OBJECTIVE To investigate the appropriate time of changing Ke Lai Fu infusion connector of central venous infusion catheter.METHODS The patients were selected from Internal Oncology Dept in our hospital based on certain criteria,and divided these patients with central venous infusion catheter into 4 groups.The new infusion connector of their central venous catheter was changed every 7 days,10days,15 days and 30 days etc.The replaced infusion connectors were rinsed by normal saline and their residual flush liquids were sent for bacterial culture.The group that their bacterial culture of residual flush liquids was negative was determined as the best changing days of infusion connectors.RESULTS The bacterial culture positive rates of Ke Lai Fu infusion connectors which were renewed every 7 days,10 days,15 days and 30 days,were 0,8.1%,10.3%and 29.7%,respectively.The best renewing days of connector was 7 days.CONCLUSIONS This result of the study provides a valuable guidance for the proper application of infusion connectors and effectively prolonging the indwelling days of central venous infusion catheter;therefore it can decrease hospital infection rate.

Objective To investigate the reasons and nursing countermeasures of the discomfort of peripher-ally inserted central catheter(PICC)intubation patients in the process of placing tube.Methods 290 patients with PICC who were treated with PICC for the first time were summarized.Results 290 patients with PICC in catheter had not comfortable experience.The main reason of causing discomfort was psychological factors,accounted for 90.0%, catheter when the cold experience leads to the discomfort of 82.8%,catheter environmental factors accounted for 6 3 .8 % ,pain caused by discomfort accounted for 15.5% ,puncture posture factors leading to 13.1% .Conclusion The causes of discomfort in the process of PICC is more,strengthen preoperative health education and the operation of effective communication,to create a relaxed comfortable environment to help patients take comfortable posture,improve a catheter success rate,preventing catheter during cold and other measures can improve the patients'comfort.

Objective To observe the effect of hot compress with medicinal salt pack in preventing PICC-associated mechanical phlebitis.Method Totally 200 inpatients undergone PICC intubation were randomized into a treatment group and a control group, 100 cases in each group. After PICC intubation, the treatment group was intervened by hot compress with medicinal salt pack, while the control group was by hot compress with warm wet towel. The occurrence of mechanical phlebitis was observed at different time points and compared between the two groups. Result The occurrence rate of mechanical phlebitis was 9.0% in the treatment group versus 26.0% in the control group, and the difference was statistically significant (P<0.05). In the treatment group, the occurrence rate of mechanical phlebitis was respectively 6.0% and 3.0% when treatment≤72 h and>72 h, versus 16.0% and 10.0% in the control group, and the differences were statistically significant (P<0.05). Conclusion Hot compress with medicinal salt pack can effectively reduce the occurrence of PICC-associated mechanical phlebitis.

Objective To investigate the clinical significance of universal newborn hearing screening for deaf‐ness predisposing genes in newborns .Methods A total of 965 newborns at Subei Hospital in Yangzhou were taken blood samples at heel and received for deafness predisposing genes screening .The most common deafness genes were detected by gene sequencing ,including mt12SrRNA c .1555A > G ,c .1494C > T ,GJB2 35delG ,167delT ,176_191del16 ,235delC ,299_300delAT ,SLC26A4 281C> T ,589G>A ,IVS7 -2A>G ,1174A> T ,1226G> A ,1229C> T ,IVS15+5G> A ,1975G>C ,2027T > A ,2162C> T ,2168A> G ,GJB3538C> T ,547G> A .At the same time ,all infants received hearing screening .Otoacoustic emission(OAE) was used as the first step screening ,and OAE combined with auto-auditory brainstem response(AABR) detection were used as the second step screening . Results Fifty -three cases (5 .49% ) had partial gene mutation ,one case of 12SrRNA gene mutation ,33 cases of GJB2 gene mutation ,18 cases of SCL26A4 gene mutation ,one case of GJB3 gene mutation .Of 965 cases ,28 cases failed to pass hearing screening while 18 cases did not pass rescreening .There were 10 cases taking audiological di‐agnosis at the age of three months .Six cases were confirmed with hearing loss .There were 905 cases passed thehearing screening and genetic screening ,11 failed born hearing and gene screening .Conclusion That the newborn gene screening was added into the hearing screening can be helpful to find out the deafness predisposing genes and drug -induced or late-onset hearing loss .

Objective To explore the relationship of catheter-directed thrombolysis and deep venous thrombosis.Methods We analyzed 2267 consecutive central venous catheter attempts from January to December in2006.Results 18 patients had deep venous thrombosis,and several studies have identified factors associated with mechanical complications of central venous catheter.These factors include illness,the use of drug,mobility.Conclusion It is very important to prevent and cure deep venous thrombosis and decrease incidence of death of knowing many risk factors and clinical symptoms of catheter-directed thrombolysis.

Objective:To retrospectively evaluate the prognostic risk factors of T1-2 stage breast cancer patients with one to three positive node(s) and their effects on the benefits of post-mastectomy radiation therapy (PMRT). Methods:We retrospectively analyzed 457 breast cancer patients with T1-2 stage and one to three positive axillary lymph nodes treated in our hospital between 2000 and 2002. The independent prognostic factors of the patients were calculated by the Cox proportional hazards model. The patients were fur-ther classified into high-risk and low-risk subgroups according to the risk factors to explore the benefit of PMRT on the prognosis of dif-ferent subgroups using survival analysis. Results:PMRT was not an independent beneficial factor of overall survival (OS) (HR=0.949;CI:0.435-2.074;P=0.896) or loco-regional recurrent free survival (LRRFS) (HR=0.611;CI:0.231-1.614;P=0.320) in all patients. Ex-tracapsular extension (ECE) and pathological grades were independent prognostic risk factors, and the benefits of PMRT were signifi-cantly different on the prognosis of high-risk subgroup patients (group ECE+OS:P=0.020, LRRFS:P=0.014;group GradeⅢOS:P=0.002, LRRFS:P<0.001). Meanwhile, PMRT failed to prolong the OS and LRRFS of low-risk subgroup patients (group ECE+OS:P=0.353, LRRFS:P=0.796;group GradeⅠtoⅡOS:P=0.267, LRRFS:P=0.589). Conclusion:ECE and gradeⅢwere the independent risk factors of death and loco-regional recurrence in the T1-2 breast cancer patients with one to three positive lymph node(s). PMRT was an effective adjuvant therapy to improve the prognosis of patients with high-risk factors. However, the benefit of PMRT had no sig-nificance in patients with ECE-or gradeⅠ-Ⅱ.

ObjectiveTo investigate the genetic polymorphisms of 21 short tandem repeat(STR)loci (D3S1358, D13S317, D7S820, D16S539, Penta E, D2S441, TPOX, TH01, D2S1338, CSF1PO, Penta D, D10S1248, D19S433, vWA, D21S11, D18S51, D6S1043, D8S1179, D5S818, D12S391 and FGA). Methods A total of 560 blood samples were collected from unrelated healthy individuals of Han population in Hunan Province. Chelex-100 extraction method was applied to the extraction of genomic DNA, and an AGCU EX22 Kit and 9700 STR amplification was used in amplification reactions. The products were separated and analyzed on 310 Genetic Analyzer.ResultsA total of 248 alleles were observed, the al-lelic frequencies ranging from 0.001 to 0.518. Observation of genotype distributions for each locus showed no deviations from Hardy-Weinberg equilibrium exceptPentaE(P=0.023). The combined pow-er of discrimination, combined power of exclusion, and combined matching probability of the 21 STR loci were approximately 0.999 999 999 999 999 999 999 999 8, 0.999 999 998, and 1.36×10-25, respectively. ConclusionThe 21 STR loci show high polymorphisms in the Han population, which can provide valu-able data and a theoretical basis for forensic individual identification and paternity testing.