By using the procedures of the routinization of risk assessment - implementation - evaluation of result-modification to the risk management and carring out the feasibility exploretion on the application and effect of the ward nursing management, so that care defects, nursing errors and the number of cases of occurrence of accidents has significantly reduced, the patients satisfactory degree has rised from 92.5% to 98.5%, improved the quality of care and ensured the safety of patients, fully enhanced the quality of nursing services.

OBJECTIVE To find out the epidemiology of Salmonella aberdeen outbreaks in NICU and the ways to preventing and treating this nosocomial infection. METHODS The 22 cases who developed S.aberdeen in NICU from Mar 26 to Apr 20 2007 were studied prospectively to find out the reasons of the epidemic and treatment s based on the fecal sample culture results. RESULTS These 22 inpatients fecal samples cultures were tested positive for S.aberdeen,but 14 of 22 inpatients were developed infectious diarrhea. CONCLUSIONS S.aberdeen is confirmed as the cause to this infectious diarrhea outbreak,which is mainly transmitted by close contacts.The occurrence of infection outbreak can be reduced or controlled by emphasizing the hands hygiene and aseptic operation of medical workers,attaching importance to surface disinfection of environment and equipments,and establishing the early warning mechanism.

The conditions of the mosquito-borne HBsAg were investigated with the RPHA method in Henan Province. The number of capture of Anopheles hyrcanus sinensis was small, and no HBsAg was detected from them. HBsAg was detected in both Culex pipiens pallens and Armigeres subalbatus and their positive rates of HBsAg were 10.3 and 4.6% respectively. The positive rates varied with different physiological conditions of mosquitoes, being 15.0, 7.2 and 7.5% respectively for fed, unfed and gravid females.With the digestion of the blood in the mosquito's stomach, most of the HBsAg was excreted in the feces gradually. This new finding of the transmission of HBsAg inside the mosquito's body has not been reported. The fact that HBsAg was not detected in eggs and larvae showed that it is not transmitted by eggs.

Objective To investigate the phenotype and function of antigen-specific CD8+ cytotoxic T cells (CTL) from HLA-A2+ healthy human donors induced by high-carcinogenic HPV 16 E7 peptide in vitro.Methods Peripheral blood T cells from 26 HLA-A2+ healthy human donors were incubated with HPV 16E711-20 peptide (HLA-A*0201/YMLDLQPETT), recombinant human interleukin 7 (IL-7) and IL-2 for 7 days to yield antigen-specific CD8+ CTL. Then, four-color flow cytometric analysis was performed to detect the percentage of antigen-specific CD8+ CTL expressing different surface markers including CD45 and CD27. The expression of three intracellular cytokines including perforin, granzyme-B and FasL in the antigen-specific CD8+ CTL was also measured by intracellular flow cytometry. A wrong peptide, HBVcoxe18-27 (FLPSDFFPSV),was used as an isotype control. Results A significant increase was observed in the percentage of antigen-specific CD8+ CTL in peripheral T cells stimulated with HPV 16 E7-peptide compared with the non-stimulated T cells (0.73% ± 0.33% vs 0.02% ± 0.03%, P ＜ 0.01). The percentage of CD45RA+CD27- effector T cells,CD45RA-CD27- effector memory T (TEM) cells, CD45RA-CD27+ central memory T (TCM) cells, and CD45RA+CD27+ naive T cells in antigen-specific CD8+ CTL was 26.07% ± 13.46%, 7.97% ± 7.11%, 33.25% ± 19.68%and 32.73% ± 13.89%, respectively in HPV 16 E7-stimulated group, significantly higher than that in nonstimulated group (0.02% ± 0.03%, 0.02% ± 0.03%, 0.02% ± 0.03% and 0.02% ± 0.05%, all P ＜ 0.01 ). Elevated proportions of perforin-, granzyme-B- and FasL-expressing antigen specific CTL were observed in HPV 16 E7-stimulated group compared with non-stimulated group (47.01% ± 18.69% vs 0.38% ± 0.55%, 80.53% ±13.32% vs 0.34% ± 0.22%, 26.48% ± 7.81% vs 0.16% ± 0.16%, all P ＜ 0.01 ). Conclusions HPV 16 E7peptide could induce the clonal proliferation of CD8+ T cells, generation of antigen-specific CD8+ CTL and secretion of toxic cytokines, finally lead to a highly efficient and specific killing of virus-infected target cells through different mechanisms, hence, it might play a crucial role in antiviral immune responses.

OBJECTIVE To study the effect of different antibiotic and nursing care in the treatment of patients with malignant tumor complicating with infection,analyze the high-risk factors and provide the dependable basis for controlling infection in hospital.METHODS In the retrospective investigation of our department,there were 82 times of 68 patients complicating with infection from Jan 2006 to Jun 2007.We analyzed the constituent proportion of infection and risk factors.The patients were divided into 4 groups,group A treated with broad-spectrum antibiotic,group B treated with narrow-spectrum antibiotic,group C treated with de-escalation therapy and group D treated with escalation therapy.We observed the course of therapy and the clinical effect.RESULTS The respiratory tract infection was 68.29%(56/82)and it was the highest one.The difference between groups C and D was significantly in susceptible factors(P

Objective To analyze the incidence of hospital-acquired infection and the distribution of pathogens through data from the hospital infection surveillance networks in Shandong. Methods A meta-analysis was made of the data submitted by the hospitals involved in the provincial surveillance networks from August 2001 to July 2004. Results The surveillance data involved 1 776 030 hospitalized patients, of whom 43 355 had a hospital-acquired infection, the incidence of hospital-acquired infection being 2.44‰. Respiratory-tract infections were most frequent, followed by gastroenteric-tract infections, urinary-tract infections and surgical-site infections. A total of 6 251 strains of pathogens were isolated, the most commonly identified pathogens being Escherichia coli, Pseudomonas aeruginosa, Staphylococcus aureus, Klebsiella pneumoniae, Candida albicans and Staphylococcus epidermidis. Conclusion It is imperative to reinforce the sterilization of air and medical instruments, strictly abide by aseptic manipulation, and promote the rational use of antimicrobials. Hospital infection surveillance ought to be conducted by the combined method of prevalence surveys and the targeted surveillance of key sectors.

Objective To investigate the association between apolipoprotein E (apoE) genotype polymorphism and cerebral palsy (CP) in Han Chinese children. Methods Two hundred and forty Han Chinese children were selected, including 120 children with cerebral palsy (CP group) and 120 normal children (control group).Polymerase chain reaction-restricted fragment length polymorphism analysis was used to determine the genotype and alleles of apoE genotype in the two groups. Results The genotype distributions of apoE in the two groups were consistent with the existence of a Hardy-Weinberg equilibrium. There were significant differences in the distributions of allelic frequency and apoE genotype between the two groups. Carrying the ε4 allele was related to cerebral palsy, and the overall risk for cerebral palsy was elevated about 5.5-fold among children carrying the ε4 allele.Conclusions There is an association between apoE genotype and cerebral palsy, and apoE's ε4 allele is the associated risk factor.

Objective : To analyze the trend of lung cancer incidence in Shaoxing, Zhejiang Province from 2014 to 2019, so as to provide the basis for lung cancer prevention and control. Methods : The data of lung cancer were collected through the information management system of chronic disease surveillance in Zhejiang Province.The crude incidence rate, age-standardized incidence rates by Chinese standard population ( ASIRC ) and by world standard population ( ASIRW ), truncated rate ( 35-64 ) years old ), and cumulative rate (0-74 years old) were calculated. The annual percentage change ( APC ) was used to analyze the trend of lung cancer. The annual contribution rate was used to analyze the contribution of the incidence trend with age to the total trend. Results : Totally 22 261 cases of lung cancer were reported in Shaoxing from 2014 to 2019. The crude incidence rate, ASIRC, ASIRW, truncated rate ( 35-64 years old ), and cumulative rate ( 0-74 years old ) were 83.51/100 000, 41.28/100 000, 41.01/100 000, 57.00/100 000 and 5.11%, respectively. The crude incidence rate, ASIRC and ASIRW increased significantly from 2014 to 2019, with the APC values of 8.56%, 6.42% and 6.05%, respectively ( P<0.05 ). The crude incidence rate, ASIRC, ASIRW, truncated rate ( 35-64 years old ), and cumulative rate ( 0-74 years old ) of man were 105.25/100 000, 48.09/100 000, 50.69/100 000, 62.03/100 000 and 6.42%, respectively, which were higher than those of women ( 61.84/100 000, 33.05/100 000, 31.35/100 000, 51.71/100 000 and 3.76% ).The crude incidence rate increased with age. The annual contribution rates of lung cancer incidence in people aged 15-<45 years, 45-<55 years, 55-<65 years and ≥65 years were 51.20%, 30.86%, 15.79% and 2.15%, respectively. The crude incidence rate in people aged 15-<45 years, 45-<55 years and 55-<65 years increased significantly from 2014 to 2019, with the APC values of 23.84%, 13.79% and 6.78%, respectively ( P<0.05 ). Conclusion From 2014 to 2019, the incidence of lung cancer in Shaoxing shows an increasing trend, and the age of onset is getting younger.

Objective To determine the effects of dose reduction on multi-slice spiral CT(MSCT) of neonatal head and assess the lowest possible radiation for acceptable clinical images.Methods Fifty-seven newborns suspected intracranial hemorrhage were entered into the study and underwent MSCT scans.Original images at three anatomic levels (posterior fossa, basal ganglia, centrum semiovale) were collected and synthetic noise was added so as to simulate dose reductions of 25%, 40%, 50% and 70%, respectively by using the noise addition tool.A total of 855 image data sets were obtained for the 57 patients.Original and simulated dose-reduction scan images were analyzed.Image noise and image quality were assessed by two independent experienced pediatric radiologists using diagnostic acceptability score, subjective image noise score on a 5-peint scale and objective noise index.Image noise was measured by respectively placing region of interest (ROI) at cerebellum, thalamus and corona radiata of 3 different slices.And the noise index and mean value was calculated.The degree of inter-observer concordance was determined by Kappa statistical analysis.The Spearman statistical correlations between the noise index and diagnostic acceptability score were performed.Results On the images of original dose and simulated dose reductions of 25%, 40%, 50% and 70%, the diagnostic acceptability was 4.47±0.51, 3.96±0.33, 3.21±0.45, 2.92±0.32, and 1.85±0.57, respectively,the subjective image scores were 1.62±0.48, 1.99±0.48, 2.76±0.81, 3.19±0.67, and 4.27±0.54, respectively, the noise index were 1.90±0.19, 2.17±0.20.2.44± 0.25, 2.68±0.28, and 3.37±0.39, respectively.The two radiologists had good intembserver agreement for diagnostic acceptability (K=0.860, P=0.017) and for image noise scoff ng (K=0.630, P=0.022).There was significant statistical correlation between image noise index and diagnostic acceptability (r= 0.826,P=0.001).At 40% dose reduction to the standard protocol, the noise index was 2.44 and the image quality score was 3.21 which were considered clinically acceptable.Conclusion The study revealed that acceptable imagos could be obtained with mean noise index of 2.44 and 40% dose reduction.

Objective To evaluate the alteration of left atrium function during left ventricular geometric remodeling in essential hypertension (EH) with real-time triplane strain rate imaging. Methods Totally 92 patients with EH and 50 healthy volunteers were enrolled. Base on Ganau, patients with EH were divided into 4 groups:normal geometry (A), concentric remodeling (B), concentric hypertrophy (C) and eccentric hypertrophy (D). Systolic peak strain rate (S_(SR)), early diastolic peak strain rate (D_(SR)) and atrium diastolic peak strain rate (A_(SR)) were measured at left atrium walls. Results Compared with normal group, S_(SR) and D_(SR) decreased in group A, B, C and D (P<0.01), A_(SR) increased in group A, B and C (P<0.01), then decreased in group D (P<0.01). Conclusion Left atrium function has changed before LV geometry changes in patients with EH. Real-time triplane strain rate imaging can assess left atrium function and its alteration correctly during left ventricular geometric remodeling in patients with EH.