OBJECTIVE To develop the countermeasures how to strengthen disinfection and isolation in the basic(medical) and health institutions.METHODS Through investigation,to analyze the current situation and problem of disinfection and isolation in the basic medical and health institutions.RESULTS There were some problems of the(disinfection) and isolation in the basic medical and health institutions and some possibility for patient catching(nosocomial) infection.CONCLUSIONS It is very important for strictly observing Medical Instrument Surveillance and Management Regulations published by the State Council and Hospital Infection Management Standards,Disinfection Technology Standards and Disinfection Management Methods published by Ministry of Health,and strengthening the management of disinfection and isolation in the basic medical and health institutions.

Objective To investigate the reasonable operation timing for patients with acute pancreatitis without obvious infectious manifestation. Methods The findings during the operation and pathological changes in 27 pantients with necrotic pancreatitis were analysed retrospectively.Results Six patients underwent surgical treatment with in 3 weeks. The delimitation between non-necrotic pancreas and necrotic pancreas was not very clear, and the abdominal adhesion and edema were serious. Other 14 cases were subjected to the surgical treatment 3-4 weeks after the onset of illness. The delimitation was clear in 9 cases without obviously infectious signs, but the adhesion of the pancreas bed to the greater omentum or the transverse mesocolon was evident. Various degrees of necrosis was found in 3 cases, and the infection together with pancreatic necrosis developed in the other 2 cases. The rest 7 patients were operated on 5-7 weeks after the disease onset, different degrees of infection and necrosis developed in 3 cases, and local pancreatic abscess formation could be observed.There was a lot of necrosis of fatty tissues on the peri-pancreas and the root of mesentery. Conclusions Clear away of necrotic pancreatic tissue is suitable in 3-4 weeks after the onset of illness in patients with non-infectious necrosis of pancreas.If operation is performed in the initial 3 weeks, intraoperative bleeding may be severe because the detachment between the non-necrotic tissues and necrotic tissues of pancreas was not yet formed completely, which may lead to hard to do the operation and result in increasing intraoperative bleeding and even increasing reoperation .If operation was done after 5 weeks, the infection of the necrotic pancreatic tissues can be seen in most of the cases, and the infection degree in the abdominal cavity may also be serious, which may need more operations to treat.

Objective To study the value of various MR imaging techniques in the preoperative diagnosis and preoperative assessment of resectability in patients with hilar cholangiocarcinoma.Methods Seventy-eight (patients) with hilar cholangiocarcinoma were diagnosed by imaging of MRI/MRCP/MRA.Based on imaging (analysis) of the extent of local tumor invasion,vascular involvement,hepatic lobar atrophy and distant (metastasis),a preoperative imaging assessment of resectability was done in 78 patients.This preoperative (assessment) was compared with the surgical and pathological findings,so as to evaluate the imaging value in prediction of whether or not resection was feasible in patiens with hilar cholangiocarcinma.Results Of 21 (patients) with unresectable disease according to imaging evaluation, laparotomy was performed in 10 cases,and in all 10cases the tumor was proven not to be resectable at operation.Thus,the surgical and pathological (findings) were in accordance with the result of imaging.Surgical exploration was performed in 57 patients with potentially resectable disease according to imaging evaluation. In this group, the intra-operative diagnosis of the location and nature of tumor was to be in line with the preoperative assessment of imaging, The (diagnosis) accuracy rate was 100%, and 40 patients underwent resection,the resection rate was 70.2%. Of 40 (patients) with resection,29 patients underwent curative resection,the curative resection rate was (50.9)%;11 patients underwent palliative resection.The other 17 patients were found to have (unresectable) disease at laparotomy,including 3 portal venous involvement,5 hepatic arterial (invasion),7 metastatic disease,2 hepatic parenchymal massive involvement. These diseases were not found in pre-operative imaging evaluation.Conclusions MR multi-imaging techniques have high accuracy in the diagnosis of the location and nature of hilar cholangiocarcinoma,and could evaluate accurately the feasibility of resection in patients with hilar cholangiocarcinoma. The main causes of unresectability lie in metastasis of tumor and local vascular involvement.

ObjectiveTo investigate the popularity of the sedated gastrointestinal endoscopy in mainland China.MethodsThe survey on the popularity of the sedated gastrointestinal endoscopy was conducted with questionnaires sent by e-mails or telephones to the GI endoscopy units of three levels of hospitals.ResultsFrom May,2010 to November,2010,169 units from 28 provinces (90.3％ ) were enrolled,including 46 hospitals of grade Ⅲ,91 of grade Ⅱ and 32 of grade Ⅰ.Sedated gastrointestinal endoscopy were performed in 110 (65.1％,110/169) hospitals,i.e.93.5％ (43/46) grade Ⅲ hospitals,68.1％(62/91) grade Ⅱ hospitals and 15.6％ (5/32) grade Ⅰ hospitals.Significant difference was observed between the grade Ⅲ and the grade Ⅱ hospitals (P ＜ 0.05 ),so was between the grade Ⅱ and the grade Ⅰ hospitals ( P ＜ 0.05 ).Propofol was frequently used in sedation in 98 hospitals ( 89.1％ ).The only 9.1％( 10/110)hospitals,which had full-time anesthetists or anesthetic nurses,were all grade Ⅲ hospitals.ConclusionThere has been great progress in the popularity of sedated gastrointestinal endoscopy in mainland China during the past decade.However,it is less frequently pefformed in grade Ⅰ and Ⅱ hospitals.Shortage of full-time anesthetists is still a problem.

Objective To explore the relationship between the variation of leptin receptor (LR) gene and type 2 diabetes mellitus (DM), obesity and plasma lipid levels. Methods The variation of LR gene exon 20 was detected by polymerase chain reaction (PCR) and restriction fragment length polymorphism (RFLP) and their relations to type 2 DM and obesity were analyzed. Results The variant frequency at 3 057 nucleotide of G to A transversion was 82.09% for total, 87.33% for DM group, 75.42% for control group. The frequency of AA genotype in DM cases was higher than that in controls, but that of GA genotype was lower, and that of GG in cases did not indicate. According to BMI and WHR level, there was no obvious relationship between gene variations and obesity. There were significant differences between AA genotype and GA genotype about the serum levels of TG, HDL and SBP, DBP. Conclusion At nucleotide 3 057 in LR exon 20, a G to A transversion was found, which may be the susceptibility marker of DM in Chongqing population. An allele was associated with high blood lipid and increased blood pressure.

Objective To explore the correlation between Helicobacter pylori (Hp) infection and recurrent abdominal pain (RAP) in children over 6 years old and its relative treatment.Me-thods One hundred and eighty children over 6 years old with the diagnosis of RAP from Mar.2007 to Feb.2009 were selected,30 healthy children without RAP were taken as the healthy control group at the same period.14C-urea breath test (14C-UBT) was used to detect whether the patient was infected by Hp.The radical cure of Hp was given to the Hp-positive children with RAP,and the remission rate of children with RAP and the Hp negative rate were observed.Results The positive rate in RAP group was 58.33%,which was higher significantly than that in healthy control group(20.00%)(P0.05).The positive rate of those with and without bad eating habits were 45.56% and 12.78%,and the positive rate of with and without family gastrosis history was 49.44% and 8.89%,which both had significant difference between them(Pa

Objective To evaluate the correlation between the degree of cochlea endolymphatic hydrops(EH) and hearing loss and symptoms in patients with unilateral Meniere's disease. Methods Fifty seven patients with unilateral Meniere's patients were retrospectively quantitatively analyzed, which evaluated the correlation between the cochlea EH and hearing loss and symptoms. The affected ears in the experimental group(57 ears) and the asymptomatic ears in the control group(57 ears), were confirmed by bilateral intratympanic Gd-DTPA injection and 3D real IR MRI scan after 24 h. The maximum length of endolymph space and labyrinth chamber along the modiolus cochleae and their ratio which represented the endolymph space proportion of each turn(R1, the basal turn;R2, the middle turn;R3, the apical turn) were calculated. And the paired t test was used to compare the differences in EH degree between the experimental and control group;Pearson correlation analysis was used to analyze the correlation between the cochlea EH degree and hearing loss and duration of symptoms. Results R1, R1 and R3 of ipsilateral cochlea were higher than normal cochlea(ipsilateral R1:0.354±0.097 vs. normal R1:0.185±0.031, P<0.01;ipsilateral R2:0.445 ± 0.098 vs. normal R2:0.201 ± 0.046, P<0.01;ipsilateral R3:0.467 ± 0.102 vs. normal R3:0.221 ± 0.053, P<0.01). A positive correlation was found between the degree of EH in each turn and high-frequency hearing loss(r=0.275, 0.281, 0.329, respectively;all P<0.05), whereas no correlation was found between the extent of EH and the time of vertigo, tinnitus and hearing loss(P>0.05). In addition, there was a correlation between the degree of EH in the apical turn and low, medium, high-frequency hearing loss(r=0.271, 0.269, 0.329, respectively; all P<0.05). Conclusions The degree of cochlea EH in the basal and second turn showed great relevance with the high-frequency hearing loss, and the apical turn EH degree was relevant with the low, medium, high-frequency hearing loss, but there was no correlation between the EH degree of each turn, ages and symptoms.

Objective To investigate the influence of the genotype distribution of methylenetetrahydrofolate reductase (MTHFR) C677T,A1298C and methionine synthase reductase (MTRR) A66G in threatened abortion of Chinese Han gestationalage women in Sanya city,which involved in the folic acid biosynthetic pathway among.Methods One hundred and thirty-nine samples of case group and the same number of control group were recruited from Sanya region in Hainan Province.Genomic DNA was extracted from the mucosal epithelium of the subjects.The gene polyrnorphisms of MTHFR and MTRR were detected by Fluorescence quantitative PCR technology.The distribution frequencies of both case group and control group.were analyzed and compared,to investigate the effect of the gene polymorphisms on threatened abortion.Results Both the case group and the control group complied with Hardy-Weinberg law.The genotype frequency of MTHFR C677T,MTHFR A1298C and MTRR A66G were not significantly different.Conclusion This study suggests that the gene polymorphism which involved in folic metabolism was not significantly different from the group of threatened abortion and the control group,and whether the metabolism related genes are the risk factors of threatened abortion need to be further discussed.

DNA ; administration & dosage ; Gene Transfer Techniques ; trends ; Genetic Therapy ; methods ; Genetic Vectors ; Humans

Cold perfusion of liver can significantly alleviate the ischemia-reperfusion injury caused by hepatic blood flow occlusion. We have modified the technique of cold perfusion of liver and applied it to total pancreatectomy for patients with pancreatic head carcinoma complicated with metastasis to the body and tail of pancreas and with portal invasion. After skeletonization of the hepatoduodenal ligament, the amputation of the portal vein and blockage of the superior mesentoric vein were performed before portal perfusion. Meanwhile, pancreatic head resection, duodenectomy, subtotal gastrectomy and partial resection of the superior mesenteric vein and portal vein were carried out. Superior mesenteric vein and portal vein bypass grafting was achieved with artificial vessels. The digestive tract was reconstructed after it was freed of the spleen and resection of the body and tail of pancreas to the left side of superior mesenteric vein, greater omentum and intestine from the end of the colon to splenic flexure of colon. The patient was followed up for 3 months, and the general condition was good, although diarrhea frequently occurred. No tumor metastasis occurred.