OBJECTIVE To explore countermeasures to improve the quality of hospital infection control. METHODS The hospital control problems were analyzed through clinical practice. RESULTS Hospital infection control management was restricted by the inadequate understanding of the importance,the lack of related knowledge,the medical treatment cost and economic performance. CONCLUSIONS To establish an effective mechanism dealing with hospital infection control,education of the importance of infection control and training and to implement the target responsibility system are the keys to improve the quality of hospital infection control.

Objective A design of guide wire localization apparatus for the internal fixation of dens fractures. Methods From October 1999 to February 2000, 5 cases of dens fractures were treated by anterior internal fixation using cannulated compression screws; 4 cases were of Anderson typeⅡ and 1 case was typeⅢ . The guide wire localization apparatus was used for all of the patients during operations. Results The operating time was 2 to 2.5 hours, averaging 2 hours 15 minutes. The amount of bleeding was 20 to 100 ml, averaging 60 ml. The time of follow-up was 5 to 9 months, averaging 6.7 months. The locations of all the 5 cannulated compression screws were excellent, positioning in the center of the odontoid process without deviation. 4 cases healed normally and 1 had delayed bone healing. Conclusion The use of a guide wire location apparatus increased the accuracy of internal fixation of screws in dens fracture, decreased X-ray to radiation to the bodies, and reduced the possibility of pollution in operation.

BACKGROUND: Unstable cases of Hangman’s fracture or traumatic spondylilisthesis which are type II, IIa and III should be treated surgicaly. Retropharyngeal approach was employed in exposure of anterior upper cervical region. However, dissection and traction around important structures make the procedure complicated and increase the chance of nerve injury.
OBJECTIVE:To evaluate the clinical curative effect and safety of an innovative operative technique in which a polyetheretherketone cage was used to perform cervical spinal fusion for the treatment of Hangman’s fracture.
METHODS: Eight patients with type II or IIa Hangman’s fracture were enroled in this study and received cervical fusions at C2/3 levels. During folow-up postoperatively, they received X-ray examination. Fusion time and implant position were evaluated. The angle of deformity (α) and the displacement distance (β) were compared pre-operatively and 6-month post-operatively to measure reduction. The functional outcomes were also compared using the Post-Traumatic Neck Score (Mayo) pre-operatively and 6-month post-operatively, while neck pain was further investigated by Visual Analogue Scale score.
RESULTS AND CONCLUSION:Al eight patients were folowed-up successfuly, with an average folow-up of 13 months (range 6-26 months). Compared with pre-operatively, Clinical Post-Traumatic Neck Score (Mayo) was increased, Visual Analogue Scale score, angle deformity (α) and displacement distance (β) were reduced at 6-month post-operatively (P < 0.05). Neck activity was not limited in final folow-up. Bone fusion was found in al patients at 3 or 6 months post-operatively, and no complication was detected. Results confirm that polyetheretherketone cage for type II and IIa Hangman’s fracture could achieve good outcomes and safety.

Objecitve To observe the diffusion and distribution of imported Oncomdania snails in non-endemic areas of schistosomiasis.so as to provide scientific basis for developing the scheme of snail surveillance.Methods Oncomelania snails from the msrshland of Dongting Lake were imported in a waste land in March,2008,Qingxin County,which belonged to non-endemic areas of schistosomiasis.and their diffusion and distribution condition were observed from May to December in the same year.Resuits A total of 1 600 Oncomelania snails were imported.The occurrence rate of frame with snails in sunny days and cloudy rainy days were22.88%and 29.24%,respectively,and there was a statistically significant difference between them(χ~2=4.113,P=0.043).Those in waste Land and the sides/bottoms of the ditches were 9.38%and 35.99%,respectively,and the difference between them also showed a statistical significance(χ~2=67.246,P<0.001).The average density of living snails in sunny days and cloudy rainy days were 0.79 and 1.11 No./0.1 m~2,respectively,and those in waste land and the sides/bottoms of the ditches were0.11 and 1.34 No./0.1 m~2.The furthest diffusion distance of snailswas 4.5 m.Conclusions The detective opportunity of imported snails is relatively high in cloudy rainy days,which mainly distribute at the sides/bottoms of ditches and diffuse along the ditches.

OBJECTIVE:To understand the prophylactic antibiotics use in general surgeries performed in the hospital where the authors work.METHODS:500copies of discharge record of common surgical cases written between Jul.2005and Feb.2006were checked randomly,and the questionnaires about the general data and medication of the patients were filled out.Then the collected data were analyzed statistically.RESULTS:The prophylactic drug use rate in TypeⅠincision operations reached up to98.8%,of which58.5%cases lacked clear indications of medication.The high rate of prophylactic drug use,improper time of drug use,and the prolonged continuous drug use were among the problems that existed in TypeⅠand TypeⅡincision operation.CONCLUSION:There remain many problems in the use of prophylactic antibiotics in the general surgeries performed in our hospital,which requires the strengthening of standardized administration of prophylactic antibiotic use.

Biomphalaria straminea,the intermediary host of Schistosoma mansoni,was found by survey in local areas of Shen-zhen City in 1981,which was the first finding of the snail in inland China. By 2013,the snail had spread in large range of Shen-zhen City and overspread to the surrounding regions,Dongguan City and Huizhou City. Due to the facts that Shenzhen City has many international communications and is a key area of labor export,with high population mobility,while the reports of S. manso-ni infection in the returnees of our country from Africa have been increasing recently,it must be paid a high attention to whether the epidemic or transmission of schistosomiasis mansoni may happen under the present circumstance. This paper initially discusses the finding,distribution,spreading and overspreading and transmission risk of B. straminea in inland China and puts forward some related control suggestions.

Objective To evaluate the clinical outcome of mono-segment transpedicular fixation of type B thoracolumbar fracture.Methods A retrospective analysis was conducted on 40 cases suffering from type B thoracolumbar fracture treated with mono-segment transpedicular fixation from May 2003 to October 2012.According to the AO classification,13 cases were identified with type B1.1,11 type B1.2,11 type B2.2,2 type B3.1,2 type B3.2,and 1 type B3.3.Radiological results were evaluated by measuring compression rate of the fractured vertebra and Cobb' s angle of the vertebra adjacent to the fractured segment.Clinical results were assessed using Frankel classification for spinal cord injury and visual analogue scale (VAS) for pain.Results Mean operation time was 71 minutes and mean intrao perative blood loss was 105 ml.Mean period of follow-up was 47.5 months (range,24-82 months).Mean Cobb' s angle of the vertebra adjacent to the fractured segment and compression rate of the fractured vertebra revealed great correction at one week post-operation compared with preoperative ones (6.2° vs 20.1° and 10.1％ vs 38.9％ respectively,P ＜0.05) and there was no significant correction loss at the last follow-up (6.9° and 10.8％ respectively,P ＞ 0.05).Mean VAS was 8.6 points before operation,but mean VAS was 2.4 points at final follow-up (P ＜ 0.05).Neurological performance improved in 37 cases (93％).No cases experienced neurological deterioration.Conclusions Mono-segment transpedicular fixation has small incision,short operation time,few bleeding and decreased motor function loss.The procedure is indicated for most type B thoracolumbar fracture and clinical results are satisfactory.

BACKGROUND: Posterior lumbar non-fusion devices have been developed to control vertebral column movement, change load pattern of instability segment, restrict abnormal action, as well as avoid adjacent segment degeneration.OBJECTIVE: To investigate the efficiency of Wallis dynamic stabilization system in the treatment of lumbar vertebrae instability.METHODS: Ten cases suffering from lumbar instability were selected, including 3 males and 7 females, aged 43-65 years. One patient sustained L_(1/2) and L_(4/5) segmental instability, one was L_(2/3) and another was L_(3/4), and the others were L_(4/5). Two patients complicated with lumbar disc herniation and 7 patients combined with lumbar spinal stenosis at the same affected segment, and 3 patients associated with lumbar spinal stenosis at adjacent segment. All unstable segments were treated with decompression, posterior implantation of Wallis dynamic stabilization system. Visual analogue scale (VAS) and Japanese Orthopedic Association (JOA) scores for low back pain and Oswestry disability index (ODI) were used to evaluate clinical outcomes. In addition, therange of motion (ROM) at the instrumented segment and adjacent segments and posterior disc height (PDH) in standing and extension position at L_(4/5) segment were also measured.RESULTS AND CONCLUSION: All the patients were followed-up for 2-13 months, mean 9.2 months. The mean operation duration was 128 minutes (90-185 minutes), with bleeding volume of 264 Ml (50-600 Ml). Sings and symptoms of all patients were improved significantly after operation, except one patient with recurrence of L_(4/5) lumbar spinal stenosis at 3 month after surgery, whose symptoms relieved by revision with fenestration and decompression. The postoperative VAS was dramatically decreased than that of preoperation (P=0.003); the JOA score was obviously increased (P=0.002), and the ODI score was decreased (p=0.008). The postoperative range of motion decreased significantly (P<0.05). However, there was no obviously difference between preoperative and postoperative L_(3/4), L_5/S_1 and posterior disc height (P>0.05). Good clinical results can be achieved by surgical intervention with Wallis dynamic stabilization system in treating lumbar vertebrae instability.

Objective To investigate the feasibility of mono-segment pedicle instrumentation (MSPI)in management of thoracolumbar fracture (AO classification,A1 and A3) by being compared with short-segment(two-segment) pedicle instrumentation(SSPI).Methods Overall 141 patients with tape A1 or A3 thoracolumbar fractures,aged from 20 to 60 years (average,40.5 years),were enrolled in this prospective study.According to a simple randomized method,35 patients with type A1 fracture and 41 patients with type A3fracture were treated with MSPI,while 26 with type A1 fracture and 39 with type A3 fracture were treated with SSPI.Low back outcome score (LBOS) and ASIA2000 were used to evaluate clinical outcome.Eighteenth month postoperatively was assigned as the last follow up period.Wedge index (WI) and sagittal index (SI) of the affected vertebrae on radiography were measured and compared preoperatively,one week postoperatively and at the final follow-up.Results All patients were followed up successfully.The blood loss and duration of operation of MSPI group were significantly less than that of SSPI group,respectively.However,there were no significant differences of clinical outcome between two groups.For type A1 fracture,correction rate and correction loss of WI in MSPI group were better than those in SSPI group.For type A3 fracture,there were no significant differences of correction rate and correction loss of WI and SI between MSPI group and SSPI group; however,the failure rate of MSPI group was significantly higher than that of SSPI group.Conclusion For type A1 and partial type A3 thoracolumbar fractures,MSPI can provide the same or better fixation with less blood loss and operative duration than SSPI.Since MSPI for type A3.2 thoracolumbar fracture has a higher failure rate,the surgical indication should be strictly controlled.

Objective To investigate the mastery of nursing knowledge for diabetic patients with disease deterioration between Chinese and Australian nursing students and possible influencing factors,and to provide a reference for improving nursing teaching method in China.Methods From May to June,2016,a self-designed online knowledge questionnaire was used to investigate the mastery of clinical emergency knowledge among the third-grade nursing students in Chongqing Medical University in China and Hinders University in South Australia.A total of 303 questionnaires were collected,among which 243 valid questionnaires (164 from Chinese students and 79 from Australian students) were included in statistical analysis,with an effective collection rate of 80.20％.SPSS 19.0 software was used for statistical analysis,and the paired t-test or the chi-square test was used for data comparison.Results Australian nursing students had a significantly higher score of clinical emergency knowledge than their Chinese counterparts (t=4.115,P=0.000).Compared with the low-score group (score ＜12),the high-score group (score ≥ 12) had a significantly higher proportion of students with a family/medical history of diabetes,clinical experience in diabetes care,or self-learning as the main method (P＜0.05).As for learning method,Australian nursing students tended to use online self-learning (60 students,75.95％) and do assignments (56 students,70.89％) and participate in class discussion (51 students,64.56％),while Chinese students tended to receive theoretical teaching (138 students,84.15％),consult clinical teachers (138 students,84.15％),and receive simulation/experimental teaching (123 students,75.00％).Conclusion Chinese nursing students have lower degrees of willingness for self-learning and mastery of knowledge for disease deterioration than Australian nursing students.Focus on specialized practice,development of online teaching,and cultivation of the awareness and ability for self-learning may help to improve the mastery of clinical emergency knowledge among nursing students.