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 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.

Background Krüppel-like factor 6 (KLF6) is related to the physiological or pathological process,such as growth,cell differentiation,proliferation,apoptosis,angiogenesis,tissue repair,and so on.But in ophthalmology,it is less reported about the expressing level of KLF6 protein in lens epithelial cclls (LECs) or the effect of KLF6 on the proliferation of human LECs.Objective This study was to investigate whether KLF6 can inhibit proliferation of human LECs.Methods KLF6 eukaryotic expression plasmid (pEGFP-C2-KLF6) was constructed using reverse transcription PCR(RT-PCR) and identified by double enzyme digestion method and PCR.Human LECs strain (HLE-B3) was cultured and passaged using low glucose DMEM containing 10％ fetal bovine serum and then divided into 4 groups.KLE-B3 transfection reagents were added in the culture medium of all groups.In addition,no agent was used in the blank control group;only insulin-like growth factor-1 (IGF-1) was appended to the medium in only IGF-1 group ;null vector was transfected and IGF-1 was appended in the null plasmid transfection+ IGF-1 group;while pEGFP-C2-KLF6 eukaryotic expression plasmid was transfected into the cells,and simultaneously IGF-1 was added in the pEGFP-C2-KLF6 plasmid transfection+IGF-1 group.After 24 hours of intervene,water soluble tetrazolium salt-1 (WST-1) test was used to detect the growth status of the cells,and Western blot assay was used to assay the relative expressing level of KLF6 protein in the cells.In the other hand,the cells were cultured at the density of 1 ×104/piece,and 0,0.10 and 0.25 μg pEGFP-KLF6 were transfected into each piece of cells respectively,and then IGF-1 was added with a final concentration of 50 μg/L for 24 hours after cell culture.Expressions of Ki-67 protein and mRNA in the cell pieces were detected by immunocytochemistry and fluorescent semiquantitative PCR,respectively.Results The PCR product bands were consistent with KLF-6 gene in length,and the product fragments were corresponding with expectant ones via PCR and double enzyme digestion method,showing a successful construction of pEGFP-C2-KLF6 eukaryotic expression plasmid.After 24 hours of IGF-1 stimulation,the absorbance values of the cells were 0.86±0.00,2.10±0.01,2.24±0.12 and 1.06±0.02 in the blank control group,only IGF-1 group,null plasmid transfection + IGF-1 group and the pEGFP-C2-KLF6 plasmid transfection + IGF-1 group,with a significant difference among the 4 groups (F =38.322,P ＜ 0.05),and that in the pEGFP-C2-KLF6 plasmid transfection +IGF-1 group was significantly lowed in comparison with the only IGF-1 group and the null plasmid transfection+IGF-1 group (q=6.42,7.31,both at P＜0.05).Western blot assay showed that the relative expressing levels of KLF6 protein were statistically different among the four groups (F =591.858,P＜0.05),and those in the pEGFP-C2-KLF6 plasmid transfection+IGF-1 group were 1.47,2.04,3.27 folds higher than those in the blank control group,only IGF-1 group,respectively and null plssmid transfection+IGF-1 group,respectively.Immunocytochemistry revealed that the expressing intensity of Ki-67 protein was gradually weakened with the decrease of pEGFP-C2-KLF6 plasmid dose in the 0,0.10 and 0.25 μg pEGFP-C2-KLF6 plasmid transfection+IGF-1 groups.Fluorescence semiquantitative PCR results showed that the relative expression values of Ki-67 mRNA in the cells were O.15±0.08 and 0.11±0.03 in the 0.10 μg and 0.25 μg pEGFP-C2-KLF6 plasmid transfection+ IGF-1 groups,which were significantly lower than O.77± 0.12 of the 0 μg pEGFP-C2-KLF6 plasmid transfection group,with a statistically significant difference among the three groups (F =54.825,P＜0.05).Conclusions KLF-6 can effectively inhibit IGF-1-induced proliferation of human LECs,and it can be regarded as one of the regulatory factors of the proliferation of HLE-B3 cells.

ObjectiveTo investigate the risk factors of nosocomial infection (NI) of patients with spinal cord injury (SCI).MethodsClinical data of SCI patients hospitalized in our hospital from Jan 1999 to Dec 2004 were analyzed retrospectively.ResultsThe NI rate of SCI patients was 27.78%, and the highest was in summer (33.09%), the lowest was in winter ( 22.41 %). The most common infection sites were urinary tract (71.07%), followed by respiratory tract (14.72%).ConclusionSCI patients are susceptible to NI; prevention and control measures should be taken to decrease the NI rate.

Personnel training marks a key assurance for the healthy and sustainable development of healthcare sector and healthcare institutions in China, rendering it critical importance to include personnel training into performance appraisal. The authors analyzed the connotation and orientation of personnel training index assessment in the performance appraisal at tertiary public hospitals in the country, sorted out the assessment details to be optimized. On such basis, the authors recommended on optimal assessment methodology, combining the gradual improvement of medical personnel training assessment indexes and interval range assessment. These efforts aim at providing references for further improving the scientificity, standardization, homogeneity, as well as vertical and horizontal comparability and operability of personnel training index assessment.

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.

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 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.