OBJECTIVE To investigate the restrained factors in the disposal of medical dispute caused by nosocomial infection and try to find out the method to solve the problem. METHODS The several restrained factors in the disposal of medical dispute about nosocomial infection were enumerated and analyzed. RESULTS There are several restrained factors in the disposal of medical dispute about nosocomial infection according to law. First, nosocomial infection can not be died out, and medical dispute about nosocomial infection will exist for ever as a result of the specialty of supply of medical service. Secondly, current legal system construction of nosocomial infection management in our country is in the stage of being established and consummated step by step. Determinant criteria of medical negligence behavior are not perfect. Feasibility of part of the actual rules and standard in nosocomial infection is not good. Thirdly, collecting evidence is very difficult in some medical dispute caused by nosocomial infection . It is restricted by hospital condition, medical cost and medical documents. Because of the restrained factors mentioned above, when nosocomial infection occurs, medical workers concerned can not find or confirm the reason of infection in most cases. Then hospital has to compensate patients for loss in order to make concessions to avoid trouble. CONCLUSIONS We make following suggestions for the status. First, we should strengthen legal system construction about nosocomial infection, and safeguard both of hospital and patients′ interests . Secondly, insurance system of medical risk should be perfected. Thirdly, medical workers should abide by rules of operation. Fourthly, we can not hide the truth when nosocomial infection occurs. Fifthly, we must fulfil the "attention duty" in order to reduce medical dispute.

OBJECTIVE To ascertain the causes of unreported hospital infection in our hospital and apply countermeasures. METHODS To adopt investigation way to review and analyze 34 694 hospital files in our hospital from Aug 2002 to Jul 2004. RESULTS From them 1164 cases had experienced hospital infection,264 were unreported,the monthly unreported rate decreased from 52.50% to 0;the yearly unreported rate decreased from 36.17% to 10.67%. CONCLUSIONS The unreported reason is because the relevant staff lack infection knowledge,the control and supporting system isn′t so efficient.So the key to reduce the missing report rate is to enhance the awareness of the hospital infection control among the staff in hospital,to strengthen communication and cooperation,and to implement the administrative regulation.

Objective To investigate the clinical characteristics of elderly patients with multiple myeloma and their prognostic factors.Methods 100 multiple myeloma patients with age≥ 60 years and 100 multiple myeloma patients with age <60 years who admitted in our hospital from December 2007 to December 2015 were collected as research subjects.100 patients with age ≥60 years were divided into elderly multiple myeloma group,100 cases with aged <60 years were divided into non -elderly multiple myeloma group.The clinical data and laboratory results of two groups were compared,the prognosis factors in elderly patients with multiple myeloma were analyzed.Results The incidence rate of ISS stage Ⅰ -Ⅱ in elderly multiple myeloma group (45.0%)was lower than non -elderly multiple myeloma group (60.0%),the incidence rate of stage Ⅲ was higher than non -elderly multiple myeloma group (χ2 =4.511,P <0.05).The infection incidence of elderly multiple myeloma group(30.0%)was higher than non -elderly multiple myeloma group(15.0%)(χ2 =10.452,P <0.05 ).The hemoglobin,serum albumin contents of elderly multiple myeloma group [(83.7 ±19.8)g/L,(27.89 ±6.87)g/L]were less than non -elderly multiple myeloma group[(92.1 ±22.5)g/L,(33.15 ±7.69)g/L](t =4.297,4.426,all P <0.05).The calcium content,the propor-tion of bone marrow plasma cells,serum creatinine and blood β-microspheres protein levels of elderly multiple mye-loma group [(2.51 ±0.41)mmol/L,(39.43 ±18.64)%,(182.24 ±125.47)μmol/L,(9.02 ±6.24)mg/L]were higher than non -elderly multiple myeloma group [(2.36 ±0.48)mmol/L,(37.45 ±19.86)%,(143.25 ± 116.43)μmol/L,(5.87 ±3.41)mg/L](t =5.945,4.196,4.375,4.264,all P <0.05).The median survival time of elderly multiple myeloma patients were significantly correlated with the patients'age,the proportion of plasma cells in bone marrow,blood β2 -microglobulin,albumin,and ISS staging (χ2 =4.125,3.254,8.542,5.748,9.244,all P <0.05).Conclusion The condition of elderly myeloma patients is more serious,age,proportion of plasma cells in bone marrow,blood β2 -microglobulin,albumin and ISS stage affect myeloma patients prognosis.

Objective To explore the values of electromyography to examine birth injuries.Methods 34 cases of birth injuries were studied,the electromyography and motor nerve conduction of brachial plexcy were recorded.Then,the location and severity of birth injuries were determined.Results Among 34 cases,according to the location of injuries,there were 10 cases of upper trunk injuries,7 cases of upper and middle trunk injuries,5 cases of middle and lower trunk injuries,5 cases of lower trunk injuries,and 7 cases of whole brachialplexus injuries.On the other hand,according to the severity of injuries,there were one case of complete injuries and 33 cases of incomplete injuries which included 2 cases of severe injuries and 31 cases of slight injuries.Conclusion Electromyography is the reliable method to identify the location and severity of brachial plexus injuries,and this examination is necessary to diagnose birth injuries with great clinical values.

Objectives:To observe growth suppressive effects of human wild type p53(wt p53) gene on human esophageal cancer cell line. Methods:Using the retroviral vector to introduce exogenous wt p53 gene into human esophageal cancer cell line ECA109,the gene expression and tumor inhibition were studied in vitro and in vivo . Results:The expression of p53 in transfected cell lines(ECA 109/p53 ) was increased.The growth rates and the ability to form colony in soft agar were greatly inhibited in ECA 109/p53 cells versus ECA109/neo and ECA109 cells.The G 0+G 1 ratio increased and S ratio decreased in cell cycle distribution,and apoptosis index significantly rose in the ECA109/p53 cells,which were confirmed by FCM analyzing.The tumorigen icity of ECA109/p53 cells in nude mice was obviously suppressed by exogenous p53. Conclusions:Exogenous wt p53 mediated by retroviral vector could inhibit the growth of human esophageal cancer cell.

OBJECTIVE To overcome shortcomings in use of bed sheet,and to improve it for examining bed.METHODS Based on the working principle of the reel toilet paper and industrial drive belt,a reel device for(disposable) whole bed sheet was designed,and used on the bed examining more than 300 times.(RESULTS) The new designed reel aevice with disposable whole bed sheet was operated easy and safely,with decreased cost and(contamination) in use.It could alleviate infection opportunity in favor of control againt hospital infection and(environmental) protection.(CONCLUSIONS) The device can mount on any size of examining bed and widely accept for use.

ObjectiveTo study the therapeutic effects of cerebellar fastigial nucleus electrical stimulation (FNS) on motor and depression symptoms and monoamine neurotransmitters in the spinal cord fluid of patients with Parkinson's disease (PD).Methods65 patients with idiopathic Parkinson's disease following depression were divided into stimulation group (FNS+Madopar, n=35) and control group (Madopar, n=30). The stimulation group took Modopar, and treated with FNS, 30 miniutes once a day for 30 days. The control group took Modopar only. Madopar dose has no change during the treatment. The patients were evaluated by Webster Parkinson's Disease Evaluation Form, and Hamilton Depression Scale (HAMD) before and after FNS treatment. The loading of monoamine neurotransmitters was measured by high performance liquid chromatography-electrochemical process.ResultsAfter the treatment, the stimulation group improved in clinical feature and depression, scored significantly lower on Webster and HAMD than the control group(P<0.05); the loading of 5-hydroxytryptamine(5-HT) in spinal cord fluid increased; however noradrenalin and dopamine had no different. But there was no significant change in the symptoms and the loading of monoamine neurotransmitters in the control group.ConclusionFNS is efficient to relieve the motor and depression symptoms of PD, which possible mechamism might be central neuroprotection and the release of 5-HT by FNS induction.

Objective:To observe the clinical effect of omeprazole based triple therapy in the treatment of children with peptic ulcer.Methods:From September 2016 to September 2018, 86 children with peptic ulcer in the People's Hospital of Qingyuan County were selected in this study.By using the random number table method, they were divided into two groups, with 43 cases in each group.The control group received ranitidine based triple therapy treatment, the observation group was given omeprazole based triple therapy treatment.The treatment course of the two groups was 30 d. The eradication rate, clinical effect, gastrointestinal hormone level and adverse reactions of helicobacter pylori were compared between the two groups.Results:The eradication rate and total effective rate of helicobacter pylori in the observation group were 97.67%(42/43) and 95.35%(41/43), respectively, which were higher than those in the control group[81.40%(34/43) and 79.07%(34/43)], the differences were statistically significant (χ 2=6.081, 5.108, all P<0.05). After treatment, the levels of gastrin and motilin in the observation group were (75.29±8.31)μmol/L, (164.88±15.05)ng/L, respectively, which were lower than those in the control group [(81.07±8.96)μmol/L, (204.15±17.67)ng/L], the differences were statistically significant( t=3.102, 11.095, all P<0.05). The somatostatin level of the observation group was (22.67±3.95)ng/L, which was higher than that of the control group [(18.31±3.31)ng/L], and the difference was statistically significant( t=5.548, P<0.05). There was no statistically significant difference in the incidence of adverse reactions between the two groups(χ 2=0.938, P>0.05). Conclusion:Omeprazole based triple therapy is safe and effective in the treatment of children with peptic ulcer, which is helpful to eradicate helicobacter pylori, reduce gastrin, motilin levels and improve the level of somatostatin.

PURPOSE: . The aim of this study was to evaluate the clinical performance and reliability of plasma sprayed nanostructured zirconia (NSZ) coating. MATERIALS AND METHODS: . This study consisted of three areas of analysis: (1) Mechanical property: surface roughness of NSZ coating and bond strength between NSZ coating and titanium specimens were measured, and the microstructure of bonding interface was also observed by scanning election microscope (SEM). (2) Biocompatibility: hemolysis tests, cell proliferation tests, and rat subcutaneous implant test were conducted to evaluate the biocompatibility of NSZ coating. (3) Mechanical compatibility: fracture and artificial aging tests were performed to measure the mechanical compatibility of NSZcoated titanium abutments. RESULTS: . In the mechanical study, 400 μm thick NSZ coatings had the highest bond strength (71.22 ± 1.02 MPa), and a compact transition layer could be observed. In addition, NSZ coating showed excellent biocompatibility in both hemolysis tests and cell proliferation tests. In subcutaneous implant test, NSZcoated plates showed similar inflammation elimination and fibrous tissue formation processes with that of titanium specimens. Regarding fatigue tests, all NSZ-coated abutments survived in the five-year fatigue test and showed sufficient fracture strength (407.65-663.7 N) for incisor teeth. CONCLUSION . In this study, the plasmasprayed NSZ-coated titanium abutments presented sufficient fracture strength and biocompatibility, and it was demonstrated that plasma spray was a reliable method to prepare high-quality zirconia coating.

Background Macrophages are essential components of the natural immune system. They play a significant role in resisting foreign bodies in the respiratory tract and maintaining the homeostasis of the internal environment of lung tissue. Objective To investigate the mechanism of macrophage pyroptosis induced by silica dust with different particle sizes. Methods The modified murine macrophage cell line, RAW-ASC cells, was cultured and divided into a blank control group, a lipopolysaccharide (LPS) group (1 μg·mL⁻¹ LPS), a nano-SiO₂ group (1 μg·mL⁻¹ LPS+100 μg·mL⁻¹ nano-SiO₂), a micro-SiO₂ group (1 μg·mL⁻¹ LPS+750 μg·mL⁻¹ micro-SiO₂), and a positive control group [1 μg·mL⁻¹ LPS+3 mmol·L⁻¹ adenosine triphosphate (ATP)]. Apart from the blank control group, cells in other groups were pretreated with LPS for 6 h, and then exposed to SiO₂ or ATP for 4 h. According to the molecular target NOD-like receptor pyrin domain-containing protein 3 (NLRP3) and reactive oxygen species (ROS), we applied MCC950 (NLRP3 inhibitor) and N-acetyl cysteine (NAC, ROS scavenger) to macrophages. CCK-8 assay was used to detect cell viability; 5-ethynyl-2'-deoxyuridine (EdU) staining was used to detect cell proliferation; lactate dehydrogenase (LDH) assay kit was used to detect LDH in supernatant; calcein AM/PI fluorescent double-staining was applied to evaluate cell rupture; 2',7'-dichlorofluorescin diacetate (DCFH-DA) fluorescent probe was used to measure the content of ROS; Western blotting was used to measure the expressions of NLRP3, apoptosis-associated speck-like protein containing CARD (ASC), Caspase-1, gasdermin D (GSDMD), and interleukin-1β (IL-1β). Results Compared with the blank group, 100 μg·mL^-1nano-SiO₂ and 750 μg·mL^-1micro-SiO₂ dust exposure reduced the cell viability to 40% and 68% (P<0.05), and the cell proliferation rate to 30% and 33% (P<0.01), respectively; they also induced cell lysis and ROS release, upregulated NLRP3, ASC, Caspase-1, GSDMD, and IL-1β at protein level (P<0.05), and induced macrophage pyroptosis. After intervening with MCC950 (10 μmol·L^-1) and NAC (10 mmol·L^-1), the expressions of NLRP3, ASC, Caspase-1, and IL-1β decreased (P<0.05), and, specifically, NAC effectively reduced ROS levels (P<0.05). Conclusion Both nano- and micro-SiO₂ dust have cytotoxicity, can upregulate ROS level, activate NLRP3 inflammasome, and promote the release of cytokines, leading to pyroptosis. These results are helpful to reveal the molecular mechanism of macrophage pyroptosis induced by SiO₂ dust.