Objective To evaluate the effect of improved cleaning and disinfection method for subclavian venipunc-ture dressing change to prevent catheter-associated infection. Methods 120 hospitalized patients with right subcla-vian venipuncture at an intensive care unit in January-June 2012 were divided into control group (n= 60)and experi-mental group(n= 60)according to venipuncture date. Control group adopted conventional dressing change :disin-fected skin at and around puncture point by 2% iodine tincture,then used 75% alcohol for deiodination;experimen-tal group adopted improved dressing change :Wiped skin at and around puncture point three times by normal saline, cleaned catheter,disinfected skin around puncture point (avoid puncture point)three times by 75% alcohol,disin-fected skin at and around puncture point three times by 0 .5% iodine tincture ,then disinfected catheter . Associated infection rate between two groups were compared . Results Focal infection rate and CRBI rate of experimental group were both lower than control group(5.00% vs 16.67% ;1.67% vs 13.33% ),the difference was statistically different (P< 0.05 ). Conclusion Effect of improved dressing method is better than the conventional dressing method,it can effectively prevent occurrence of focal infection and CRBI.

Objective To construct high-capacity ribosome display single-chain Fv library for selection of high affinity ScFv antibody.Methods We isolate human lymphocyte from peripheralblood(2 normal,3 gastric cancer,3 colonic cancer,1 pancreatic cancer,each 5 mL and 2 newborn,each 2 mL)and extract RNA for cloning whole human heavy chain and light chain gene by RT-PCR.VH and VL were rearranged randomly by SOEing(splicing by overlap extension,SOEing).Finally,the elements for in vitro screening such as T7 promoter and ribosome binding site were introduced while the SOEing products were amplified.Moreover,ribosome display template were verified by blue/white screening and further sequencing.Results We successfully constructed ribosome display ScFv library with a volume of 1.1?1013.Conclusion The construction of high-capacity ScFv library shed light on multiple therapeutic ScFv screening.

Objective: To observe the efficacy of mild moxibustion combined with arthroscopic meniscal repair in the treatment of meniscal injury and to explore its action mechanism. Methods: Ninety-eight patients with meniscal injury were divided into a surgery group and a moxibustion plus surgery group by the random number table method, with 49 cases in each group. Both groups received arthroscopic meniscal repair, and the moxibustion plus surgery group was treated with add-on mild moxibustion. The Lysholm score, visual analog scale (VAS) score, and mobility of the affected knee were measured before and after treatment, and transforming growth factor (TGF)-β1 and platelet-derived growth factor (PDGF) levels were measured in the fluid of the affected knee joint. The healing of the meniscus was recorded at a follow-up visit 3 months after the surgery. Results: After treatment, the Lysholm score increased, the VAS score decreased in both groups, and the intra-group differences in both groups were statistically significant (P<0.05). The Lysholm score was higher in the moxibustion plus surgery group than in the surgery group, and the VAS score was lower in the moxibustion plus surgery group than in the surgery group. The differences between groups in both scores were statistically significant (P<0.05). The mobility of the affected knee joint increased in both groups (P<0.05), and it was greater in the moxibustion plus surgery group than in the surgery group (P<0.05). When compared with pretreatment, the levels of TGF-β1 and PDGF in the fluid of the knee joint increased in both groups (P<0.05), and the levels of TGF-β1 and PDGF in the fluid of the affected knee joint were higher in the moxibustion plus surgery group than in the surgery group (P<0.05). The healing of the meniscus in the moxibustion plus surgery group was significantly better than that in the surgery group at the follow-up visit 3 months after the surgery (P<0.05). Conclusion: The effect of mild moxibustion combined with arthroscopic meniscal repair is better than the surgery alone in improving knee function, relieving pain, increasing mobility of the affected knee, and promoting meniscal healing, which may be related to the up-regulation of TGF-β1 and PDGF levels in the fluid of knee joint.

Objective Investigate the clinicopathological characteristics of h?rthle cell tumors of the thyroid. Methods Sixteen cases of HCT were studied by the clinicopathological study and immunohistochemical and review of the literature. Results There were 13 cases of h?rthle cell adenomas, 5 h?rthle cell follicular carcinomas. Immunostains showed that almost all benign and malignant HCT expressed TG, vimentin, S-100 protein. Conclusions HCT is a potential malignant tumor with a defined pathologic feature. It should be follow up for a longer time to their biological behaviors. To distinguish between the benign and the malignant depends on traditional encapsulation, and whether there is a blood vessel invasion or metastasis.

The purpose of this paper was to find a safe and effective concentration of lido- caine in intravenous combining anesthesia.33 cases had been maintained with the intravenous instillation of 0.5% lidocaine and 0.1% scotine the lidocaine concentrations at the period of after introduction,30＇,60＇,90＇,120＇and recovery were measured respectively.The safty and effective range of this drug would be 2.1—5?g/ml. Also,in this paper,the relationship between the rate of instilation and the concentration of Lidocaine was studied.There was a positive correlation between the drope per minute amd the concentration during the period of the first 60 minutes. After 90 minutes from the beginning,there was no linear correlation.If we want to maintain the safty and effective blood concentration(2.1—5?g/ml), the necessary rate of instillation is 46?10 drops/minute during the first 60 minutes and 27.8?5 drops/minute after 90 minutes.This result shows that lidocaine is easy to accumulate obviously in the body.If we want the patient to recover at the time of the operation just performed,we must stop this drug 50 miuutes before the operation is finished.

This study investigated the anti-HSV-2 effect of alumen through in vitro and in vivo experiments. Viable cell counting was employed to assess the toxicity of alumen on Vero cells. The inhibition rate of HSV-2 was defined as the cytopathic effect (CPE) of the cells infected with the virus. Alumen suppositories of different concentrations were vaginally applied to the guinea pigs which were then infected with HSV-2 via a vaginal route. The clinical symptoms were observed and the local virus titer calculated. The results showed that alumen had an in vitro anti-HSV-2 effect by means of antiviral duplication, direct killing of the virus, and antiviral adsorption. Alumen suppositories of different concentrations could reduce or completely inhibit HSV-2 infection in guinea pigs. It was concluded that alumen had an in vitro anti-HSV-2 effect through multiple approaches and it could suppress in vivo vaginal HSV-2 infection of guinea pig to some extent.

Objective To explore the impact of family education methods and parental rearing or not on the psychological problem tendency of primary school students.Methods The mental health test (MHT) was used on getting mental health data of the 2 838 primary school students from Dongguan city.Results (1) The results of MHT showed that 94.28％ of primary school students had no psychological problems,the tendency rate of psychological problems was 4.29％,and 1.43％ of them were suffering from serious psychological problems.Learning anxiety,physical symptoms and allergy tendency were more prominent.(2) The total MHT scores of primary school students with authoritarian,democratic,permissive and neglected family education methods were (34.84±14.58),(31.04±13.60),(35.19±12.82) and (41.19±13.10)respectively.There was no statistically significant difference in the terrorist tendency dimension scores of primary school students with different education methods (F=2.33,P=0.054),and the differences in the MHT total score and other dimensions were statistically significant (F=4.35-16.88,P＜0.01).(3) There were statistically significant differences in the scores of the total score of psychological problem tendency,dimensions of learning anxiety,anxiety to people,allergy tendency and impulse tendency of primary school students who were parental rearing or not (t=2.09-3.67,P＜0.05).However,there was no statistically significant difference in the dimensions of loneliness tendency,self-accusation tendency,physical symptoms and terrorist tendency (P＞0.05).Conclusion Family education methods and parenting styles has a impact on the mental health of primary school students.

Objective To systematically evaluate the incidences of complications of high frequency oscillatory ventilation ( HFOV) and conventional mechanical ventilation ( CMV ) in premature infants. Method Randomized controlled trials of HFOV and CMV in premature infants published in databases including PubMed, Embase, Cochrane Library, CNKI Database, Wanfang Database, Weipu Chinese Sci－Tech Periodical Database were searched.The retrieval time was from the establishment of the databases to January 2018.The quality of the literature were evaluated , and Stata 15.0 statistical software was used for meta－analysis.Result A total of 18 articles and 3 888 premature infants were included in the study , including 1 910 in the HFOV group and 1 978 in the CMV group.No significant differences were found in the incidences of in－hospital mortality, air leakage syndromes , retinopathy of prematurity (ROP),≥grade 3 intraventricular hemorrhage (IVH), periventricular leukomalacia (PVL), necrotizing enterocolitis (NEC) and patent ductus arteriosus ( PDA) requiring medication or surgery ( P ＞0.05 ).The incidences of bronchopulmonary dysplasia (BPD) (RR ＝0.90,95%CI 0.83 ～0.98),≥grade 2 ROP (RR ＝0.78, 95%CI 0.63～0.96) and pulmonary hemorrhage (RR＝0.63, 95%CI 0.47～0.85) in HFOV group was significantly lower than the CMV group (P＜0.05).In the subgroup analysis, the results of the researches in 1980s, 1990s, 2000s, and 2010s showed that no significant differences existed in in－hospital mortality between the HFOV group and the CMV group on ventilator pressure control mode and volume control mode (P＞0.05).Conclusion Current evidences suggested that comparing with CMV , the application of HFOV in preterm infants might reduce the incidences of BPD ,≥grade 2 ROP and pulmonary hemorrhage.

Objective: To study the correlation between the empty bottle volume, negative pressure and gas production of the freeze-dried powder in the out-patient pharmacy intravenous admixture center of a children' s hospital in order to provide reference for the drug production. Methods:20 ml Syringes were used to measure the volume of empty bottles, negative pressure and produced gas. The relationship between the theoretical drug dissolution volume and the actual dissolution volume was compared, and the precautions for the drug production were put forward. Results:Among the tested 30 drugs, 6 ones were with the actual dissolution volume half of the theoretical dissolution volume, 8 ones were with negative pressure in the bottles, and 3 ones were with produced gas after dissol-ving. It was appropriate that the empty bottle volume be 4 ml larger than the theoretical dissolution volume, and it was appropriate that the negative pressure volume of drugs was slightly larger than the theoretical dissolution volume. Negative pressure should be still kept in the bottles after the gas production. Conclusion:The design of part of freeze-dried powder injection needle shows defects resulting in drug mixing difficulties to a certain extent.

Objective:To establish a calculation model of drug preparation difficulty coefficient for outpatient pharmacy intrave -nous admixture center ( OUIVA) in a children's hospital, and construct the performance model .Methods: All the prescriptions in a week in OUIVA of Shanghai children's medical center were randomly selected .According to the actual difficulty level in the process of outpatient and emergency drug preparation , a basic drug difficulty coefficient and difficulty coefficient addition method was constructed . The difficulty index of every prescription was calculated .All the prescriptions in a week were randomly selected , and according to the difficulty coefficient analysis method , the daily difficulty coefficient of the prescriptions was calculated in order to build a performance model for OUIVA in the hospital .Results:The difficulty coefficient of medicine mainly included four basic difficulty coefficients and nine difficulty addition coefficients .According to the statistics , the average difficulty coefficient of daily prescriptions was (3.83 ± 2.86 )with the highest difficulty coefficient of 35, and the prescription data showed that there was significant difference between outpa -tient and emergency prescriptions and daytime blood tumor prescriptions .Conclusion:A performance model based on the difficulty co-efficient for OUIVA in children ' s hospital is a more scientific reflection to the daily work .