OBJECTIVE To strengthen the hospital infection control and the link management, and to improve the medical care and nursing quality. METHODS The main methods were to strengthen the organization leadership, set up and enhance the management system of infection; strengthen the continuing education about the hospital infection knowledge, control the hospital infection, and standardize medical personnel′s hand hygiene; choose the correct washing and maintenance method for the apparatus and instruments; and strengthen the management of the medical wastes. RESULTS After that to set up the management of each link, eliminate the dangers in medical action, improve the antiseptic quality, and decrease the rate of hospital infection. CONCLUSIONS The hospital infection controls and the link management are two of the important indexes of appraising the management level of the hospital, and it is the important guarantee of improving medical care and nursing quality and supporting the medical treatment′s security.

OBJECTIVE To investigate the tendency of bacterial distribution and resistance of hospitial infections,and to provide the reference for the clinical treatment and infection control in hospital.METHODS Bacteria isolated from patients in our hospital from Jan 2004 to Dec 2005 were identified by ATB expression,and bacterial susceptibility tests were performed on strains using Kirby-Bauer method.RESULTS A total of 3066 pathogens strains were isolated,among them 927 strains were Gram-positive cocci(30.2%).The most common pathogens of them were Staphylococcus.Meticillin resistant strains of Staphylococcus aureus and coagulase negative Staphylococcus(CNS) accounted for 69.0% and 77.6%,respectively.In our data,no vancomycin resistant S.aureus were isolated.There were 2134 strains of Gram-negative bacilli(69.6%),the most common pathogens of them were Pseudomonas aeruginosa,Escherichia coli,Klebsiella pneumoniae,Acinetobacter baumannii and Enterobacter cloacae.The ESBLs producing strains of E.coli and K.pneumoniae accounted for 30.1% and 40.1%,respectively.The highest susceptible to Gram-negative bacilli was carbapenem,then were cefoperazone/sulbactam,piperacillin /tazobactam and cefepime.Mainly pathogenic bacteria were multi-resistant to some antibiotics.CONCLUSIONS Drug resistance of the nosocomial infection bacteria is a serious problem.It's important and urgent to carry out surveillance of bacterial resistance for appropriate using of antibiotics and effective controlling nosocomial infections.

OBJECTIVE To investigate the tendency of bacterial distribution and drug resistance of pathogens in department of respiratory medicine,then instruct clinical application of antibiotics reasonably.METHODS By the retrospective methods,we analyzed the pathogens isolated from the sputa of the hospitalized patients with lower respiratory tract infection in the department of respiratory medicine from Jul 2007 to Jun 2009 and their drug resistance.RESULTS A total of 1508 strains of pathogens were isolated,Gram-negative bacilli were 47.3%,The most common pathogens of them were Pseudomonas aeruginosa(15.6%).The rate of the ESBLs-producing strains of Escherichia coli and Klebsiella pneumoniae were 41.0% and 35.8%,respectively.Fungi were 44.1%.And all the fungi were sentive to amphotericin B,fluconazole and ketoconazole.Gram-postive cocci accounted for 8.6%.The most common pathogen of Gram-postive cocci was Staphylococcus.Meticillin resistant strains of Staphylococcus aureus accounted for 62.4%.CONCLUSIONS The drug-resistance of pathogenic bacteria due to nosocomial infection and community-acquired infection in respiratory medical ward is increasing year-by-year.It is necessary to continuously monitor drug-resistance and rationally use antibiotics.

[Summary] Microcephalic or Majewski's osteodysplastic primordial dwarfism type Ⅱ ( MOPD Ⅱ) is an extremely rare genetic disease mainly caused by pericentrin ( PCNT) gene mutations. This paper reported one 13-year-old boy, who was admitted because of the slow growth for more than 13 years and deepened skin color over six months. He was diagnosed as MOPD Ⅱ associated with a combination of growth hormone deficiency, type 2 diabetes, hypertension, acanthosis nigricans, multiple café-au-lait spots. On magnetic resonance imaging of brain, no vascular malformations such as aneurysms were shown. There were novel compound heterozygous mutations of PCNT gene in the patient, with the nonsense mutations of c. 502C > T ( p. Gln168 * heterozygous variation) and c. 3103C > T (p. Arg1035* heterozygous variation). His father carried a nonsense mutation c. 3103C > T ( p. Arg1035 *heterozygous variation ) and his mother had a nonsense mutation c. 502C > T ( p. Gln168 * heterozygous variation). After treatment with metformin for three months, his blood glucose returned to normal, and acanthosis nigricans was improved. It seems critical to evaluate the abnormal condition of blood vessels regularly for MOPD Ⅱpatients with PCNT gene mutations.

Purpose To investigate the diagnostic value of gray-scale ultrasound on ovarian cystic teratoma.Materials and Methods 83 patients with primary diagnosis of ovarian cystic teratoma underwent gray-scale ultrasonography. The ultrasonic images were compared with postoperative pathologic results. Results 91 cases of 83 lesions were detected. The ultrasonic features were categorized into 6 types: cystoid, solid-like, intracystic dough sign, intracystic hair-ball, intracytic fat-fluid level, and intracytic cluttering sign. The diagnose accordance rate for each sign was 81.0%, 77.8%, 96.2%, 100% and 70.0% respectively. The diagnose accordance rate of ultrasonic diagnosis compared with pathologic results was 89.0% (81/91), and misdiagnosed rate and rate of missing diagnosis was 11.0% (10/91). Conclusion The ultrasonic features of ovarian cystic mature terotoma were of importance diagnostic value, whereas differentiation with ovarian chocolate cysts and ovarian mucus-cystic adenoma should be made cautiously.

The changes of intracoronary electrocardiogram (IC-ECG) and surface electro-cardiogram (S-ECG) were recorded simultaneously during percutaneous transluminal coronary angioplasty(PTCA) in 33 cases of coronary heart diseases with 41 vessel lesions. The results sug-gested that ST-segment change rate on IC-ECG(90. 2%) was higher than that on S-ECG(56%). ST-segment elevation on IC-ECG was earlier and more significant than that on S-ECG. The IC-ECG appeared to be more sensitive than S-ECG for detecting myocardial ischemia. The technique for recording IC-ECG is simple and it can help to perfome the PTCA successfully.

Objective To investigate the effect of emergency nursing pathway in emergency treatment of patients with questionable sources. Methods A clinical nursing pathway for the treatment for patients with questionable sources was formulated. From February to December 2014, 78 patients with questionable sources treated by clinical nursing pathway were selected as the observation group. From January to November 2013, 75 patients with questionable sources treated by routine nursing care methods were selected as the control group. Differences were compared in duration of staying in the emergency department, nursing complication and fees paid rate between the two groups. Results For the average duration of staying in the emergency department, the observation group was lower than that in the control group [19.35%(9.08) vs. 19.90%(25.20), P< 0.05)]. For the nursing complication rate, the observation group was significantly lower than that of the control group [1.28%(1/78) vs.10.67%(8/75), P<0.05]. For the fees paid rate, the observation group was significantly higher than that in the control group [64.10%(50/78) vs. 33.33%(25/75), P<0.01]. Conclusions By the emergency nursing pathway, emergent patients with questionable sources will be treated with satisfactory result in the shortest time.

Objective To analyze the clinical feature, diagnosis and treatment of Alstrom syndrome. Method The clinical data of a case of Alstrom syndrome and the result of her ALMS1 sequencing by the two generation sequencing were retrospectively reviewed. Results The 12 year and 10 month old female suffered from dilated cardiomyopathy, obesity, optic nerve diseases, sensorineural hearing loss, high blood glucose and irregular menstruation since one month of birth. Laboratory examination showed she had high testosterone level, hyperglycemia, hyperlipidemia and fatty liver. High-throughput sequencing confirmed there was ALMS1 gene mutation which includes hybrid frameshift mutations of c.5418delC and p.Y1807Tfs*23, and heterozygous nonsense mutation of c.10549C>T and p.Q3517*, and c.5418delC was a new variation reported for the first time. Conclusion Alstrom syndrome is an autosomal recessive genetic disease, which is characterized by multiple organ dysfunction and metabolic syndrome, and can be diagnosed by gene detection.

Objective To investigate the accuracy of 320-slice row CT system for the detection of coronary artery disease(CAD)in high pre-test probability population without heart rate/rhythm control.Methods Thirty patients with a high pre-test probability of CAD underwent 320-slice row CT without preceding heart rate/rhythm control.Invasive coronary angigraphy(ICA)served as the standard reference.Data sets were evaluated by 2 observers in consensus with respect to stenoses≥50% decreased diameter.The sensitivity,specificity,positive predictive value(PPV),negative predictive value(NPV)and Youden index were analyzed;the impact of heart rate and calcification on image quality as well as diagnostic accuracy were also analyzed by Chi-square test Results Mean heart rate during scanning was 73.7±15.4 beats per min(bpm),and median(QR)of Agatston score of segment was 45.6(181).On a per-segment analysis,overall sensitivity was 96.1%(74/77,95%CI:89.03%-99.19%),specificity was 98.3% (337/343,95%CI:96.23%-99.36%),PPV was 92.5% (74/80,95%CI:84.39%-97.20%),NPV of 99.1% (337/340,95%CI:97.44%-99.82%)and the Youden index was 0.94.In both heart-rate subgroups(242 in heart rate＜70 bpm group,169 in heart ratet≥70 bpm group),diagnostic accuracy for the assessment of coronary artery stenosis was similar(P＜0.05).The accuracy and the quality score of the subgroup Agatston score≥100 were lower than that of the subgroup Agatston score＜100;however,the difiercnce of results between 320-slice row CT and ICA was not significant(P＜0.05).Conclusion 320-detector row CT can reliably detect coronary artery stenoses in a high pre-test probability population without heart rate/rhythm control.

Objective To explore the clinical manifestation and gene mutation of primary renal glucosuria (PRG). Methods The clinical data and gene detection results of a child with PRG were analyzed. Results A girl aged 2 years and 10 mouths had glucose ++++ by urine dipstick analysis and 22.4 g of the 24 h urine glucose. Her father was urine glucose positive. Genome DNA was extracted from peripheral blood of the girl and her parents, SLC5A2 gene were amplified by PCR for sequencing, including exons and splicing areas. The results showed a homozygous point mutation (c.127-16C>A) in girl, and both of her patents had the same heterozygous mutation. This mutation had been classified to pathogenic mutations by ClinVar data base. Conclusions The diagnosis of PRG is confirmed in this child and SLC5A2 gene mutation is the cause.