OBJECTIVE To study the sites of nosocomial infection in the Traditional Chinese Medical Hospital and the pathogen distribution and drug resistance;to provide basis against nosocomial infection. METHODS Retrospective analysis was performed for 851 strains of bacteria isolated from those tested specimens sent by the inpatient department from 2005 to 2007. RESULTS The main sites of nosocomial infection was respiratory tract,followed urinary tract and wounds,the main responsible bacteria was Gram-negative bacilli,their rate was 52%.While the rate of Gram-positive cocci was 36%,the rate of fungi was 12%.The common bacteria in nosocomial infection our hospital were Klebsiella pneumoniae,Escherichia coli,Pseudomonas aeruginosa,Staphylococcus and Candadi albicans,whose rate of drug resistance was similar to that in the comprehensive hospital. CONCLUSIONS In nosocomial infection the proportion of Gram-positive cocci and fungi is increasing,so is their rate of drug resistance.It mustn′t be neglected in clinic.

Objective To explore the clinical efficacy of dendritic cell activated and cytokine induced killer cell ( DCIK ) combined chemotherapy in treatment of patients with advanced esophageal squamous carcinoma. Methods 60 patients with advanced esophageal squamous carcinoma were selected as the research subjects, they were divided into observation group (32 cases) and control group (28 cases) by random number method.The obser-vation group was given DCIK combined systemic chemotherapy treatment, while the control group was only given chemotherapy.The short-term efficacy,life quality improvement,the immune indexes and the adverse reactions were compared in the two groups 1 month after treatment.Results The short-term efficacy in the observation group was significantly better than the control group(Z=2.807,P<0.05),and the control rate was significantly higher than control group(χ2 =4.133,P<0.05).The life quality in the observation group was significantly better than the control group(Z=2.373,P<0.05),and the effective rate of the observation group was also higher than the control group (χ2 =6.459,P<0.05).The CD3+CD1+8 ,CD3+CD5+6 rates after treatment in the observation group were significantly increased than before treatment (t=7.394,P<0.05),which were significantly higher than the control group(t=-4.564,P<0.05).Conclusion DCIK cell combined chemotherapy not only can improve the immune function in patients with advanced esophageal squamous carcinoma,but also can improve the clinical symptoms and short-term life quality,which has significant clinical application value.

BACKGROUND:Mechanical factors play an important role in wound healing and scar formation. Finite element model is established to stimulate, analyze and optimize different sutures, which has become a hotspot to guide surgies accurately. OBJECTIVE:To analyze the stress distribution of different simple interrupted suturing directions on the skin wound by establishing the skin finite element model, and to provide basic data for the study of scar formation. METHODS:Porcine back skin uniaxial tensile test was performed to provide reference for the mechanical properties of human skin. Orthotropic skin wound model was established using ABAQUS to calculate the stress distribution on the wound in different suturing directions. RESULTS AND CONCLUSION:The anisotropic mechanical properties of skin wound influenced the suture stress significantly. The elastic modulus along the Langer’s line was larger than that in the vertical direction. The stress increased orderly in the Langer’s line direction, the Langer’s line deflected 30°, bias Langer’s line 45° and vertical Langer’s line. These results suggest that the clinical incision should be made along the Langer’s line direction. Additional y, the cut at an angle with Langer’s line can also reduce the stress of suture.

2(38.2 vs 34.4 months, P=0.214).The 1, 2 and 3-year local control rates were 84.0%, 72.9% and 56.7%, respectively.Conclusion:When given a sufficient combination of modality treatment for selected elderly patients with esophageal carcinoma, the tolerance and therapeutic efficacy were not significantly worse than those of younger patients.Therefore, combined chemoradiotherapy for elderly patients is worthy of further study.

Objective To study the diagnosis and surgical treatment of thyroid microcarcinoma. Methods The authors reviewed 53 cases of thyroid cancer, which were diagnosed during and after surgery from December 1993 to January 2002,including 42 cases of thyroid microcarcinoma. Results Out of the 53 cases,35 cases were diagnosed during surgery by frozen section method while the other 18 cases were postoperatively diagnosed by pathological examinations;complicated carcinomatous conversion in contralateral lobe was found in 2 cases and neck lymphatic metastasis in 3 cases; lobectomy plus excision of isthmus was performed in 35 cases, 7 of which simultaneously underwent neck lymph node clearance,and unilateral lobectomy or unilateral or bilateral subtotal lobectomy was adopted in the remaining cases. Recurrence in 2 cases was found during a follow-up period for 2 months～96 months (mean,46 months) in 35 cases, and no fatal cases occurred. Conclusions A high rate of missed diagnosis of thyroid microcarcinoma is present. Thyroid microcarcinoma should be surgically removed.

Objective To study epidemiological and clinical patterns of leprosy in children in China. Methods The data of leprosy in children from 1989 to 1998 in China were analyzed in terms of gender, infection source, detection mode, skin lesion, nerve damage, leprosy reaction, clinical type and skin smear. Results A total of 22 437 leprosy cases were detected during 1989～ 1998, of which 912 (4.1％ ) were child cases (560 males and 352 females). Average delay in detection was 1.13 years (n=909). The main source of infection was close contact within families, accounting for 69.2％ , and majority of cases were detected through active modes. Among children with leprosy, 96.8％ were with skin lesions, 76.0％ with nerve damage, 4.7％ with leprosy reactions, 12.4％ with grade II disability and 41.2％ with positive skin smears. The average proportion of child cases was 4.2％ in Yunnan, Guizhou and Sichuan Provinces, and 1.3％ in Shandong, Jiangsu and Zhejiang Provinces. The proportion of child cases was stable in Guizhou and Sichuan Provinces during this period, whereas in 1998 it significantly increased to 11.6％ in Yunnan. Conclusion The present study suggests that proportion of children with leprosy is one of the sensitive indicators of leprosy endemicity. The sources of leprosy infection in children is predominately due to the contact with active cases within families.

BACKGROUND:The mechanical environment of skin tissue and spreading state of epithelial cels are closely related with the wound healing and scar formation process. OBJECTIVE:To analyze the effect of extracelular mechanical stimulation on cel spreading, to test the cel proliferation in order to analyze the effect of spreading form on cel proliferation and other physiological activities. METHODS: Cyclic sine wave mechanical stretching was exerted on immortalized human keratinocyte by using FX-4000 flexible substrate loading system, on the condition of 0.2 Hz and at frequency of 10% amplitudes. The spreading form was compared at 0, 24 and 48 hours, the cel proliferation was analyzed with flow cytometry, and the distribution of vinculin was analyzed with immunofluorescence staining. RESULTS AND CONCLUSION: human keratinocyte would keep the spreading state and could induce more cel proliferation by 24 hours mechanical stretching stimulation. Conversely, after stimulated for 48 hours, the morphology of the human keratinocyte was significantly changed, and the number of human keratinocyte in the division stage was larger than that in the static control group; under tensile stress, the distribution of vinculin was transformed from the surrounding nucleus membrane area to the cel edge. The results indicate that proper mechanical stimulate can increase cel proliferation with keeping cel spreading and adhesion state; the stimulating time of continuous cyclic stretching is the major factor to determine cel spreading morphology and adhesion regions of immortalized human keratinocyte.

ObjectiveTo study the epidemiological characteristics of leprosy in China,2001-2010.MethodsData were collected from the database of the national system of leprosy surveillance.A descriptive and comparative analysis was performed.ResultsTotally,15 507 new leprosy cases were detected from 2001 to 2010 with an average case detection rate of 0.118 per 100 000 population.Among these cases,2.7％ were children under 15 years,86.5％ multibacillary,and 22.5％ suffered from grade 2 disability.From 2001 to 2010,a total of 1506 relapse cases were detected,and relapse occurred after multi-drug therapy(MDT) in 464 of these cases.There were significant differences between low and high endemic areas in the proportion of children under 15 years,females,immigrant patients among newly detected patients as well as the proportion of cases of relapse after MDT among all the relapse cases.By the end of 2010,the registered leprosy cases were 6032 with a prevalence rate of 0.450 per 100 000 population,among whom 2886 were under MDT.ConclusionsThe leprosy case detection rate continued to decrease in China from 2001 to 2010 with an unequal distribution.The pocket areas were in Yunnan province,Guizhou province,Sichuan province,Guangdong province,Hunan province and Tibet Autonomous Region.It is warranted to enhance the control of leprosy and reduce the prevalence of disability due to leprosy.

Objective To study the high risk factors of anastomotic leakage after colon cancer surgery ,so as to provide evidence for the prevention of anastomotic leakage. Methods Fifty-three patients with anastomotic leakage after colon cancer surgery of 916 cases were selected as research objects,then the correlation between systemic factors,local factors and occurrence of anastomotic leakage was analyzed and studied. Results The correlation between age, ASA grade, serum hemoglobin, red blood cell, total protein, fasting blood glucose of systemic factors except for sex and occurrence of anastomotic leakage was obvious (P< 0.05). There was correlation between the methods of anastomosis, anastomotic tension, setting position of drainage tube, intestinal obstruction, abdominal infection and degree of tumor differentiation except for with or without chemotherapy and radiotherapy and occurrence of anastomotic leakage(P < 0.05). Conclusion The high risk factors of anastomotic leakage after colon cancer surgery are multiple,and well various work should be done during perioperative period.

Objective To analyze the epidemiological features of leprosy in China from 2011 to 2015,and to provide scientific evidences for prevention and treatment strategies.Methods An epidemiological analysis and a trend analysis were conducted based on the national leprosy surveillance data from 2011 to 2015.Results The leprosy detection rate in China decreased from 0.085 per 100 000 in 2011 to 0.049 per 100 000 in 2015,with an average annual decline rate being 12.9％.A total of 4 775 leprosy cases were newly detected during 2011-2015,including 106 (2.2％) children,1 499 (31.4％) females,518 (10.8％) floating people,4 041 (84.6％) multibacillary cases and 1 134 (23.7％) cases with grade 2 disabilities.From 2011 to 2015,328 relapsed cases were reported,including 153 (46.6％) cases recurring after combined chemotherapy.The prevalence rate of leprosy in China decreased from 0.407 per 100 000 in 2011 to 0.235 per 100 000 in 2015,with an average annual decline rate being 12.9％.By the end of 2015,there had been 3 230 registered leprosy cases and 124 counties with a prevalence rate above 1 per 100 000.Conclusions The detection rate and prevalence rate of leprosy in China were both decreasing continuously from 2011 to 2015.The high-epidemic provinces were Yunnan,Guizhou,Sichuan and Guangdong.However,leprosy control in middle-and low-epidemic provinces can not be ignored.