Objective To explore the application value of control chart in the management of nosocomial infection in intensive care unit (ICU) by using quality control chart to monitor the infectionsin ICU.Methods From October 2011 to June 2016, ventilator-associated pneumonia (VAP), central line-associated bloodstream infection (CLABSI) and catheter-associated urinary tract infection (CAUTI), namely the three catheters, occurred in ICU of the Affiliated Hospital of Guizhou Medical University were monitored and recorded monthly, then the data was imput into the Excel, and the data was analyzed using SPSS. According to the properties of the data, control chart was derived for monitoring nosocomial infections, finding out problems and for taking actions on time.Results From October 2011 to June 2016, the numbers of new patients in ICU were 23-103 cases per month and the median was 45.00 (39.00, 55.50) cases per month. The numbers of new VAP patients were 0-7 cases per month which median was 3.00 (1.00, 4.00) cases per month and the VAP rates were 0-22.58 cases per 1000 ventilation-days which median was 8.62 (3.28, 12.10) cases per 1000 ventilation-days. The numbers of new CLABSI patients were 0-3 cases per month which median was 0.00 (0.00, 1.00) cases per month and the CLABSI rates were 0-14.82 cases per 1000 catheter-days which median was 0.00 (0.00, 5.38) cases per 1000 catheter-days. The numbers of new CAUTI patients were 0-8 cases per month which median was 1.00 (0.00, 2.00) cases per month and the CAUTI rates were 0-14.06 cases per 1000 catheter-days which median was 3.02 (0.00, 5.86) cases per 1000 catheter-days. 57 points of the three catheter-associated infections incidences were continuously monitored monthly, in which some data points overstepped the warning limit, only 1 CAUTI infection incidence overstepped the control limit, the other monthly three catheter-associated infections incidences were in the control range and had no abnormal arrangement occurred, so all of them were in a controlled state. By using the control chart, the situation of nosocomial infections were analyzed scientifically and intuitively, the existing problems were discussed in time, the improvement programs were made, and the three catheter-associated infections were in a controlled state.Conclusion Control chart has the characteristics of simple operation, intuitive results, and finding problems on time, so it can be used in daily monitoring of nosocomial infection and is worthy of generalization.

To investigate the distribution of Hepatitis B virus (HBV) genotypes among the population of Dai nationality in Xishuangbanna, Yurman Province HBV genotypes of the Serum samples were tested by PCR-RFLP. This is the first time to discover the B+E genotypes in China. This finding provides new information for understanding the distribution of HBV genotype in China and a provides a basis for establishing a Chinese gene bank.

Objective To investigate the impact of calcification on differential diagnosis of thyroid nodule using shear wave elastography (SWE). Methods One hundred and forty-six patients with thyroid nodules were prospectively enrolled in the study. Ultrasound observations included nodule size, boundary, shape, envelope, internal echotexture, posterior acoustic enhancement, and the relationship with surrounding tissue. According to the presence of internal calciifcation, patients were divided into calciifcation group (groupⅠ) and no calciifcation group (groupⅡ). Real-time shear wave elastography (young′s modulus value) were taken in both groups. Taking surgical pathologic results as the gold standard, receiver operating characteristic (ROC) curve of SWE in diagnosis of benign and malignant thyroid nodule were drawn for two groups respectively. Results In groupⅠ, 25 cases were benign and 38 cases were malignant. The malignant incidence was 60%. Among them the rate of malignant nodules in microcalcification group was 92%(24/26). The incidence of malignant nodules in coarse calcification group was 38%(14/37). The area under the curve (AUC) of SWE in groupⅠwas 0.564. In groupⅡ, 67 cases were benign and malignant had 16 cases. Using 30.43 kPa as the diagnostic point of young′s modulus value, the sensitivity, speciifcity, accuracy and AUC were 93.2%, 81.2%, 84.8%and 0.824. Conclusion In no calciifcation group, SWE is more meaningful in the differential diagnosis of benign and malignant thyroid nodules.

Objective To prepare a kind of new lipid perfluorooctylbromide(PFOB) nanoparticles and to explore its potential application as an ultrasound contrast agent. Methods Lipid PFOB nanoparticles were prepared by microfluidization techniques. The morphology and distribution were observed with optical microscope and transmission electron microscope. Particle size and electric potential were determined with Malvern laser light scattering analyzer. Twelve normal Wistar rats were performed directly contrast imaging after injection of PFOB nanoparticles via caudal vein. Vital signs of the rats were monitored during the whole study. And eehogenie intensity of the liver was dynamically quantified through DFY ultrasound quantified analysis system. The mechanism of enhancement was studied by the frozen sections of rat's liver and spleen. Results The nanoparticles size and distribution were highly uniformed. The grey scale ultrasound imaging of the rat's liver and spleen were enhanced by PFOB nanoparticles. Ten seconds after PFOB nanoparticles injected,enhancement of liver began, the peak time was approximately 3 - 4 min, the duration of contrast enhancement was nearly up to 1 h, The enhancement of spleen was more significant and the duration was much longer. No abnormal changes of the rat's vital signs appeared during the study. Frozen sections suggested that PFOB nanoparticles accumulated in the liver and spleen was the potential mechanism of enhancement. Conclusions This novel and safe lipid PFOB nanoparticles could make prolonged enhancement of rat's liver and spleen,which has a good potency for ultrasound application.

Objective To study the feasibility of the Fe3O4-loaded lipid perfluorooctylbromide nanoparticles (Fe3O4-PFOB) for enhanced ultrasound imaging.Methods The Fe3O4-PFOB nanoparticles,incubated with RAW264.7 macrophage cells,were monitored by microscope and ultrasound.Twelve SD rats were randomized into two groups,Fe3O4-PFOB group and PFOB group.Ultrasound imaging of rats' liver was performed before and after intravenous injection of the contrast agents.The liver echogenic intensity was quantified by DFY ultrasound quantified system analysis.Results Incubation of the Fe3O4-PFOB nanoparticles with macrophages resulted in the uptake of Fe3O4-PFOB by macrophages.Macrophages loaded with Fe3O4-PFOB exhibited enhanced echogenicity in vitro.In in vivo imaging,Fe3O4-PFOB produced better and prolonged ultrasound enhancement of rats' liver compared to PFOB nanoparticles.Conclusions Fe3O4-PFOB nanoparticles could enhance ultrasound imaging and may potentially serve as a multimodal probe for ultrasound,CT and MR imaging.

Objective To investigate how many probably benign lesions on ultrasound(US) fulfilled the published criteria and to evaluate how clinical and personal factors influenced the categorization of breast lesions.Methods A total of 487 lesions in 487 women with more than 12 months follow-up after the initial category 3 assessment on US were included.The initial US images were retrospectively reviewed according to previously published criteria,and evaluated several factors that could influence the characterization of breast lesions in clinical practice such as age,multiplicity,palpability,radiologist 's experience,and lesion size.Results Of 487 lesions,479 (98.36%) were benign and 8 (1.64%) were malignant.Of 487 lesions,203(41.68%) including 8 malignancies were reassessed as category 4.If strict criteria had been applied at initial US examination,the positive biopsy rate would have been only 3.94% (8/203) and 96.06% (195 of 203) biopsies would have been unnecessary.Lesions in women 40 years or older and multiple lesions were more frequently reassessed as category 4 (P = 0.008 and P = 0.006,respectively).The presence of palpability,lesion size,and the radiologist 's experience did not significantly influence the categorization of breast lesions on US.Of 487 probably benign lesions,41.68 % could be classified as category 4 lesions when strict criteria were applied in initial practice.Conclusions The multiplicity of the lesion and the patient 's age were found to have a significant influence on the classifcation of probably benign solid masses.

Objective To prepare the Fe3O4 loaded polymer microspheres(Fe3O4/PLGA),and to investigate the influence of Fe3O4/PLGA combined with high-intensity focused ultrasound (HIFU) on rabbits bearing breast tumor.Methods Double emulsion method were utilized to prepare the Fe3O4/PLGA.14 days after implantation of VX2 tumor in breast,32 rabbits were randomly divided into four equal groups.In group Ⅱ,Ⅲ,and Ⅳ,the rabbits received a percutaneous injection of 0.5 ml saline,PLGA,and Fe3O4/PLGA microcapsules solution into breast tumor at 3,6,9,12 dots,about 3 mm around the tumor respectively,and massaged for 1 min before receiving HIFU ablation,while HIFU group received HIFU ablation only.HIFU ablation parameters were the same:ablated-dot mode,acoustic power 150 W,exposure duration 5 s.After HIFU ablation,the volume of coagulative necrosis was calculated,HE staining,TEM and immunohistochemical examination of PCNA were performed to detect the structure changes of the targeted tissue caused by HIFU ablation.Results The volume of coagulative necrosis caused by HIFU ablation was substantially larger and the positive index of PCNA was lower in the necrotic region after the injection of Fe3O4/PLGA microcapsules compared to the group without injection agents,the group of saline and the group of pure PLGA microspheres under the same irritation(P ＜0.05).Pathological examination demonstrated the targeted tissue was destroyed severely,Fe3O4 nanoparticles were seen depositing in residual tumor cells under TEM.Conclusions The self-made Fe3O4/PLGA microspheres can effectively enhanced the biomedical effect of HIFU surgery on rabbits bearing VX2 breast tumor.

ObjectiveTo study the optimal power of self-made polymeric microcapsules with liquid perfluorocarbon enhancing high intensity focused ultrasound (HIFU) ablation of normal bovine in vitro and the treatment efficacy of HIFU ablation of normal rabbit liver in vivo.Methods The experiment was divided into two parts:the first part was HIFU ablation of bovine in vitro:The bovine was injected different drugs before HIFU ablation to find the optimal power and treatment time.It was divided into four groups:①HIFU + 0.9％ NaCl(NACL) group; (② HIFU + poly( lactic-co-glycolic acid) (PLGA) group; ③ HIFU + perfluorohexane(PFH) group; ④ HIFU + PLGA + PFH group; The second part was HIFU ablation of normal rabbit liver.Similarly,It was also divided into four groups as above.Each group was undergone HIFU ablation with same parameters after ear vein injection of drug.Then the ultrasonographic changes and its value,and the actual situation of liver damage in target areas of each group were observed and compared before and after the ablation area.ResultsIn experiments of vitro bovine,gray scale changes and coagulation necrosis could be seen in the liver in group 2,3,4 with HIFU power of 150 W and treatment time of 2 s.In experiment of normal rabbit liver,the average gray-scale of group 3 and 4 were larger than that in group 1 and 2,the difference was statistically significant (P ＜0.001),and its gray change area gradually reduced with time elapsed.While there was no statistically significant difference between group 3 and 4 ( P ＞0.05).In pathological specimens,there was no significant liver damage in group 1 and 2.There was hemorrhagic necrosis and white coagulation necrosis in group 3 and 4.Conclusions The polymeric microcapsules with liquid perfluorocarbon can effectively enhance the efficacy of HIFU ablation and be used as a good synergist for HIFU.

Objective To develop perfluorocarbon lipid particles and investigate their basic properties,and target them to human hepatocellular carcinoma cells in vitro by hepatoma monocolonal antibody HAb18 with avidin-biotin interaction.Methods Rotary evaporation and high pressure homogen were used to prepare perfluorocarbon lipid particles, and the appearance and distribution of them were investigated by microscope and electron microscope, the concentration and the size and electric potential were detected.The biotinylated monoclonal antibody HAbl8 was prepared, then the biotinylated degree of the antibody was determined.The biotinylated perfluoroearbon lipid particles labelled with NBD were prepared and targeted to human hepatocellular carcinoma cells in vitro with avidin-biotin interaction.Results These perfluorocarbon lipid nanoparticles were uniform and stable,and the mean diameter of them was 171.9 nm.Hepatocellular carcinoma cells were surrounded by the biotinylated particles labelled with NBD.Conclusions A steady perfluoroearbon lipid particles were prepared and the biotinylated particles can be targeted to hepatocellular carcinoma cells with avidin-biotin interaction.

Objective To prepare lipid-coated ultrasound microbubbles containing 10-HCPT(HLM) and explore the antitumor effects on mice xenografed H22 solid tumor using the technique of ultrasound-mediated HLM destruction. Methods Sixty-four tumor-bearing mice were radomly divided into A and B groups. Each group was divided into four groups again and administered respectively by tail vein with HI.M, non-drug-loaded microbubbles,10-HCPT and saline once a day. Ultrasound irradiation was applied on the tumor sites immediately after injection. After 7 days of consecutive treatment, all mice in group A were sacrificed and the tumors were harvested to measure weights. The tumor inhibition rate was calculated by weights. The tumor microvessel density (MVD) was detected by immunohistochemical staining. The tumor growth curve was depicted according to volumes. The survival time of mice in group B was recorded. Results The tumor inhibition rate was the highest in HLM group while this group's MVD was the lowest. Survival time in HLM group and 10-HCPT group were obviously longer compared with the control group,while no statistic difference was observed between the two groups. There was no statistic difference between the group of non-drug-loaded microbubbles and the control group. Conclusions Ultrasound irradiation mediates HLM destruction so that the drug is released from the vihicles at the same time, which can significantly enhance the tumor inhibition effect of 10-HCPT on the H22 tumor. This technique is expected to be adopted as a novel tool for liver cancer chemotherapy.