OBJECTIVE The status and risk factors of nosocomial infections in intensive care unit(ICU) were investigated to make the intervention strategy. METHODS Use prospective monitoring and retrospective investigation to analyze the 198 nosocomial infections patients. RESULTS The lower respiratory tract infection was the main infection in ICU,about 69.4%.The risk factors were old ages,long hospitalization time,the use of many antibiotics,severe underlying illness,invasive operation manipulation and so on. CONCLUSIONS General intervention strategy should be adopt in the control of ICU nosocomial infections to low the infection rate and raise the rate of rescue.

OBJECTIVE To investigate distribution and drug resistance status of infections in urinary system and offer scientific basis for reasonable usage of antibiotics. METHODS Totally 258 isolates collected from urinary infection specimens were identified and drug susceptibility test was performed. RESULTS Escherichia coli rated the top one,73.3%.The isolates were susceptible to imipenem and amikacin.The resistant rate to other 6 antibiotics were above 50%. CONCLUSIONS The drug resistance rate of isolates collected from urinary infection specimens goes upward,so we should pay attention to.

Objective To assess the effect and safety of applying Diver CE thrombus-aspirating device during direct percutaneous coronary intervention(PCI)in pations with ST-segment elevation myocardial infarction(STEMI). Methods Select 46 patients with STEMI who underwent direct PCI between July,2006 and June,2007 in Fushun Central Hospital. Dividing these patients into thrombus-aspirating group and direct PCI group,comparing the difference in chest pain relieving.magnitude of ST-segment declining in 2h,TIMI flow grade 3,the maximum value of CK and CK-MB,EF and MACE outcome(death、myocardial infarction and targert vessel revascularization).Results The percent of chest pain relieving、magnitude of ST-segment declining 、TIMI flow grade 3、the maximum value of CK and CK-MB,and EF in thrombus-aspirating group are piror to the direct PCI group(P0.05).Conclusion applying Diver CE thrombus-aspirating device during PCI can obviously reduce thrombus in coronaty artery and distal embolization,improve myocardial reperfusion more effectively.

[ ABSTRACT] AIM:To compare the expression of SIRT2 in ovarian surface epithelial ( OSE) cell line and serous ovarian carcinoma ( SOC) cell lines, and to investigate the effects of SIRT2 on the cell proliferation, migration and inva-sion.METHODS:The expression levels of SIRT2 in the OSE cell line and the SOC cell lines were determined by Western blot.The SIRT2 siRNAs and overexpression construct were designed and verified.Transient transfection of SIRT2 siRNAs or overexpression construct was performed, and the effect of SIRT2 on the cell proliferation, migration and invasion was e-valuated.RESULTS:SIRT2 levels in the 5 strains of SOC cell lines were significantly lower than that in the OSE cell line.SIRT2 knockdown in HOSEpiC cells significantly enhanced the ability of cell colony formation and accelerated the cell growth rate.On the contrary, overexpression of SIRT2 in HO8910 cells dramatically repressed the number of cell colonies and cell activity.SIRT2 significantly changed the ability of ovarian cell migration.Knockdown of SIRT2 facilitated the cell invasion.CONCLUSION:The expression of SIRT2 in the SOC cells is significantly down-regulated.In the OSE cells, SIRT2 acts as a tumor suppressor and mediates the inhibition of cell proliferation, migration and invasion.

Objective To explore the diagnosis, treatment and prognosis of acute perforation of gnstric cancer. Methods The clinical data of 24 patients with acute perforation of gastric cancer who had been admitted to Guangzhou General Hospital of PLA from July 1996 to December 2008 were retrospectively analyzed. Results Of all patients, 4 were treated by perforation repair, 2 by perforation repair combined with gastrojejunostomy, 11 by palliative subtotal gastrectomy, 2 by radical gastrectomy, and 5 by radical gastrectomy after perforation repair. The mean survival time of patients treated by perforation repair, perforation repair combined with gastro-jejunostomy, partial gastrectomy and radical gastrectomy were (4±5), (6±9), (12±7), and (25±9) months, respectively. Conclusions Early diagnosis and reasonable operation are the keys to decrease the morality and increase life quality for patients who suffered from acute perforation of gastric cancer. Different pathologic stages maybe an important factor in deciding the prognosis.

Objective To study the incidence of PTEN, p53 and Ki-67 expression in astrocytoma and show the relationship between PTEN, p53 expression and the proliferation activity. Methods The surgical specimens from 68 brain astrocytoma patients were analysed to detect PTEN, p53 and Ki-67 expression with immunohistochemical method. Results The incidence of PTEN, p53 and Ki-67 expression was 54.4 %,45.6 % and 48.5 % respectively in astrocytoma. With the grade of astrocytoma increasing the levels of PTEN protein decreased, on the other hand the levels of p53, Ki-67 increased. There was a negative correlation between PTEN expression and grade of astrocytoma while there was a positive correlation between p53, Ki-67 expression and grade of astrocytoma by using the Spearman Correlation test to analyse the data. The incidence of Ki-67 positive expression was 24.3 % in 37 cases exhibiting PTEN positive staining, whereas the incidence of Ki-67 positive expression was 77.4 % in 31 cases exhibiting PTEN negative staining. In statistics, there was an inverse correlation between PTEN and Ki-67 expression. Conclusion There is an inverse correlation between histopathological grades of astrocytoma and PTEN expression. A positive correlation is found between p53, Ki-67 expression and histopathological grades of astrocytoma. PTEN can inhibit tumor cell proliferation in astrocytoma.

Objective To investigate the effect of insulation during surgery on the prognosis of hy-potherrnic trauma patients. Methods Trauma patients (80 cases) with injury severity score (ISS) of 16～40 and anal temperature < 36℃,were selected and randomly divided into the insulation group and the control group with 40 cases in each group.Both operations went along under room temperature. The in-sulation group keep anal temperature ≥ 36 ℃,while the control group received no insulation interven-tion.The palinesthesia time,time length of hospital stay,infection of wound and fatality were observed in the two groups. Results The palinesthesia time and time length of hospital stay dramatically shortened,the infection rate of Wound and fatality reduced in the insulation group compared with that of the control group (P<0.05). Conclusions Insulation during surgery can significantly shorten the palinesthesia time and time length of hospital stay,reduce the infection rate of wound and fatality.

Objective To explore influence of perioperative protection from hypothermia on surgical site infection (SSI) in patients undergoing gastroenteritic operation. Methods A retrospective study was carried out in 1536 patients undergoing gastroenteritic operation in general surgery department of our hos-pital.Patients (764 cases) admitted before July 2006 were set as the control group,while those after July 2006(772 cases) were set as the observation group. The observation group received a series of measures for protection from hypothermia besides of routine perioperative nursing.The control group only adopted routine perioperative nursing.The SSI rate was compared between the two groups. Results The SSI rate of the observation group was lower than that of the control group(P < 0.01 ). Conclusions Incidence of periop-erative hypothermia in patients undergoing gastroenteritic operation can increase the SSI rate.Appropriate measures for protection from hypothermia can prevent the incidence of hypothermia as well as SSI.

The data on nosocomial infection of 4060 patients who were stayed in intensive care unit (ICU) more than 48 h from January 1997 to August 2008 were reviewed.From Jan 2004 the target monitoring of hospital-acquired infection was implemented in ICU.The nosocomial infection rates before and after target monitoring were 35.25% (871/2471) and 30.77% (489/1589) respectively (P ＜ 0.01);however there was no significant difference in case infection rate before and after target monitor were practiced (47.67% vs.45.25%,χ~2 = 2.2836,P ＞0.05).The incidence of Acinetobacter infection was increased after target monitoring.Targeted monitoring can decrease the nosocomial infection rate in ICU,and also reduce the cost of medical care.

Objective To introduce the clinical application of a extensive revense peroneal artery flap in repairing big soft tissue defect in foot, especially in repairing a big defect in distal foot and the exposure of one or more metatarsophalangeal joint. Methods The skin flaps were used in 11 cases to repair the big soft tissue defect in foot, including the distal part of foot. The flap upper boundary may surpass the capitulum fibulae; The lower boundary may reach the back line between external malleolus and internal malleolus; Lat-eral boundary could overrun anterior margin of fibula about 2 cm; Inboard boundary could get to medial mar-gin of gastrocnemius muscle. In attention: the two branch vessels from peroneal vessel in the site of 11-13 cm and of 5-7 cm above the outer anker would be included in the flap. Results Ten of 11 skin flaps survived satisfactory. A small, marginal portion of one flap in one case presented necrosis. Conclusion The reverse peroneal artery flap is easy to elevate and safety, which is an ideal flap for a huge soft tissue defect in foot, especial in the distal part of foot.