BACKGROUND:Peri-fracture nerve injury can inhibit osteoclast activity and promote early fracture healing. OBJECTIVE:To investigate dynamical y the effects of traumatic brain injury on the bone mineral density, microstructure, biomechanics property and bone metabolism in rat models of fractures. METHODS:Sixty-three male rats were randomly divided into three groups:sham group, simple fracture group and fracture combined with brain injury group. After 3, 6, and 3 months, the animals were sacrificed in batches under anesthesia, and then, the bones and serum specimens were used to detect the bone mineral density, microstructure, biomechanics property, serum cross-linked N-telopeptide of col agen type I and osteocalcin levels. RESULTS AND CONCLUSION:Compared with the simple fracture group, the fracture combined brain injury group had significantly increased bone mineral density of the proximal tibia, bone volume fraction of the cancel ous bone, trabecular thickness, cross-sectional area of tibial cortical bone and total area of the bone marrow, ultimate load and stress of the tibia, serum cross-linked N-telopeptide of col agen type I and osteocalcin levels at 3 and 6 weeks after modeling (P<0.05), but no differences in the above-mentioned indexes were found among the three groups at 3 months after modeling. These findings indicate that traumatic brain injury can increase the bone mineral density at the fracture site, improve bone microstructure and enhance biomechanical properties, thereby promoting bone healing and bone metabolism at the fracture site.

OBJECTIVE To analyze the cause,clinical characteristic and preventive measures in nosocomial infection of multiple sites. METHODS A total of 123 cases of nosocomial infection in multiple sites in our hospital in 2004 were prospectively monitored and analyzed retrospectively. RESULTS Among 1645 cases of nosocomial infection,123 cases suffered from nosocomial infection in multiple sites.The main infection sites were lower respiratory tract and urinary tract.The main risk factors were over usage of broad-spectrum antibiotics and invasive operation.The serious result was prolongation of duration in hospital,increase in mortality and expensiveness. CONCLUSIONS The nosocomial infection in multiple sites is a main object to be monitored.To prevent,discover and control nosocomial infection in time is an effective measure to reduce the risk of nosocomial infection.

OBJECTIVE To analyze the condition of nosocomical systemic fungus infection and make preventive and control measures against nosocomial systemic fungus infection.METHODS The 496 fungus-cultured positive cases with average age of 61.04 years old among the discharged patients from Jan 2003 to Dec 2005 were reviewed and analyzed.RESULTS The rate of nosocomical systemic fungus infection was 0.53%,from which the over 60 age senile patients accounted for 63.1%.Lower respiratory tract and urinary tract were the most frequent infection sites.The Candida albicans was accounted for 70.71%.The death rate of patients with nosocomial systemic fungus infection was 27.82%.The major correlated factors of nosocomial systemic fungus infection were the widespread use of broad-spectrum antibiotics and not be standardized and the iatrojenic injury of respiratory and urological tracts.CONCLUSIONS The causes of nosocomial systemic fungus infection are closely related to medical treatment;the death rate of patients with nosocomial systemic fungus infection is obvious higher than that without it;to prevent and control nosocomial systemic fungus infection is the key point of nosocomial treatment.

Objective To investigate the similarity and difference in chronic obstructive pulmonary disease ( COPD) evaluation and drug selection that were compared between global initiative for chronic ob-structive lung disease (GOLD) 2011 and GOLD 2006, and to explore treatment adherence by doctors ac-cording to GOLD 2011.M ethods We collected 224 patients with COPD from Department of Respiratory Medicine at the Second Xiangya Hospital to investigate the differences in COPD evaluation and drug selec-tion according to GOLD 2011 and GOLD 2006 with treatment adherence by doctors according to GOLD 2011.Results ⑴According to GOLD 2006, there were 38 patients in the most severe stage, which was different from that (Group D, 147) according to GOLD 2011 ( P <0.01).⑵The risk stratification by u-sing pulmonary function assessment was significantly different from that by using exacerbation history.⑶Symptom assessment by using COPD assessment test ( CAT) was significantly different from that by using modified British medical research council ( mMRC) .The kappa coefficient of these two questionnaires was 0.466, suggesting moderate agreement.⑷ According to GOLD 2011, 224 (100%) patients were recom-mended to use inhaled long-acting bronchodilators, which was higher than that (213, 95.18%) according to GOLD2006 ( P <0.01).⑸The level of appropriated actual prescription was 161 (71.9%) according to GOLD 2011, which was significantly different from that (120,53.1%) according to GOLD 2006 ( P <0.01).Conclusions ⑴ Compared to GOLD 2006, GOLD 2011 categorized more patients into the most severe group.⑵The risk stratification of COPD by airflow limitation severity or exacerbation risk was not i-dentical.Discordance between CAT and mMRC was observed.⑶GOLD 2011 recommends a wider range of using long-acting bronchodilators.⑷The adherence to GOLD guideline in our hospital is still far from satis-faction.

The use of high flow nasal cannula(HFNC) therapy as a noninvasive respiratory support approach for preterm infants is rapidly increasing.HFNC is an alternative to nasal continuous positive airway pressure(nCPAP) for treating apnea of prematurity,primary respiratory support for neonates with respiratory distress,post-extubation support,facilitating nCPAP weaning in preterm infants.In this article,the proposed mechanisms of HFNC and the evidence from clinical trials of HFNC use in preterm infants were reviewed,and recommendations for evidence-based practice were established.

OBJECTIVE:To investigate the drug use in the inpatients of our hospital and evaluate its rationality.METHODS:By using PASS-nested "Army Health No.1" hospital information system,the drug utilization in these patients was analyzed.RESULTS:Among 32 834 medication orders for 586 inpatients,732(1.50%)were warning ones.CONCLUSION:The drug utilization in the inpatients of our hospital was rational on the whole.PASS satisfies clinical doctors' needs,and the physicians feel satisfied with the system.Nevertheless,there are some problems remain to be tackled.

Objective To investigate the relationship between angiotensin I-converting enzyme(ACE)inserting/defaulting(I/D) gene polymorphisms and the femoral artery intima-media thickness(FA-IMT) in patients with type 2 diabetes mellitus(T2DM).Methods The polymorphisms of ACE(I/D) was determined by polymerase chain reaction-restriction fragment length polymorphism(PCR-RFLP) method and the FA-IMT was assessed using non-invasive high resolution B-mode ultrasonography in 303 patients with T2DM in Hunan province.Results The frequency of I allele of ACE gene polymorphisms was higher in T2DM than that in healthy controls,but frequency of D allele was lower in T2DM than that in healthy controls(P

Objective To explore the effects of chlamydia and mycoplasma infections on the healing of wounds after surgical operation for haemorrhoids,fistula and anoschisis.Methods Sixty-two patients with haemorrhoids,fistula and anoschisis undergoing the surgical operation during 2000.1 to 2008.10 were collected,and wounds did not heal 40 days after operation and the wound's surface infection occurred after postoperative anti-inflammatory therapy and dressing change.All patients were positive at least for laboratory Ct or Uu,and those with infections caused by other fungi,bacteria,viruses and the other systemic diseases were excluded.The correlation between the infections in 62 cases and sex,surgical types was analyzed.Results In 62 patients,there were 30 cases (48.4%) positive for both Ct and Uu,22 cases for single Ct (35.5%),and 10 cases for single Uu (16.1%),respectively.The infection rate in females was higher than in males (P<0.01).The surgical types included:surgery for 8 cases of haemorrhoids (12.9%),for 18 cases of fistula(29.0%),and for 36 cases of anoschisis(58.1%).respectively.Conclusion There is the possibility of chlamydia and mycoplasma infections in the patients with delayed healing of wounds following the surgical treatment on the anal region.Early diagnosis,early treatment,avoidance of ineffective medicines and repeatedly management of the wounds can shorten the healing period.

Objective To explore the effects of the bio-psycho-social-spiritual health model intervention on the bio-psycho-social-spiritual health model of the patients with cervical cancer.Methods 118 patients with cervical cancer were randomly assigned to the control group (60 cases) and the intervention group (58 cases).All patients received the routing nursing of cervical cancer.In addition the intervention group received the bio-psycho-social-spiritual health model intervention.Functional Assessment of Cancer Therapy-General (FACT-G) was used to investigate their quality of life before being intervened,being intervened for 3 and 6 months.Results The range of FACT-G total score was 44-96 (68.29±11.60).The total scores of FACT-G before the intervention,3 and 6 months after the intervention were 66.82 ±12.21,79.31±5.15 and 89.67±5.21,compared with those of the control group,which were 69.81 ±10.84,74.48±7.97,79.74±7.17,the time effect,Inter group effect and interaction effect were 137.723,10.944 and 14.639,P＜0.01.Conclusions The bio-psycho-social-spiritual health model intervention can improve the quality of life of patients with cervical cancer.

Objective To summarize the strategies for perioperative nursing of the patients with radical resection of esophageal carcinoma under combination of thoracoscopy and laparoscopy.Method Eighteen patients with radical resection of esophageal carcinoma were treated with a combination of thoracoscopy and laparoscopy and their histories were retrospectively reviewed.Results Before the operation,nursing care focused on psychological nursing and preparations of operating room and various operating instruments.During the operation,the key nursing points included position care,proper cooperation with doctors,strict aseptic procedures and non-tumor techniques to reduce postoperative infections and dissemination of tumor cells.All the patients lived through the successful operations,their recovery satisfactory.The blood loss ranged from 100 mL to 300 mL,averaged(225.00±24.30)mL. Conclusions Radical resection of esophageal carcinoma under the combination of thoracoscopy and laparoscopy is technically feasible and safe.The perioperative nursing care is important for the improvement of operative success.