Objective To explore the effect of comprehensive intervention measure on antimicrobial use and incidence of healthcare-associated infection(HAI)in patients in sports medicine department.Methods Antimicrobial use and incidence of HAI in hospitalized patients in the surgical departments (sports medicine department and other surgical departments)of a hospital between January 2006 and December 2010 were analyzed retrospectively(before intervention),from January 2011, comprehensive intervention based on clinical-centered multi-department cooperation was adopted by sports medicine depart-ment,the other surgical departments over the same period were not comprehensively intervened;antimicrobial use and inci-dence of HAI in patients in surgical departments between January 2012 and December 2013 were monitored prospectively (after intervention ),effectiveness of intervention was evaluated.Results Antimicrobial use and incidence of HAI in pa-tients in sports medicine department after intervention were both lower than before intervention (55.75% vs 95.26%,χ2=753.42;0.10% vs 0.32% ,χ2 =15.13,both P <0.01).Antimicrobial use in patients in other surgical departments after intervention was lower than that before intervention(65.63% vs 73.79% ,χ2 =251.57,P <0.01 );incidence of HAI was higher than that before intervention(0.55% vs 0.42% ,χ2 =19.04,P <0.01).Conclusion Comprehensive in-tervention measure based on clinical-centered multi-department cooperation is safe and effective,it can reduce antimicrobial use and incidence of HAI in patients in sports medicine department.

OBJECTIVE To investigate the distribution and drug resistance of nosocomial infection pathogens.METHODS The data of pathogen′s origin and antibacterial resistance of Intensive Care Unit(ICU) inpatients from Apr 2008 to Mar 2009 in a Hospital were analyzed.RESULTS There were 226 strains pathogens isolated from 116 nosocomial infection cases,from which the Gram-negative bacteria were predominate(63.27%).The resistance rates of Acinetobacter baumannii was the highest in Gram-negative bacteria,more than 70% isolates resistant to almost antibacterial.The main Gram-positive bacteria were Staphylococcus aureus,and the rate of meticillin-resistant S.aureus(MRSA) was 41.3%.All S.aureus were sensitive to vancomycin and Linezolid.CONCLUSIONS To control the antibacterial resistance of pathogens and decrease the nosocomial infection,it is important to strengthen the appropriate use of antibiotics.

OBJECTIVE To investigate a case of nosocomial infection incident in a hospital,analyze the reasons and put forward preventive measures.METHODS Investigation was carried out on the related people and environment in the department where the incident occurred.Analysis was made on the reasons and processing.RESULTS The nosocomial infection incident was caused by Norovirus;fecal-oral transmission and contact transmission were 2 main pathways of Norovirus.There were 7 persons who had been contaminated by Norovirus,included 5 old inpatients,1 doctor and 1 nurse.CONCLUSIONS Many people should work to prevent and control the infections in hospital,such as doctors,nurses,inpatients,hospital works etc.Hand-washing and disinfection isolation should be enhanced among the hospital staffs in the normal works.

OBJECTIVE To understand the situation of the nosocomial infection among the hospital inpatients in a grade-A hospital in Beijing.METHODS Surveillance on nosocomial infection was performed among the hospital inpatients from Jan 2005 to Dec 2007.RESULTS From Sept 2006 to Aug 2007,803 cases were infected,the incidence was 1.99%.The lower respiratory tract ranked the first place(38.97%)and the highest infected rate was in ICU(16.16%).The species were predominated by Gram-negatives.The main pathogenic microorganisms were Pseudomonas aeruginosa,Staphylococcus aureus,Escherichia coli,Acinetobacter baumannii,Klebsiella pneumoniae and Candida albicans,etc.From 2005 to 2007,the infections caused by P.aeruginosa increased gradually,and the infections caused by C.albicans reduced gradually.CONCLUSIONS Many people should work to prevent and control the infections in hospital,such as doctors,nurses,inpatients,management workers,etc.

Objective This study compared the cleaning effect of gastroscope by different cleaning mehtods and discuss practical and reliable evaluation method for the cleaning degree of gastroscope.Methods Three cleaning methods were selected and used in the cleaning of gastroscope.The Endocheck lumen was used to examine the cleaning degree of gastroscope and the effects of different methods were compared. Results The qualification rate by using ordinary cleaning method was 50.0%and it reached 60.0%and 73.3%by elevation of polyenzyme concentration and adding bedside pre-washing.which Was statistically different from that by using ordinary cleaning method(P＜0.05).Conclusions Bedside pre-washing could increase the cleaning degree of gastroscope;Endocheck lumen could be regarded as an evaluation method for the cleaning degree of gastroscope.

Objective To investigate the role of endogenous Hydrogen Sulfide (H2S) in airway inflammation and responsiveness in a rat model of chronic passive-smoking.Methods Male SD rats were randomly divided into a control group (breathing fresh air) and a passive smoking group [cigarette smoking (CS) passively] ,with 18 rats in each group.Six rats in each group were randomly intraporitoneally injected with normal saline, sodium hydrosulfide (NailS) or propargylglycine (PPG, an irreversible inhibitor of cystathionine-γ-lyase).The animals were divided into six subgroups,ie.Con group, Naris group, and PPG group, CS group, CS + Naris group, and CS + PPG group.After 4 months,lung histological change and airway tension were measured.The H2 S levels of plasma and lung tissue were analyzed by the sensitive sulphur electrode assay.The expression of cystathionine-γ-lyase (CSE) was measured by western blot.Results Compared with the Con group, CSE protein expression in lung tissues was increased in CS group(P < 0.05) ; the H2S levels of plasma were significantly higher in GS group,NariS group and CS + Naris group,and much lower in PPG group (P < 0.05, respectively).Compared with CS group, the H2 S levels of plasma were significantly higher in CS + Naris group, and much lower in CS + PPG group (P < 0.05, respectively).The H2S level of lung tissue in each group had no significant difference (P > 0.05).Compared with Con group, score of lung pathology was significant elevated, and the responsiveness of airway smooth muscles to Ach and KCI was significant augmented in CS group.Compared with CS group, the score of lung pathology was decreased, and the responsiveness of airway smooth muscles was decreased in CS + NariS group(P < 0.05), and vise versa in CS + PPG group (P < 0.01).Conclusion H2 S can alleviate airway inflammation and hyperresponsiveness induced by CS, and administration of H2S might be of clinical benefit in airway inflammation and airway responsiveness.

Objective To study the risk factors for surgical site infections (SSIs)in patients with hepatobiliary and pancreatic surgery.Methods Sixty patients who received hepatobiliary and pancreatic surgery and suffered SSIs from January 2006 to January 2010 were selected as infections group,119 patients who also received hepatobiliary and pancreatic surgery but didn’t develop infection were as control group,retrospective investigation was per-formed.Results Univariate analysis revealed the associated factors for post-operative SSIs were age,history of car-diocerebrovascular disease,history of abdominal surgery,history of smoking,preoperative anemia,abnormal pre-operative coagulation and blood sugar,pre-operative infection,use of laparoscope,incision type,duration of opera-tion,ASA score,post-operative drainage and dressing chang within 24 hours of post-operation(all P<0.05).Mult-ivariate analysis revealed that abdominal surgery history (OR95%CI:3.09 [1.21 -7.91 ]),high NISS score (OR95%CI:6.18[2.41-15.85])were risk factors of SSIs in patients with hepatobiliary and pancreatic surgery, and dressing chang within 48 hours of post-surgery were protective factor (OR95%CI:3.81 [1.56-9.34]). Conclusion History of abdominal surgery and high score of NISS are major risk factors for SSIs in patients with hepatobiliary and pancreatic surgery.To reduce the risk of SSIs,blood glucose should be actively adj usted,anemia and coagulation abnormalities should be treated;duration of operation should be shortened as far as possible,wound should be kept clean and dressing should be changed timely after surgery.

Background and purpose:Adenoid cystic carcinoma is a rare tumor from salivary gland tissues; the incidence is about 1% to 2% of all head and neck malignant tumors. The incidence of adenoid cystic carcinoma of nasal sinuses is lower. Its characteristics include slow growth, less lymph node metastasis, easy to tissue invasion and growing along the nerves. It has high rate of recurrence and distant metastasis. Patients with the disease always have poor prognosis. This study aimed to investigate the prognosis and its impacting factors in Chinese patients with adenoid cystic carcinoma of nasal cavity and paranasal sinuses.Methods:This was a single center, prospective, observational study in Chinese patients with adenoid cystic carcinoma of nasal cavity and paranasal sinuses. Total 104 patients who received radiotherapy during the period between Sep. 2000 and Nov. 2012 were included and followed up for median 5.1 years. Kaplan-Meier, log-rank test, and COX proportional hazards model were used for survival-related analysis. Results:Mean age of patients was (54.5±11.5) years with equal numbers of males and females. The most common primary site was nasal cavity (63.5%) followed by maxillary sinus (29.8%). 76.0% of patients were at clinical stagesⅢ-Ⅳ, 56.7% of patients with positive surgical margin and 34.6% of patients with positive nerve invasion. In terms of treatment regimens, 67.3% of patients received postoperative radiotherapy, 27.9% received preoperative radiotherapy, only 4.8% received pure radiotherapy, and 29.8% received chemotherapy combined with surgery and radiotherapy.Conformal radiation therapy (CRT) was the most common radiotherapy which was used in 81.7% of patients, followed by intensity-modulated radiation therapy (IMRT) which was used in 18.3% of patients. Finally, 18 patients had recur-rence and 28 patients had distant metastasis. The most common metastatic site was lung, and nerve invasion was the independent risk factor for recurrence or metastasis (P=0.000 2). The overall survival rates of 5 and 10 years were 77% (95%CI: 68.7%-85.3%) and 67.8% (95%CI: 57.8%-77.9%), respectively. The disease-free survival rates of 5 years and 10 years were 57.8% (95%CI: 48.0%-67.7%) and 56.4% (95%CI: 46.3%-66.4%), respectively. Recurrence or distant metastasis was critical risk factor for overall survival (HR=60.1, 95%CI: 8.15-443.1,P<0.0001). Positive nerve invasion was a signiifcant factor for disease-free survival (HR=2.99, 95%CI: 1.642-5.445,P=0.0002). The primary sites, clinical stage, status of surgical margin, or radiotherapy methods had no impact on the prognosis of patients with adenoid cystic carcinoma of nasal cavity and paranasal sinuses.Conclusion:Positive nerve invasion, recurrence or distant metastasis may be important factors affecting the prognosis of Chinese patients with adenoid cystic carcinoma of nasal cavity and nasal sinuses.

In November 1981,an ancient female cadaver of Qidan nationality in wulanchatu League of InnerMongolia was excavated.This cadaver was estimated approximately 25 year of age.She has been buriedfor about 900 years.The cadaver was a mummified corpse,and preserved in a comparatively intact state. The hair was intact and dark brown in colour.All viseral organs were dreg-like and dark brown incolour.The individual organ could not be identified from its exernal appearance.Only lungs werepreserved,adhering to the back of the thoracic cavity and looked like dry leaves.The peritonem wasdry and translucent and contained a few blood vessels.The muscles were also dry and dark brown or brownishgray in colour.The alveoli and the parenchma of the lung as well as bacterial spores were identified.The histologicalstructure of tissues from the heart region looked like the cross section of cardiac fiber.Collagenous fiberswere seen.Other tissues were mostly autolyzed.The cadaver were group B.According to results of toxic analysis,larger amount of arsenic was demonstratedin tissues from the stomach region.So it was deduced that the lady might die of an arsenical poisoning.Factors involving in the well preservation of this case are discussed.