OBJECTIVE To promote the multidrug-resistant bacteria infection control. METHODS Questionnaire investigated has been used to understand what degree the healthcare workers have known about controlling multidrug-resistant bacteria infection,what difficulties they would be met when they had put prevention and control measures in practice. RESULTS Total 13 questions of prevention and control multidrug-resistant bacteria nosocomial infection,the rate of right answer was 26.9% and the rate of partial right answer was 38.4%.The healthcare workers had lacked of professional knowledge about the prevention and control of multidrug-resistant bacteria nosocomial infection. The major difficulties were crowded wards,short of beds,incomprehension of patients and their families,cost of articles for disinfection and isolation when the medical staff put isolation measures into practice. CONCLUSIONS All prevention and control measures againt multidrug-resistant bacteria infection should be put into practice. We should strengthen training of healthcare workers about professional knowledge,gain support of leaders,and enhance communication between medical staff with patients and supervision.

Objective To explore the effect of ventilator circuit change frequency on the incidence of ventilator-associated pneumonia (VAP). Methods Patients receiving mechanical ventilation in the ICU,Department of Emergency, Respiratory Department and Department of Neurosurgery from March 2008 to September 2010 were randomized into two groups. For these two groups ,the ventilator circuit was changed once or twice a week. The recorded parameters included the clinical symptoms and signs of the ventilated patients. Samples at different parts of the circuit were collected for microbiological detection. The data were analyzed statistically. Results The incidence of VAP was 28. 30% ( 13/53 ) in twice-a-week group and 35.84%( 19/53 ) in once-a-week group. There was no significant difference between the two groups. The rates for positive microbiological detection in the circuit were 48. 16% and 44. 49% for once-a-week and twice-a-week group,respectively. No significant difference was observed ( P ＞ 0.05 ). Moreover, there was no significant difference in terms of the microbiology positivity between different parts of the circuit(P ＞ 0. 05 ). Gram-negative bacteria were the main pathogen of VAP with Acinetobacter baumannii ranking at the top. Conclusion Frequency of Ventilator circuit change does not influence the incidence of VAP. We suggest that the frequency for ventilator circuit change should be once a week. At the same time, the nurse staff should be trained for specific technology and the incidence of hospital infection should be controlled at multiple rings of the chain.

Objective To study the prevalence and associated factors of loneliness in individuals with speech disability.Methods Using multi-stage stratified random cluster sampling method,170 community-residing ver-bally disabled persons were selected and administered with a general information questionnaire,one single -item loneliness self-rating question and social support scale.A total of 204 study questionnaires were distributed to the subjects;170 subjects(mean age:43.1±13.7 years)completed the survey.Results As high as 46.47% (79/170)of these verbally disabled individuals reported to feel lonely often.Females (OR=2.45),unemployment (OR=2.95), first and second degrees of disability (OR=4.35),co-existence of chronic illnesses (OR=6.50)and low utiliza-tion of social support (OR=2.58)were significantly associated with the increased risk of loneliness in persons with speech disability (P =0.002~0.046).Conclusion Loneliness is highly prevalent in individuals with speech disabili-ty.Verbally disabled persons,who are female,unemployed,severely disabled,and chronically ill and have a low use of social support,are the target population of mental health services.

OBJECTIVETo assess the efficacy and safety of modified ligation of the intersphincteric fistula tract for simple transsphincteric perianal fistula.

METHODSSeventy patients with simple transsphincteric perianal fistula between October 2012 and January 2014 in our department were prospectively enrolled. According to the random number table, patients were divided into two groups: modified-LIFT group (37 cases, from the external opening close to the fistula, dissect the external sphincter fistula to the intersphincteric groove by tunneling technique, resect the lateral free fistula) and LIFT group (33 cases). Clinical parametres before and after operation were compared, and results of pelvic electromyogram (EMG) and anorectal manometry three months after operation were analyzed to evaluated anal function.

RESULTSThe operative time, pain score, hospital stay, and healing time were not significantly different between the two groups (all P>0.05). During the median follow-up of 12 months (3-20 months), the healing rate in modified-LIFT group was 83.8% (31/37), which was significantly higher than 60% (20/33) in LIFT group (P=0.029). After operation, 4 patients had persistent unhealed wound, 2 recurred in modified-LIFT group, while 8 patients had persistent unhealed wound, and 5 recurred in LIFT group. No patients developed anal incontinence. By the pelvic EMG and anorectal manometry 3 months after operation, the duration of motor unit potential, occurrence of simple phase, mean resting pressure and maximun squeeze pressure were not significantly different.

CONCLUSIONModified-LIFT procedure for the management of simple transsphincteric perianal fistulas is a simple and effective operation with higher healing rate and similar anal function as LIFT.

Anus Diseases ; surgery ; Humans ; Ligation ; Operative Time ; Pelvis ; Pressure ; Rectal Fistula ; surgery ; Recurrence ; Treatment Outcome ; Wound Healing

OBJECTIVETo investigate the expression of prostaglandin transporter (PGT) in colorectal cancer (CRC) tissues and its relationship with clinicopathological features.

METHODSThe mRNA and protein levels of PGT were determined by real-time PCR, Western blot and immunohistochemical methods in cancer tissues and adjacent normal tissue from 80 patients with colorectal cancer and their relationship with clinicopathological features was analyzed.

RESULTSCompared with the adjacent normal tissue of colorectal cancer, the PGT mRNA relative expression (0.57 ± 0.33 vs. 2.33 ± 1.20) and the PGT protein expression in cancer tissues decreased significantly [PGT/GAPDH 0.45 ± 0.16 vs. 0.78 ± 0.23, integral A 718.7 ± 359.4 vs. 10412.0 ± 6423.3, average A 0.03 ± 0.01 vs. 0.12 ± 0.09, all P<0.01]. Lower mRNA and protein expressions of PGT in colorectal cancer were associated with depth of invasion T3 to T4 and TNM stage III( to IIII( (P<0.01), while not associated with gender, age, tumor location and differentiation degree (all P>0.05).

CONCLUSIONExpression levels of PGT mRNA and protein in colorectal cancer tissue are significantly down-regulation. PGT expression is associated with invasion depth and late stages.

Colorectal Neoplasms ; Down-Regulation ; Humans ; Neoplasm Invasiveness ; Neoplasm Staging ; Organic Anion Transporters ; RNA, Messenger

OBJECTIVETo evaluate the feasibility and efficacy of transanal endoscopic microsurgery (TEM) by transanal glove port combined with colonoscopy for excision of rectal tumors.

METHODSEight patients with rectal cancer eligible for local resection were chosen to receive a procedure performed via a "glove TEM port" from October 2012 to March 2013. This device was constructed on-table using a circular anal dilator (CAD), standard surgical glove, colonoscopy instruments and straight laparoscopic instruments.

RESULTSProcedures of all the patients were completed successfully by glove TEM. The median (range) diameter of tumor was 2.6(1.5-3.5) cm, the median (range) operative time was 55.6(30-110) min. Postoperative pathology included villous adenomas (n=3), tubular adenomas (n=2), tubulovillous adenomas (n=2), serrated adenoma (n=1), low-grade intraepithelial neoplasia (n=2), and high-grade intraepithelial neoplasia (n=1). All resection margins were negative. Two patients presented with postoperative minor bleeding. There were no serious intraoperative complications. No cancer recurrence was found during a follow-up of 1-5 (median 3.1) months.

CONCLUSIONTransanal endoscopic microsurgery by transanal glove port combined with colonoscopy in the treatment of early rectal cancer is easy and safe.

Adult ; Aged ; Colonoscopy ; methods ; Female ; Follow-Up Studies ; Humans ; Male ; Microsurgery ; methods ; Middle Aged ; Rectal Neoplasms ; surgery ; Treatment Outcome

Obejective To evaluate the feasibility and efficacy of transanal endoscopic microsurgery (TEM) by transanal glove port combined with colonoscopy for excision of rectal tumors. Methods Eight patients with rectal cancer eligible for local resection were chosen to receive a procedure performed via a “glove TEM port” from October 2012 to March 2013. This device was constructed on-table using a circular anal dilator(CAD),standard surgical glove,colonoscopy instruments and straight laparoscopic instruments. Results Procedures of all the patients were completed successfully by glove TEM. The median (range) diameter of tumor was 2.6 (1.5-3.5) cm,the median (range) operative time was 55.6 (30-110) min. Postoperative pathology included villous adenomas (n=3 ) , tubular adenomas ( n=2 ) , tubulovillous adenomas ( n=2 ) , serrated adenoma ( n=1 ) , low-grade intraepithelial neoplasia ( n=2 ) , and high-grade intraepithelial neoplasia ( n=1 ) . All resection margins were negative. Two patients presented with postoperative minor bleeding. There were no serious intraoperative complications. No cancer recurrence was found during a follow-up of 1-5 (median 3.1) months. Conclusion Transanal endoscopic microsurgery by transanal glove port combined with colonoscopy in the treatment of early rectal cancer is easy and safe.

Objective To investigate the expression of prostaglandin transporter (PGT) in colorectal cancer (CRC) tissues and its relationship with clinicopathological features. Methods The mRNA and protein levels of PGT were determined by real-time PCR , Western blot and immunohistochemical methods in cancer tissues and adjacent normal tissue from 80 patients with colorectal cancer and their relationship with clinicopathological features was analyzed. Results Compared with the adjacent normal tissue of colorectal cancer , the PGT mRNA relative expression (0.57 ±0.33 vs. 2.33 ±1.20) and the PGT protein expression in cancer tissues decreased significantly [PGT/GAPDH 0.45 ±0.16 vs. 0.78 ±0.23, integral A 718.7 ±359.4 vs. 10412.0 ±6423.3, average A 0.03 ±0.01 vs. 0.12 ±0.09, all P<0.01]. Lower mRNA and protein expressions of PGT in colorectal cancer were associated with depth of invasion T3 to T4 and TNM stage Ⅲ to Ⅳ (P<0.01), while not associated with gender, age, tumor location and differentiation degree (all P>0.05). Conclusion Expression levels of PGT mRNA and protein in colorectal cancer tissue are significantly down-regulation. PGT expression is associated with invasion depth and late stages.

Objective To explore the feasibility of in vitro biological soft tissue imaging by using synchrotron radiation phase contrast CT.Methods Three samples of resected human cardia,two samples of resected human esophageal carcinoma and esophagus,as well as two samples of middle cerebral artery tissue extracted from corpses were fixed and airdried at room temperature for synchrotron radiation phase contrast CT imaging.The images of soft tissue structures were observed and compared with pathological findings.Results The images of synchrotron radiation phase contrast CT showed three-layer structure of cardia and esophagus,mucous,submucosa and muscular layer.The surface of mucous layer was smooth.The images of esophageal carcinoma showed cancerous tissue infiltrating esophageal wall.The wall and lumen of cerebral arteries could be also clearly displayed.Conclusion Synchrotron radiation phase contrast CT imaging can clearly display fine structures of in vitro biological soft tissue.

Obejective To evaluate the feasibility and efficacy of transanal endoscopic microsurgery (TEM) by transanal glove port combined with colonoscopy for excision of rectal tumors. Methods Eight patients with rectal cancer eligible for local resection were chosen to receive a procedure performed via a “glove TEM port” from October 2012 to March 2013. This device was constructed on-table using a circular anal dilator(CAD),standard surgical glove,colonoscopy instruments and straight laparoscopic instruments. Results Procedures of all the patients were completed successfully by glove TEM. The median (range) diameter of tumor was 2.6 (1.5-3.5) cm,the median (range) operative time was 55.6 (30-110) min. Postoperative pathology included villous adenomas (n=3 ) , tubular adenomas ( n=2 ) , tubulovillous adenomas ( n=2 ) , serrated adenoma ( n=1 ) , low-grade intraepithelial neoplasia ( n=2 ) , and high-grade intraepithelial neoplasia ( n=1 ) . All resection margins were negative. Two patients presented with postoperative minor bleeding. There were no serious intraoperative complications. No cancer recurrence was found during a follow-up of 1-5 (median 3.1) months. Conclusion Transanal endoscopic microsurgery by transanal glove port combined with colonoscopy in the treatment of early rectal cancer is easy and safe.