Objective To understand the cleanliness of hands and uniforms of health care workers(HCWs)while they were working in a hospital.Methods Specimens of hands and uniforms of HCWs while they were working were collected and detected.Results A total of 342 specimens were collected, 173 were specimens from hands and 169 were from uniforms, the total qualified rate was 78.65%,qualified rates of hands and uniforms were 76.30% and 81.07% respectively.Qualified rates of hands and uniforms of different HCWs were compared respectively, differences were both statistically significant (both P<0.05);qualified rates of hands and uniforms of nurses were both highest (87.93% and 92.86% respectively), followed by doctors (75.86% and 87.72% respectively), while medical auxiliary persons were the lowest(64.91% and 62.50% respectively).Correlation analysis between qualified rates of hands and uniforms of HCWs in general wards showed that the correlation coefficient was 0.930 (P<0.01).Conclusion Cleanliness of hands and uniforms of HCWs needs to be further improved, especially medical auxiliary persons;cleaning frequency and cleanliness standard of HCWs' uniforms needed to be studied further.

Objective: To study the attenuating effect of angiotensin I type 1 receptor antagonist losartan and an-giotensin converting enzyme inhibitor captopril on aortic atherosclerosis in rabbits. Methods: Thirty-one male New Zealand rabbits were randomly divided into 5 groups:control group,high cholesterol diet group,losartan group, captopril group and combined drug administration groupdosartan+captopril). The animals were killed after 16 weeks and the serum total cholesterol ,triglyceride, high and low density cholesterol .atherosclertic ratio,endothelin,NO,plaque area percentage,aortic cholesterol content and vascular smooth muscle cell (VSMC) apoptosis were determined. Results:The plaque area percentage,aortic cholesterol contents and endothelin levels of 3 drug treatment groups were significantly lower than that of high cholesterol group,NO contents and VSMC apoptosis were significantly higher. Conclusion:Losartan and captopril can attenuate aortic atherosclerosis induced by high cholesterol diet .combined administration of the 2 drugs at low doses are more effective. The mechanism may be related to the protection of endothelial function and the effect on apoptosis of VSMC.

Objective To study bacterial conditions in amniotic cavity of the third trimester and the delivery. Methods Patients underwent cesarean section due to various reasons were randomly enrolled in the study. Ten ml aqua amnii taken from using aspesis were cultured and the bacteria were identified and tested for drug sensitivity. All patients were not treated with antibiotics before and during operation,conventional antibiotics treatnent was used after operation. The patients were divided into 3 groups based on their status: 34 cases of premature rupture of membrane ( PROM ), thirty-four cases of labor without PROM, and 27 cases of pregnancy without PROM. The positive rate, species , distribution and drug sensitivity of bacteria in the 3 groups were analyzed. Results The positive rate was 61.8% (21/34) in PROM ,52. 9% ( 18/34 ) in labor without PROM,11.1% (3/27)in pregnancy without PROM. The positive rates were significantly different among the 3 groups (x2 = 17.29 ,P =0.000). However, there was no significant difference between the labor without PROM group and the pregnancy without PROM group ( x2 = 0.541 , P = 0.462 ). Staphylococcus epidermidis was the most common isolated bacteria, following by staphylococcus aureas, streptococcus, colon bacillus, and pseudomonas. There were no significant differences of bacterial species between labor without PROM and pregnancy without PROM( x2 = 11.9,P =0.535 ). The relative higher positive rate in the labor without PROM and PROM indicated that they were important inducement of bacteria infection. There were no significant difference on positive rate and bacteria species distribution between the PROM and labor without PROM group,which suggested that up-bound along vagina to amniotic cavity was the most common route of infection. Sensitive antibiotics should be given to the patients of PROM and labor without PROM targeted at staphylococcus,streptococcus, colon bacillus and monad. Antibiotics such as Cephems, Penicillins and Clindamycin were sensitive to various bacteria and safe to both mother and baby, thus were recommended. Quinupristin, Vancomycin,Furantoin, Fusidic ,Teicoplanin, Amikacin and Meropenem were also sensitive to various bacteria, but due to their side effects and the principle of ladder antibiotics using, they were recommended as second line antibiotics. Conclutions Up-bound along vagina to amniotic cavity is the most common route of infection. For rupture of membrane and labor without PROM patients, antibiotics should be given, and strict aseptic technique,washing cavity and incision, using antibiotics after operation are necessary to prevent infection.

Objective To knockout and identify the Antigen 43 (Ag43) in the Escherichia Coli JM109 .Methods Mutation group Ⅱ introns RNA protein complexes (RNP) gene sequence was obtained by Sigma Company′s TargeTron Gene Knockout Sys‐tem and Ag43 gene specific designed PCR primers amplification ,then ,to acquired Ag43 specific recombinant RNP plasmid pACD4K‐Ag4 ,this gene sequence was inserted into the plasmid pACD4K‐C of RNA′s expression .Finally ,pEGFP‐Ag43 was trans‐formed into JM109 and inserted the group Ⅱ intron into the Ag43′s locus by IPTG inducing expression .Results The best insertion locus was between 1 812 and 1 913 .Through the agarose electrophoresis gel ,the RNP gene sequence was consistent with the expec‐ted value (350 bp) .The pEGFP‐Ag43 vector was correctly constructed which was proofed by endonuclease Nhe Ⅰ and Hind ⅡI di‐gestion as predicted products (3 646 and 4 029 bp;7 000 and 550 bp ,respectively ) .The PCR and gene sequence results indicated that the group Ⅱ intron was inserted into the locus between 1 812 and 1 913 in the Ag43 gene .Conclusion Successful knockout of the Ag43 in Escherichia Coli JM109 found basis to further study the Ag43′s function and regard the coli as host bacteria of Ag43 chimeric protein recombinant .

Objective To observe the clinical effect ofJiedu-Huayu granule for the Dengue Fever (DF).Methods The patients with DF were randomly divided into the treatment group and control group. Both groups received the conventional treatment, and the treatment group addedJiedu-Huayu granule. The clinical effects were detected.Results At the baseline, the ALT and AST in the treatment were significantly higher than those in the control group (t=2.830,P=0.014;t=2.109,P=0.044). But after treatment, there was no difference between groups. The ALT in the treatment group showed a gradual change and AST recovery time showed short. Compared with control group, the concentration of sVCAM-1 in the treatment group was higher at baseline and the third day (t=2.780,P=0.018;t=2.130,P=0.460), but the concentration of MCP-1 desceased significantly on the 6th day (t=-2.164,P=0.042).Conclusions Compared with the western medicine, the treatment of western medicine andJiedu-Huayu granule could alleviate liver injure, shorten the recovery time, and reduce the concentration of sVCAM-1 and MCP-1.

Based on the International Federation of Nursing Anesthetists (IFNA) education and training base, our hospital has built a training base for anesthesia specialized nurses in Nanjing from the following aspects: the application for training base of anesthesia specialized nurses, the qualification and examination of students' and teachers' qualification, the settings of training curriculum, the examination contents and methods, and the evaluation of post-training effect. This article summarizes the construction experience of this base, therefore, providing support and standard for the training of anesthesia specialized nurses.

Objective To investigate the restrictive factors in the development of foreign medical education. Methods From the years 2011 to 2013, 350 foreign students conducted a questionnaire survey in Chongqing Medical University, and recovered 339 valid questionnaires. Results Only 33.0%(112/339) students thought that the teacher's English was fluent and 70.2% (238/339) needed to add Chinese class. Additionally, 69.6% (236/339) and 63.1% (214/339) students considered theoretical knowledge and practi-cal experience were not enough. 92.3%(313/339) students came from developing countries in Southeast Asia. 86.1%(292/339) foreign students considered that university management was insufficient. Conclusion The survey found the restrictive factors included students' demand for English and Chinese, lack of medical ex-pertise and practice, the problem of student sources and daily management difficulties and so on.

Objective To investigate the diognostic value of multi-sllce helical CT(MSCT) in spinal tuber-culosis, and making a further understanding of this disease. Methods The MSCT and post-processing films manifes-tations of 23 spinal tuberculosis proved by operation and pathology were reviewed retrospectively. Results MSCT could show the bone destructions location, range, relationships with neighbor tissues, osseous vertebral narrowing and para-vertebral abscess,etc. MPR, CPR, SSD and VR could more completely and stereoscopically show these character-istics of spinal tuberculosis. Conclusion MSCT post-processing techniques could make up for the lack of axial CT scan. It has high value in elevating the diagnosis accuracy of spinal tuberculosis.

Objective To explore the aesthetic results of medial upper Iip repair for skin and soft tissue defects using local flap.Methods According to the location and the size of upper lip defect,the modified rhomboid flap of 60 ° above the defect was designed to repair the wound in philtrum;the O-L flap along philtral column to vermilion border was designed to cover the wound close to the peak and lateral to philtral column.Results Twenty-one postoperative patients that underwent pigmented nevus removal (12 female,9 male;ages 16-33 years) had defects in philtrum for 10 cases and close to the peak and philtral column for 11 cases.The diameter of the defect ranged from 0.5 cm to 1.0 cm.All flaps survived primarily without any complications and follow-up was for 1 to 18 months with excellent outcomes in all cases.All patients were satisfied with contour and functions.No pigmented nevus recurrence occurred.Conclusions The flap designed according to the aesthetic principle could be used to repair medial upper lip defect of medium-sized,which not only obtains functional reconstruction,but also satisfies aesthetic results,with aesthetic subunits saved and scar concealed.

Objective To investigate the effect of human umbilical cord mesenchymal stem cells (hUC-MSCs) on autophagy and the secretion of chemokine receptor CXCR4 induced by low-dose immunosuppressive durgs.Methods Flow cytometry was used to detect the changes of hUC-MSCs surface markers after treatment with low-dose tacrolimus and rapamycin.The effect of treatment with tacrolimus and rapamycin on proliferation of hUC-MSCs was analyzed with WST-1 assay.Regular RT-PCR was applied to analyze the mRNAs expression of ligands such as LC3B,Atg5 and Beclin1 in hUC-MSCs.Western blotting was carried out to detect the expression of LC3B,Atg5,Beclin1 and p-ULK1 in hUC-MSCs after treatment with tacrolimus and rapamycin.The secretion of chemokine receptor CXCR4 in hUC-MSCs was analyzed under the state of autophay by flow cytometry.Results Flow cytometry analysis confirmed low-dose immunosuppressive drugs tacrolimus and rapamycin did not cause changes in hUC-MSCs phenotypes significantly.Low-dose tacrolimus had no cytotoxic effect on hUC-MSCs,while,rapamycin could inhibit the proliferation of hUC-MSCs after 24 h or 48 h,with survival rate being 73.66％ and 68.81％ (P＜0.05) of controls,respectively.Moreover,both tacrolimus and rapamycin could inhibit PI3K/AKt/mTOR signaling pathway to activate hUC-MSCs autophagy,and the related proteins of LC3B,Atg5 and Beclin1 increased significantly and induced the up-regulation of CXCR4 secretion.Conclusion Our results here demonstrated that low-dose tacrolimus and rapamycin induce autophagy in hUC-MSCs and promote the secretion of CXCR4.