Objective To explore influence of different positive end expiratory pressure(PEEP)level on ventilative efficincy of premature infant with respiratory distress syndrome(RDS).Methods Forty preterm infants who were diagnosed RDS and needed ventilation were randomly assigned to lower PEEP(0.49~0.59 kPa)and high PEEP(0.59~0.78 kPa)group.They were treated by ventilation and pulmonary surfactant(PS).When they were medically stable,blood gas was done at 15 min,2,6,12,24 h after ventilation.Then the ratio of pa(O2)/FiO2,oxygen index(OI),ventilation index were calculated.Result The ratio of pa(O2)/FiO2,OI,ventilation index were better in lower PEEP group than those in high PEEP group(Pa

Objective To explore the effects of dopamine and dobutamine on thyroid stimulating hormone(TSH),total thyroxine(T4) and growth hormone(GH) in preterm infants with hypotension.Methods Forty-seven preterm infants with hypotension were enrolled in the stu-dy,and 38 preterm infants remained hypotensive after two dose of isotonic saline solution,who were divided into two groups and assigned to receive dopamine or dobutamine.Drug infusion were all started at 4 ?g /(kg?min) and the dose increased by 2 ?g /(kg?min) in a stepwise fashion until either the mean blood pressure normalized or a maximal dose 20 ?g /(kg?min) was reached.Haemodynamic variables and se-rum levels of TSH,T4,and GH were assessed during the first 72 h of treatment and the first 3 d after stopping treatment.Microplate luminometer was used to test TSH,T4,GH levels.Results Necessary cumulative and mean drug doses and maximum infusion required to normalize blood pressure were significantly higher in the dobutamine group than those in the dopamine group(Pa0.05].Conclusions Dopamine and dobutamine both increase the syste-mic blood pressure,with higher drug doses in dobutamine group.Dopamine reduces levels of serum TSH,T4 and GH in preterm infants but such suppression is quickly reversed after treatment is stopped.

According to the investigation about the current ability of military hospitals to cope with bioterrorism , we suggest that military hospitals improve the capability for bioterrorism response based on the research above by satisfying mission requirements , combining peacetime with wartime , carrying out crisis management , classifying response and cooperating with local sectors .

Objective Evaluation of left ventricular ( LV) function has great clinical significance in patients with early chro-nic kidney disease (CKD).The study was to evaluate whether two-dimensional speckle tracking imaging (2D-STI) technique can offer additional information of cardiac dysfunction in early CKD patients . Methods Conventional echocardiography and 2D-STI echocar-diography were performed in CKD group of 20 patients at stage Ⅱ-Ⅲ and control group of 20 healthy volunteers .LV structure and function were evaluated by conventional echocardiography .Multidirectional strain , strain rate and LV twist parameters were analyzed by 2D-STI technique. Results There was no statistical difference in conventional echocardiographic parameters such as left atrial diam -eter, end-diastolic LV diameter and ejection fraction between CKD group and control group .By applying 2D-STI technique, CKD group had significantly decreased value of global longitudinal strain (-19.8 ±2.4)%and strain rate(-1.1 ±0.3)S-1 in comparison to control group(-22.6 ±2.1)%、( -1.8 ±0.2)S-1, along with significant increase in the values of maximum LV rotation (11.6 ± 4.4)°and LV twist(19.6 ±3.8)°in comparison to control group(8.2 ±3.7)°、(13.5 ±3.6)°(P<0.05).There was no differences in both global circumferential and radial deformation parameters as well as maximum rotation value of LV assist device between two groups(P>0.05). Conclusion 2D-STI can detect subclinical LV dysfunction sensitively in early CKD patients .

Objective To evaluate the mental health of medical workers, and develop an EAP suitable for heahhcare sector. Methods A 1-year EAP was implemented in a hospital in Beijing, in which SF-36 and JSS scales were used to study the health-related quality of life and job satisfaction of these workers. Results Work pressure is found to be the main source of pressure for medical workers, accounting for 63.7%. Scores of the group receiving EAP service are found to be significantly higher (P<0.01) in all dimensions (excepting work nature and supervisor dimension) of both SF-36 and JSS. Conclusions Medical workers are exposed to high pressure of work, having strong need for EAP service as result. EAP is an effective means to maintain mental health and improve quality of life and job performance, if applied widely.

Objective To investigate the causes and treatment measures of an outbreak of Norwegian scabies oc-curred in a hospital.Methods In May 2013,an outbreak of Norwegian scabies among health care workers(HCWs) occurred because of the misdiagnosis of a patient with Norwegian scabies,epidemiological investigation was carried out by healthcare-associated infection(HAI)control department,medical intervention and disinfection and isolation measures were performed.Results A total of 27 HCWs and patients’relatives developed Norwegian scabies.After active medical treatment,patients’condition improved;all appliances used by patients were cleaned and disinfected after being wrapped and sealed with plastic bags for one week.Epidemic trend of infection was under control and no new case was found.Conclusion With highly contagious,Norwegian scabies can be spread in local area,it is neces-sary to improve HCWs’diagnostic ability to this disease and take effective measures to prevent the epidemic once HAI occur.

Objective To assess the coronary flow reserve in the patients with systemic lupus erythematosus(SLE)by transthroracic echocardiography(TTE).Methods Coronary sinus blood flow of 24 SLE patients and 18 matched healthy controls were assessed by TTE.The coronary flow reserve was calculated as the ratio of hyperemic to baseline blood flow.Hyperemia was induced by intravenous administration of dipyridamole.Results Adequate recordings of blood flow in the coronary sinus under both conditions were obtained by TTE in all study subjects.Patients with SLE were found to have significantly decreased coronary flow reserve comparing with normal SUbiects(1.55±0.21 versus 2.51±0.33.P＜0.01).Conclusions Coronary flow reserve can be measured by TTE in SLE patients,Coronary flow reserve is impaired suggesting that SLE patients may have subclinical coronary artery disease.

Objective To assess the prevalence of hand hygiene compliance rates of health care workers (HCWs) at general hospitals in China in 2010-2012. Methods Literatures about hand hygiene compliance of HCWs from 2010 to 2012 were retrieved from China Biology Medicine disc (CBM),China National Knowledge Infrastructure (CNKI),Wan Fang database,VIP ,and PubMed database ,Comprehensive Meta Analysis V2 software and Stata 1 2 .0 software were adopted to conduct statistical analysis . Results Ninety literatures were selected with heterogeneity (Q= 48 118.32,P<0.01),random effect model was used. The overall hand hygiene compliance rate of HCWs was 47.83% (95% CI:43.27% -52.42% );When stratified by occupation group,the overall compliance rate of doctors,nur-ses,and unclassified HCWs was 40.36% (95% CI:35.42% -45.49% ),46.70% (95% CI:41.81% -51.65% ),and 40.72% (95% CI:27.75% -55.13% )respectively. According to subgroup analysis,there was no statistical difference in compliance rate between doctors and nurses(Q= 3.12,P>0.05);the compliance rate after patient contact was higher than before patient contact (54.33% [95% CI :44.76% -63.59% ]vs 20.21% [95% CI:14.12% -28.06% ])(Q= 32.59, P<0.01 );hand compliance rate from field observation was higher than from covert observation (70.91% [95% CI :70.71% - 71.10% ]vs 41.20% [95% CI:37.55% -44.94% ])(Q= 247.66,P<0.01).Conclusion The overall hand hygiene compliance rate of HCWs in 2010-2012 was low,in order to reduce the risk of healthcare-associated infec-tion,hand hygiene compliance of HCWs need to be increased .

OBJECTIVE:To study the effects of Tiaojing zhuyun capsules on the number of blastocyst implantation,estrogen, progestogen and their receptors(ER,PR)in mice with implantation dysfunction. METHODS:48 pregnant mice were randomly di-vided into normal control group (normal saline),pathological model group (normal saline) and Tiaojing zhuyun capsules group (24 g/kg),with 16 mice in each group. They were given relevant medicine intragastrically,once a day,for consecutive 3 d. On the 4th day,those mice were given mifepristone 0.1 ml subcutaneously to induce implantation dysfunction model except for normal control group. On the 5th day,the mice were sacrificed. The number of blastocyst implantation sites was observed. The serum lev-els of estradiol (E2) and progesterone (P) were determined by radioimmunoassay,and the expression of ER and PR protein were determined by immunohistochemistry. RESULTS:On the 5th day of pregnancy,the number of embryo implantation sites,serum levels of E2 and P and the protein expression of ER and PR in pathological model group were significantly lower than in normal con-trol group(P<0.05);the number of embryo implantation sites,levels of E2 and P,the protein expression of ER and PR in Tiao-jing zhuyun capsules group were significantly higher than in pathological model group (P<0.05). CONCLUSIONS:Tiaojing zhuyun capsules can effectively improve the serum levels of E2 and P,the protein expression of ER and PR,and increase the num-ber of blastocyst implantation sites in mice.

ObjectiveTo explore the influence factors of prognosis of spinal cord injury patients. MethodsFollow-up data of 121 cases with spinal cord injury was analysed with retrospective cohort study.ResultsThe highest recover rate was in the patients who accepted the special rehabilitation therapy,while that of recovering two class was in the patients who accepted the magnetic stimulation.Conclusions Special recovering cure and magnetic stimulation can surely promote recovery of spinal cord injury patients.