OBJECTIVE To explore the management method to improve the control quality of hospital infection.METHODS Three-rating organization management of hospital infection was adopted,to make a management net for hospital infection control which contains leaders,doctors and nurses.RESULTS Three-rating organization management not only raised the understanding level of medical staff to hospital infection,but also good for implementing the regulations and rules to control hospital infection.CONCLUSIONS Three-rating organization management is a practicable method to control hospital infection.

[Objective]To explore the outcome of treatment of traumatic talipes equinus with Ilizarov technique.[Method]From Dec 2004 to Feb 2006,Ilizarove technique was used for treatment of traumatic talipes equinus in 8 patients,5 male and 3 female,aged from 28 years to 52 years with an average of 34.6 years.The main reasons of the food deformity included rupture or defect of the anterolateral muscle group of the leg in 3 patient,compartment syndrome of the leg in 2 patients,peroneal nerve injury in 2 and supercondylar fracture of the femor combined with popliteal artery injury in a patient.Ankylosis of the ankle ranged from 50 to 65 degrees.During operation,Ilizarov fram was placed in relative position of the foot and leg,and cross Kirschner wires 2 mm in diameter were inserted and fixed the limb with the frame in different level rings.Form 3～5 days after operation,distraction 1～2 turns four times per day was conducted till the ankle was placed in neutral position and the deformity corrected satisfactorily,then,discontinued the distraction and maintained the external fiation for another 2～3 months.[Result]All of the patients were followed up for 10 months to 21 months with an average of 12.5 months. No severe complications,such as necrosis of skin,neurovascular injuries occurred in any patient of this group.All of the affected foot and ankle got neutral position with satisfactory ambulation function,and 3 of them had 10 degrees of active dorsal flexion.No recurrence of the deformity occurred in any patient at the latest follow up.[Conclusion]Ilizarov techinque for treatment of traumatic talipes enquinus has significant advantages over other methods,it is recommended extensive application in clinic.

OBJECTIVE:To observe the efficacy and safety of Fuyanxiao effervescent tablet in the treatment of damp-heat pour-ing downward syndrome of fungal vaginitis. METHODS:80 patients with damp-heat pouring downward syndrome of fungal vagini-tis were randomly divided into control group and observation group. Control group was given one Nystatin vaginal suppository,and the drug was given in the third day after the menstrual period ending,once every night;observation group was given one Fuyanx-iao effervescent tablet,and the drug was given in the third day after the menstrual period ending,once every night. 2%-4% Sodi-um bicarbonate solution was used for vulva cleaning before taking the medicine at night,then patients kept lying flat to let the med-icine going into the vaginal depths. There were totally 3 treatment courses with 7 days each. During the treatment,sexual activities and antibiotics were prohibited. The clinical efficacy,TCM symptom scores,vaginal lactobacillus positive rate and recurrence rate before and after treatment,and incidence of adverse reactions in 2 groups were observed. RESULTS:There were no significant dif-ferences in the total effective rate,recurrence rate and incidence of adverse reactions (P>0.05). Before treatment,there were no significant differences in the TCM symptoms and vaginal lactobacillus positive rate(P>0.05);after treatment,TCM symptoms in 2 groups were significantly lower than before,genital itching,leucorrhea color-quality and lower abdomen pain in observation group were significantly lower than control group,vaginal lactobacillus positive rate in observation group were significantly higher than before and control group,the differences were statistically significant (P<0.05),and there was no significant difference in the vaginal lactobacillus positive rate(P>0.05). CONCLUSIONS:Fuyanxiao effervescent tablet shows good efficacy in the treat-ment of damp-heat pouring downward syndrome of fungal vaginitis and improve clinical symptoms,with no recurrence rate and good safety.

Chronic rhinosinusitis (CRS) is a common disease in otolaryngology, and with the development of the therapy technology, most of the cases have reached a cure. But there are still some intractable cases in clinic, signs and symptoms of chronic rhinosinusitis of which still persist after the standardized drugs and technically adequate endoscopic sinus surgery, and this part is clinically named refractory chronic rhinosinusitis (RCRS). In recent studies of the pathogenesis of RCRS, bacterial biofilm (BBF) is attracting more attention. The main emphasis of this review will be to highlight the biological characteristics of BBF, the relationship of BBF and CRS and treatment strategies of BBF positive CRS.
Biofilms ; Chronic Disease ; Humans ; Rhinitis ; etiology ; microbiology ; Sinusitis ; etiology ; microbiology

[Objective]To investigate surgical protocol for treatment of thoracolumbar fracture with ankylosing spondylitis. [Method]A retrospective study was performed in 8 thoracolumbar-fracture patients with ankylosing spondylitis. Of them, 6 patients were neurological intact and 2 had neurological defect(Frankel grades the C level). Under general anesthesia, all of the 8 patients underwent open reduction and internal fixation with pedicle screws at two segments in both ends of the fracture. Laminectomy for decompression of the nerve tissue was performed in the 2 patients with neurological defect simultaneously.[Result]All of the 8 patients were followed up for 8 to 30 months. Solid bone healing was achieved in all of the patients. Two patients with eurological compromise had improved by two Frankel grades (complete recovery).[Conclusion]Thoracolumbar fracture in ankylosing spondylitis traverse both bone and ligaments, producing an extremely unstable situation similar to a shearing type of fracture. Reduction of the displacement and stabilization is best achieved with a pedicle screw system at two segments in both ends of the fracture.

BACKGROUND:Choosing internal fixator implants with good strength and stiffness is the key to repair femoral neck combined with ipsilateral subtrochanteric fractures. OBJECTIVE:To compare the biomechanical properties of different implant fixation for femoral neck combined with ipsilateral subtrochanteric fractures. METHODS:Totaly 24 adult antiseptic cadaver specimens were used to produce fracture models with femoral neck fracture combined with 5 cm of ipsilateral subtrochanteri medical cortical defect, and were divided into femoral proximal locking plate group, lengthening proximal femur anti-rotation intramedulary nail group and lengthening proximal femoral nail group according to the random number table method. The results of axial compression test, torsion test and axial compression failure rest in three groups were compared. RESULTS AND CONCLUSION: The axial compressive stiffness and failure load in lengthening proximal femur anti-rotation intramedulary nail group were significantly greater than those in femoral proximal locking plate group and lengthening proximal femoral nail group, and those in lengthening proximal femoral nail group were significantly greater than those in femoral proximal locking plate group (P < 0.05). The torsional stiffness in femoral proximal locking plate group was significantly greater than that in lengthening proximal femur anti-rotation intramedulary nail group and lengthening proximal femoral nail group, and that in lengthening proximal femur anti-rotation intramedulary nail group was significantly greater than that in lengthening proximal femoral nail group (P < 0.05). The indexes of biomechanical properties of specimens at the 4thand 8th weeks after fixation in three groups were slightly increased compared with those in 0 week after surgery, but the difference was no statisticaly significant (P > 0.05). These results demonstrate that to a certain extent, compared with the femoral proximal locking plate and lengthening lengthening proximal femoral nail, lengthening proximal femur anti-rotation intramedulary nail fixation for repair of femoral neck combined with ipsilateral subtrochanteric fractures has more biomechanical advantages.

Objective To study the mechanism of chemotherapy resistance caused by interleukin-6 (IL-6) in ovarian cancer cells and its related signal pathways. Methods Ovarian cancer cell lines A2780(IL-6 receptor positive, while non-IL-6-expressing and cisplatin/paclitaxel-responsive) and SKOV3 cell lines( overexpressing of IL-6 receptor and IL-6 and cisplatin/paclitaxel-resistant) were suitable models for this study. The effect of exogenous (a short period of treatment with recombination IL-6) and endogenous IL-6(by transfecting with plasmid encoding for sense IL-6 ) in A2780 cells or deleting of endogenous IL-6expression in SKOV3 cells (by transfecting with plasmid encoding for antisense IL-6) on the sensitivity to cisplatin and paclitaxel was investigated. Meanwhile, the mechanism of chemotherapy resistance caused by IL-6 in ovarian cancer cells and its related signal pathways were also analyzed. Results We found that both exogenous and endogenous IL-6 induce cisplatin and paclitaxel resistance in non-IL-6-expressing A2780 cells (the resistance multiple to cisplatin and paclitaxel was: exogenous, 6. 25 and 7.31; endogenous, 7. 13 -8. 34 and 7. 61 - 10. 70), while deleting of endogenous IL-6 expression in IL-6-overexpressing SKOV3 cells promotes its sensitivity to anticancer drugs ( the resistance multiple to cisplatin and paclitaxel was 0. 15 and 0. 10, 0. 10 and 0. 08). IL-6 significantly up-regulated the expression levels of mRNA and protein of drug resistance-associated genes, MDR1 and GST-π, and apoptosis-inhibiting genes, bcl-2, bcl-xL and XIAP in a dose-dependent manner in A2780 cells. In accordance with this finding, the mRNA and protein levels of MDR1 and GST-π enhanced in sense IL-6-transfected A2780 cells, and reduced in antisense IL-6-transfected SKOV3 cells compared with the corresponding parental and control vector-transfected cells, which had no difference. It was found that PD98059 [ mitogen-activated protein kinase-extracellular signalregulated kinase (MEK) inhibitor ] and wortmannin [ phosphatidylinositol 3-kinase (PI3K) inhibitor ]significantly antagonized IL-6-induced phosphorylation of extracellular signal-regulated kinase ( ERK ) and protein kinase B (Akt), respectively, and both of them blocked IL-6-induced cisplatin and paclitaxel resistance and the inhibitory effects of PD98059 and wortmannin were dependent on its concentration.Conclusions These data suggest that IL-6-induced chemoresistance may be associated with increase of both drug resistance-associated genes ( MDR1 and GST-π) and apoptosis-inhibiting genes ( bcl-2, bcl-xL and XIAP), and activation of MEK/ERK and PL3K/Akt. Therefore, modulation of IL-6 expression or its related signaling pathway may be a promising strategy of treatment for drug-resistant ovarian cancer.

According to the alanine aminotransferase (ALT)level, 4 509 patients were assigned into group A (n=449, with raised ALT)and group B (n=4 060, normal ALT). Between the patients of group A and B, differences existed in age [(48.5 ± 11.3 vs 55.7 ± 11.4) years, P＜0.01], duration of diabetes [( 36.8 ±45.0 vs 56.2±58.8 ) months, P＜0. 01], body mass index[BMI, (27.7±3.9 vs 25.8±3.4) kg/m2, P＜0.01], waist-tohip ratio (0.95±0.06 vs 0. 93±0.07, P＜0. 01 ), diastolic blood pressure [( 78± 10 vs 75± 10) mm Hg, 1 mm Hg=0. 133 kPa, P＜0. 01], fasting blood glucose [(9.04±2.91 vs 8.63 ±3.05 ) mmol/L, P = 0. 008], 2 h blood glucose after meal[( 13.85±4.67 vs 13.07 ± 4. 92 ) mmol/L, P=0. 002], HbA1c(8. 11% ± 1.82% vs 7.74% ±1.96%, P＜0. 01 ), fasting serum insulin[( 10.59±7.31 vs 7.97±7.18) mU/L, P＜0. 01], postprandial insulin [(48.96±43.80 vs 35.25 ±32.37 ) mU/L, P＜0. 01], homeostasis model assessment for insulin resistance ( HOMA-IR, 4.11±-2.85 vs 3.00 ± 2.92, P＜ 0. 01 )、 triglycerides [( 2.77 ± 2.50 vs 2. 19 ± 2.99 ) mmol/L, P＜0. 01], and high-density lipoprotein-cholesterol [HDL-C, ( 1.20 ± 0. 30 vs 1.29 ± 0. 83 ) mmol/L, P = 0. 01].Logistic regression analysis showed that HbA1C, postprandial insulin, and HOMA-IR, uric acid and urinary albumin were positively, and HDL-C negatively related with the ALT level. It suggests that raised ALT seems to be an index related to the clustering of cardiovascular risk factors, insulin resistance, and earlier onset of type 2 diabetes.

Primary biliary cholangitis (PBC) is a chronic cholestatic liver disease with unknown etiology, and patients with poor response to ursodeoxycholic acid and obeticholic acid may eventually progress to liver cirrhosis and even liver failure. Liver transplantation is the only effective treatment method for PBC at present. This article elaborates on liver transplantation, survival time after liver transplantation, complications, recurrence of PBC after liver transplantation, and prospects and challenges of liver transplantation in patients with PBC, so as to provide a reference for clinical outcome and treatment after liver transplantation for PBC.

Bile reflux gastritis is a common and frequently occurring disease of the digestive system,and the pathology is diverse.Professor Zhou Xinyou emphasized that the disease primarily affects the gallbladder,liver and stomach,advocating for a comprehensive differentiation of its etiology and pathogenesis across three distinct stages.In the early stage,the gallbladder is dysfunctional,which then affects the stomach;In the intermediate stage,there is congestion in the liver and gallbladder,leading to excessive wood element suppressing the earth element;in the late stage,gastric collaterals damage,with qi deficiency and blood stasis.Professor Zhou Xinyou follows the diagnosis and treatment ideas of"multiple compound methods,comprehensive application,and overall adjustment".For typical clinical symptoms,he has formulated the treatment principles and treatment methods of pain separation,general use,oral bitterness and upset,purging heat and stomach,treating gallbladder and stomach,regulating qi and resolving depression,so as to achieve both symptoms and root causes of treatment,gallbladder and stomach regulation.