Objective To establish emergency disposal procedures of healthcare-associated infection(HAI) in Pudong New Area, evaluate on-site investigation method, identify the key links and risk factors for infection, and timely control HAI outbreak.Methods From January 2012 to December 2014, epidemiological investigation on HAI outbreaks in 65 hospitals in Pudong New Area was performed, emergency plan for disposal procedures of HAI was initiated, the emergency disposal procedures of each event was evaluated by experts.Results There were 6 infection outbreaks occurred in Pudong New Area from January 2012 to December 2014, all were HAI, and no community-associated infection existed simultaneously;6 cases of HAI outbreaks involved 119 persons, the major were hospitalized patients (n=99,83.19%) and care workers (n=16,13.45%);5 outbreaks all detected Norovirus, the main transmission route wasclose contact of nurses with patients during care for patients;the evaluation of each incident revealed that the total score was >90.Conclusion The emergency disposal procedure of HAI suitable for Pudong New Area has been established, the effect is good and proved effective according to the expert evaluation on practical outbreaks.

Objective To demonstrate the possibility when discriminating between severe and nonsevere tricuspid regurgitation by E-wave velocity in tricuspid flow.Methods The peak velocity of the tricuspid inflow E-wave was measured in 107 patients,who were divided into mild group(n =39),moderate group(n =42)and severe group(n =26)according to the degree of tricuspid regurgitation(TR).Results Peak E-wave velocity of mild group,moderate group and severe group was (48.6 ±13.8)cm/s,(47.4 ±11.7)cm/s,and (78.3 ±26.1)cm/s, respectively.Mean E-wave velocity of mild group and moderate group were similar,which were lower than that of severe group (P <0.01).A peak E-wave velocity of over 62 cm/s had a sensitivity of 71% and specificity of 92% for the detection of severe TR.Conclusion Increased peak tricuspid E-wave velocity is associated with severe TR and thus can be used as a simple measure of TR grade.

Objective To examine the association of serum 25-hydroxyvitamin D levels with arterial stiffness and left ventricular hypertrophy (LVH) in elderly hypertension patients.Methods We recruited 166 elderly patients [mean age,(80.8 ± 6.2) years] with primary hypertension.Arterial stiffness was assessed by carotid femoral pulse wave velocity (cfPWV).Left ventricular mass index (LVMI) was determined according to the Devereux formula.Based on serum 25-hydroxyvitamin D levels,the patients were divided into two groups,the low 25-hydroxyvitamin D group (＜20 μg/L)and the high 25-hydroxyvitamin D group (≥20 μg/L).Results Faster cfPWV and larger LVMI values were observed in the low 25-hydroxyvitamin D group as compared with the high 25-hydroxyvitamin Dgroup [(15.00±3.04) m/s vs.(11.26±3.09) m/s;(120.14±25.82) g/m2 vs.(96.74±23.10) g/m2 ; t=-6.79,-5.16,respectively; both P=0.000].Multiple liner regression analysis showed that the 25-hydroxyvitamin D level was independently associated with LVMI (β=0.215,P=0.001) and cfPWV (β=-0.469,P＜0.001).Conclusions Serum 25-hyroxyvitamin D is independently associated with arterial stiffness,LVH Vitamin D may play an important role in the pathogenesis of arterial stiffness and LVH in elderly hypertension patients.

Objective:To explore the validity of a function assessing tool based on the International Classification of Functioning, Disability and Health′s (ICF′s) rehabilitation set in assessing aging-related disability.Methods:A total of 1610 elderly people from 15 nursing homes across China were assessed using the tool based on the ICF′s rehabilitation set and with the 12-item short form health survey (SF-12). The structural validity of the responses was analyzed using factor analysis, and criterion-related validity was also evaluated.Results:The factor analysis yielded three factors with eigenvalues greater than 1. Their cumulative explanatory power was 74.4%. Item d550 eating had double loading in the factor analysis. The item scores and the total scores of the disability assessment tool were significantly negatively correlated with the physiological function domain scores and the psychological function domain scores.Conclusion:The function assessment tool based on the ICF′s rehabilitation set when combined with a numerical rating scale has good structural and criterion-related validity in the assessment of disability due to aging.

Objective To investigate the expression of alpha 7 nicotinic acetylcholine receptor (α7 nAchR), cholinesterase (AChE), choline acetyl translocase (ChaT) after sevoflurane anesthesia. Methods A total of 120 healthy Sprague-Dawley rats with both two genders, aged 1 week, were randomly divided into 5 groups: blank group; air/O2 group; sevoflurane group (group SEV); α7 nAchR agonist group (group PUN); α7 nAchR antagonist group (group MLA), 24 in each group. Blank group received free feeding, air/O2 group was inhaled 60％ oxygen (carrier gas: 1 L/min O2+1 L/min air) 2 h; group SEV was inhaled 3.4％ sevoflurane and carrier gas for 2 h; group PUN and group MLA were injected with PNU-282987 and methyllycaconitine, respectively, after 24 h inhaled of 3.4％ sevoflurane and carrier gas for 2 h. After that, hippocampus dissection carried out in 2 h, 1 w, 4 w, and Western blot method was used to detect α7 nAchR, AChE, ChaT proteins expression. Results Two hours after anesthesia recovery, α7 nAchR in groups SEV, PNU and MLA was significantly lower than that in air/O2 group (P ＜ 0.05); AChE in groups PNU and MLA was significantly lower than that in air/O2 group (P ＜ 0.05); ChaT in groups SEV, PNU and MLA was significantly lower than that in air/O2 group (P ＜ 0.05). One week after anesthesia recovery, α7 nAchR in blank group and groups SEV and PNU was significantly higher than that in air/O2 group (P ＜ 0.05), α7 nAchR in group MLA was significantly lower than that in air/O2 group (P ＜ 0.05); AChE in blank group and and group PNU was significantly higher than that in air/O2 group (P ＜ 0.05), ChaT in blank group was significantly higher than that in air/O2 group (P ＜ 0.05), ChaT in group SEV was significantly lower than that in air/O2 group (P ＜ 0.05). Four weeks after anesthesia awake, AChE in each group was not statistically significant; α7 nAchR in group SEV was significantly higher than that in blank group (P ＜ 0.05), α7 nAchR in group PNU and MLA was significantly lower than that in blank group (P ＜ 0.05); ChaT in blank group and group PNU was significantly lower than that in air/O2 group (P ＜ 0.05), ChaT in group MLA was significantly higher than that in air/O2 group (P ＜ 0.05). Conclusion Sevoflurane inhalation can inhibit ChaT, α7 nAChR, which had no direct effect on AChE; α7 nAChR agonist can effectively help α7 nAChR and ChaT inhibition inhaled sevoflurane, and reached a peak at about 1 week; oxygen concentration around 60％ can increase α7 nAChR expression quantity, to a certain extent against sevoflurane inhibition.

BACKGROUND:Root canal preparation is a key step in root canal therapy.In recent years,with the rapid development of new nickel-titanium instruments,the results of root canal shaping ability have been significantly improved.However,the shaping abilities of different nickel-titanium instruments are also different.At present,there are few reports about the influence of the shaping ability of R-phase heat treatment NIC X-FILE and DENCO Pre-Shaper in simulated curved canals. OBJECTIVE:To compare the shaping effect of NIC X-FILE and DENCO Pre-Shaper nickel-titanium instruments in preparation for simulated curved canals. METHODS:Fifty simulated resin-curved canals were selected and randomly divided into two groups(n=25).NIC X-FILE and DENCO Pre-Shaper nickel-titanium files were used for root canal preparation.The root canal preparation time was recorded.Images of pre-and post-root canal preparation were taken.Image processing and analysis software were used to measure the amount of resin removed from the inner and outer walls of the root canal at each observation point.Statistical software was used to compare the root canal preparation time and centering ability of two kinds of mechanical nickel-titanium files. RESULTS AND CONCLUSION:(1)The average root canal preparation time was(1.58±0.02)minutes in the DENCO Pre-Shaper group and(2.22±0.03)minutes in the NIC X-FILE group.There was a significant difference between the two groups(P<0.05).(2)The amount of resin removed from the inner walls of the root canal of the DENCO Pre-Shaper group at 4,5,7,8,9,and 10 mm from the apical foramen was higher than that of the NIC X-FILE group(P<0.05).The amount of resin removed from the outer walls of the root canal of the DENCO Pre-Shaper group at 3,5,6,7,and 8 mm from the apical foramen was lower than that of the NIC X-FILE group(P<0.05).(3)At 2,4,5,6,7,8,and 9 mm away from apical foramen,the centering ability of the NIC X-FILE group was better than that of the DENCO Pre-Shaper group(P<0.05),and the centering ability of the NIC X-FILE group was the best at 4 mm away from apical foramen.(4)The results show that DENCO Pre-Shaper has higher mechanical efficiency than NIC X-FILE nickel-titanium root canal files.However,the centering ability of DENCO Pre-Shaper is inferior to NIC X-FILE nickel-titanium root canal files.

Objective To evaluate the changes in the expression of hippocampal α7 nicotinic ace-tylcholine receptor (α7nAChR) , acetylcholinesterase ( AChE) and choline acetyltransferase ( ChAT) after sevoflurane anesthesia in neonatal rats. Methods Seventy-two healthy Sprague-Dawley rats of both sexes, aged 7 days, weighing 25-40 g, were divided into 3 groups ( n=24 each) using a random number table method: control group ( group C) , air and oxygen group ( group A∕O) and sevoflurane group ( group S) . Rats were exposed to carrier gas ( air 1 L∕min plus oxygen 1 L∕min) for 2 h in group A∕O. Rats were ex-posed to 3. 4％ sevoflurane in carrier gas for 2 h in group S. Eight rats in each group were selected at 2 h, 1 week and 4 weeks after the end of inhalation, and sacrificed, brains were removed and hippocampal tis-sues were obtained for determination of α7nAChR, AChE and ChAT protein and mRNA by Western blot and real-time polymerase chain reaction, respectively. Results Compared with group A∕O, the expression of α7nAChR mRNA was significantly down-regulated at each time point after the end of inhalation, and the expression of TnAChR was down-regulated at 2 h after the end of inhalation and up-regulated at 1 week after the end of inhalation, the expression of AChE mRNA was up-regulated at 2 h after the end of inhalation and down-regulated at 4 weeks after the end of inhalation, the expression of AChE was down-regulated at 4 weeks after the end of inhalation, the expression of ChAT mRNA was up-regulated at 2 h after the end of in-halation, and the expression of ChAT was down-regulated at each time point after the end of inhalation in group S ( P<0. 05) . Conclusion The expression of hippocampal α7nAChR is down-regulated at first and then up-regulated after sevoflurane anesthesia, the expression of ChAT and AchE in the later period is down-regulated, the tendency of protein expression mentioned above is different from that of its mRNA ex-pression, suggesting that sevoflurane may affect the protein expression through other pathways.

Objective:To evaluate effect of addition and subtraction therapy of Buyang Huanwutang combined with Si Junzitang and acupuncture to poststroke fatigue （PSF） and syndrome of Qi deficiency and blood stasis， at the same time we studied the antioxidant and anti-inflammatory effects. Method:One hundred and forty-four patients were randomly divided into control group and observation group （1∶1） by random number table. 66 patients in control group completed the therapy （4 patients were falling off or missing visit， 2 patients were eliminate）， 67 patients in observation group completed the therapy （2 patients were falling off or missing visit， 3 patients were eliminate）. In control group， patinets got acupuncture， 1 time/day， 6 times/week， they also got Geqi Tongmai grain， 10 g/time， 3 times/day. Patients in observation group got acupuncture （the same as which in control group）， and addition and subtraction therapy of Buyang Huanwutang combined with Si Junzitang， 1 dose/day， and courses of treatment in two groups were 4 weeks. Before and after treatment， fatigue severity scale （FSS）， NIH stroke scale （NIHSS）， syndrome of Qi deficiency and blood stasis， stroke specific quality of life scale （SS-QOL）， and scores of ability of daily life （ADL） were recorded. And levels of superoxide dismutase （SOD）， malondialdehyde （MDA）， glutathione peroxidase （GSH-Px）， homocysteine （Hcy）， interleukin-1β （IL-1β）， IL-6， tumor necrosis factor-α （TNF-α） and C-reactive protein （CRP） were detected. And the safety evaluated. Result:Disease effect in observation group was better than which in control group （Z=2.118， P<0.05）. And effect after using traditional Chinese medicine （TCM） was also better than that in control group （Z=2.046， P<0.05）. Scores of FSS， syndrome of Qi deficiency and blood stasis， NIHSS， and levels of IL-1β， IL-6， Hcy， CRP， TNF-α and MDA in observation group were all lower than those in control group （P<0.01）， and scores of SS-QOL， ADL， and levels of GSH-Px and SOD were all higher than those in control group （P<0.01）. Then there was no related safety issues caused by drug. Conclusion:Addition and subtraction therapy of Buyang Huanwutang combined with Si Junzitang and acupuncture had effect of anti-oxidation and anti-inflammatory， and can significantly reduce fatigue and degree of neurological impairment and can improve patients' quality of life and daily life ability. The clinical effect is significant and safe， which is worthy of further research and application.