OBJECTIVE To analyze the incidence and related factors of the nosocomial infection in our hospital during a 3-year period.METHODS By using the retrospective method,all inpatient cases in our hospital from 2004 through 2006 were surveyed and analyzed.RESULTS Totally 44 759 inpatient cases were involved in the period,and 1653 cases with nosocomial infection occurred.The infection rate was 3.69%.The major sites of the infection were lower respiratory tract(45.12%),upper respiratory tract(19.12%)and urinary tract(13.77%).The most common pathogens were Klebsiella pneumonial(13.01%),Escherichia coli(11.53%),Pseudomonas aeruginosa(10.39%),and Acinetobacter baumannii(9.13%) in Gram-negative bacteria,and Staphylococcus aureus(5.02%) and S.epidermidis(3.42%) in Gram-positives.Candida albicans(21.8%) was the major isolate in Fungi.The infection rate in ICU was 20% higher than in other departments per year during 3 years.CONCLUSIONS Strengthening the medical knowledge of about nosocomial infection among employees,improving the environment quality of hospital,identifying pathogens correctly and surveying the resistance of antibiotic agents should be noted to control nosocomial infection.

Objective To investigate the liver function of patients with chronic liver diseases undergoing gynecologic laparoscopic operations.Methods Twenty-six asymptomatic HBV carriers,28 mild chronic hepatitis,21 compensatory cirrhosis were assigned to undergo gynecologic laparoscopic operations.Liver function were tested and compared in these three groups before operation and on the 1st、3rd、7th day after operation.Results 1st day after operation,ALT and AST in asymptomatic carriers and mild chronic hepatitis groups were significantly higher than preoperation ( asymptomatic carriers:ALT P ＜ 0.05,AST P ＜ 0.05 ; mild chronic hepatitis:ALT P ＜ 0.05,AST P ＜ 0.05 ).Then they recovered on the 3rd day after operation ( asymptomatic carriers:ALT P ＞ 0.05,AST P ＞ 0.05 ; mild chronic hepatitis:ALT P ＞ 0.05,AST P ＞ 0.05 ).ALB,total bilirubin (Tbil) after operation were not significantly different from those before operation on every tested day in these two groups ( asymptomatic carriers:ALB P ＞ 0.05,Tbil P ＞ 0.05 ; mild chronic hepatitis:ALB P ＞ 0.05,Tbil P ＞ 0.05 ).In compensatory cirrhosis group,ALT,AST,Tbil were significantly higher on the 1st day,3rd day after operation than preoperation ( 1st day:ALT P ＜0.01,AST P ＜0.01,Tbil P ＜0.01 ;3rd day:ALT P ＜ 0.05,AST P ＜ 0.05,Tbil P ＜ 0.05 ).ALB levels were significantly lower on the 1st day,3rd day after operation than preoperation ( 1st day:P ＜0.01 ;3rd day:P ＜0.05 ).All the indexes recovered to the levels of preoperation on the 7th day after operation( ALT P ＞ 0.05,AST P ＞ 0.05,Tbil P ＞ 0.05,ALB P ＞0.05).Conclusions To some extent,gynecologic laparoscopic operations have some adverse effects on short-term liver function after operation in patients with chronic liver diseases.Compensatory cirrhosis patients present delayed recovery compared with asymptomatic carriers and mild chronic hepatitis patients.

Objective To establish a HPLC method to determine the related substances of vitamin B6 for injection.Methods HPLC method was adopted with DiamonsilTM C18,5μm 250mm×4.6mm;the mobile phrase was length was 291nm.Results The calibration curve was linear in the concentration range of 600～1400μg/ml(r=0.9998).Conclusion The method is simple,rapid,accurate and reliable.As the supplement method of active pharmacopoeia,it can effectively control the quality of the product.

Objective To investigate the exposure levels of organic pollutants in child-bearing age women body. Methods The blood and urine specimens were collected simultaneously from each of 8 health women, aged 23-32 years, the organics were extracted with hexane and determined qualitatively by gas chromatography-mass spectrometer (GC-MS) for each specimen. Results In blood, 34 kinds of organic compounds had been detected , at average of (8.63?5.01 )kinds per person. Di-n-butyl phthalate (100%) and 14-bate-H-pregna (75.0%) revealed the highest detectable rates. In urine, 39 kinds of organic compounds had been identified, at average of (10.63?1.30) kinds per person, di-n-butyl phthalate(100%), HANFETT(100%), 14-bate-H-pregna(87.5%), docosane (87.5%), di-isobutyl phthalate(75.0%) were the chemicals noticed more frequently. Some kinds of these identified organics compounds were environmental toxic pollutants. Conclusion This study suggested that toxic organic pollutants had existed in child-bearing age women body, phthalic acid esters were the chemicals checked out more frequently. Their potential adverse health effects on women and offspring should be paid highly attention to.

Objective:To evaluate the possible roles of IL-18 in HBV infection, and to clarify the immune state during IFN? therapy. Methods:Peripheral blood lymphocytes from 2 groups of HBV infectors(including 15 asymptomatic carriers,26 patients with chronic hepatitis B) and 10 healthy individuals (as normal controls) were analyzed by flow cytometry. The levels of IL-18 were also detected before, during, and at the end of IFNa therapy,Results: (1)The level of IL-18 was the lowest in asymptomatic carrier group. However there was no significant difference between chronic hepatitis and normal control. (2)The patients with chronic hepatitis were further divided into 4 subgroups according to the inflammation degree of liver. Results showed that the severity degree of liver inflammation was accompanied with the elevation of IL-18 production. (3)IL-18 in chronic hepatitis B correlated with serum ALT positively ( r = 0.61,P

Objective To investigate the effect of lower limb rehabilitation training robot combined with task-oriented training on walking ability after stroke. Methods From February 2014 to August 2015,74 consecutive patients with post-stroke who received rehabilitation therapy and met the inclusion criteria admitted to the Department of Rehabilitation Medicine,Xuanwu Hospital,Capital Medical University were collected prospectively. They were all the patients with the first-ever stroke for 1 to 12 months. They were divided into either an observation group (n = 39)or a control group (n = 35)according to whether they were treated with the lower-limb rehabilitation robot. The patients of both groups received task-oriented training,2 times a day,once for 20 min,5 days a week for 12 weeks. The observation group was also treated with the lower-limb rehabilitation training robot,1 time a day,once for 30 min,5 days a week. Berg balance scale,Fugl-Meyer assessment (FMA),timed up-and-go test (TUG)and knee flexion active range of motion (KFAROM)were used to assess the efficacy. Results (1)After treatment,the Berg scale and FMA scale scores were increased in the observation group and the control group compared with before treatment. There was significant difference (Berg scale:28 ±9 vs. 22 ±9,29 ±9 vs. 24 ±9;FMA scores:47 ± 8 vs. 36 ± 8,40 ± 6 vs. 36 ± 7;all P < 0. 01),however,there was no significant difference between the two groups (P <0. 05),and there was significant difference in FMA scores between the 2 groups (P < 0. 01 ). The differences of Berg scale scores in the observation group and the control group were 10. 75 + 0. 30 and 4. 71 + 0. 14 respectively before and after treatment. There was no significant difference between the 2 groups (t = 0. 95,P = 0. 345). The differences of FMA scores in the observation group and the control group were 5. 8 ±0. 6 and 4. 9 ±0. 8 before and after treatment (t =5. 16,P <0. 01). (2)After treatment,the tug test and KFAROM of the observation group and the control group were better than those before treatment. There were significant differences (TUG test:35 ± 13 s vs. 56 ± 18 s,53 ± 17 s vs. 58 ± 18 s;KFAROM:82 ± 24° vs. 60 ± 23°,63 ± 23° vs. 57 ± 26°;all P < 0. 01),and there were significant differences between the 2 groups (all P < 0. 01). The differences of the TUG test in the observation group and the control group before and after treatment were 21. 5 ± 5. 0 and 4. 6 ± 0. 6 s respectively. There was significant difference between the 2 groups (t = 9. 55,P < 0. 01);the differences of KFAROM in the observation group and control group before and after treatment were 5.8 ±0.6° vs. 4.9 ±0.8° respectively. There was significant differences between the 2groups (t =4.17,P <0. .01). Conclusion Lower limb rehabilitation training robot combined with task-oriented training may improve the lower extremity motor function,walking ability,knee flexion joint activity of the patients after stroke,but the improvement effect of the lower limb balance is not obvious.

Objective To explore the diagnostic and treatment value of serum B-type natriuretic peptide (BNP) levels for the chronic heart failure and its correlation with cardiac function classification.Methods 155 patients with heart failure were selected as treatment group.According to cardiac function,grade Ⅱ in 48 cases,grade Ⅲ in 56 cases,grade Ⅳ in 51 cases.122 healthy people during the same period were selected as the control group.Retrospectively detected serum BNP levels of the subjects,and the BNP levels of the treatment group were detected before and after treatment,and its correlation with heart function was analyzed.Results The serum BNP level of the treatmentgroup was (738.67 ± 61.32) pg/mL,which was higher than (22.36 ± 21.89) pg/mL of the control group,the difference was statistically significant (t =19.38,P ＜ 0.05).The serum BNP level of the treatment group after treatment was (329.58 ± 90.74) pg/mL,which was lower than (738.67 ± 161.32) pg/mL of the control group,the difference was statistically significant(t =19.38,P ＜ 0.05).The serum BNP levels of grade Ⅱ,grade Ⅲ and grade Ⅳ patients after treatment compared with pre-treatment,the differences were statistically significant (t =13.65,15.18,17.39,all P ＜ 0.05),from pre-treatment to pro-treatment,the serum BNP levels were gradually increased with increased grade,the differences were statistically significant (t =10.61,21.33,11.06,16.40,all P ＜ 0.05).Conclusion The serun BNP level of chronic heart failure patients significantly increases,and it increases with the increase of cardiac function classification,and shows correlation.As the objective indicators of chronic heart failure,it has better clinical diagnosis value and treatment and prognostic significance.

Objective To explore the application of evidence-based medicine in rehabilitation therapy in clinical teaching. Methods 45 interns were divided into 2 groups. The interns during July, 2011 to April, 2012 as the control group (n=23) received the traditional teaching method and the interns during July, 2012 to April, 2013 as the test group (n=22) accepted the evidence-based medicine teaching method in addition. They were assessed with the test scores of theory and operation, and questionnaires. Results The operation scores and the total scores were higher in the test group than in the control group (P<0.05). The satisfaction was better in the test group than in the control group in the items of improving the ability of self-study, taking the initiative, developing clinical thinking, improving the ability of obtaining information, improving the ability of selecting literature, improving the ability of analyzing and summarizing, improving their overall level and degree of satisfaction with this teaching method (P<0.05). Conclusion The evidence-based medicine teaching method can facilitate to improve the practical skills, cultivate the clinical thinking and improve the overall level for students in rehabilitation therapy in clinical practice.

Objective To study the potential mechanism of recovery from dysphagia after surface electrical stimulation. Methods 3 cases recovery from dysphagia caused by lower brainstem infarction after surface electrical stimulation of lower mandible and trigeminal nerves were analyzed. Results After 3～16 weeks surface electrical stimulation, the swallow assessment scores reached from 0 to 6 in all the 3 patients. Conclusion Surface electrical stimulation can facilitate the recovery of swallow function, which may be involved with the sensory input, especially the integration of nucleus of the solitary tract (NTS).

Purpose To explore the diagnostic value of multiple image technique derived from dual-energy CT in arterial+parenchymal phase scan mode in detecting pancreatic adenocarcinoma so as to provide more valuable information for clinical treatment.Materials and Methods Thirty two patients with pancreatic adenocarcinoma proved pathologically underwent dual-phase scan with dual-source CT.Linear blend image,non-linear blend image and iodine map were acquired.The absolute enhancement value of tumor (AEV),the relative enhancement value of tumor (REV),enhancement ratio (ER) of tumor to pancreatic parenchyma,and the image contrast to noise ratio (CNR) were also calculated,so that the diagnostic value and the ability image in two phases to display the pancreatic adenocarcinoma lesions could be assessed.Results On arterial phase,the differences in AEV,REV and CNR value were significant among the three groups images (P＜0.05).On parenchymal phase,the difference in REV,ER,and CNR value were also significant among the three groups (P＜0.05).When the three sequences on the 2 phases were compared with each other,the differences in AEV and REV value of tumor tissues were significant among the groups (P＜0.05).Moreover,the differences of ER value in linear blend image and CNR in the iodine map were significant in dual phase enhancement (P＜0.05).Conclusion Dualenergy CT enhanced scan mode on dual phase combined with multiple sequences can improve the sensitivity in detection of pancreatic adenocarcinoma lesions.