Objective To evaluate the occurrence and risk factors for healthcare-associated infection(HAI)in pre-mature infants.Methods The occurrence of HAI among premature infants who were born in a hospital from Janu-ary 2011 to June 2015 and admitted in the neonatal intensive care unit within 24 of birth were investigated prospec-tively,the related risk factors and intervention measures were analyzed.Results 644 premature infants were inves-tigated,32(4.97%)had HAI,the main infection site was lower respiratory tract (n=18,56.25%).34 pathogenic isolates causing HAI were detected, 24 (70.59%) were gram-negative bacteria, the major was Klebsiella pneumoniae (n=14);10 isolates were gram-positive bacteria(29.41%).Logistic regression analysis revealed that small for gestational age, low birth weight, severe amniotic fluid pollution, mechanical ventilation, feeding intolerance,indwelling gastric tube,irrational antimicrobial use,and long length of hospital stay were risk factors for HAI in premature infants (all P < 0.05).Conclusion Risk factors for HAI in premature infants are multiple, targeted interventions,such as shorten the length of hospital stay,reduce unnecessary invasive operation,use antimicrobial rationally,improve the feeding tolerance,are helpful for reducing the risk factors for HAI in premature infants.

Medical Higher Mathematics,an important fundamental course,is important to improve the students' ability of innovation.According to the characteristics of the students at medical school,and considering the content abstract and the problems difficult to learn and understand,a new teaching model which can focus on absorbing some contents of Pharmacokinetics into Medical Higher Mathematics is dis cussed.At the same time the article discusses how to combine the both courses in three aspects:professional features,the background of the student's knowledge,and teaching method.

The degree of satisfaction of the curriculum is related not only to the degree of the curriculum but also to the degree of the students' development. With the concept of teaching reform micro system engineering, using the SIMPP analysis of the degree of satisfaction of the curriculum, the relevant factors of the students are studied. The results show that, the learning state, learning objec-tives, and the education level of mother affect the students more easily on the curriculum satisfaction. Research shows, in the present curriculum condition, educators should guide the students to study hard, establish a clear and reasonable learning goal, give the students the introduction and analysis of the curriculum, can effectively improve the students on the curriculum satisfaction, enhance the enthusiasm of the study.

Academic diligence level can not only directly affect the academic performance of students, but also affect the individual's emotional and physical health. In this study, through a question-naire survey of university students, with the method of SIMPP and the concept of the micro system engi-neering in higher education teaching reform, the related factors of diligence and the college students' behavior mode with respect to diligence are systematically analyzed. Analysis shows that, students' diligence level is affected not only by inherent factors such as clear learning objectives, learning state and after-school learning time, but also by the school ethos, the influence factors of the curriculum and parents' re-quirements.

Objective To evaluate the effects of perioperative rehabilitation for patients with self-forearm internal arteriovenous fistula.Methods Divided 124 patients with end-stage renal disease into the functional training group (65 cases,A group)and the control group(59 cases,B group) randomly,and then compared certain related indexes between the two groups.Results In the A group,the artery diametcr was obvious widen before functional training without operation,and the vein diameter was obvious widen before functional training without operation too,P ＜ 0.05.After operation,the A group Anastomotic unobstructed was obviously better than B group in one-stage,P ＜ 0.05.A group with thrombosis cases significantly less postoperative than B group,P ＜ 0.05.A group with edema of hands was significantly shorter than B group,P ＜ 0.01.Postoperative fistula time to maturity in the A group was (43.76 ± 2.21) days,which was significantly shorter than that of in the B group,(49.69 ± 5.85) days,P ＜ 0.01.Conclusion Systematic strengthening of perioperative functional exercises can significantly improve preoperative vascular conditions,improve the success rate of operation,reduce risk of thrombosis cases,shorten the time of hand edema and the time of fistula in mature.

OBJECTIVE:To observe clinical efficacy and ADR of Houttuynia cordata eye drops combined with Olopatadine eye drops in the treatment of allergic conjunctivitis. METHODS:160 eyes with allergic conjunctivitis were randomly divided into observation group and control group,with 80 eyes in each group. The control group was given olopatadine eye drops,and observa-tion group was additionally given H. cordata eye drops(medication interval>10 min)on the basis of control group. Both groups were treated for 14 days. Symptoms and signs of 2 groups were observed and scored before treatment and 14 d after treatment. Ef-fective rates of 2 groups were calculated,and the occurrance of ADR was observed. RESULTS:Compared with before treatment, symptoms and sings score of 2 groups were decreased,with statistical significance (P<0.01 or P<0.05);the decrease of two score in observation group were more significant than in control group,with statistical significance (P<0.05);effective rates of control group and observation group were 37.50%and 77.50%,with statistical significance(P<0.05). CONCLUSIONS:H. corda-ta eye drops combined with olopatadine eye drops can ameliorate clinical symptoms and signs of allergic conjunctivitis patients sig-nificantly,and improve therapeutic efficacies without obvious ADR.

Objective To explore the relationship between parental authority,parental psychological control, parental attachment and medical students' social anxiety, and to provide theoretical guidance for medical students' mental health.Methods 2105 medical students were assessed with the social phobia inventory (SPIN), Parental authority questionnaire (PAQ), Parental psychological control questionnaire, Inventory of parent attachment (IPA).Results The mean SPIN score of social anxiety was 17.75 ± 10.47.Girls scored higher than boys,but there were no statistically significant differences between them( 17.97±10.44 vs 17.29 ± 10.52, t =1.305, P=0.192).Rural medical students scored higher than urban students,and the difference had statistical significance (19.47 ± 10.60 vs 15.85 ± 10.01, t = 7.478, P ＜ 0.01 ).Stepwise regression revealed that, for urban students' anxiety, father communication and mother authoritative/flexible were protective factors, father unconscionable emotional response, mother alienation, father unconscionable viewpoint and mother communication were risk factors; and for rural students' anxiety father communication was protective factor, mother alienation and mother authoritarian were risk factors.Conclusion Factors such as parental authority, parental psychological control and parental attachment will affect medical students' social anxiety.But the factors are not same between urban and rural.So these factors are considered when carrying out health education for parents.

Objective To investigate the impact of preload fasting and meal replacement in patients with metabolic syndrome.Methods A total of 92 subjects with metabolic syndrome were enrolled in the study.They were assigned into the preload fasting group (PFG),the meal replacement group (MRG),and the control group (CG) for 12-weeks intervention.Special dietary with 100 kcal was provided 30 min before each meal in the PFG,and while in the MRG the same dietary was taken just before each meal and the amount of meal was reduced appropriately.The subjects in CG took meals as usual.Body mass index,waist circumference,and insulin resistance were assessed.Satiety situation was investigated by the scale.Results After 12 weeks,improvement were found in fasting insulin(-3.29 mU/L) and waist circumference (-4.04 cm) in the PFG and significant difference was shown compared to the CG (P＜0.05).Satiety index in the PFG was the most significant among the three group.Conclusion Preload fasting is helpful in improving insulin resistance,reducing waist circumference,and enhancing satiety.

Objective: To investigate the clinical characteristics, cell morphology, genetics, gene mutations of the patients with chronic neutrophilic leukemia (CNL). Methods: Five CNL patients from the Second Hospital of Shanxi Medical University between May 2011 and May 2017 who conformed to 2016 World Health Organization (WHO) diagnostic criteria were retrospectively analyzed from clinical characteristics, laboratory features and treatment methods. Results: The peripheral blood white blood cell count (WBC) of 5 CNL patients was significantly increased, and the average WBC was 81.26×10⁹/L [(29-217)×10⁹/L]. Morphological analysis of peripheral blood cell showed a sustained increasing number of matured neutrophilia (0.80-0.85). Neutrophil alkaline phosphatase (NAP) activity was increased (144-266). Bone marrow cell morphology typically showed granulocyte proliferation without obvious dysplasia. Gene detection showed 3 patients with CSF3R T618I mutation and 2 patients with JAK2 V617F mutation in 5 WHO-defined CNL patients. Bone marrow biopsy with reticular staining showed that marrow fibrosis (MF) degree in patients with JAK2 V617F mutation (MF≥2) was higher than that in patients with CSF3R T618I mutation(MF<2). Conclusions CNL is a rare type of chronic leukemia, and CSF3R T618I mutation is a specific diagnostic index for CNL. JAK2 V617F mutations alone may be related to myelofibrosis, which remains to be further studied.