Objective To investigate transmission routes of healthcare-associated infection(HAI)caused by methi-cillin-resistant Staphylococcus aureus (MRSA),and make effective measures for preventing and controlling the oc-currence and epidemic of HAI caused by multidrug-resistance bacteria.Methods From February 24 to March 29, 2012,12 MRSA-infected patients were performed epidemiological study,these patients underwent bronchoscopy be-cause of tracheal stenosis,strains were identified by amplifying the sequences of 16S rRNA ,femA and mecA with real-time quantitative polymerase chain reaction (PCR),homology analysis of strains were performed by Spa geno-typing.Results All 12 MRSA-infected patients were susceptible to multidrug-resistance bacterial infection,5 cases of MRSA infection occurred during this hospitalization.Detection of specimens from health care workers and envi-ronment were all negative;Spa gene of all 12 MRSA isolates was type t 030 ,which was the main epidemic strain in Asia;Spa gene of Staphylococcus aureus isolated from nurses’noses was type t1425 .Conclusion The assumption of MRSA spread among health care workers aren’t supported by the epidemiological investigation results,genotypes of 12 MRSA isolates are identical,but the result of gene typing can’t be as the evidence of homology of infection ;patients at high risk for MRSA infection should be screened as early as possible,early contact isolation should be performed,so as to prevent and control the occurrence of HAI.

OBJECTIVE To investigate the management and sanitation status of the air circumstance in laminar flow operating rooms of grade two and above hospitals in Beijing.METHODS Air surveillance methods,cleaning methods of intakes,cleaning status of pipelines and frequency of renewing filter systems were investigated through interviewing charge nurse of 18 hospitals by questionnaires.RESULTS 50.0% of pipelines had never been cleaned,14.3% of intakes had never been cleaned.Air surveillance method of all hospitals was using sedimentation,with a low sensitivity.The monitoring systems were poor in 50.0% of hospitals.CONCLUSIONS Now there is only requirements of construction standard of clean surgery region,lacking routine regulations and technologies of contamination controlling standard,nor available dynamic contamination controlling system.Potential hazard exists in routine regulations of laminar flow operating room and it demands for making contamination controlling standard urgently in hospitals.

Objective To investigate the clinical manifestation, inherited pattern and the related factor of Hunting?ton disease families. Method The clinical data from 12 HD families was collected from 2013-2014. Patients received the genetic test and neurological evaluation including motor, cognitive and problem of behavior. Results There were 12 patients having the IT15 gene dynamic mutations, including 1 Juvenile Huntington disease patient and 3 pre-symptomat?ic mutant gene carriers. The average CAG repeats of these patients was between the range of 40 to 60, and the average on?set age ranged from 13 to 54 year-old. Positive family history and genetic anticipation could be observed. Patients pre?sented with different clinical manifestations at the early stage while had typical chorea movements, declined cognitive and psychiatric symptoms at the late stage of the illness. Conclusions There are typical triad symptoms in the late stage but not in the early stage nor pre-symptom stage illness. Clinical manifestation and the neuroimaging are both of great ref?erence value, and the genetic test is essential for final diagnosis.

Objective To approach the application value of diffusion weighted imaging with background suppression (DWIBS) combined with routine MR sequence in differentiating benign and malignant lymph nodes,and assessing therapeutic effect of lympho-genic tumors.Methods 48 patients with cervical lymph node enlargement who were confirmed by pathology and follow up under-went DWIBS and routine MRI examination,malignant lymph nodes were 83,benign lymph nodes were 79.16 patients with malig-nant lymph nodes were rechecked after radiotherapy and chemotherapy,Apparent diffusion coefficient (ADC)values of the solid part for lymph nodes were compared.Results More lymph nodes can be detected in DWIBS than conventional sequence.ADC values of the solid part for malignant lymph node(0.898±0.111)×10-3 mm2/s were lower than that of benign lymph node(1.043±0.106)× 10-3 mm2/s,there was significant difference between them (P<0.05).ADC values of all malignant lymph nodes after treatment (1.205±0.121)×10-3 mm2/s were significantly higher than that of pretherapy (0.883±0.090)×10-3 mm2/s (P<0.05).Conclu-sion DWIBS could more sensitively detect lymph node than conventional MR sequence.ADC value could provide some reference values for differentiating benign and malignant lymph nodes and assessing therapeutic effect.

OBJECTIVE To explore an effective cleaning method to improve the quality of sterilization,in order to control infections in the hospitals. METHODS To adopt orthogonal experimental forms of L_9(3~4) and take water temperature,cleaning agent type and cleaning method as experimental factors,in this way to investigate decontamination method for surgical instruments,using TOSI indicator cards and Browne STF load device to test the effectiveness of cleaning results. RESULTS It showed that by KQ-4200SY medical digital full-automatic ultrasonic cleaner with washing water at 33-35℃ an optimal cleaning result would be obtained. CONCLUSIONS It is practical to clean surgical instruments by KQ-4200SY medical digital full-automatic ultrasonic cleaner,and by TOSI indicator cards and Browne STF used as test method.

Objective To investigate the application value of diffusion-weighted imaging with background suppression (DWIBS) in lymph node metastasis of rectal cancer.Methods 30 patients with rectal cancer diagnosed by colonoscopy underwent routine MRI and DWIBS examinations.Metastatic and non-metastatic lymph nodes were confirmed by postoperative pathology.Apparent diffu-sion coefficient (ADC)values of the solid part of metastatic and non-metastatic lymph nodes were measured and compared.ROC curve analysis was used to define the threshold between the metastatic and non-metastatic lymph nodes.Results In all 73 lymph nodes,there were 52 metastatic lymph nodes and the other 21 were non-metastatic.ADC values of the solid part of metastatic and non-metastatic lymph nodes were (0.881 ± 0.094)× 10 -3 mm2/s and (1.072 ± 0.108)×10 -3 mm2/s respectively,the difference was statistically significant (P <0.05).With the threshold ADC value of 0.957×10 -3 mm2/s,the sensitivity and specificity for dif-ferentiating metastatic from non-metastatic lymph nodes were 90.5% and 80.8% respectively.The diagnostic value was excellent (Az value = 0.91 9,P <0.05).Conclusion ADC values may be used to differentiate lymph node metastasis of rectal cancer,and DWIBS has higher application value in assessing lymph node metastasis of rectal cancer.

OBJECTIVE:To study the rational use of antibacterials in inpatients.METHODS:A discussion was made on the use of antibacterials for 4 948 inpatients in 2004 and 5 476 inpatients in 2005 in our hospital,managed in accordance with the requirements for hospital management by level and the Guidelines for Clinical Use of Antibacterials.RESULTS & CONCL- USIONS:The inpatient use of antibacterials in our hospital has been made basically rational through implementation of systematic management,enactment of antibacterials management by level,monitoring on usage of antibacterials and enforcement of warning system for overusing.