Objective To study how polyclonal antibodies against ciliary neurotrophic factor (CNTF) reduce botulinum toxin-in- duced axonal sprouting and affect paralytic muscle.Design Experimental study.Participants 20 New Zealand rabbits.Methods In 10 rabbits randomly selected,left superior rectus were as control (Group 1),right superior rectus were injected with botulinum toxin A (BTXA) 2.5U (Group 3).At 14th day,bilateral superior recti were taken out under general anaesthesia.In the other 10 rabbits,left su- perior recti were injected equivalent physical saline (NS) as control (Group 2);right superior recti were injected with BTXA 2.5U,after 4 days,injected with 50?l polyclonal antibodies against CNTF at same site (Group 4).And at 14th day,bilateral superior recti were taken out for electron microscopy,dyed with acetylcholinesterase,argentums (Ag) to show nerve axonal sprout,and accounted and mea- sured with Leica microsystems.Main Outcome Measures The mean number of sprouts and the mean total length of sprouts,and the uhrastructure change of muscle by electron microscopy.Results In Group 1,the mean number of sprouts and the mean total length of sprouts were 5.75% and 10.53?m respectively;Group 2 were 6.11% and 11.16?m;Group 3 were 84.04% and 170.71?m;and Group 4 were 54.77% and 68.12?m.The differences were statistically significant (all P=0.000).Electron microscopy showed that after admin- istration BTXA alone (Group 3),muscle atrophied obviously,nerve myelin sheath increased,while the structure of nerve and muscle re- main invariable.The Group 4 showed that local myofilament disrupted and dissolved,degenerative myocytes necrotized and disintegrat- ed into fragments,which led to partial unreversible destroy.Conclusion Polyclonal anti-CNTF can reduce BTXA-induced axonal sprout- ing,lead to partial unreversible destroy of muscle,which may prolong the time of paralytic muscle resuming.It suggests that polyclonal anti-CNTF could prolong the duration of muscle paralyses induced by botulinum toxin.

Objective To investigate the discharge outcome and its clinical influential factors of acute poisoning in children, and to provide the clinical references for prevention. Methods Questionaire about acute poisoning in children made by the research group,the hospitalized children and the influential factors were analyzed according to the outcome. Results Among 168 cases of acute poisoning hospitalized children,the curative rate was 80.95%, 16 cases(9.52%) were improved,6 cases (3.57%)were quitted,1.20% was ' not curative' and 4. 76% died. The factors including age,treatment time, route of entry, varieties of poison, medical examination of admission were statistically associated with the discharge outcome.Conclusion The outcome can be improved through an intensive nurse of the children under the age of three and early treatment. The cases who were not poisoned by the invasion of gastrointestinal tract,paraquat poisoning,and those with abnormalities of breathing, pupilla, awareness in medical examination of admission would have poor discharge outcomes, and should be monitored closely and treated timely.

Objective To investigate the effect of madopar combined with entacapone administration on plasma homocystein ( Hcy) level in patients with Parkinson's disease ( PD) .Methods Thirty healthy person were selected as a control group, 20 PD subjects with no levodopa ( LD) taking were as no treatment group, 63 subjects with madopar were as madopar group and 49 subjects with madopar combining entacapone were as combination group. Meanwhile levodopa concentration in peripheral blood and Unified PD Rating Scale Ⅲ ( UPDRSⅢ) score were measured.The plasma Hcy levels of all the researchers were detected.Results The L-dopa concentration in plasma of combination group was statistically significantly higher than that of madopar group ( P<0.05 ) .The score of UPDRSⅢscale of madopar group and combination group were significantly lower than that of madopar group ( all P<0.05).Compared with control group, the Hcy concentration in non-treatment group, madopar group and combination group were significantly increased ( all P<0.05 ) .And the Hcy concentration in madopar group was significantly higher than those in none treatment group and combination group ( all P<0.05 ) .Conclusion Madopar combined with entacapone therapy can significantly reduce plasma Hcy levels in patients with PD, which may be beneficial to the treatment of PD.

Objective To explore the impact of elective caesarean section and vaginal delivery on maternal pelvic floor dysfunction. Methods A total of 131 pregnant women from January 2014 to March 2015 in our hospital were divided into observation group which re-ceived elective caesarean section and control group which received vaginal delivery.All the maternal and neonatal clinical data were counted. The occurrence of pelvic floor dysfunction disease in postpartum women after 6 to 8 weeks was observed.The occurrence of vaginal wall pro-lapse,uterine prolapse,stress urinary incontinence (SUI)and maternal pelvic floor muscle damage between two groups were compared and analyzed.Results There were varying degrees anterior vaginal wall prolapse phenomenon occured on 31 cases in obervation group,the pro-lapse rate was 67.39%,compared with 92.94% of the control group,the difference was statistically significant (P <0.05).Observation group with 13 cases of descent vaginae posterior,the prolapse rate was only 28.26%,compared with 75.29% of the control group,the differ-ence was statistically significant (P <0.05 ).The maternal uterine prolapse rate of observation group was about 13.04%,compared with 35.29%(30 cases)of the control group,the difference was statistically significant (P <0.05).Observation group with 6 cases of maternal SUI, the probability is about 13.04%,compared with 29.41% of control group,the difference was statistically significant (P <0.05).There was no significant difference in deep and shallow maternal pelvic floor muscle between two groups(P >0.05).Conclusion To adopt elective cesar-ean section has a lower probabilities of postpartum pelvic floor dysfunction disease than that by vaginal delivery for maternal women,which is propitious to the recovery of pregnant women,while it has nothing to do with pelvic floor muscle damage.

Objective:To study the curative efficacy of metformin combined with Jinlida granules in the treatment of gestational diabetes mellitus and its effects on the serum vascular endothelial growth factor (VEGF),adiponectin (APN) and homocysteine(Hcy) levels.Methods:94 patients of gestational diabetes mellitus who were treated from July 2014 to July 2016 in our hospital were selected.According to random number table,those patients were divided into the observation group (n=47) and the control group (n=47).On the basis of routine treatment,such as control diet,reasonable exercise and healthy diet,etc,the control group was treated with metformin,while the observation group was combined with Jinlida granules on the basis of the control group.The changes of blood glucose,blood lipid and serum VEGF,APN and Hcy before and after treatment were compared between the two groups,the incidence of maternal complications and neonatal adverse outcomes were compared.Results:Compared with before treatment,the blood glucose,blood lipid of both groups after treatment were significantly improved (P ＜0.05),the fasting plasma glucose (FBG),postprandial 2h blood glucose (2hPG),glycosylated hemoglobin (HbAlc),total cholesterol (TC),triacylglycerol (TG),low density lipoprotein cholesterol(LDL-C) of observation group were significantly lower than those of the control group,the serum high density lipoprotein cholesterol (HDL-C) level was significantly higher than that of the control group(P＜0.05);after treatment,the serum VEGF,APN and Hcy levels were significantly improved than those before treatment in both groups (P＜0.05),and the serum VEGF,and Hcy levels of observation group were lower than those of the control group,the serum APN level was higher than that of the control group (P ＜ 0.05);the incidence of gestational hypertension,hydramnios,cesarean section and premature delivery of observation group was significantly lower than that of the control group (P ＜0.05);the incidence of giant child,neonatal Jaundice and neonatal respiratory distress in the observation group was significantly lower than that of the control group (P＜0.05).Conclusion:Metformin combined with Jinlida granules was effective for the gestational diabetes mellitus,which could effectively control the blood glucose,blood lipid levels and might be related to the regulation of serum VEGF,APN and Hey levels.

OBJECTIVE:To provide reference for improving the service quality of outpatient pharmacy in hospital. METH-ODS:A questionnaire survey was conducted to investigate and analyze the patients’satisfaction and related influential factors to outpatient pharmacy in a third grade class-A hospital in Chengdu. RESULTS:Totally 165 questionnaires were sent out,and 150 were effectively received with effective recovery of 90.91%. The total score for patients’satisfaction was (44.67 ± 7.81) scores, and the rate of satisfaction was(81.22±14.19)%. The top three entries were“the will you choose to come to our hospital again if necessary”,“the notices about time and place for taking the medicine”and“the overall evaluation of the professional ethics of med-ical staff”,scored 4.38,4.25 and 4.25,respectively;the last three entries were“waiting time for taking medicine”,“the notices about how long it takes to take the medicine”and“service facilities and environmental facilities for drug taking”,scored 3.55, 3.63 and 3.95,respectively. The top three suggestions were“long waiting time for taking medicine and inconvenient”,“noisy envi-ronment,bad order”and“expensive drugs charges but less reimburse”. The univariate analysis and multivariate analysis showed that gender,age,marital status,education,occupation,family income per month,resident,drug taking times and payment etc. factors showed no significant effects on patients’satisfaction scores(P>0.05). CONCLUSIONS:The degree of patients’satisfac-tion in outpatient pharmacy have no obvious specificity and preference,the key to improve the degree of satisfaction lies on strengthening the service of the hospital and the perception of the patients. While the next research will focus on how to find the breakthrough points and key points to improve the experience of waiting,standardize process management and logistics manage-ment,and make patients aware of the service development.

Objective To investigate the effect of implementation of hand hygiene(HH)activities on HH compliance among health care workers(HCWs).Methods In May-December 2013,a series of HH intervention measures in a hospital were implemented,compliance to HH among all clinical and laboratory HCWs in April-December 2013 (before and after in-tervention)were surveyed and compared.Results After implementing HH activities,HH compliance rate of HCWs in-creased from 39.82% before intervention to 80.77% after intervention,HH compliance rates of doctors,nurses and clean-ing staff increased from 41.09%,41.30% and 34.33% before intervention to 83.87%,91.89%,and 59.54% after inter-vention respectively,the differences between before and after intervention were all statistically significant (all P <0.001). Except intensive care unit,HH compliance rates of HCWs in departments of surgery,internal medicine,and radiotherapy were all higher than pre-intervention(all P <0.001).Compliance to five indications for HH among HCWs after interven-tion were all higher than pre-intervention(all P <0.001 ),HH compliance rate before touching a patient increased from 23.88% to 73.37%,before clean/aseptic procedure increased from 58.65% to 94.23%.Conclusion Through the imple-mentation and supervision of HH activities,both the awareness and compliance of HH among HCWs have been significant-ly improved,good HH habit is gradually developed.

Objective To explore the effect of execution sheet for health education in chronic heart failure (CHF) patients. Methods About 50 CHF patients hospitalized from October 2015 to December 2015 were assigned as the control group and another 50 CHF patients hospitalized from January to March 2016 were set up as the experiment groups. The control group was instructed by the regular health education and the experiment group was instructed by the execution sheet for health education. Results The executive ability in the experiment group were stronger than that of control group (P<0.01). The level of self management among the patients in the experiment group was higher than those of the that control group. Conclusions The health education execution sheet increase the patients' self-management and strengthen nursing ability for discharged patients. It is worthy of popularization in clinical practice.

Objective By using multi detector row spiral CT (MDCT) to investigate the CT imaging findings of gallbladder abnormalities caused by hepatic parenchymal diseases and those of inflammatory cholecystitis. Methods CT and clinical data of 80 patients with gallbladder abnormalities were retrospectively reviewed. Fifty patients were in hepatic disease group, including 20 chronic hepatitis, 25 liver cirrhosis, and 5 cirrhosis with hepatocellular carcinoma. Thirty patients were in inflammatory group, including 19 chronic cholecystitis, 6 acute cholecystitis, 3 cholecystitis with acute pancreatitis, 1 gangrenous cholecystitis, and 1 xanthogranulomatous cholecystitis. All patients underwent MDCT plain scan and contrast enhanced dual phase scanning of upper abdomen. Results In hepatic disease group, 48 cases had evenly thickened gallbladder wall (96%) with mean thickness of (3.67?0.49) mm; 38 cases had clear gallbladder outlines (76%); 38 cases had gallbladder wall enhancement of various degree (76%); 14 cases had gallbladder bed edema and localized non dependant pericholecystic fluid collection (28%). In inflammatory cholecystitis group, 28 cases had obscuring gallbladder outlines (93%) ; 26 cases had gallbladder wall evenly thickened (87%), 4 cases showed unevenly thicked wall (13%), the mean thickness being (4.54?1.14) mm; 30 cases had inhomogenous enhancement of the gallbladder wall (100%); 9 cases had high attenuation bile (30%); 4 cases had dependant pericholecystic fluid collection (13%); 5 cases had transient enhancement of adjacent hepatic bed in arterial phase (17%); micro abscess and gas in the gallbladder wall was observed in 1 case respectively. Conclusion MDCT can offer imaging findings useful for differentiating abnormal gallbladder changes caused by hepatic parenchymal diseases from those due to inflammatory cholecystitis.

Objective To evaluate the two methods for quantitative hepatitis B virus (HBV) DNA test. Methods The Hybrid Capture II system from Digene Co. and Real Time PCR fluorimetry quantitative HBV DNA test kit from PIJI Bio Technical Development Company Ltd. were used to detect sera HBV DNA in sera of patients with chronic hepatitis B. Results With the two quantitative methods, the positive rates of HBV DNA were 98 6% and 94.6% respectively. The concordant rate of these two methods was 93.2%. In assessing the sensitivity of the two kits with a serial of 10 fold diluted patients′s sera, PG kit could test 10 -7 of diluted serum, and HC II could test 10 -6 . The test value of HC II was more accurate in quantitation than PG kit especially in higher titer of HBV DNA. Whereas in the case of low titer of HBV DNA, the deviation of test value increased in both two methods. For monitoring the anti virus effect with quantitative HBV DNA in CHB patients, these two methods had same sensitivity, and the test value of HBV DNA had the same trend of change. Conclusion HC II system and PG test kit were sensitive and reliable, and they were worthy of monitoring the anti virus efficacy and of clinical practice.