Objective To realize the status in the implementation of three industry standards of central sterile sup-ply department (CSSD),and provide a scientific basis for carrying out of the standards. Methods According to three standards,investigation forms were designed by specialists,written survey on 365 hospitals in 9 provinces and field investigation on 1 5 hospitals in 3 provinces were performed,the implementation of three standards were investi-gated.Results Of 365 hospitals,the number of provincial and ministerial level,municipal level,and county level hospitals were 90,87 and 188 respectively. More than 94% of hospitals established CSSD management system and regulations,>90% of hospitals met the requirements of CSSD layout;All hospitals were equipped with pressure steam sterilizer,all levels of hospitals basically equipped with the necessary equipments and facilities;CSSD respon-sible officers of 94.52% (345/365)of hospitals participated in training on standards;69.61% (252/362)of hospi-tals were using or developing CSSD information systems;>92% of the CSSD responsible officers considered that three standards played an important role in facilitating centralized management,and improving the quality of clean-ing,disinfection and sterilization.Conclusion Hospitals need to strengthen the management and training on stand-ards of CSSD,management of loaner instruments and development of information system need to be standardized.

Objective To discuss with micro-tympanoplastic operation with osteo retention on treating cholesteatomatous otitismedis. Methods Choose 33 cases cholesteatomatous otitis medis patients who toke the tympanoplastic with osteo retention operation,then analyze the postulate and method of the operation, curative effect and complication after operation. Results Follow up with those patients by 12-72 months, and when 3-4 months after operation we endoscopiced the ears, could see that 43 cases of patients ear mastoid process and tympanic sinus were covered with epithelium, those mastoid cavity were well epithelial metaplasia;and the middle ear was separate from mastoid cavity; 39 cases patient of transplant eardrums are heal up (39/43, 90.7%). 2 cases have perforation of the tympanic membrane toke place after 4 months and 6 months with the operation, and it will heal up by anti-inflammatory drug and laser burning, 1 case had tympanic sinus hyperplasia with granulation tissue, and also had grassery juice; after taken anti-inflammatory drug and change bandage for 15 weeks, the symptom disappear. 1 case had grassery juice of operation cavity, after taking anti-inflammatory drug and physiotherapy, the symptom disappear in 24 weeks. After operation the pure tone audiometry shows that air conduction raise (16.8±6.8) dB HL, hearing raise up to:79.1%(34/43). Conclusion Base on right indication of operation choose, taken combined therapy of ambi-operation period, focus of infection are thoroughly cleaning up. Tympanoplastic with osteo retention are treating well with patients of cholesteatomatous otitismedis.

Objective To investigate the safety and efficiency of large-dose alcohol sclerotherapy in treating simple hepatic cyst. Methods Patients with hepatic cyst were divided into two groups. One group with 49 patients was treated with small-dose (<80 ml) absolute alcohol instillation. The other one with 32 patients was treated with large-dose (≥80 ml) absolute alcohol instillation. Blood alcohol concentration (BAC) was recorded right after and 30 rain, 1 h,2 h,3 h after the treatment. Diameter of cyst as a parameter of efficiency was recorded and compared between two groups during 1 year follow-up visit. Results Large-dose group was significantly more efficient in treating hepatic cyst than small-dose group. All BAC records were within the safe range and below the legal limit after drinking. BAC reached its peak 30 minutes after the treatment began and then decreased gradually. A significant correlation was found between BAC and the alcohol dosage. Conclusions Ultrasound-guided sclerotherapy with repeated large-dose absolute alcohol instillation is a safe and efficient treatment for simple hepatic cyst from the perspective of BAC.

OBJECTIVE: To evaluate the osteogenetic character and repairing maxillary sinus superior wall fractures capability of calcium phosphate cement (CPC) before and after combined with recombinant human bone morphogenetie protein-7(rhBMP-7). METHOD: A 10 mmX5 mm bone defect in the maxillary sinus superior wall was induced by surgery in all 24 New Zealand white rabbits. These 24 rabbits were randomly divided into two groups. The defects were repaired with CPC group (n = 12) and CPC/rhBMP-7 group (n = 12). The osteogenesis of bone defect was monitored by gro'ss observation, histological examination, observation under scanning electron microscope and measurement of ALP activity at 6 and 12 weeks after the implantation. RESULT: In group CPC,new bone was found to form slowly and little by little. In group CPC/rhBMP-7, however, new bone was observed to form early and massively. The ALP activity in group CPC showed significant statistical difference with that of group CPC/rhBMP-7 (P < 0.05). CONCLUSION The CPC/rhBMP-7 composite has osteoconductibility and osteoinductibility, comparing the use of CPC/rhBMP-7 with CPC for the repair of orbital fracture, the former show obvious advantage repairing ability in maxillary sinus superior wall defect.
Animals ; Bone Cements ; chemistry ; therapeutic use ; Bone Morphogenetic Protein 7 ; therapeutic use ; Calcium Phosphates ; chemistry ; Disease Models, Animal ; Fractures, Bone ; pathology ; surgery ; Humans ; Maxillary Sinus ; pathology ; Osteogenesis ; Rabbits ; Random Allocation ; Recombinant Proteins ; therapeutic use

Objectives:To understand the current situation of premenstrual syndrome (PMS) and type D personality in female college students,and to explore the relationship between them.Methods:Totally 856 female college students were assessed with the Premenstrual Syndrome Scale (PMSS,those with total score of 6 or higher as having PMS) and Type D Personality Scale 14 (DS-14,those negative emotion and social inhibition factor with total score of 10 or higher as having type D personality).Result:A total of 280 students were detected with PMS,and the rote was 32.7％.Totally 272 students were detected with the type D personality,and the rote was 31.8％.The total score of DS-14 and the score of 2 factors were higher in PMS group than in non-PMS group (Ps ＜0.001).The rate of PMS was lower in type D personality group than in non-type D personality group (11.76％ vs.25.34％,P ＜ 0.001).Conclusions:The occurrence of premenstrual syndrome may be related to the type D personality.The evaluation of personality characteristics should be taken into consideration when formulating the intervention program.

OBJECTIVETo explore the effectiveness of absorbable hemostatic fluid gelatin in preventing postoperative cerebrospinal fluid leakage.

METHODSThe clinical data of 17 patients with dura mater tear were retrospectively analyzed from March to September in 2003. There were 16 males and 1 female, aged from 16 to 67 years old with an average of (39.6 ± 15.4) years. The injury site was at cervical vertebrae in 1 case, thoracic vertebrae in 9 cases, thoracolumbar junction in 4 cases, lumbar vertebrae in 3 cases. There were burst fracture in 4 cases and fracture-dislocation in 13 cases. According to ASIA grade, 12 cases were grade A, 2 cases were grade B, 2 cases were grade D, 1 case were grade E. Two cases caused by traffic accident, 10 by high falling, 4 by heavy parts crash, 1 by stairs fell during the earthquake. Absorbable hemostatic fluid gelatins were used to plug the dura mater tear,in order to prevent postoperative cerebrospinal fluid leakage. Postoperative drainage were recorded every day.

RESULTSOf 17 patients, 15 cases did not develop with cerebrospinal fluid leakage. Two cases develop with cerebrospinal fluid leakage after operation and their drainage were removed at 6 to 7 days after operation. In all cases, no complications related with cerebrospinal fluid leakage occurred, such as headache, dizzy, fever,neck resistance, rash, incision disunion, incision infection, hematoma, neurologic symptoms aggravation. No abnormal phenomena was found on incision surrounding at follow-up of 9 months.

CONCLUSIONUsing absorbable hemostatic fluid gelatin to plug the dura mater tear during operation is an effective method in preventing postoperative cerebrospinal fluid leakage.

Adolescent ; Adult ; Aged ; Cerebrospinal Fluid Leak ; prevention & control ; Female ; Gelatin ; administration & dosage ; Hemostatics ; administration & dosage ; Humans ; Male ; Middle Aged ; Postoperative Complications ; prevention & control

Objective To investigate the effects of neutrophil gelatinase associated lipocalin(NGAL) on renal tubular epithelial cells apoptosis and apoptosis-regulated protein fas,bcl-2 in rat renal ischemia reperfusion injury (IRI).Methods Renal IRI models of rats were established.Rats were randomly divided into 3 groups,including control group,IRI model group and NGAL group.The pathological change of kidney tissue was investigated by hemotoxylin-eosin staining.Renal tubular epithelial cells apoptosis was detected by TUNEL method.Expression of fas and bcl-2 was measured by real-time PCR and Western blotting.Results Compared with IRI model group,NGAL group showed a decreased number of renal tubular epithelial cells apoptosis [(8.6±3.4)/HP vs (20.8±3.7)/HP,P＜0.05],down-regulated fas mRNA (2.34±0.51 vs 6.84±2.34,P＜ 0.05),fas protein (0.65±0.05 vs 0.95±0.08,P＜0.05) and up-regulated bcl-2 protein (0.33±0.05 vs 0.24±0.03,P＜0.05),but the bcl-2 mRNA had no significant change.Conclusion NGAL can protect renal tubular epithelial cells in renal IRI,which may be associated with decreasing cell apoptosis and adjusting protein expression by apoptosis-regulated cytokines.

Objective To investigate the curative effects of damage control surgery in treatment of borderline severe multiple fractures.Methods The study involved 37 patients with severe multiple fractures(ISS of 16-42,Pape classification of borderline type)surgically treated from January 2009 to June 2010.All patients underwent staged surgeries according to damage control principles:hemostasis,debridement and provisional fixation were given in the first stage;antishock,anti-coagulation dysfunction,anti-hypothermy,anti-infection were performed in the second stage;definitive operations for fractures were performed as soon as possible in the third stage,provided that their physiological condition was permitted.Results All the patients received effective treatments such as debridement,provisional fixation and antishock in the first and second stages,with no iatrogenic secondary injury.The patients had significant recovery in the 6-14 months of follow-up,with total disability rate of 16％.Conclusion The staged operations according to damage control principles are effective and safe in treatment of borderline severe multiple fractures.

Objective To investigate the effect of tandem mass spectrometry and gas chromatography-mass spectrometry to make prenatal diagnosis of methylmalonic acidemia (MMA) by detecting organic acid and acylcarnitine in amniotic fluid.Methods From October 11,2007 to December 20,2014,131 pregnant women with MMA proband received prenatal diagnosis of MMA in Xin Hua Hospital Affiliated to Shanghai Jiao Tong University School of Medicine (case group).Another 120 cases of pregnant women for conventional prenatal diagnosis at the same period were as control group.The pregnant women of two groups had the amniocentesis at 16 to 20 weeks of gestation.The levels of propionylcarnitine(C3) and acetylcarnitine(C2)in amniotic fluid were detected by tandem mass spectrometry.The methylmalonic acid and methylcitrate acid were detected by gas chromatography-mass spectrometry.MMA gene of cells in amniotic fluid of eighty fetuses with proband clearly diagnosed were detected by gene testing.Data were analyzed by Wilcoxon test.Results In case group,29 fetuses were found positive for higher level of C3,C3/C2,methylmalonic acid and methylcitrate acid compared with normal reference value,and the detected rate of fetal MMA was 22.1％(29/131).The levels of C3 and C3 / C2 in amniotic fluid of these 29 cases were higher than those in control group[8.13(2.42-16.70) vs 1.04(0.52-3.40) μmol/L,Z =-8.313; 0.77(0.30-1.79) vs 0.10(0.05-0.22),Z=-8.374; P ＜ 0.05 respectively].The levels of methylmalonic acid and methylcitrate acid were also higher[9.13(1.68-61.78) vs 0.00(0.00-1.31) mmol/mol Crea,Z=-11.348; 0.58(0.00-1.90) vs 0.05(0.00-0.52) mmol/mol Crea,Z=-6.632,P ＜ 0.05 respectively].For the other 102 cases in case group,the levels of C3,C3/C2,methylmalonic acid and methylcitrate acid were not higher than normal reference value,and were similar to those in control group (P ＞ 0.05); while they were lower than those of positive MMA fetuses (all P ＜ 0.05).Among 29 positive fetuses,16 fetuses were detected MMA gene,five were diagnosed as MUT forms of MMA and 11 were MMACHC forms of MMA.In 102 MMA negative fetuses,64 fetuses were detected MMA gene,44 were found one mutant site and 20 were found no gene mutation.The coincidence rate between gene detecting and mass spectrometry was 100％(80/80).Conclusions Mass spectrometry could be used to measure the C3,methylmalonic acid and methylcitrate acid levels in amniotic fluid of pregnant women with MMA proband to make prenatal diagnosis.

Objective To evaluate the effects of domestic irbesartan on blood pressure and renal function in the aged with primary hypertension.Methods Renal function,plasma and urine β2 microglob ulin WBS measured and blood pressure was investigated by 24-hour ambulatory blood monitoring in 42 aged with primary hypertension who received domestic irbesartan(1 50 mg/d,followed up every 1-2 weeks.If the effect was not ideal,the dose could be added to 300 mg/d)in 8-week's treatment.Results After the treatment.24 hours recall systolic blood pressure,24-hour mean diastolic blood pressure,mean day systolic blood pressure,mean day diastolic blood pressure,mean night systolic blood pressure,mean night diastolic blood pressure were significantly reduced.At the same time,domestic irbesartan induced a remarkable reduction of plasma and urine β2 microglobulin [(5.9±3.3)μg/L vs(2.6±2.6)μg/L, (811.2±97.2) mmol/L vs(457.6±69.8)mmol/L,respectively].Conclusion The antihypertensive effects of domestic irbesartan can persist for 24-hour and Can reduce urinary protein.