OBJECTIVE To explore the risk factors in aged patients with ventilator-associated pneumonia(VAP) and to provide the corresponding clinical prevention strategies. METHODS The ages,underlying diseases,mechanical ventilation method,use of antibiotics,and pathogenic bacteria of the VAP patients were investigated and analyzed. RESULTS Totally 155 VAP of elderly patients had serious underlying diseases,and treated with broad-spectrum antibiotics,tracheal intubation or trachea incision.Most pathogenic bacteria were mutiple-resistant. CONCLUSIONS The prevention of VAP was in priority for control of VAP patients.In order to control the occurrence and spread of VAP,clinicians should cut the time of ventilator,pay more attention to sterilization and isolation,and strengthen the tend of the patients.

OBJECTIVE To study drug resistance status of infected bacteria in abdominal surgical wound for their countermeasures. METHODS The abdominal surgical infection of a hospital was investigated from Jan 2000 to Dec 2004.Bacterial isolation and identification were carried out complying with National Operation Procedure of The Clinical Laboratory.Drug sensitivity test was performed with KB method. RESULTS The infection rate was 4.1%.The species were predominated by Gram-negative bacilli(71.1%),especially Escherichia coli(17.2%),Pseudomonas aeruginosa(16.7%) and Klebsiella pneumoniae(12.7%),and they all beared high antibiotics resistance. CONCLUSIONS Special attention should be paid to abdominal surgical wound infection.

Objective To evaluate the occurrence of multidrug-resistant organism (MDRO)infection in a general hospital,and take effective comprehensive intervention measures,so as to reduce MDRO infection.Methods Targeted monitoring on MDROs was performed from October 2012 to December 2013,comprehensive intervention measures were conducted,the occurrence of MDRO infection before and after intervention was compared.Results A total of 62 384 pa-tients were investigated,17.91%(n=11 176)were sent specimens for pathogen culture,606 times of culture for patients’ specimens were detected MDROs,292(0.47%)cases were MDRO healthcare-associated infection(HAI),314 were com-munity-acquired infection or colonization.MDRO infection case rate decreased from 0.65%(75/11 603)before intervention to 0.26%(36/13 875)after intervention (χ2 =21.08,P <0.05).Conclusion Comprehensive intervention measures can effectively reduce the occurrence of MDRO HAI.

Objective To investigate the value of ultrasound-guided Mammotome minimal invasive system in the treatment of breast fibroadenoma.MethodsFrom January 2007 to October 2008,266 benign breast lesions of 183 cases were treated by ultrasound-guided Mammotome minimal invasive system.The diameter of the masses ranged from 4 to 25 mm(≤ 10 mm in 73 cases,10-20 mm in 148,and ≥ 20 mm in 45).ResultsThe 266 lesions in the 183 patients were excised completely by using the Mammotome system.The excision was performed for a mean of 15 times in each case(ranged from 5 to 44 times) with an average operation time of 26 minutes(10 to 60 minutes).No complication was found after the surgery except slight subcutaneous ecchymosis in 2 cases.The length of the incisional scar,which was not apparent,ranged from 2.5 to 4 mm.The 183 cases were followed up by ultrasonography for 2 to 22 months(mean,12 months),during which their BI-RADS scales ranged from Ⅰ to Ⅱ,no local recurrence was found.ConclusionsUltrasound-guided Mammotome minimally invasive system is feasible for total resection of breast fibroadenoma with appropriate sizes.The technique leads to fewer complications and good cosmetic results.Further studies on the system are necessary for the treatment of multiple breast fibroadenomas.

The present study is designed to investigate the histochemical changes of cholinesterase, norepinephrine in nuc. Supraopticus and locus coeruleus of rats following electo-acupuncture and their possible relation to pain threshold. The preliminary results indicated that the elevation of pain threshold following electro-acupuncture concomittantly with increase in histochemical reaction of cholinesterase, and norepinephrine both in nuc. Supraopticus and locus coeruleus of electro-acupunctured rats. The increase in intensity was shown to be correlated with the elevation of pain threshold. The intensity of increased cholinesterase activity was more obvious in the animals with pain threshold elevated for above two folds than those elevated only one fold. On the other hand, the higher intensity of norepinephrine was obser ed in locus coeruleus with one fold of elevation of pain threshold. The significance of the changes in these two nuclei and their possibld function were briefly discussed.

Objective To investigate the influence of recombinant human parathyroid hormone [rhPTH (1-34)]on the proliferation of HaCaT cells induced by tumor necrosis factor-α (TNF-α) in vitro.Methods Cultured HaCaT cells were treated with various concentrations of rhPTH (1-34) for different durations after incubation with recombinant human TNF-α of 10 g/L for 24 hours.MTT assay and flow cytometry were performed to detect the proliferation and cell cycle of HaCaT cells,respectively.Results As contrast phase microscopy showed,the growth of HaCaT cells was inhibited by rhPTH (1-34) along with a decrease in the growth speed.MTT assay showed a suppressed proliferation of HaCaT cells after being treated with rhPTH (1-34) of 0.05,0.2,0.8,3.2 and 12.8 pmol/L for 36 and 48 hours (P＜ 0.01 or 0.05).The percentage of cells at G1 phase in HaCaT cells markedly increased (all P ＜ 0.01 ),while that at S phase declined (all P ＜ 0.01 )after 48-hour treatment with rhPTH(1-34) of 0.2,0.8,3.2 and 12.8 μ mol/L.Conclusions rhPTH(1-34) has an obvious inhibitive effect on the proliferation of HaCaT cells induced by TNF-α in vitro,and the effect is in a dose-dependent manner.

Objective To detect of clostridium perfringens by qPCR in mouse models and a clinical case in order to offer early diagnosis.Methods 40 Kunming mice were randomly grouped and intramuscular injected clostridium perfringens type A in leg 0.1 ml(3.5 × 109cfu/ml or 3.5 × 108cfu/ml or 3.5× 107cfu/ml,diluted with saline),while control group was injected with 9% sodium chloride 0.1ml.The mouse models and a clinical case were detected by qPCR.Results The death rate of 3.5 × 109,3.5 × 108,3.5 × 107cfu/ml and the blank group were 90%,70%,10% and 0% after intramuscular injection for 72 h spectively.The mean Ct values among these groups were 21.21 ±2.69,28.45 ±2.74,32.49 ±2.87 and 0.00 ± 0.00(P ＜ 0.05).The Ct values of the patient were 30.67 and 30.44.Conclusions Cclostridium perfringens could be successful identified with qPCR in mouse models when the mice still did not show any symptoms.

Objective To investigate the prognostic factors in acute myeloid leukemia subtype M2 (AML-M2) patients with chromosome translocation of 8 and 21. Methods By using G-banding analyses karyotype and combining the clinical data, prognostic factors in 94 cases of de novo adult AML-M2 in our hospital from 2001 to 2007 were retrospectively analyzed. Results Chromosome 8 and 21 translocation were identified in 53.2 % (50/94) of AML-M2 cases. In the patients with other aberrations in addition to t(8;21), their complete remission (CR) rates, overall survival (OS) was lower than the patients with sole t (8;21) and normal karyotype(P <0.05). And the patients with sole t (8;21) whose CR rates and OS had no difference with patients with normal karyotype (P>0.05). The patients were divided into 3 subgroups (low index, less than 2.5;intermediate index, 2.5-20;high index, 20 or more) according to WBC index. The CR had no difference among the 3 subgroups, but the OS of the 3 subgroups was different (P<0.05). The OS in the lowest index group was longer than that in the others. Conclusion Cytogenetically, 53.2% cases had chromosome 8 and 21 translocation, 46 % cases had t(8;21) with additional chromosomal abnormalities, and the main additional abnormalities were loss of a sex chromosome (LOS). t(8;21) AML-M2 patients with additional chromosome abnormalities had low complete remission rate and shorter survival time, and its prognosis was poorer. WBC index have no influence on complete remission rate but effected the survival time.

Objective To investigate the prevalence of psoriatic arthritis (PsA) in patients with psoriasis and its clinical features.Methods A cross-sectional study was conducted among patients diagnosed with psoriasis from January 2014 to January 2015.Through a questionnaire survey,the diagnosis of PsA was confirmed according to the Classification Criteria for Psoriatic Arthritis (CASPAR) in patients with suspected PsA.Clinical data were collected from patients with newly and previously diagnosed PsA.Statistical analysis was carried out by t test for two-group comparisons,one-way analysis of variance (ANOVA) for multi-group comparisons,and chi-square test for comparisons of rates.All the statistical tests were two-sided.Results Totally,1 062 outpatients with psoriasis were enrolled into this study,and 125 were suspected to have PsA.According to the CASPAR,70 (6.59％) patients were finally diagnosed with PsA,with the ratio of male to female being 2.1 ∶ 1,and 45 of them (64.29％) were newly diagnosed.Psoriasis vulgaris lesions were observed in 50 (71.43％) patients with PsA,and were the most common type of skin lesions in patients with PsA.There were 5 clinical types of PsA in these patients,including asymmetrical oligoarthritis (23 cases,32.86％),symmetric polyarthritis (19 cases,27.14％),distal interphalangeal predominant arthritis (10 cases,14.29％),vertebral or sacroiliac arthropathy (7 cases,10.00％),and arthritis mutilans (11 cases,15.71％),with some overlap among these clinical types.As relatively distinctive manifestations of PsA,dactylitis and enthesitis were observed in 14 (20.00％) and 8 cases (11.43％) respectively.In addition,43 (61.43％) cases had nail involvements.Conclusion To master clinical features of PsA and to diagnose it early are of great significance for long-term prognosis of PsA patients.

Objective To discuss peer education on the rehabilitation in schizophrenia recovery.Methods According to the order of admission,108 cases of hospitalized recovery of schizophrenia patients were divided into observation group and control group,each group in 54cases.The observation group received psychiatric conventional treatment and care at the same time add peer educations,the control group only accepted psychiatric conventional treatment and care.The observation group was given for a period of 20 weeks peer education.The nurse brief mental scale (N -BPRS),self -knowledge and treatment attitude questionnaire scale (ITAQ)were assessed in the two groups at the beginning,10 weeks,20 weeks.Results The difference of N -BPRS score between the two groups was not statistically significant (t =0.191,P =0.850).In the observation group,the scores had significant differences between 10 weeks and 20 weeks peer education (t =2.757,P =0.069;t =4.000,P =0.000).The ITAQ scores of the observation group at the beginning,20 weeks peer education were (11.22 ±3.55)points,(17.22 ±4.31)points, the difference was statistically significant (P <0.01).In control group,ITAQ scores before and after treatment were (10.84 ±5.19)points,(13.12 ±6.12)points,the difference was not statistically significant (P >0.05).Conclusion Schizophrenia convalescence patients accept peer education is helpful to rehabilitation.