OBJECTIVE To survey the varieties of microorganism on nurse hands and probe into its controlling measure in general hospital.METHODS We sampled microorganism of nurse hands during intravenous fluids infusion in the Respiratory Department,the Cardiovascular Department,the Department of Digestion,Gynecology and Obstetrics Department,the Department of Thoracic Surgery and the Department of Organ Transplantation in our hospital.All samples carried out co-cultures of fungi and bacteria.RESULTS The varieties of microorganism included not only opportunistic pathogens such as Acinetobacter,Corynebacterium,Pantoea agglomerans(Enterobacter agglomerans) former,and Escherichia coli,but also strong pathogenic microorganisms such as Staphylococcus aureus,and it is so common that finding meticillin-resistant coagulase-negative staphylococci.CONCLUSIONS Nursing staff's hands contamination is serious in the process of manipulating operation in general hospital,emphasis should be placed on prophylaxis and control for nosocomial infection.

Objective To explore the airway management strategy of patients with double-lumen tracheal intubation during anesthesia recovery period.MethodsA retrospective analysis of clinical data of 60 patients who underwent double-lumen tracheal intubation were enrolled from december 2014 to december 2016 in oue hospital was conducted.The mean arterial pressure (MAP), blood oxygen saturation (SpO2), heart rate (HR) and respiration (R) of all patients were measured at different time points,before and after operation, before and after extubation.ResultsThere was no significant difference in MAP and SpO2 between before and after operation,the levels of MAP and SpO2 before extubation and in extubation were significantly higher than those before operation (P<0.05), and five to ten minutes after extubation returned to the preoperative level.There was no significant difference in HR and R indexes between before and after operation, and the HR and R indexes in extubation and before extubation were significantly higher than those before operation, the difference was statistically significant(P<0.05), which was returned to preoperative level ten minutes after extubation.ConclusionIn the patients with double-lumen tracheal intubation, the observation and scientific care of the airway in the recovery period of anesthesia can not only ensure the stability of the vital signs, but also improve the safety of the patients.It is worthy of clinical application.

Objective To analyze the clinical results of surgical treatment of nerve compression of the upper limb.Methods The clinical characterisitcs treatment methods and prognosis of nerve compres sion of the upper Iimbs in 646 padents were analyzed.Results Four hundred and of them were followed up for from 6 months to 3 years.The numbness disappcared and the function five of the nerve innervation area became normal or near normal after operation in 252 cases(62.2%),improved in 124 cases(30.6%),no change or worse in 29 cases(7.2%).The excellent rate of nerve funcfion recovery were 93%after rehabilitation teatment.Conclusions The loss degree of sensorimotor function of the effected limbs provides reference for operating mode and iS closely related to nerve functional restoration.The evaluation of the loss degree of sensorimotor function of the affected limbs before the operation should be taken into account.Rehabilitation teatment after operation can promote functional restoration and prevent teratogencsis.

Background:Gastroesophageal reflux disease(GERD)is a common disorder of digestive system,however,some of patients are not responding to conventional 4-8 weeks proton pump inhibitor therapy. Aims:To investigate the effect of digital music gastric electrical pacing on clinical symptoms,anxiety and depression and esophageal motility in patients with refractory GERD. Methods:Fifty-three patients with refractory GERD from Jan. 2014 to Oct. 2015 at the Third Affiliated Hospital,the Third Military Medical University were recruited. All of them fulfilled the Montreal definition of GERD. Digital music gastric electrical pacing was performed for 15 days and the efficacy was evaluated by clinical symptom scoring,Hamilton anxiety scale( HAMA),Hamilton depression scale( HAMD)and esophageal motility manometry. Results:After 15-day treatment,the main symptoms,including heartburn,daytime and nocturnal acid reflux,upper abdominal pain,nausea,and sleep disorder were significantly improved(P < 0. 001). A great proportion of patients were complicated with anxiety and/ or depression at recruitment,and after treatment the scores of HAMA and HAMD were decreased significantly(P < 0. 001). Meanwhile,the lower esophageal sphincter resting pressure(LESP),distal wave amplitude,peristaltic wave duration,speed of peristaltic wave and distal contraction integral after treatment were significantly increased as compared with the baseline values(P < 0. 05). Conclusions:Digital music gastric electrical pacing is effective for treatment of refractory GERD with increase of LESP and esophageal body motility. The clinical symptoms and anxiety and depression are improved simultaneously. Digital music gastric electrical pacing is expected to be a new choice of non-medicine treatment for esophageal motility disorders.

Gastric ''inflammation-cancer'' transformation stars from inflammation and ends as gastric cancer （GC）， and the pathogenesis is still unclear. In China， GC features high morbidity and mortality and poor prognosis， influencing the quality of life and physical and mental health of patients. Therefore， it is of great significance to construct the prevention and treatment system for GC. Chronic atrophic gastritis （CAG） plays a key role in the occurrence， development， and outcome of gastric ''inflammation-cancer'' transformation. Modern therapies for CAG generally aim at eliminating causes and alleviating clinical symptoms， which show satisfactory short-term efficacy， but the reverse and recurrence are common. Based on the holistic view， syndrome differentiation-based treatment， and the ''inflammation-cancer'' transformation in modern medicine， traditional Chinese medicine emphasizes both prevention and treatment， with individualized therapies for CAG and GC to control the transformation. According to the pathogenesis of CAG-asthenia in origin and sthenia in superficiality and deficiency-excess in complexity， this study proposed the theory of spleen deficiency and pathogen stagnation in CAG， and believed spleen deficiency， pathogen， and stagnation are respectively the root cause of， the main factor of， and the key to ''inflammation-cancer'' transformation， respectively. Spleen deficiency and pathogen stagnation are closely related to the process of the transformation. For the treatment， the spleen-invigorating and pathogen-eliminating method should be used for invigorating the spleen to consolidate original Qi， improve the blood supply in stomach， and regulate immunity， and eliminating the pathogen to relieve stagnation， reduce the occurrence of non-controllable inflammation， and improve inflammatory micro-environment. As a result， the gastric inflammation is controlled at the early stage and the gastric ''inflammation-cancer'' transformation is blocked. The gastric mucosal lesions are blocked， delayed， or even reversed. This study provides a new idea in clinical diagnosis and treatment of CAG and in the prevention of GC.

Objective To explore the differential gene expression profile and small molecule drugs for chronic atrophic gastritis(CAG)by bioinformatics technology.Methods Two gene expression samples of CAG chips(GSE27411,GSE116312)were obtained through the Gene Expression Synthesis(GEO)database,screen the differentially expressed genes(DEGs)of CAG by R language,and CAG immune-related genes were obtained for gene ontology(GO)and Kyoto Encyclopedia of Genes and Genomes(KEGG)analysis.Protein-protein interaction(PPI)network was constructed using STRING database to screen out core genes,further study on immune invasion of core genes based on GSE27411 dataset,small molecular compounds interacting with core genes were predicted,molecular docking was carried out by MOE2022,and survival analysis was carried out by GEPIA2 website.Results A total of 517 DEGs were screened out based on GEO database.GO function enrichment analysis found that it mainly involved in granulocyte chemotaxis、leukocyte chemotaxis and neutrophil chemotaxis biological processes.KEGG pathway enrichment analysis showed that it mainly involved in cytokine-cytokine receptor interaction、nuclear factor kappa B signaling pathway、interleukin-17 signaling pathway.Six key genes of NR1H4、CCK、CCL20、CXCL1、LCN2、SAA1 were obtained by PPI network,through relevant verification,NR1H4 was regarded as the core gene.Immune cell infiltration analysis showed that central memory CD8 T cell、effector memeory CD4 T cell、gamma delta T cell、natural killer T cell、neutrophil and other immune cells may be involved in the development of CAG,and the neutrophil was positively correlated with NR1H4.It was predicted that six small molecular drugs,corilagin,stigmasterol,geniposide,tangeretin,chenodeoxycholic acid and epigallocatechin 3-gallate,have good binding force with NR1H4.Conclusion The potential mechanism of CAG is preliminarily explored in this study,the key gene of NR1H4 and neutrophil may play an important role in the"inflammatory cancer transformation"process of CAG,which can provide a certain reference for the study of the"inflammatory cancer transformation"mechanism of CAG.

ObjectiveTo explore the effect of Weiwei Tongtiao decoction （WTD） on chronic atrophic gastritis （CAG） rats and the underlying mechanism. MethodA total of 90 SD rats were randomized into normal control group， model group， high-dose， medium-dose， and low-dose WTD groups （18， 9， 4.5 g·kg^-1·d^-1 WTD， respectively， ig）， and weifuchun control group （0.45 g·kg^-1·d^-1 weifuchun aqueous solution， ig）， with 15 rats in each group. The N-methyl-N'-nitro-N-nitrosoguanidine （MNNG） was employed to induced CAG in rats. After the modeling （identified by histopathological examination）， the administration began and lasted 12 weeks. Then， gastric mucosa tissues of the rats were collected and stained with hematoxylin and eosin （HE）， and the pathological changes of gastric mucosa were observed under the optical microscope. Real-time PCR， immunohistochemistry （IHC）， and Western blotting were applied to examine the mRNA and protein expression of indexes in nuclear factor kappa-B （NF-κB） signaling pathway in the gastric mucosa of rats. ResultCAG rats showed irregular arrangement and morphology of the inherent glands in gastric mucosa and the glands decreased or disappeared. In addition， inflammatory cell infiltration was observed in the lamina propria of CAG rats， and about 48.4% presented intestinal metaplasia. WTD significantly alleviated the reduction of the glands and intestinal metaplasia in a dose-dependent manner. Compared with the normal control group， the model group demonstrated increase in the mRNA expression of cyclooxygenase-2 （COX-2）， NF-κB p65， interleukin （IL）-1α， IL-1β， IL-10， IL-8α， and IL-8β， and protein expression of COX-2， NF-κB p65， and IL-10 （P<0.01）. WTD and weifuchun lowered the mRNA expression of COX-2， NF-κB p65， IL-1α， IL-1β， IL-10， IL-8α， and IL-8β， and the protein expression of COX-2， NF-κB p65， and IL-10 in gastric mucosa of CAG rats （P<0.01）. The expression of the above indexes after the intervention with high-dose WTD was close to that of the normal control group. ConclusionWTD can improve or even reverse the diseased gastric mucosa of CAG rats， and the mechanism is the likelihood that WTD down-regulates the mRNA and protein expression of the indexes in NF-κB signaling pathway in gastric mucosa of CAG rats.