Objective To select a practical and reliable method in cleaning and disinfecting endo-scope, and to investigate the efficacy of endoscope disinfection. Methods A study was done on the disinfection efficacy using or not using enzyme cleaning plus 2% glutaraldehyde immersion, and disinfection efficacy of automated washer/disinfectors for endoscopes at tertiary hospitals in Beijing. Results In 301 cases of en-doscopes cleaned with enzyme ( Epizyme rapid multi enzyme cleanse) and immersed in 2% glutaraldehyde for 7 minutes, culture was negative in 283 cases (94. 02% ) ; in 155 cases without enzyme cleaning but with immersion for 7 minutes in 2% glutaraldehyde, culture was negative in 137 cases (88. 39 % ). Taking 20 or less bacteria per endoscope as the eligibility criterion, there were 298(99.00% ) and 147(94. 84% ) cases eligible in enzyme treated and enzyme untreated group respectively , P

Objective To investigate the incidences of malnutrition (including undernutrition, overweight, and obesity) and abdominal obesity in elderly type 2 diabetes. Methods Totally, 133 elderly type 2 diabetes patients [study group, aged (66.9 5±.4) years] and 133 age-matched healthy subjects [control group, aged (66. 3 ±5.8) years] who met entry criteria and obtained informed consent were randomly enrolled into this study. Body weight, total body fat (TBF), abdominal fat, visceral fat, visceral fat area, and waist-to-hip ratio (WHR) were measured by multi-frequency bioelectric impedance analysis. The incidences of undernutrition, overweight, obesity, and abdominal obesity judged by BMI and WHR respectively were compared between the two groups. Results Com- pared to control group, BMI [(25.7 3.8) vs. (24.2 2.2) kg/m2, P = 0.001 ], TBF [ (20.1±6.9) vs. (17.4 5.0) kg, P = 0.001], WHR (0. 92±0.10 vs. 0.87±0.06, P =0.001), abdominal fat [(10.2 3.4) vs. (8.6 2.5)kg, P= 0.001], visceral fat [(2.7±0.9) w. (2.3 0.7)kg, P =0.001 ], and visceral fat area [ (89.1±28. 8) vs. (75. 7±21. 6) cm2, P =0.001 ] significantly increased in study group. The incidences of undernutrition (BMI<18.5, 3.8% vs. 0, P=0.024) and obesity (BMI^28.0, 26.3% vs. 6.0%, P = 0.001) judged by BMI Chinese standard in study group were significantly higher than those in control group. The incidences of "over-TBF" (52. 1% vs. 34. 1% , P =0.023) and abdominal obesity in males of study group (83.6% vs. 67.1% , P =0. 017) were significantly higher than those in control group. Conclusion Measurement and control of TBF, waist circumference, and abdominal and visceral fats should be emphasized in elderly patients with type 2 diabetes.

Antiviral therapy is the most important treatment for chronic hepatitis C.This paper reviews the progress in antiviral treatment o-ver recent years,including the combination therapy with polyethylene glycol-Interferon (PEG-IFN)and ribavirin (RBV),specific target therapy,and gene therapy.The paper believes that the anti-hepatitis C virus treatment needs more effective drug combination therapies, shorter courses,less side effect,higher drug resistance threshold,etc.

Hospitalization expenses constitute the main part of the compensation of medical insurance.The aim of this paper is to analyze the variation of medical expenses of hospitalized patients with medical insurance in different modes of accounting,find the influencing factors in accounting quotas on hospitalization expenses,and set up a scientific and reasonable mode of accounting with a full consideration of the huge demands of medical resources.

Objective To investigate the clinical efficacy of adefovir dipivoxil in antiviral treatment of chronic hepatitis B and its effect on peripheral blood T lymphocyte subsets.Methods 40 cases of patients with chronic hepatitis B were selected from The Fourth People’s Hospital of Qinghai in October 2009 to June 2012,the patients were given the antiviral treatment of adefovir dipivoxil.Before treatment,3 months,6 months and 12 months after treatment,the changes of liver function indicators of alanine transaminase(ALT),aspartate transaminase(AST)and total bilirubin(TBiL),and hepatitis B virus-DNA(HBV-DNA)were recorded;the total effective rate was observed;the peripheral blood T lymphocyte subsets changes was tested and analyzed by flow cytometry.Results The ALT,AST and TBiL of the patients all improved good,and the indicators of ALT,AST and TBiL after 12 months decreased significantly than before treatment,the HBV-DNA testing of the patients recovered negative,the difference was statistically significant (P<0.05 );the total effective rate of hepatitis B patients is 92.5%;the peripheral blood T lymphocyte subsets has no significant improvement in patients after antiviral treatment for 3 months.After the treatment for 6 months and 12 months,the CD4 +T and CD4 +/CD8 +T were significantly higher than those before treatment,there was no significant changes in CD3 +T and CD8 +T before and after treatment.Conclusion Adefovir dipivoxil has a good clinical efficacy in antiviral treatment of chronic hepatitis B,and can significantly improve the patients’liver function,improve peripheral blood T lymphocyte subsets imbalance.

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 explore the associations of anxiety with optimism ,resilience and related demographic factors in lung cancer patients , and to provide a scientific basis for reducing the level of anxiety and improving the psychosomatic health. Methods A total of 130 lung cancer pa-tients from the department internal medicine of respiratory tumors in Liaoning Cancer Hospital&Institute were investigated by convenience sam-pling method from February 2013 to January 2014. The survey was anonymous. Finally,107 questionnaires were effective,and the effective rate was 82.307%. Results Among lung cancer patients,optimism and resilience were positively and significantly associated with anxiety. Physical ex-ercise had an effect on the anxiety symptoms. Conclusion Optimism and resilience have significant predictive value on the anxiety among lung cancer patients. It is important to encourage lung cancer patients to improve their psychological health ,so as to reduce their anxiety symptoms effec-tively.

With the development of business of manned spaceflight, the body damage of astronauts on the space en-vironment has received growing concern. Weight loss is the most important cause of various diseases, and the weightlessness muscle atrophy is one of urgent problems to be solved in aerospace medicine. Although there is no concept of weightlessness or weightlessness muscle atrophy in the theory of traditional Chinese medicine (TCM), TCM can grasp the pathogenesis of complex diseases, and provide important theoretical references for the prevention and management of weightlessness diseases, especially weightlessness muscle atrophy. In this paper, TCM Cognition of weightlessness and the pathogenesis of weightlessness muscle atrophy was studied by the sight of TCM theory of qi hoisting. The discussion was made from aspects of circulation of qi and blood, zang-fu function. This work is wished to be beneficial to apply the TCM theory in aerospace medicine.

Objective To investigate the value of platelet-to-lymphocyte ratio (PLR) in the prognosis prediction of patients with diabetic ketoacidosis (DKA).Methods Total of 105 patients with DKA who were treated in resuscitation room of Peking Union Medical College Hospital from January 1,2006 to December 31,2015 were reviewed.Among them,there were 8 cases died,and the other 97 cases survived.Another 105 patients with diabetes mellitus who were treated in the ward of Endocrinol ogy Department in the same period were selected as non DKA control group.The clinical characteristics of the patients in each group were compared and Logistic regression analysis was performed on the prognosis of DKA.Results Mechanical ventilation,simultaneous other organ dysfunction,PLR,Glasgow coma score related to prognosis of DKA (P ＜ 0.05).The OR value of platelet-to-lymphocyte ratio was 3.242.The optimal cutoff value of PLR for predicting the prognosis of patients was 256.50.Its sensitivity and specificity were 87.5％ and 88.7％,respectively.Conclusions PLR can be used as a sensitive indicator to predict the prognosis of DKA patients.

Objective To evaluate effect and safety of first-line chemotherapy regimen combined with rh-endostatin for osteosarcoma of the extremities.Methods Sixty three patients with osteosarcoma were randomly divided into experiment group and control group.There were 32 patients in experiment group,and 31 patients in control group.Nine patients 9 were rejected because they did not meet the standard.Finally,54 patients were enrolled in this study,including 29 patients in experiment group,and 25 patients in control group.In the experiment group,the patients were treated with rh-endostatin combined with MTX,IFO,DDP,and ADM,while patients in control group were treated with MTX,IFO,DDP,and ADM.Several indexes including median progression-free survival time,clinical benefit rate,progression-free survival rate,limb salvage rate,and survival rate were used to assess clinical effect.The safety of rh-endostatin was evaluated by comparing incidence of adverse events in the two groups.Results The median progression-free survival time of experiment group and control group was 18.9 months and 13.1 months,respectively; there was no significant difference.In the experiment group,the clinical benefit rate,progression-free survival rate,survival rate and limb salvage rate were 89.7％,37.9％,65.5％,and 89.7％,respectively; while in the control group,the clinical benefit rate,progression-free survival rate,survival rate,and limb salvage rate were 88.0％,36.0％,68.0％,and 96.0％,respectively.There was no significant difference in 4 indexes mentioned above between two groups.Conclusion After being combined with first-line chemotherapy regimen,rh-endostatin doesn't show significant advantage in controlling tumour progression and improving survival rate.No more toxicity and new side effects are found after using rh-endostatin.