OBJECTIVE To explore the process safety management of the details of its application,storage and disinfection.METHODS Poutine managements of every link of the EO disinfection Process such as the responsibility,operation procedure,regularly inspection,etc were carried out.RESULTS There were no accident occured since April,2004,when the EO disinfection machine began to work.Every monitoring sign was within the permitted scope.CONCLUSIONS Strictly management of every key procedure is the safety guarantee for the whole process of EO disinfection.

OBJECTIVE To explore the methods of management of ethylene oxide disinfection and evaluate its effects.METHODS The biological and chemical indicatons were used to monitor the effects in the disinfection process.The operating procedures were carried out strictly.RESULTS In 150 times disinfection processes 4.6% were not up to the standards in the two kinds of indicators.The main reason was incorrect operations in the whole process.CONCLUSIONS Strictly management and correct monitoring are very important to improve the disinfection quality for safety operation.

OBJECTIVE Employing biological and chemical monitoring methods in steam sterilization qualification tests,to assure the qualification of the steam sterilizers. METHODS BI PCD and B-D test pack for three consecutive testings in empty chamber were used to qualify steam sterilizers. RESULTS Biological and chemical monitoring methods were the most effective monitoring techniques for steam sterility assurance. CONCLUSIONS The qualification tests should be executed exactly with the introduction of steam sterilizer in OR sterile supply division to assure medical safety.

?AIM:To investigate the correlation between dry eye and different degrees of diabetic retinopathy ( DR ) in type 2 diabetic patients.?METHODS: In the cross-sectional study, 340 patients (340 eyes) with type 2 diabetes were enrolled. Tear film function tests including tear meniscus height, tear film breakup time ( BUT ) , fluorescein staining, Schirmer Ⅰtest were performed followed by surveying questionnaires about dry eye. Retinal status was evaluated by retinal color photography and indirect ophthalmoscopy exam with dilated pupils to evaluate DR and whether companied by macular edema.?RESULTS:The prevalence of dry eye was 49. 41%. The mean duration of diabetes in patients with dry eye was 11.15±7.07a, while 6.92±5.45a without dry eye(P<0.01). Dry eye had the positive correlation to the development of DR. The incidence of dry eye in people with mild nonproliferative diabetic retinopathy ( NPDR ) , moderate NPDR, severe NPDR and proliferative diabetic retinopathy (PDR) was 1. 097 times, 1. 724 times, 2. 86 times and 5. 43 times respectively, compared with people without DR. The occurrence of dry eye in people with macular edema increased by 3. 697 times compared with people without macular edema.?CONCLUSION: Dry eye was more prevalent in people with type 2 diabetes. The incidence of dry eye increased gradually with the occurrence and development of diabetic retinopathy.

Objective:To investigate the use of proton pump inhibitors ( PPIs) in the patients with cirrhosis or hepatitis in one hospital and evaluate the use rationality .Methods:A retrospective study was carried out on 211 patients with the diagnosis of hepatitis or cirrhosis in the infectious disease ward between 2013 and 2014 , and the use rationality of PPIs was evaluated .Results: A total of 211 cases were inspected, and among them, 192 ones were treated with PPIs (91%) with 62 ones treated with PPIs irrationally, which accounted for 29.3%of the total cases.The main irrational use of PPIs was long treatment course (24.5%), inadequate prophylaxis indications (5.7%) and purposeless use (2.6%).Conclusion: Irrational use of PPI is common in hepatitis or cirrhosis patients . Clinical pharmacists should strengthen pharmaceutical care to improve the rational drug use .

Objective Getting the robust exogenous gene expression vector under the control of porcine insulin promoter, and to lay the foundation for pancreaticβ-cells specific transgene expressing pigs.Method Using porcine insu-lin promoter ( PIP, 1500 bp of the 5′UTR from the porcine INS gene including the first exon and the first intron) to con-struct expression vector, the HindIII restriction site which connected the sequences of PIP and EGFP was designed before ATG, named PIP-HindIII-EGFP.Considering that the different location of restriction site may affect the expression efficien-cy of the transgene, we optimized the expression vector.Firstly the HindIII restriction site was deleted to realize the seam-less connection of PIP and EGFP,the vector was named PIP-EGFP.Also we mutated the 3′intron splicing acceptor site( SA) of the first intron into HindIII restriction site, named as PIP-SA( M)-EGFP.Three different EGFP expression vectors were respectively transfected MIN-6 mouse pancreatic β-cells, pig ear fibroblasts and kidney cells.The transfected cells were cultured for 48 h and harvested for RT-PCR, flow cytometry and Western blot analysis, to analyze and compare the expres-sion efficiency of vectors.Results After transfection,green fluorescence was observed only in MIN-6 mouse pancreaticβ-cells.RT-PCR analysis and product sequencing showed that the three expression vectors did have different stability with in-tron splicing.The PIP-HindIII-EGFP construct and PIP-EGFP vector produced two kinds of mRNA with the first intron spliced and no spliced, indicating the instability of intron splicing.Mutation of the PIP splice site would cause the first in-tron not spliced, while flow cytometry and Western blot displayed that the mutation induced a most efficient expression of the downstream gene.Conclusions A robust and specific β-cells expression vector has been successfully generated by mutating the intron splicing acceptor site of the porcine insulin promoter.It provides the foundation for preparation of pigs with pancreaticβ-cells specifically expressing the transgene.

Objective To evaluate the accuracy of electromyography (EMG) in localizing the compressed nerve root in lumbar intervertebral disc protrusion (LIDP) pre-operatively.Methods Data were collected on 198 cases of LIDP.Of those,152 cases had positive EMG findings and were treated surgically to relieve compression of the nerve roots caused by LIDP.The intra-operative findings were compared with the pre-operative EMG findings.Results The sensitivity of EMG in detecting radiculopathy was 76.8％ (152/198).Among those 152 EMG positive cases,140 were confirmed in the subsequent operation (92.1％),24 clinically suspected cases of single L5 or S1 compression had indicated of both L5 and S1 damage by EMG and subsequently confirmed on surgical exploration.Conclusions Almost all preoperative EMG findings were confirmed in the subsequent operations (92.1％).Moreover,the indication of combined double nerve root damage by EMG was valuable for guiding the surgical procedure.

Objective: To explore the early diaghostic value of thyroid hormone level in patients with left ventricular diastolic dysfunction. Methods: Our work included 4 groups:①Normal control group, n=40,②Impaired left ventricular diastolic function
group, n=40,③Failure of left ventricular diastolic function group, n=41 and④Impaired left ventricular systolic function group, n=40. The cardiac function was assessed by color Doppler lfow imaging and tissue Doppler imaging for the early diastolic mitral lfow velocity (E), the peak early diastolic mitral annular velocity (Em) and the ratio of E/Em. The blood levels of NT-proBNP and FT3, FT4, TSH, rT3 were examined in clinical laboratory.
Results: Blood levels of FT3 and rT3 were different in pair wise comparison among 4 groups, P<0.05, and FT4 and NT-proBNP were different in pair wise comparison among 4 groups, except for Normal control group and Impaired left ventricular diastolic function group, P<0.05. The TSH level was similar among 4 groups, P>0.05. The ratio of E/Em was negatively related to FT3 (r=-0.724, P<0.05) and FT4 (r=-0.49, P<0.05), while positively related to rT3 (r=0.87, P<0.05) and NT-proBNP (r=0.83, P<0.05).
Conclusion: The changes of thyroid hormone level may exist in patients with impaired diastolic function and it may vary with the severity of the cardiac dysfunction. Blood levels of NT-proBNP with thyroid hormone might be used as a reference index for early diagnosis of diastolic dysfunction.

ObjectiveTo investigate the effects and mechanism of rosuvastatin on the expression of tissue factor in cultured human monocyte-macrophages cells which was induced by oxidized low density lipoprotein(ox-LDL).MethodsThe human monocyte-macrophages cells were divided into four groups:control group,ox-LDL group,Poly-inosine monophosphate (Poly Ⅰ) group,rosuvastatin group.The expression of LOX-1mRNA and TF mRNA was assayed by RT-PCR.The ELISA was performed to determine the protein concentration of TF.ResultsCompared with control group,the expression of LOX-1 mRNA and TF mRNA was increased in the ox-LDL group[ (3.25156±0.15772) vs (1±0) ; (2.522451±0.138967) vs (1±0) ],and it was in a concentration-dependent manner (P＜0.01).Compared with the expression of LOX-1 mRNA in the Poly-inosine monophosphate group and rosuvastatin group,TF mRNA were decreased in the ox-LDL group[ (2.95139±0.157253) vs(3.25156±0.15772) ; (2.877343±0.156558) vs(3.25156±0.15772) ; (1.811956±0.169699) vs (2.522451±0.138967) ; (1.687701±0.174647) vs (2.522451±0.138967)],and it was in a concentration-dependent manner(P＜0.05).Compared with control group,the expression of TF in the ox-LDL group was increased [(207.7233±1.154701) vs (184.8467±0.871799) ],and it was in a concentration-dependent manner (P＜0.01).Compared with the Poly-inosine monophosphate group and rosuvastatin group [(197.8733±1.505003) vs (207.7233±1.154701) ;(202.9567±2.722744)vs(207.7233±1.154701) ],the expression of TF in the ox-LDL group were decreased,and it was in a concentration-dependent manner (P＜0.05).ConclusionsLOX-1 may be responsible for the expression of TF in human monocyte-macrophages cells induced by ox-LDL.Rosuvastatin is able to down-regulate the expression of LOX-1mRNA in human monocyte-macrophages cells through oxLDL,and TF mRNA and TF expression can be reduced.

Objective To analyze the complications, treatments and prognosis of simultaneous pancreas-kidney transplantation. Methods Forty cases of simultaneous pancreas-kidney transplantation performed between Dec. 1999 and Jan. 2010 in our center were retrospectively analyzed. Results Regarding surgical complications, 4 cases had severe hematuria after operation,which needed clinical intervention, including 1 patient receiving catheterization in duodenum to stop bleeding. Two patients were treated with continuous bladder irrigation, and the remaining one received surgical haemostasis because of donor's duodenum and bladder anastomotic artery hemorrhage.Abdominal hemorrhage occurred in 4 patients, including pancreatic hemorrhage in 3 cases and duodenal muscularis hemorrhage in one case. All of them received surgical treatment for hemostasis.Abdominal infection occurred in 8 cases: one died of multiple organ failure, 2 cases were cured after drainage of abscess, 2 cases underwent surgical removal of abscess, and 3 cases were cured after antibiotic therapy. In one case of postoperative anastomotic leakage, pancreas was resected. Four cases of postoperative ileus were cured by continuous clysis with traditional Chinese medicine. Seven cases had pulmonary bacterial infections, including one cases associated with fungal infection. They were cured by the anti-infective treatment. Other complication included poor healing in 5 cases and urinary infection in 2 cases. After combined simultaneous pancreas-kidney transplantation, 10 patients received reoperation because of surgical complications (14 operations). The re-operation rate was 25 %, including 2 patients (4 operations) for hematuria, 4 patients for abdominal hemorrhage, 2 patients (3 operations) for abdominal infection, 1 patient for pancreatic venous thrombosis, 1 patient for anastomotic leakage, and 1 patient for pancreatic fistula. Conclusion Although simultaneous pancreas-kidney transplantation provides a successful and effective treatment for diabetics with endstage renal disease, surgical complication is still affecting the pancreas and kidney grafts after transplantation.