Objective To understand the current situation of hospital infection management in some hospitals in China and explore its development tendency. Methods Surveys were made by means of questionnaires on hospital infection management in 16 hospitals of various tiers in Beijing, Shanghai and Guangzhou and the results were compared with those of the two nation-wide surveys conducted respectively in 1994 and 1999. At the same time a dynamic assessment was made of hand hygiene implementation. Results The infection management systems in large and medium-sized hospitals in China were becoming increasingly perfect and a fairly high level was reached in function construction, team structure and expertise of hospital infection management departments. However, there were still many problems. 60% of medical staff washed their hands after patient-contact while only 35% did so before patient-contact and after item contact. Conclusion Hospital infection management in China has reached an important stage of accelerated development with substantial accumulation and more solid foundation. However, as far as development tendency is concerned, we should introduce technical indexes for quality control, put more emphasis on process-evaluation rather than result-evaluation in quality control management, stress the guiding role of evidence-based medicine in hospital management and promote a benign interaction between the hospital infection management and medical treatment process.

Objective To evaluate hand hygiene compliance (HHC) after patient contact and the influence of different factors on HHC in China. Methods HHC by different levels of medical workers from different departments were observed on 8 tertiary hospitals in Beijing, Shanghai and Guangzhou. Results The average HHC was 56. 5%( 61. 0% by the doctors and 53. 8% by the nurses). HHC was 52. 8% in the presence of gloves and 82. 0% in the absence of gloves; the difference was statistically significant. When alcohol-based hand rub or soap (hand sanitizer) was provided, HHC was respectively 58. 7% and 61. 3%; when they were not provided, it was respectively 51. 2% and 48. 4% (P

The present study was designed to investigate the effects of cytochalasin E(CE) on the integrity of Sertoli cell barrier. The results indicate that: (1) In the CE-treated testis(1000-2000 ?mol/L CE/testis, 6-14 hr), actin filaments of the ectoplasmic specialization (ES) in area of Sertoli cell barrier were disrupted, the accumulation of amorphous material and fragmented small vesicles of SER were observed in cytoplasm of Sertoli cell. The above changes appeared to be dosage and duration dependent; (2)In the seminiferous tubules of animals receiving CE (1000-2000 ?mol/L testis, 6-14 hr) plus fixation with 10% hypertonic dextrose solutions, usually the germ cells shrinkage and exaggeration of intercellular spaces withint he basal as well asthe adluminal compartments were observed. The tight junction between Sertoli cells were also appeared to be separated by hypertonic action of dextros; (3) The results of tracing experiments showed that lanthanums as tracer could be seen to pass through the Sertoli-Sertoli cell junction of the barrier and enter into the adluminal compartment, the tracer that surrounding the spermatocytes and round spermatids were discernible readily. The above results suggest that cytochalsin E disturbed actin filaments of Sertoli ectoplasmic specialization thus altered the functional integrity of the Sertoli cell barrier. The relationship between the actin filaments and Sertoli cell barrier was discussed.

OBJECTIVE To evaluate the hand hygiene compliance(HHC) in China.METHODS The field observation for hand hygiene compliance,the hand hygiene material and equipment were performed in parallel in 8 hospitals from Beijing,Shanghai and Guangzhou.RESULTS It was shown that the average hand hygiene compliance before contacting patient was 35.3%,much lower than the compliance after contacting patient(56.5%).The nurse′s HHC(39.3%) was the best among groups before contacting patient,but the physicians took the first place of HHC after contacting patient.The best discipline in HHC was gynecology and obstetrics departments,especially before contacting patient and after contacting other surface,comparatively the worst was the surgeons.Most of hospitals(83.3%) provided the unmedicated detergent for handwashing.The alcohol-based hand rub(ABHR) for hand disinfection was available(56%) in many hospitals,in contrast the HHC with ABHR was quite low(14.2%).CONCLUSIONS These results indicated that the HHC is relatively low and improving adherence to hand hygiene practice is a multidisciplinary and systematic approach in China.It might be essential for promoting the HHC of health care workers,especially the physicians and surgeons,to strengthen the education and enlarge the continuous investment for some hard-ware improvement.

Objective To investigate lymph node metastasis on the middle and lower segment of lⅡ and Ⅲ stage of esophageal squamous cell carcinomas,understand the factors influencing the lymph node metastasis,and provide the basis for the key areas of lymph node cleaning.Methods A retrospective study was made on the specimens of 186 patients who were middle and lower segment of Ⅱ and Ⅲ stage of esophageal squamous cell carcinomas,who had underwent radical operation through left thoracic,thoraco abdominal two field lymph node cleaning.All the cases were patients from April 2010 to December 2013 at the Inner Mongolia Medical University Clinical Medical College of Chifeng.Results A percentage (67.9％) of patients (126/186) was found with lymph node metastasis.A total of 4259 lymph node was dissected,with an averaged cleaning of (22.9 ± 8.1) lymph nodes for each case.A total of 622 lymph nodes (14.6％ =622/4 259) existed metastasis.The rate of mediastinum metastasis for middle and lower segment of esophageal cancer was 56.1％ and 16.5％,respectively.The rate of metastasis to the lower mediastinal lymph nodes was 34.6％ and 54.4％,respectively.The rate of metastasis to the celiac lymph nodes was 23.4％ and 46.8％,respectively.A significant difference was found in the metastasis locations of middle and lower segment of esophageal carcinomas (P ＜ 0.05).The top three locations of lymph node metastasis in the middle segment of esophageal squamous cell carcinomas were the lymph nodes of left artery paraesophageal,carina,and gastric bypass.The top three locations of lymph node metastasis in the lower segment of esophageal squamous cell carcinomas were paraesophageal,cardia,and gastric lymph nodes.The depths of tumor invasion,differentiation,intravascular cancer embolus were statistically significant effect on lymph node metastasis rate (P ＜ 0.05).Tumor location,and lesion length had no significant effect on the lymph node metastasis rate (P ＞ 0.05).Conclusions The lower segment of Ⅱ,Ⅲ stage esophageal squamous cell carcinoma with lymph node metastasis occurs in the lower mediastinal and abdominal lymph nodes.The middle segment Ⅱ,Ⅲ stage esophageal squamous cell carcinoma with lymph node metastasis occurs in the thoracic and abdominal lymph nodes with Jump transfer characteristics.The lymph node cleaning of the mid-dle segment includes the left artery near the stomach,paraesophageal,and carina lymph node.The lymph node cleaning of the lower segment includes paraesophageal,cardia,and gastric lymph nodes.The metastasis rate of vascular tumor thrombus is related to the depth of tumor invasion and differentiation degree.

Objective To study the expression of phosphorylated serine 910 of focal adhesion kinase(FAKps910)in circulation endothelial cells(CEC)from patients with hemorrhagic fever with renal syndrome(HFRS).Methods Fifty HFRS patients were involved in the study and divided into mild(n=17),moderate(n=20)and severe(n=13)groups according to patients' conditions. Twenty healthy volunteers were enrolled as control group. CEC were isolated by Percoll density gradient centrifugation method. The expression of FAKps910 in specific APC-CD31+ CEC was measured by flow cytometry. The data were analyzed by one-way ANOVA. Results The positive rates of FAKps910 in CEC were 59.87%±9.58% in early febrile stage patients and 21.14%±2.53% in the healthy controls, while it was 11.64%±2.17%in the later febrile or hypotension stage patients(F=262.31,P＜0.01).It gradually restored to normal afterwards. The positive rates of FAKps910 in CEC were 17.45%±2.64%,13.84%±2.54% and 7.47%±2.57%,respectively in mild, morderate and severe groups in the later febrile or hypotension stage, which were all significantly different from that in control group(F=52.642,P＜0.01).Conclusions FAK in CEC iS related with the clinical severity of HFRS patients. FAK may be involved in intergrin β3-mediated endothelial injury during Hantavirus infection.

AIM To study the chemical constituents from Phyllodium pulchellum (L.) Desv..METHODS The ethyl acetate and n-butanol fractions of P.pulchellum 95％ ethanol extract were isolated and purified by Sephadex LH-20,silica,ODS and pre-HPLC column,then the structures of isolated compounds were identified by physicochemical properties and spectral data.RESULTS Eleven compounds were isolated and identified as phydroxybenzoic acid (1),protocatechuic acid (2),protocaechuic acid methyl ester (3),protocatechuic acid ethyl ester (4),ethyl gallate (5),p-coumaric acid (6),caffeic acid ester (7),loliolide (8),uridine (9),arbutin (10),daucosterol (11).CONCLUSION Compounds 4-11 are isolated from genus Phyllodium for the first time,compounds 2 and 3 are first obtained from this plant.

Aim To investigate the effect of chronic intermittent hypobaric hypoxia ( CIHH) on the paeonol induced vasomotion of isolated rat ’ s thoracic aorta rings and its underlying mechanisms. Methods Spra-gue-Dawlay ( SD ) rats were randomly divided into 2 groups: control group ( CON ) and CIHH treatment group ( CIHH) . CIHH rats were exposed to hypoxia in a hypobaric chamber simulating 5 000 m altitude, 6 hours daily for 28 days. CON rats lived in the same en-vironment as CIHH animals except hypoxia. Organ bath technique was used to observe the effect of pae-onol on isolated thoracic aorta rings of rats. Results There were no significant differences of noradrenaline ( NE )- and KCl-induced contraction in thoracic aorta rings among CIHH and CON rats;CIHH enhanced va-sodilative effects of paeonol on isolated thoracic aorta rings of rats; the vasodilative effects on CIHH rats could be partly decreased by β-receptor blocker prop-ranolol,ATP-sensitive potassium channel ( KATP ) bloc-ker glibenclamide and NO synthase inhibitor L-NAME. Paeonol significantly inhibited NE-induced intracellular and extracellular calcium-dependent contraction in CIHH rats. Paeonol didn ’ t inhibit NE-induced con-traction by intracellular calcium release and its inhibi-tory effect couldn ’ t be blocked by glibenclamide in CON. Vasodilative effects of paeonol couldn ’ t be re-versed by indomethacin, a cyclooxygenase inhibitor, in CIHH and CON rats. Conclusion CIHH significantly enhances vasodilative effects of paeonol on isolated tho-racic aorta rings of rats. Besides promoting the signa-ling pathway of paeonol in CON, CIHH significantly enhances vasodilative effects of paeonol via activating KATP and inhibiting Ca2+ release from sarcoplasmic re-ticulum.

Objective To evaluate the inhibitory effects of shRNAs targeting genes encoding viral capsomeres VP1-VP4 on enterovirus 71 (EV71) replication when used alone or in combination.Methods Short hairpin RNAs (shRNAs) targeting genes encoding VP1-VP4 protein of EV71 were designed and then respectively inserted into lentiviral vector pLKD-CMV-GFP-U6 to construct the recombinant plasmids.The expression plasmids together with psPAX2 and pMD2.G were transfected into 293T cells to induce the expression of recombinant lentiviruses,which were collected on the third day after transfection.The titers of recombined lentiviruses were determined by real-time PCR.The effects of shRNAs used alone or in combination on the expression of EV71 at mRNA and protein levels were respectively detected by real-time PCR and Western blot.Results The inhibitory effects of shRNAs on EV71 replication showed no significant differences among various strains (isolated from fatal cases,severe cases,mild cases and FY0805) (P＞0.05).Their inhibition rates were 51.6％ (sh-VP1-1),85.1％ (sh-VP1-2),76.4％ (sh-VP1-3),57.5％ (sh-VP2-1),81.4％ (sh-VP2-2),79.5％ (sh-VP2-3),68.9％ (sh-VP3) and 56.7％ (sh-VP4) respectively,and they were in a dosage dependent manner.sh-VP1-2 in combination with sh-VP2-2 showed the highest inhibition rate reaching up to 96.6％.Moreover,shRNAs used in combination showed better effects than any one used alone even at double dosage.Conclusion All shRNAs targeting viral capsid VP1-VP4 genes showed inhibitory effects on EV71 replication with inhibition rates over 50％ and the effects could be strengthened when using shRNAs in combination.