OBJECTIVE To investigate the nosocomial infection management,prophylaxis and control in delivery room and then to prevent the nosocomial infection events in delivery room. METHODS Concluding and analyzing the risk factors of nosocomial infection in delivery room,the management methods,prophylaxis and controlling measures were formulated. RESULTS The risk factors of nosocomial infection in delivery room were controlled by means of carrying out management and prophylaxis measures strictly. CONCLUSIONS Doing well in management,prophylaxis and control of risk factors in delivery room are the key to prevent the nosocomial infection event in delivery room.

Background and purpose: Brain metastases are common occurrences in patients with non-small cell lung cancer (NSCLC). Gefitinib is a specific inhibitor of epidermal growth factor receptor-associated tyrosine kinase, which has been commonly used in the treatment for advanced NSCLC. The aim of this study was to evaluate the antitumor efficacy of gefitinib in NSCLC patients with brain metastases. Methods: Fifty NSCLC patients with brain metastases were reviewed retrospectively. All of them were treated with gefitinib, given orally at a daily dose of 250 mg. These patients discontinued administration of gefitinib when disease progression, death or intolerable side effects appeared. X~2 test was applied in response analysis. Survival analysis was compared with Kaplan-Meier method and Log-rank test respectively. The multivariate analysis was perfonned with Cox's proportion risk model. Statistical significance was defined as P<0.05. Results: In terms of intracranial lesions, partial response (PR) was observed in 5 patients (10%), stable disease (SD) in 37 patients (74%) and progressive disease (PD) in 8 patients (16%), objective response rate (ORR) and disease control rate (DCR) were 10% and 84%, respectively. As for systemic disease, PR was observed in 5 patients (10%), SD in 30 patients (60%) and PD in 15 patients (30%), overall ORR and DCR were 10% and 70%, respectively. Overall DCR was related to the patients' PS score and the number of brain metastases (P=0.004, P=0.022), but there was no statistical difference in overall DCR among different subtypes of age, gender, smoking history, histology, the onset of brain metastases, chemotherapy, brain radiotherapy and side effects (P>0.05). The median time to disease progression (MTTP) was 7.0 months, which was related to the patients' PS score and smoking history (P=0.000, P=0.045). The median survival time (MST) was 10.8 months, and 1-and 2-year survival rates were 44% and 6% respectively. The univariate analysis showed that the survival time was related to the patients' PS score. smoking history and the number of brain metastases (P=0.011, P=0.028, P=0.044). The multivariate analysis indicated that both the patients' PS score and smoking history were two independent prognostic factors (P=0.005, P=0.006) and the relationship of the survival time and the number of brain metastases was near to statistical significance (P=0.075). Conclusion: The patients with non-smoking history and favorable performance status(PS 0-1) may have better survival benefit and those with single brain metastasis have a trend to survive longer. Gefitinib may be effective on brain metastases in NSCLC patients and appears to be a possible new treatment option.

OBJECTIVE To investigate the characteristics of mycoplasma infection and antifungal resistance to guide the clinical reasonable usage.METHODS Mycoplasma was isolated and its antibiotic susceptibility was detected by Mycoplasma IES test kit.RESULTS Among the 1103 samples,418(37.8%) were positive,including 268 with Ureaplasma urealyticum(Uu)(64.1%),13 with Mycoplasma hominis(Mh)(3.1%),and 137 with mixed infection(Uu and Mh)(32.8%),Young people with the age from 20 to 45 were the highest group of infection(80.1%),Sensitive antibiotics to mycoplasma in precedence order were doxycyline,minocycline,tetracycline,josamycin,and clarythromycin.CONCLUSIONS Mycoplasma is a common pathogen resulting in urogenital tract infection.We should pay more attention to monitor mycoplasma infection and use antibiotics properly and to guide clinically antibiotics usage.

11?-hydroxylase deficiency is one of the main causes of congenital adrenal hyperplasia (CAH),which is caused by the mutation of CYP11B1 gene that encodes the enzyme.Researches have shown that mutations of CYP11B1 gene would result in decreased activity or inactivation of the enzyme in classical 11?- hydroxylase deficiency,and their relationship between genotype and phenotype of 11?-hydroxylase deficiency is not clear.

Objective To analyze the treatment and prognosis of lung cancer patients with brain metastases.Methods The clinical data of 352 lung cancer patients with brain metastases were retrospectively reviewed.According to the treatment modalities,patients were divided into palliative therapy group(n=28),simple whole brain radiotherapy(WBRT)or chemotherapy group(n=49)and comprehensive treatment group(n=275).Comprehensive treatment group was subdivided into WBRT plus chemotherapy group(n=192),stereotactic radiosurgery(?knife)plus chemotherapy/WBRT group(n=72,n=16 for?knife plus chemotherapy and n=56 for?knife plus WBRT and chemotherapy)and neurosurgical resection plus chemotherapy/WBRT group(n=11).In comprehensive treatment group,111 patients received chemotherapy≤3 cycles,and the other 164≥4 cycles.Survival curves of each group were drawn respectively,and both survival time and survival rates were compared among groups.Results The median survival time of palliative therapy group,simple WBRT or chemotherapy group,WBRT plus chemotherapy group,?knife plus chemotherapy/WBRT group and neurosurgical resection plus chemotherapy/WBRT group was 1.7,3.2,9.0,11.6 and 17.1 months,respectively.It was revealed by survival analysis that WBRT plus chemotherapy group was better than simple WBRT or chemotherapy group (P=0.0000),?knife plus chemotherapy/WBRT group was better than simple WBRT or chemotherapy group(P=0.0000),and neurosurgical resection plus chemotherapy/WBRT group was better than simple WBRT or chemotherapy group and WBRT plus chemotherapy group(P=0.0001,P=0.0229).There was no significant difference in survival rates between neurosurgical resection plus chemotherapy/WBRT group and?knife plus chemotherapy/WBRT group(P=0.2543),and there was no significant difference in survival rates between those with?knife plus chemotherapy and those with?knife plus WBRT and chemotherapy(P=0.3804).In comprehensive treatment group,the survival rates of those with chemotherapy≥4 cycles was significantly higher than that of those with chemotherapy≤3 cycles(P=0.0000). Conclusion Both WBRT plus chemotherapy and?knife plus chemotherapy and WBRT are effective modalities for the treatment of lung cancer patients with brain metastases,and the latter has the tendency to gain more survival benefit.There is no significant difference in the survival time between patients receiving?knife with WBRT and those without.It is proper for the patients to have no less than 4 cycles of chemotherapy.

Background and purpose:Brain is one of the most common sites for distant metastasis in patients with non-small cell lung cancer,and the prognosis of patients with brain metastasis is usually dismal.The purpose of this retrospective study is to document the relationship between the prognosis of lung cancer patients with brain metastasis and the expressions of p53,nm23 and VEGF in resected lung cancer tissues.Methods:Ninety-two patients who were definitively treated with surgery for non-small cell lung cancer but lately developed brain metastasis between 1997 and 2005 were identified in our institution.Their clinical data were retrieved and retrospectively reviewed.All pathological specimens of their resected lung cancer were examined for the expressions of p53,nm23 and VEGF by immunohistochemical staining.The association between the treatment outcome and the expression of the above mentioned biomarkers were analyzed.Results:The median survival time(MST) of patients with p53(+) versus p53(-) was 11.0 versus 11.9 month,respectively.The 1,2,and 3-year overall survival rates were 45.71%,22.86%,and 18.29% respectively for p53(+) patients,and 49.55%,16.12%,and 8.89% respectively for p53(-) patients(P=0.5179);The MST of patients with nm23(+) versus nm23(-) was 13.0 versus 10.1 month,respectively.The 1,2,and 3-year overall survival rates were 54.20%,21.51%,and 16.45% respectively for nm23(+) patients,and 32.0%,12.0%,and 4.0% respectively for nm23(-) patients(P=0.1075);The MST of patients with VEGF(+) versus VEGF(-) was 10.5 versus 12.2 months,respectively.The 1,2,and 3 year overall survival rates were 42.20%,0,and 0 respectively for VEGF(+) patients,and 50.0%,25.41%,and 16.57% respectively for VEGF(-) patients(P=0.0231).Conclusions:VEGF was a significant adverse prognostic factor for patients with non-small cell lung cancer who developed brain metastasis.Lung cancer patients whose tumor tissue demonstrated positive VEGF expression had reduced overall survival rates at 1,2,and 3 years after surgery.The expression of p53 and nm23 are not significantly associated to the prognosis of this group of patients.

Objective To compared intensity modulated radiation therapy (IMRT) with conventional radiotherapy(CR) for the left side breast cancer after breast-conserving surgery in regard to the homogeneity of dose in the target area, cardiac dose and irradiation volume in the target area. Methods Thirty-eight patients received inverse planning of IMRT with dynamic multi-leaf collimation (dMLC). Prescription dose was 46Gy in breast volume with X-ray, and added electron boost dose was 14Gy in the tumor bed, with a total dose of 60Gy. Clinical target volume(CTV) and heart were evaluated with dose-volume histograms(DVH) in the two plans, with the t test taken with SPSS 11.0. Results Average received dose of 95% breast volume(D 95) was (4541?34),(4517?62)cGy, volume of 105% of dose prescription(V 105%) was 17.5%?17.6%,29.4%?26.3%, while V 110% was 0.3%?0.8%,3.7%?8.2% with IMRT and CR, respectively. Received 30Gy by the heart(V 30) was 4.6%?4.3%,18.8%?12.2%(P

BACKGROUND:The functional reconstruction of large maxillary defects is a significant challenge due to the lack of bony support.In this paper.a new approach for segmental maxillary reconstruction and bony support foundation is put forward and tested by animal experiment.OBJECTIVE:To evaluate the possibility of segmental maxillary regeneration by internal curve distraction osteogenesis of zygoma with the self-developed distractor.DESIGN:Animal experiment.SETTING:Department of Stomatology.the 252 Hospital of Chinese PLA.MATERIALS: Two healthy female hybrid canines of 1-1.5 years old and 20-25 kg were selected. Internal curve distractor was composed of three parts:curve track,movable part and a flexible central thread bar fixed at the center of the curve track.The former two parts,which was made of TC4,(Ti-6AI-4V),and the flexible central thread bar was made of nickel titanium wire. A 360° of counter clockwise rotation of the distraction activator achieved an advancement of 0.35 mm for the movable part;the maximum distraction length allowed by the distractor was 25 mm.METHODS: The experiment was carried out in the animal experimental center of Fourth Military Medical University of Chinese PLA from October 2003 to February 2004. The segmental defect of 18-20 mm in width was made in maxilla and zygoma to simulate maxillary defects.Then an osteotomy distal to the defect was performed to create the variable transport disk. The distractor was fixed to the residual zygoma and zygomatic arch for internal curve distraction osteogenesis.After a latency period of 5 days,the distraction started at a ratio of 1.05 mm per day (0.35 mm once,3 times per day) for 13 consecutive days. Before and after distraction and at the second, fourth and eighth week of consolidation, the bone radiographs of residual zygoma and zygomatic arch were taken routinely.MAIN OUTCOME MEASURES: The general condition of the animals and distractor, and the quality and quantity of new formation bone in the distracted gap.RESULTS:Canines and distractor were in good condition during the experimental period.X-ray film showed that at the end of distraction, the bony transport disks were distracted about 12 mm around arc.At the 8th week of consolidation,the density of new bone was close to that of normal bone,and the curved bony regeneration was almost completed.CONCLUSION: The serf-designed curve internal distractor is fit the condition of major maxillary defects,and could be used for the internal curve distraction of zygoma.

The morbidity and nortality of esophageal carcinoma showed an upward trend in recent years.Neoadjuvant radiochemotherapy is the nain mode of treatment for advanced esophageal carcinoma,including neoadjuvant chemotherapy,neoadjuvant radiotherapy and neoadjuvant radiochemotherapy.However,there are still many controversies on efficacies and advantages or disadvantages of treatment mode.In this article,authors will investigate the present situations and future direction of neoadjuvant therapy for locally advanced esophageal carcinoma.

Objective To explore the impact of transtheoretical model on sun protection behaviors of soldiers in plateau area.Methods A total of 208 male soldiers trained in 4 200 meters altitude and medically supported by our hospital were randomly divided into the experimental group(n=104) and the control group(n=104).The experimental group received health education based on the transtheoretical model,and the control group received routine health education.Score of sun protection behaviors questionnaire,sunscreen using behavior and score of the Dermatology Life Quality Index (DLQI) before and after the intervention between two groups were compared.Results Score of sun protection behaviors questionnaire in the experimental group was higher than that in the control group (P＜0.05),sunscreen using behavior in the experimental group was better than the control group(P＜0.05),score of the Dermatology Life Quality Index in the experimental group was lower than the control group(P＜0.05).Conclusion Health education guided by the transtheoretical model can improve the plateau soldiers' sun protection behaviors,and it is an effective method of health education.