Objective To investigate the epidemiological characteristics and risk factors for healthcare-associated infection(HAI)in a newly built rehabilitation hospital.Methods A prospective survey was adopted to monitor HAI among all patients admitted to a newly built rehabilitation hospital between January 2011 and December 2014, related data were collected and analyzed statistically.Results A total of 22 126 patients (male,n=12 023;female, n=10 103)were monitored,age were 4 months-100 years old.HAI rate was 3.25%(n=720),HAI case rate was 3.34% (n=738).Patients in department of spinal rehabilitation had the highest HAI rate (9.76%);the main HAI site was lower respiratory tract (n = 388,52.57%);a total of 186 pathogenic isolates were detected,154 (82.80%)were gram-negative bacteria,25 (13.44%)were gram-positive bacteria,and 7 (3.76%)were fungi. Multivariate logistic regression analysis showed that paralysis (OR,1 .77 [95% CI ,1 .24 - 2.53 ]),length of hospital stay ≥60 days(OR,4.62 [95% CI ,3.28 -5.10]),age ≤ 10 years old (OR,1 .55 [95% CI ,1 .33 -2.93]),age ≥60 years old (OR,4.59 [95% CI ,1 .02-20.59]),chronic underlying diseases(OR,1 .56 [95% CI , 1 .37-11 .34]),invasive procedure (OR,3.33 [95% CI ,1 .21 -6.86]),and coma(OR,6.77 [95% CI ,5.41 -7.05])were major risk factors for HAI in patients in the rehabilitation hospital.Conclusion Investigation on newly built rehabilitation hospital is helpful for realizing the occurrence status of HAI,health care workers can carry out the corresponding prevention and control measures.

ObjectiveTo improve the compliance behavior of discharged patients with chronic obsturctive pulmonary disease(COPD)by health education of telephone visit.Methods240 COPD patients were divided randomly into the experimental group and the control group with 120 cases in each group.The experimental group accepted telephone visit regularly for six months after 1 week since discharged from hospital and the control group did not receive any intervention.Six months later,the compliance behavior and the readmission of two groups were compared.ResultsThe results indicated that the compliance behavior of the experimental group was significantly better than that of the control group (P<0.01).ConclusionsConducting the health education of telephone visit can strengthen the patients' compliance behavior,postpone the process of disease,prevent complications,lighten economic burden and improve their life quality.

In recent years ,lots of studies indicated that inflammation plays an important role in occurrence and de‐velopment of cardiovascular diseases .Neutrophil to lymphocyte ratio (NLR) is a novel inflammatory marker ,the cost of detection is low and it's easy to obtain .NLR is not only related with poor prognosis of stable coronary artery disease and acute coronary syndrome ,but also closely associated with prognosis of acute heart failure .The present article made a review on the correlation between NLR and cardiovascular diseases .

Objective To analyze and discuss the expression of serum polymyositis‐scleroderma(PM‐Scl) antibody and its clinical significance in patients with systemic scleroderma(SSc) .Methods 315 hospitalized patients diagnosed with scleroderma by typical clinical manifestations or skin pathology from 2009 to 2012 were enrolled in the study .All patients were grouped into PM‐Scl antibody positive(PM‐Scl + ) group(90 cases) ,Scl‐70 antibody positive(Scl‐70+ ) group(70 cases) ,anti‐centromere antibody positive( ACA+ ) group(75 cases) and antibody negative group(80 cases) according to autoantibody spectrum .The severity of skin and visceral damage among all the groups were analyzed and compared .Results Patients in PM‐Scl+ group were characterized with different clinical manifestations .Compared with the other 3 groups ,the incidence of myositis in PM‐Scl+ group was significantly higher( all P< 0 .05) ;patients in Scl‐70+ group had higher incidence of visceral organ damage than PM‐Scl+ group(all P < 0 .05) .The incidence of skin lesions ,Raynaud′s phenomenon and capillary expansion in ACA+ group were higher than that of PM‐Scl+ ,while the incidence of interstitial lung disease ,heart disease and kidney disease were lower(all P< 0 .05) .Conclusion It is helpful for clinicists′ further understanding of common autoantibodies in Ssc patients and making correct assessment of the disease through analyzing the expression of PM‐Scl antibody .

Objective To explore the role of cell cycle regulators in tuberculosis with lung carcinoma.Methods p53,MDM_2,p21~ ras and p21~ WAF1 proteins were detected by LsAB immunohistochemical technique in 69 cases of tuberculosis with lung carcinoma.Results As compared with primary tuberculosis with lung carcinoma,the expression rate p53 or MDM_2 protein in relapsing NPC was similar(78% to 80%,84% to 83%),and the expression rate of p21~ ras and p21~ WAF1 protein in relapsing NPC was obviously descended(73% to 93%,52% to 84%);The high-expression rate of p53 protein in relapsing NPC was similar(42% to 51%),the high-expression rate of MDM_2 protein in relapsing NPC was obviously risen(57% to 32%),and the high-expression rate of p21~ ras and p21~ WAF1 protein in relapsing NPC was obviously descended(16% to 65%,17% to 46%).Among of them,the significant rise of MDM_2 protein expression level in relapsing NPC mainly occurred in the patients of group 2 which relapsing-interval was shorter than 34 months(P

Objective Summarize the interventional nursing experiences for patients with coronary chronic total occlucion by transraidal approach. Methods Preoperative evaluation, careful psychological nursing, perioperative observation and prevetion complications were used for 105 patients with coronary chronic total occlusion when curred by transraidal approach intervention. Results There were 97 cases had successful operation, while 8 cases failure. There were 14 cases of perioperative hypotension, 6 cases of coronary acute occlusion, 4 cases of coronary perforation and 3 cases of no- reflow. There were no radial- as-sociated complication in any patients. Conclusions Effective and careful nursing measures can prevent complications.

Objective To explore the clinical efficacy of acupuncture point embedding therapy in the treatment of slow transit constipation (STC)and the influence on the colon transmission function,plasma substance P(SP), vasoactive intestinal peptide(VIP). Methods A total of 128 slow transit constipation patients were involved in the study and divided randomly into two groups by using stochastic indicator: a treatment group (treated with acupuncture point embedding therapy) and a control group (treated with lactulose oral liquid). The clinical effects, colon transmission function, the influence of SP, and VIP were observed for STC patients. Results In the treatment group, CCS score was (13.52±3.93) before treatment and(8.15±3.77) after the treatment. In the control group CCS score was (14.11±4.24) and (9.01±2.93) respectively before and after the treatment, CCS score in both groups showed significantly improvement after the treatment (P<0.01), and there was no significant difference between groups (P>0.05). The plasma SP and VIP level of the two groups after the treatment [treatment group (46.73±1.50) ng/L,(206.10±12.14) ng/L, the control group(40.92±6.25)ng/L,(214.73± 7.62)ng/L] were also improved than before [treatment group was(26.66±0.88)ng/L, (332.68±17.84)ng/L, the control group was (23.32±1.75)ng/L,(306.22±20.01)ng/L], with statistically significant(P<0.05), and the difference between the two groups were also significant(P<0.05).Conclusion The acupuncture point embedding therapy is effective for STC, and it can regulate the level of SP and VIP.

Objective:To discuss and analyze the clinical efficacy and application value of transperineal ultrasound dynamic monitoring for the contraction function of pelvic floor muscle to guide training based on its feedback in the treatment of stress incontinence of female.Methods: 169 female patients with stress incontinence were enrolled this study. And all of them were treated by using the Koegel physical training of pelvic floor muscle under the guidance of doctor, at the same time, the relative contraction function indicators of pelvic floor muscle before and after treatment were observed and compared by applied transperineal ultrasound dynamic monitoring.Results: The differences between before and after treatment of physical training on pelvic floor muscle about the length of the levator hiatus, the acreage of pelvic diaphragm hiatus, and the perimeter of pelvic diaphragm hiatus in contraction and silent period were significant (t=-2.858,t=-2.949,t=-4.899,P<0.05), and that of after treatment was higher than that of before treatment. The horizontal distance of pubis combined with margo inferior, vertical distance and thickness of viscera on pubis of after treatment were significant higher than that of before treatment (t=3.674, t=-4.899,t=4.230,P<0.05). The posterior urethra intersection angle and the intersection angle of left and right levator after treatment were significantly higher than that of before treatment (t=-4.087,t=6.584, P<0.05).Conclusion: Transperineal ultrasound dynamic monitoring can correctly evaluate the clinical efficacy of the contraction function of pelvic floor muscle to guide training based on its feedback in the treatment of stress incontinence of female. And this method has important clinical value.

Objective To analyse the mutation types of the NOTCH3 gene with cerebral autosomal dominant arteriopathy with subcortical infarcts and leukoencephalopathy(CADASIL). Methods Including 4 probands of CADASIL,10 cases of CADASIL and 4 normal members from 3 CADASIL families and 100 healthy controls were recruited. Genomic DNA was extracted from white blood cell. The amplicons were analyzed by the denaturing high-performance liquid chromatography (DHPLC) technique. The positive samples which identified by the DHPLC were sequenced to determine the specific mutation or polymorphism, respectively. Results Three heterozygous missense mutations including Cys90Arg, Arg141Cys, Cys134Tyr located in the exon3 and exon4 were found in the 4 probands and 10 cases of CADASIL among the 3 families. 15 polymorphisms were also found. 2 members individual from family 1 and 2 were found to carry the same pathological mutations as in their proband but without clinical symptoms. They were identified as preclinical patients. Conclusions Mutation detection of NOTCH3 is the molecular genetic mechanical for CADASIL. The exon3 and exon4 are possible hot mutation spots in Chinese patients. The mutation of Cys134Tyr in exon4 is a novel mutation which has not been reported previously in China.

Objective To investigate the efficacy and safety of long guidewire exchange technique in performing cerebral angiography via radial artery approach.Methods The clinical data of 257 patients,who received cerebral angiography during the period from June 2014 to May 2016 at Daxing Hospital of Capital Medical University,Beijing,China,were retrospectively analyzed.Among the 257 patients,186 had type Ⅱ or type Ⅲ aortic arch.According to the different looping technologies for Simmons-2 catheter used in the performance of cerebral angiography,these 186 patients were divided into the study group (n=90) and the routine group (n=96).The success rate of radial artery puncturing,the success rate of Simmons-2 catheter looping formation,the success rate of supra-arch arterial catheterization,the time spent for angiography,the radiation exposure time,complications,etc.were recorded.Results The success rate of radial artery puncturing was 100％ in both groups.The success rate of Simmons-2 catheter looping formation in the study group was 97.8％,which was significantly higher than 72.9％ in the routine group (P＜0.05).The success rates of catheterization for the left subclavian artery,left common carotid artery and right carotid artery in the study group were 97.8％,97.8％ and 97.8％ respectively,which were remarkably higher than 72.9％,72.9％ and 72.9％ respectively in the routine group (P＜0.05).No statistically significant difference in the success rates of catheterization for right subclavian artery and for right vertebral artery existed between the two groups (P＞ 0.05).The time spent for angiography in the study group and the routine group was (22.5±9.4) min and (28.3±8.3) min respectively.The radiation exposure time in the study group was (8.9±4.5) min,which was obviously lower than (12.6±6.5) min in the routine group (P=0.017 and P=0.035,respectively).The incidences of complications in the study group and the routine group were 4.4％ and 5.2％ respectively,the difference was not statistically significant (P＞0.05).No severe complications,such as intracranial arterial embolie events,puncture bleeding,arterial occlusion,etc.,occurred in all patients of both groups.Conclusion The use of long guidewire exchange technology can improve the success rate of Simmon-2 catheter looping formation and the success rate of supra-arch arterial catheterization,it can also shorten the time for angiography procedure and reduce the radiation exposure time.This technique is very effective with higher safety.Therefore,this long guidewire exchange technique should be used as a common method for cerebral angiopraphy via radial artery approach in patients with type Ⅱ or type Ⅲ aortic arch.