OBJECTIVE To discuss the risk factors of surgical site infection and to provide the basis for the infection control.METHODS Strengthening the organization management and training emphasizing the measures such as the skin disinfection of the medical care personnel hands and the patients before operation,carrying out the asepsis operation correctly,cleaning the disinfection surgery instrument strictly and enhancely the management of perioperative patients were carried out.RESULTS Of the 74 investigated hospitals,16% were unqualified in preparing or over-preparing skin and the disinfection method;20% were without antibacterial bathes before operation and 64% were inproper time of in skin preparing.CONCLUSIONS Well monitoring of surgical site is the important means to prevent the surgical-site infections,and enhancing management of perioperative patients is the key to control infection.

[ ABSTRACT] AIM:To establish a perforated whole-cell patch-clamp technique withβ-escin to record L-type cal-cium current (ICa,L) in osteoblasts.METHODS:ROS 17/2.8 is a rat osteoblast-like osteosarcoma cell line.β-escin was applied to the pipette solution to permeabilize the cell membrane and the perforated patch recording mode was obtained. RESULTS:β-escin at concentration of 50μmol/L easily permeabilized the cell membrane and obtained a perforated patch recording mode in 2~7 min.This technique prevented ICa,L rundown and preserved cytoplasmic signaling pathways.CON-CLUSION:β-escin may be used as an alternative ionophore for perforated patch-clamp studies in osteoblasts and results in minimal rundown that could facilitate recordings of ICa,L in osteoblasts.

Objective To investigate the changes and clinical significance of the plasma cytokines and endothelium function in patients with chronic pulmonary heart failure disease at high altitude area.Methods Plasma levels of tumor necrosisfactor-alpha(TNF-?),interleukin-6(IL-6),endothelin-1(ET-1) were measured in 278 chronic pulmonary heart patients with various degrees of heart failure and in 48 healthy controls.Left ventricular ejection fraction(LVEF),Right ventricular ejection fraction(RVEF) and Pulmonary(PASP) were examined with echocardiography.Results Plasma levels of TNF-?,IL-6,ET-1 were elevated in patients of functional classes Ⅱto Ⅳ as compared with age-matched control subjects and were progressively elvated with the decreasing functional status of the patients.The levels of TNF-?,IL-6,ET-1 respectively were positively correlated with PASP but negtively correlated with LVEF and RVEF(P

Objective To improve the corrected results of the nasal deformities of the hare lip nose. Methods Based on the reposition of the lower lateral cartilages and the caudal septum, the authors corrected the secondary hare lip nose with the L shaped silicon rubber graft to reinforce and model the nasal tip.Results From 1996～2000, the procedure was performed for 20 cases (15 male, 5 female ), aged from 16～21 years. Follow up was from 3 months to 4 years. All cases obtained satisfactory results. Conclusions The results of utilizing L shaped silicon rubber graft combined with reposition of the mislocated nasal cartilages are better than the latter method only, especialy for the nasal tip. The procedure is easy to learn .The material silicon rubber graft is cheap and can be trimmed very conveniently. And it can also correct the saddle nose at the same time.

Sterols are one of the active classes of compounds in Inonotus obliquus for their effective therapy of many diseases. In field environment, this fungus accumulates large amount of sterols. In cultured mycelia, however, this class of compounds is less accumulated. For analyzing the factors responsible for differing sterol composition, the field-grown and cultured mycelia were extracted with 80% ethanol at room temperature and total sterols were prepared using silicon gel column chromatography followed by identification using either GC-MS or spectroscopic methods. For culturing Inonotus obliquus, the seed culture was grown either in basic medium consisting of glucose (2%), yeast extract (0.5%), KH2PO4 (0.01%), MgSO4·7H2O (0.05%) and distilled water at pH 6.5, or the basic medium supplemented with serial concentrations of AgNO3. The results indicated that field-grown mycelia contained lanosterol and inotodiol (comprised 45.47% and 25.36% of the total sterols, respectively) and other 10 sterols (comprising the remaining 30.17%) including ergosterol biosynthetic intermediates such as 24-methylene dihydrolanosterol, 4,4-dimethylfecosterol, 4-methyl fecosterol, fecosterol and episterol. Column chromatography also led to the isolation of lanosterol, Inotodiol, trametenolic acid, foscoparianol B and a new triterpenoid foscoparianol D in field-grown mycelia. In comparison, the cultured mycelia only contained three sterols with ergosterol as the predominant one (82.20%). Lanosterol only accounted for 3.68%. Supplementing Ag+ into the culture at 0.28 μmol·L-1 greatly enhanced content of lanosterol (accounting for 56.81%) and decreased the content of ergosterol (18.5%) together with the presence of intermediates for ergosterol biosynthesis. These results suggested that the sterol composition in mycelia of the fungus can be diversified by supplementing substances inhibiting enzymatic process towards the synthesis of ergosterol. Harsh growth conditions in field environment (I.e. temperature variation, UV irradiation etc.) can delay the synthesis of ergosterol and hereby diversify the sterol composition in the mycelia of Inonotus obliquus.

Objective To investigate the role of mitogen-activated protein kinases (MAPK)/extracellular signal regulated kinase1/2 (ERK1/2) signal transduction pathway in regulating the expression of aquaporin 3 (AQP3) in human amnion epithelial cells.Methods Primary cell culture of human amnion epithelial cells deriving from amnion of term pregnancy with normal amniotic fluid volume (AFV) or isolated oligohydramnios was conducted in the Second Affiliated Hospital of Wenzhou Medical College from January to November 2011.Either group included 10 elective cesarean cases.The primarily cultured cells were treated with different concentrations (0,5,10,20 and 40 mol/L) of ERK inhibitors (U0126) for 12 h,and then the optimal concentration of U0126 which resulted in the lowest expression of phospho~ERK1/2 (p-ERK1/2) was added for different durations(0,2,6,12 and 24 h).Immunocytochemistry was used to detect the localization of AQP3 and Western blot analysis was used to examine the expression of total ERK1/2,p-ERK1/2 and AQP3 in human amnion epithelial cells.Statistical analysis was performed by t-test and one-way ANOVA.Results (1) Compared with those in normal AFV group,p-ERK1/2 and AQP3 expression in human amnion epithelium cells decreased in oligohydramnios group,respectively (p-ERK1/2:3.46 ± 0.33 and 2.46±0.25;AQP3:2.34 ± 0.18 and 1.56±0.10,t=9.243 and 13.292,P＜0.01).(2) In oligohydramnios groups,after treated with different concentrations of U0126,the expressions of total ERK1/2 did not change (F=0.365,P＞0.05).The expression of p-ERK1/2 and AQP3 in 5,10,20,40 μmol/L U0126 (p-ERK1/2:0.96±0.16,1.12±0.13,0.98±0.17 and 1.02±0.26; AQP3:1.10±0.09,1.12±0.08,1.13±0.06 and 1.11±0.06) were all significantly lower than those in 0 μmol/LU0126 group (p-ERK1/2:2.46±0.25; AQP3:1.56±0.10,P＜0.05).However,the expression of p-ERK1/2 and AQP3 showed no significant difference among 5,10,20,and 40μmol/L U0126 groups (P＞0.05).The optimal concentration of U0126 was 5 μmol/L.After treated with 5 μmol/L U0126 for 2 h,the expressions of p-ERK1/2 and AQP3 (1.27±0.29 and 1.44±0.12)were lower than those after treated for 0 h (2.55±0.12 and 2.15±0.09,P＜0.05).However,there was no significant difference among groups treated for 2,6,12 and 24 h.Therefore,the optimal treatment time was 2 h.(3) The expression of AQP3 was distributed in both cell membrane and cytoplasm in amnion epithelial cells with normal amniotic fluid volume or isolated oligohydramnios,but mainly in cytoplasm.U0126 did not change the localization of AQP3 expression.Conclusions U0126 inhibits the phosphorylation of ERK1/2 and expression of AQP3 of women with oligohydramnios,indicating that the MAPK/ERK1/2 signal transduction pathway might regulate the expression of AQP3 in human amnion epithelial cells,and therefore affect the balance of amniotic fluid volume.

Objective To investigate the predictive value of metabolic tumor volume (MTV) in angiogenesis and hematoge‐nous metastasis of patients with colorectal cancer .Methods Totally 108 patients with colorectal cancer from January 2011 to De‐cember 2015 were enrolled into the study and divided into metastasis group (n=42) and non‐metastasis group (n=66) according to whether combining with hematogenous metastasis .All patients received 18 F‐2‐fluoro‐D‐glucose positron emission tomography/com‐puted tomography (18F‐FDG PET/CT) before operation ,then used the PET VERA software to automatically calculate MTV ac‐cording to the 40% of standard uptake value max(SUVmax ) as the threshold .The blood vessels were identified with CD34+ immu‐nohistochemical staining ,then measured the microvessel density (MVD) .The clinical pathologic data ,SUVmax ,MTV and MVD were compared between metastasis group and non‐metastasis group .The area under the receiver‐operating characteristic curve (AUC) was performed to evaluate the predictive value of MTV on hematogenous metastasis .Results SUVmax ,MTV and MVD in metastasis group were significantly higher than that in non‐metastasis group (P<0 .05) .There were significant differences in MTV and MVD among patients with different T stage (P<0 .05) .Pearson correlation analysis results showed that MTV was positively correlated with MVD (r=0 .636 ,P<0 .001) ,and there was no significant relationship between MTV and SUVmax (r= 0 .161 ,P=0 .096>0 .05) ,MVD and SUVmax (r=0 .179 ,P=0 .064>0 .05) .AUC of MTV was 0 .736 ,and the best threshold value was 15 .016 cm3 ,whose sensitivity ,specificity ,positive predictive value ,negative predictive value and Youden index were 83 .3% ,63 .6% , 59 .3% ,85 .7% and 47 .0% respectively .Conclusion Compared with SUVmax ,MTV of colorectal cancer is associated with angio‐genesis and hematogenous metastasis ,so as to predict the prognosis of colorectal cancer ,which is worthy of clinical application .

Objective To explore the relationship between the classification and imageology,the dynamic changes of bronchoscopy and CT features of endobronchial tuberculosis(EBTB).Methods CT findings and bronchoscopic findings in 48 cases with EBTB proved by sputum culture , bronchoscopic biopsy and surgical pathology were analyzed.The classification,dynamic changes and CT characteristics were also evaluated.Results Bronchoscopic results showed 13 of edematous-hyperemic type, 8 of caseous nocrosis type, 5 of fibrostenotic type, 2 of tumorous type, 6 of granular type, 7 of ulcerative type and 7 of mixed type. CT manifestations in different types were intersected,including thickened bronchial wall (64.6%) , bronchial stenosis (41.7%) , aerated bronchus sign ( 37.5% ) ,intra-luminal nodules ( 25% ), bronchial structure with obstructive atelectasis ( 37.5% ) and pneumonia (25% ) .The corresponding rate between bronchoscopy and CT was 83.3% in detecting diseases.19 cases were followed-up by bronchoscopy during the initial 1~5 months of treatment,and 12 cases (3 edematous-hyperemic,4 caseation,3 ulcerative,2 mixed type) were resolved or healed without sequelae,6 cases changed into the other type,4 cases changed into the fibrostenotic type, 2 cases remained in a fibrostenotic state in spite of drug therapy.28 cases were followed-up by CT during the initial 1~5 months of treatment, and 20 cases (6 edematous-hyperemic,4 caseation,3 ulcerative, 1 granular,2 fibrostegnotic 1 tumorous,3 mixed type) were improved,6 cases changed into the other type,2 cases turned into the fibrostenotic type, 2 cases did not improve despite antituberculosis chemotherapy.CT correlated well with fibrobronchoscope(88.5%) in predicting the therapeutic outcome of EBTB.Conclusion CT as a non-invasive method has high clinical value in observing the evolution , predicting the complications and evaluating the therapeutic effect of EBTB.

Objective To analyze the MR features of atypical meningiomas,so that to improve the diagnostic accuracy of this tumor pre-surgery.Methods There were 12 cases of atypical meningiomas proved by surgery and pathology.All of these patients underwent plain and contrast-enhanced MR examinations.Results Totally 12 cases,included 2 cases of multiple meningiomas,2 cases of lateral ventriclar meningiomas,2 cases of completely calcific meningiomas,3 cases of cystic meningiomas and 3 cases of malignant meningiomas.Conclusion The external cerebral signs of the tumors are the important basis for the localizing diagnosis of atypical meningiomas.Atypical MR signs of meningiomas are of complimentary value in qualitative diagnosis.

This guideline was published by the American Institute of Ultrasound in Medicine,which has been developed to assist physicians performing sonographic studies of the brain in neonates and infants.Neurosonography should be performed only when there is a valid medical reason,and gain the necessary diagnostic information.Although it is not possible to detect every abnormality,adherence to the following guideline will maximize the detection of most abnormalities of the brain in neonates and infants that can be imaged with ultrasound.