OBJECTIVE To find out the status of and impact factors on bacterial concentration in clean operating room.METHODS Set a questionnaire to the staff in the operating room of 24 tertiary 3A hospitals.RESULTS The 9 basic questions got correct and accordant answers.The answers for the 5 questions which were related to the characteristic of clean operating room had biger errors and difference.CONCLUSIONS The investigatees know about the basic requirements of the detecting method for bacterial concentration,but lack for the exact cognition of special requirements in clean operating room(e.g.State standard).The sticking point of the current problem is the misunderstanding on the 5 key questions.In order to make sure the excellent air condition in the cleaning operating room,the training of correlative specialty is very important.

Objective We sought to compare the ability of MEWS score,APACHE Ⅱ score and combination of the two scoring systems to predict the prognosis of patients in emergency medical department.Methods During January to March 2014,640 patients in emergency medical department who met the criteria were set as the research object.The patients admission was the starting point for clinic observation.The relevant data were collected for carrying on the MEWS and APACHE Ⅱ ratings,tracking the patients' prognosis.The corresponding predictors for prognosis of patients such as sensitivity,specificity,positive predictive value,negative predictive value and ROC curve by MEWS score,APACHE Ⅱ score and combination of the two scoring systems were compared.Results The area under the receiver operating characteristic curve was 0.93,0.79 and 0.93 with MEWS score,APACHE Ⅱ score and combination of the two scoring systems.The comparison of either of the two scoring systems showed significant difference.When death was named as the prediction factor,the sensitivity,specificity,positive predictive value and negative predictive value were 76.92％,91.70％,51.02％,97.23％ for MEWS score; 83.08％,62.80％,20.15％ and 97.04％ for APACHE Ⅱ score; 92.31％,86.43％,43.48％ and 97.58％ for combination of the two scoring systems.Conclusions Combination of the MEWS and APACHE Ⅱ scoring systems can be used to predict the prognosis of patients in emergency medical department.It posesses high sensitivity,specificity,positive predictive value and negative predictive value,which indicating a high predictive capability.

Objective To investigate the relationship between clinical types and related risk factors in female patients with post-adolescent acne.Methods Female outpatients with post-adolescent acne aged more than 25 years were enrolled from Department of Dermatology of Renji Hospital between January and October 2016.A questionnaire survey was conducted to investigate related risk factors for post-adolescent acne in the females.Skin lesions and clinical types were evaluated by dermatologists.Statistical analysis was carried out by t test for comparison of means between two groups and by chi-square test for comparison of ratios.Results A total of 312 female patients with post-adolescent acne completed the survey,including 268 (85.9％) with mild to moderate acne and 44 (14.1％) with severe acne,241 (77.2％) with persistent acne and 71 (22.8％) with late-onset acne,or 102 (32.7％) with comedonal post-adolescent acne (CPAA) and 210 (67.3％) with papular post-adolescent acne (PPAA).Survey on related risk factors showed that 121 patients reported seasonal factors and 59 (18.9％) patients became worse in summer,and spicy,sweet and fried foods can aggravate the condition in 131 (42％),93 (29.8％) and 85 (27.2％) patients respectively.Other risk factors such as premenstrual period (62.8％,196/312),psychological factors (51.6％,161/312) and exogenous chemical exposures (43.6％,136/312) were complained of by the patients.Furthermore,premenstrual period,diet and constipation were found to be more associated with PPAA compared with CPAA (x2 =4.523,4.068,3.910,respectively,all P ＜ 0.05).Exogenous chemical exposures,such as the use of cosmetics,exposure to polluted air environment and occupational hazards,were more associated with CPAA compared with PPAA,as well as with late-onset acne compared with persistent acne (x2 =6.579,9.057,both P ＜ 0.05).In addition,premenstrual exacerbation occurred more frequently in patients with persistent acne compared with those with late-onset ache (x2 =4.512,P ＜ 0.05).Conclusions The risk factors for the occurrence of female post-adolescent acne are very complex.Premenstrual exacerbation plays a major role in the aggravation of papular and persistent post-adolescent acne,diet and constipation are more associated with PPAA,and exogenous chemical exposures are still be considered in the aggravation of comedonal and late-onset post-adolescent acne.Thus,clinical types should be considered in the diagnosis and treatment of post-adolescent acne in females.

Objective To study activation effect of a natural compound baicalein on cystic fibrosis transmembrane conductance regulator(CFTR) chloride channel.Methods A cell-based fluorescence assay was used to determine CFTR-mediate iodide influx rate/dt(mmol?L-1?s-1)] activated by baicalein(the concentrations were 0.18,0.55,1.65,5,15,44,133 and 400 ?mol?L-1).Results The Ka of flavonoid baicalein stimulating CFTR was about 16 ?mol?L-1.The half of maximal activity was reached in ten minutes and the activation disappeared in 20 min after baicalein was washed out.The activation of baicalein was not affected obviously under different concentrations of Forsklin(0,20,50 and 100 nmol?L-1)and the activation could be totally inhibited by CFTRinh-172.Conclusion Baicalein can stimulate CFTR-mediated iodide influx in a dose-dependent way and its activity manifests a rapid and reversible characteristic.It might work in both elevating CFTR protein phosphorylation and direct binding way.

Objective The study aimed to evaluate the application effect of clinical pathways in laparoscopic cholecystectomy patients by using the meta-analysis.Methods Published randomized controlled trials (RCT) about laparoscopic cholecystectomy patients were searched and screened in China National Knowledge Infrastructure (CNKI),China Scientific Journal Database by VIP,Wanfang Database under present standards.The quality of the included studies was evaluated by certain standards.The Review Manager 5.2 software was used for analysis.Results Totally 29 studies including 5 570 cases were eligible to the criteria (2 753 in the experimental group and 2 853 in the control group) altogether.The meta-analysis showed that the hospitalization time and hospitalization costs in the clinical nursing pathway group were significantly less than those of the control group (SMD=-1.69 and-3.75),the satisfaction degree and the mastering of health knowledge in the clinical nursing pathway group were significantly higher than those of the control group (RR=1.16 and 1.26),the differece had statistical significance.Conclusions Application effect of clinical nursing pathways is superior to the traditional nursing method in laparoscopic cholecystectomy patients.

PurposeTo explore the multislice CT (MSCT) and clinical manifestations of diaphragmatic hiatus hernia with hernial sac effusion, in order to improve its diagnostic rate.Materials and MethodsMSCT data were retrospectively analyzed for morphologies and clinical manifestations in 32 patients with diaphragmatic hiatus hernia and hernial sac effusion.Results32 patients included 21 males and 11 females (χ2=0.64,P>0.05). 25 patients were older than 60 years and 7 cases younger than 60 years (χ2=13.58,P<0.01). There were 27 cases with non-viscera hiatus hernia including 23 cases of combined fat-water hernia and 4 cases of simple effusion. 5 cases were of viscera type hiatus hernia (χ2=5.47,P<0.05). 28 cases showed ascites including 23 cases with non-viscera hiatus hernia and 1 case with viscera type hiatus hernia (χ2=9.56,P<0.01). The axial images from different levels of non-viscera hiatus hernia with liquid hernial sac demonstrated quasi-circular, meniscus, ringlike and teardrop shapes.Viscera type hiatus hernia and liquid hernial sac were found to be irregular shape . All patient sufferered from dysphagia, chest distress and epigastric discomfort.ConclusionThe increased pressure gradient between thorax and abdomen driving ascites into supradiaphragmatic hernial sac and clamping by hiatus may be the main mechanism. Quasi-circular, meniscus, ringlike andteardrop were the characteristic signs of diaphragmatic hiatus hernia with hernial sac effusion.

Objective To determine the effect of individualized oral hygiene instruction (OHI) on volatile sulfur compounds (VSCs) level in mouth air of patients with chronic periodontitis.Methods The individualized oral hygiene instruction was provided for 31 patients with chronic periedontitis (Organoleptic score was over two points).The VSCs and plaque index (PLI) were evaluated pre-OHI and post-OHI.Results The score of PLI decreased from 3.09±0.44 to 2.63±0.46 significandy (P<0.05).The organoleptic score (OS) decreased from 2.68±0.70 to 2.35±0.75 significandy (P<0.05).While there was no significant difference on the VSCs level pre-OHI and post-OHI (P<0.05).Conclusions Individualized oral hygiene instruction is helpful to remove plaque and improve oral hygiene.But the effect of OHI on VSCs level in mouth air is limited.

BACKGROUND:Carrier material provides an essential part of microenvironment for seed cell culture. There are some investigations analyzing the long-term in vitro culture of cartilaginous cell in calcium alginate gel matrix.OBJECTIVE: This study was designed to investigate the activity, morphology and microstructure of cultured in vitro bone marrow stromal cells (BMSCs) immobilized in calcium alginate beads.DESIGN: Single sample studySETTING: It was conducted at the Orthopaedic Institute of Zhengzhou University and Orthopaedic Laboratory of Shanghai Second Medical University.MATERIALS: The experiment was conducted at the Orthopaedic Laboratory of Shanghai Second Medical University from September 2001 to March 2002. Eight New Zealand white rabbits, with an age ranging from 4 to 6weeks, were used for collecting BMSCs.METHODS: Eight rabbit were anaesthetized and 1.0-2.0 mL bone marrow was aspirated from the humerus of femur using a 16-gange biopsy needle pretreated with heparin for primary and passage culture of BMSCs.Sodium alginate solution was prepared. The sodium alginate-BMSCs composite formed calcium alginate beads, with a cell density of 1×109 L-1 and tology characteristics of BMSCs were examined using toluidine blue staintron microscope (TEM).scope, many aggregate cells with round shape, in all sizes, occasionally characteristics of BMSCs: Cells and matrix materials were well-mixed, with no materials stained. The cells were equably stained, in all sizes, with large nuclei and little plasma, and occasionally having two or more nuclei and cell division. These cells had an intact structure, well-defined border, and tures of BMSCs: The cells had normal structures, with no mitochondrion swelled and no degranulation in ribosomes. They had a continuous nuclear membrane, with babyhood morphology, round shapes,oval shapes or irregular shapes, and occasionally having two nuclei.CONCLUSION: BMSCs-calcium alginate beads exhibit advantages including a good hydrophilicity, easiness for nutritive matter to penetrate and proliferating actively. It is feasible to amplify BMSCs through in vitro cullage repair by tissue engineering (TE) method.

BACKGROUND: Seed cells and supporting materials are two key problems for cartilaginous tissue engineering. Enough functional cells in supporting materials is the foundation in the formation of bone and cartilaginous tissue in vivo.OBJECTIVE:To perform a morphological study on the tissue engineered bone and cartilage constructed with calcium alginate, in vitro cultured bone marrow stem cells(BMSCs) and growth factors.DESIGN:Morphological comparative study with the results observed for 12 weeksSETTING:Orthopaedic Institute of Zhengzhou University and Orthopedic Laboratory of the Second Affiliated Hospital of Shanghai Medical University.MATERIALS:This experiment was completed from September 2001 to June 2002 in the Orthopedic Laboratory of the Second Affiliated Hospital of Shanghai Medical University. Nine New Zealand male rabbits at the age of 3 months were selected, their mean body mass was 3.2 kg.METHODS: Rabbits received dorsal subcutaneous injection of five kinds of the following combinations at two points for each combination and in the Ⅰ+TGF-β. Totally ten points were marked. Three rabbits were put to death at the 4th, 8th, 12th weeks after injection respectively and dorsal subcutaneous hyperplasia tissues were collected for observation by using hematoxylin and eosin (HE), toluidine blue, Masson, tomato red-O staining techniques.MAIN OUTCOME MEASURES: Histological observation of dorsal subcutaneous hyperplasia tissues.RESULTS: At the fourth week, cartilaginous like tissues island could be observed in calcium alginate+ BMSCs + IGF-Ⅰ group, calcium alginate+BMSCs +TGF-β group and calcium alginate + BMSCs + IGF-Ⅰ +TGF-βgroup, with chondrocblasts surrounded by alkaline matrix; A great deal of cartilaginous-like tissue appeared at the eighth week with part of it transforming into bone, and cells secrete much matrix, part of the chondroblast clustered. At the 12th week, approximately all of the cartilaginous tissues turned into bone in calcium alginate+ BMSCs + IGF- Ⅰ +TGF-β group, and began to absorb.CONCLUSION: The compound composed of calcium alginate, BMSCs and growth factor might form bone and cartilaginous tissue. Calcium alginate is suitable for the growth of BMSCs and is believed to be an optimal bone and cartilaginous engineering carrier.

The professional competency of medical informatics graduates from China Medical University in 1992-2011 was investigated, the requirements of employers for their professional competency were analyzed, and the current medical informatics curriculum system was evaluated with suggestions put forward for the reform of medical informatics curriculum system, including revision of its training target, measures for curriculum system reform, and improvement of confidence.