OBJECTIVE To discuss etiological factors and control strategies of hospital infection,in order to reduce the occurrence of hospital infection in the outpatient department of stomatology.METHODS According to the etiological factors of the hospital infection in outpatient department of stomatology,the corresponding control measures were presented.RESULTS The occurrence of hospital infection could be cut down by steps such as establishing the perfect rules and regulations,executing technical operation rules strictly,strengthening knowledge training for the medical staff,occupational protection,environmental disinfection management of outpatient department of stomatology,equipment disinfection management,hand hygiene of medical staff and standardizing the classification of the collection of clinical waste.CONCLUSIONS Occurrence of hospital infection has been effectively cut down by management measures of hospital infection taken in the outpatient department of stomatology.

OBJECTIVE:To analyze the general patterns and characteristics of drug-induced lupus (DIL) induced by inflix-imab,and to provide reference for the safety of drug use. METHODS:Usinginfiximab,lupusas searching words,inflix-imab-induced DIL literatures included in CJFD,VIP and PubMed from Jan. 2002 to Jun. 2016 were retrieved and analyzed. RE-SULTS:Totally 30 effective literatures were retrieved,involving 31 DIL patients,there were 8 male cases (25.81%) and 23 fe-male cases(74.19%);17 patients aged more than 50(54.84%). 20 cases occurred within 5-24 weeks(64.51%). 16 patients re-ceived infliximab alone (51.61%). Main clinical manifestations were skin rash or photosensitivie enteritig (15 cases),joint pain (16 cases,multiple arthritis and synovitis)and fever(12 cases). 5 patients suffered from 3 above symptoms simultaneously. Labo-ratory examination mainly manifested as antinuclear antibody,double stranded DNA antibody and anti-histone antibody positive. Thirty patients with DIL received drug withdrawal or steroid hormones treatment,among which the symptoms of 26 patients disap-peared after drug withdrawal or treatment within 6 months,and 1 patient deteriorated. CONCLUSIONS:DIL-induced by inflix-imab invovle patients'age and gender,disease types,family history and other factors. Clinicians should be aware of rules and char-acteristics of DIL induced by infliximab,and tighten drug use monitoring to reduce ADR.

Objective To explore the difference between pressure-regulated volume controlled ventilation (PRVCV) and volume controlled ventilation (VCV) during videothoracoscopic bhb excision.Methods Consecutive 20 patients scheduled to undergo videothoracoscopic bleb excision were enrolled into the study.After induction, endotracheal blocker was advanced into endotracheal tube to establish one-lung ventilation,each patient was randomly assigned to receive successively PRVCV and VCV for 20 minutes.Ventilatory variables were kept constantly(tide volume 6 ml/kg, respiratory rate 15 breaths/min and I: E ratio 1: 2).Heart rate,blood pressure,peak airway pressure and blood gas parameters were compared.Results Peak airway pressure was significantly lower with PRVCV than that with VCV [(12.7±3.6 ) cmH_2O(1 cm H_2O =0.098 kPa) vs (18.2±4.3) cm H_2O,P < 0.01].However,there was no significant difference in arterial oxygen tension,arterlal partial pressure of carbon dioxide,heart rate and blood pressure between PRVCV and VCV.Conclusion During one-lung ventilation in videothoracoscopic bleb excision, PRVCV offers lower peak inspiratory airway pressures while maintaining equal oxygenation compared with VCV.

Objective To study the effect of endotracheal tube's resistance on the respiratory systolic variation test(RSVT).Methods The RSVT,a test to predict fluid responsiveness was performed in 20 patients.The test consisted of the delivery of three congecutive pressure-controlled breaths with incremental peak inspiratory pressures of 10,20 and 30 cm H2O(1 cm H2O=0.098 kPa).The minimal values of the systolic arterial pressure following each of these three breaths were measured and plotted against their respective airway pressures,producing the RSVT slope.RSVT slope were compared between normal airway resistance and increased resistance circumstances,and the latter was simulated by advancing a Cooperdech bronchial blocker into endotracheal tube.Results Under normal resistance,RSVT slope was(0.39±0.21) volumes were(461.5±95.9),(891.5±149.8)and(1207.5±159.1)ml,when peak inspiratory pressures of 10,20 and 30 cm H2O were dehvered.When bronchial blocker was advanced into endotrecheal tube, (0.27±0.17)mm Hg,cm H2O significantly(P<0.01),and tidal volumes decreased to(434.5±92.8), (796.5±96.6)and(1097.5±68.4)ml(P<0.05 or<0.01).Conclusion Changes in endotraeheal tube's resistance can distort the RSVT slope.

Objective To compare the effects of target-controlled infusion (TCI) of propofol and remifentanil and inhalation anesthesia on the stress response in patients undergoing laparoscopic cholecystectomy (LC). Methods Selective LC was performed on 60 cases. Before the surgery,the patients were randomly divided into experiment (TCI of propofol and remifentanil) and control (standard general anesthesia combined with inhalation of fluorinated alkane and laughing gas) groups with 30 cases in each. The serum levels of cortisol and IL-6 were detected before the induction (t1) and 20 minutes after pneumoperitoneum (t2). In addition,the MAP and HR of the two groups were monitored at seven time points. Results The serum levels of cortisol and IL-6 in the experiment group were similar to those in the control at t1 [Cortisol:(227.48?50.81) ?g/L vs (233.21?41.02) ?g/L,t=0.481,P=0.633; IL-6:(105.99?30.65) ng/L vs (111.20?34.80) ng/L,t=-0.615,P=0.541],but significantly lower at t2 [Cortisol:(241.00?69.11) ?g/L vs (354.70?37.55) ?g/L,t=7.918,P=0.000; IL-6:(116.06?30.89) ng/L vs (172.73?23.54) ng/L,t=-7.992,P=0.000]. The MAP and HR in the experiment group were significantly lower than those in the control at t2 to t5 (5,10,15,and 20 minutes after the pneumoperitoneum; P

To identify the best inducing condition, we studied the expression of membrane protein HSP70 and mRNA of H22 cell at various temperature. Using MTT,RT-PCR, immunofluorescence and FCM techniques, we observed H22 cell survival rate, the expression of HSP70 mRNA and membrane HSP70. No effects of H22 cell survival rate under 42 ~ 43℃ was observed, but cell survival rate declined with increasing stress time at 44 ~ 45 ℃; the level of HSP70 mRNA decreased initially (0.5~4.0) hours but gradually resumed and increased from 8 to 12 hours at 42℃. Membrane HSP70 expressing cells were significently higher in heat shock treatment group than in a control group ( P

Objective To evaluate the effectiveness of training management applying character color theory in patients with peritoneal dialysis on the compliance and dialysis effect. Methods Of 95 patients undergoing catherization for peritoneal dialysis from January 2013 to May 2014 in the peritoneal dialysis center,72 patients accepted character color psychological questionnaire designed by Le Jia for character color analysis.72 patients were divided into matched control group and experimental group according to their choice with red, yellow, blue, green character color, 36 cases in each group. The control group adopted the traditional training way of accepting 7 days′training course teached by the professional nursers,one follow- up management each month. According to the difference of character color,the experimental group were given different education training courses, interactive learning, and follow- up time. After 6 months′follow- up, the two groups adopted peritoneal dialysis self management behavior questionnaire designed by Liu Pengfeng and self- efficacy scale designed by education research center for chronic disease in Amercian Stanford University. The score of self management ability and self- efficacy and the change of load capacity, blood pressure, dialysis adequacy and biochemical indicators of the two groups were analyzed. Results In the control group and experimental group,the score of self management ability and self- efficacy and the level of dialysis adequacy were statistically significant, respectively, (5.64±1.57) points vs. (6.75±1.32) points;(5.22±1.48) points vs. (6.69±1.43) points; 1.64±1.64 vs 1.85±0.13.Z and P values were respectively -2.969, -3.828, -6.361, and 0.003, 0.000, 0.000.Edema happened in the control group was 24 cases, and 11 cases in the experimental group. P and χ2 values were 0.013 and 10.017.Systolic blood pressure and di-astolic blood pressure were respectively (147.78±15.69) mmHg (1 mmHg=0.133 kPa) vs.(135.39±9.01) mmHg,(95.86±7.50) mmHg vs. (83.94±7.46) mmHg in the two groups. Z and P values were respectively -3.843, -5.666, and 0.000, 0.000.There was significant difference between the experimental group and control group. Conclusion The education and training applying character color feature in patients with peri-toneal dialysis can mobilize the initiative of self management, improve the patients' self- care competency and self-efficacy, enhance patients′compliance, that can improve the effect of peritoneal dialysis.

Objective To assess the noninvasive index for diagnosing the degree of esophageal varices (EV) in patients with hepatitis B virus (HBV)-related cirrhosis. Methods The clinical data of 112 patients with HBV-related cirrhosis were studied retrospectively. The patients were divided into non-EV (NEV) group (30 cases) and EV group (82 cases) according to the results of gastroscopy. In EV group, there were mild varices in 21 cases (mild EV group), moderate varices in 47 cases (moderate EV group) and severe varices in 14 cases (severe EV group). The age, gender, platelets, glutamyl transpeptidase, prothrombin time, albumin, bilirubin, portal vein diameter, spleen vein diameter and thickness of spleen were compared, and the relationship was analyzed between each index and EV. Results There were no statistical differences in gender, age, albumin, bilirubin, prothrombin time and glutamyl transpeptidase between NEV group and EV group (P>0.05). The portal vein diameter, spleen vein diameter and thickness of spleen in EV group were significantly higher than those in NEV group:(14.1 ± 3.1) mm vs. (10.6 ± 2.3) mm, (8.9 ± 2.1) mm vs. (7.6 ± 1.6) mm and (4.8 ± 0.9) mm vs. (3.8 ± 1.0) mm, the platelets in EV group was significantly lower than that in NEV group:(86.8 ± 20.2) × 109/L vs. (163.5 ± 18.1) × 109/L, and there were statistical differences (P<0.01 or<0.05). The portal vein diameter, spleen vein diameter and thickness of spleen in moderate EV group and severe EV group were significantly higher than those that in NEV group and mild EV group: (13.5 ± 2.1) and (14.8 ± 3.6) mm vs. (10.6 ± 2.3) and (11.2 ± 3.1) mm, (8.3 ± 2.1) and (9.1 ± 1.1) mm vs. (7.6 ± 1.6) and (8.1 ± 1.9) mm, (4.7 ± 1.1) and (4.9 ± 0.9) mm vs. (3.8 ± 1.0) and (4.1 ± 1.2) mm, the platelet levels were significantly lower than those in NEV group and mild EV group: (72.8 ± 11.6) × 109/L and (63.8 ± 15.6) × 109/L vs. (163.5 ± 18.1) × 109/L and (100.2 ± 10.3) × 109/L, and there were statistical differences (P<0.05). The area under curve of response operating characteristic for predicting the presence of moderate and severe EV with portal vein diameter and platelets were 0.719 and 0.735, and the cut off value were 14 mm and 69 × 109/L. Conclusions The portal vein diameter and platelets can predict the presence of moderate and severe EV in patients with HBV-related cirrhosis.

Objective To study the clinical characteristics, diagnosis, treatment and prognosis of cancer metastasis to the thyroid gland. Methods A restropective review was performed on 35 patients with cancer metastasis to the thyroid gland in our hospital from 1958 to 2010. Diagnosis was confirmed by fineneedle aspiration cytology or histopathology in all cases. Results Primary tumor origin was identified in all but three cases. The lung was the most common primary tumor site( n = 16), followed by esophagus( n =9),breast ( n = 2), kidney ( n = 2), hypopharynx ( n= 1 ), nasopharynx ( n = 1 ) and soft palate ( n = 1 ). Thyroid metastasis was found before the diagnosis of the primary tumor was established in 12 cases; in the other 23 cases, the time lapse from diagnosis of the primary tumor to metastasis to the thyroid gland ranged from 0- 168 months, median 24 months. In 6 patients, this interval was more than 36 months. Fine-needle aspiration cytology ( FNAC ) confirmed metastatic malignancy in 7 patients, histology in 24, combined application confirmed the diagnosis in 4. After the metastasis to the thyroid gland was established, the median survival time for the entire group was 11.5 months, the 1-, 3- and 5-year survival rate was 43.8%,27. 8% and 11.9%, respectively. 28 patients were treated surgically, and 7 received nonsurgical therapy.The overall survival rate in the surgical group was higher than that in the nonsurgical group (P ＜0. 01 ). In those patients with metastatic cervical lymph nodes, median survival time did not vary from patients undergoing thyroidectomy with neck dissection to those undergoing thyroidectomy alone (P ＞ 0. 05 ).Conclusions Metastasis of carcinoma to the thyroid gland has an occult occurrence, thyroid metastases can be detected conclusively with FNAC. Metastasis to the thyroid gland implies advanced malignant tumors,often with poor prognosis.

Objective To explore a method for establishing the hamster model of Clostridium difficile-associated diarrhea (CDAD)and the indicators for its evaluation.Methods Clindamycin was administered to hamsters subcutaneously (day 1),and 24 h later infected with C.difficile clinical isolates KH1 (ribotype 027,106-108 CFU/mL)or SH9 (ribotype 001 ,108-1010 CFU/mL)by gavage.Animals were observed for CDAD symptoms such as diarrhea,weight loss and death.At the end of ob-servation period (day 7 or death),the cecum was collected from each animal for histological evaluation of inflammation.Results Following a single dose of 100 mg/kg clindamycin subcutaneously,all the animals challenged with KH1 (108 CFU/mL)devel-oped diarrhea and then died within 5 days.All the hamsters challenged with SH9 (1010 CFU/mL)developed diarrhea as well but only 66.7% died at the end of observation period.Among other groups,only one or none developed diarrhea and then died. The symptoms of hamsters with diarrhea included loose stool,wet tail and weight loss.On histological examination,conges-tion,hemorrhage and neutrophil infiltration of the mucosa were observed in the hamsters died of CDAD.Conclusions We have successfully established a hamster CDAD model that allows for future investigations.