Objective To monitor the incidence of catheter-associated infection (CAI)in patients in general inten-sive care unit (ICU),and provide basis for taking proper prevention and control measures.Methods Targeted monitoring method was conducted,incidence of healthcare-associated infection (HAI)among patients receiving urinary catheterization,intravascular catheterization,and tracheal intubation in the general ICU of a tertiary hospital between January 2012 and December 2013 were surveyed.Results A total of 299 ICU patients with catheterization were investigated,the overall hospitalization days were 2 700 days,41 patients developed 48 episodes of HAI, incidence of HAI was 13.71%,case incidence was 16.05%,incidence of HAI per 1 000 catheter days was 15.19‰,37 patients developed 44 episodes of CAI;the other types of HAI were blood stream infection(n=1),skin and soft tissue infection(n = 1 ),antibiotic-associated diarrhea(n = 1 ),and herpes zoster(n = 1 ).Incidence of catheter-associated urinary tract infection (CAUTI),catheter-related bloodstream infection (CRBSI),and ventilator-associated pneumonia (VAP ) per 1 000 catheter days were 2.94‰,2.12‰,and 15.72‰ respectively. Conclusion CAI is the main HAI type in ICU patients with catheterization,and the major is VAP.

Objective To measure Tei index in patients with idiopathic or ischemia dilated cardiomyopathy, and to evaluate its correlation with other conventional indexes of echocardiography of left ventricular(LV) function,and its applicability in assessing cardiopulmonary exercise capacity in those patients.Methods Seventy consecutive patients (53?14 years) with heart failure(New York Heart Association [NYHA] class, Ⅱ to IV) who had received echocardiographic diagnosis, and believed to be suffering from dilated or ischemia cardiomyopathy were studied. Echocardiography were performed; LV volume as well as ejection fraction were measured from the apical view of the two-dimensional echocardiogram using a modified Simpson’s rule algorithm in all patients. The following variables: peak early transmitral filling velocity (E), late transmitral filling velocity (A), their ratio (E/A), the deceleration time of E (DT), and Tei index were measured by spectral Doppler echocardiography. Furthermore, all patients underwent a cardiopulmonary exercise using 6min walk test. Results Advanced NYHA class was associated with higher Tei index values. A positive correlation was found between Tei index and early /late filling velocity ratio, while a negative correlation was found between Tei index and A wave, E wave, DT, and LV EF. Tei index showed no correlation with heart rate, blood pressure or age. Compared with the parameters of left ventricular function Tei index had a closer relation to the distance of 6min walk. Stepwise regression analysis revealed that the Tei index and the late LV filling velocity were the only independent predictors for cardiopulmonary exercise capacity.Conclusion Tei index correlates inversely with LV performance and reflects disease severity, which is a useful complimentary variable in the assessment of cardiopulmonary exercise performance in patients with heart failure.

Objective:To explore the best bathing posture in neo nates.Methods:Normal mature neonates 664 total were randomly seperated into two groups .The bathing posture was the traditional upwards from face to back in the control group,but upwards from back to face in the experimental group .The noise and comfort levels of the neonates were observed.Results:Uncomfortableness in the experimental gr oup was markedly lowerthan in the control group(χ2=45.78，P<0.0001).Bathing style,i.e.in basin or in shower,did not have an effect on the postures (P> 0.05).Conc lusion:The bathing posture of upwards from back to face is better than upwards from face to back.In this position,the neonates feel safer and more comfortable,and can be stroked while being bathed by the neonates' parents.

Objective To explore the effect and lung function of the budesonide combined with montelukast for treatment of chronic obstructive pulmonary disease(COPD)and the effect on serum IL-6,IL-8 and TNF-α.Methods 120 patients with COPD in our hospital from April 2012 to December 2013 were randomly divided into observation group and control group (n =60 ).Observation group was given budesonide combined with montelukast on the basis of general routine treatment and control group was given budesonide on the basis of general routine treatment.The lung function and the level of IL-6、IL-8 and TNF-αin serum were detected berore and after treatment.Results The efficacy in observation group was significantly better than that in control group(P<0.05).The forced vital capacity(FVC),forced expiratory volume in one second(FEV1),maximal mid expiratory flow(MMEF),and peak expiratory flow(PEF)in the observation group were significantly higher than those in the control group(P<0.05 ).In addition, after treatment the levels of IL-6,IL-8 and TNF-αexpression in serum of the observation group and control group were significantly lower than before treatment,but the levels of the observation group after treatment was significantly lower than the control group,the difference were statistically significant (P<0.05).Conclusion The efficacy of the budesonide combined with montelukast for treatment of COPD is exact by reducing cytokine release, controling airway inflammation to improve the lung function.It is worthy to be popularized.

Cerebral smal vessel disease (CSVD) can be divided into sporadic and hereditary CSVD. The exact pathogenesis of sporadic CSVD is unknow n. Genetic factors may also play an important role, except for environmental and vascular risk factors. As a complicated disease, sporadic CSVD has the characteristics of multigenetic susceptibility. Therefore, investigating the related genetic factors may contribute to understanding the pathogenesis of sporadic CSVD. This article review s the advances in research on the genetics of sporadic CSVD.

BACKGROUND: Preliminary experimental study found that the human amniotic mesenchymal stem cells (hAMSCs)transplantation can improve nerve injury symptoms of rats with cerebral infarction.OBJECTIVE: To observe the survival, colonization and differentiation of hAMSCs in the infarct area of cerebralinfarction rats.METHODS: Sixty Sprague-Dawley rats were randomly assigned into hAMSCs transplantation, model or shamoperation groups (n=20/group). Animal models of middle cerebral artery occlusion were produced in the model andtransplantation groups by Zea-Longa method. One day after modeling, rats in the hAMSCs transplantation groupwere given in situ transplantation of 10 μL of hAMSCs (2×106) into the damaged striatum and cortex, while those inthe model and sham operation group were given the same volume of PBS. Within 1 week after transplantation, ratneurological defects were assessed and changes in their body mass were continuously monitored. Two weeks aftertransplantation, TTC staining was used to observe cerebral infarct size, hematoxylin-eosin staining was used forpathological observation of brain tissues, and immunofluorescent staining was used to detect expression ofneuron-specific nuclear protein.RESULTS AND CONCLUSION: With time, weight loss was increased while neurologic deficit scores were graduallyreduced in the hAMSCs and model groups. Compared with the model group, the weight loss and neurologic deficitscores were lower in the hAMSCs group,; however, there was a significant difference in the neurologic deficit scoresbut not in the weight loss between the two groups. Additionally, the hAMSCs significantly reduced infarct size,attenuated pathologic injury, and decreased the number of inflammatory cells. Immunofluorescence stainingshowed that the hAMSCs were observed at 1 week after transplantation under inverted luorescence microscope,and gradually differentiated into nerve cells at 2 weeks after transplantation. In conclusion, transplanted hAMSCsmay migrate to and survive in the cerebral infarct region, and differentiate into nerve cells in situ in rats with cerebralinfarction.

Objective To investigate the role of infiltrating inflammatory cells in photoaging process by comparing the type and number of these cells in sun-exposed and-unexposed skin.Methods The expression of CD3,CD45RO and CD68 were detected by immunohistochemieal staining in 46 paraffin-embeded skin samples from the extensor forearms(sun-exposed)and upper-inner arms(sun-unexposed) of 23 healthy female volunteers.The number of positive cells in sun-exposed and -unexposed sites was counted and statistically tested by paired samples t test,and Pearson correlation analysis was performed to assess the relationship between the number of positive cells and age of these volunteers.Results The number of cells positive for CD3,CD45RO and CD68 per square millimetre in sun-exposed skin was significantly higher than that in sun-unexposed skin(48.91±13.173 vs.40.61±11.571,46.83±12.915 vs.38.00±10.109,85.43±22.346 vs.73.48±16.208,respectively,P<0.01 or 0.05).The number of cells positive for CD3 and CD45RO increased significantly with age (r=0.557,0.555,respectively,both P<0.01) in the sun-exposed skin but not in sun-unexposed skin,and the number of CD68-positive cells was uncorrelated with age in either sunexposed or -unexposed skin.Conclusion T lymphocytes and macrophages may play a role in the process of photoaging.

Objective To explore the role of problem-based learning(PBL) nursing ward round on critical thinking capacity of nurses from surgical departments. Methods All nurses from surgical depart-ments were randomly divided into the experimental group(86 nurses) and the control group(85 nurses) by drawing lots. Objects from the experimental group received PBL nursing ward round training twice a week for 8 months, while those from the control group used the traditional nursing ward round training. The influ-ence of the different teaching methods on the critical thinking capacity of the nurses was assessed before and after the training, using critical thinking disposition inventory-Chinese version (CTDI-CV). Results Total critical thinking capacity was improved significantly in the experimental group after the training. All sorts of critical thinking characteristics were strengthened in different degree. Conclusions PBL nursing ward round training can effectively facilitate the critical thinking capacity of surgical nurses.

The nurse's multiple-sites practice is currently being implemented,but there are debates regarding advantages and disadvantages.This review analyzed the background and advantages of the nurse's multiple-sites practice,and its main obstacles encountered in China,and put forward our opinions and suggestions about nurse's multiple-sites practice connecting with the practical situation.

ObjectiveTo explore the effect of doctor-nurse integration mode in treating patients with liver cirrhosis treated with endoscopic variceal ligation (EVL).Methods According to the random number table,74 patients were randomly divided into control group and experiment group with 37 in each group.The control group was given routine nursing,while the experiment group was managed by doctor-nurse integration nursing mode.The two groups were compared in respect of early re-bleeding after EVL and mastery of health knowledge.Result The mastery of health-related knowledge in the experiment group was better than the control one and the rate of re-bleeding was significantly lower (P<0.05).Conclusion The doctor-nurse integration care mode can reduce the early postoperative re-bleeding after EVL in patients with liver cirrhosis and enhance the health education awareness.