Objective To explore the causes of an outbreak of 168 cases of incisional infection in one hospital.Methods The secretory substances of incisioral wound infection from 168 cases of operation patients were collected,cultured and identified in bacterium strain.We also did drug sensitivity test,pathological examination and investigation of environment.Results Above these experinental studies demostrated that the large-scale outbreak of incisiona infection was caused by mycobacterium chelonei in operation room.Used 0.137% glutaradehyde as disinfectant immersion surgical tools ,but the concentration too low to kill the mycobacterium chelonei,which polluted the hickeyes of surgical instrument.The pollution leading to outbreak of incisional infection.Conclusions By reason of the event lesson,authors suggest that the doctors and nurses should strengthen the detection of atypical mycobacterium,so as to reduce the iatrogenic infection,reducing,or stoping the outbreak of incisinal Infection.

Objective:To investigate the effect of vitamin E, selenium and quercetin on the expression of zf-9 mRNA of hepatic stellate cells (HSC) during early acute liver injury in rats. Methods:90 healthy SD rats were randomly divided into four groups: normal control, pathological control, VE 20 mg/(kg bw﹒d) + Se 16 ?g/(kgbw﹒d) supplement, and quercetin 50 mg/(kg bw﹒d) supplement through intragastric way for 15 d respectively. The normal control group was injected with normal saline, the others were given intraperitonal CCl4 once to induce acute liver injury model. The serum levels of MDA, SOD, ALT and AST were determined at 3 h, 6 h, 12 h and 24 h after CCl4 injection respectively. The pronase-collagenase perfusion of liver was used to isolate HSC, and the expression of zf-9 mRNA was examined by RT-PCR. Results: Serum levels of MDA were lower in VE+Se supplement group and quercetin supplement group than pathological group. Supplementation with VE+Se and quercetin could decrease the level of ALT and AST and down-regulate the expression of zf-9 mRNA. Conclusion:Dietary supplementation of VE,Se and quercetin could effectively down-regulate the expression of zf-9 mRNA in HSC during early acute liver injury in rats.

Objective:To analyze the magnetic resonance imaging (MRI) features of parasellar cavernous haemangioma and improve the diagnosis and differential diagnosis accuracy.Methods:13 patients with parasellar cavernous haemangioma were collected.All the patients were diagnosed by MRI and confirmed by pathology.Based on the pathologic findings,the MRI features were discussed.Results:9 cases presented horizontal dumbbell.The lesions located in the parasellar were larger than the sella turcica.The main body position of the lesions were centered lateral to the parasellar and encasesed the intracavernous internal carotid artery (ICICA).While,1 cases were similar in size and shape.1 case was located in the sella turcica.2 cases was centered lateral to the ICICA.pituitary were detected obscurity in 7 cases and displaced in 6 cases,6 cases appeared extremely high homogeneous intensity on T2-weighted images:as bright as cerebrospinal fluid signal.Only 5 cases underwent three-dimensional arterial spin labelling perfusion imaging (3D-ASL).The lesions revealed marked hypoperfusion.The cases of misdiagnosis were 9,including 4 cpituitary adenomas and 5 meningiomas.Conclusions:The characteristics of MR images ofparasellar cavernous haemangioma were horizontal bottle gourd form,the main body position of the lesions were centered lateral to the parasellar and encasesed the (ICICA),and their extremely high homogeneous intensity on T2-weighted images:as bright as cerebrospinal fluid signal.In cases that are equivocal,3D-ASL were useful in differentiating cavernous haemangiomas from parasellar meningiomas,which could decrease mistaken diagnosis.Graspping the imaging feature and differential diagnosis were helpful for the diagnosis of this disease.

Objective To determine whether or not 810 nm low power Ga-Al-As laser treatment can stimulate the regeneration of damaged optic nerves by measuring the expression of growth associated protein 43 ( GAP-43 )and flash-visual evoked potential (F-VEP). Methods Eighty-eight Wistar rats weighing (180-220) g were randomly divided into a laser therapy group with 40 rats,an injury group with 32 rats,and a normal control group with 16 rats.Each group was subdivided into 1st,3rd,6th and 9th week subgroups.A standardized crushing of the optic nerve was applied to make the model.After this,the laser therapy group was treated for 3 minutes daily at 60 mW applied transcutaneously to a 5 mm diameter spot on the injured optic nerve.The injury and normal control groups received the same treatment with no laser output.The expression of GAP-43 was detected by immunohistochemistry and RT-PCR after 1,3,6 and 9 weeks of treatment.F-VEP was measured pre-injury,immediately after injury and 1,3,6 and 9 weeks post injury. Results After the optic nerve was injured,obvious changes in F-VEP were detected,including significantly prolonged latencies of N1,P1 and N2 waves.The latency increased immediately after the optic nerve injured,and then recovered,but after 1 and 3 weeks the latency was still prolonged.There was significant recovery from the 3rd to the 9th week.In the laser therapy group,the peak latencies of the N1,P1 and N2 waves were also prolonged,but the changes were less than those in the injury group.Expression of GAP-43 was hardly detectable in normal retinas and optic nerves.GAP-43 had its highest expression level at 1 week post-injury,and then decreased.At the 1st,3rd and 6th week post-injury,the expression of GAP-43 in the laser therapy group was significantly higher than in the injury group.GAP-43 mRNA content in the retina showed the same tendency as GAP-43 protein. Conclusion A 810 nm low power Ga-Al-As laser can promote neural repair and axonal regeneration after optic nerve injury.

Objective To investigate the distribution of congenital cardiovascular malformations in fetuses with chromosomal abnormalities.Method Congenital cardiovascular malformations of fetuses were diagnosed by prenatal ultrasonic cardiography from Jan 2011 to Sep 2013,and whose chromosomal karotype were tested by amniocentesis or cordocentesis.The association between chromosomal karyotypes and distribution of congenital cardiovascular malformations was analyzed.Result In 173 Fetuses with chromosomal abnormalities,20(11.56％) cases had congenital cardiovascular malformations,including seven 21-trisomies,eight 18-trisomies,three 13-trisomies and two 45,X.64％ (16/25) fetuses with congenital cardiovascular malformations accompanied with other malformations had chromosomal abnormalities.Only 1.87％ (52/4379) fetuses with normal karotype had congenital cardiovascular malformations.Conclusion Chromosomal abnormality is the most reason of complicate CHD.Chromosomal karotype test should be detected in fetus with complicate CHD.

Objective To investigate the significances of karyotyping analysis on umbilical cord vein blood lymphocytes in the diagnosis of abnormal karyotypes in middle to late period of pregnant fetus.Methods A volume (0.5 ～ 1 ml) of umbilical cord vein blood was extracted from pregnant women in third trimester pregnancy with prenatal detection indications,and collected in sterilized anticoagulant tube.Lymphocytes were cultured and collected for karyotyping analysis after fixed and dropped on slides.Data were analyzed statistically.Results Lymphocytes were cultured successfully in 1 211 cases out of total 1 213 cases collected.Totally 142 abnormal karyotypes were found,which includes 81 cases (detection rate 6.68 ％) of non-heteromorphic abnormal chromosomes and 61 cases (detection rate 5.03％) of heteromorphic chromosomes.Among these abnormal karyotypes,50 cases (accounting for 35.21％ in total abnormal cases) of aneuploidy include 4 cases of chimerical karyotype.Structural abnormalities were found in 31 cases (accounting for 21.83％ in total abnormal cases) samples including 11 cases of translocations,17 cases of inversion and 3 cases of deletion.Conclusions Based on our findings,karyotyping analysis on umbilical cord vein blood lymphocytes could be an effective method for detect abnormal karyotypes in middle to late period of pregnant fetus and played an important role in prenatal diagnosis.

Objective To research and discuss the scientificalness and effectiveness of professional core competence training in the operating theatre so as to seek for a way for the professional growth of operating room nurses.Methods Under the guidance of Guideline on Core Competence Building of Professional Nurses compiled by Department of Health of Guangdong Province in 2009,in accordance with the theory of core competence training and taking into account of different yearly salaries and levels of 21 nurses,we made respective plans and carried them out.Results After implementing professional core competence training,the rate of operating nurses' mastering basic knowledge and techniques reaches 92.50％,the rate of mastering professional knowledge and techniques reaches 86.25％,the ability of clinical thinking increases by 85％,the ability of education and research development increases by 78.50％,the ability of self-training raises by 98.20％,safe management raises by 91.50％,and the emergency ability raises by 93.60％.The analysis and compare are based on seven aspects,therefore are of statistical significance.Conclusion The training of the core competence in the operating theatre is practical,scientific and feasible in-service education which not only improves operating room nurses' abilities of clinical thinking and solving clinical nursing problems,but also provides career progress for operating room nurses.

Objective To investigate the pathogens and their drug resistance of neonatal skin infection in Maternal-Neonatal Unit to provide evidence for rational selection of antibiotics.Methods Secretions of skin lesions from newborns with skin infections delivered in Maternal-Neonatal Unit,Department of Obstetrics of Beijing Daxing People's Hospital from Jan.2009 to Dec.2010 were collected,cultured and identified for bacterial serotype.Antibiotic resistances of pathogens were determined.Enumeration data was presented by frequency and rate.The difference between groups was compared with Chi-square test.Results Two hundred and six newborn skin infection cases were diagnosed,which accounted for 2.3％ of all newborns (n=9131) delivered in the hospital during the study period.Two types of skin infection were identified,impetigo (n=192,93.2％) and omphalitis (n=14,6.8％).Totally 154 pathogens were found,including 95 (61.7％) Gram-positive cocci and 59 (38.3 ％) Gram-negative bacilli.The major pathogens among Gram-positive cocci were Staphylococcus aureus (45/154, 29.2％), followed by Staphylococcus epidermidis and Staphylococcus haemolyticus.Staphylococcus was sensitive to Cefazolin,Amoxicillin/clavulanic acid and Piperacillin/tazobactam,while resistant to Penicillin,Ampicillin and Erythromycin.The major pathogens among Gram-negative bacilli were Enterobacter cloacae (19/154,12.3％),followed by Escherichia coli and Klebsiella pneumoniae.Drug resistance rate of Gram-negative bacilli was high in penicillin,aminoglycosides and cephalosporins,while they were sensitive to piperacillin/tazobactam,Ampicillin/sulbactam,carbapenems and Quinolones.Conclusions Gram-positive cocci are the main pathogens of neonatal skin infection in the Maternal-Neonatal Unit,and among which Staphylococcus aureus is the major pathogen.Multi-drug resistance is common in the identified pathogens.Attentions should be paid to use antibiotics reasonably according to drug sensitivity test.

Objective To evaluate the effect of two different venous drainage patterns on the prognosis of fetal pulmonary sequestration( PS) . Methods Sixty cases of fetal PS with confirmed venous drainage diagnosed by prenatal ultrasound were retrospectively analyzed . Changes of the volumes of PS lesions and the clinical outcomes were compared between two different venous drainage patterns . Results Among the total 64 cases ,34 cases were pulmonary venous drainage and 30 cases were systemic venous drainage . There was no case combined with any abnormality in pulmonary venous drainage group;whereas , 6 cases combined with other abnormalities in systemic venous drainage group ,between which significant difference was noted( P =0 .02) . In pulmonary venous drainage group ,there was no significant difference in the volumes of PS lesions between at 20-24 weeks′gestational age(WGA) and at 24+1 -30 WGA( P >0 .05) ;but not between at 24+1 -30 WGA or at 20 -24 WGA and at 30+1 -39 WGA ( P < 0 .05) . However ,in the systemic venous drainage group ,the volumes of PS lesions were stable at these three stages ( P > 0 .05) . Postnatal respiratory symptoms and postnatal surgery rates were similar between the two groups( P > 0 .05) . Conclusions PS with systemic venous drainage is more likely combined with other abnormalities than PS with pulmonary venous drainage . The lesion volumes of PS with pulmonary venous drainage decreas remarkably during the middle‐late pregnancy . Nevertheless ,the clinical postnatal outcomes are both favorable in the two groups .

Objective To study the safety and feasibility of endobiliary intraductal radiofrequency ablation (RFA) to reopen occluded self-expandable metal stents in patients with malignant biliary obstruction.Methods 11 patients with malignant biliary obstruction and blocked metal stents were prospectively studied.During ERCP, after biliary cannulation, the blocked metal stents underwent RFA using a bipolar radiofrequency probe which was introduced into the stenotic bile duct via a guide wire.This was followed by a balloon to repeatedly remove debris and then endoscopic nasobiliary drainage.The patients were closely observed and followed up.Results RFA was successfully carried out in all the patients and patencies were achieved when compared with pre-RFA.The median post-RFA luminal diameter of the strictures showed significant improvement: 6 (4 ～ 10) mm versus 2 (0 ～ 5) mm, and the mean post-RFA total bilirubin level decreased sharply : (39.4 ± 8.7) μ mol/L versus (130.1 ± 38.2) μmol/L.Following this intervention, 3 patients developed fever, which were controlled with conservative therapy.There was no mortality, haemorrhage, bile duct perforation or bile leak.Of the 11 patients, 3 were dead and 6 were alive at a median follow-up of 187 (75 ～ 304) days.The median stent patency was 135 (75 ～ 203) days and the median survival was 278 (75 ～ 304) days.Four patients had their stents patent at the time of the last follow-up or death.Seven patients had their stents blocked on 113, 124, 154, 203, 96, 135 and 112 days post-procedure.Condusions Endobiliary intraductal RFA is technically feasible and safe to reopen occluded metal stents in malignant biliary obstruction.This efficacy needs to be confirmed by future randomized studies.