Objective To understand healthcare-associated urinary tract infection (HA-UTI)and pathogens causing HA-UTI in intensive care unit (ICU)patients,so as to provide scientific basis for the prevention and control of HA-UTI. Methods Targeted surveillance data about HA-UTI in 32 hospitals in 2013 were analyzed.Results A total of 23 680 ICU patients were monitored,157 cases of HA-UTI occurred,HA-UTI rate was 0.66%;the usage rate of urinary tract cathe-ter was 80.83%,catheter-associated UTI was 1.25‰.A total of 162 pathogenic strains were detected,the percentage of fungi,gram-negative bacteria,and gram-positive bacteria was 40.74% (n=66);31.48 % (n=51),and 27.78% (n=45)respectively.Conclusion The main pathogens causing HAI-URI are fungi,comprehensive intervention measures should be taken to control HA-UTI in ICU patients.

Objective:To summarize the clinical experience of surgical treatment abdominal gastrointestinal foreign body in children, thus to provide a theoretical basis for clinical decision-making.Methods:The clinical data, including age distribution, clinical manifestations, surgical treatment strategy and prognosis, from 60 children with abdominal gastrointestinal foreign body treated by operation in Children's hospital of Hu′nan Province from January 2015 to June 2020, were retrospectively analyzed. Among the 60 children, 38 males and 22 females, with a median age of 2.9 years. Observation data included the type and location of foreign bodies in the digestive tract, clinical manifestations and surgical methods, operation time, intraoperative blood loss, postoperative hospital stay. The following-up time was 6 months to 2 years by telephone or clinic. The short/long-term complications was observed.Results:Children under 3 years old accounted for 56.7%. Types of foreign bodies included magnetic foreign bodies, sharp objects[paper clips, nails, screws, fish bone and others, etc], crystal ball, jujube pit, gastric hair stone, batteries and badminton holder. The foreign bodies were mainly located in stomach and small intestine. Abdominal pain and vomiting were the most common symptoms. The patients of foreign body with long residence time had peritonitis such as fever and abdominal pain, among 21 cases were combined with gastrointestinal perforation. There were varieties kind of operaion methods, including gastrointestinal incision and foreign bodies removal( n=22), appendectomy and foreign bodies removal( n=7), repair of gastrointestinal perforation( n=6), intestinal resection and anastomosis( n=17), intestinal resection plus enterostomy( n=5)but whose fistula was closed after 3 months, lateral wall of rectum repair( n=3). Fifty-two patients underwent common open abdomen operation, 8 patients underwent laparoscopic operation. The operating time was(93.5±19.3) min. Intraoperative blood loss was(20.2±4.3) mL. The postoperative hospitalization was 13(5, 19) d. The postoperative complications occurred in 3 patients who were nonoperative treatment recovery. Conclusions:Magnetic foreign body, sharp foreign body, crystal ball, jujube nucleus and corrosive foreign body are the main causes of digestive tract obstruction and perforation in children. Individualized operation plan should be selected as soon as possible according to the number of foreign bodies, retention position and whether or not digestive tract perforation.

ObjectiveTo establish a new biomechanical test for evaluating biomechanical properties of femoral metaphysis in ovariectomized rats.MethodsTwenty-five-month-old female Sprague-Dawley rats were randomly divided into ovariectomized (OVX) group and the sham-operated (Sham) group (n=10).Twelve weeks after operation,femur BMD and histomorphometry of distal femur were detected.Furthermore,femur biomechanical parameters were determined by diaphysis three-point bending test and a new designed metaphysis bending test.The relationships between the biomechanical parameters and BMD or bone histomorphometry were assessed with Pearson correlations.ResultsThe femur BMD,bone histomorphometrical indexes(％Th.Ar,Tb.N,Tb.Th),and biomechanical parameters(maximum load,yield load and stiffness) of OVX group significantly decreased compared with Sham group.In metaphysis bending test,the mean difference of the maximum load(Fmax),yield load(Fy) between group OVX and Sham were significant higher than that in diaphysis three-point bending test.Positive correlations between biomechanical parameters and femur BMD or bone histomorphometry indexes were observed in both the diaphysis bending and metaphysis bending test.The biomechanical parameters in the metaphysis bending test showed stronger correlations with BMD and bone.ConclusionFemur metaphysis bending test could be used to evaluate the biomechanical properties of osteoporosis.When compared with diaphysis bending test,femur metaphysis bending test is more sensitive in evaluating the change of biomechanical properties of femur in osteoporotic rats.

Objective To explore the effect of community comprehensive intervention on stroke-prevention-related knowledge, belief and behavior of hypertensive patients. Methods The community-based comprehensive interventions were done to 77 hypertensive patients, with the measures including archives establishment, hypertension-phased management, regular follow-up and multi-mode health education. The stroke-prevention-related knowledge, belief and behavior of them were assessed by the stroke-preventing knowledge questionnaire (SPKQ), champion′s health belief model scale (CHBMS) and (stroke-prevention behavior questionnaire,SPBQ) before and after the intervention. Results Their knowledge on daily-life and pre-stroke symptoms and part of their behaviors (health duty, physical exercises and stress management after the intervention were superior, as compared to the pre-intervention (P<0.05). There were no significant differences in other stroke-related knowledge and behaviors and health belief in comparison of the pre-and post-intervention (P>0.05). Conclusion The community-based intervention can improve parts of stroke prevention knowledge and health behavior among hypertensive patients. The intervention needs to be modified based on ecological models of health promotion and health belief model.

Objective To analyze and evaluate the effect of posterior circumferential fusion for treatment of the mechanical instability of lumbar spine, and discuss the relative merits,indications and contraindications in this procedure. Methods Two hundred and two patients with mechanical instability of lumbar spine treated by the posterior instrumented circumferential fusion technique from January 2001 to January 2007. One hundred and thirty-two patients were selected who were treated with only one segment fusion and followed up for at least 1 year, of them 97 patients suffered lumbar spondylolisthesis, 35 patients suffered degenerative lumbar instability. X-ray was used to evaluate the fusion condition of the bone graft, and VAS and ODI questionnaire were applied to assess the pain of back and leg,and the conventional function. Results All patients were followed up for 12-84 months, averaged (43±23) months,125 patients got bone fusion, accounted for 94.7%(125/132). The VAS of low back pain was (6.71 ± 1.31) points before operation, while (3.20 ± 1.14) points after operation (P < 0.05) ,and the VAS of leg pain was (8.33 ± 1.78) points before operation,while (4.31 ± 1.15) points after operation (P< 0.05). The ODI was (68.6 ± 14.7) % before operation, while (13.6 ± 1.5) % after operation (P < 0.05). Conclusions Posterior circumferential fusion is a positive and excellent treatment for the mechanical instability of lumbar spine. With its merits, the high fusion rate and good clinical results can be received.

ObjectiveTo evaluate the effect of labor analgesia and the outcome of maternals and neonatals by applying the vitamin B6- folic acid mixture to combined with spinal-epidural analgesia(CSEA) in nulliparous women at latency.MethodsAll the 112 full-term nulliparous parturients were selected and divided into the treated group and controlled group.Nulliparous women in two groups received CSEA,with which the additional vitamin - folic acid mixture was used only in treatment group.The contrast between the analgesic effect in groups,and alalgesic effect-acting period,fentanyl Apgar score and newborn usage were compared between groups also.ResultsThe analgesic effect-acting period and fentanyl dosage in the treated group were significantly decreased.There was significant difference between the 2 ( P ＜ 0.05 ).ConclusionsIt could be effective applying vitamin B6- folic acid mixture at latency in nulliparous women based on CSEA,which could shorten the lumbar hemp effect-acting period and reduce fentanyl narcotic drugs dosage.

Traumatic spinal cord injury (TSCI) is a common nerve injury in the world, which has a high incidence and disability rate. Intraspinal pressure (ISP) monitoring is performed by placing a pressure sensing probe under the dura of the most severe part of the spinal cord injury after anterior/posterior laminectomy or vertebral body decompression. ISP value is monitored dynamically and objectively in real time by the pressure sensing system. Recent studies have found that ISP monitoring plays an important role in the clinical management and prognosis evaluation of TSCI. The author reviews the recent advance in ISP monitoring in TSCI in order to provide references for the improvement of clinical diagnosis and treatment of TSCI.

Traumatic spinal cord injury (TSCI) is a common nerve injury in the world, which has a high incidence and disability rate. Intraspinal pressure (ISP) monitoring is performed by placing a pressure sensing probe under the dura of the most severe part of the spinal cord injury after anterior/posterior laminectomy or vertebral body decompression. ISP value is monitored dynamically and objectively in real time by the pressure sensing system. Recent studies have found that ISP monitoring plays an important role in the clinical management and prognosis evaluation of TSCI. The author reviews the recent advance in ISP monitoring in TSCI in order to provide references for the improvement of clinical diagnosis and treatment of TSCI.

Different degrees of visual function impairment is the main reason for first visit of children with optic pathway glioma; it seriously affects the quality of life of children. Early diagnosis, timely treatment, maximum preservation or restoration of the children's vision function, and improvement of quality of life of children are major challenges. This article reviews the recent advance in visual function assessments for children with optic pathway glioma, aiming to provide some references for early clinical objective assessment of visual function impairment and clear diagnosis.

Objective To observe the inhibited effect of gastrodin on chemotherapy-induced neuropathic pain and its mechanism.Methods Fifty SD rats,chosen according to the threshold of pain,were randomly divided into 5 groups(n=10):control group,model group,and gastrodin treatment groups (30 mg/kg,60 mg/kg and 120 mg/kg).Vincristine (125 μg/kg,i.p.) was administered on alternate days to establish chemotherapy-induced neuropathic pain models in the model group and gastrodin treatment groups,and then,on the 9th d of modeling rats in the gastrodin treatment groups were treated with different doses of gastrodin,while those in the control group and model group were given normal saline on the 16th d of modeling.Paw withdrawal mechanical threshold and thermal pain threshold were measured;protein expressions of CX3CR1 and p-p38MAPK were detected by Western blotting,and tumor necrosis factor α (TNF-α) protein expression was detected by ELISA.Results As compared with control group,model group had significantly decreased pain threshold and increased protein expressions of CX3CR1,p-p38MAPK and TNF-α (P＜0.05);as compared with those in the model group,the pain threshold increased and the expressions of CX3CR1,p-p38MAPK and TNF-α decreased in 60 mg/kg and 120 mg/kg gastrodin treatment groups,with significant differences (P＜0.05).Conclusion Gastrodin can relieve the chemotherapy-induced neuropathic pain,probably by inhibiting the expressions of CX3CR1 and p-p38MAPK in the activation passageway of microglial cells in the spinal cord,and then,reducing the expression of TNF-α.