OBJECTIVE To study approaches to effective infection management,so that it can function high effectively.METHODS Some important facts were reviewed,analyzed and summarized,which had influence on hospital infection management.RESULTS The quality and knowledge of the team in charge of infection management,the organization and regulations concerned were prerequisite to effective infection management,with reasonable incentive means.CONCLUSIONS Analysis and much emphasis to be given on the facts affecting hospital infection management are key points to its improvement.

Mice, were each infected with 48-52 different geographic Schisto-soma japonicum cercariae of Zhejiang Hangzhou, Jiangsu Wuxi,Anhui Guchi,Jiangxi Nanchang,Hubei Hanyang , Hunan Yueyang & Yunnan Dali. 32-35 d after infection, the mice were treated orally with praziquantel at a single dose of 400 mg/kg. The worm reduction rates of each geographic S. japonicum were compared with that of Anhui Guchi schistosomes which was known to be more sensitive to praziquantel. The results showed that the worm reduction rate of Yunnan Dali schistosomes was 35.1%, which was much less than 75.4% of Anhui Guchi schistosomes. No apparent difference in susceptibility of other 5 geographic schistosomes to praziquantel was observed as comparing with Anhui Guchi schistosomes.When mice infected with Yunnan or Anhui schistosomes for 5 weeks were treated orally with praziquantel at a single dose of 300 mg/kg. the drug-induced hepatic shift rate of the worms and morphological changes of the worms were more or less similar in both geographic schistosomes within 28 d after medication. It was considered that less effect of praziquanfel on Yunnan Dali schistosomes may be ascribed to less susceptibility of the worms to the drug.

Objective To explore the experience of nursing patients with large area bum.Methods Thirty-one hospitalized patients with large area bums in our hospital during January 2012 to July 2013 were set as the control group,where fasting was done within 24 hours at admission and enteral nutrition was done after surviving shock phase.Another 31 patients with large area bums in the hospital during August 2013 to August 2015 were set as observation group,where short peptide enteral nutrition powder was administered within 24 hours at admission,followed by enteral nutrition was done after surviving shock phase.The two groups were compared in terms of nutrition indexes and intestinal complication rate before admission and 4 weeks after treatment.Result After enteral nutrition,the nutrition indexes in the observation group were all better than those the control group (P＜0.05) and the rates of complications on gastric retention and reflux,aspiration were insignificantly different between the two groups (P＞0.05);the rates of complication on abdominral pain and diarrhea were lower those of the control group (all P＜0.05).Conclusion For patients with large area bums,early enteral nutrition can better the nutrition and it is a safe therapy.

The incidence and mortality of colorectal cancer (CRC) increased rapidly in recent decades and become enormous challenges in China.Lack of effective early warning of molecular markers and dynamic monitoring technology in term of early diagnosis,treatment evaluation,dynamic recurrence and metastasis monitoring are the clinical diagnosis and treatment bottlenecks of CRC.Traditional diagnosis and treatment of CRC rely on a single level of patient information with low accuracy.Based on the system of biology medical model,to carry out a joint diagnostic model,will overcome the traditional problems through a number of multi-level information integration of the joint diagnosis model,will significantly improve the sensitivity and specificity of diagnosis of CRC.The major challenge in patients with advanced and metastatic CRC is the instability of the tumor genome and the treatment-induced resistance during chemotherapy and targeted therapy.It is necessary to carry out continuous dynamic biopsy in order to accurately guide the development of treatment decisions.Compared with the pathological examination of traditional surgical specimen,liquid biopsy,such as circulating tumor cells,circulating tumor DNA detection technology,with noninvasive,real-time dynamic monitoring,could evaluate the efficacy of treatment,and guide the precise individual diagnosis and treatment.Today,the new strategy and new technology need to undergo clinical trials urgency,through technology optimization,reduction of costs and improvement of detection accuracy,would quickly extended to clinical applications in future.

BACKGROUND:It has been studied that the distribution of bone morphogenetic protein 2 is regular under bone defect situation. OBJECTIVE:To observe the expression of bone morphogenetic protein 2 in rabbit radial defect site with different lengths. METHODS:Forty-eight New Zealand rabbits were divided into two groups randomly, 0.5 cm bone defect and 3.0 cm bone defect were made by wire saw at the middle part of radius bone after anaesthesia. RESULTS AND CONCLUSION:Western blot results showed that in the 0.5 cm bone defect group, the expression of bone morphogenetic protein 2 of the tissues in the bone defect site was increased gradual y at 1, 3, 4 weeks after operation, and the expression in each defect group was increased when compared with that immediately after injury (P<0.05). In the 3.0 cm bone defect group, the expression of bone morphogenetic protein 2 of tissues in bone defect site was increased gradual y and reached to its peak at 3 weeks after the operation (P<0.05), and the peak value in the 3.0 cm bone defect group was significantly higher than that in 0.5 cm bone defect group (P<0.05). The peak value was maintained in high level. The comparison of bone cal us formation showed that the bone cal us formation of 3.0 cm bone defect group was less than that of the 0.5 cm bone defect group at 3 and 4 weeks after operation (P<0.05). The results indicate that expression of the bone morphogenetic protein 2 in 3.0 cm bone defect site is increased significantly, but the expression level cannot make the bone defect heal itself.

Objective To develop and evaluate a porcine model for training the single needle running suture method of laparoscopie urethrovesical anastomosis(LUA). Methods Twenty minipigs with mean weight of 30kg were general anaesthetized with Sumianxin solution 0. 1 ml/kg intramuscularly. Pneumoperitoneum was created by insufflation of carbon dioxide by a veress needle inserted through the umbilicus. One 10mm port and two 5mm ports were positioned after the establishment of pneumoperitoneum. The intestine was used as "bladder". The procedures were completed with the single needle running suture method of laparoscopic urethrovesical anastomosis. Six trainees performed the LUA procedure based on the models during a laparoscopic training course, following the technique used in the operation room. The learning curve was analyzed by operative time. Results The porcine model for laparoscopic training was established successfully and 3 LUAs could be performed on each pig. Each trainee performed 10 LUAs based on the models during the training course of laparoscopic urology. The operative time declined from (55.3±10. 4)min initially to (22.4±4.8)min (P＜0. 01) after the training course. At the end of training, all trainees could accomplish a watertight LUR procedure on the model. Conclusions The establishment of the training model is feasible. The trainees could acquire the skills necessary to perform LUA in vivo based on this model. The model provides a platform for training the basic techniques of LUA procedures.

Objective: To evaluate the clinical efficacy of total arthroscopic anterior talofibular ligament repair for chron-ic lateral instability of ankle joint. Methods: Data of 70 patients with chronic lateral mechanical instability of ankle joint treated by anterior talofibular ligament repair under full scope from September 2016 to October 2017 were retrospectively analyzed. There were 48 males and 22 females, aging from 18 to 49 years old (average, 32.3±3.4 years). Arthroscopic exploration, synovial mem-brane cleaning, extraction of lateral malleolus free body or microfracture were used in the operation, and the anterior talofibular lig-ament was repaired with knottless anchors to restore ankle stability. After the operation, plaster support was used for fixation, and relevant rehabilitation plans were conducted. X-ray films of the front drawer stress position of the ankle joint was taken preopera-tively and during follow-up, and the talus advancing distance was measured preoperatively and during follow-up. Ankle function was evaluated by American Orthopaedic Foot and Ankle Society (AOFAS) ankle and hindfoot function score, and pain was evaluat-ed by visual analogue scale (VAS). Results: Seventy patients were followed up for 8-18 months, with an average of 11.5 months. The incisions of all patients were healed in one stage without internal plant rejection reaction. The plaster was fixed for 2 weeks af-ter operation, followed by rehabilitation training 2 weeks later, non-confrontational physical exercise 3 months later and confronta-tional physical exercise 6 months later. Within one year after operation, 58 patients could meet the needs of daily life and exercise. Seven basketball and football fans complained of ankle joint soreness and discomfort after strenuous exercise, and the symptoms were relieved after treatment. The symptoms of foot and ankle instability were not significantly improved in 5 patients. Stress X-ray showed that the talus advancing distance was improved from 11.70±1.05 mm before operation to 3.25±1.09 mm at the latest follow-up, and the difference was statistically significant (t=32.15, P< 0.0001). VAS decreased from 5.70±2.90 before operation to 2.05±0.52 at the latest follow-up (t=11.75, P< 0.0001). AOFAS increased from 54.50±7.40 before operation to 87.80±5.60 at the latest follow-up (t=34.04, P< 0.0001). There was excellent in 53 cases, good in 8 cases, fair in 5 cases, poor in 4 cases, thus the excellent and good rate was 87.14% (61/70). One of the patients suffered from joint pain in ankle metatarsal flexion half a year later, and MRI reexamination found that the anchor had entered the joint cavity, whose symptom was relieved after the anchor was cleared by arthroscopy at the later stage. Conclusion The treatment of lateral chronic instability of ankle joint with arthroscopic non-knot anchor nail repair of anterior talofibular ligament can effectively restore the stability of ankle joint and the movement ability of pa-tients. The operation has advantages of definite curative effect, minimally invasive, fast recovery and easy acceptance by patients.

Surgical resection remains the only curative therapy for colorectal adenocarcinoma and liver metastasis. Synchronous robotic resection for colorectal liver metastasis (CRLM) offers the advantage of avoiding double surgical stress, while providing the benefits of small incision, quicker recovery, shorter hospital stay and faster postoperative adjuvant therapy. Compared with the laparoscopic approach, robotic approach is mostly suitable for rectal cancer liver metastasis, which is associated with low conversion rate, good nerve protection, high success rate for major hepatectomy and resection of difficult segments. Appropriately selected patients, multidisciplinary cooperation and skillful robotic surgeons are the key to success. Current data have demonstrated the feasibility and safety of synchronous robotic resection for CRLM. With the coming randomized controlled trial data and evolution of robotic surgical system, the future of synchronous robotic resection for colorectal liver metastasis is promising.

Surgical resection remains the only curative therapy for colorectal adenocarcinoma and liver metastasis. Synchronous robotic resection for colorectal liver metastasis (CRLM) offers the advantage of avoiding double surgical stress, while providing the benefits of small incision, quicker recovery, shorter hospital stay and faster postoperative adjuvant therapy. Compared with the laparoscopic approach, robotic approach is mostly suitable for rectal cancer liver metastasis, which is associated with low conversion rate, good nerve protection, high success rate for major hepatectomy and resection of difficult segments. Appropriately selected patients, multidisciplinary cooperation and skillful robotic surgeons are the key to success. Current data have demonstrated the feasibility and safety of synchronous robotic resection for CRLM. With the coming randomized controlled trial data and evolution of robotic surgical system, the future of synchronous robotic resection for colorectal liver metastasis is promising.

Objective:To explore effects of intervention based on story theory on self-management behavior and emotional state of patients with rectal cancer undergoing anus-preserving surgery.Methods:Using the convenient sampling method, a total of 80 patients with rectal cancer who underwent anus preserving surgery in Henan Provincial People's Hospital from January to September 2019 were selected as the research objects. The patients were randomly divided into 42 cases in the control group and 38 cases in the observation group. The patients in the control group adopted perioperative routine nursing methods for patients with rectal cancer, while patients in the observation group adopted an intervention program based on story theory at basis of the control group. Profile of Mood States-Short Form (POMS-SF) and Bowel Symptoms Self-Management Behaviors Questionnaire For Rectal Cancer Patients After Anus Preservation were used for evaluation.Results:In the end, the control group recovered 40 valid questionnaires and the observation group recovered 38 valid questionnaires. After intervention, scores of all dimensions of POMS-SF of the two groups were compared and the differences were statistically significant ( P<0.05) . In the observation group, scores of dimensions of stress-anxiety, depression-depression, anger-hostility, fatigue-dullness and bewilderment-disorder were lower than those of the control group, and the score of energy-vitality was higher than that of the control group. After intervention, there was no statistically significant difference in the score of treatment management dimension in Bowel Symptoms Self-Management Behaviors Questionnaire For Rectal Cancer Patients After Anus Preservation between the two groups ( P>0.05) . The scores of diet management, perianal skin management, seeking help from others and self-emotional adjustment in the observation group were higher than those in the control group, and the differences were statistically significant ( P<0.05) . Conclusions:Intervention based on story theory can effectively improve the emotional state of patients with rectal cancer undergoing anus-preserving surgery and improve dietary management, perianal skin management, seeking others' help and self-emotional regulation behaviors in patients' intestinal self-management behaviors, which has good clinical application values.