OBJECTIVE To prevent and control the incidence of nosocomial infection,and improve the inner quality of nosocomial infection management.METHODS A total of 49 363 cases of inpatients in the recent four years were retrospectively analyzed.RESULTS Of them 2 409 cases were infected,the incidence was 4.88%.The lower(respiratory) tract ranked the first place (34.16%) and the highest infected rate was in medicine(department)((8.29%).) Totally 505 isolates of bacteria were found,of which Gram-negative ones accounted for 45.15%,(Gram-)positives 25.15%,fungi were for 29.70%.CONCLUSIONS The incidence of nosocomial infection is(connected) with following factors such as age,inpatient factor,invasive diagnosis and treatment manipulation,the misusage of(antibiotics),and the environment quality.

Objective To compare among three different methods in performing hepatic vascular blockade during hemihepatectomy for primary hepatic carcinoma ( PHC). Methods Between 2000 and 2005, 83 PHC patients underwent the Pringle's maneuver (Group A) , 67 cases in combination Pringle's maneuver and inferior vena cava (IVC) clamping (Group B) , and 32 cases received anatomical blood flow blockade for the half liver for hemihepatectomy ( Group C). Results Operation time in group C was longer than that in group A and B(t =3. 27、2. 74,all P

Objective To explore the effect of Bushen decoction on Na+-K+ATPase 、Ca2+-Mg2+ATPase and succinate dehydrogenase(SDH) in rats with heart failure. Methods 60 heart failure rats were established by ligating left anterial descending coronary artery. Theywere randomly divided into model group, sham operation group, trimetazidine group, Bushen low-dose group, Bushen middle-dose groupand Bushen high-dose group with 10 rats in each group. They were gavaged 2 weeks after modeling for 8 weeks, hemodynamic changes includingleft ventricular systolic pressure (LVSP), left ventricular diastolic pressure (LVEDP), and the maximum rate left ventricular pressurerised or decreased (±LVdp/dtmax) were recorded as well as the level of Na+-K+ATP ase、Ca2+-Mg2+ATPase and SDH through the spectrophotometer.Results Compared with the sham operation group, the LVSP and + LVdp/dtmax of rats in model group decreased (P<0.05), LVEDPand -LVdp/dtmax increased (P<0.05). After Bushen intervention, contractility and diastolic function of myocardial of rats in middle and highdose group were better than model group (P<0.01), especially in high dose group. Na+-K+ATP ase、Ca2+-Mg2+ATPase and SDH activity werehigher in Bushen groups than the model group, but lower than the sham operation group. With the increase of the doses, Na+-K+ATP ase、Ca2+-Mg2+ATPase and SDH activity gradually increased. Conclusion Bushen decoction can improve the cardiac function of rats with heartfailure that may be associated with Na+-K+ATPase, Ca2+-Mg2+ATPase and SDH activity.

Objective To explore the therapeutic effect,advantages and shortcomings of pleural effusion controlled by interrupted drainage via central venous catheter.Methods The research group had 52 cases with pleural effusion controHed by interrupted drainage via central venous catheter,and the control group had 50 cases with pleural effusion controlled by conventional pleuracentesis.Pleural effusion disappearing time,average hospitalization time,pleuracentesis frequency,related therapy expenses and complications of two groups were observed and compared.Results The pleuracentesis frequency,pleural effusion disappearing time,average hospitalization time,related therapy expenses and per capita incidence of complications of the research group were(1.06±1.30)times,(4.31±2.20)days,(9.87±2.30)days,(264.77±37.20)yuan and 9.62%and in the control group were(4.20±2.60)times,(9.92±3.70)days,(15.08±5.80)days,(487.62±55.56)yuan and 38.00%.The differences between two groups were particularly remarkable.Conclusion The method of pleural effusion controlled by interruptod drainage via central venous catheter is safe,eonvenient,economical and microtraumatic,and it is worth using more widely.

OBJECTIVE:To observe the efficacy and safety of doxofylline combined with ceftazidime in the treatment of elder-ly patients with chronic emphysema. METHODS:Data of 78 elderly patients with ceftazidime was collected and divided into single drug group(31 cases)and combined medication group(47 cases)according to different treatment methods. All patients adopted flu-id infusion,oxygen inhalation and nutrition support. Based on it,single drug group received 0.05 g Doxofylline injection,once ev-ery 12 h. Combined medication group additionally received 1.0 g Ceftazidime for injection,once every 12 h. If the symptoms were out of control,20 mg prednisone was given,twice a day. The courses of 2 groups were 10 d. Total efficacy,pulmonary functions [maximum mid-expiratory flow(MMEF),1s forced expiratory volume percent predicted(FEV1%),peak expiratory flow(PEF)] before and after treatment,American Concise Health Survey Questionnaire(SF-36 scale)(QLS)and the incidence of adverse reac-tions in 2 groups were observed. RESULTS:The total effective rate in combined medication group was significantly higher than sin-gle drug group,the difference was statistically significant (P<0.05). Before treatment,there was no significant difference in MMEF,FEV1%,PEF and QLS scores between 2 groups(P>0.05). After treatment,MMEF,FEV1%,PEF and QLS scores in 2 groups were significantly higher than before,and combined medication group MMEF,FEV1%、PEF were higher than single drug group,the difference was statistically significant (P<0.05),but there was no significant difference QLS scores in 2 groups(P>0.05). And there was no significant difference in the incidence of adverse reactions in 2 groups (P>0.05). CONCLUSIONS:Based on conventional treatment,doxofylline combined with ceftazidime shows better efficacy than doxofylline alone in the treat-ment of elderly patients with chronic emphysema,it can improve pulmonary functions,with better safety.

Objeetive To discuss the correlation of creatinine reduction ratio(CRR2)from posttransplant day 1 to day 2 and early graft function recovery status after kidney transplantation. Methods Clinical data of 80 patients after renal transplantation from Jan 2005 to Mar 2007 were retrospectively analyzed.Patients were divided into three groups according to the post-operative serum creatinine level:53 patients within IGF group[cereatinine＜265.2 μmol/L by post-operative day(POD)no.5],14 patients within SGF group(creatinine＞265.2 μmol/L on POD no.5,but no need for dialysis),and 13 patients within DGF group(need for dialysis in the first week post-transplant).Then the value and 99%CI of CRRz of these three groups were calculated. Results The value of CRR2 of IGF,SGF and DGF was(46.8±14.6)%,(25.6±13.5)%and(0.7±17.7)%respectively.And CRR2 99%CI of IGF,SGF and DGF was 41%-52%,15%-36%and-14%-16 0A respectively.There was significant difference in the value of CRR2 among IGF,SGF and DGF group.So a criteria for early diagnosis of IGF,SGF and DGF by CRR2 99%C1 was established:IGF(CRR2≥40%),SGF (15%＜CRR2＜40%)and DGF(CRR2≤15%). Conclusion CRR2 has a good correlation with early graft function recovery after kidney transplantation,and can be used to predict the occurrence of SGF and DGF.

Objective:To analyze the clinical efficacy of internal fixation and prosthesis revision in the treatment of periprosthesis fracture after total knee arthroplasty.Methods:A total of 35 patients (35 knees) with periprosthetic fractures after total knee arthroplasty were retrospectively analyzed from January 2008 to January 2022 in the Department of Orthopaedics, West China Hospital, Sichuan University, including 13 males and 22 females, aged 71.4±4.1 years (range, 62-81 years). Left knee 19 cases, right knee 16 cases. There were 20 cases of Rorabeck type II and 15 cases of Rorabeck type III. The initial replacement was performed using a fixed platform post-stabilized knee prosthesis, which was fixed with bone cement. Patients with Rorabeck type II were treated with internal fixation alone (internal fixation group) and patients with Rorabeck type III underwent revision with replacement prosthesis (revision group). The Hospital for Special Surgery (HSS) score, range of motion (ROM) of knee joint, alignment of lower extremity and incidence of postoperative complications were compared between the two groups.Results:All patients successfully completed the operation and were followed up for 5.2±3.6 years (range, 1-12 years). Intraoperative blood loss was 680±102 ml (range, 420-1100 ml). The operative time in the internal fixation group was 105±17 min, which was less than 140±21 min in the revision group, and the difference was statistically significant ( t=-5.450, P<0.001). There was no complication of nerve or blood vessel injury during the operation. Five cases in the internal fixation group had unsatisfactory lower extremity force lines (>3° deviation from normal) after surgery, and all lower extremity force lines in the revision group were satisfied, and the difference in the satisfaction rate of lower extremity force lines between the two groups was not statistically significant ( P=0.057). The fracture healing time, knee ROM and HSS scores at the last follow-up were 5.1±1.3 months, 86°±5° and 84±5 in the internal fixation group and 4.8±1.5 months, 83°±6° and 82±4 in the revision group. One case in the revision group was diagnosed postoperatively with periprosthetic infection with pathogen culture suggestive of Candida albicans, recurrent anterior knee sinus tracts and patellar ectasia, which progressed to osteomyelitis, and mid-thigh amputation was performed 1 year after revision. Conclusion:The stability of prosthesis is an important reference for the treatment of periprosthetic fractures after total knee arthroplasty. Strong internal fixation in patients with unloosened prosthesis and revision with replacement of prosthesis in patients with loose prosthesis can achieve good knee joint function.

Objective To explore the diagnostic value of quantitative radiomics features from dual-modal ultrasound composed of elastography and B-mode for axillary lymph node metastasis in breast cancer patients. Methods We retrospectively analyzed 161 axillary lymph nodes (69 benign and 92 metastatic) undergoing real-time elastography and B-mode ultrasound from 158 patients with breast cancer. We extracted a total of 428 features, consisting of morphologic features from B-mode, and intensity features and gray-level co-occurrence matrix features from the dual modalities,and the optimal subsut of features was selected through least absolute shrinkage and selection operator (Lasso) under the condition of leave-one-out cross validation. We used SVM for the classification of benign and metastatic nodes. Results The sensitivity, specificity, accuracy and Youden's index of the 35 radiomics features selected with Lasso were 86.96%, 85.51%, 86.34% and 72.46%, respectively. Conclusion The radiomics features from dual-modal ultrasound (elastography and B-mode) have demonstrated good performance for classification and have potential to be applied to clinical diagnosis of axillary lymph node metastasis.

Objective:To explore the effect of problem-based learning (PBL) combined with case teaching method in the three-year probationary teaching of clinical urology in three-year higher vocational colleges.Methods:A total of 45 students from Class 1, Grade 2015, and 37 students from Class 2, Grade 2016 of Ningxia Medical University were selected as study subjects. They were divided into experimental group and control group. Forty-two students in experimental group were taught with PBL combined with case teaching method. 40 students in control group were taught with traditional clinical probation teaching method. Besides, a questionnaire survey was conducted among two groups of students in the Department of urology.Results:There was no significant difference in the scores of theoretical examination between the experimental group and the control group ( P>0.05). The scores of medical history collection, physical examination, practical skills and total scores were much higher in the experimental group than in the control group. The results of the questionnaire survey showed that the teaching of the experimental group could significantly motivate students' enthusiasm and participation, as well as enhance ability of self-study, information acquisition, innovation, analysis and problem-solving and team consciousness ( P<0.05). Conclusion:The new model of PBL combined with case teaching is helpful in improving students' academic performance, probation effect and comprehensive practical ability in urology internship teaching, which is worth being popularized in clinical teaching.

Objective:To compare the clinical outcomes and correction effects of kyphosis between Zero-profile device (Zero-p) and plate/cage structures (PCC) in treating cervical spondylotic myelopathy (CSM) patients with cervical kyphosis.Methods:From August 2016 to July 2018, a total of 54 cases of cervical spondylotic myelopathy patients with cervical kyphosis were analyzed retrospectively, including 26 cases treated with Zero-p and 28 cases treated with PCC system. There was no significant difference between the two groups in gender, age, body mass index (BMI) and operative segment. The operation duration and the blood loss were recorded. The clinical outcomes of the patients were measured by visual analogue score (VAS) for neck pain and Japanese Orthopedic Association (JOA) score for neurological function. Moreover, JOA recovery rate was obtained to assess the surgical results. The cervical lordosis (C 2-C 7 Cobb angle), the Cobb angle of the operation segment, the C 2-C 7 vertical axis (C 2 SVA) and the cervical range of motion (ROM) were measured on the lateral and dynamic radiographs of the cervical spine, respectively. Results:In the Zero-p group, the operation duration was 83.0±14.9 (range 60-120) min, intraoperative blood loss was 70.5±27.3 (range 30-150) ml. In PCC group, the operation duration was 100.0±23.9 (range 65-145) min, intraoperative blood loss was 104.2±38.8 (range 30-250) ml. There were significant difference in above parameters between two groups ( t=3.40, 2.06; P=0.00, 0.04). The follow-up duration in Zero-p group was 30.4±5.8 (range 24-36) months and 31.2±4.9 (range 24-36) months in PCC group without significant difference ( t=1.061, P=0.291). The VAS/JOA score of the Zero-p group was improved from (5.9±1.0)/(9.2±1.7) preoperatively to (2.1±0.8)/(14.9±1.0) at 1 month postoperatively, and to (3.4±1.0)/(15.1±0.9) at the last follow-up. The difference between them was statistically significant ( F=130.96, 221.40, P=0.00). The VAS/JOA score of the PCC group was improved from (5.9±1.1)/(8.7±1.6) preoperatively to (2.3±0.9)/(14.9±1.0) at 1 month after surgery, and to (2.6±0.9)/(15.6±1.1) at the last follow-up. The difference between them was statistically significant ( F=303.35, 126.64, P=0.00). However, the VAS score of neck pain in the Zero-p group at the last follow-up was significantly deteriorated, which was significantly higher than that in PCC group ( P<0.05). The cervical lordosis/operative segment Cobb angle in the Zero-p group was improved from preoperative (-6.7°±2.7°)/(-6.5°±3.2°) preoperatively to (14.2°±4.9°)/(12.9°±4.9°) at 1 month postoperatively, and to (5.9°±4.7°)/(5.0°±4.0°) at the last follow-up with statistical significance ( F=196.98, 179.97, P=0.00). The cervical lordosis/operative segment Cobb angle in the PCC group was improved from (-5.7°±3.5°)/(-6.1°±4.0°) preoperatively to (13.9°±6.9°)/(13.0°±6.4°) 1 month after surgery, and to (11.0°±5.5°)/(10.4°±5.6°) at the last follow-up with statistical significance ( F=127.27, 119.98, P=0.00). However, the cervical lordosis and operative segment Cobb angle at the last follow-up in the Zero-p group were significantly lost compared with those at 1 month after surgery, which were significantly smaller than those in the PCC group ( P<0.05). The incidence of dysphagia after operation was 7.7% (2/26) in the Zero-p group and 28.6% (8/28) in the PCC group (χ 2=5.11, P=0.02). Conclusion:For CSM patients with cervical kyphosis, PCC could achieve much better mid-term kyphotic correction and clinical outcomes. However, Zero-p should be avoided as much as possible.