OBJECTIVE To understand the status of medical wastes sorting disposal and the use of sharp containers in the second-level hospitals. METHODS The status of medical wastes sorting disposal and the use of sharp containers in some of the second-level hospitals in Zunyi City,Guizhou Province were investigated. RESULTS It was 77.8% where the medical wastes were sorted,packed and signed,It was 55.6% and 22.2%,respectively,where the plastic infusion bottles and the glass seal bottles were sorting and placed as recycle wastes. It was 33.3% where the hospitals used sharp containers according to the requirement of the People's Republic of China(PRC). CONCLUSIONS Partial second-level hospitals lack of enough recognition to the medical wastes management,and do not perform strictly these rules; therefore,all of the hospitals should strengthen the study of medical policies and regulations,the management of medical wastes should be standardized. The hospitals should use the wrapping sack and sharp containers making of regular factories and conforming to the national requirement for decreasing the environmental pollution of medical wastes and the sharps injury in the health care workers,and the management of recycle medical waste should be strengthened.

Objective To assess the long-term survival and prognosfie factors in a series of patients with distal bile duet carcinoma. Methods A retrospective clinical analysis was made on 76 cases of distal bile duct cancer who were admitted into our hospital from January 1996 to December 2006. Clinicopathologic factors with possible prognostic significanees were selected and analyzed. Survival was calculated with the Kaplan-Meier method. A multivariate analysis of these individuals was performed using the Cox proportional Hazards Model. Results There were 46 males and 30 females. The age ranged from 21 to 88 years with a mean of 65.21 patients received palliative surgery including, bypass procedure, intraoperative biliary stenting, or percutaneous transhepatie biliary drainage. Radical resection was performed on 42 cases and the 1-, 3- and 5-yeur survival rates were 88.0%, 41.3% and 29.2% respectively. 38 cases died of liver metastasis or recurrence. In multivariate analysis, surgical procedure (P = 0.006) and liver metastasis (P = 0.008), but not sex, age, invasion of pancreas, invasion of duodenum, diameter or differentiation of tumor, were significant independent prognostic factors. Conclusions Radical resection is only curative treatment modality. Prevention on postoperative liver metastasis is essential for improving survival.

Objective To investigate the correlation between VEGF-C and COX-2 expression in human rectal cancers and its significance in cancer metastasis. Methods VEGF-C expression was detected with Western blot in LOVO cells treated with NS-398 or PGE2. VEGF-C and COX-2 expression in 45 rectal adenocarcinomas was tested with immunohistochemistry. Results NS-398 inhibited the VEGF-C expression, and PGE2 up-regulated the expression of VEGF-C in a dosage-dependent way in LOVO cells. VEGF-C expression was significantly higher in adenocarcinomas with lymph node metastasis, and was related with the expression of COX-2 in 45 rectal adenocarcinomas. Conclusion COX-2 up-regulates VEGF-C and VEGF-C plays an important role in lymphatic metastasis of rectal cancers.

Objective To evaluate clinical risk factors for Meropenem resistant Pseudomonas aeruginosa (MRPA) infection in surgical intensive care unit. Methods Retrospective case-control study was designed. Resultant MRPA and Meropenem sensitive Pseudomonas aeruginosa ( MSPA) cases were paired with respective control group. Candidate clinical factors including gender, malignancy, duration of ICU stay, length of operation, volume of blood loss, transfusion, kind of incision ( clean/contaminated/ infected) , and previous antibiotics history were examined by bivariates and multivariate regression. Results Risk factors for MRPA infection included duration of ICU stay before infection (odds ratio [ OR] = 2. 234, 95% confidence interval [ CI] = 1. 710 - 2. 918), administration of third generation cephalosporins (OR = 2. 885, 95% CI = 1. 133 - 7. 345) and Imipenem ( OR = 1. 238, 95% CI = 1. 469 - 35. 659). A long ICU stay (OR = 2. 284, 95% CI = 1. 772 - 2. 945), malignancy (OR =4.796, 95%CI = 2.001 -11.491), previous medication of quinolones ( OR = 3.563, 95% CI = 1.499 - 8.468) and third generation cephalosporins (OR = 3. 796, 95% CI = 1. 543 - 9. 343) were associated with MSPA infection. Conclusion MRPA infection was affected by multiple clinical factors. Short ICU stay, restrict use of third generation cephalosporins and Imipenem may help to prevent MRPA infection.

OBJECTIVES To analyse the diagnosis and treatment of 24 hereditary nonpolyposis colorectal cancer (HNPCC) kindreds and report mismatch repair gene mutations. METHODS The diagnosis, treatment and follow-up of 24 HNPCC kindreds were reviewed retrospectively, cancer incidence and spectrum were recorded. Clinical characteristics and treatment were analyzed. Peripherial blood and genomic DNA were extracted from family members who had provided informed consent. PCR and SSCP were used to screen coding regions of the hMLH1 and hMSH2 genes. Variant bands were sequenced by 377 DNA sequencer after purification. RESULTS One hundred and 25 malignant neoplasms were diagnosed in 75 patients (multiple cancers in 24) with an average age of 51 years in 24 pedigrees. The onset of the disease occurred earlier than expected with the passing of each generation within large kindreds. The neoplasm mainly included colonic cancer (63 patients), rectal cancer(21), stomach cancer(13), endometric cancer(7), and esophageal cancers(6). 84% patients received radical operations. Of 64 patients with colorectal cancer 16 had metachronous colorectal cancer. 24% colorectal patients developed metachronous cancer within 10 years after initial operation and received re-operation. In 3 detected families with germline hMSH2 and hMLH1 mutations resulting in truncated protein, 12 carriers were found. CONCLUSIONS The main characteristics of hereditary nonpolyposis colorectal cancer include early onset and frequence of cancer; predominance of colorectal cancer, especially right-sided colonic cancer; frequency of multiple primary cancer, especially colorectal cancer; and age anticipation in large HNPCC pedigrees. Segmental resection of colorectal cancer is not suitable for colorectal cancer patient in HNPCC kindred. Intensive follow-up is important for all patients and possible gene carriers.
Adaptor Proteins, Signal Transducing ; Adult ; Aged ; Carrier Proteins ; Colorectal Neoplasms, Hereditary Nonpolyposis ; diagnosis ; genetics ; therapy ; DNA-Binding Proteins ; Female ; Humans ; Male ; Middle Aged ; MutL Protein Homolog 1 ; MutS Homolog 2 Protein ; Mutation ; Neoplasm Proteins ; genetics ; Nuclear Proteins ; Proto-Oncogene Proteins ; genetics