule, lixin wan, xin bao wan, qiangli tianmai duzhong wan,tongsaimai pian, maitong capsule, da h uoluo dan and xiaoshuan tongluo capsu le. When(r) =0. 65, there were 6 kinds of drugs similar in cluster,namely buchang naoxintong capsule, xin bao wan, qiangli tianmai duzhong wan, tongsaimai pian, maitong capsule and xiaoshuan tongluo capsule. When(r) =0. 87, there were 2 kinds of drugs similar in cluster, namely buchang naoxintong capsule and xin bao wan.CONCLUSION: It is indicated in the research that the drugs are in rich of trace and constant elements. The larger the correlation coefficient of drugs is,the more similar the pharmaceutical efficacy is. It is discovered the close interrelationship of the trace and constant elements in drugs with their pharmaceutical efficacy. In this research, fuzzy classified method is used to discuss, in the view of trace elements, the similarity of quantitative indexes in efficacy of Chinese patent medicine commonly administrated in the treatment of cardio-cerebral vascular disease, which has provided a new approach for the quality evaluation of Chinese patent medicine.

Objective To evalume the efficacy and side effect of capecitabine combined chemotherapy regimen in treatment of advanced cohrectal cancer in senile patients.Methods Seventy-seven cases senile patients with advanced colorectal cancer were randomly divided in two groups.capecitabine combination group (36 cases) received oxaliplatin (L-OHP)+ eapecitabine regimen, OLF group (41 cases) received L-OHP+ FU/CF regimen. The efficacy and side effect were observed and compared between two groups.Results eapecitabine combination group:the cfficiency rate was 41.67%,the tumor control rate was 77.78%.meso-tumor to progression was 7.9 months.OLF group:the efficiency rate was 39.02%,the tumor control rate was 75.61%,meso-tumor to progression was 7.2 months.The effectiveness in two groups had no significant difference (P＞005).There was no serious chemotherapy related side effect in two groups.The rates of marrow inhibition,nausea,vomiting,diarrhea,alopecia,rash,the lesion of liver and renal function and peripheral neuritis were similar in two groups.The rate of hand-foot syndrome was apparently higher in capecitabine combination group compared with OLF group (P＜0.05).Conclusions For senile advanced colorectal cancer patienrs,the treatment efficiency is similar between capecitabiae combination regimen and OLF regimen,the side effect is all tolerated in two regimens.capecitabine combination regimen is oral adminisuered and decurates hospitnlization time and improved the life quality of senile patients.capecitabine combination regimen is a suitable fast-line regimen for senile advanced colorectal cancer pafients.

Objective To evaluate the monitoring value of serum albumin and plasma von willebrand factor in patients with stroke.Methods Serum albumin and plasma von willebrand factor were measured from 145 patients with stroke(95 patients with nonpoor outcome and 50 patients with poor outcome) in two weeks and after six months from stroke onset to study the relationships with prognosis.Results Serum albumin level was significantly higher in patients with nonpoor outcome(mRS≤2) after six months stroke onset than those with poor outcome(mRS≥3) and was lower after six months stroke onset than in two weeks from stroke onset.On the other hand,plasma vWF level in patients with stroke was significantly higher than that in healthy controls and was higher in two weeks than after six months from stroke onset.Patients with poor outcome had higher plasma vWF level than patients with nonpoor outcome in two weeks and after six months from stroke onset,but had no significant difference.Conclusion The level of serum albumin and plasma von willebrand factor is related with nutritional status,active extent and prognosis in patients with stroke.

Water deprivation and loading tests were performed in a patient with sustained hypernatremia and hypodypsia. Results suggested that the regulation of ADH release was still retained despite of the raised threshold, being consistant with the diagnosis of essential hypernatremia. The hypernatremia of this patient was partially improved by dihydrochlorothiazide and desmopression acetate (DDAVP).

Objective To explore the relating factors for cognitive dysfunction in patients with acute exacerbation of chronic obstructive pulmonary disease (AECOPD).Methods Totally 150 patients with acute exacerbation of COPD (AECOPD) and 150 gender and age-matched healthy subjects (controls) received the cognitive and depression function assessment.150 AECOPD cases were classified into two groups:COPD patients with or without cognitive dysfunction.Fasting blood uric acid (UA) was measured and compared between the two groups.Relating factors for cognition dysfunction were analyzed.Results The score of Montreal Cognitive Assessment (MoCA) was reduced in AECOPD patients as compared with controls [(19.01±3.58) vs.(26.58±1.42)scores,t=-3.48,P=0.032].The score of Hamilton depression (HAMD) scale was higher in AECOPD patients than in controls [(18.05 ± 4.50) vs.(9.98 ± 3.51) scores,t =4.63,P =0.028].The prevalence of cognitive impairment in the patients with AECOPD was 82 cases (54.7％).The serum UA level was lower in the AECOPD patients with cognitive impairment than in patients without cognitive impairment [(235±42) μmol/L (n=82) vs.(332±45) μmol/L (n=68),t=-6.65,P=0.003].In AECOPD patients,the cognitive function was correlated with education,length of hospital stay,serum UA level,COPD stages,disease duration and the depression level,but was not correlated with smoking and body mass index.Conclusions The cognitive impairment is highly prevalent in patients with AECOPD,which is associated with lower serum UA level,longer hospital stay and disease severity.

Objective To evaluate the role of spinal κ-opioid receptors in remifentanil-induced postoperative central sensitization in a rat model of incisional pain by in vivo electrophysiology.Methods Sixty adult male Sprague-Dawley rats in which intrathecal catheters were successfully implanted,weighing 230-270 g,were divided into 5 groups (n=12 each) using a random number table:control group (group C),incisional pain group (group I),remifentanil group (group R),remifentanil plus incisional pain group (group R+I),and κ-opioid receptor agonist U50488H group (group U).A 1 cm longitudinal incision was made through skin,fascia and muscle of the plantar aspect of the right hind paw in isofiurane-anesthetized rats to establish the model of incisional pain.Remifentanil was intravenously infused for 1 h at a rate of 10 μg · kg 1 · min-1 in group R.In group R+I,remifentanil was intravenously infused for 1 h at a rate of 10 μg · kg-1 · min 1,and the model of incisional pain was established at the same time.In group U,U50488H 10 μg/10μl was injected intrathecally,30 min later remifentanil was intravenously infused for 1 h at a rate of 10 μg · kg-1 · min-1,and the model of incisional pain was established.Six rats in each group were randomly selected,the mechanical pain threshold (MPT) was measured in bilateral hind paws before implanting intrathecal catheter (T0),before operation (T1),and at 1 h,4 h and 1,2 and 3 clays after operation (T2-6).Six rats in each group were randomly selected to record the C fiber-evoked filed potentials in the spinal dorsal horn from 60 min before administration or operation to 180 min after administration or operation,the long-term potentiation (LTP) induced was also recorded,and the area under the curve (AUC) of C-fiber-evoked field potentials was calculated.Results No LTP was recorded in C,I and U groups,and the LTP was recorded in R and R+I groups.Compared with group C,the MPT in bilateral hind paws at T5,6 was significantly decreased in group R,the MPT in ipsilateral hind paws at T2 6 was decreased in group I,the MPT in ipsilateral hind paws at T2-6 and in contralateral hind paws at T5,6 was decreased in group R+I,the MPT in ipsilateral hind paws at T2-4 was decreased in group U,and the AUC of C-fiber-evoked field potentials was increased in R and R+I groups (P＜0.05).Compared with group Ⅰ,the MPT in ipsilateral hind paws at T4-6 and in contralateral hind paws at T5,6 was significantly decreased,and the AUC of C-fiber-evoked field potentials was increased in group R+I (P＜0.05).Compared with group R+ I,the MPT in ipsilateral hind paws at T2-6 and in contralateral hind paws at T5,6 was significantly increased,and the AUC of C-fiber-evoked field potentials was decreased in group U (P＜0.05).Conclusion The results of in vivo electrophysiology confirm that inhibition of spinal κ-opioid receptor function mav be involved in the mechanism by which remifentanil induces postoperative central sensitization in a rat model of incisional pain.