Objective To compare postoperative pulmonary infection in patients undergoing surgical operation at different surgical opportunities.Methods Patients who underwent surgical operation in a hospital from January to December 2014 were surveyed retrospectively,patients' data were reviewed,patients with postoperative pulmonary infection were compared.Results A total of 20 343 surgical patients were investigated,227(1.12％) had postoperative pulmonary infection.Postoperative pulmonary infection rate in patients undergoing emergency operation was higher than that of selective operation (5.13 ％ vs 0.70 ％,x2 =307.49,P＜0.001).Postoperative pulmonary infection rates in patients undergoing emergency neurosurgical,general surgical,and cardiothoracic surgical operation were all higher than selective operation (all P ＜ 0.001).Among patients with pulmonary infection following emergency operation,the proportion of those who aged ＜60 years,with preoperative irrational antimicrobial use,cardiovascular disease,hypertension,and tracheotomy were all higher than those who received selective operation (all P＜0.05);the proportion of patients with cancer is lower than that of elective surgery patients(P＜0.05).Conclusion Postoperative pulmonary infection rate in patients undergoing emergency operation is higher than selective operation,postoperative pulmonary infection rates in patients undergoing emergency neurosurgical,general surgical,and cardiothoracic surgical operation are high.Patients with cardiovascular disease and hypertension are the focus of protection;for elective surgery,cancer patients are the focus of protection.

0.05).The symptom of peripheral neuropathy emerged 1 w after poisoning,the numbers of gait abnormal were 3,4 and 4 respectively in groups A,B and C,and there were no significant difference among those groups.It showed that the necrosis of segments of muscle fibers and macrophages infiltration scattering distribution were observated in the necrosis area and muscular interstition.At the end of 3 w,4 w and 8 w,there were significant differences in the area of muscular necrosis between group A and C(P

[Objective]To investigate the influence of the two different methods on the runtime of capsule endoscope in the small bowel.[Method]There were 31 patients who accepted the examination of capsule endoscope.Among these patients,we used pro- kinetic agents or gastroscope for 12 cases with capsule endoscope staying in the stomach for more than 60 minutes.We analyzed the influence on runtime of capsule endoscope in the small bowel with the two methods above and that of the 19 untreated cases. [Result]In the control group,15 cases completed the examination on the whole small bowel,with the average runtime 234.4?70.3min,and 4 of them failed.In medicine group,5 cases completed the examination with the average runtime 121.8?103.7min. 7 cases with the help of gastroscope all completed the examination on small bowel and its average runtime was 275.3?81.8min. [Conclusion]Taking prokinetic agents tends to have more influence on the runtime of capsule endoscope in the small bowel,but it has disadvantages over the observation of small bowel diseases;Help of gastroscope takes less effect on the runtime of capsule en- doscope in the small bowel,while it loses the advantage of no traumas and sufferings.

Idiopathic hypogonadotropic hypogonadism (IHH) is characterized by delayed or absent puberty and lowered sexual function as a result of impaired pulsatile gonadotropin-realeasing hormone (GnRH) secretion.Identification of TAC3/TACR3 mutations as the culprits of IHH revealed that neurokinin B (NKB) signaling pathway was involved in the regulation of pulsatile GnRH secretion.This review focuses on the involvement of NKB signaling in pulsatile GnRH release,the discovery of TAC3/TACR3 mutations and the phenotypes,and treatment of patients who carry TAC3 or/and TACR3 mutations.

Objective To investigate the effects of exogenous glial cell derived neurotrophic factor (GDNF)on colon glial cells in slow transit constipation (STC ) rats,and to explore the optimal concentration of GDNF in order to provide evidence for intestinal neurotrophic therapy in the treatment of STC.Methods A total of 132 SD rats were divided into STC group and control group,66 rats in each group.STC rats were established by feeding with rhubarb.Six rats were randomly selected from either groups to verify whether STC model was successfully established.And the left 120 rats of two groups were randomly divided into six subgroups:STC group one to group six and control group one to group six,ten rats in each group,which were untreated,injected through tail vein with saline,and 0.001 ,0.010, 0.050,0.100 μg/L GDNF 2 mL respectively for one week.The expression of Sox-8 at protein level of either group were detected by Western blotting.Independent sample t test was performed for statistical analysis.Results After treated with 0.001 μg/L GDNF (STC group three),there was no significant
difference in expression level of Sox-8 between STC group three and STC group one (13.38 ±0.70 vs 13.39±0.45 ,t = 0.042,P = 0.969 ).After treated with 0.010 μg/L GDNF (STC group four),the difference in expression level of Sox-8 between STC group four and STC group three was significant (21 .11 ±2.56 vs 13.38±0.70,t=5 .040,P <0.01).After treated with 0.050 μg/mL GDNF (STC group five),the expression level of Sox-8 was higher than that in STC group four (31.86±1.57 vs 21.11±2.56,t=-6.198,P <0.01 ).The Sox-8 expression of untreated,saline treated,0.001 and 0.050 μg/L GDNF treated STC rats (STC group one,two,three and five)were lower than those of the corresponding control groups (t= 3.394,12.103,10.302,- 6.120,all P < 0.05 ).Conclusion Exogenous GDNF could increase Sox-8 expression in colon tissue of STC rats,an increase in the number of colon glial cells could repair enteric nervous system,and 0.050 μg/L was the optimal concentration.

Objective To understand the occurrence of healthcare-associated infection(HAI) in intensive care units (ICUs) in secondary and above hospitals in a province, and provide basis for HAI management.Methods HAI management quality control center in a province performed targeted monitoring on HAI in ICUs in secondary and above hospitals in a province from July 1, 2010 to June 30, 2015.Results ICUs in 176 hospitals were monitored, the incidence of HAI in ICUs for 6 consecutive years was 7.23％, case incidence of HAI was 9.72％;incidence of HAI showed a decreased trend in 6 years(P<0.001).The adjusted rate of HAI per 1 000 patient days in the general hospital ICUs was higher than that of special hospital ICUs (4.30‰ vs 3.53‰).Incidence of HAI in surgical ICUs and general ICUs were both relatively higher, adjusted rates of HAI per 1 000 patient days were 4.79‰ and 4.21‰ respectively.Respiratory tract, urinary tract, and bloodstream infection were major HAI in ICUs, accounting for 68.64％, 14.45％, and 10.09％ respectively, the utilization rates of central venous catheter, ventilator, and urinary catheter were 49.86％, 39.16％, and 81.95％ respectively, incidence of three catheter-associated infection were 1.74‰, 13.77‰, and 2.08‰ respectively, incidence of three catheter-associated infection decreased year by year (P<0.001).The utilization rates of ventilator, central venous catheter, and urinary catheter in different ICUs were not correlated with the incidence of infection(all P>0.05).A total of 36 223 strains of pathogens were isolated, the top 6 isolated pathogens were Acinetobacter baumannii(22.77％), Klebsiella pneumoniae (11.96％), Pseudomonas aeruginosa(11.94％), Staphylococcus aureus (8.08％), Candida albicans (5.63％), and Escherichia coli(5.55％).The isolation rates of carbapenem-resistant Klebsiella pneumoniae showed a increased tendency for 6 years(P<0.05).Conclusion Continuous targeted monitoring on HAI in ICUs, regular analysis on risk factors for HAI, and timely implementation of intervention measures can effectively decrease the incidence of HAI.

Objective To analyze the drug resistance and homology of Acinetobacter baumannii (Ab) isolated from patients with explosive injury ,so as to explore the characteristics of drug resistance and prevalence of infection .Methods A total of 61 strains of AB isolated from clinical specimens of patients with explosive injury were collected .The antimicrobial susceptibility of these iso‐lates was detected by using K‐B test .All the strains were gene typed by using the pulsed field gel electrophoresis .Results The re‐sults of antimicrobial susceptibility test shown that the 61 isolates of Ab had high resistance rate ,and were multi‐drug resistant to common antibacterial agents ,except for tigecycline (the resistante rate was 11 .5% ) and minocycline (the resistante rate was 48 .0% ) .The 61 isolates of Ab were divided into 8 kinds of genotypes ,among which type A was the most prevalent one (25 strains) .Other genotypes were type B(10 strains) ,type C(6 strains) ,type D(4 strains) ,type E(8 strains) ,type F(3 strains) ,type G(4 strains) and type H(1 strain) .The isolates of Ab were with high homology .Conclusion Multi‐drug resistance is observed in strains of Ab isolates from patients with explosive injury .Clonal strains of AB may be disseminates among regions ,which indicates that high attention should be paid to these strains .

OBJECTIVE To discuss the clinic presentation,imaging characteristics and surgical management of the external auditory canal cholesteatoma (EACC) with invasion of the tympaniccavity and the mastoid. METHODS This was a retrospective study including the clinical data of 14 cases of EACC invading tympanic cavity and mastoid from 1998 to 2003 . RESULTS All 14 cases showed different bone erosion in the four walls of external auditory canal with extention to the mastoid . Pars flaccida perforation were found in 4 cases with invasion of the cholesteatoma into the tympanic cavity, the ossicular chains were compressed or destroyed. The bony mastoid segment of facial canal was destroyed in 3 cases . Cerebral plate destruction and congenital stenosis of external auditory canal were found in one case respectively. According to the extent of disease, modified radical mastoidectomy was performed in 8 cases and radical mastoidectomy in 5 cases , meatoplasty in one case. The post-operative hearing of 10 cases with intact ossicula chains were normal.One case with compression,shift of ossicules also got normal audition after the operation. The hearing threshold of the air condition in 3 cases with ossicular disruptions got 15 to 20dB of improvement among the language frequency after reconstruction of ossicular chain. The 14 cases were followed-up from 18 months to 5 years and no recurrences were found. CONCLUSION The exact etiology of EACC still remains unclear. There is some difficulty in diagnosing external auditory canal cholesteatoma (EACC) invading the tympanic cavity and the mastoid because of its untypical clinic presentation . High-resolution temporal bone CT scan could help to find out the primary lesion and determine the range of the pathological changes, and choose the proper surgical approach.

Objective To investigate the effects of acupuncture at acupoints at different time points on the occurrence of postoperative nausea and vomiting ( PONV ) in patients undergoing radical rectal cancer operation.Methods One hundred and thirty ASA Ⅰ - Ⅲ patients,aged 40-59 yr,with body mass index of 20-25 kg/m2,scheduled for elective radical rectal cancer operation,were randomly divided into 5 groups ( n =25 each):control group ( group Ⅰ ),treatment with the conventional drug group (group Ⅱ ),preoperative acupuncture group ( group Ⅲ ),acupuncture during operation group (group Ⅳ ),and postoperative acupuncture group (group Ⅴ ).Granisetron 3 mg was injected intravenously before the end of the operation in group Ⅱ.Acupuncture was performed at 30 min before induction of anesthesia,at skin incision and at the end of operation in groups Ⅲ,Ⅳ and Ⅴ respectively.Bilateral Neiguan ( PC6 ),Hegu ( LI4 ),Zhigou ( SJ6 ),and Quchi ( LI11 ) acupoints were selected in groups Ⅲ,Ⅳ and Ⅴ.Acupuncture stimulation lasted for 30 min.Blood samples were collected from the peripheral vein after admission to the operating room (T0),at 1 h after skin incision (T1),at the end of operation (T2 ),and at 24 h after operation (T3) to determine the plasma gastrin concentration.The occurrence of PONV was recorded within 2 h after operation,during 2-6 h,6-12 h and 12-24 h after operation,and within 24 h after operation.Results Compared with group Ⅰ,the incidence of PONV within 2 and 24 h after operation,and the plasma gastrin concentration at T3 were significantly decreased in groups Ⅱ and Ⅲ ( P ＜ 0.05),and no significant change was found in the indexes mentioned above in groups Ⅳ and Ⅴ (P ＞ 0.05).Compared with group Ⅱ,the plasma gastrin concentration at T3 was significantly decreased in group Ⅲ,the incidence of PONV within 2 and 24 h after operation was significantly increased in groups Ⅳ and Ⅴ ( P ＜ 0.05).Compared with group Ⅲ,the incidence of PONV within 2 and 24 h after operation,and the plasma gastrin concentration at T3 were significantly increased in groups Ⅳ and Ⅴ ( P ＜ 0.05 ).Conclusion Preoperatvie acupuncture at acupoints can decrease the occurrence of PONV in patients undergoing radical rectal cancer operation,the efficacy is similar to that of the conventional drugs,and the decreased concentration of the plasma gastrin after operation is involved in the mechanism.

Objective To investigate whether pregnant rats exposure to ketamine cause offspring changes in space cognitive abilities and exploration abilities.Methods 3-month Sprague-Dawley female rats ( n =24)were randomly divided into four groups:group N (control group),group K1 (small doses of ketamine group),group K2 ( clinical anesthesia dose of ketamine group),group K3 ( large doses of ketamine group).3-month Sprague-Dawley male rats ( n =4) and female rats were mated at the same cage by the proportion of 2∶ 1.Pregnant mice were treated at tenth day:group N were treated saline with equal-volume to ketamine vein injection; group K1,group K2,group K3 administered vein injection 3,8,20mg/kg of ketamine.Then the 20-day offspring rats'learning and memory were assessed used Open Field Test ( record the time of the offspring in the central case through the number of grid within 2 min ) and Hole Board Test ( Counting the times of offspring stretch into the hole in 5 min) at postnatal days 20.Results In the Open Field Test,the retention time in central check of group N,group K2 and group K3 were (2.45 ± 1.23)s,(6.42 ±2.50)s,(6.41 ±2.19)s.Compared with group N,the retention time in central check of group K2 and group K3 were significantly higher (F=13.42,P＜0.01 ),and group K1 were not significant different ( t =1.33,P＞0.01 ),and the locomotion of group K1,group K2,group K3 were significantly reduced( ( 15.33 ± 6.81 ),( 13.75 ± 5.93 ),( 16.92 ± 6.54 ),F =4.24,P ＜ 0.05 ).In the Hole Board Test,the times of offspring stretch into the hole were not significant different comparing with the control group(F=2.17,P ＞ 0.05 ).Conclusion The dose of ketamine that equivalented clinical anesthesia can affect offspring rats' space cognitive abilities; but the exploring cognitive ability were not significantly influenced.