In modern hospital outpatient management, patients should be paid more attention to than hospital management and economic management. Automatic and paperless management is also important. So, the software and hardware all should be updated to gain great social and economic benefit.

Objective To investigate the basic data and quality control indicators of infection monitoring in 67 hospitals in Chongqing area ,and provide basic data for the exploration of hospital infection monitoring norms .Methods According to the sur‐vey of the basic data and quality control index of hospital infection monitoring by the national health planning commission ,a ques‐tionnaire survey was conducted in some medical institutions in Chongqing area ,and the data were collected and analyzed .Results A total of 67 valid questionnaires were collected ,21 for tertiary hospitals ,46 for secondary hospitals ,of which there were 5 teaching hospitals ,47 general hospital ,11 hospital of traditional Chinese medicine ,3 factories hospitals ,1 private hospital .Electronic medical records management system in 67 hospitals accounted for 71 .64% ,the hospital infection information system accounted for 83 .33% ,surgical anesthesia system accounting for 31 .34% ,antimicrobial drug management and monitoring system accounted for 68 .65% .Hospital infection monitoring was mainly based on routine monitoring and target monitoring ,the correct rate of monito‐ring objects was 74 .62% ,and the usage of antibiotics was 44 .78% in the operation room .Monitoring statistics took month as a u‐nit ,accounting for 73 .13% ,the correct rate of P75 value was not high when calculating the risk factors of NNIS operation ,opera‐tion and diagnosis and treatment operation confusion accounted for 97 .01% ,the knowledge and technology of microbiological exam‐ination was relatively low .Conclusion Basic data of hospital infection monitoring and quality control survey can understand the sit‐uation of hospital infection management ,it can help to improve the monitoring level of nosocomial infection by investigating the weak links and strengthening the intervention .

Objective:To establish an HPLC method for the determination of clindamycin phosphate in compound phenytoin sodi-um ge1s. Methods:The HPLC analysis was carried out on a ZORBAX SB-C18 column(250 × 46 mm,5 μm)with 0. 1 mol·L-1 KH2PO4 solution(adjusting pH to 2. 5 with H3PO4 solution)-acetonitrile(75:25)as the mobile phase at the flow rate of 0. 8 ml· min-1 . The detection wavelength was 210 nm,the column temperature was 25℃ and the injection volume was 10μl. Results:The lin-ear range of clindamycin phosphate was 3. 00-18. 00 μg(r=0. 999 5). The average recovery was 101. 11%(RSD=0. 34%,n=6). Conclusion:The method is simple,sensitive and reproducible,and can be used in the determination of clindamycin phosphate in com-pound phenytoin sodium gels.

Objective To investigate the causes of a healthcare-associated lower respiratory tract infection(HA-LRTI) outbreak due to Enterobacter cloacae(E.cloacae), and provide basis for clinical prevention and control of HAI.Methods Epidemiological data of patients with E.cloacae HA-LRTI following bronchoalveolar lavage(BAL) in the departments of respiratory disease and thoracic surgery of a hospital were collected, antimicrobial resistance analysis on isolated pathogens from patients and environment was performed, pulsed-field gel electrophoresis (PFGE) was used for genotyping.Results On March 8-16, 2013, a total of 15 patients underwent BAL in the fiberobronchoscopy room in the departments of respiratory disease and thoracic surgery of a hospital, 13 of whom developed E.cloacae LRTI, 4 cases were community-associated infection (the initial case was included), the other 9 cases were HAI;8 environmental specimens were detected 2 strains of E.cloacae, the strains were from vacuum suction joint of fiberbronchoscope and scissors used for trimming disposable controllable sputum suction pipeline.15 strains of E.cloacae from environment and patients were screened by antimicrobial susceptibility testing, 11 strains were with similar antimicrobial susceptibility testing result, 2 of which were environmental strains, 6 were from inpatients, and 3 were from patients in community.PFGE typing of 11 strains revealed that there were 8 strains with the same genotype, 6 of which were from patients in department of thoracic surgery, 2 were from vacuum suction joint of fiberbronchoscope and scissors used for disposable controllable sputum suction pipeline;the other 3 strains were of the same genotype, and from departments of respiratory disease and thoracic surgery.Conclusion This outbreak is due to contamination of bronchofibroscope by the same E.cloacae strain, the strain is susceptible to the clinic commonly used antimicrobial agents, such events should be paid attention in clinic, the key to control infection is to take necessary measures for cutting off the spread of the epidemic.

Objective:To investigate the number and distribution of macrophages (Mφ) and natural killer(NK) cells in hepatocellular carcinoma (HCC), paraneoplastic,cirrhosis and normal liver tissues and their relationship with the prognosis of HCC patients.　Methods:Surgical specimens from 60 cases of HCC, 62 cases of cirrhosis and 23 cases of normal liver tissues were investigated by immunohistochemical staining of CD68 and CD57 with a streptavidin-horseradish peroxidase detective system.The correlation of the number of Mφ and NK cells in different tissues with the clinical tumor parameters was also studied.　Results:①The order of the number of Mφ from the highest to the lowest was:paraneoplastic,cirrhosis, normal, HCC(P<0.05)；and the number of NK cells from the highest to the lowest was:HCC, paraneoplastic, normal, cirrhosis(P<0.05).②The number of Mφ decreased successively with the decrease of the HCC differentiation(P<0.05)；There was no relationship between the number of NK cells in HCC and histological grade. ③There was no relationship between the number of Mφ in HCC and clinical TNM stage ；The number of NK cells in HCC had degressive tendency with the clinical TNM stage(P<0.05). ④The number of Mφ and NK cells in HCC in the cases with metastasis in 15 months was significantly lower than that without metastasis(P<0.05, 0.01）.⑤There was a linear positive correlation between the number of Mφ and NK cells in HCC (r＝0.344, P<0.05).　Conclusion:The number of Mφ and NK cells in HCC in the cases with metastasis is significantly lower than that without metastasis；The number of Mφ has a close correlation with the HCC differentiation, and positive correlation with the number of NK cells；The number of Mφ and NK cells might be important markers to estimate the immune status and useful factors to predict the prognosis of HCC patients.

Animals ; Animals, Newborn ; Cells, Cultured ; Cyclic AMP ; metabolism ; Glucagon-Like Peptide 1 ; pharmacology ; Insulin ; secretion ; Islets of Langerhans ; drug effects ; secretion ; Peptide Fragments ; pharmacology ; RNA, Messenger ; genetics ; Rats

Objective To investigate the clinical value of medical image-three dimensional visible system (MI-3DVS) in percutaneous transhepatic cholangioscopy lithotripsy (PTCSL) for the treatment of hepatolithiasis.Methods The clinical data of 66 patients with hepatolithiasis (55 were from the First People's Hospital of Shunde City and 11 were from the Zhujiang Hospital) were retrospectively analyzed.The images of computed tomography were three-dimensionally reconstructed with MI-3DVS.The location,number,size,shape of the stones were figured out,and the operation strategies of PTCSL were designed according to the types of the disease.The clinical value of MI-3DVS was evaluated according to the operation results and postoperative recovery of patients.All the patients were followed up via telephone or out-patient re-examination.Results Liver,biliary system,stones and blood vessels were three-dimensionally reconstructed with the MI-3 DVS,and the size,number,shape,location of the stones and location,degree,length of the biliary stricture and its anatomical relationship with adjacent blood vessels were clearly displayed.The coincidence rate of planned and actual operations was 95.5％ (63/66).The mean operation time,intraoperative blood loss,rate of stone clearance,complication rate and duration of hospital stay of 63 patients were (117 ± 9) minutes,(18 ± 1) ml,92.4％ (61/66),6.1％ (4/66) and (15 ± 4) days,respectively.All the patients were followed up till September 2012,the median survival time was 16 months (range,1-69 months),and the recurrence rate of hepatolithiasis was 9.1％ (6/66).One patient died of tumor metastasis and multi-organ dysfunction syndrome postoperatively.Conclusion MI-3DVS could effectively improve the safety and efficiency of PTCSL for patients with hepatolithiasis.

To explore the clinical manifestations, diagnosis and treatment of pulmonary thromboembolism associated with protein C (PC)/protein S (PS) deifciency. Two male patients 29 and 26 years old diagnosed with PC deifciency and/or PS deifciency were retrospectively analyzed and related literatures were reviewed. The most common symptoms were pain in the lower limbs with chest pain or decreased vision. Color dopper lfow imaging (CDFI) showed lower deep venous phlebothrombosis. Multislice CT angiography (CTA) revealed pulmonary embolism. The level of serum homocysteine (HCY) increased and the level of plasma PC/PS content decreased to PC 57.4%, and PS 28.9%in patient 1, while PS 33.4%in patient 2. Poor routine anticoagulant response was observed. After the diagnosis of PC/PS deficiency, vitiamin B6 and B12 anticoagulant therapy was added, and the symptoms in the patients improved significantly. Congenital thrombophilia should be taken into consideration for young patients with lower deep venous thrombosis and pulmonary embolism which occur recurrently without obvious predisposing causes before 40. Plasma PC/PS concentrations or activity help a lot in the diagnosis and treatment.

ObjectiveTo study the correlation of personality dysfunction with resilience in secondary vocational students.MethodsBy adopting the questionnaire of Personality Dysfunction Inventory for Middle School Students (MPDI) and Healthy Kids Resilience Assessment scale (HKRA) to assess 358 secondary vocational students.ResultsThe secondary vocational student's scored lower on relationship dysfunction (4.15 ±2.67) than ordinary high school students'( 5.18 ± 3.37 ),and higher on behavioral deviation (6.07 ± 3.20) than ordinary high school students (5.18 ± 3.37 ).There existed great capable difference of total and every fact of personality dysfunction according to grade (P ＜ 0.05,P ＜ 0.01 ),and the quo of personality dysfunction on second year in high vocational school students was better than high and senior high vocational school students.Both parents of secondary vocational student's scored lower on relationship dysfunction( 3.96 ± 2.36),emotional deviation (3.96 ± 2.36 )and personality dysfunction( 15.50 ± 6.27 ) than Single-parent family of secondary vocational students ( 5.73 ±4.12,6.51 ± 3.72,19.78 ± 10.44).There existed great capable difference of total and every fact of personality dysfunction according to relationship with parents (P ＜ 0.05,P ＜ 0.01 ),and the more harmonious in parental relationship,the better in personality.There also existed great capable difference of total and every fact of personality dysfunction according to educational background of parents (P ＜ 0.05,P ＜ 0.01 ),and the higher degree,the better in personality.Personality dysfunction of Students of secondary vocational was negatives correlated with their resilience (Pearson correlation coefficient was between -0.064 and -0.345 for each pair).The linear regression showed thatthepeerrelationshippredictedpersonalitydysfunctionofsecondaryvocationalstudents.ConclusionThe personality dysfunction of secondary vocational students is affected by their parental relationships,educational background of parents,grade and resilience.

Objective:To investigate the number of CD+68 cells in hepatocellular carcinoma (HCC),paraneoplastic tissues,cirrhosis tissues and normal liver tissues and their clinical significance.Methods:Surgical specimens from 60 cases of HCC,62 cases of cirrhosis and 23 cases of normal liver were investigated by immunohistochemical staining of CD+68with streptavidin-horseradish peroxidase detective system.Results:(1)The order of the mean number of CD+68cells in the tissues from the highest to the lowest was:paraneoplastic,cirrhosis,normal liver and HCC tissues(P〈0.01);(2)The number of CD+68cells in the tissues decreased successively with the decrease of HCC differentiation (P〈0.05);(3)There was no relationship between the number of CD+68cells in HCC and its clinical TNM stage;(4)The number of CD+68cells in the cases with metastasis within 15 months was significantly lower than that without metastasis (P〈0.05).Conclusion:The number of CD+68cells might be an important marker to estimate the immune status and a useful factor to predict the prognosis of HCC patients.