Objective To study the detail of quality control method during the implementing the new CSSD guideline in the district level hospitals. Methods The quality control was divided into 5 steps:Wrote the hospital' s CSSD quality system documents and comply them into a booklet. Set up reasonable quality control positions and staff and designed relative record files. Record the problems in the dynamic patrol handbook in time. Summary and discuss the problem by period. Made flow charts to improve the quality control details. All the above 5 steps formed the frame of the detail quality control. Results It had distinctly difference for inspection on quality efficiency ( Lumen clean, 175 vs 290, χ2 = 25.29, P ＜ 0. 01 ), and thescores of nursing inspection of( satisfaction ,94.26 ± 1.22 vs 98.46 ± 1.67 ,t =42. 10,P ＜0. 05 ), after the detail quality control.Conclusions It can solve the anti-guideline problems, improve work quality and efficiency and low down cost for the implementation of the CSSD guideline of the district level hospital by detail quality control method.

Objective To establish the management moved forward mechanism of detail problem in disinfection supply room,so as to achieve the purpose of the process control.Methods Management moved forward mechanism was established,such as finding problem,recording detail problem,discussing details problem,and tracing back to the effect in disinfection supply room.Deviation situation,efficiency targets of job quality,clinic satisfaction were compared before and after the management mechanism implemented.Results Compared before and after the management moved forward mechanism implemented in disinfection supply room,decontamination area deviation were cases (78 vs 12),qualified cleaning were ( 175 vs 290 cases),satisfaction survey scores were (94.26 ± 1.22 vs 98.46 ± 1.67),the difference was statistically significance ( P ＜ 0.05 ).Conclusions Management moved forward mechanism established in disinfection supply room can ensure the process coritrol on the details.

It has been over 30 years that acupuncture was first introduced and later used to treat patients in Eritrea. There are acupuncture clinics at three hospitals to treat various common diseases. As one of the valuable treatments to cure diseases, acupuncture has been accepted by the government and the public in Eritrea. It is the fruits of public recognition, government support and the devotion of Chinese clinic practitioners.
Acupuncture ; trends ; Acupuncture Therapy ; trends ; Eritrea ; Humans

Objective To evaluate the accuracy of MSCT in the pre-operative N-staging and diagnosis of metastatic lymph nodes in each group of gastric cancer.Methods Pathological and CT data of 91 patients with gastric cancer proved by surgery and pathology were analyzed retrospectively.Three-phase dynamic enhancements were performed before surgery in a unified way of hypotonic oral water,N-stage and grouping of lymph nodes of the preoperative CT imaging were evaluated by using the established diagnostic criteria and then compared with the results of surgery and pathology,the accuracy of staging and grouping was analyzed by using Kappa test.Results The accuracy of MSCT diagnosing the N-staging as a whole was 86.3%.The accuracy for N0,N1,N2 and N3 was 83.5%,89.0%,83.5% and 89.0%,respectively.The sensitivity was 86.5%,83.3%,50% and 47.4%,respectively.The specificity was 79.5%,89.4%,89.6% and 100.0%, respectively.The sensitivity for N0 was statistically different from that for N2, N0 and N3(P≤0.007).The detected accuracy for the group of left side of the cardium (No.2), periphery of the splenic hilum (No.10), posterior of the pancreastic head (No.13) were higher than other groups on MSCT with the accuracyof 100%.The sensitivity for the group of No.2,periphery of the coeliac trunk(No.9),No.10,and No.13 was 100%.The specificity for the group of No.2,No.10,and No.13 was 98.9%.Conclusion Relatively high accuracy in the preoperative N-staging and diagnosis of metastatic lymph nodes in each group of gastric cancer can be obtained by MSCT, which provide reliable information for preoperative assessment and intraoperative lymph node dissections.

Objective:To observe the therapeutic effect of electroacupuncture (EA) at local points plus point injection on House-Brackmann facial nerve function classification grade (H-B) and facial disability index (FDI) in pregnant women with Bell palsy (BP). Methods:A total of 40 eligible BP patients during pregnancy were randomized into a treatment group (n=20) and a control group (n=20). The treatment group was intervened by EA at Sizhukong (TE 23), Tongziliao (GB 1), Sibai (ST 2), Quanliao (SI 18), Yifeng (TE 17), Dicang (ST 4), Jiache (ST 6) and point injection at Zusanli (ST 36) and Yanglingquan (GB 34) on the affected side, 30 min every time, 10 sessions as a course, for 2 courses in total while control group by EA with the same points, manipulation and courses as the treatment group. Results:After the treatment, the H-B classification in the treatment group was better than that in the control group, with a significant inter-group difference (P<0.05); after the treatment, the change of FDI score in the treatment group was significantly different from that in the control group (P<0.05). Conclusion:EA at local points plus point injection can produce a more significant efficacy than EA in the treatment of BP during pregnancy.

Objective To study antimicrobial resistance and genotyping of methicillin-resistant Staphylococcus au-reus(MRSA). Methods A total of 967 no-repetitive strains of Staphylococcus aureus(S.aureus)isolated from a hospital between January 2014 and November 2015 were collected,antimicrobial susceptibility testing,mecA gene,and Panton-Valentine leukocidin gene(PVL gene)were detected;staphylococcal cassette chromosome mec(SCCmec)typing,multilocus sequence typing(MLST),S.aureus protein A(spa)gene typing,and S.aureus ac-cessory gene regulator(agr)typing were performed with multiplex polymerase chain reaction. Results Of 967 strains of S.aureus,210(21.72%)were MRSA;detection rate of MRSA from sputum specimen was higher than that of skin and soft tissue specimen(68.09% vs 1 1.83% ,P<0.05);vancomycin- and linezolid-resistant S.aureus strains were not found,susceptibility rates of MRSA to gentamicin,tetracycline,erythromycin,clindamycin,levo-floxacin,ciprofloxacin,moxifloxacin,nitrofurantoin,and rifampicin were all lower than those of methicillin-sensi-tive Staphylococcus aureus(MSSA),differences were all statistically significant(all P<0.05);antimicrobial sus-ceptibility rate of MRSA to compound sulfamethoxazole was higher than MSSA,difference was significant(P<0.05). Susceptibility rates of MRSA isolated from skin and soft tissue to gentamicin,levofloxacin,ciprofloxacin,moxifloxacin,and rifampicin were 86.90% -95.24%,while MRSA isolated from sputum were only 1.56% -15.63%.Of 967 strains of S.aureus,210 harbored mecA gene,10 harbored PVL gene,8(3.81%)of 210 MRSA strains weren't typed. The main types of MLST,SCCmec,spa,and agr were ST 239(n= 177 strains),type Ⅲ(n= 177 strains),t 030(n= 177 strains),and typeⅠ(n= 196 strains)respectively.Conclusion The main epidemic clone of MRSA strain in this hospital is ST239-MRSA-SCCmec III-t030,antimicrobial resistance is serious,monitoring on drug-resistant strains in hospital should be strengthened.

BACKGROUNDOxidative Stress and p38 mitogen-activated protein kinase (p38MAPK) play a vital role in renal fibrosis. Pioglitazone can protect kidney but the underlying mechanisms are less clear. The purpose of this study was to investigate the effect of pioglitazone on oxidative stress and whether the severity of oxidative stress was associated with the phosphorylation level of p38MAPK.

METHODSRat mesangial cells were cultured and randomly assigned to control group, high glucose group and pioglitazone group. After 48-hour exposure, the supernatants and cells were collected. The protein levels of p22(phox), p47(phox), phosphorylated p38MAPK, total p38MAPK were measured by Western blotting. The gene expressions of p22(phox), p47(phox) were detected by RT-PCR. The levels of intracellular reactive oxygen species (ROS) were determined by flow cytometry. The levels of superoxide dismutase (SOD) and maleic dialdehyde (MDA) in the supernatant were determined respectively.

RESULTSCompared with the control group, the expression levels of p22(phox), p47(phox), phospho-p38 and ROS significantly increased, activity of SOD decreased in high glucose group, while the level of MDA greatly increased (P < 0.01). Pioglitazone significantly suppressed p22(phox), p47(phox) expressions and oxidative stress induced by high glucose. The expressions of p22(phox), p47(phox), phospho-p38MAPK and ROS generation were markedly reduced after pioglitazone treatment (P < 0.05). The activity of SOD in the the supernatant increased (P < 0.05), while the level of MDA decreased greatly by pioglitazone (P < 0.05). The level of oxidative stress was associated with the phosphorylation level of p38MAPK (P < 0.01).

CONCLUSIONPioglitazone can inhibit oxidative stress through suppressing NADPH oxidase expression and p38MAPK phosphorylation.

Animals ; Blotting, Western ; Glucose ; pharmacology ; Mesangial Cells ; drug effects ; enzymology ; NADPH Oxidases ; genetics ; metabolism ; Rats ; Reactive Oxygen Species ; metabolism ; Thiazolidinediones ; pharmacology ; p38 Mitogen-Activated Protein Kinases ; genetics ; metabolism

Objective To establish the mechanism of management-pass antedisplacement of detail problem and improve the effects of the quality control.Methods Made the former management-model of finding,noting and improving detail problems more fine and more material,established the platform of the management-pass antedisplacement of detail problem,and encouraged all staffs participating in management of detail problems and casting back effects of improving.Results After the implementation of the managementpass antedisplacement model of detail problem,the indexes of working quality were improved significantly.And comprehensive scores in various areas increased significantly such as removing dirt zone [(96.9 ± 1.7) vs(91.6 ± 1.8)],packing-check sterilization zone [(97.2 ± 1.6) vs (93.7 ± 2.4)],asepsis-goods storing zone [(98.8 ± 1.7) vs (94.5 ± 1.1)],skill-knowledge competition[(97.9 ± 1.5) vs(93.9 ± 1.7)],and clinical satisfaction degree [(98.2 ± 1.8) vs (93.5 ± 1.7)] were significantly higher than those before (t =-7.22,-4.79,-3.54,-6.26,-7.29,respectively;P ＜ 0.01).Conclusions The management-pass antedisplacement of detail problem can effectively improve the effects of quality control in sterilization-supply unit.

Objective To compare the effect of two kinds of soaking methods on bloodstained surgical insturments,and analyze influence factors for instruments clean effect,control key link,improve quality and clean surgical instruments washing efficiency,and to reduce the consumption.Methods Points on three analysis phase:analysis of the cause and gory surgical instruments clean effect.Factors validation phase:on the basis of the moisturizing method is verified.Improve phase:for key factors,establishing countermeasure.Results Oxidation rate of instruments in water group was 19.60％,and 2.30％ in disinfection group,the difference between two groups was significant ( x2=26.04,P ＜0.01 ).Re-washing rate of oval forceps was 23.7％ and consumption rate was 15.0％ before quality control and those were 0.7％ and 0 after quality control,the difference was significant ( x2=74.25,48.69,respectively; P ＜ 0.01 ).Conclusions Sterilization supply &distribution control two keys could improve the quality and washing efficiency of surgical instruments,and reduce the consumption.

OBJECTIVETo construct an eukaryotic expression vector for vascular endothelial growth factor (VEGF) 165 gene and obtain VEGF expression in rat bladder smooth muscle cells.

METHODSVEGF165 cDNA was cloned into the eukaryotic expression vector pcDNA3.1(-), and the resultant recombinant vector pcDNA3.1(-)/VEGF165 was transfected into the rat bladder smooth muscle cells by electroporation. VEGF expression in the cells was determined by RT-PCR and immunofluoresence assay, and the biological activity of VEGF in the supernant of the transinfected cell culture was tested by MTT assay.

RESULTS AND CONCLUSIONVEGF expression was obtained in the transinfected cells, and the supernant of the transinfected cell cultures stimulated the proliferation of the endothelial cells.

Animals ; Animals, Newborn ; Cell Line ; Cell Proliferation ; drug effects ; Cells, Cultured ; Cloning, Molecular ; Culture Media, Conditioned ; metabolism ; pharmacology ; DNA, Complementary ; genetics ; Eukaryotic Cells ; metabolism ; Fluorescent Antibody Technique ; Gene Expression ; Genetic Vectors ; genetics ; Humans ; Myocytes, Smooth Muscle ; cytology ; metabolism ; Rats ; Reverse Transcriptase Polymerase Chain Reaction ; Transfection ; Urinary Bladder ; cytology ; Vascular Endothelial Growth Factor A ; genetics ; metabolism ; pharmacology