Objective To investigate the management status of loaner surgical instruments,and evaluate the effect of plan-do-check-act cycle (PDCA)quality control on loaner surgical instrument management.Methods From July 2011 to June 2012,8 965 pieces of loaner surgical instruments before adopting PDCA quality control management was as control group;from July 2012 to June 2013,8 564 pieces of loaner surgical instruments adopting PDCA quality control was as ob-servation group.The defects of loaner surgical instruments during application process and effect of PDCA quality control on loaner surgical instrument management were analyzed.Results There were many problems in checking-tracking,cleaning quality and company personnel of loaner surgical instruments.The qualified rate of observation group was higher than that of control group(99.36% vs 96.27%)(χ2 =194.74,P <0.01).The main causes for unqualification of observation group were unqualified cleaning (n=21 ,38.18%)and incomplete function of instruments(n=8,14.55%);while the main causes for unqualification of control group were the loss of instruments(n=81,24.25%),lack of monitor and record (n=71, 21.26%),unqualified cleaning(n=55,16.47%)and the soaking of package(n=54,16.17%).Conclusion PDCA quality control is an effective method for loaner surgical instruments management,it is helpful for building long-term effective quali-ty control system for loaner surgical instruments,and make loaner surgical instrument management more scientific,system-atic,and standard.

Objective To investigate the role of Treg/CD4~+ T in the pathogenesis and prevention of bowel dysfunction after acute enteritis in rats.Methods Studies were conducted in 40 female Wistar rats with weights of 170-180 g.The rats were divided into normal control,experimental control,antibi- otics-treated,probiotics-treated and combined treated groups.The latter 4 groups were first infected with shigella flexneri by garage to establish the model of acute infectious enteritis,then normal control and experimental control group were administered 1 ml saline once everyday for 10 days.Antibiotics- treated group was given gentamycin 1 ml (8.32 mg?kg~(-)?d~(-1)) for 3 days,then was given saline 1 ml once everyday for 7 days.Probiotics-treated group was given medilac-S 1 ml (52 mg?kg~(-1)?d~(-1)) by gavage for the first 7 days,and 1 ml saline for the latter 3 days.The combined treatment group was given gentamycin for the first 3 days and medilac-S for the latter 7 days using the same dose.All rats were given colon-rectal balloon distention 16 to 22 days after the occurrence of bowel inflammation.The contraction of enteric smooth muscle was measured in vitro,the proportion of Treg cells in blood and mesenteric lymph node were analyzed by flow cytometry,and the histological changes were also observed at the same time.Statistical analyses were performed by using t test or one way ANOVA. Results No obvious changes of distal colon were histological observed in different groups.The perceptual threshold of rat gut decreased and the tension integral of enteric smooth muscle increased,and the ratio of Treg/CD4~+ T in blood and mesenteric lymph node was significantly lower in experimental control group [(4.40?0.43)%;(2.47?1.36)%] than normal controls [(5.15?0.47)%;(4.01?1.12)%,P＜0.05],while that of combined treatment group had no difference from normal controls [(4.95+0.41)%;(3.22?1.86)%].Conclusions The ratio of Treg/CD4~+ T may play an impor- tant role in the pathogenesis of post-infectious bowel dysfunction in animals.Treating acute enteritis with both antibiotics and probiotics can normalize the abnormalities,and thus prevent the occurrence of bowel dysfunction.

Objective To evaluate the efficacy of tegaserod in treating overlapping symptoms of chronic constipation and dyspepsia or reflux.Methods Eighty eight patients with overlapping symptom were enrolled and randomly divided into:tegaserod group(TEG group,received tegaserod 6 mg bid), PPI group(esomeprazole 40 mg qd)and combined group(tegaserod 6 mg bid and esomeprazole 40 mg qd).Esomeprazole was taken 30 min-prior to the meals in the morning.Each group was treated for 4 weeks.Endpoints to evaluate the clinical efficacy including complete relief rates(CRRs)of epigastric symptoms,the total scores of gastrointestinal symptoms,gastric emptying and colonic transit time and gastric sensation.Results The total scores of gastrointestinal symptoms were all significantly decreased in three groups after four-week therapy,which were more decreased markedly in TEG group(7.23?3.13)and the combined group(5.13?2.26)than that in PPI group(13.58?2.02,P

Objective To study the oxidative stress and apoptosis relative protein expression in rat striatum during the pathogenesis of Parkinson's disease (PD) induced by 6-hydroxydopamine (6-OHDA). Methods 6-OHDA was stereotacticly injected into the right striatum of the rats at two sites to produce PD models. Activities of superoxide dismutase (SOD), glutathione peroxidase (GSH-Px), contents of reduced glutathione (GSH) and malondialdehyde (MDA) in the injured and normal striatum were measured using assay kits; and levels of Bax and Bcl-2 were detected by Western blotting in injured striatum. Results In 10 successful PD rats, compared with either the sham group or the normal group, activities of SOD and GSH-Px and contents of GSH in the right striatum significantly decreased while contents of MDA increased obviously (P<0.05); And levels of Bax significantly increased while expression of Bcl-2 obviously decreased. Conclusion Oxidative stress plays a key role in the pathogenesis of PD. Furthermore, Bax and Bcl-2 were involved in the regulation of apoptosis under oxidative stress induced by 6-OHDA.

ObjectiveTo determine survival and differentiation of cultured neural stem cells (NSCs) into viable and functional neurons upon transplantation into the brain of MPTP-induced Parkinson's Disease (PD) mode micel.MethodsMice model of PD was established with intraperitoneal (i.p.) injections of 1-methyl-4-phenyl-1,2,3,6-tetrahydropyridine (MPTP,40mg/kg) twice interspersed by 16 hr. Tissues isolated from an embryonic rat midbrain were cultured in clonal density. After labeled with 5-bromo-2′-deoxyuridine (BrdU), the NSCs were transplanted into the uni- or bilateral striatum of PD mice. Tyrosine hydroxylase (TH) immunofluorescence was used to evaluate the toxicity of MPTP on the neural cells in the substantia nigra. Immunohistochemistry and laser confocal were used to detect the survival and differentiation of transplanted NSCs.ResultsTH positive neural cells were significantly reduced in the substantia nigra after MPTP injection. Immunohistology showed that the uni-or bilateral transplanted NSCs could survive in the brains of PD model mice.Some transplanted NSCs could properly differentiate into targeted TH positive neural cells in vivo.ConclusionsThe transplanted multipotent NSCs could survive, differentiate into functional dopamine neurons in the brains of PD model mice.

AIM To establish an HPLC method for the simultaneous content determination of four constituents in Xiaojie'an Capsules (Forsythiae Fructus,Leonuri Herba,Spatholobi Caulis,etc.).METHODS The analysis of chloroform extract of this drug was carried out on a 30 ℃ thermostatic Diamond C1scolumn(250 mm ×4.6 mm,5 μm),with the mobile phase comprising of acetonitrile (A)-0.05 mol/L monosodium phosphate (B) flowing at 1.0 mL/min in a gradient elution manner,and the detection wavelength was set at 278 nm.RESULTS Berberine hydrochloride,palmatine chloride,phillyrin and rutin showed good linear relationships within the ranges of 0.033 7-0.337 2 μg (r =0.999 1),0.054 8-0.548 3 μg (r =0.999 0),0.025 9-0.258 8 μg (r=0.999 2) and 0.008 4-0.084 2 μg (r =0.999 6),whose average recoveries were 98.8％ (RSD =1.3％),99.8％ (RSD =0.7％),98.8％ (RSD =1.3％) and 96.8％ (RSD =1.0％),respectively.CONCLUSION This sensitive and accurate method can be used for the quality control of Xiaojie'an Capsules.

OBJECTIVETo observe the effect of Zhibai Dihuang Decoction (ZDD) on mRNA and protein expressions of transient receptor potential family vanilloid subtype 1 (TRPV1) and transient receptor potential family vanilloid subtype 5 (TRPV5) in Ureaplasma urealyticum (UU)-infected rat semens and spermatogenic cells, and to explore the pathomechanism of UU-infected infertility and the intervention of ZDD.

METHODSTotally 45 were randomly selected from 60 4-5 months old SD rats. UU testicular infected animal models were set up after bladder inoculation of UU suspension. The remaining 15 rats were simultaneously injected with normal saline as a normal control group. After a successful modeling, UU infected model rats were randomly divided into the model group, the azithromycin group, and the ZDD group, 15 in each group. Rats in the ZDD group were administered with ZDD at the daily dose of 1 g/kg by gastrogavage. Rats in the azithromycin group were administered with azithromycin suspension at the daily dose of 0. 105 mg/kg by gastrogavage. Equal volume of normal saline was administered to rats in the normal control group and the model group. All medication was performed once daily for 21 successive days. Testes and epididymis were extracted after rats were killed and UU positive rates were compared among all groups. Sperm cells were separated using a mechanical separation technique. Sperm motility parameters were detected using color sperm motion detection system. mRNA and protein expressions of TRPV1 and TRPV5 in spermatogenic cells were determined by real-time quantitative PCR and Western blot.

RESULTSThe UU positive rate was obviously higher in the model group than in the normal control group [(86.7% (13/15 cases) vs. 0] P < 0.05). It was lower in the ZDD group [33.3% (5/15 cases)] and the azithromycin group [26.7% (4/15 cases)] than in the model group (P < 0.05). Compared with the normal control group, class A and B sperms were reduced, the linear velocity and the average velocity were significantly lowered, mRNA and protein expressions of TRPV1 and TRPV5 in spermated genic cells significantly decreased in the model group (P < 0.05). Compared with the model group, class A and B sperms were increased, linear and curve velocities and the average velocity were significantly elevated, mRNA and protein expressions of TRPV1 and TRPV5 significantly increased in the ZDD group and the azithromycin group (P < 0.05, P < 0.01). Compared with azithromycin group, class A and B sperms were increased, the linear velocity and the average velocity were significantly elevated, mRNA and protein expressions of TRPV1 and TRPV5 significantly increased in the ZDD group (P < 0.05, P < 0.01).

CONCLUSIONZDD could fight against UU infection and elevate semen quality, which might be associated with up-regulating mRNA and protein expressions of TRPV1 and TRPV5 in spermatogenic cells.

Animals ; Calcium Channels ; metabolism ; Drugs, Chinese Herbal ; pharmacology ; Infertility ; Male ; RNA, Messenger ; Rats ; Rats, Sprague-Dawley ; Semen Analysis ; Sperm Motility ; Spermatozoa ; TRPV Cation Channels ; metabolism ; Testis ; Ureaplasma Infections ; Ureaplasma urealyticum

Objective To investigate the effects of colon dialysis on chronic renal failure(CRF).Methods 120 patients with CRF were randomly divided into two groups and they were given the same conventional therapy including alimentary control,blood pressure control,etc.The A group (colon dialysis group,n=60) was given colon dialysis,the B group (conventional therapy group,n=60) was given conventional therapy for 4 weeks.The serum creatinine(SCr),urea nitrogen,24 h proteinuria were observed in two groups.The therapeutic effects of colon dialysis were assessed by the changes of SCr.Results The colon dialysis and conventional therapy can decrease the SCr from (363.97±82.34) μmol/L to (280.87±87.52) μmol/L and (371.73±87.46) μmol/L to (339.90±68.59) μmol/L respectively.The former was more effective than the latter.The effects of colon dialysis in the renal function compensation stage and decompensation stage were more effective than in renal failure stage but no difference was detected between the former stages.Conclusions The colon dialysis has certain effects to CRF,especially to those with serum creatinine ＜443 μmol/L can get more benefit.

OBJECTIVETo compare the advantages and disadvantages of the Foley catheter draining method versus the urethral stent plus gastric tube draining method for urine drainage following urethroplasty for hypospadias.

METHODSWe retrospectively analyzed the clinical data of 361 cases of hypospadias treated by urethroplasty. After operation, 91 of the cases received urine drainage with the Foley catheter (group A) and 270 with a urethral stent plus a gastric tube (group B). We compared the incidence rates of bladder irritation, fistula, urethral stricture, and urethral diverticulum between the two groups of patients.

RESULTSNo statistically significant differences were found between groups A and B in the incidences of bladder irritation (9.89% vs 10.70%, P > 0.05) and urethral diverticulum (1.09% vs 2.22%, P > 0.05). The incidence rate of fistula was markedly higher in group A than in B (20.80% vs 13.30%, P < 0.05), and so was that of urethral stricture (10.90% vs 5.55%, P < 0.05).

CONCLUSIONThe urethral stent plus gastric tube draining method is more effective than the Foley catheter draining method for urine drainage following urethroplasty.

Aged ; Child ; Diverticulum ; etiology ; Drainage ; methods ; Humans ; Hypospadias ; surgery ; Incidence ; Male ; Retrospective Studies ; Stents ; Urethra ; surgery ; Urethral Stricture ; etiology ; Urinary Catheterization ; instrumentation ; methods

Objective To evaluate the efficacy of anesthesia with etomidate administered by TCI in combination with continuous iv remifentanil infusion titrated to maintain BIS values at 40-60 for non-cardiac surgery in a prospective randomized single-blinded multicenter controlled clinical study.Methods Two hundred and forty-four ASA Ⅰ or Ⅱ patients of both sexes aged 20-60 yr undergoing non-cardiac surgery lasting less than 3 h were randomly allocated into 2 groups:etomidate group (group E,n =123) and propofol group (group P,n =121 ).The patients were unpremedicated.A bolus of midazolam 0.03 mg/kg was injected iv immediately before induction of anesthesia.Anesthesia was induced with sufentanil 0.3-0.4 μg/kg and TCI of etomidate (effect-site concentration (Ce) =0.5-1.0 μg/ml) or propofol (Ce =3-4 μg/ml).Tracheal intubation was facilitated with rocuronium 0.9 mg/kg.The patients were mechanically ventilated (VT 8-10 ml/kg,RR 10-12 bpm,FiO2 =1 ).PETCO2 was maintained at 35-40 mm Hg.Anesthesia was maintained with TCI of etomidate ( Ce =0.3-0.8 μg/ml ) or propofol ( Ce =3-4 μg/ml) in combination with continuous iv infusion of remifentanil at 0.1-1.0 μg· kg-1 ·min-1 and intermittent iv boluses of rocuronium.BIS values were maintained at 40-60 during operation.Sufentanil 0.1 μg/kg was administered iv before skin closure.Ce at loss of consciousness,during maintenance of anesthesia and at emergence,the consumption of remifentanil and vasoactive agents,the emergence time and extubation time were recorded.The incidences of injecton pain,post-operative nausea and vomiting (PONV) and emergence agitation were measured.Results Ce of etomidate at loss of consciousness,at emergence and during maintenance of anesthesia was (0.50 ± 0.22),(0.16 ± 0.09) and 0.22-0.39 μg/ml respectively.The incidence of injection pain and the consumption of vasoactive agents were significantly lower but more remifentanil was needed in group E than in group P (P ＜0.05 or 0.01).There was no significant difference in emergence time and extubation time between the 2 groups (P ＞ 0.05).The incidence of PONV and emergence agitation were significantly higher during recovery in group E than in group P ( P ＜ 0.05 ).Conclusion The hemodynamics is stabler during operation,but the incidence of PONV and emergence agitation are significantly higher during recovery in group E than in group P.Etomidate induces little injection pain.