OBJECTIVE To provide an effective management mode of antisepsis for dental handpiece in dental(hospital) where a system called "one handpiece for one patient" is supposed to be found.METHODS Development and(running) mode of Antisepsis Center for Dental Handpiece were reviewed and function of the Center was(evaluated).(RESULTS) It was found that working process in the outpatient department could be simplified and much labor saved by maintain,antisepsis and refixation for dental handpiece in a wholesale mode.Furthermore,working efficiency and financial benefit of the dental hospital be greatly improved in this mode.CONCLUSIONS Antiseptic quality for dental handpiece is guaranteed by a standardized and programmed sterilization process in the Antisepsis Center for Dental(Handpiece).Management for handpiece in a wholesale mode is quite practicable and scientific.

OBJECTIVE:To provide reference for reducing the occurrence of ADR and disposing ADR correctly. METHODS:Using the Excel statistics and manual screening,528 ADR reports were collected from a third grade class A hospital in Chongqing during Oct. 2005 to Dec. 2015. Those ADR cases were analyzed statistically in respects of general information of ADR patients, routes of administration and occurence time,types of ADR-inducing drugs,organs/systems involved in ADR and clinical manifesta-tions,disposal and outcomes,etc. RESULTS:A total of 285 cases(53.98%)of ADR occurred in elderly patients aged more than 65. Most of original diseases were respiratory system disease(144 cases,27.27%). 124 ADR cases occurred in people who had al-lergic history(23.48%). Most of ADR cases were induced by intravenous administration(428 cases,81.06%). ADR frequently oc-curred within 1 h after medication(385 cases,72.92%). Anti-infective agents(211 cases,39.96%)and TCM preparations(67 cas-es,12.69%) were the top 2 involved drug types. The most common ADR occurred in skin and its appendants (175 cases, 33.14%),followed by general reaction(148 cases,28.03%)and administration sites(63 cases,11.93%). The treatment of ADR mainly involved drug withdrawal and symptomatic treatment (285 cases,53.98%). ADR mainly were cured and recovered (509 cases,96.40%). CONCLUSIONS:The characteristics and regularity of ADR disposal should be analyzed to formulate clinical path-way for ADR diagnosis,suspected cases observation,examination,disposal and rescue. When the patient has general reaction or re-spiratory system and circulatory system problems,treatments should be more actively processed.

OBJECTIVE:To provide reference for drug production,parchase and use in local governments,health care depart-ment,hospitals,manufacturers and sales enterprises,etc. METHODS:By consumption sum sorting method,the information of 14 categories and key types in 34 hospitals from Chongqing area during 2012-2014 were analyzed statistically such as sales,produc-tion manufacturers. RESULTS:The consumption sum of 34 hospitals from Chongqing area increased by 15%-17% during 2012-2014. The consumption sum and proportion of anti-infective drugs showed a downward trend,decreasing by 3.28%. Those of respi-ratory system drugs and anti-tumor drugs had the largest increase,with increasing rate of 79.01% and 69.39%,respectively. Do-mestic drugs accounted for about 73% market share,and sales of imported drugs increased more than domestic and joint-stock drugs,increasing by 40.17%. Among 6 Chongqing pharmaceutical manufacturers on the top 100 consumption sum shortlist,total consumption sum of 3 manufacturers had increased;the consumption sum of top 10 foreign pharmaceutical manufactures increased year by year. CONCLUSIONS:The consumption sum of drugs is increasing in Chongqing area. Anti-infective drugs accounted for less than 16%,which is the achievements of clinical application of antibiotics special rectification activities for 3 years. Both respi-ratory system disease and malignant tumor have high incidence in Chongqing area. Domestic drugs still are main types in hospital. Foreign manufacturers develop well in China,but Chongqing pharmaceutical manufacturers show unsatisfactory development pros-pect.

Objective To investigate the level of CD73 expression in CD4+ regulatory T(Treg) cells in patients with systemic lupus erythematosus ( SLE ) and explore its role in the pathogenesis of SLE.Methods We selected 29 untreated/active SLE patients and 22 healthy controls. Frequencies of CD4+ CD25+CD73+ T cells and levels of FOXP3 protein expressed in CD4+ CD73+ CD4+ CDhi25, CD4+ CDhi25, CD4+ CD25+ T cells were analyzed by flow cytometry. Meanwhile, the levels of SLE disease activity index ( SLEDAI), C reactive protein (CRP), ESR,immunoglobulin and complement were measured. Results The percent of CD4+ CD25+ CD73+ T cells was decreased in new-onset SLE compared with healthy controls[(1.25±1.32) % vs (2.35±1.09) %, P ＜0. 01], and it had no correlation with the levels of SLEDAI, CRP, ESR, et al and anti-C1qand anti-nucleosome antibodies ( P ＞ 0.05 for each). Both in groups of new-onset SLE and healthy controls, CD73 level expressed in CD4+ CDhi25CDhi25T cells[(29.05 ± 12. 53)%, (43.35 ± 10. 09)%]was higher than that expressed in CD4+ CD25+ T cells[( 17.48 ± 6. 92 ) %, ( 29. 98 ± 10. 39 ) %, P ＜ 0.01]. In both SLE patients and healthy controls, levels of FOXP3 protein expressed in CD4+ CD73+ T cells[(65. 36 ± 14. 40)%,(63.80±14.05)%]and CD+4 CDhi25CD4+ CDhi25 T cells[(67. 30 ± 13.04)%, (56. 30 ±9. 21 )%]were higher than those in CD4+ CD25+T cells[(45.70 ± 12. 74)%, (43.98 ±5. 17)% ,P ＜0. 001], while it had no significant difference between the CD4+ CDhi25CD4+ CDhi25 and CD4+ CD73+ T cells(P＞0.05). Conclusion These results demonstrate that CD73 may be a new surface marker of regulatory T cells, and the abnormal expression of CD73 in Treg cells may participate in the pathogenesis of SLE.

Objective To investigate the long-term efficacy of Botulinum toxin type A (BTX-A) on spasticity in cerebral palsy, and theeffect of rehabilitation on it. Methods 230 children with spastic cerebral palsy were treated with BTX-A block. The dose of BTX-A wasidentified with the weight of the children and the Modified Ashworth Scale (MAS). They were divided into group A who exercised morethan 2 h/d, and group B who exercised less than 2 h/d or not. They were assessed with Gross Motor Function Measure (GMFM) 1 year aftertreatment. Results There was no significant difference between group A and B with ages, weight, MAS, GMFM before block (P>0.05), norwith BTX-A effect time (P>0.05). The GMFM improved significantly in both group A and B 1 year after block (P<0.05), and it improvedmore in group A than group B (P<0.01). Conclusion The long-term efficacy of BTX-A block is positive. The rehabilitation training afterblock can help children to improve their gross motor function.

Objective To observe the effect of Botulinum toxin-A (BTX-A) injection on spastic iliopsoas in the children with cerebral palsy. Methods July 2006 to August 2012, 37 cerebral palsy children with spastic iliopsoas were treated. The age ranged from 3 to 15 years.The control group (n=20) was treated by physical therapy. The experimental group (n=17) accepted BTX-A injection in addition. The dose of BTX-A block was identified with the weight of the child and the modified Ashworth Scale (MAS). The dose of injection ranged from 15 IU to 45 IU, average (31.2±13.9) IU. Results There was no significant difference between 2 groups in age, weight, MAS score, Gross Motor Function Measure (GMFM) score and extension angle of hip joints before treatment (P>0.05). In both groups, the MAS score decreased,GMFM score and extension angle of hip joints increased after 8 weeks. In the control group, the GMFM score improved significantly (P<0.05). In the experimental group, MAS score, GMFM score and extension angle of hip joints changed significantly after treatment. There was significant difference between 2 groups in MAS score, GMFM score and extension angle of hip joints after treatment (P<0.05). Conclusion The BTX-A injection can relieve iliopsoas spasticity on the children with cerebral palsy efficiently.

Objective To investigate the changes of T lymphocyte immune balance in the patients with COPD.Methods Forty-eightpatients with AECOPD from January 2015 to December 2016 in this hospital were selected as study group and 30 healthy subjects as control.T cells and cytokines in peripheral blood were detected by flow cytometry and ELISA,respectively.The levels of them were compared between the two groups.The correlations of them and principal components were analyzed among the two groups.Results (1) CD8+T cells in the study group decreased [23.8％(17.5％,30.1％) vs.28.2％(23.8％,31.5％),P＜0.05],TregandTh17increased[8.5％(8.3％,9.0％) vs.5.6％(4.9％,6.1％),P＜0.01;2.9％(2.8％,3.0％) vs.1.2％(1.2％,1.4％),P＜0.01],respectively.(2)In the study group,IL-12 [54.97 pg/mL(31.20,161.59) pg/mL],IL-22 [17.70 pg/mL(15.60,35.99) pg/mL],IL-23[120.28 pg/mL(82.97,169.27) pg/mL],IL-23R [0.15 pg/mL(0.15,0.71)pg/mL]and TNF-α[1 000 pg/mL(1 000,1 000)pg/mL] were higher than that of the control group[31.20 pg/mL(31.20,56.23)pg/mL,15.60 pg/mL(15.60,15.60)pg/mL,78.10 pg/mL(78.10,99.08)pg/mL,0.15 pg/mL(0.15,0.15)pg/mL,722.16 pg/mL(494.25,941.44)pg/mL,P＜0.05].(3)Correlation analysis showed that there was a negative correlation between Th17 and Treg (r=-0.883,P＜0.01) in the study group (r=-0.883,P＜0.01),and IL-22 was positively correlated with IL-23 (r=0.340,P＜0.05).In the control group,there was a negative correlation between CD4+T cells and CD8+ T cells,Th17 and CD3+ T cells,Th17 and CD8+T cells (r was-0.578,-0.393 and-0.569,respectively,P＜0.05),and a positive correlation between Th17 and Treg,IL-23 and CD4+T cells,TNF-α and DNT(r=0.403,0.440 and 0.392,respectively.(4) There were 5 main components among each group,but the variable factors differed in the study group from the controls,as that:Th17/Treg,Th17,Treg vs.CD4+ T/CD8+ T cells,CD4+ T cells,CD8+ T cells and CD4+T/CD8+T cells,CD8+ T cells vs.Th17/Treg,Treg and CD4+ T cells,CD3+ T cells vs.IL-12,IL-23R andIL-12,IL-23R vs.CD3+ T cells and IL-23,IL-22 vs.TNF-α,DNT.Conclusion The increasing immune function of Th17 cells with IL-22 and IL-23 may be involved in the pathological mechanism of COPD,which accompanied with the weakened toxicity of CD8+T cells and regulation of DNT.

Objective:To discuss the classification and treatment of ureteroileal anastomotic stricture (UAS) after radical cystectomy.Methods:The clinical data of 34 patients with UAS after radical cystectomy in the Department of Urology of Tongji Hospital from January 2017 to January 2022 were reviewed and analyzed. There were 25 males and 9 females. The average age was (66.3±7.7)years, including 2 cases of bilateral hydronephrosis and 32 cases of unilateral hydronephrosis. The average time of UAS was detected (14.7±6.5)months after radical cystectomy. There were 32 patients of unilateral hydronephrosis and 2 patients of bilateral hydronephrosis. Two patients had undergone nephrostomy in an external hospital. Three patients had elevated leukocytes in blood routine. Among them, two patients had fever. First, nephrostomy on the hydronephrosis side and anti-infection treatment were performed. After routine blood tests showed that the white blood cells were normal and antibiotics were stopped for 24 hours without fever, the operation was performed. 34 patients had preoperative hydronephrosis of (2.7±0.6) cm. Of the 34 cases in this group, 5 cases were injected with methylene blue through a preoperative nephrostomy tube, and 29 were injected with methylene blue through the renal pelvis using an 18G puncture needle under ultrasound guidance. Using a ureteroscope to observe in the ileal bladder, methylene blue was seen in 4 cases. Methylene blue was used to guide the search for the stenosis and a super smooth guide wire was inserted. Among them, 3 cases were dilated with a 5 mm ureteral dilation balloon catheter, 1 case was dilated with a F14 ureteral access sheath, and then a F6 single J stent was inserted. Methylene blue was not seen in the ileal conduit in 30 cases, of which 16 cases were treated with a flexible ureteroscope through the nephrostomy to locate the stenosis, incised with a 30 W holmium laser. 9 cases were treated with 5 mm ureteral dilation balloon catheter, and 7 cases were treated with a F14 ureteral access sheath, and then an F6 single J stent was inserted. 14 cases were unable to find the stenosis by antegrade method. According to the operation time and patient's condition, it was decided to perform immediate or second stage dual endoscope surgery. Through the nephrostomy, a flexible ureteroscope was used to enter the stenosis along the super slide guide wire. A rigid ureteroscope was used to observe the stenosis through the ileal conduit, and the stenosis was found. The stenosis was found in 10 cases and incised with a 30 W holmium laser. 8 cases were treated with 5 mm ureteral dilation balloon catheter, and 2 cases were treated with a F14 ureteral access sheath, and then an F6 single J stent was inserted. 4 cases were still unable to accurately locate the stenosis using the dual endoscope surgery(one case was bilateral stenosis, and one side was relieved), and continued indwelling nephrostomy. The definition of successful removal of stricture in this study is that an F6 single J stent can be inserted into the ureter.Results:UAS were classified into four types based on the severity of the intraoperative findings: Type Ⅰ, the narrow ureteral lumen is more than 50% narrower than the normal ureteral lumen, but methylene blue can pass through in strands; Type Ⅱ, needle like stricture of the ureteral lumen, allowing only methylene blue filaments to pass through; Type Ⅲ, membranous atresia of the ureter, with a narrow segment of 1 to 3 mm in length, and methylene blue cannot pass through; Type Ⅳ, long segment stenosis. Of the 34 cases in this group, 4 cases were type Ⅰ, and the stenosis was dredged by retrograde method; 16 cases were type Ⅱ, and the stenotic segments were dredged by antegrade method; 10 cases were type Ⅲ, and the stenosis was dredged by the dual endoscope surgery; Four cases were of type Ⅳ (one case was of bilateral UAS, one side was of type Ⅲ, and the other side was of type Ⅳ, which was classified as type Ⅳ). The stenotic segment could not be solved through the above methods. Among the 34 patients, 30 patients were successfully relieved of anastomotic obstruction, and 1 patient with bilateral obstruction was unilaterally relieved of anastomotic obstruction. In the other 3 cases, because the stenosis segment was too long, 2 cases were changed to nephrostomy, and 1 case was changed to open surgery, with a success rate of 88.2%. UAS was classified into 4 types based on the severity of UAS seen during surgery. No serious complications occurred during and after the operation. During the follow-up of 6-24 months, the imaging evaluation of 4 patients showed that hydronephrosis was aggravated, with an average increase in creatinine of (32.5±10.9)μmol/L, requiring replacement of a single J tube. The imaging evaluation of the remaining 26 patients showed that the postoperative hydronephrosis was 0.9 ± 0.6 cm less than the preoperative hydronephrosis 2.6 ± 0.6 cm, with a statistically significant difference ( P<0.01). The quality of life score at 3 months after surgery was (1.9±0.6), which was significantly improved compared to the preoperative indwelling nephrostomy period (5.2±0.7), with a statistically significant difference ( P<0.01) Conclusions:The treatment of UAS after radical cystectomy with retrograde, antegrade, and dual endoscope surgery has a high success rate, which can help some patients avoid the inconvenience of indwelling external drainage tubes and the risk of open surgery. Choosing an appropriate surgical method can achieve the goal of treating UAS with minimal trauma.

Objective To observe the effect of Botulinum toxin type A (BTX-A) injection on spastic hamstring in the children with cerebral palsy. Methods 39 cerebral palsy children with spastic hamstring were divided into control group (n=20) and experimental group (n= 19). The control group accepted physical therapy, while the experimental group accepted BTX-A injection in affected hamstring in addition.They were assessed with modified Ashworth Scale (MAS), Gross Motor Fucntion Measure (GMFM-88) and flexion angle of knee joints before and after treatment. Results The scores of MAS and GMFM-88, and flexion angle of knee joints improved significantly 6 weeks after treatment in the experimental group (P<0.05), and improved more than that in the control group (P<0.05). Only the score of GMFM-88 improved significantly in the control group (P<0.05). Conclusion BTX-A injection can relieve hamstring spasticity in children with cerebral palsy, which may be helpful to correct abnormal gait and improve the motor function.

Recent innovations in nanomaterials inspire abundant novel tumor-targeting CRISPR-based gene therapies. However, the therapeutic efficiency of traditional targeted nanotherapeutic strategies is limited by that the biomarkers vary in a spatiotemporal-dependent manner with tumor progression. Here, we propose a self-amplifying logic-gated gene editing strategy for gene/H₂O₂-mediated/starvation multimodal cancer therapy. In this approach, a hypoxia-degradable covalent-organic framework (COF) is synthesized to coat a-ZIF-8 in which glucose oxidase (GOx) and CRISPR system are packaged. To intensify intracellular redox dyshomeostasis, DNAzymes which can cleave catalase mRNA are loaded as well. When the nanosystem gets into the tumor, the weakly acidic and hypoxic microenvironment degrades the ZIF-8@COF to activate GOx, which amplifies intracellular H⁺ and hypoxia, accelerating the nanocarrier degradation to guarantee available CRISPR plasmid and GOx release in target cells. These tandem reactions deplete glucose and oxygen, leading to logic-gated-triggered gene editing as well as synergistic gene/H₂O₂-mediated/starvation therapy. Overall, this approach highlights the biocomputing-based CRISPR delivery and underscores the great potential of precise cancer therapy.