0.05) and systolic velocity of regional myocardium, the difference between Ven and Vep, and mitral valve annulus have improved during the follow up study( P

Objective To investigate healthcare-associated infection(HAI)prevalence and antimicrobial use in a hospital.Methods HAI prevalence rate,antimicrobial use and pathogen detection in all inpatients on August 21 , 2013 were investigated with cross-sectional survey method.Results A total of 2 238 inpatients were investigated, 104 patients developed 126 times of HAI,HAI prevalence rate and case rate was 4.65% and 5.63% respectively;the top four sites for HAI were lower respiratory tract (28.57%),upper respiratory tract(18.25%),urinary tract (7.94%)and gastrointestinal tract(4.76%).Rate of specimens delivered for detection was 91 .35%(95/104),the main specimen was sputum (26.32%),followed by blood (25.26%)and urine (10.53%).Antimicrobial usage rate was 24.58%,therapeutic,prophylactic plus therapeutic,and prophylactic use accounted for 36.55%,45.09%, and 18.36% respectively;the usage rate of single,combination of 2,and 3 antimicrobial agents accounted for 75.82%,20.91 % and 3.27% respectively.Risk factors of HAI were age (<15 or >60 years),all kinds of inva-sive procedures (tracheotomy,mechanical ventilation,urinary catheterization,arteriovenous intubation,hemodialy-sis),and anti-tumor chemotherapy.Conclusion Survey on HIA prevalence helps to know the occurrence of HAI and usage of antimicrobial agents,as well as risk factors and high-risk departments of the occurrence of HAI,it also provides basis for subsequent targeted monitor on HAI.

Objective To explore the application of adenosine triphosphate (ATP )bioluminescence assay in evaluating cleaning quality of medical devices.Methods Manual and machine cleaned medical devices were randomly selected from central sterile supply department of a hospital in 2011 -2013,cleaning quality was detected with ATP biolumi-nescence assay,relative light unit (RLU)value was determined to assess the cleaning quality.Results A total of 460 pieces of cleaned devices were detected in 2011 -2013,404 (87.83%)were qualified.The qualified rates of manual cleaning and machine cleaning were 70.73% and 94.07% respectively,the qualified rates of general surgical devices and lumen devices were 90.71 % and 81 .76% respectively,there were significant differences in qualified rates of different cleaning methods and different categories of medical devices (both P <0.01 ).The qualified rates of manual cleaning in 2011 - 2013 were 32.35%,79.63%,and 94.29% respectively,machine cleaning were 79.45%,98.15%,and 98.08% respectively;differences in qualified rates of manual cleaning and machine cleaning in different years were significant (all P <0.01 ).Conclusion ATP bioluminescence assay can be used for evalua-ting cleaning quality of medical devices.

Objective To detect bacterial content on surface of mobile phones of health care workers (HCWs)by adenosine triphosphate (ATP )bioluminescence assay.Methods HCWs in departments of internal medicine,surgery, medical laboratory,and administration were randomly selected,50 in each department,field detection on bacterial content on surface of mobile phones of HCWs was conducted,the relevant data were recorded.Results A total of 200 mobile phones were detected,33 mobile phone surface were qualified,the qualified rate was 16.50%.Qualified rate of mobile phone surface of HCWs in different departments as well as mobile phone disinfected by different modes were different(χ2 =13.46,10.24,respectively,both P <0.01);difference in qualified rate of mobile phones of different types,different service life,and different protective case were all not significant (χ2 =4.37,1 .87,0.25 respectively,all P >0.05).Conclusion The qualified rate of bacterial content on surface of HCWs’mobile phone is low,the awareness of hand hygiene of HCWs should be strengthened,regular cleaning and disinfection on the mo-bile phone can effectively reduce bacteria on the mobile phone surface.

Totally 126 patients with malignant breast tumors diagnosed with ultrasound were followed up.The ultrasonic image characters were analyzed and compared with the pathologic outcomes. Ultrasound had a 92.1%(116/126) veracity in the diagnosis of malignant breast tumor,which were characterized by strong echo in the border of the tumors and halo (72.2%, 91/126).There were differences in ultrasonic images of malignant breast tumors with different pathologic types. Ultrasound can determine the character of most breast tumors.

Objective To investigate the correlation between serum tumor markers levels with the disease condition activity and the tumor occurrence in the patients with rheumatoid arthritis(RA).Methods Serum tumor marker CA199,CA153 levels were de-tected in 35 patients with RA (RA group)and 31 healthy controls(normal control group).ESR and CRP were examined and the disease activity (DA)was assessed by the DAS28 score in the RA group.The serum tumor markers levels and the positive rates were compared between the RA group and the normal control group.The correlation between the serum tumor markers levels with ESR,CRP and DAS28 score was analyzed.Results Serum levels and positives rate of CA199,CA153 in the RA group were higher than those in the control group(P <0.05).The serum CA153 level had a positive correlation with the ESR,CRP and DAS28 score in the RA group(P <0.05),but the serum CA199 level had no significant correlation with them.Conclusion The serum levels and positive rates of CA199 and CA199 could be increased in the patients with RA,moreover the increase of serum CA153 level is corre-lated with DA of RA.Therefore the serum tumor marker CA153 level may be used as one of reference indexes for evaluating the DA in the patients with RA.

Objective To investigate the clinical efficacy of treatment for chronic pancreatitis and mass in the head of the pancreas.Methods The clinical data of 19 patients with chronic pancreatitis with mass in the head of the pancreas who were admitted to the China-Japan Union Hospital of Jilin University from May 2008 to May 2013 were retrospectively analyzed,including 2 patients with gallstone.Methods of treatment were selected by in traoperative pathological results.All the patients were followed up by outpatient examination and telephone interview till January 2014.Results The operations of the 19 patients were successfully done,including 11 with pancreaticoduodenectomy,5 with exploratory laparotomy and 3 with the laparoscopic cholecystectomy and choledochojejunostomy.The operation time and intraoperative blood loss were (249± 140)minutes (50-390 minutes) and (320 ± 260)mL (50-900 mL).The postoperative mean time of recovery of gastrointestinal function and duration of postoperative hospital stay were 3.0 days (2.0-6.0 days) and 22.6 days (8.0-30.0 days) after the operation.The mean casein-IgG4 of 12 patients was higher (2.64 g/L) after operation.Five patients with operation-related complication were cured after symptomatic treatment,among 2 patients with leakage of the pancreatic fluid,2 with operative incision fat necrosis and liquefaction and 1 with bile leakage.No patients died perioperatively.Nineteen patients were followed up for 11.0 months to 36.0 months with the median time of 28.2 months.The pancreatic head mass of 8 patients with non-pancreaticoduodenectomy were reduced or disappeared by a computed tomography (CT) or magnetic resonance imaging (MRI) rescan,who were treated by the oral prednisone.No complications were detected in the other 11 patients with pancreaticoduodenectomy.Conclusion Method of surgery or medicine treatment for atypical mass in the head of the pancreas is selected according to the pathology results by effective communication with patients and family members,exploratory laparotomy and interpretative aspiration biopsy.

Objective To study the clinical features and protective measures of AIDS with fungal esophagitis as the initial presentation,improve the knowledge of non-specialist medical staff of AIDS. Methods The clinical manifestations,laboratory tess.endoscopic examination,and medical protective measures of 15 AIDS patients with fungal esophagitis were analyzed. Reults The patients were infected through sexual transmission mainly,and manifestation included difficuhy in swallowing,retrostemal pain,weight loss,fever,loss of appetite,fatigue and other symptoms.The patients got confirmed diagnosis by our hospital after visiting many other hospitals.3 patients were automatically discharged after confirmed diagnosis,other patients impreved after antifimgal therapy and symptomatic treatment.No iatrogenic infection occurred during hospitalization. Conclusions Non-specialist medical staff in AIDS should recognize the clinical features of AIDS,give timely confirmed diagnosis and treatment,avoid missed diagnosis and misdiagnosis,strengthen protective measures and avoid iatrogenic infection.

Objective To study the clinical characteristics of primary Sj(o)gren's syndrome (pSS) patients with dry eyes.Methods Ninety-six pSS patients with dry eyes admitted to the Department of Rheumatology and Immunology,the Affiliated Hospital of Guilin Medical College from August 2009 to August 2011 were retrospectively analyzed.Results In all 96 patients,89 patients had symptoms,23 of whom had two or more symptoms.The tear-film break-up time (BUT) of 154 eyes were Less than 5 seconds,18 were between 5-10 second,and twenty were more than 10 seconds,with the average of 3.7±1.9 seconds.The length of tear flow of 154 eyes'width of tear mocus was less than 3 millimetres (mm),with the average of (0.21±0.10) mm.The average score of corneal fluorescein staining score was 5.2±2.4.The wet lengths of filter paper of 192 eyes were all less than 10 mm/5 min,with the average of (4.6±1.8) mm.The average score of meibomian gland function was 1.5±0.9.Conclusion In patients with pSS,the width of tear meniscus and the wet lengths of filter paper are reduced,which implies less tear secretion.At the same time,BUTs are short,and the Meibomian gland dysfunction are observed.Dry eyes of pSS are mixed in type,not only aqueous tear deficiency.

Objective To investigate the correlation between serum osteocalcin and type 2 diabetes mellitus (T2DM) in elderly patients.Methods A total of 55 T2DM patients (diabetic group) and 50 non-diabetic subjects (control group) aged ≥60 years were enrolled in this study.The levels of fasting blood glucose (FBG),glycated hemoglobin (HbAlc),insulin resistance index (HOMA IR),osteocalcin (OC),body mass index (BMI) and bone mineral density (BMD) in groups were compared.The correlations between serum osteocalcin and the above indicators were analyzed.Results The levels of OC and BMD were higher in control group than in diabetic group [(11.2±3.2)μg/Lvs.(4.1±3.0)μg/L,(-1.3±0.3) vs.(-2.6±0.5),respectively,both P＜0.05].The levels of FBG,HbAlc,FINS,HOMA-IR were lower in control group than in diabetic group [(4.7±2.0) mmol/L vs.(9.4±2.1) mmol/L],[(4.8±1.5) ％ vs.(7.6±1.6)％,(7.4±3.2) U/L vs.(23.7±3.0) U/L,(1.5±0.7) vs.(9.9±1.2),respectively,all P＜0.05].Serum osteocalcin concentration was negatively correlated with the levels of FBG,HbAlc,FINS and HOMA-IR in elderly patients with T2DM (r=-0.739,-0.713,-0.613,-0.092,all P＜0.01).Conclusions Serum osteocalcin concentration is correlated with the levels of blood sugar and insulin resistance index in elderly patients with T2DM.A further study on the correlation between osteocalcin and T2DM may provide a new target for the treatment of type 2 diabetes mellitus.