Objective To understand the cleaning status of hospital environment,and evaluate the effect of fluo-rescence labeling method plus feedback and training on hospital environmental cleaning effectiveness.Methods A total of 27 departments in a hospital were investigated,1 cleaning staff and 2 inpatients were selected from each de-partment,cleaning staff’s knowledge about cleaning and disinfection of environmental object surfaces,as well as cleaning status of inpatients’wards were surveyed,cleaning efficacy of hospital environmental object surfaces were detected with fluorescence labeling method,the surveyed results were performed timely feedback to clinical depart-ments,training on cleaning and disinfection knowledge was conducted,the effective cleaning rate of environmental object surface before and after the training was compared.Results A total of 27 cleaning staff were surveyed,the correct response rate for cleaning frequency was 96.30% ,awareness rate for section concept was 96.30% ,accuracy rate of cleaning order was 92.59% ,accuracy rate of post-cleaning immersion time of sanitary wares in disinfectant was 85.19% ,accuracy rates of replacing,drying,and repeated immersing wiping cloths were 81.48% ,48.15% ,and 25.93% respectively,rates of correct disinfectant formulating method and mop drying time were both 0. Among 54 investigated patients,bed units and ground of wards of 28 patients were cleaned both 1-2 times/day;bed units of 8 patients had never been wiped,18 patients in 9 departments cannot be conducted statistics due to completely in-consistent responses with the other patients of the same departments. The effective cleaning rates of environmental object surfaces before and after the training were 34.62% and 64.96% respectively,difference was significant(χ2=21.81,P<0.01).Conclusion Fluorescence labeling method plus feedback and training can improve cleaning efficacy of hospital environmental object surfaces.

This study is to investigate the effects of concentration, intestinal section, pH, paracellular route, substrate/inhibitor of enzyme (CYP3A) and proteins (P-gp, MRP2, SGL1) on the absorption of forsythoside A. The absorption of three concentrations (2.6, 5.2, and 10.4 microg x mL(-1)) of forsythoside A in different intestinal segments was studied with phenol red as the marker by rat circulation in situ. The results showed that the residue of forsythoside A with different concentrations had little significant difference from that obtained after perfusing via duodenum, jejunum, ileum and colon, which indicated that the absorption of forsythoside A was passive diffusion and had no difference in different segments of rat intestine. The residue of forsythoside A increased to 466.160 and 463.429 microg respectively when cyclosporine (4 microg x mL(-1)) or midazolam (50 micromol x L(-1)) was added to the circulation fluid, which showed significant difference compared to the control group (P < 0.05). Moreover, the residue of forsythoside A showed a tendency of increase with the increase of cyclosporine or midazolam. When digoxin (50 micromol x L(-1)) or EDTA (10 microg x mL(-1)) was added to the circulation fluid, the residue of forsythoside A decreased to 325.110 and 369.888 microg respectively, which showed significant difference as compared to the control group (P < 0.05). Besides, the residue of forsythoside A showed a tendency of reduction with the increase of digoxin or EDTA. However, there is no significant change in the absorption of forsythoside A when the different concentrations of mannitol were added to the circulation fluid. The results above indicated that the absorption of forsythoside A was mainly passive diffusion and involved paracellular route at the same time. In addition, the substrates of P-gp or CYP3A had dose-dependent effect on the absorption of forsythoside A.

Objective:To investigate the predictive value of the clinicopathological features of breast cancer for pathological complete response (pCR) after neoadjuvant chemotherapy (NAC) and to establish a predictive model based on the clinicopathological features.Methods:Clinicopathological data collected from 182 patients who underwent NAC and surgical treatment in Affiliated Hangzhou First People’s Hospital, Zhejiang University School of Medicine from Jan. 2013 to Dec. 2019 were retrospectively analyzed. The univariate and multivariate analysis were used to analyze the relationship between clinicopathological features and pCR after neoadjuvant chemotherapy. The predictive value in predicting the efficacy of NAC was evaluated, the receiver operating characteristic (ROC) curve and Nomogram prediction model were constructed.Results:Multivariate Logistic regression analysis showed that progesterone receptor (PR) , human epidermal growth factor 2 (HER2) and platelet distribution width (PDW) were independent predictors of pCR after NAC for breast cancer. The area under the curve (AUC) of model for predicting efficacy of NAC was 0.810 (95% CI:0.745-0.864) and the sensitivity and specificity was 68.75% and 82.67% respectively when the Jordan Index is at its maximum. Conclusion:ER-, HER2+ and PDW≤13.4% show better efficacy of NAC. The Nomogram model based on them can accurately predict the efficacy of NAC and can provide a reference for the selection of treatment options in clinical diagnosis and treatment.

Objective:To investigate the value of visfatin in the differential diagnosis of benign and malignant breast tumors and the feasibility of visfatin as a molecular marker of breast cancer.Methods:A total of 195 breast cancer patients hospitalized in the Cancer Hospital of The University of Chinese Academy of Sciences from December 2017 to July 2018 were selected as the breast cancer group, all of them were women. 80 patients with benign breast diseases in the same period were randomly selected as the breast benign disease group, all of them were women. 80 female employees with normal physical examination in the same year were selected as the normal control group. Enzyme linked immunosorbent assay (ELISA) was used to detect the serum level of visfatin. Logistic regression was used to analyze the relationship between visfatin and clinicopathological features of breast cancer. Receiver operating characteristic (ROC) curve was drawn to get area under curve (AUC) value, and the diagnostic efficacy was analyzed.Results:The serum visfatin level in breast cancer group was significantly higher than that in benign breast disease group and normal control group ( P<0.05). Univariate analysis showed that the serum visfatin level was related to lymph node metastasis, tumor node metastasis (TNM) stage and body mass index (BMI) (all P<0.05). The serum visfatin level was positively correlated with TNM stage and lymph node metastasis of breast cancer patients ( r=0.336, P=0.043; r=0.632, P=0.027, respectively). Multivariate regression analysis showed that lymph node metastasis was a risk factor for serum visfatin [ OR=1.098, 95% CI(1.073, 1.226), P=0.02]. According to the ROC curve of serum visfatin level in benign breast disease group and normal group, the AUC of serum visfatin were 0.652 and 0.701, respectively. When the Youden index was the highest, the sensitivity was 52.30% and 55.90% respectively, and the specificity was 73.10% and 75.0% respectively. Conclusions:Serum visfatin level can be used to distinguish benign and malignant breast cancer patients. It has a certain clinical value in the auxiliary diagnosis of breast cancer, and may be used as a potential molecular marker of breast cancer.

type of extreme heat with yin asthenia.But discrepancy of CO and EF between type of deficiency of both QI and YIN and type of QI-stagnation and blood stasis all had not statistical significance.Conclusion: In clinic to aim directly at left ventricular contractile dysfunction of senile diabetics,no matter syndrome differentiation belonging to type of deficiency of both QI and YIN,type of QI-stagnation and blood stasis or type of deficiency of both yin and yang,all can benefit after treatment with supplementing QI and activating blood circulation method;but syndrome differentiation belonging to type of extreme heat with yin asthenia advocates not to use supplementing QI and activating blood circulation method.

Preoperative serum specimens were collected from 249 endometrial cancers and 99 uterine leiomyomas and their concentrations of human epididymis protein 4 (HE4),CA 125 and CA 19-9 were detected.The indices of diagnostic evaluation were calculated.Preoperative serum concentrations of HE4,CA125 and CA19-9 in endometrial carcinoma group were significantly higher than those of control group.The areas under curve of HE4,CA125 and CA19-9 were 0.736,0.615 and 0.661 respectively and that of combiued markers was 0.774.At a 90％ specificity,the sensitivities for HE4,CA125,CA19-9 were 55.0％,26.9％ and 30.1％ while that of combined markers was 56.2％.HE4 is an ideal tumor marker for endometrial cancer and combined detection improves diagnostic rate.

Objective To investigate the function of major histocompatibility complex (MHC)class Ⅰ-related gene (MIC) in ulcerative colitis (UC) pathogenesis. Methods The difference of MICA, M ICB and their ligand NKG2D genes expression in colonic mucosa tissue of 34 UC patients and 12 healthy people were determined by fluorescent real-time reverse-transcriptase polymerase chain reaction (RT-PCR) and the expression location of M ICA in colonic mucosa tissue was obtained by laser scanning confocal microscope. Results The mRNA level of MICA, MICB and NKG2D expression in UC groups (3. 5408±2. 6658, 8. 9879±3. 2893 and 2. 4395±0. 8147 accordingly) was significantly higher than that in the healthy controls ( 1. 0477 ± 0. 7201, 4. 6293 ± 1. 2616 and 1. 1624±0. 3954 accordingly) (P = 0.0053, 0.0039 and 0. 0078 accordingly). It suggested that MICA was expressed in colonic epithelia cell membranes by laser scanning confocal microscopy.Conclusion The mRNA level of MICA, M ICB, and their ligand, NKG2D expression were all up regulated in the colonic mucosa of UC patients, which indicated MIC gene might perform important local function in UC.

Objective To investigate the application value of combined detection of serum human epididymis protein 4 (HE4),cancer antigen 125 (CA125) and cancer antigen 19-9 (CA 19-9) in early endometrial carcinoma.Methods Two hundred and six patients with early endometrial carcinoma (endometrial carcinoma group) and 118 patients with uterine fibroids (uterine fibroids group) were selected.Serum level of HE4 was measured by enzyme linked immunosorbent assay (ELISA),and serum levels of CA 125 and CA 19-9 were measured by chemiluminescence immunoassay(CLIA).The positive rates of serum HE4,CA125 and CA19-9 in the 2 groups were compared.The changes between pre-and post-operative in the serum levels of serum HE4,CA125 and CA19-9 were compared in 147 endometrial carcinoma patients.Results The serum levels of HE4 and CA19-9 in endometrial carcinoma group were significantly higher than those in uterine fibroids group [76.57 (56.92-104.60) pmol/L vs.56.75 (48.33-68.91) pmol/L,13.26(6.07-25.90) kU/L vs.7.64(3.76-16.45) kU/L],there were statistical differences (P =0.000),there was no statistical difference in serum level of CA125 between the 2 groups (P=0.106).In endometrial carcinoma group,the positive rates of serum HE4 and HE4 + CA125 + CA19-9 were significantly higher than the positive rates of serum CA125,CA19-9,CA125+CA19-9,there were statistical differences (P ＜ 0.01).The positive rates of serum HE4,CA19-9,HE4 +CA125,HE4 +CA19-9 and HE4 +CA125 +CA19-9 in endometrial carcinoma group were significantly higher than those in uterine fibroids group,there were statistical differences (P ＜ 0.01).The serum levels of HE4,CA125 and CA19-9 in post-operative in 147 endometrial carcinoma patients were significantly lower than those in pre-operative,there were statistical differences (P ＜ 0.01).Conclusion The diagnostic value of serum HE4 in early endometrial carcinoma is better than CA125 and CA19-9,while combined detection of serum HE4,CA125 and CA19-9 can raise the positive rate and be helpful for therapeutic effect evaluation.

A 9-year-old boy presented with pruritic erythema and erosions of the scalp for 1 month, which spread all over the body for 1 week. Histopathological examination of the skin lesions showed blisters forming under the granular layer of the epidermis, a large number of acantholytic cells in the blisters, and perivascular infiltration of lymphocytes and eosinophils in the superficial dermis. Direct immunofluorescence study showed reticular deposition of IgG and complement C3 between epidermal cells, and negative staining for IgM and IgA. Enzyme-linked immunosorbent assay showed the presence of serum anti-Dsg1 antibody (157.00 U/ml) . The patient was diagnosed with pemphigus foliaceus. After admission, the patient showed poor response to the treatment with prednisone at a dose of 40 mg/d. After the treatment with low-dose rituximab (100 mg per week, 4 weeks) combined with prednisone (20 mg/d) , her condition was well controlled. The dosage of prednisone gradually decreased to 7.5 mg/d for maintenance treatment, and no recurrence was observed during 24-month follow-up.

OBJECTIVE: To study curative effects of endoscopic sinus surgery performed on orbital periosteum abscess. METHOD: Application of ceftazidime and vancomycin 24 h later, operation on maxillary sinus and ethmoidectomy were performed under general anesthesia, Meanwhile bacterial culture and drug sensitive test were performed to the purulent secretion from accessory nasal sinuses. Nasal septum and middle turbinate, which hampered the drainage or clearing in nasal cavity, were undertaken operation in same or second stage. After operation 24 h, the wadding in nasal cavity was removed, and the effusion in nasal cavity was suctioned for 2 times daily until wound surface was covered by fresh granulation. Patients were used ceftazidime and vancomycin for 5 days, in which some patients was replaced antibiotics by drug sensitive test. RESULT: No complications occurred. Ophthalmagia, expanding of eye and headache were obviously improved, dropsy of blepharon and chemosis were decreased obviously and the movement of eye was increased much. After operation 13 - 22 days, the physical sign in ocular region recovered normal in all patients, no recurrence occurred during a 6 months follow-up, and only 6 patients presented discontinue pain in ocular region. CONCLUSION Endonasal endoscopic surgery for acute orbital of intraorbital abscess is safe and effective technique with obvious privillege.
Abscess ; surgery ; Adolescent ; Adult ; Child ; Endoscopy ; Female ; Humans ; Male ; Orbital Diseases ; etiology ; surgery ; Sinusitis ; complications ; surgery ; Young Adult