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 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 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 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 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 study the clinical significance for the establishment of diagnosis of small bowel obstruction by selective small bowel enterography through a nasointestinal decompression tube. Methods Tirty-five patients with small bowel obstruction, with no strangulation or other contraindications, were intubated with a 300 cm nasointestinal decompression tube till upper jejunum under X-ray monitoring. The patients firstly underwent intra-small-intestinal suction therapy. When the tube reached the diseased region, a selective small bowel enterography was performed. Under X-ray inspection, 20-100 ml of 76% meglumine diatrizoatis and 50-200 ml of air were slowly injected via the decompression tube to perform double contrast intestinal radiography. Results Intubation was successful in all the 35 patients. Mter the small intestinal decompression therapy. Obstruction was cured in 20 cases, alleviated in 15 cases, and 10 cases received operation. Small bowel enterography in this series was all of high quality, there were 6 cases in which no abnormal X-ray findings, adhesive small bowel obstruction was suggested in 15 cases, small bowel tumor was identified in 4 cases (3 metastatic tumor, 1 small bowel cancer), small bowel Crohn's disease in 3 cases, radioactive enteritis in 3 cases, enteric intussusception in 2, polyp of the small intestine in one, and carcinoma of the ascending colon in one. Conclusions The nasointestinal decompression intubation with X-ray monitoring serves a dual function for the patients with intestinal obstruction, it decompresses the small bowel and does small intestinal radiography, in this way the locale of obstruction was found and the cause of the obstruction identified.

Objectives To analyze and compare four correction methods for measuring thyroid volume,and to find out the best one for thyroid volume correction of children aged 8-10.Methods In 2012 and 2013,the project was carried out in iodine deficient rural areas (water iodine below 10 μg/L) of Jilin and Gansu Provinces,10 villages in each province were chosen as survey sites,and 40 children of 8 to 10 years old were chosen from each village,half boys and half girls.Utrasonography was adopted to determine the thyroid volume,and height and weight were measured.The thyroid volume was corrected by Body Mass Indicator(BMI),weight and height,body surface,and height,separately.Body Mass Indicator corrected Volume (BMIV),Weight and Height corrected Volume Indicator(WHVI),Body Surface Area corrected Volume(BSAV) and Height corrected Volume Indicator(HVI) were calculated and compared with their original thyroid volumes to find out the best one.Results Datas of 450 and 408 children were collected from Jilin and Gansu Provinces,separately.According to their original thyroid volumes,goiter rates of Jilin and Gansu were 10.4％ (47/450) and 0.5％ (2/408),respectively.All these four methods could decrease the difference between provinces and sexes.Among the four methods,WHIV and BSAV were abnormal for correction of different ages,heights and weights.HVI had the most normalized distribution and stronger correlation with the original thyroid volumes than others(r =0.961).The HVI corrected results had similar distribution with the original thyroid volume but the data were different.After being adjusted by 1.7 × HVI,the results were close to the original thyroid volumes.Goiters in Jilin and Gansu Provinces,were 9.1％(41/450) and 0.5％(2/408),respectively,after correction.Conclusion The 1.7 × HVI is the most suitable method for correcting the thyroid volume of children aged 8-10.

Objectives To study the changes of thyroid function under different urinary iodine levels and pregnant trimesters,and to investigate the urinary iodine standard of pregnant women,taken thyroid function as a golden standard.Methods Early,mid and late trimester pregnant women in the iodine deficient rural areas of Gansu and Jilin Provinces were selected,at least 70 cases were included for each trimester in each province.Pregnant women included were physically healthy;cases should be excluded if their immediate relatives had a thyroid disease history.Urinary iodine,free triiodothyronine (FT3),free thyroxine (FT4),thyroid stimulating hormone (TSH),thyroid peroxidase antibody (TPOAb),thyroglobulin antibody (TgAb),and edible salt iodine from pregnant women's home were tested.The urinary iodine was measured with the method for determination of iodine in urine by As3+-Ce4+ catalytic spectrophotometry (WS/T 107-2006).Thyroid function was tested by chemiluminescence method,salt iodine was determined by direct titration method (GB/T 13025.7-1999).Results Totally 439 pregnant women were investigated in the two provinces.Median of urine iodine was 178.6 μg/L;for the 215 women in Gansu,the value was 156.4 μg/L;for the 224 women in Jilin,the value was 206.4 μg/L.Along with the increase of urinary iodine,the FT3 of Gansu decreased from 5.77 pmol/L to 5.34 pmol/L,TSH increased from the lowest 2.63 mU/L to 3.75 mU/L;the FT3 of Jilin increased from 4.41 pmol/L to 4.45 pmol/L,TSH increased from the lowest 0.92 mU/L to 1.50 mU/L.Five indicators of thyroid function of more than 97％ pregnant women were in normal range and FT3 was the most stable in the three trimesters.FT3 of the three triimesters in Gansu was 6.27,5.76,5.28 pmol/L,respectively,and that in Jilin was 4.50,4.42,4.32 pmol/L,respectively.The 5％ and 95％ quantile were 55.24,581.27 μg/L of urinary iodine,of pregnant women with normal thyroid function.Conclusions Under different urinary iodine levels,pregnant women's thyroid function is relatively stable.TSH has showed an increasing trend with increasing iodine level.Along with the progress of pregnancy,the urinary iodine is different among the three pregnancy periods,but the thyroid function is stable.The pregnant women with normal thyroid function have a urinary iodine level between 50-600 μg/L.