OBJECTIVE To diminish and discontinue intra-hospital cross infection in Disinfection Supplier Centre.METHODS The administration of personal resources control was developed,the equipment and systemic control of aseptic process and isolation was reasonably arranged,and the quality control was enhanced.We executed the routine seriously during our daily work,and gave strict measures during quality management such as disposal,classification,washing,disinfection,packaging,sterilization,monitoring,stockpile,and handout.RESULTS Every criterion of aseptic and isolation work were all adapted to the demanding set up by Ministry of Health referred to hospital infection control quality standard,The infection control in our Centre was standardized and regular scientific channel was set up.CONCLUSIONS Quality administration care can play a main and key role in the control of cross hospital infection in Disinfection Supplier Centre.

Objective To analyze the diagnostic methods of Achilles tendon rupture by MRI.Methods All 16 cases with Achilles tendon rupture were examined with sagital T 1,2 WI and axial T 1WI imaging.4 cases were appended Gd-DTPA enhancement.6 cases were followed up with MRI after 6～8 weeks.Results MRI appearance of Achilles tendon rupture represented Achilles tendon thickening,decrescent ratio of wide/vertical survey,hyperintensity in tendon,discontinuous fibrous bundle,fluid collected around tendon comparing with of normal Achilles tendon.Conclusion MRI is an valuable tool for the diagnosis of Achilles tendon rupture.

Objective By exploring difference of mental characteristics,coping style,social support and health between schizophrenia primary affection and convalescent schizzy,it's expected that the related rationale will be developed for further formulating treatment for schizophrenia primary affection and convalescent schizophrenia.Methods By taking advantage of symptom checklist,questionnaire of NEO-FFI,Simplified Coping Style Questionnaire,social support scale,we compared 150 schizophrenia primary affection who were under the clinic of new antipsychotics and in convalescent period (schizzy group)with 169 normal persons (normal group)on the mental characteristics,coping style,social support and mental health of individual and correlation.Results The following factors of scl-90 showed statistical significance between patient group and normal group:somatization (1.83±0.14) vs.(1.27-±0.48),interpersonal sensitivity(1.96±0.21) vs.(1.65±0.51),depression(1.89±0.24) vs.(1.50±0.59),anxiety(1.69±0.15) vs.(1.39±0.43),photic anxiety (1.56±0.13) vs.(1.23±0.41),psychoticism factors (1.56± 0.14) vs.(1.23±0.41) (all P＜0.01).The personality traits differences between patient group and normal group were as follows:neuroticism (3.13± 0.15) vs.(2.61 ± 0.36),extraversion (2.96± 0.31) vs.(3.19± 0.23),agreeableness (3.20± 0.25) vs.(3.48±0.35) and conscientiousness (3.19±0.65) vs.(3.42± 0.16),and all these factors showed statistical significance with P＜0.01.The differences of subjective support factors between patients group and normal groups were as follows:subjective support (23.51 ±3.62) vs.(26.29±3.91),objective support (7.35±2.07) vs.(8.91 ± ±2.89),support use (7.61± 1.23) vs.(8.97± 1.35) and total score of supports (37.63± 6.52) vs.(43.51 ± 6.32) and the scores of patients group were poorer than those of normal group(P＜0.01).These two groups also showed statistical significance in coping styles:positive coping style(27.03±6.05) vs.(33.75±4.53) and negative coping style (32.63±5.31) vs.(43.51±6.32),patient group got lower scores than normal group(P＜0.01).Depression factor and obsessive compulsive symptom factor,objective support and hostility factor,passive coping and hostility,neuroticism factor in patients group are positive correlation,and photic anxiety factor and obsessive compulsive symptom,depression factor,conscientiousness factor and psychoticism factor,passive coping,neuroticism factor and somatization factor were negative correlation.Conclusion A effective recovery plan of treatment of schizophrenia primary affection and convalescent schizzy must integrate medical perspective,active interest in his personality characteristics,mental health,coping style,social support.

Objective To evaluate the feasibility of dual-source computed tomography(DSCT)coronary angiography in a population with premature heart-beats.Methods Seventy patients with suspected coronary artery disease and premature heart-beats were routinely imaged on a DSCT scanner(Somatom Definition,Siemens AG,Germany).The images were reconstructed before and after ECG editing.Two readers independently assessed image quality of all coronary segments using a four-point grading scale from excellent(1)to non-assessable(4).The results ofthe two groups were compared with a paired t-test,and a P value of less than 0.05 Was considered significant.Results The mean heart rate during examination ranged from 49 to 111 bpm[mean(70.7±12.4)bpm].Twenty-eight of 70 patients with relatively small variability of the heart rate[(41.0±18.4)bpm]got diagnostic image quality without ECG editing.In other 42 patients with larger variability of the heart rate[(71.4±28.7)bpm],the meal image quality scores were 2.09±1.27 and 1.50±0.79 before and after ECG editing,there Was a significant difference(t=13.764,P＜0.01).The proportion of non-assessable segments Was reduced from 24.8%(154/620)to 3.4%(21/620)through ECG editing(X2=121.846,P＜0.01).Finally,the diagnostic image accounted 98.0%(1014/1035)in all segments of 70 patients.Conclusion DSCT can provide diagnostic images for patients with premature heart-beats.The image quality in patients with larger variability of the heart rate can be significantly improved through ECG editing.

Objective To observe the effect of reperfusion therapy on the prognosis of acute myocardial infarction (AMI) complicated by eardiogenic shock(CS)in reperfusion era.Methods 89 cases of AMI with CS were included with 57 male and 32 female.50 cases received conservative therapy and 39 cases reperfusion therapy.28 of the 39 cases had suecessflll reperfusion and 11 eases failed.18 patients had intra-aortic balloon pump (IABP) within 1 hour of CS,they constituted an early group;35 patients treated with IABP 1 hour after CS were of a late group.A group of 36 cases were not treated with IABP (no IABP group).Results The mortality of the early group with IABP Was significantly lower than that of the late and no IABP group(33.3% vs.74.2% vs.86.1%,P＜0.01).The mortality of the group with sucessful reperfusion was significantly lower than that of unsuccessful reperfusion and conservative no IABP group (42.8% vs.81.8% vs.84.0%,P＜0.01).logistic regression analysis showed that successful reperfusion therapy (OR 4.232,95% CI 1.407～12.730,P=0.01) and THE TIME of using IABP(OR 0.22.95% CI 0.063～0.764,P=0.017)were independent risk factors for death.Conclusion Early successful reperfusion and early institution of IABP were the most important therapeutic measures for reducing mortaliIv of AMI complicated by CS.

AIM: To study the protective effect of puerarin on the atherosclerosis of RAW264.7-derived foam cells.METHODS: The model of foam cells was established by incubating the RAW264.7 cells with ox-LDL.The choles-terol uptake was evaluated by a DiI-ox-LDL binding assay.The ability of cholesterol efflux of the RAW264.7-derived foam cells was detected by cholesterol efflux assay.The protein levels of LC3II, P62, CD36, ABCA1, LAL and p-AMPK were determined by Western blot.RESULTS: Puerarin treatment reduced the cholesterol uptake capacity and enhanced the cho-lesterol efflux rate.The protein levels of LC3II, ABCA1 and LAL in puerarin group were higher than that in ox-LDL group, while the protein levels of P62 and CD36 were obviously decreased, and those in rapamycin treatment group had the same change as puerarin group.The protein levels of LC3II, ABCA1 and LAL were obviously decreased and the protein level of p-AMPK was increased after co-treated with 3-MA.CONCLUSION: Puerarin promotes LAL and ABCA1-mediated cho-lesterol efflux in ox-LDL-treated RAW264.7 macrophages, which might enhance autophagy through AMPK-dependent path-way for cholesterol efflux regulation, and reduce the uptake of lipids by CD36 negative regulation.

Objective To evaluate the treatment effect of compound Chinese medicine on skeletal fluorosis in rats by Micro-CT.Methods Eighty-eight Wistar rats which had been weaned for two weeks were divided into four groups according to body weight [(91.1 ± 10.0)g] by the method of random number table:control group(16 mts),middle fluorine(MF)group(24 rats),high fluorine(HF) group(24 rats),and high fluoride and low calcium low protein (HF-LC-LP) group (24 rats).The amounts of fluorine of MF,HF and HF-LC-LP groups were 50,100 and 100 mg/kg,respectively.The contents of calcium and protein in HF-LC-LP group were half of MF and HF groups.Six months after treatment with fluoride,eight rats of each group were put to death with femoral artery bleeding.The rest 16 rats of each fluorosis group were divided into two groups,one was the control group and the other was fed with both fluorine and the compound Chinese medicine which simulated the actual situation of fluorosis area.Each rat of the treatment group was given the medicine 194 mg/100 g for six days every week.Daily urine samples were collected when the medicine had been used for 0,30 and 60 days.All the rats were put to death with femoral artery bleeding after the medicine had beengiven for 90 days,and limbs bones were dissected.Urine fluoride was tested by the method of fluoride ion selective electrode ; bone fluoride was tested by the method of high temperature ashing-fluoride ion selective electrode; bone mineral density(BMD),tissue mineral density(TMD),structure model index (SMI),trabecular thickness (Tb.Th),trabecular separation (Tb.Sp),anisotropy (a1/a3),trabecular connection density(Conn.D),the volume ratio of trabecular and bone tissue,the ratio of bone surface area and volume(BS/BV),and trabecular number(Tb.N) were detected by Micro-CT technology.Results The level of urinary fluoride of high fluoride and low calcium low protein treatment group [(11.01 ± 3.67)mg/L] was lower than that of its control group [(34.32 ± 9.50)mg/L,t =3.13,P ＜ 0.05] when rats were remedied with the compound Chinese medicine for 60 days.The level of bone fluoride of high fluoride treatment group[(275.38 ± 171.65)mg/kg] was lower than that of its control group[(701.67 ± 178.16)mg/kg,t =5.42,P ＜ 0.05] when rats were remedied withy the compound Chinese medicine for 90 days; bone fluoride of high fluoride and low calcium low protein treatment group[(313.26 ± 124.51)mg/kg] was lower than that of its control group[(794.66 ± 261.35)mg/kg,t =3.25,P ＜ 0.05].The differences of Tb.Th,Tb.Sp,a1/a3,Conn.D,BV/TV,BS/BV and Tb.N among groups were statistically significant(F =2.785,2.681,3.039,27.231,2.595,2.854,5.050,all P ＜ 0.05).Tb.Th[(0.04 ±0.01)mm] and Tb.Sp[(0.03 ± 0.01)mm] of middle fluorine treatment group were higher than those of their control groups[(0.02 ± 0.00),(0.02 ± 0.00)mm,all P＜ 0.05]; al/a3,Corm.D,BV/TV and Tb.N[(0.77 ±0.61),(510.91 ± 304.99)mm-3,(0.42 ± 0.06) and (13.58 ± 2.48)mm-1] were lower than those of their control groups[(1.11 ± 0.01),(2 403.69 ± 124.02)mm-3,(0.46 ± 0.03) and (18.12 ± 0.69)mm-1,all P ＜ 0.05].BV/TV(0.44 ± 0.04) of high fluoride treatment group were lower than those of their control groups(0.49 ± 0.00,P ＜ 0.05) ; Tb.Th[(0.04 ± 0.01) mm] was higher than that of its control group [(0.03 ± 0.00)mm,P ＜ 0.05].Conclusion The compound Chinese medicine may has therapeutic effect on rat skeletal fluorosis.

ObjectiveTo evaluate the impact of patient's heart rate(HR)on coronary CT angiography(CTA)image quality(IQ)and reconstruction timing in dual-source CT(DSCT).Methods Ninety-five patients with suspicion of coronary artery disease were examined with a DSCT scanner(Somatom Definition.Siemens)using 32×0.6 mm collimation.All patients were divided three groups according to the heart rate(HR):group 1,HR≤70 beats per minute(bpm),n=26;group 2,HR＞70 bpm to≤90 bpm, n=37;group 3,HR＞90 bpm,n=32. No beta-blockers were taken before CT scan.50-60 ml of nonionic contrast agent were injected with a rate of 5 ml/s. Images were reconstructed from 10%to 100% of the R-R interval using single-segment reconstruction. Two readers independently assessed IQ of all coronary segments using a 3-point scale from excellent(1)to non-assessable(3)for coronary segments and the relationshiD between IQ and the HR. ResuitsOverall mean IQ score was 1.31 ±0.55 for all patients with 1.08±0.27 for group 1,1.32±0.58 for group 2 and 1.47±0.61 for group 3. The IQ was better in the LAD than the RCA and LCX(P＜0.01).Only 1.4%(19/1386)of coronary artery segments were considered non-assessable due to the motion artifacts.Optimal image quality of all coronary segments in 74 patients(77.9%)can be achieved with one reconstruction data set.The best IQ was predominately in diastote(88.5%)in group 1,while the best IQ was in systole(84.4%)in group 3. ConclusionsDSCT can achieve the optimal IQ with a wide range of HR using single-segment reconstruction. With the increasing of HR,the timing of data reconstruction for the best IQ shifts from mid-diastole to systole.

BACKGROUND: Stent under-expansion and procedurally related abnormal lesion morphologies (e.g. dissection, thrombus) are associated with stent restenosis and acute, subacute and chronic thrombosis.OBJECTIVE: To explore whether larger post-procedural final minimum stent area can be acquired and more procedurally related complications can be identified in stent implantation guided by intravascular ultrasound.DESIGN, TIME AND SETTING: Retrospective analysis was performed at the Heart Center of Beijing Chaoyang Hospital, Capital Medical University between January 2004 and February 2005.PARTICIPANTS: Fifty patients with coronary artery disease with 52 lesions were enrolled in the study and underwent stenting guided by intravascular ultrasound. The patients were characterized as non-diffused lesion with vessel diameter ≥ 2.5 mm. Patients with severe left main lesion were excluded.METHODS: Qualitative and quantitative analyses were carried out in 50 patients with 52 lesions before and after stent implantation. The stent diameter and the end-point of therapy were determined by intravascular ultrasound standard.MAIN OUTCOME MEASURES: The differences of end point for stent implantation and the enlargement of lumen area gained by stent implantation were compared between cardioangiography and by intravascular ultrasound.RESULTS: The average stent diameter guided by intravascular ultrasound was larger than by cardioangiography (P=0.011); the peak balloon pressure was higher in intravascular ultrasound group than cardioangiography group (P < 0.001), and area stenosis percentage measured by quantitative coronary angiogram was smaller in intravascular ultrasound group than cardioangiography group (P=0.044). ②Cardioangiography showed success rate was 96.2% and intravascular ultrasound showed the success rate was only 37.7% after first balloon high-pressure dilation. Intravascular ultrasound subgroup analysis showed higher peak balloon pressure (P < 0.001), larger lumen diameter (P < 0.001), larger lumen area (P < 0.001), and smaller area stenosis percentage (P < 0.001). No obvious stenosis was found at the proximal and distal segments of the stent observed by cardioangiography, while atherosclerotic lesions at proximal segment were found in 39 cases (75.0%) and at distal segment were in 23 cases (44.2%) observed by intravascular ultrasound. The lumen area was larger in non-fatty plaque than in fatty plaque after stent implantation (P < 0.001). Compared with non-fatty plaque, the enlargement of vessel area was 1.30 mm2 smaller, while plaque compression was 0.48 mm2 larger. CONCLUSION: Stent implantation guided by intravascular ultrasound can acquire larger final lumen area and identify more procedurally related complications.

Objective To investigate the ultrasonic characteristics of angiographical normal left main (LM) branch of coronary artery observing with intravaseular ultrasound(IVUS). Methods Seventy-six patients whose coronary angiogram showed the lesions restricted only in left anterior descending (LAD) branch or left cireumflex(LCX) branch and no lesion was found in LM branch were enrolled and IVUS was performed. The plaque burden was measured and the quality of atherosclerosis was identified in lesion site of LAD or LCX by IVUS. Meanwhile,the absence or existence of lesions in LM was identified,and the quality of lesions was analyzed if it showing those existed lesions. The diameter and area of lumen in left main were measured and diameter and area of vessel were also measured. The plaque burden were measured for those who atheroselerosis existed in LM. Results IVUS showed 28 cases completely normal, 12 cases with intimal membrance hyperplesia,36 cases with plaque and 2 cases with intimal membrance flap in patients which LM was angiographically normal. Among those there were 30 eccentric plaques and 6 concentric plaques. For 36 patients whose lesions existed in LM observed by IVUS,there were 25 cases (69.4%) with soft plaque,4 eases (11.1%) with fibrous plaque,2 cases (5.6%) with calcific plaque,5 cases (13.9%)with mixed plaque. IVUS showed lumen diameter was (5.32±0.68)mm and lumen area was (23.34±5.27)mm2 for female patients; and lumen diameter was (5.90±0.50)mm and lumen area was (27.75±4.47)mm2 for male patients. The difference had significane when comparing lumen diameter and lumen area between male and female patients (P=0.042 and P=0.048, respectively). Vessel diameter was (5.90±0.47)mm and vessel area was (27.58±4.21)mm2 in patients with intimal membrance hyperplesia; lumen diameter was (4.39±0.54)mm and lumen area was (17.45±5.23)mm2,vessel diameter was (5.99±0.67)mm and vessel area was(26.61±6.27)mm2 n patients with atherosclerotic plaque.Diameter stenosis percentage was(26.17±7.87)%and plaque burden was(34.79±9.37)%in LM.Conclusions IVUS can find those lesions in LM which CAG cannot detect and identify the quality and severity of lesion precisely.