Objective To understand the incidence and related risk factors of healthcare-associated infection(HAI)in neu-rological patients with cerebrovascular diseases.Methods The occurrence and risk factors of HAI in patients with cerebro-vascular diseases in a hospital between Jan and December 2013 were investigated and analyzed.Results Of 3 573 investiga-ted patients,214 had HAI,the incidence of HAI was 5.99%;the main infection site was respiratory tract (54.67%),fol-lowed by urinary tract (25.23%).Univariate analysis revealed that age,length of hospitalization,disturbance of conscious-ness,chronic obstructive pulmonary disease,diabetes mellitus,invasive procedures,application of antacids,and antimicro-bial prophylaxis were all related to the occurrence of HAI (P<0.05).Multivariate logistic regression analysis revealed that disturbance of consciousness,old age,invasive procedures,chronic obstructive pulmonary disease,and diabetes mellitus were independent risk factors for the occurrence of HAI (all P <0.05).Conclusion The incidence of HAI is high in hospitalized patients of the neurology department,there are multiple risk factors associated with HAI,it is necessary to take corresponding interventions for reducing the incidence of HAI.

OBJECTIVE:To establish a method for the bacterial endotoxin test of chlorphenamine maleate injection. METHODS: The interference test and bacterial endotoxin test of 28 batches of chlorphenamine maleate injections from 14 manufacturers were carried out in accordance with the bacterial endotoxin test approved by Chinese Pharmacopeia (2005 edition). RESULTS: Diluted to a concentration of below 0.025 mg?mL-1,the samples showed no interference action on bacterial endotoxin test. The limit value of the bacterial endotoxin was 5 EU?mg-1. The results of the bacterial endotoxin test of the 28 batches of samples were all accorded with the standard of the established quality control. CONCLUSION: The established TAL method is applicable for bacterial endotoxin test of chlorphenamine maleate injection.

Objective To analyze the changes of the quality of life of patients with advanced lung cancer accompanied with dyspnea before and af?ter methylprednisolone therapy,so as to investigate the effects of methylprednisolone on the quality of life of the patients. Methods Totally 134 ad?vanced lung cancer patients with dyspnea were divided into two groups,the methylprednisolone group and the control group,according to whether they consented to the use of hormone therapy. All of them were followed with visual analog scale(VAS),the quality of life questionnaire?core 30 (EORTC QLQ?C30)and the quality of life questionnaire?lung cancer module 13(QLQ?LC13)questionnaire. Results At one hour after treatment compared to before treatment,the VAS scores for both groups were significantly decreased(P<0.01),and the score for the methylprednisolone group were lower than the control group(P<0.05). At two weeks after treatment compared to before treatment,social function,emotional function, and overall quality of life scores for both groups were decreased(P<0.05). But the scores of pain,dyspnea,insomnia,loss of appetite,constipation, dysphagia were increased(P<0.05). Compared to the methylprednisolone group,the dyspnea and pain score for the control group was higher(P<0.05). Conclusion Methylprednisolone may improve the quality of life of advanced lung cancer patients with dyspnea in short term and slow down the deteriorating process of their quality of life.

Objective To discuss mammographic findings and pathologic foundation of the fat necrosis of the breast and to improve the imaging diagnosis of the fat necrosis of the breast. Methods The mammographic findings of 91 cases with pathologically proved breast fat necrosis were retrospectively analyzed, of which 2 cases were bilateral breast fat necrosis, and a comparison with pathological results was made. Results The mammographic findings included (1)No abnomal mammographic findings (n=14, 15.4%);(2) Single and multiple lipid-cysts (n=6, 6.6%);(3) Masses (n=20, 22.0%), of which 1 case was bilateral breast mass;(4) Nodules (n=13, 14.3%);(5) Focal opacities like stars or pieces in the subcutaneous fat layer (n=28, 30.8%), of which 1 case was bilateral breast lesion;(6) Faint reticular opacity in the subcutaneous fat layer (n=5, 5.5%);(7) Structure distortion (n=5, 5.5%). The location of the liesions:(1) 55 lesions located in fat layer;(2) 13 lesions standed out to the fat layer or located the boundary of the fat layer and breast parenchyma. When routine mammography demonstrated the disease located the boundary of the fat layer and breast parenchyma, there will be helpful with tangent location mammography to show the disease in the subcutaneous fat layer;(3) 9 lesions located in the breast parenchyma;(4) 14 lesions did not find abnormity in the mammography. The pathologic appearance (1) A lipid cyst is the characteristic mammographic finding in the early stage of the lesion;(2) Asymmetry density masses or nodules in the subcutaneous fat layer is the characteristic mammographic finding in the metaphase stage of the lesion, which hinted necrotic fatty tissue gradually be replaced by fibrous tissue;(3) Focal opacities like stars and irregular reticulation findings in the subcutaneous fat layer or superficial layer adenoid tissues are the characteristic mammographic findings in the later stage of the lesion, which hinted that necrotic fatty tissue was licked up, circumference remained some fibrous tissue.The mammographic findings of the different pathological stages often appear in the same time. Conclusion The mammographic findings of fat necrosis of breast was different in its different stage. The mammography is very helpful for making the diagnosis of breast fat necrosis.

Preeminent Doctors Education and Training Plan has put forward an urgent request to reform the five-year clinical undergraduate medical talent training mode and strengthen the professional spirit cultivation for medical students. As a pilot project, our college continuously explored the professional spirit cultivation mode for medical students in preeminent physician class and has almost established the three-dimensional mode of whole process, joint participation, multi approach and stressing practice.

Objective To estimate direct economic burden of patients with moderate to severe psoriasis in China,and to assess its influencing factors.Methods A questionnaire survey was carried out in 150 patients with moderate to severe psoriasis from 29 third-grade class-A hospitals in 7 cities.Data on demographic characteristics,clinical features and direct economic burden were collected.Descriptive statistics were performed to analyze the direct economic burden of moderate to severe psoriasis,and multiple regression analysis was carried out to determine predictors of cost of illness.Results The patients were aged (43.87 ± 13.42) years,with an average clinical course of 3 years(range,2-6 years).Of them,82 had moderate psoriasis,and 68 had severe psoriasis.The average direct cost was (6 452 ± 6 391)RMB per patient-year,with significant difference between the patients with moderate psoriasis and those with severe psoriasis ((4 163 ± 4 605) vs.(9 212 ± 7 146) RMB,z =5.70,P ＜ 0.001).Regression analysis indicated that disease severity,clinical type,hospitalization,complications,and inhabited cities were factors influencing the direct economic burden of patients with moderate to severe psoriasis.Conclusions The direct eonomic burden of severe psoriasis seems to be twice that of moderate psoriasis in China.Physicians should strengthen the control of complications and disease severity,and pay more attention to other types of psoriasis than psoriasis vulgaris,during the treatment of psoriasis.

Leukoaraiosis (LA) is a group of clinical syndrome caused by multiple etiologies.It belongs to one of the types of cerebral small vessel diseases.Studies have shown that LA usually can lead to different degrees of cognitive impairment.In recent years,with the development of imaging techniques,the studies about correlation between maging findings and cognitive impairment in LA patients and cognitive impairment are increasing gradually and have drawn some new conclusions.And thus,the understanding of the clinical significance of LA has been further deepened.This article mainly reviews the advances in research on the correlation between imaging findings and cognitive impairment in LA patients.

Objective To explore the effects of different infants-feeding patterns on preschoolers' physical development, intelligence development and bone mineral density (BMD). Methods A total of 953 preschoolers from seven cities and two rural areas in China were recruited by multiple stage stratified cluster sampling methods from November 2011 to April 2012. Physiology measurement was performed to get their height and weight and to calculate body mass index(BMI). BMD of distal radius was measured by ultrasound BMD scanner. The intelligence quotient was assessed by Standford-Binet Test of Intelligence(Chinese Version). The demographic factors and the feeding ways were investigated by an interviewer-administered questionnaire and all subjects were divided into three groups : exclusive breastfeeding, mixed feeding and artificial feeding group. ANOVA analysis, Chi-square test and non-parametric test were used to analyze the data. Results There were 476, 335 and 142 children in exclusive breastfeeding, mixed feeding and artificial feeding groups, respectively. The exclusive breastfeeding rate in urban areas was significantly lower than that in rural areas [47.2%(343/726) vs 58.6%(133/227), χ2=9.780, P=0.008]. The height-for-age Z score and weight-for-age Z score were significantly different among children with different feeding ways (χ2=10.728 and 12.175, P=0.005 and 0.002). The children in the exclusive breast feeding group showed lower height-for-age Z score and lower weight-for-age Z score comparing with those in the mixed feeding and artificial feeding groups (all P<0.05). The value of speed of sound of BMD was significantly different among exclusive breastfeeding, mixed feeding and artificial feeding groups [(3 640.2±142.0) vs (3 613.9±141.9) and (3 613.4±143.0) m/s, F=3.946, P=0.020], and that in the exclusive breastfeeding group was higher than in the mixed feeding group (P<0.05). No significant difference was found in BMI-for-age Z score, intelligence score and food allergy rate and food intolerance rate among the three groups(all P>0.05). Conclusions Feeding patterns during the first several months after birth may affect the weight, height and BMD in preschool-children, but not the intelligence development of these children.

OBJECTIVE:To establish a method for the bacterial endotoxin test of nicardipine hydrochloride glucose injection.METHODS:The bacterial endotoxin test was carried out according to the bacterial endotoxin test in the addenda of China Pharmacopeia 2005 edition(second part).RESULTS:Nicardipine hydrochloride glucose injection showed interference on the bacterial endotoxin test when water was taken as solvent.The preliminary interference test and interference test revealed that using thinnerⅠas solvent,the sample injection in over 4-fold dilution had no interference on the bacterial endotoxin test.CONCLUSIONS:It is feasible for bacterial endotoxin test of nicardipine hydrochloride glucose injection be conducted in a limit value of 0.5 EU?mL-1.The bacterial endotoxin text can substitute pyrogen test in the detection of nicardipine hydrochloride glucose injection.

Objective To discuss the value of the mammography in the diagnosis of ductal carcinoma in situ (DCIS) and guidelines ofthe operation.Methods 107 pathologically proved DCIS were retrospectively reviewed.Results There were 62 microcacifications(57.9%),the range of microcacifications was varied , of them,13 were masses or local compact with microcacifications ; 17 were localized infiltration and bad structure (15.9%);20 were masses (18.7%) ;1 papillae enhancement (0.9%),7 were normal(6.5%).Conclusion Multiplicity microcacifications are the most frequently appearance of X-ray in DCIS;mammography could find the early microcarcinoma and the early carcinoma , especially the DCIS ; mammography could exactly reflect the multifocus , it is of value in confirming the range of the operation.