OBJECTIVE To discuss the reasonable application of multi-enzyme abluent in the process of endoscopic cleaning and disinfecting.METHODS The multi-enzyme abluent was reasonably used to clean the endoscope in the pre-cleaning and disinfection process at thebedside,to enable it to achieve the best cleaning effect.RESULTS The reasonable application of multi-enzyme abluent could enhance the effect of endoscope cleaning to ensure the success of endoscopic disinfection.CONCLUSIONS Multi-enzyme abluent can protect the successful endoscopic disinfection and prevent the iatrogenic infection.

Objective To explore the survival rate and early-term effects of sensory reconstruction of the modified first dorsal metacarpal artery (FDMCA) flap in treatment of thumb distal soft tissue defect.Methods From March 2004 to October 2007, 65 patients with soft tissue defects of the thumb underwent the FDMCA flap in our department. Forty-nine cases with complete data were included in the study. There were 37 males and 12 females, with an average age of 32 years (ranged, 18-65 years). The conventional surgical methods were used in 18 cases while the improved surgical methods were in 31 cases. The distal necrosis, the vascular crisis rate and the sensory recovery were recorded. Results The mean follow-up period was 2 years (ranged, 20 months to 3 years). Forty-six flaps survived completely. Vascular crisis occurred in five cases harvested by the conventional methods. Eventually, three of them had a partial distal necrosis.Improved FDMCA flap survived well in all 31 patients. Flaps in these patients with nerve anastomosis restored satisfied sense and all sense were located in the thumb. Eighteen cases of nerve transfer group had different levels of mixed feelings (33%) or ectopic sensory (62%). Sense was located in the thumb completely in 1 case. Conclusion The modified FDMCA flap significantly increased the survival rate. Neurorrhaphy could make the sense of the flap locate in the thumb; however it had not been proved that its impact on the recovery of two-point discrimination and stereognosis.

The average daily selenium intake of staff of the Institute of Health in Beijng was surveyed to be 66.4?g and that of children in nursery and kindergarten was 34.7?g, which could meet the Recommended Dietary Allowance as suggested. Cereals were the major source of dietary selenium which accounted for 63.6% of total dietary intake, and animal and plant foods provided about 25.9% and 10.5% respectively. Both cereals and animal foods were the major sources of selenium in children diet, which accounted for 48.9% and 44.3% respectively, and intake of selenium from other sources was negligible.The selenium concentrations in whole blood and hair of the population were 0.146ppm and 0.578ppm respectively, and both correlated well with the daily selenium intake.The daily intake of mercury, arsenic, and cadmium for population in Beijing were estimated to be 3.4, 52.7, and 42.7*g respectively, which were within the normal range of intake and would not significantly interfere with the bioavailability of selenium ingested. It was suggested thal these levels of selenium daily intake surveyed would be adequate for human consumption and could be helpful as a reference for the establishment of dietary allowance.

The content of selenium and several antagonistic metals such as mercury, arsenic, and cadmium in foods from Beijing market has been determined. Results showed that marine products, Viscera (particularly kidney), eggs, and mushroom were good dietary sources of selenium. The selenium contents of imported cereals and pulse are much higher than those grown in China as far as the sample analysed. Most vegetables and fruits contained selenium below a level of 0.010ppm with exception of garlic and mushroom.The selenium content of human milk was higher than other kinds of milk, milk products and milk-substitutes. Selenium content of Beijing foods was far higher than those in affected area of Keshan disease. The mercury, arsenic, and cadmium content of foods was below the National Allowance Standard except a few marine products.The selenium content of natural plant foods was positively correlated with its protein content (r=0.844, p

Results obtained from previous studies shoved that at low level of dietary selenium(0.03 ppm) weanling rats fed with diets of low protein level usually possessed higher selenium concentration and GSHPx activity in their blood and tissues. The results were reproduced in chickens in this observation. Furthermore, even the original selenium level could not be maintained in blood and tissues of chickens fed with low protein diet (12.4%) because of faster growth rate and the lower selenium content (0.01 ppm) of the diet used in this study.Of the 27 chickens consuming 18.2% protein diet in the 14 days expe- riment, 23 suffered from exudative diathesis and 3 died without any sign of exudative diathesis, while in the 12.4% protein group only one of the 26 chickens suffered from exudative diathesis during the 14 days experiment and 6 of the 12 chickens in this group observed for another two weeks showed exudative diathesis. In the 18.2% protein group the first chicken with signs of exudative diathesis appeared on the 9th day while it appeared on the 14th day in the 12.4% protein group.How to improve the selenium nutritional status of the residents in Ke-shan Disease areas was discussed.

Objective To introduce a modified replantation for thumb rotating avulsion amputation,and to evaluate its short term clinical outcome.Methods From January 2007 to July 2009,7 patients with thumb rotating avulsion amputation underwent replantation,including 6 males and 1 female,aged from 21 to 47 years (average,28.3 years).The amputation level of each thumb was metacarpophalangeal joint.During operation,fusion of metacarpophalangeal joint was performed according to injury degree of soft tissue; interphalangeal joint of the thumb was fixed in 15 degrees of flexion by sewing flexor pollicis longus muscle tendon and extensor pollicis longus muscle tendon to tendon sheath or soft tissue; the superficial vein harvested from ipsilateral forearm was used to bridge the dorsal carpal branch of radial artery and the ulnar palmacollateral artery of the thumb; direct anastomoses of dorsal veins were performed in 6 cases and venous transplantation in 1 case; and bilateral nerves were transferred to the back of the first metacarpal and anastomosed to the superficial branch of the radial nerve.Results All 7 replanted thumbs survived completely.Arterial crisis occurred in 1 case after operation,which was cured after operative and medication treatment.The follow-up period ranged from 3 to 24 months.The appearance and opposition function of replanted thumbs were satisfactory and the sensation of fingertip recovered to S4 in 4 cases and to S3 in 3 cases.The two point discrimination ranged from 8 to 12 mm.Conclusion Because bridging the dorsal carpal branch of radial artery and the ulnar palmar collateral artery of the thumb with a superficial vein harvested from ipsilateral forearm to reconstruct blood supply of the thumb is available and easy to be performed,this modified replantation is an ideal way to repair thumb rotating avulsion amputation.

Objective To investigate the clinical significance of I-FISH for detection of genomic abnormalities in MM. Methods Twenty newly diagnosed MM patients(seven cases at stage Ⅰ , five cases at stage Ⅱ and eight cases at stage Ⅲ according to Bataille staging) were analyzed by combining the technique of CC (R-binding stain) and I-FISH [ including GLP13q14 (RBI gene), GLP17p13. 1 (P53 gene),GLP13q14. 3(D13S319) ,GLP1q21 ,GLP14q32(IgH gene) DNA sequence probes]. These two methods were compared for the detection rates of chromosomal and genomic abnormalities in MM and the association between genomic abnormalities and Bataille stages was also analyzed. Results CC examination showed only 1 case [5% (1/20) ] was found complex chromosomal abnormalities--46,XX,-2,del(3) (p21) ,add(6)(q26) ,der(10)(q26),der(14)(q32), + mar, inc[6]. While I-FISH assay showed that 12 cases [60%(12/20) ] were found genomic abnormalities. The frequencies of RB1, D13S319 and P53 were all 30%(6/20), and the frequencies of IgH gene and 1q21 were both 20% (4/20). The detection rate of the I-FISH was much higher than CC (χ2 = 9. 09, P = 0. 001) according to paired χ2 test. Of 20 patients,6 cases had RB1 gene abnormality, 1 case at stage Ⅰ , 2 cases at stage Ⅱ and 4 cases at stage Ⅲ. Of 20 patients, 6 cases had D13S319 gene abnormality, 2 cases at stage Ⅰ , 1 case at stage Ⅱ and 3 cases at stage Ⅲ. Of 20 patients, 6 cases in 20 had P53 gene abnormality, 2 cases at stage Ⅰ and 4 cases at stage Ⅲ. Of 20 patients, 4 cases had 1q21 gene abnormality, 2 cases at stage Ⅰ and 2 cases at stage Ⅲ. Of 20 patients, 4 cases had IGH gene abnormality, 1 case at stage Ⅰ and 3 cases at stage Ⅲ. Conclusion Ⅰ-FISH has higher detection rate for the genomic abnormalities in MM and can be used in detection of MM patients in different Bataille stages.

To retrospectively analyze the safety and efficacy of low dose subcutaneous decitabine regimen in patients with acute myeloid leukemia (AML) and intermediate-or higer-risk myelodysplastic syndrome (MDS).Of 6 AML cases,2 achieved complete remission (CR),2 with partial remission(PR),1 with stable disease(SD),1 with progressive disease(PD).As to the 8 MDS patients,one achieved CR and 6 with hematologic improvement (HI),1 case SD.Low dose subcutaneous decitabine regimen could be an alternative choice of older AML or MDS patients.

Objective To improve the cognition of sever liver injury of treating Philadelphia positive acute lymphoblastic leukemia (Ph+ ALL) with salvage chemotherapy of dasatinib combined with high-dose methotrexate (HD-MTX) and L-asparaginase (L-Asp).Methods Severe drug-induced liver injury caused by dasatinib with HD-MTX and L-Asp in one patient with Ph+ ALL was reported.Results Severe drug-induced liver injury happened on the seventh day after treatment,TBIL 221.7 μmol/L,DBIL 156.1 μmol/L,IBIL 65.6 μmol/L,ALT 111 U/L,AST 131 U/L,ALP 354 U/L,GGT 256 U/L,TBA 199.2 μmol/L.Through proper treatment,the patient recovered quite good,and the patient achieved complete remission after this chemotherapy.Conclusion Salvage chemotherapy which contains dasatinib,MTX and L-Asp can be effectively used in Ph+ ALL,but they are all of the hepatotoxicity,so drug-induced Liver injury may happen while they are used together.

A modification of Watkinson's method was used for the flaorimetric determination of selenium in blood, hair, urine and animal tissues with 2,3-Di-aminonaphthalene. A mixture of sulphuric, perchloric acid and sodium molybdate was used for digestion. As little as 3 ng selenium in the sample could be estimated out. Coefficients of variation and recoveries for blood, hair, urine and animal tissues were 3.9, 5.5, 3.3 and 5.6%, and 97.0, 95.0, 97.8 and 99.8% respectively. No significant difference in selenium content estimated was found as graded amounts of samples were taken for analysis, indicating no foreign interference in the extracts. Both precision and accuracy of this method are satisfactory.