Objective To evaluate the influence of the placement of instant hand disinfectant in compliance and qualified rate of hand hygiene of clinicians.Methods Hand hygiene compliance of clinicians in departments of gyne-cology,obstetrics,and general surgery were observed after the placement of instant hand disinfectant at the door-way of wards,hand specimens were taken to check hand hygiene effectiveness.Results Before and after placement of instant hand disinfectant at the doorway of wards of above departments,hand hygiene behaviors of 300 person-times were observed.Hand hygiene compliance rate among clinicians in department of gynecology,obstetrics,and general surgery increased from 32.33% to 74.33%,33.67% to 85.67%,and 26.33% to 64.00%,respectively(all P <0.001).Each department selected 98 hand hygiene specimens,the qualified rate was 98.98%,100.00% and 94.90% respectively.Conclusion The placement of instant hand disinfectant at the doorway of each ward can effec-tively improve clinicians’hand hygiene compliance and hand hygiene effectiveness.

Objective To compare the RIFLE and AKIN diagnosis criteria for acute kidney injury ( AKI) in patients undergoing cardiac surgery. Methods Patients undergoing cardiac surgery from January 2004 to June 2007 were retrospectively evaluated. RIFLE and AKIN criteria were employed for the diagnosis and staging of AKI which occurred 7 d after cardiac surgery. The diagnosis sensitivity and precision for prediction of hospital mortality were compared between these two criteria. Results One thousand and fifty-six patients were included in this study. There was no significant difference between the prevalence of AKI after cardiac surgery diagnosed by RIFLE criteria and that diagnosed by AKIN criteria (29.55% vs 31.06%, P>0.05). There was no significant difference between the total hospital mortality and the hospital mortality of each stage of AKI diagnosed by RIFLE criteria and those diagnosed by AKIN criteria ( P > 0. 05). Logistic regression analysis suggested that the relative risk of hospital mortality for AKI was similar between patients diagnosed by AKIN criteria and those diagnosed by RIFLE criteria. The area under the ROC curve for hospital mortality was 0. 856 for RIFLE and 0.865 for AKIN in all patients (P<0.001). Conclusion Compared to RIFLE criteria, AKIN criteria do not improve the sensitivity of diagnosis and predictive ability of hospital mortality of AKI after cardiac surgery.

Objective:To measure the salary satisfaction level of medical staff in county-level public hospitals and provide reference for the design of policy reforms. Method:Eight county-level public hospitals were investigated. All analyses were performed using SPSS 19. 0 via statistical description and binary logistic regression. Results: The total salary satisfaction of the medical staff was 48 . 8%, and the average score was 54 . 05 ± 18 . 04 . The welfare satis-faction is the lowest (38. 8%), and the average score is 7. 98 ± 3. 51. Logistic regression analysis shows that the ac-ademic degree, department category, working hours per week, acceptance of bribes, and officially budgeted posts are the main factors affecting overall compensation satisfaction. Conclusion:The overall salary satisfaction level of medi-cal staff in county-level public hospitals is very low, and the welfare satisfaction is the lowest. Establishing the rea-sonable level of compensation, the rise of compensation, and the welfare mechanism are feasible choices to improve salary satisfaction.

Objective To investigate the incidence, risk factors and outcome of acute kidney injury (AKI) following cardiac surgeries. Methods Clinical data of 1056 patients undergoing open heart surgery in Renji Hospital from January 2004 to June 2007 were retrospectively analyzed. Univariate and multivariate analyses were used to evaluate possible pre-,intra-, and post-operative parameters associated with AKI according to AKI Network (AKIN). Results Of the 1056 patients, 328 (31.06%) developed AKI. In-hospital mortality was 4.07% in all discharges while 11.59% in AKI patients (P<0.01). Multivariate logistic regression analysis revealed that increased age (OR=1.40), pre-operative hyperurieemia (OR=1.97), pre-operative left ventricular insufficiency (OR=2.53), combined surgery (OR=2.79), prolonged operation time (OR=1.43), post-operative circulation volume insufficiency (OR=11.08) were risk factors of AKI. Conclusions AKI is a common complication and associated with increased mortality following cardiac surgery. Increased age, pre-operative hyperuricemia, pre-operative left ventricular insufficiency, combined surgery, prolonged operation time, post-operative circulation volume insufficiency are useful in stratifying risk factors for the development of AKI.

Objective To explore the relationship between the immune function of cellin peripheral blood with the virureplication and hepatitiviru(HCV)-cAg expression in the patientwith chronihepatiti(CHC) .MethodPeripheral blood lymphocytesubpopulation ,HCV-Rnand HCV core antigen (HCV-cAg) in 63 healthy people undergoing the physical exami-nation (control group) and 85 caseof CHC(Chgroup) were analyzed by the flow cytometry ,real-time Pcand ELIS,respec-tively .ResultThe percentageof total cell,T4 cell,T8 cell,double negative cell(DN) and double positive cell(DP) in the Chgroup were (67 .37 ± 10 .43)% ,(37 .11 ± 10 .28)% ,(21 .63 ± 8 .87)% ,(7 .80 ± 4 .57)% and (0 .20 ± 0 .29)% , respectively ,the absolute contentwere in turn (0 .70 ± 0 .44) × 109/L ,(0 .37 ± 0 .22) × 109/L ,(0 .22 ± 0 .17) × 109/L ,(0 .08 ± 0.06)×109/Land(0.19±0.68)×107/L,respectively.TheratioofT4/T8was(2.18±1.26)% .Theresultsindicatedthatthe percentage of T8 cellin the Chpatientwadecreased obviously (P＜0 .01) ,which resulted in the ratio of T4/T8 raising(P＜0 .05);meanwhile ,the absolute contentof the total cell,T4 cell,T8 celland Dnwere all decreased obviously (P＜0 .05);moreove,the percentage of T4 celland Dnin the patientwith HCV-Rnpositive and HCV-cAg positive wasignificantly in-creased (P＜0 .05) .Conclusion When HCV replicating in the patientwith CHC,the T lymphocyte subpopulation haobviouab-normity .The low immune function or immune tolerance ofT cells may be the important cause of recurrence and uncurability of CHC.

In this paper,the indoor air quality of several hotelsand dancing halls was evaluated by using of two monitoring indexes.The results showed that the concentration of carbon dioxide of three dancing halls is low before opening,and the oxygen consumption is low too.But after opening an hour,the concentrations of carbon dioxide and carbon monoxide raises with increase of oxygen consumption correlation analysis between the concentration of air-negative ion and the oxygen consumption showed that both is negative correlation,(r=-0.354,P

Objective:To explore the present situation of medical students' professionalism cognition and provide reference for medical personnel training and medical education.Methods:A cross-sectional survey was conducted on medical students among 2 affiliated hospitals of a medical university in H province by cluster sampling. Exploratory factor analysis and reliability and validity test were carried out and a descriptive analysis of the present situation of professionalism was conducted by SPSS 20.0. Amos21.0 software was used for a confirmatory factor analysis on the samples.Results:The measurement scale had good reliability and validity, and the Cronbach alpha coefficient of the scale was 0.901. The average professionalism score of the medical students was about 80 points. The score of "physical and mental status and self-development ability" was the highest (83.65 points), and the lowest score was "academic ability" (72.21 points). There was a little difference in the professionalism cognition between the two hospitals, with significant differences between the dimension "respect and care" and "responsibility".Conclusion:This study has initially formed a medical professionalism measurement scale with good reliability and validity. The professionalism of medical students in the 2 affiliated hospitals of a medical school in Province H is in good condition as a whole. In the future, medical education should pay more attention to the combination of basic professional knowledge and clinical practice of medical students, and change the training model of medical students in order to improve the academic ability of medical students and medical students' overall cognition of professionalism.

OBJECTIVE:To establish HPLC fmgerprints of Naodesheng solid dispersion capsules.METHODS:HPLC method was adopted.The determination was performed on Hyspersil ODS2 column with mobile phase consisted of acetonitrile-0.05％ phosphoric acid (gradient elution) at the flow rate of 1.0 mL/min.The detection wavelengths were 210 nm (puerarin),345 nm (hydroxfsaffior yellow A).The column temperature was 30 ℃,and sample size was 10 μL.Using puerarin and hydroxysaffior yellow A as reference,HPLC fingerprints of 10 batches of sample were determined.Similarity evaluation,common peak identification and chemical components confirmation were performed by using Similarity Evaluation System of TCM Chromatographic Fingerprints (2012 edition).RESULTS:There were 29 and 23 common peaks in HPLC fingerprints of 10 batches of samples at 210 nm and 345 nm,respectively.The similarity was higher than 0.90.The medicinal material attribute of common peaks were Panax notoginseng,Ligusticum chuanxiong,Carthamus tinctorius,Pueraia lobata and Crataegus pinnatifida.Moreover,7 chemical components were identified at 210,345 nm,respectively.CONCLUSIONS:Established HPLC fingerprints can provide reference for identification and quality evaluation of Naodesheng solid dispersion capsules.

OBJECTIVETo discuss the key role of various mode of circulation assist in the radical operation of retro-peritoneal malignancy with the inferior vena cava thrombotic involvement.

METHODS>From the June 1999 to the March 2001, 6 patients with retro-peritoneal malignancy with thrombosis involving the inferior vena cava, were completely resected with various mode of circulation assist.

RESULTSAll the patients operated have good outcomes and follow-up (1 - 20 months) except one death 1 month after operation.

CONCLUSIONAccording to the various types of tumor thrombi, individualized and technically feasible circulation assist mode should be utilized to achieve the satisfactory outcomes.

Aged ; Assisted Circulation ; Humans ; Male ; Middle Aged ; Retroperitoneal Neoplasms ; blood supply ; surgery ; Surgical Procedures, Operative ; Vena Cava, Inferior ; surgery

Objective: To evaluate the effect of dexmedetomidine on hypoxia-inducible factor-1alpha (HIF-1 α) signaling pathway during hypoxia in mice with lung cancer. Methods: Eighteen clean-grade healthy adult male BALB/c nude mice, aged 8 weeks, weighing 20-30 g, were divided into 3 groups (n=6 each) using a random number table method: lung cancer group (group L), hypoxia+ lung cancer group (group HL), and hypoxia plus lung cancer plus dexmedetomidine group (group HLD). Human lung adenocarcinoma A549 cell suspension 1×10⁶/150 μl was injected via the tail vein to establish the mouse model of lung cancer.After the model was established successfully, chronic intermittent hypoxia was performed as follows: the mice were placed in air-tight modular incubation chambers, and the atmosphere was controlled by a constant gas flow containing 10% O₂ for 3 h once a day for 3 weeks.The mice in group HL were exposed to hypoxia.After the end of hypoxia exposure, the animals in group HLD were intraperitoneally injected with dexmedetomidine 25 μg/kg 3 times a week for 3 weeks in total.The mice in group L were placed in air-tight modular incubation chambers and the atmosphere was controlled by a constant gas flow containing 21% O₂ for 3 h once a day for 3 weeks, and the equal volume of normal saline was injected intraperitoneally.The mice were sacrificed by cervical dislocation, and the lung tissues were removed for determination of lung cancer nodules count, HIF-1α expression (by immunohistochemistry), expression of HIF-1α, survivin and X chromosome linked inhibitor of apoptosis protein (XIAP) (by Western blot), and expression of matrix metalloproteinase-2 (MMP-2) and MMP-9 (by real-time polymerase chain reaction). Results: Compared with group L, the number of lung cancer nodules was significantly increased, and the expression of HIF-1α, survivin, XIAP, MMP-2 and MMP-9 was up-regulated in the other two groups (P<0.05). Compared with group HL, the number of lung cancer nodules was significantly increased, and the expression of HIF-1α, survivin, XIAP, MMP-2 and MMP-9 was up-regulated in group HLD (P<0.05). A small number of HIF-1α positive cells were found in group L, a medium number of HIF-1α positive cells in group HL, and a large number of HIF-1α positive cells in group HAD. Conclusion Dexmedetomidine can promote proliferation of tumor cells in mice with lung cancer during hypoxia, and the mechanism is related to activating HIF-1α signaling pathway.