Stethoscope diaphragms were sampled randomly for bacteria culture and identification from nursing and medical staff in 3 community health institutions in Zhongshan city. Anonymous filling in questionnaire was taken for investigating frequency of cleaning stethoscope by staff. A total of 100 stethoscope diaphragms were sampled, and a total of 523 bacteria strains were isolated. Eighty-six percent of stethoscopes surveyed were contaminated with bacteria, among the isolated organisms, G+ bacteria and G-bacteria accounted for 78% and 22% respectively. The Bacterial contamination rate and G- rate of stethoscopes used by inpatient staff were 6. 2 strains and 2. 1 strains per stethoscope respectively, which were significantly higher than those used by outpatient staff (4. 8 strain and 1. 1 strain per stethoscope, P ＜0. 05 and P < 0. 01, respectively). A total of 105 questionnaires showed that 21% (6/28) of nursing staff cleaned stethoscope monthly, meanwhile 12% (7/56) of outpatient medical staff and 14% (3/21) of inpatient medical staff (P ＜0. 01) did so; 29% (8/28) of nursing staff cleaned their stethoscopes once a year or never, meanwhile, the figures for outpatient and inpatient medical staff were 55% (31/56) and 57% (12/21) respectively (P ＜0. 01). Results indicate that there is high rate of bacterial contamination in stethoscopes, and G- is more frequently found in stethoscopes used by inpatient staff than outpatient. In general, the frequency of stethoscope cleaning is low, however, more frequently for nursing staff than medical staff.

Objective:To explore the effect of calcium release-activated calcium channel modulator 1 (ORAI1) on the migration and invasion of colon cancer cell line SW480 and its mechanism. Methods:The SW480 cells were infected with ORAI interference lentivirus. The expression of ORAI1 mRNA and protein was confirmed by quantitative real-time polymerase chain reaction and Western blot. Transwell chamber, adhesion, angiogenesis, and vasculogenic mimicry experiments were conducted to detect the ability of cell invasion, migration, and angiogenesis and the intercellular adhesion of homogeneous and heterogeneous cells among each group. Confocal microscopy was employed to detect the difference of store-operated Ca2+entry (SOCE) in each group. Western blott was used to detect the expression of ERK1/2, p-ERK1/2, MMP-2, VEGF, and E-cadherin protein. Results:After the infection of SW480 with the ORAI1 interference lentivirus for 72 h, significant fluorescence expression was observed. Compared with the empty vector group and control group, the expression of ORAI1 was lower in the interference group (P<0.01). Invasion and migration ability decreased (P<0.01); the intercellular adhesion ability of homogeneous cells increased (P<0.05); the intercellular adhesion ability of heterogeneous cells decreased (P<0.05);the angiogenesi and vasculogenic mimicry were enhanced (P<0.01);the internal flow peak of SOCE was low (P<0.05); the expression of p-ERK1/2, MMP-2, and VEGF proteins decreased (P<0.01); and the expression of E-cadherin protein increased (P<0.01). Conclusion:ORAI1 may promote the migration and invasion of SW480. This mechanism may be associated with the increase of SOCE.

Objective To evaluate the effect of adenosine triphosphate postconditioning on myocardial ischemia reperfusion injury in rabbits by ultrasound speckle tracking imaging(STI).Methods Forty-two healthy rabbits were randomly divided into three groups averagely:ischemia-reperfusion (IR ) group, ischemia postconditioning(IPost)group,ATP-pharmacological postconditioning(PPost)group.The model of myocardial ischemia reperfusion was established.Echocardiography examinations were conducted before the coronary artery ligatured,after 45 min later and at the end of reperfusion.Pathological examinations were applied to detect the change of which two rabbits randomly selected from each group after the coronary artery ligatured 45 minutes later and the rests after reperfusion of 120 min.Results ①Ischemic and infarct changes could find in the six rabbits which were sacrificed after the coronary artery ligatured 45 minutes later.The same changes also could be found in the three groups after reperfusion,and the damage in IR group was the most significant.②After block of coronary artery,left ventricular ej ection fraction(LVEF) decreased in all groups (P <0.05)and STI index decreased in all groups (P <0.01).③After reperfusion of 1 20 min later,global longitudinal systolic strain rate (GLSrsys ),global longitudinal systolic strain (GLSsys)increased in IPost group and GLSrsys increased in ATP-PPost group,and longitudinal systolic strain rate(SrLsys),longitudinal diastolic strain rate(SrLd),longitudinal systolic strain(SLsys)increased both in IPost group and ATP-PPost group(P <0.05 or P <0.01).Compared in groups,GLSsys,SrLsys, SLsys in IPost group and ATP-PPost group all higher than those in IR group (P <0.05).Conclusions STI can evaluate exactly the global and regional myocardial function of rabbit myocardial infarct-reperfusion model and local index is better than overall index.STI can also detect correctly the protect effects on myocardial reperfusion inj ury of ATP.

A highly sensitive immuno-PCR assay based on sandwich ELISA and PCR was developed to detect the circulating antigen in trichinellosis. Antigens were purified from the muscle larvae of Trichinella spiralis, and the myeloma cells were fused with spenocytes immunized with T. spiralis antigens to product the specific monoclonal antibodies. Indirect ELISA was used to select the antibody-secreting hybrodoma cells. By this method of procedure, monoclonal antibody F4C6 against the T. spiralis ES antigen was obtained, which was used as the indicator antibody, while the rabbit polyclonal antibodies against T. spiralis were to be used as capturing antibodies. The plasmid Bluecript Ⅱ KS was amplified by PCR with biotin-labeled primer M13-20, and thus the biotin-labeled DNA was obtained. Both the second antibody and DNA labeled with biotin were to be linked with 100 ng/ml avidin. The whole procedures of assay consisted of two steps, in which the circulating antigens were captured by monoclonal antibody through sandwich ELISA in the first step, and the DNA linked by monoclonal antibody was amplified by PCR in the second step. The sensitivity of this method was compared with that of the ELISA assay. It was found that the measuring ranges to detect the circulating antigens in trichinellosis were 50 pg/L to 0.005 pg/L for the immuno-PCR assay, and 5 μg/L to 0.05 μg/L for ELISA assay, the former was quite higher than that of the latter. It is evident that this method is highly sensitive for the detection of circulating antigens in trichinellosis.

Objective: To discuss the conversion coefficient of morphine injection with continuous intravenous pump delivery or subcutaneous injection for the patients with advanced cancer pain demanding high dose of opioids.Methods: Using a retrospective survey, the patients with advanced cancer pain demanding high dose of opioids with poor efficacy were divided into 3∶1 group and 2.5∶1 group, and the conversion coefficient of 3∶1 or 2.5∶1 was used for the opioids equivalently conversed to intravenous or subcutaneous injection of morphine.After the conversion, the degree of pain relief, the analgesic efficiency in the conversion process, titration time, daily oral morphine equivalent amount at stable pain, morphine related adverse reactions and the other indicators were studied to evaluate the analgesic effect of morphine injection with different conversion coefficient.Results: There was no statistical significant difference between the two groups in the degree of pain relief, the effective rate of analgesia and the daily oral akministration amount of morphine at sable pain(P>0.05).The adjustment times for morphine in the two groups was (1.57±0.93) and (1.0±0.00), respectively, and the difference was statistically significant (P<0.05).The daily oral administration amount of morphine at stable pain in the two groups respectively was (226.67±69.74) mg and (258.67±101.34) mg;the morphine related adverse reactions were mainly constipation, and there was no significant difference in the incidence (P>0.05).Conclusion: Giving morphine injection to the patients with terminal cancer pain demanding high dose of opioids with poor effect, the use of PCA pump through intravenous or subcutaneous injection can effectively relieve pain.Using the conversion coefficient of 2.5:1 can quickly complete the titration process, and safely achieve the effective analgesia.

Objective:To prepare PLGA nanoparticles modified with folic acid conjugated chitosan oligosaccharide containing pa-clitaxel (F-CS-PLGA-NPs) and study the inhibitory effect on SKOV-3. Methods:F-CS-PLGA-NPs were prepared by an interface dep-osition method, 30% ethanol was used as the release medium for the in vitro release profiles of nanoparticles, and MTT was adopted to evaluate the inhibitory effect of paclitaxel with different formulations and concentrations on SKOV-3. Results:The particle size and zeta potential of F-CS-PLGA-NPs was (321 ± 0. 76) nm and (22. 6 ± 0. 26) mV, respectively, the drug loading was (5. 1 ± 0. 25)%, and the encapsulation efficiency was (41. 96 ± 1. 96)%. F-CS-PLGA-NPs had a similar in vitro release profiles with the ordinary nanoparti-cles ( PLGA-NPs) . About 35% of paclitaxel was released from the nanoparticles in the initial 24 h, and then a near zero order release at a relative slow rate was shown, and the cumulative release rate in 144 h was about 75%. The results of cell experiments suggested that at the same paclitaxel concentration, the inhibition effect of F-CS-PLGA-NPs group was stronger than that of the PLGA-NPs group and the solution group. The inhibition effect of F-CS-PLGA-NPs could be reduced by free folic acid. Conclusion:PLGA nanoparticles modified with folic acid conjugated chitosan oligosaccharide can increase the targeting efficiency in SKOVS-3 tumor cells.

Objective:To provide reference for the introduction and application of intelligent access system. Methods:The intelli-gent access system and its work process in our hospital were introduced. The application effects in the emergency pharmacy were inves-tigated and the key points that should be paid more attention in the practice were discussed. Results:Comparing with the situation be-fore the application, the system could decrease prescription time by about 26. 1% and reduce walking work intensity by about 5 times, and the drug store room was decreased by about 30%. No dispensing error happened in nearly half a year after the application of the in-telligent access system. Conclusion:The application of intelligent access system in emergency pharmacy is the development trend of the future.

Objective To investigate the diagnosis of value 99mTc-MIBI SPECT and CT fusion imaging in the differential solitary pulmonary nodule ( SPN). Methods Thirty-nine patients with SPN underwent 99mTc-MIBI-SPECT and positioning CT fusion imaging, and the imaging results carried on the qualitative and semi-quantitative analysis. The diagnostic value of the imaging method for SPN was judged according to the results of the final diagnosis. Results Of 39 cases with SPN, 13 cases were malignant and 26 cases were benign. The diagnostic sensitivity, specificity, accuracy, negative predictive value and positive predictive value of 99mTc-MIBI-SPECT positioning CT fusion imaging qualitative analysis in benign and malignant SPN was 92.31%(12/13),88.46%(23/26),89.74%(35/39),80% (12/15) and 95.83% (23/24),respectively. Receiver operating characteristic (ROC) curve analysis showed:using 99mTc-MIBI early uptake ratio (EUR) ≥1.474 as the critical value for identification the benign and malignant SPN, the sensitivity and specificity was 100% and 76.90%, respectively;using 99mTc-MIBI delayed uptake ratio (DUR) ≥ 1.38 as the critical value, the sensitivity and specificity was 100%and 76.90%. Conclusion The method of 99mTc-MIBI-SPECT and positioning CT fusion imaging has a high clinical value in the differential diagnosis of SPN.

Objective To evaluate the postoperative related aesthetic parameters and satisfactory degree between CT 3D reconstruction augmentation rhinoplasty with silicone and augmentation rhinoplasty with silicone in adult Han women.Methods Totally 60 adult healthy Han women voluntarily subjected to augmentation rhinoplasty with silicone were randomly divided into groups A and B,30 people each group;Row CT 3D reconstruction augmentation rhinoplasty with silicone was performed in group A,and the augmentation rhinoplasty with silicone in group B;6 months after surgery related data measurement and questionnaire collected,we compared the objective and subjective indicators for the nasal root,dorsum and ministry,respectively.Results There was a difference between group A and group B in the nasorostral angle,the nasal facial angle,the asofrontal angle and the height of the nasal root (89.50±1.40)°,(28.85±2.20)°,(136.26±1.92)°,(6.45±0.27) mm in group A,and (85.40±3.70)°,(26.43±4.39)°,(138.88±4.78)°,(5.28±0.34) mm in group B (all P＜0.05).There was a difference between group A and group B in operation time (51.77 ± 5.35) min vs (29.83±5.76) min (P＜0.05).Conclusions Owing to its preoperative prosthesis design purpose and avoiding local swelling,CT 3D reconstruction augmentation rhinoplasty with silicone has better effects than that of augmentation rhinoplasty with silicone,especially on the nasal dorsum and the nasal root),which can obviously shorten the operation time,and therefore it is more suitable for the defects of the nasal root and dorsum.

Objective To explore preliminarily the effects of preoperative depression condition in patients with breast cancer on the efficacy of intravenous analgesia with dezocine and the serum level of 5 hydroxytryptamine.Methods Sixty patients with breast cancer were assessed with Hamilton depression scale (HAMD).The total patients were divided into three groups according to HAMD scores,including normal group (26 cases),suspicious group (22 cases),and depression group (12 cases).The postoperative analgesia was facilitated with patients intravenous control analgesia with dezocine and the postoperative pain was assessed by visual analogue scale (VAS) at 2 hours,12 hours,and 24 hours.Yhe serum concentration of 5 hydroxytryptamine was measured by enzyme-linked immunosorbent assays before anesthesia,2 hours after surgery beginning,and 24 hours after surgery.Results The postoperative VAS at 12 hours and 24 hours in suspicious group and in depression group were higher than those in normal group (P ＜ 0.05).There was no statistical difference between depression and suspicious groups (P ＞ 0.05).The serum concentrations of 5 hydroxytryptamine in three groups increased obviously at 2 hours after surgery beginning (P＜0.05),and then decreased at 24 hours postoperation.The serum concentrations of 5 hydroxytryptamine in suspicious group and depression group at three measurement point were significantly lower than those in normal group (P ＜0.05).The serum concentrations of 5 hydroxytryptamine in depression group at three measurement point were significantly lower than those in suspicious group (P ＜ 0.05).Conclusions Under this preliminary study condition,the preoperative severity of the depression in patients with breast cancer may affect the analgesia effect of patients intravenous control analgesia with dezocine and maybe have some relationships with serum levels of 5 hydroxytryptamine.