OBJECTIVE:To explore the risk factors for nosocomial infection of multidrug-resistant organism (MDRO) in ICU,and to provide reference for preventing and controlling MDRO in ICU. METHODS:In retrospective study,246 patients with nosocomial infection from ICU of Xi'an Aerospace General Hospital (hereinafter referred to asour hospital) during Jan. 2011-Dec. 2015 were selected and divided into non-MDRO infection group (140 cases) and MDRO infection group (106 cases). The detection and drug resistance of MDRO were analyzed in MDRO group. Univariate analysis and binary Logistic regression anal-ysis were used to explore risk factors for nosocomial infection of MDRO. RESULTS:During 2011-2015,435 strains of MDRO were isolated from 106 MDRO infection patients,in which Gram-negative bacteria accounted for 89.43%,showing severe drug re-sistance. Univariate analysis showed that the following 13 factors were related to nosocomial infection of MDRO,such as ICU ad-mission time,hypoproteinemia,acute cerebrovascular diseases,renal abnormalities,mechanical ventilation time,arterivenous cath-eterization time,urethral catheterization time,indwelling gastric tube time,type and time of using antibiotics,combined use of an-tibiotics,application of carbapenems and the third generation caphalosporins(P<0.05). Binary Logistic regression analysis showed that acute cerebrovascular diseases,type and time of using antibiotics were the independent risk factors for nosocomial infection of MDRO in ICU [odds ratios were 2.816,1.582,1.265,95%CI were (1.540,5.151),(1.085,2.306),(1.131,1.415)]. CONCLU-SIONS:Some prevention and control measures should be taken actively for high-risk MDRO infection patients in ICU to reduce the incidence of nosocomial infection of MDRO and improve the quality of health care.

Objective:To comprehend morphology changes of temporomandibular joint in adults with mandible deviation,and the correlation in these changes.Methods:The mesofault radiographs of temporomandibular joint were taken in 21 adult patients with mandible deviation.The data described morphology of temporomandibular joint were analysed.Results:In adult patients with mandible deviation,the condyle process of opposite side was anterior and inferior when compared with deflected side.The height of condyle process,the upper height of condyle process,the gradient of prosobevel of condyle process and the gradient of back bevel of glenoid fossa were augmented when compared to deflected side.The gradient of prosobevel of condyle process showed positive correlation to the prosoblank of joint and the deep of glenoid fossa,and the height of condyle process showed positive correlation to the upper height of condyle process in both sides.The gradient of back bevel of condyle process showed positive correlation to the gradient of back bevel of glenoid fossa in deflected side.The gradient of back bevel of condyle process showed negative correlation to the supper blank of joint and the height of articular tubercle in opposite side.Conclusion:There are some differences in morphology of both temporomandibular joint in adults with mandible deviation,and there is some correlation between these changes.

Alzheimer's disease (AD) is the most frequent type of dementia in elderly,which has been regarded as a neurodegenerative disease.The traditional point of view considers that AD and vascular dementia are two different types of dementias both from their pathogenesis and treatment;however,in recent years,a growing body of evidence indicates that the vascular factors are playing an important role in the development and occurrence of AD.This article reviews cerebral ischemia and its risk factors including the effects of hypertension,diabetes,and cholesterol in the development and occurrence of AD,so as to provide new strategies in preventing,and delaying the occurrence and progression of AD.

Objective: To study the effect of recombinant human intestinal trefoil factor ( rhITF) on the healing of rat chronic gastric ulcer , protect gastric mucosal and mechanisms are involved. Methods: (1) Acute gastric mucosal injury was induced by ethanol, stress, aspirin and pylorusl ligation. The injury index ,MDA, GMBL,hexosamine (Hex) and acid output were measure. (2) Chronic gastric ulcer was induced in rats by application of 50% glacial acetic acid to the serosa of the glandular stomach. After injury, rats received by rhITF or vehicle orally twice daily for 11 days. On day 12, gastric mucosal blood flow(GMBF)was measured under ether anesthesia. Then the pylorus was ligated for 3 hours and each stomach removed. The gastric acid output, ulcer index, Hex and nitric oxide(NO) content in gastric mucosa, as well as iNOSmRNA in the ulcer bed were determined. Results: (1) rhITF protected gastric mucosa from the acute lesion, and increased Hex content in gastric mucosa. (2) rhITF treatment significantly decreased the ulcer index and gastric acid output, but increased the GMBF, Hex and NO content in comparison with the control groups. In addition, rhITF also stimulated iNOSmRNA expression in the ulcer bed by situ hybridization analysis. Conclusion: rhITF can protect gastric mucosa against acute lesion, and enhance the healing of chronic gastric ulcer in the rats.This action may result from the inhibition of gastric acid output, increase of GMBF.Hex and NO content and rhITF stimulated iNOSmRNA expression.

Objective To investigate the gender difference in the smile aesthetic features in aged Han Chinese with normal occlusion and its clinical significance.Methods Fifty-six aged Han Chinese (male:28,female:28,aged 60-66 years)with normal occlusion were included in this study.Smiling images of the resting-position and mandibular postural position were obtained in an anteriorposterior view.The CoSmileMAA1.0 software was used to evaluate the indices associated with the smile-aesthetic features,and its clinical significance was analyzed.Results Significant differences were noted in the nasal ala width,upper lip length,lip clearance,angle oris width in resting-position/ smiling position together with the changes of lip clearance,angle oris width,distance of inferior margin of upper lip to cutting edge of the maxillary incisor teeth,distance of superior border of lower lip to cutting edge of the maxillary incisor teeth,smile line ratio and type of smile (all P＜0.05).When the subjects were smiling,the changes of lip clearance was greater in females than in males [(10.7±1.9)mm vs.(11.3±1.6)mm,P＜0.05],the changes of angle oris width was greater in males than in females [(14.1±1.6)mm vs.(13.4±1.3)mm,P＜0.05],and the smile line ratio was less in males than in females [(0.9±0.2) vs.(1.1±0.5),P＜0.05],which indicate that the females had more attractive smile in aged Han Chinese with normal occlusion than males.The type of smile was mainly high smile in elderly females and median smile in elderly males [53.6％ (15 cases) and 60.7％ (17 cases),x2 =6.43,P＜0.05].Conclusions Significant gender difference is noted in the smile-aesthetic features in aged Han Chinese with normal occlusion.Modulation of maxillary incisor teeth length and smile line ratio can contribute to the aesthetic appearance of smiling.

Command of the JCI standard is conducive to promoting the "Patient-centered" quality management concept awareness and realizing the patient safety objective. To this end, a campaign to stage the hospital quality management system and bottom-up quality activities has been launched. These efforts may help improve the hospital quality management system, covering such aspects as standardized document management, human resource management, normalized diagnosis and therapy management centering on clinical path, clinical nursing service quality, safety management, equipment and facility management, as well as data analysis and quality improvement system. These have been subject to and certified by JCI with a gold medal.

Objective To explore the effects of murinecytomegalovirus(MCMV)infected mouse embryonic fibroblasts(MEF)on the proliferation and activation of regulatory T cell in vitro. Methods A co-culture system of T cell and MCMV infected MEF(T-MEF MCMV)was established.The viral load of supernatant was determined by plaque assay.The proliferation of T cells was observed with cell counting.The proportion of CD4+ CD25+ cells was measured by flow cytometry.The levels of Foxp3 protein were measured by Western blot.Reverse transcription polymerase chain reaction(RT-PCR)assay was utilized tO determine whether MCMV infection of MEF influenced the level of transforming growth factor(TGF)-β mRNA.The level of TGF-β protein in supernatant was measured by double-antibody sandwich enzyme linked immunosorbent assay(ELISA).The difference between T-MEF MCMV group and control group was assessed by one-way ANOVA.Results When T cells were co-cultured with MCMV infected MEF for 1 day and 3 days,the viral load in supernatant decreased.But when co-culture lasted for 6 days,the antiviral effect obviously diminished,as the viral load[(5.58±0.67)×105 PFU/mL]of the experimental group showed no statistic difference with MEF MCMV control group[(6.05±0.34)×105PFU/mL].When co-cultured with MCMV infected MEF for 3 days,T cell increased from pre-culture level of[(2.02±0.05)×106/mL]to(2.25± 0.13)×106/mL(P＜0.05).But when co-culture lasted for 6 days,the number of T eelI returned to (2.08±0.14)×106/mL,which had no statistic difference with that of co-culture for 3 days system. Both the expressions of Foxp3 protein and the proportion of CD4+ CD25+ Foxp3+ Treg cells in T-MEF MCMV group were up-regulated as the infection time extended,which were two times and three times of the control group level,respectively.The mRNA level(A value)of TGF-β in MCMV infected MEF increased from baseline of 1.09±0.13 to 3.15±0.54 on day 3 after infection.The expression of TGF-β in supernatant 3 days after infection was(3.85±0.32) μg/L,which was significantly higher than that before infection[(1.74±0.14)μg/L,P＜0.05].Conclusions Activated T cells have antiviral effect.However,the function of T cells is rapidly inhibited after activation,which may be due to the expression of Foxp3 mRNA induced by MCMV infected MEF and increased CD4+ CD25+ Treg proportion of the co-cultured T cells.TGF-β level is significantly increased after CMV infection,which may be an important mechanism of Treg proliferation.MCMV may manipulate Treg to evade specific immune elimination and,as a result,to cause CMV replication.

Objective To evaluate the effects of Taoist cognitive psychotherapy on depression of aged patients with cerebral stroke hemiplegia convalescence. Methods Seventy-seven hemiplegia convalescence patients with depression were divided into general treatment group (38 patients, received general back-up psychology therapy) and combined treatment group (39 patients, received general back-up psychology therapy and Taoist cognitive psychotherapy) by random digits table. All patients were treated for 8 weeks and followed up for 6 months. Two groups were evaluated with HAMD and SS-QOL before treatment and at the end of the 2 weeks,4 weeks, 8 weeks and 6 months after treatment. The results were analyzed with statistics. Results In general treatment group, the HAMD scores were gradually decreased, and the HAMD scores of patients after 8 weeks' treatment were significantly lower than those before treatment[(22.35 ± 4.69)scores vs. (29.62 ± 5.95 ) scores,t = 6.425 ,P ＜ 0.01]. At the end of 6 months after treatment, the scores increased [(24.48 ± 4.12 ) scores vs. (22.35 ± 4.69 ) scores, t = 2.014, P ＜ 0.05], but they were lower than those before treatment(t = 4.836, P ＜ 0.01 ). At the end of 6 months after treatment, the SS-QOL scores were lower than those after 8 weeks' treatment (t =2.543,P ＜0.05),but they were higher than those before treatment (t = 2.790,P ＜ 0.05 ). In combined treatment group, the HAMD scores decreased continuously,and the scores after 8 weeks' treatment [(20.08 ± 4.60) scores] and 6 months' treatment [( 15.21 ± 3.42)scores] were significantly lower than those before treatment [( 30.14 ± 4.92 ) scores] (t = 8.341,15.443, P ＜0.01). Meanwhile,the HAMD scores after 6 months'treatment were significantly Iower than those after 8 weeks' treatment (t =4.724,P ＜ 0.01 ). The SS-QOL scores after 8 weeks' treatment [( 117.56 ± 26.22)scores] and 6 months' treatment [(126.57 ±21.82) scores] were significantly higher than those before treatment[(86.54 ± 23.90) scores] (t = 6.716,8.916,P ＜ 0.01 ) ,and there was significantly difference(t=2.378,P ＜ 0.05). The HAMD scores of combined treatment group after 8 weeks' and 6 months' treatment were significantly lower than those of general treatment group at the same time(t = 2.118, P ＜ 0.05 ;t = 8.405,P＜ 0.01 ) ,and SS-QOL scores were significantly higher than those of general treatment group at the same time (t = 3.123,P ＜ 0.05 ;t = 6.580,P ＜ 0.01 ). Conclusions General back-up psychology therapy combined with Taoist cognitive psychotherapy can improve depression and life quality of cerebral stroke hemiplegia convalescence in aged patients. The effects of Taoist cognitive psychotherapy is slower, but it is more beneficial in the long time.

A questionnaire was used to survey the perspective of the 22 mentors,24 students, 27 graduate students and 27 public health units on the competence of MPH student. The result showed that the practice skill,analyzing skill,program plan and practice skill,and emergency reaction abil-ity got more attention. This suggested that to the training of MPH,the training objective should focus on the ability to resolve problems; the curriculum should focus on the characters of public health and on the practice training.

Objective To investigate graduate students' common compulsory courses settings of the Military Medical University and put forward suggestions.Methods With self-made questionnaires,we investigate with simple random sampling all the concerned principals of teaching about their opinions of English,politics and statistics courses.Results Most of the experts thought graduate students should not be required to study English but test should be required(68.9％),that politics course was more than required (76.0％),and the percentage of the experts who thought the contents in graduate and undergraduate courses were less overlapped and more overlapped is respectively 47.9％ and 46.6％.Conclusion To satisfy scientific research needs of graduate students in military medical university,the common courses should be reformed,including teaching politics in various methods like lectures,taking software studying and experiment design into statistics,implementing the policy of students taking English test in the exemption of English study,etc.