Cleaning quality of different cleaning methods for reusable laparoscopic instruments / 中国感染控制杂志

Objective To evaluate the cleaning quality of different cleaning methods for laparoscopic instruments, ensure the cleaning quality of instruments.Methods The used laparoscopic instruments were classified into two categories: non-lumen instruments and lumen instruments. Three cleaning methods, traditional manual cleaning (A), manual cleaning + ultrasonic cleaning (B), manual cleaning + automatic cleaning disinfector (C), were adopted respectively for treating instruments. Cleaning quality of instruments were detected with ATP bioluminescence assay.Results The qualified rates of laparoscopic non-lumen instruments cleaned by methods A, B, and C were 78.75％, 95.71％, and 96.00％ respectively, difference was significant (χ2=16.453, P＜0.001);qualified rate of methods B and C for cleaning non-lumen instruments was higher than that of method A (P＜0.016), there was no significant difference between methods B and C (P＞0.016). Qualified rates of laparoscopic lumen instruments cleaned by methods A, B, and C were 76.47％, 98.75％, and 91.55％ respectively, difference was significant (χ2=21.087, P＜0.001); qualified rates of methods B and C for cleaning lumen instruments were both higher than that of method A (P＜0.016), there was no significant difference between methods B and C (P＞0.016). Conclusion Effect of manual cleaning + ultrasonic cleaning and manual cleaning + automatic cleaning disinfector on used laparoscopic instruments are both better than that of traditional manual cleaning method, can effectively guarantee the cleaning quality of instruments and help to ensure the operation safety of patients.

Magnetic resonance spectroscopy on hepatocellular carcinoma after transcatheter arterial chemoembolization / 癌症

<p><b>BACKGROUND AND OBJECTIVE</b>Proton magnetic resonance spectroscopy (MRS) of the liver in vivo is in experimental phase. MRS observation on liver cancer after transcatheter arterial chemoembolization (TACE) has seldom been reported. This study was to investigate the value of MRS in assessing the metabolic changes of hepatocellular carcinoma (HCC) after TACE.</p><p><b>METHODS</b>Twenty-five consecutive patients with pathologically-confirmed HCC received 1H MRS of all hepatic lesions using 1.5T whole body MR scanner before TACE and at 3-10 days after TACE. Choline-to-lipid (Cho/Lip), glucogen/glucose-to-lipid (Glu/Lip), and glytamine/glutamate-to-lipid (Glx/Lip) ratios were measured and analyzed statistically.</p><p><b>RESULTS</b>The Cho/Lip, Glu/Lip, and Glx/Lip ratios were 0.21 +/- 0.08, 0.11 +/- 0.05, 0.28 +/- 0.10 before TACE, respectively, and were 0.10 +/- 0.08, 0.07 +/- 0.07, 0.18 +/- 0.12 after TACE, respectively, with significant differences (P < 0.05).</p><p><b>CONCLUSIONS</b>Using MRS can evaluate the early metabolic responses of HCC to TACE.</p>

The study of inhibiting heart rate and rapidly terminating atrial flutter of ibutilide on canine / 中华心血管病杂志

<p><b>OBJECTIVE</b>To observe the electrophysiological effects of ibutilide on canine and to explore the potential mechanisms of ibutilide on terminating atrial flutter.</p><p><b>METHODS</b>Eighteen mongrel dogs were anesthetized and intubated. The heart was exposed through thoracotomy for electrodes implantation. The electrophysiologic variables (heart rate, the conduction of intraatrium and interatrium, the conduction ratio of isthmus, the effective refractory period) were measured in the absence or presence of ibutilide (10 minute infusion with 0.10 mg/kg ibutilide, 30 minutes later with a maintaining dose of 0.01 mg/min).</p><p><b>RESULTS</b>Ibutilide significant suppressed sinus atrial node function, the peak effect was observed at 20 - 30 min post drug infusion and heart rate returned to normal at 2 hours post infusion. Post ibutilide infusion, 1 canine developed sinus pause for 5 seconds and 2:1 atrioventricular conduction block was evidenced in another canine. The atrial, ventricular and pulmonary vein effective refractory periods were all significant prolonged (all P < 0.05) post ibutilide infusion. However, conduction of intraatrium, interatrium and isthmus remained unchanged post ibutilide infusion (all P > 0.05).</p><p><b>CONCLUSIONS</b>Ibutilide could suppress sinus atrial node and the atrioventricular node function. The mechanism of ibutilide on rapidly terminating atrial flutter might be related to the prolongation of the refractory periods which might then result in the reduction of the whole excitable gap of the reentrant circuit and induce proceed inability of reentrant wavefront.</p>