OBJECTIVE To give a general introduction to the infection in the hospital,and supervision to key departments in order to prevent nosocomial infection occurrence. METHODS A vertical analysis was made on the basis of the survey involving the following three periods: the first period covered the second half of the year 2000(from Jul to Dec 2000),the second period covered the second half of the year 2002(from Jul to Dec 2002),and the third period covered the second half of the year 2004(from Jul to Dec 2004). RESULTS The periodical supervision and the vertical analysis in the same period showed the following: the rates of the infected patients in the departments showing a tend to go on rising from 2000 to 2002,and showing a tend to decline from 2002 to 2004. CONCLUSIONS The control of using antibiotics must be emphasized and they should be applied in a scientific and reasonable way.The key points include the management of purchasing drugs,clinical indications and usages,supervise and news feedback,etc.All of these measures could prevent the occurrence of nosocomial infection effectively.

Objective To study the effects of rational emotive behavior therapy (REBT) in the rehabilitation of patients with spinal cord injury (SCI).MethodsA total of 300 SCI patients from six institutions were divided into a research group and a control group. Systematic rehabilitation was given to the patients of the control group, while systematic rehabilitation and REBT were given to the patients of the research group. All patients were followed up for 1 year. Psychological state, activities of daily living (ADL), and quality of life (QOL) were evaluated with a symptom check list (SCL-90), a modified version of the Barthel index (MBI) and the World Health Organization's quality of life assessment (WHOQOL-100).ResultsOne year after treatment, the improvement in QOL of patients in the research group was better, on average, than that in the control group. The differences were primarily in mental items. The ADL ability of patients in both groups improved, and any differences were not significant. The psychological state of patients in the research group had improved significantly 1 year after treatment, while the improvements in the control group were not significant on average, except in terms of interpersonal sensitivity.ConclusionREBT had little effect on the ADL ability of SCI patients, however, it improved their psychological state significantly, and thus improved their QOL.

Objective:To explore the effect of prospective nursing oriented to hypothermia prevention on the recovery of consciousness and stress response of general anesthesia patients in the Operating Room.Methods:The convenience sampling was used to select 120 surgical patients undergoing general anesthesia in Shanxi Provincial People's Hospital from June 2019 to December 2020. According to the operation time, the patients were divided into the control group and the observation group, each with 60 cases. The control group conducted conventional heat-preservation nursing, and the observation group carried out prospective nursing oriented to hypothermia prevention. The differences in perioperative stress indicators, recovery quality, and adverse reactions of anesthesia were compared between the two groups.Results:There was no significant difference in serum cortisol (COR) and norepinephrine (NE) before anesthesia and 12 hours after operation between the two groups ( P>0.05) . Serum COR and NE in the observation group were lower than those in the control group 30 minutes after the operation and 10 minutes after extubation, and the differences were statistically significant ( P<0.05) . The observation group's spontaneous breathing, recovery of consciousness, catheter removal, and Post-Anesthesia Care Unit (PACU) retention time were shorter than those of the control group, and the differences were statistically significant ( P<0.05) . The total incidence of adverse reactions of anesthesia in the observation group was lower than that in the control group also with a statistical difference ( P<0.05) . Conclusions:Prospective nursing oriented to hypothermia prevention can reduce the perioperative stress response of general anesthesia patients in the Operating Room, improve the quality of consciousness recovery, and reduce the adverse reactions of anesthesia.

Objective To reduce the incidence of muscle spasm during hemodialysis by using the management method of the quality control circle (QCC).Methods QCC team was founded to determine the theme and plan events. Brainstorming was used to develop countermeasures. Countermeasures implementation was divided into four stages and verification conducted, so as to ensure clear countermeasure effectiveness. The patients confirmed the effect and the team members performed self-evaluation.Results After QCC management mode, muscle cramps patient during dialysis incidence dropped to 2.3%, decreased significantly compared with that before implementing countermeasures (P＜0.05). After the implementation of quality control circle, circle members self-evaluation 8 content, in which seven scores were higher than the previous implementation with a statistically significant difference (P＜0.05).Conclusions The quality control circle pattern can significantly reduce the incidence of muscle spasms, improve the professional level as well as the ability to work in all the medical staff, and bring a new operating mode for future health care work.

Objective To illustrate the clinical and pathological features of Chinese upper tract urothelial carcinoma (UTUC) patients and to investigate the regional difference and the possible prognostic factors.Methods A retrospective study was performed on 2 628 patients from 9 centers of three different regions (Beijing:2 centers with 1 022 cases,Shanghai:1 center with 814 cases,Sichuan:6 center with 792 cases).The median age was 68 (range 20 to 93) and the mean age was 66.3.There were 1 447 male patients (55.1％) and 1 181 female patients (44.9％).The clinical information,pathological outcomes and prognosis were collected and analyzed based on South (Shanghai and Sichuan) and North (Beijing)region.Results The distribution of Ta + T1,T2,T3 and T4 was 914 (34.8％),715 (27.2％),857(32.6％) and 142(5.4％).Patients from North were more likely to be female (55.9％ vs.38.0％,P＜0.001) and suffer from ureteral tumors (43.4％ vs.35.9％,P ＜ 0.001);while in patients from South higher tumor stage(T3 or T4,42.5％ vs.31.0％,P ＜ 0.001),high grade(72.0％ vs.34.0％,P ＜0.001) and larger tumor size [(3.73 ±2.17) cm vs.(3.36 ±2.02) cm,P＜0.001] were more prevalent.Subgroup indicated that female patients in North had obviously lower tumor stage (T3 or T4,27.2％ vs.35.9％,P =0.014),while relatively higher tumor stage were noticed in female patients in South (T3 or T4,48.2％ vs.38.9％,P =0.004).The median follow-up was 41 (1-206) months,and 963 patients (36.6％) died including 815 (31.0％) died from cancer.In North female patients had better 5-year overall survival (75.5％ vs.62.2％,P ＜0.001) and cancer-specific survival (78.3％ vs.65.0％,P＜0.001),but in South gender had no impact on overall survival (58.5％ vs.60.1％,P =0.927) or cancer-specific survival (62.0％ vs.65.8％,P =0.345).Conclusions This study demonstrated that in Chinese patients with UTUC,those from North were featured for lower tumor stage and grade,higher proportion of females and females had better survival.High age,high tumor stage and grade,large tumor diameter,and the presence of lymph node metastasis or lymphovascular invasion were risk factors for poor prognosis in Chinese UTUC patients.

ObjectiveTo investigate the effects of Guizhi Fulingwan on oxidative stress and renal fibrosis in diabetic mice based on the nuclear factor E₂-associated factor 2/antioxidant response element （Nrf2/ARE） pathway， and to explore its mechanism of action. MethodA diabetic mouse model was established by feeding high-fat diet combined with intraperitoneal injection of streptozotocin. The diabetic mice were divided into a model group， a metformin group （250 mg·kg^-1）， and Guizhi Fulingwan low， medium， and high dose groups （400.4， 800.8， 1 601.6 mg·kg^-1）， with 10 mice in each group. Another 10 mice were included in a normal group. The treatment was conducted continuously for 8 weeks. Body mass and blood glucose were recorded， and the renal index was calculated. Triglyceride （TG）， total cholesterol （TC）， urea nitrogen （BUN）， serum creatinine （SCr）， superoxide dismutase （SOD）， and malondialdehyde （MDA） levels were measured. Pathological changes in renal tissues were observed using Hematoxylin-eosin， periodate-Schiff， and Masson staining. The protein levels of α-smooth muscle actin （α-SMA）， fibronectin （FN）， and transforming growth factor-β₁ （TGF-β₁） were detected by immunohistochemistry. The protein levels of Nrf2， Kelch-like ECH-associated protein 1 （Keap1）， SOD1， NAD（P）H single-nucleotide oxidase 1 （NQO1）， and heme oxygenase-1 （HO-1） were detected by Western blot. ResultCompared with the normal group， the model group showed elevated glucose， renal index， TG， TC， BUN， and SCr levels， thickened glomerular basement membrane， increased collagen fibers in renal tissues， decreased SOD activity， elevated MDA content， increased protein levels of FN， TGF-β₁， α-SMA， and Keap1， and decreased protein levels of Nrf2， SOD1， NQO1， and HO-1 （P<0.01）. Compared with the model group， the Guizhi Fulingwan and metformin groups showed reduced blood glucose， renal index， TG， TC， BUN， and SCr levels， improved renal histopathological injury， significantly increased SOD activity， significantly reduced MDA content， reduced protein levels of FN， TGF-β₁， α-SMA， and Keap1， and increased protein levels of Nrf2， SOD1， NQO1， and HO-1 （P<0.05， P<0.01）. ConclusionGuizhi Fulingwan can improve oxidative stress and inhibit renal fibrosis， and its mechanism may be related to the activation of the Nrf2/ARE signaling pathway.