OBJECTIVE To use ultrasound technique to rinse the medical apparatus and raise the rinsing quality of apparatus.METHODS Under the magnifier to examine the cleanliness of the apparatus.According to pyrogen test by standard Limulus lysate,to verify the ultrasound rinsing effect by pyrogen removing.RESULTS It was very clean when rinsing the apparatus and with no blind area to uneven parts and articular ones.Monitoring result of pyrogen was negative through rinsing the syringe by ultrasound.CONCLUSIONS The rinsing quality of apparatus is improved.

Objective: To analyze the level of resilience and its influencing factors in the young and middle-aged patients with type 2 diabetes mellitus ( T2DM ), so as to provide reference for optimizing mental interventions for the patients. Methods: The young and middle-aged patients with T2DM from September 2019 to September 2020 in Hangzhou First People's Hospital, affiliated to the Medical School of Zhejiang University, were selected as the subjects, the general information questionnaire, Perceived Social Support Scale ( PSSS ) , Conner-Davidson Resilience Scale ( CD-RISC ), Diabetes Distress Scale (DDS) and Diabetes Management Self-efficacy Scale ( DMSES ) were used to investigate, the multivariate linear regression model was used to analyze the influencing factors for resilience in young and middle-aged patients with T2DM. Results: A total of 250 questionnaires were distributed and 238 valid questionnaires were recovered. The effective recovery rate was 95.20%. Among 238 patients, 142 cases ( 59.66% ) were males and 96 cases ( 40.34% ) were females; 168 cases ( 70.59% ) were 45-59 years old. The CD-RISC score was 70.49±12.81, PSSS score was 63.70±10.90, DDS score was 2.14±0.87, and DMSES score was 130.22±38.49. The results of multivariate regression analysis indicated that educational level, average monthly family income, fasting blood glucose, self-efficacy, social support and diabetes distress were the influencing factors for resilience of young and middle-aged patients with T2DM ( P<0.05 ). Conclusion The level of mental resilience in young and middle-aged patients with T2DM is mainly related to the level of education, monthly family income, blood glucose control, diabetes distress, self-efficacy and social support.

Objective To explore the value of transvaginal color doppler ultrasound(TVS) in the differential diagnosis of endom-etrial hyperplasia(EH) and endometrial cancer(EC) .Methods The clinical data concerning TVS in 48 patients with EH and 37 pa-tients with EC were reviewed retrospectively ,then we compared the ultrasonic diagnosis with the pathological diagnosis to observe the preoperative diagnostic accuracy of ultrasonic diagnosis .Results In 48 patients with EH ,the inspection results of 44 cases were accordant with the pathological diagnosis .The rest of 4 cases were misdiagnosed by TVS as EC before operation ,and the accurate rate is 91 .67% (44/48);In 37 patients with EC ,the checking results of 34 cases were consistent with the pathological diagnosis . The rest of 3 cases were misdiagnosed by TVS as endometrial atypical hyperplasia ,and the accurate rate is 91 .89% (34/37) .Con-clusion TVS has diagnostic significance in the differential diagnosis of EH and EC .

Objective To explore the clinical value of fetal syetem ultrasound union real-time three-dimensional ultrasound to diagnose the abnormalities of fetal palms and feet in medium-term pregnancy.Methods The results of fetal syetem ultrasound u-nion real-time three-dimensional ultrasound in 23 675 cases during dmedium-term pregnancy in our department from January 2009 to November 2013 were retrospectively analyzed,including 47 350 palms and feet.Results If using the fetal syetem ultrasound u-nion real-time three-dimensional ultrasound to examine fetal palms and feet more than three times,the display rate of palms and feet was 100.0%,while the first-time display rate of finger and toes was 81.2%,second-time display rate was 97.2% and the third-time and more display rate more thatn 99.8%.136 cases hand-foot deformity were diagnosed,including 37 cases of hand gesture abnor-malities,6 cases of finger abnormalities,93 cases of food abnormalities,and the main abnormality was strephexopodia.Of all the 136 cases,there were 2 cases also with Trisomy 18,4 cases with Trisomy 21.Conclusion Malformations of fetal palms and feet can be detected by fetal system ultrasound combined with real-time three-dimensional ultrasonography during the second trimester,which is important indicators of prenatal screening for chromosomal abnormalities.

This paper presented the hereditary pattern of otosclerosis in families. Among 1500 cases there were 13 patients, belonging to 6 families, and 20 ears were surgically treated. There was often a marked similarity in clinical features of affected siblings within the same family.The clinical characteristics are as following: (1) The age at inset of hearing loss seems similar. There is a difference of 1 or 2 years in two families znc 3 to 10 years in the other four. (2) The side of first hearing loss is the same in affected individuals of 6 families. (3) The propositi are females in 5 families (83.3%). (4) Auditory curve of hearing loss is similar in 4 familiers, and different in the other two. (5) The footplate lesions are similar in macroscopic features, thin footplate in two fimalies and thick footplate in the other four.

OBJECTIVE To explore an effective cleaning method to improve the washing quality of contaminated complicated medical instruments.METHODS The used puncture needles were washed by three methods(ultrasonic wave only,ultrasonic wave + polyenzyme detergent,ultrasonic wave + spray washing with special washing-rack designed by ourselves,while artificial washing group as control group,3 pieces per group).After washing,the samples were further assayed with HemoCheck-s swab to compare the washing effect.RESULTS The color of cotton swabs was turned blue or light blue.CONCLUSIONS Our results have demonstrated that ultrasonic cleaning plus spray washing with special washing-rack can improve the cleaning quality.

Objective To investigate and analyze the prevalence rate as well as antibiotics use in this hospital and to improve the awareness of the hospital infection administration for the medical staff .Methods The hospital infection prevalence rate in hospital and the risk factors were analyzed by prevalence survey and bed-side and case records investigation .Results In all 320 patients sur-veyed ,25 patients were diagnosed with hospital infection and the rate was 7 .81% ;27 cases of hospital infection was reported and the cases prevalence rate was 8 .44% .The main infection site was respiratory tract and it accounted for 48 .14% ,moreover ,the in-tensive care unit ,urology ,and neurology were the high incidence departments .The day of usage rate of antimicrobial drug was 62 .50% ,prevention of drug use was 46 .50% ,a kind drug use was 74 .00% ,and the two kind drug uses was 22 .00% .The positive rate of hospital infection pathogenic detection was 46 .87% .Hospital infection rate was related to the age ,urinary tract intubation , and ventilator factors .Conclusion Hospital infection administration should be strengthened to reduce invasive procedures for key depart-ments and focus groups ,meanwhile ,the rational application of antibiotics should be regulated to reduce hospital infection rates .

Objective To observe the short-term efficacy and adverse reactions of S-1 combined intrathoracic and intraperitoneal injection for the treatment of aged patients with gastric cancer and with malignant hydrothorax and ascites.Methods The patients were divided into treatment group (A group,22 cases) randomly and control group (B group,24 cases).The two groups underwent intrathoracic and intraperitoneal injection chemotherapy and biological therapy.Drainage tubes were placed in thoracic or abdominal cavity to discharge the effusion,cisplatin 40-60 mg,lentinan 4-6 mg,dexamethasone 10 mg were injected into the chest or abdomen,once per week,administered for 2-4 weeks.S-1 was added to the treatment group,S-1 capsules were administered orally on the first day of serous cavity drug injection,40-60 mg/m2,2 times per day,oral administration after morning and evening meal for 14 days,stop for 7 days,21 days were 1 cycle.The short-term curative effects,clinical quality of life and adverse reactions were compared between the two groups.Results Total effective rate of group A was 77.3 ％,50.0 ％ in B group,the difference of short-term effects of two groups was with statistical significance (P ＜ 0.05).The improvement rates of quality of life (QOL) of group A and group B were 86.4 ％ and 70.1％ respectively,with significant difference in the two groups (P ＜ 0.05).The major adverse reactions were gastrointestinal reaction and bone marrow suppression,nausea and vomiting rate in A group was 54.5 ％ (12/22),grade Ⅲ-Ⅳ neutropenia was 54.5 ％ (4/22),significantly higher than that in B group,there was significant difference in two groups (P ＜ 0.05).No treatment related death.Conclusion There is curative effect of S-1 combined with cisplatin and lentinan in treatment of the aged patients of gastric carcinoma and malignant hydrothorax and ascites.Gastrointestinal side efforts and bone marrow suppression in treatment group have been observed,but it is tolerable.This scheme can improve the QOL of patients and prolong the survival period.

Objective To review and summarize the latest development of the therapy for the Duchenne muscular dystrophy (DMD). Methods The recently-published articles related to the therapies for DMD were extensively reviewed and briefly summarized. Results The therapeutic approaches for DMD included the gene therapy, the cell therapy, and the pharmacological therapy.The gene therapy and the cell therapy were focused on the treatment for the cause of DMD by the delivery of the missing gene, the modification of the mutated gene, and the transfer of the normal cells including the stem cells, while the pharmacological therapy dealt with the downstream events caused by the dystrophin gene defect, slowed down the pathologic progress of DMD, and improved the DMD patient's life quality and life span, by medication and other factor treatments. Conclusion There is still no cure for DMD because of various difficulties in replacing or repairing the defected gene and of the multifaceted nature of the severe symptoms. Therefore, it is imperative for us to find out a more effective treatment that can solve these problems.

AIM: This study was designed to investigate the effects of sodium restriction and sodium supplementation on the expression of angiotensinogen mRNA in myocardium of rats with congestive heart failure(CHF).METHODS: Radioimmunassay and in situ hybridization techniques were used to determine the angiotensin Ⅱ(AngⅡ)contents and the expression of angiotensinogen(ANG)mRNA in myocardium, respectively.RESULTS: In sodium restricted group, the plasma sodium was obviously lower than that in CHF group(P