OBJECTIVE According to the characteristics of ophthalmic surgical instruments,to select the best sterilization method in order to guide clinic.METHODS The different methods of disinfection and sterilization,surgical volume and postoperative infection of ophthalmic surgical instruments from 2005 to 2007 were reiewed and compared the current pros and cons of various sterilization methods.RESULTS The use of low-temperature sterilizer before(2005) the number of surgical cases of 2275 cases,the infection rate was 0.04%;the use of low temperature plasma sterilizer after the(2006) the number of surgical cases of 2752 cases,the infection rate was 0;the use of low-temperature plasma and low-temperature steam formaldehyde sterilization sterilization(2007) Example surgery for 2830 cases,the infection rate was 0.035 percent;low-temperature sterilization of surgical instruments can ensure sterilization,but also enhance the volume of surgery.CONCLUSIONS Hydrogen peroxide plasma sterilization technology with the use of low-temperature range,fast,convenient and reliable features,more suitable for ophthalmic surgical instruments after the section of the sterilizer.

OBJECTIVE To investigate the hospitals containing above 500 sickbeds in the Beijing area,in order to find out the relationship between the environmental sanitation monitoring(including air,object surface,medical personnel hand,using desinfectant compound,and ultraviolet lamps) and the hospital infection control.METHODS Choosing hospitals with above 500 sickbeds in Beijing,through a written survey and questionnaire covering the actual environmental sanitation monitoring quantity,the positive rate and the situations of hospital infections outbreak in 2005,then calculate the statistical analysis.RESULTS After calculating the environmental sanitation monitoring cost for the hospitals with above 500 sickbeds,it could conclude the monitoring expense for 1000 sickbeds hospital per year for each bed was 192.10 RMB;the monitoring expense for 500 sickbeds hospital per year for each bed was 145.60 RMB.It could also conclude the positive rate of object surface and the hands of medical personnel was higher.CONCLUSIONS Through the analysis,each hospital carries out the monitor according to the requirement of the "Standards",the monitoring expense for hospitals with 1000 sickbeds is higher that of hospitals with 500 sickbeds.It is no correlation between the hospital monitoring positive rate and the hospital infection outbreak.The medical personnel′s knowledge of hospital infection control and hand hygiene training must be strengthened.

Objective To investigate the clinical results of left ventricle retraining procedure. Methods From Apr. 2001 to May 2004, 7 consecutive cases of simple TGA underwent left ventricle retraining procedure, which was composed of aorto-pulmonary shunt and pulmonary artery banding. At the operation, the ratio of systolic pulmonary/systemic pressure increased from 0.34 to 0.76. Contemporary atrial septum excision was performed in 2 cases and pulmonary artery banding revision in one. Results There was no hospital death in this series. 4 cases underwent second stage arteries switch operation (ASO) successfully 2 weeks after primary retraining procedure and discharged uneventfully. 1 case was readmitted 3 months later for ASO and died of postoperative hepatic failure. 2 cases were discharged without second staged operation because of postoperative complications. Conclusion Left ventricle retraining is necessary preparation for ASO in cases of simple TGA beyond the neonatal period. Atrial communication plays an important role in left ventricle retraining procedure. The surgical results of rapid two-stage ASO are quite satisfactory.

Objective To study significance of anicteric biliary tract dilatation in early diagnosis and treatment of patients with periampullary carcinoma.Method Review the resection rate and survival rate of 16 periampullary carcinoma patients with anicteric biliary tract obstruction found out by B-ultrasound,CT or PTC during 13 years(1986-1999).Result The operative resection rate was 87.50%(14/16) ,5-year survival rate was 43.75%(7/16),3-year survival rate was 62.50%(10/16).Conclusions Biliary tract dilatation existed before icterus occurred,while syndromes such as upset of upper abdomen,reclusion, epigastralgia distention and anorexia, may occur 1-3 months ahead of icterus occurred in patients with periampullary carcinoma. If the patient has syndromes mentioned above, more than 40 years of age and biliary tract dilatation found by B-ultrasound, CT,PTC or ERCP, periampullary carcinoma should be considered. The patients should be checked by operation,so as to raise the operative resection rate and survival rate.

Objective To compare the clinical therapeutic efficacy of excision and primary suture after the hydrogen peroxide and methylene blue treatment, and Limberg transposition flap for the treatment of pilonidal sinus. Methods The clinical data of 55 patients with sacrococcygeal pilonidal sinus were analyzed retrospectively. Thirty-six patients were treated by excision and primary suture after the hydrogen peroxide and methylene blue treatment (suture group), and 19 patients were treated by Limberg transposition flap (flap group). The operation time, length of hospital stay, incision healing time, incidence of complications and recurrence rate were compared between 2 groups. Results There were no significant differences in the length of hospital stay, incision healing time, incidence of complications and recurrence rate between 2 groups (P>0.05). The operation time in suture group was significantly shorter than that in flap group: (51.25 ± 7.02) min vs. (71.42 ± 12.29) min, and there was statistical difference (P = 0.000). Conclusions Excision and primary suture after the hydrogen peroxide and methylene blue treatment is a good method for the treatment of pilonidal sinus. The operation time is short. It is easy to operate, and could achieve good results.

Objective To analyze the diagnosis and treatment of pancreatic trauma with main pancreas duct break. Methods Forty-four cases of severe pancreatic trauma with main pancreas duet break were retrospectively analyzed including their diagnosis and different operation performed according to the severity of pancreatic trauma. Results All of severe pancreatic trauma could be diagnosed by CT scan and B-ultrasonic examination. But the main pancreas duct break or not should be determined by surgical exploration. Emergency operations were performed for all cases , distal part pancreaticojejunostomy in 27 cases; modified duodeno-divertiulaization in 3 cases, duode-nojejunostomy in 3cases, pancreaticeduodenectomy in 2 cases, 41 cases were cured. The mortality was 6.8%. Conclusion CT scan is the most helpful means to diagnose pancreatic trauma. An appropriate and timely emergen-cy operation is the key to reduce mortality.

Objective To study the relationship between calcitonin gene related peptide(CGRP)and enhanced osteogencsis after brain injury by investigating the expression of CGRP in callas and the level of CGRP in serum of rats with brain injury and femoral fracture.Method The experiment was conducted in the Laboratory of Surgery,Affiliated Hospital of North Claim Coal Medical College.Totally 56 male Sprague-Dawley(SD)rats were divided randomly into 3 groups:fracture group(n=24),fracture with brain injury group(n=24)and normal control group(n=8).The parietal skull revealed,the bone windowwas opened,rats models of brain injury were established by falling freely,and rats models of fracture were established by cutting the right middle femur.The rats in normal control group were killed at the 21 days after operation,the rats in other two groups were killed at 7,14and 21 days after operation,respectively.The X-ray of femoral fracture was obtained,the CGRP concentration in serum was detected by mdioimmunoassay,and tissues at 5mm above and below the fracture were stained by HE and SP immtmohistochemistry to observe the expressions of CGRP and the fracture healing.The data were expressed as mean±SEM and ahalyzed with student't t test with SPSS,Results The serum levels of CGRP in fracture group were(91.58±28.67)ng/L,(102.46±27.95)ng/L,(86.54±24.13)ng/L at 7,14,21 days after operation,respectively,which were significantly higher than that in the control group.In fracture with brain injury group,the serum levels of CGRP(165.49±43.28)ng/L significantly increased at 7 days after operation,and compared with fracttwe group,there was significant difference.The serum levels of CGRP decreased at 14,21 days after operation,with 104.72±31.36)ng/L,(74.93±21.57)ng/L,respectively,and compared with fracture group,there was significant difference at 21 days.The mean optical density in callus of the fracture in brain injury group (0.496±0.108)were higher than that in the fracture group[(0.348±0.076)]at 7 days after operation(P＜0.01),but there were no significant difference on the 14 and 21 days.Conclusions CGRP may play a role in osteogenesis after brain injury.

Objective To analyze the significance of levels and combined detection of plasma homocysteine(Hcy),high-sensitivity C reactive protein(hs-CRP) and lipoprotein-associated phospholipase A2(Lp-PLA2) in patients with ischemic cerebral stroke(ICS).Methods A total of 140 patients with ICS were selected into ICS group,and 100 healthy individuals were recruited in the control group.The plasma levels of Hcy,hs-CRP,Lp-PLA2 were examined,then the positive rates of them were statistically analyzed.Analyzed the value of the levels and joint detection of Hcy,hs-CRP and Lp-PLA2.Results The plasma levels and the positive rates of Hcy,hs-CRP and Lp-PLA2 in ICS group were statistically higher than those in the control group(P<0.05).The area under the receiver-operating characteristic curve of combined detection of Hcy,hs-CRP and Lp-PLA2 in diagnosis of ICS was 0.949,the sensitivity was 0.850,and the specificity was 0.807,which were higher than Hcy,hs-CRP and Lp-PLA2 alone.Conclusion The plasma levels of Hcy,hs-CRP and Lp-PLA2 increase in ICS patients,and the combined detection of the three indicators might improve the early diagnostic value of ICS.

OBJECTIVE To provide a practical action plan which can prevent and control the similar occurrence through studying the epidemiological characteristics of a norovirus-induced diarrhea outbreak in the wards of our hospital. METHODS To obtain the information about the epidemic situation of norovirus involving 15 patients in the two wards of our hospital, during the period from Nov 12 to 15, 2006. RESULTS It was a norovirus gastroenteritis outbreak in the 8 cases among 15 patients and there were other 7 sporadic cases. The consummate monitoring system on nosocomial infection could gain the information of disease, and be very helpful to control its transmission. Beijing Municipal Center for Quality Control and Improvement of the Management of Nosocomial Infection was known the information and shared it among different kinds of hospitals. Thus an unnecessary panic was avoided in Beijing at that time. CONCLUSIONS The social factor, senile situation and immunocompromise are the causes of this norovirus outbreak. The effective control measures and the information exchange in time could prevent the spread of infection. It is shown that the nosocomial infection monitoring network could catch the epidemic tendency of nosocomial infection sensitively, so to strengthen the monitoring network is the key.

Objective Through comparing ultrasound-guided microwave ablation (MWA) with surgical resection for the treatment of nodular goiter to evaluate the effect of RFA on the thyroid function.Methods A total of 50 patients with nodular goiter,who were admitted to authors' hospital during the period from January 2010 to January 2013 to receive ultrasound-guided MWA,were selected and used as the study group;and other 96 patients with nodular goiter,who were encountered at authors' hospital during the same period to receive partial thyroidectomy,were collected and used as the control group.Of the 50 patients in the study group,RFA of unilateral lobe nodules was performed in 8 and RFA of bilateral lobe nodules in 42.Among the 96 patients in the control group,unilateral lobe nodules were seen in 52 and bilateral lobe nodules in 44.Postoperative complications were recorded,the serum FT3,FT4,TSH levels were determined at one week,as well as one,3,6 and 12 months after the treatment.The results were statistically analyzed.Results All patients were followed up for 12 months.In the study group,no complications occurred;one week after RFA the serum FT3 and FT4 levels increased while the serum TSH level decreased when compared with preoperative ones,and the differences were statistically significant (P＜0.05).In the control group,bleeding asphyxia occurred in one patient,hoarseness in 5 patients and hypocalcemia convulsion in 3 patients.One week after partial thyroidectomy,the serum FT3 and FT4 levels increased while the serum TSH level decreased when compared with preoperative data,and the differences were statistically significant (P＜0.05).One week after surgery thyroxine replacement therapy was routinely given to 44 patients who had received bilateral subtotal thyroidectomy.Three patients who had received unilateral subtotal thyroidectomy developed hypothyroidism at 3,6 and 8 months after the surgery respectively.In other 49 patients receiving unilateral subtotal thyroidectomy the serum FT3,FT4,TSH levels determined at one,3,6 and 12 months after surgery were significantly different from those in the patients of the study group (P＜0.05).Conclusion For the treatment of nodular goiter,ultrasound-guided MWA is quite safe.MWA has very slight effect on thyroid function and is definitely superior to subtotal thyroidectomy.Therefore,MWA is a minimally invasive technique which is worthy of clinical promotion.