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OBJECTIVE To explore the canonical prevention and management method to improve the control quality safety of hospital infection in operating room,and the medical care quality.METHODS The key points included infection institution,nosocomial control,operating room management,effective infection disinfection,isolation and other measures.RESULTS According to canonical scientific management available to quality safety of infection prevention,it could prevent infection in operating room.CONCLUSIONS In order to prevent nosocomial infection the accomplishment of effective disinfection and isolation measures during contaminated operation in hospital operating room is an important guarantee to the medical care quality.

Objective To investigate the role of CT three-dimensional reconstruction (3D-CT) in the diagnosis of bronchial foreign body.Methods Thirty-seven suspected pediatric cases of bronchial foreign bodies underwent CT scanning and 3D-CT reconstruction,whose accuracy was defined by bronchoscopical or surgical findings.Results For all the 37 cases,chest X-ray showed 8 cases (group A) had bronchial foreign body,while 29 cases(group B) were negative.In group A,CT findings suggested lung infection in 5 cases,congenital pulmonary dysplasia-lung lobe absence in 2 cases and tracheo-esophageal fistula in 1 case.In group B (29 patients),25 cases with bronchial foreign bodies were suspected by CT scanning and further bronchoscopical examination confirmed the existence of 24 cases of vegetable foreign body,one case of the tracheal tumor.For the four cases with negative result of bronchial foreign bodies after CT scanning,lung infection and laryngitis were confirmed in two cases respectively.Among the 24 surgically-confirmed cases of vegetable foreign bodies,CT scanning showed tracheobronchial foreign body in fourteen positive results,irregular tracheal stenosis in six cases and obstructive atelectasis,emphysema,pneumonia in seven each.Tracheobronchial foreign body and irregular tracheal stenosis were direct signs,accounting for 74%(20/27).Obstructive atelectasis,emphysema and pneumonia were indirect signs,accounting for 26%(7/27).Conclusion 3D-CT plays an important role in diagnosis and differential diagnosis of bronchial foreign body.

Polycystic ovary syndrome is a common endocrine disorder characterized by hyperandrogenemia and menstrual disorders. Patients not only have a high incidence of insulin resistance and metabolic syndrome, but also a high incidence of sleep disorders, especially obstructive sleep apnea. Obesity, hyperandrogenemia, insulin resistance,and other factors are responsible for the high prevalence of sleep apnea in women with polycystic ovary syndrome.

BACKGROUND:The physical properties of macromolecule ocular prosthesis materials, such as density, hardness, mechanical strength, can affect the working accuracy of ocular prosthesis and can also affect the surface roughness of ocular prosthesis, thus affecting the comfort when the patients wear.
OBJECTIVE:To study the differences of different macromolecule ocular prosthesis materials in bubble generation rate, hardness and surface roughness.
METHODS:Thirty-seven test pieces, 30 mm×30 mm×2 mm, were made and then divided to seven groups according to their brands, caled groups A, B, C, D, E, F, G, each group of five pieces. One surface of each test piece was polished in accordance with the principle of coarse to fine, the surface roughness of the two surfaces and hardness on the polished surface were measured, and then the bubble formation rate of the material was calculated.
RESULTS AND CONCLUSION:The surface roughness values of groups A-G were (0.078±0.016), (0.074±0.019), (0.075±0.022), (0.066±0.020), (0.075±0.017), (0.068±0.015), and (0.067±0.017) μm, respectively. There was no significant difference in the surface roughness between the groups (P > 0.05). The hardness values of groups A-G were 766.92±3.71, 771.84±14.51, 791.20±9.64, 804.50±4.49, 779.00±17.92, 772.20±19.18, 704.00±7.23, respectively. There was a significant difference in the hardness between groups D, G and the other groups (P < 0.05) as wel as between group D and group G (P < 0.05), but there was no significant difference between the other groups (P > 0.05). The bubble generation rates of groups A-G were (8.87±0.29)%, (8.29±1.02)%, (6.94±0.43)%, (4.83±0.20)%, (7.59±0.19)%, (8.61±0.25)%, (4.89±0.17)%, respectively. There was a significant difference in the bubble generation rate between groups D, G and the other groups (P < 0.05), but there was no significant difference between group D and group G (P > 0.05), as wel as between the other groups (P > 0.05). To a certain extent, the smaler the bubble formation rate is, the greater the hardness and the smaler the surface roughness are.

Objective To analyze the effect of acromio-humeral interval on the occurrence of subacromial impingement syndrome (SIS) after the clinical application of clavicular hook plate in acromioclavicular joint dislocation (Tossy Ⅲ). Methods From July 2005 to October 2008, 63 cases of acromioclavicular joint dislocation (Tossy Ⅲ) were treated with clavicular hook plate. There were 48 males and 15 females with an average age of 33.6 years (range, 21-53 years). The relationship of the acromio-humeral interval (AHI)were analysed between the two groups by X-ray measurement. The AHI and plate-humeral interval (PHI)were measured on X-ray film to detect difference between the two groups. Results After the operation, all t he 63 cases were divided into two groups according the occurrence of SIS. There were 14 cases in the group of SIS and 49 cases in the group without SIS. The mean follow-up was 12.2 (average, 6-15) months.The average AHI of was (8.5±2.1) mm and (9.7±2.6) mm in the group of SIS and the group without SIS respectively. The difference between the two groups was statistically significant. The average PHI of the group of SIS and the group without SIS was (6.1±2.8) mm and (6.8±2.4) mm respectively. There was no difference between the two groups. After removal of the clavicular hook plate, the clinical sign disappeared in the group of SIS. According the Karlsson scoring system, the excellent and good rate of the shoulder function was 100%. Conclusion The occurrence of SIS after the clinical application of clavicular hook plate has related to the width of the subacromial interval. The syndrome could be treated by the removal of clavicular hook plate.

BACKGROUND:The micro-ecological environment has been broken when the ocular prosthesis was inset into the conjunctival sac. The recede of self cleaning function is more conducive to the microbial growth and colonization. The cleaning of plaque biofilm on ocular prosthesis surface affects the patient's wearing comfort and quality of life. It is necessary to seek an effective cleaning method. OBJECTIVE:To compare the clearance effect of five cleaning methods on the palque biofilm on ocular prosthesis surface. METHODS: The conjunctival secretions from 84 patients who were subjected to ocular prosthesis repair were taken for bacterial culture and identification. Fifty pieces of self-curing resin and thermosetting resin artificial eyes were produced. The artificial eyes in each group were randomly divided into five groups, and were cleaned respectively with clear water, volume fraction of 75% ethanol, Boston SIMPLUS, polident and toothpaste. After the completion of the cleaning, the test piece was conducted residual biofilm culture. The clearance effects of different processing modes were evaluated using colony counting method. RESULTS AND CONCLUSION: Eighty-four specimens were submitted for inspection, of which 49 were positive. The Staphylococcusaureus separation rate was 14.29%.Staphylococcus epidermidis separation rate accounted for 13.10%. Maxwel Corynebacterium separation rate accounted for 7.14%. When water, Boston SIMPLUS and toothpaste were used for cleaning, theStaphylococcus aureus colony number in the self-curing resin group was higher than that in the thermosetting resin group (P< 0.05); when ethanol and polident were used for cleaning, there was no difference in the Staphylococcus aureus colony number between these two groups. In self-curing resin, the colony count in the clear water treatment group was higher than that in the other treatment groups (P < 0.05). The colony count in the ethanol treatment group was lower than that in the Boston SIMPLUS group (P < 0.05). There was no significant difference in the colony count between other groups. In thermosetting resin, the colony count in the clear water treatment group was higher than that in the other treatment groups (P < 0.05). There was no significant difference in the colony count between other groups. These results demonstrate that ethanol, Boston SIMPLUS, polident and toothpaste have better cleaning effects onStaphylococcus aureusbiofilms on the surface of two kinds of ocular prostheses than the clear water rinse. Overal, it is encouraged to clean the artificial eyes using polident and Boston SIMPLUS, in order to avoid the occurrence of microbial infection in the conjunctival sac after wearing ocular prosthesis.

Objective To evaluate the effect of neuraxial and general anaesthesia for total joint arthroplasty by meta-analysis.Methods We searched online Pubmed,Web of science,Cochrane li-brary,CNKI,CBM and searched the literature of the Chinese series journals.All randomized controlled trials (RCT)that met their standards of neuraxial and general anaesthesia for total joint ar-throplasty were collected.The quality of trials was strictly assessed.RevMan 5.3 software was used for data analysis.Results Twenty-one RCTs involving 1 874 cases were included.Compared with general anaesthesia,the pooled data showed that the neuraxial anaesthesia significantly reduced blood loss (WMD=-97.52,95% CI = - 1 73.60-- 21.44,P = 0.01 ),associated with lower risk of deep vein thrombosis (RR=0.68,95%CI=0.48-0.95,P =0.02)and pulmonary embolism (RR=0.58, 95%CI=0.35-0.91,P =0.03),decreased the number of postoperative nausea and vomiting (RR=0.74,95%CI=0.60-0.92,P =0.008).Subgroup analysis showed that compared with general anaes-thesia,the neuraxial anaesthesia associated with lower risk of deep vein thrombosis (RR=0.5 1,95%CI=0.38-0.69,P < 0.000 01 )and pulmonary embolism (RR = 0.34,95% CI = 0.18-0.65,P =0.001)in patients who did not receive chemical antithrombotic prophylaxis.Conclusion Neuraxial anaesthesia seems to improve the outcome of patients undergoing total joint arthroplasty and reduce postoperative complications.

BACKGROUND: There is a positive correlation between the serum cholesterol and osteoarthrosis incidence. However, it is still unclear whether the high-sugar and high-fat diet participates in the process of articular cartilage degeneration leading to osteoarthrosis, and the participation mechanism is unknown. OBJECTIVE: To investigate the changes in knee cartilage morphology of New Zealand white rabbits fed with high-sugar and high-fat diet and to explore the effect of high-sugar and high-fat diet on articular cartilage degeneration. DESIGN, TIME AND SETTING: The randomized controlled experiment was performed in Animal Laboratory, Xiangya Medical College from January to September 2008. MATERIALS: Forty healthy adult male New Zealand white rabbits, weighing about 2 kg, were randomly divided into 4 groups with 10 in each group. METHODS: Male New Zealand white rabbits were divided into four groups: ①normal diet group(NG), ②high-sugar diet (mixture of 37% cane sugar and 63% normal fodder) group(SG), ③high-fat diet (mixture of 20% lard and 80% normal fodder) group(FG), ④high-sugar and high-fat diet (mixture of 37% cane sugar, 10% lard and 53% normal fodder) group(SFG), MAIN OUTCOME MEASURES: Fasting blood samples were extracted every 4 weeks. The levels of blood sugar, triglyceride, cholesterol and insulin were detected, and body mass was recorded. The femoral condyle cartilage were dyed with toluidine blue, observed with transmit electron microscope after general observation of rabbit knee joints at the 28th weeks. RESULTS: ①Blood sugar, triglyceride, total cholesterol in FG and SFG were obviously higher than that in NG, the level of blood insulin in FG and SFG increased first, and then decreased significantly (P 0.05). ② By light microscope and transmit electron microscope observation, the FG and SFG demonstrated that tide line disappeared, cartilage cells were ranged in disorder, collagen fibers fractured, cartilage cells and a change in shape, such as shrinkage. These changes of morphology were not observed in SG. CONCLUSION: Long-term high-fat diet or high-sugar and high-fat diet may induce or aggravate the disorder of articular cartilage, suggested that it may take part in the development of osteoarthritis.

OBJECTIVE To explore the canonical prevention and management method to improve the control quality and safety against hospital infection in outpatient operating room. METHODS To strengthen infection institution,nosocomial control,and operating room management actually,constitute effective disinfection,isolation,and deal of measure. RESULTS By strengthening quality of hospital outpatient operating room,to improve the medical care quality. CONCLUSIONS According to canonical scientific management,to favor the quality and safety of infection prevention in operating room.