Adolescent ; Bronchoscopy ; Child ; Child, Preschool ; Female ; Foreign Bodies ; surgery ; Humans ; Male ; Respiratory System ; Treatment Outcome

Adult ; Bronchi ; Foreign Bodies ; Humans ; Male ; Trachea ; pathology

Objective To evaluate the use safety of a unitary package peracetic acid ( PAA) disinfectant through acute and subacute toxicity experiments in rats.Methods This study was conducted according to the Technical Standard For disinfection ( Version 2002 ) .In the acute toxicity experiment, 60 healthy Wistar rats were randomly divided into different groups of PAA given by single intragastric gavage.Symptoms of poisoning of the animals were observed to calculate the half lethal dose ( LD50 ) .In the subacute toxicity experiment, 40 healthy Wistar rats were randomly divided into three dose groups and negative control group.The rats were given 33-342 mg/kg BW PAA for 28 days.At the end of test, the body weight, the organ-to-body weight ratio and the hematological and biochemical indices were determined, and pathological examination was performed.Results The acute oral LD50 of female rats was 1470 mg/kg BW, and the LD50 of male rats was 1710 mg/kg bw.The results of subacute toxicity test showed that the body weight, the organ-to-body weight ratio and the hematological and biochemical indices had no significant difference between the dose groups and control group.No obvious abnormality was observed in gross anatomy and histopathological examination.Conclusions The results of the acute toxicity test prove that PAA has a low toxicity level, and no significant subacute toxicity was observed at the exposure doses.

OBJECTIVE To investigate the factors related to sharp injuries of medical staff and explore the standardized occupational safety management model. METHODS According to the recent 4-year registration of 66 cases of medical staff suffered from exposure to sources of blood-transmitted diseases because of sharp injury,a retrospective investigation was taken and the relevant factors were analyzed. RESULTS Operating room and transfusion room had a high incidence of sharp injury,36.4% and 9.1%,respectively. It occurred frequently in treatment of the morning hours (45.5%). As lack of occupational safety prevention and awareness of the standardized preventive measures,there was a high incidence in lower stage clinical medical staff and interns (60.6%). CONCLUSIONS It is necessary to pay attention to the occupational safety standardized management of sharp injuries for medical staff in order to promote medical professional safety.

Objective To explore compliance of anti-platelet therapy of patients after coronary stent implantation and relative factors. Methods 75 patients after coronary stent implantation were investigated by APGAR and drug compliance evaluation scale. Results 44.0 ％ of patients (n =33) failed to take anti-platelet drugs exactly following the prescription, the main form is omitting to take anti-platelet drugs (28.0％). The total score of understanding about antiplatelet medication knowledge in 75 patients was (26.36 ± 2.85 ), they took not much knowledge about antiplatelet druys' side effects and adverse consequences. The median adherence score of compliamce of antiplatelet drugs was 15.61. Fully accounted for 56.0％. The main non-complicance behavior was missed 28.0％. Different time of stent placement, antiplatelet druy type, duration of patient understanding of medication and medication compliance in patients with family functioning were statistically significant differences ( P ＜ 0. 05 ) ; Medication compliance and stent placement time was negatively correlated (r =-0. 304,P ＜ 0. 01 ), and duration of antiplatelet drug use to understand the situation, family functioning was positively correlated (r =0. 259,0. 266 ; P ＜ 0. 05 ). Conclusions The rate of good compliance of antiplatelet therapy of patients after stent implantation is much lower. Nurses should emphasize the education about anti-platelet therapy and start family support system in order to improve the compliance of anti-platelet therapy.

Objective To investigate the effect of emulsified isoflurane anesthesia on the expression of hippocampal amyloid-beta protein (Aβ) and phosphorylation of Tau protein in rats.Methods Seventy-two healthy Sprague-Dawley rats,aged 8 weeks,weighing 250-300 g,were randomly divided into 3 groups:normal control group (group C,n =12),fat emulsion group (group E,n =12),and 8％ emulsified isoflurane group (group EI,n =48).30％ fat emulsion and 8％ emulsified isoflurane 0.15 ml/100 g were slowly injected via the tail vein in groups E and EI,respectively.Morris water maze test was performed 6 days before anesthesia.Twelve animals in each group were chosen at 2 h after administration (T1) in E group,at the corresponding time points in C group,or at T1 and 1,7 and 14 days after administration (T2-4) in EI group and underwent spatial probe tests,and the escape latency was measured.The rats were anesthetized with intraperitoneal 1％ pentobarbital sodium 4 g/100 g after the end of Morris water maze test.Blood samples were taken for determination of the plasma S100 protein concentration.The rats were then sacrificed and brains were removed for determination of the expression of hippocampal Aβ and phosphorylated Tau (p-Tau) protein by immunohistochemistry.Results The escape latency and swimming distance were significantly shorter on 3rd,4th and 5th days than those on 1st day of place navigation test before anethesia (P ＜ 0.01).Compared with group C,the escape latency and swimming distance were significantly prolonged and the time of staying at the original platform quadrant was shortened at T1,and the plasma S100 protein concentration was decreased at T4 in group EI (P ＜ 0.05),and no significant change was found in the each parameter of Morris water maze test,plasma S100 protein concentration,and expression of Aβ and p-Tau protein in group E (P ＞ 0.05).The escape latency and swimming distance were significantly shorter and the time of staying at the original platform quadrant was longer at T2-T4 than at T1 in group EI (P ＜ 0.05).Conclusion Emulsified isoflurane anesthesia exerts no effect on the expression of hippocampal Aβ and phosphorylation of Tau protein,indicating that hippocampal Aβ and Tau protein are not involved in emulsified isoflurane anesthesia-induced cognitive dysfunction in rats.

Objective To investigate the value of brachial-ankle pulse wave velocity (baPWV) in the prediction of hypertension in middle-aged men with prehypertension.Methods A total of 2580 middle-aged (35 to 55 years old ) prehypertensive individuals who underwent health check-up during September 2006 and December 2007 in our hospital were recruited for this prospective cohort study.After a 4-year follow-up,2451subjects entered final analysis.Logistic regression analysis was used to assess the value of baPWV in the prediction of hypertension.Results(1) Two hundred and eight subjects (8.5％ )developed hypertension after 4-year follow-up study.( 2 ) At baseline,no significant differences of family history of hypertension,heart rate and total cholesterol were found between normotensive and hypertensive subjects (P ＞0.05 ).(3) Logistic regression analysis showed that in age-adjusted model (Model1),the odds ratio (OR) and 95％ confidence interval (CI) of baPWV (140 cm/s) was 2.20 (1.78 to 2.62 )( P ＜0.01) ; while in multi-factor adjusted model ( Model 3 ),OR and 95c％c CI of baPWV was I.49 (1.15 to 1.73) (P ＜ 0.01).(4) Subjects were stratified by quartiles of baPWV at baseline.OR and 95％ CI of hypertension in those of highest quartile was higher than those of lowest quartile ( Model1:OR =10.9,95％CI 5.1-22.7,P＜0.01; Model 3:0R=2.6,95％CI1.2 -6.1,P＜0.05).Conclusion baPWV could be an independent predictor of hypertension among prehypertensive populations.

Objective To investigate the CT imaging characteristics of primary malignant fibrous histiocytoma (MFH) of the liver.Methods The CT, clinical and histopathologic data of 6 patients with MFH were analyzed retrospectively.All the cases were confirmed by surgery and histopathological examinations.Results The tumors were located in the right liver in 4 patients and the left liver in 2 patients.The maximum diameter of the tumors ranged from 5 to 20 cm.All the tumors were unevenly hypodense on plain CT scan.Four tumors had relatively well-defined margins, while 2 tumors had ill-defined margins.After contrast enhancement, the peripheral and internal divisions of the three storiform-pleomorptic MFH showed progressive enhancement.The peripheral and internal divisions of the two inflammatory MFH were obviously enhanced in the arterial phase, and the enhancement decreased in the portal and delayed phases.The hypodense areas of the one myxiod MFH were not enhanced, but the internal floc and divisions were progressive enhanced.On gross pathology, the tumors were round or irregular in shape, most had a complete capsule with multiple surrounding vessels.These findings correlated well with the CT findings.Conclusions CT findings of primary Hepatic MFH have some characteristics.The enhancement pattern is manifested in a fast wash-in and slow wash-out pattern.However, the final diagnosis still relies on histopathological examination.

Objective To summarize the condition of surgical treatment and prognosis of 54 cases of jugular foramen tumors in the past 5 years.Methods All 54 cases were treated with operation by Fisch approach.Thirty-eight cases underwent total or near total resection of the tumor.Most resection of the tumor was underwent in 16 cases,in which,7 cases underwent postoperative radiotherapy or gamma knife therapy.The facial nerve monitoring was used in all cases.The facial nerve was anatomized and shifted in 35 cases,was just anatomized like a bridge in 10 cases,and was excised partly in 9 cases,in which,4 cases underwent facial-hypoglossal nerve anastomosis and 3 cases underwent transplantation of facial nerve and great auricular nerve.Results The external auditory canal was closed in 41 cases.The near pedicled temporalis muscle flap was obliterated in the operating cavity in 35 cases.Six cases underwent fat filling in the operating cavity.Eighteen patients showed facial palsy in varying degrees after operation.Among them,14 cases improved to different extents in 2 weeks to 9 months and 4 cases did not improve.One case showed recurrent laryngeal nerve paralysis in the same side before operation and improved in half a year after operation.Postoperative subcutaneous hematoma occurred in 2 cases,wound infection in 1 case.All the cases improved by debridement suture and anti-infective therapy.The cavity filling necrosis occurred in 2 cases,which recovered after debridement and dressing.For half a year after operation,except 9 cases of residual or recurrent,and the rest showed no recurrence.Conclusion The Fisch approach of surgical treatment of jugular foramen tumors can provid good exposure,clear vision,facilitate hemostasis.The skills of intraoperative facial nerve monitoring,facial nerve anatomy like a bridge or anatomy and shift when necessary are beneficial to the total or nearly total resection of tumor and reduce the injury of facial nerve.The operating cavity filling and selective external auditory canal closure can effectively reduce the surgical cavity effusion and the incidence of postoperative infection.

According to the characteristics of postgraduates of clinical medicine and features of radiology and based on traditional teaching, picture archiving and communicating system (PACS), tutorial system, lecture and modernized tests with the help of problem-based learning (PBL) were ap-plied so that the effect of students' rotation internship was improved.