Objective To survey the point prevalence of healthcare-associated infection(HAI) in 13 tertiary hospitals in Dongguan,understand the occurrence of HAI in tertiary hospitals,so as to provide guidance for the prevention and control of HAI.Methods Through bedside investigation and medical record reviewing,HAI among inpatients in 13 tertiary hospitals in Dongguan at 0:00-24:00 of September 24,2014 were investigated.Results A total of 11 344 patients were investigated,379 patients developed 404 times of HAI,HAI rate was 3.34％,HAI case rate was 3.56％.Incidence of HAI in the intensive care unit was highest (12.82％).The main infection site was respiratory tract(n =173,42.48％).The usage rate of antimicrobial agents was 30.50％,most were for therapeutic use (including therapeutic+ prophylaxis) (n =2 545,73.55 ％)and single use (n =2 689,77.72％),pathogenic microorganism detection of specimens from patients receiving therapeutic antimicrobial use was 53.79％.A total of 299 strains of pathogenic orgamisms were detected from infected patients,the major were Escherichia coli (n =56,18.73 ％),Pseudomonas aeruginosa (n =54,18.06 ％),and Klebsiella pneumoniae (n =35,11.71 ％),92 strains of multidrug resistant organisms(MDROs) were isolated,accounting for 30.77％ of total isolated pathogens.Conclusion The basic characteristics of HAI in tertiary hospitals in this city were preliminarily investigated,identification of high risk departments,high risk population,and high risk links should be strengthened,HAI prevention and control measures should be implemented.

ObjectiveTo describe self efficacy,pregnancy pressure and serum cortisol levels during late pregnancy period in primiparas and explore the mediating effects and regulating effects of self efficacy between pregnancy pressure and serum cortisol levels. MethodsBy convenient sampling,General Selfefficacy Scale and Pregnancy Pressure Scale were conducted to estimate the self-efficacy and pregnancy pressure in primiparas.Maternal venous blood was collected to measure cortisol levels. ResultsThe selfefficacy was positively related to pregnancy pressure and cortisol levels.Self-efficacy has acted partial mediating effects and regulating effects between pregnancy pressure and cortisol levels in primiparas,the mediating effect to the total effect was about 32.6％. ConclusionsSelf-efficacy has acted partial mediating effects and regulating effects between pregnancy pressure and cortisol levels in primiparas.

OBJECTIVE: Understand the changes before and after treatment in patients with severe OSAHS serum S100β protein, NSE levels and cognitive function. To investigate the molecular mechanisms of cognitive dysfunction in patients with severe OSAHS. Serum S100β protein, NSE levels and cognitive function were examined before and after the therapy. METHOD: Select one hundred patients diagnosed as severe OSAHS were included, by polysomnography (PSG) diagnosis of severe OSAHS patients. Determination of serum S100β protein, and NSE levels and theat the same time be MoCA score were checked at after the day after admission, CPAP treatment for the 7th days after CPAP treatment and the 90th day after, comprehensive treatment in these patients for 3 months. Assessment of severe OSAHS patients with serum S100β protein, NSE basic level and MoCA score situation. Comparison of three groups serum S100β protein, NSE levels and MoCA score changes. Serum S100β protein, NSE detection assay (ELISA) method using enzyme-linked immunosorbent. RESULT: (1) Severe OSAHS patients with serum S100β protein, and NSE levels in severe OSAHS patients were positively correlated with AHI, but negatively correlated with lowest oxygen saturation (LSaO2); (2) MoCA score in patients with severe OSAHS was significantly negatively correlated with AHI, but positively correlated with LSaO2; (3) S100β protein, NSE levels were negatively correlated with MoCA score; (4) Compared with admission, serum S100β protein, and NSE levels in these patients have declined after 7 days CPAP therapy, compared with admission the difference was statistically significant (P < 0.05). After 3 months of comprehensive treatment, patients' serum S100β protein and, NSE levels were significantly decreased, compared with the admission and the 7th days after CPAP treatment. The difference was statistically significant (P < 0.05). (5) After CPAP treatment for 7 days, the MoCA scores were slightly higher, but have there was no statistically significant difference compared with the admission (P > 0.05). After 3 months of comprehensive treatment, MoCA score improved significantly, compared with the admission and 7 days after CPAP treatment the difference was statistically significant (P < 0.05). CONCLUSION Comprehensive treatment can reduce serum S100β protein, and NSE levels, and improve MoCA score. Disease severity in patients with OSAHS have a correlation some relative.with the serum S100β protein, NSE levels and MoCA score. Long-term hypoxemia and the structure of sleep disorders may be the cause of elevated serum S100β protein, NSE levels elevated and causes of cognitive dysfunction. Comprehensive treatment can improve patient hypoxemia, correct disorders of sleep structure ,and can improve cognitive function and to improve the quality of life of patients.
Cognition Disorders ; blood ; etiology ; Continuous Positive Airway Pressure ; Humans ; Polysomnography ; Quality of Life ; S100 Calcium Binding Protein beta Subunit ; blood ; S100 Proteins ; blood ; Sleep Apnea, Obstructive ; blood ; therapy

Objective To observe the efficacy of open - door expansion laminoplasty in treatment of 36 cases with cervical stenosis. Methods 36 cases with cervical stenosis were all carried out open - door expansion laminoplasty. Then the efficacy and JOA17 scores were observed. Results 36 patients were followed up, the surgery fine rate was 85% ,JOA17-score of peroperation and postoperation was 5.23 and 10. 25 respectively. Conclusion The open - door expansion laminoplasty was a safe and effective surgery methods in treatment of cervical stenosis

Objective To investigate the effeit of Reconstruction of tantalum metal rod implantation in the treatment of early ischemic necrosis of femoral head( Steinberg Ⅰ～Ⅱ period) ,to explore the early femoral head ischemic necrosis of minimally invasive treatme(n)t. Method 24 patients( Steinberg Ⅰ～Ⅱ period) using C-arm fluoroscopy machine,under the greater trochanter through the neck hole to avascular necrosis zone,the first zone of the medullary sclerosis core decompression, re-implantation of tantalum rod to the subchondral bone is about 0.5 cm, through the Harris score before and after surgery for comparison. Results After follow-up 9(2 ～ 12) months,preoperative pain and function were significantly limited nuitigation. The excellent rate was 83% after opertion. MRI manifestations in patients with stable,non-ischemic necrosis increased performance. Conclusion Core decompression can significantly reduce the pressure on the femoral head hardening region, tantalum rod weight-bearing area of femoral head implant provides a structural support for subchondral bone. This method has the characteristics decompression,structural support,minimally invasive,it is worth for clinical use.

OBJECTIVE: As a subtype membrane receptor of tumor necrosis factor alpha, not much is known about the link between the soluble TNF receptor-I and obstructive sleep apnea hypopnea syndrome. We hypothesized that the TNF receptor might play an important role in the inflammation in patients with OSAHS, moreover this study was undertakan to investigate the effects of multimodality therapies on its periphery blood level. METHOD: Seventy-seven adults with habitual snoring and mean age of 34.9 +/- 11 years old consented to participate in the study. All participants were studied with overnight polysomnography, physical examination and a blood crew at baseline. According to the severity of OSAHS, they were categorized into three groups and one control group. Moderate and severe OSAHS groups returned for a repeat test of polysomnography and a blood crew at 3 months after the ENT surgery or continuous positive airway pressure (CPAP). serum levels were measured by using an immunoluminometric assay kit. RESULT: (1) Compared with control non-OSAHS group, serum sTNF-R I levels prior to treatment in OSAHS groups were significantly greater, with a mean serum levels at (742 +/- 258 & 340 +/- 102) pg/ml (P < 0.05), respectively. (2) Plasma solube tumor necrosis factor receptor-I responsed sensitively to the effect of comprehensive therapies when we compared its prior treatment levels with post ones. (3) Analysis was used to assess the associations adjusting for age, gender, BMI and weight ,a positive assosiation were found between apnea-hypopnea index (AHI) and sTNF-R I (r = 0.646, P < 0.01) a negative assosiation were found between lowest nadir oxygen saturation (LSaO2) and (r = 0.522, P < 0.01). CONCLUSION ln summary, independent of age, gender, BMI and weight ,our datas suggest a relationship can be found between the the severity of OSAHS and periphery blood level of soluble TNF receptor-I. Comprehensive therapies is effective in changing sTNF-R I. sTNF-R I may be recommended as a Inflammation factor of OSAHS.
Adult ; Biomarkers ; blood ; Continuous Positive Airway Pressure ; Female ; Humans ; Male ; Middle Aged ; Polysomnography ; Receptors, Tumor Necrosis Factor ; blood ; Sleep Apnea, Obstructive ; blood ; therapy ; Snoring ; blood ; Tumor Necrosis Factor-alpha

Objective To investigate the influence on developmental potential of frozen-thawed rabbit oocytes with double assisted activation followed by intracytoplasmic sperm injection (ICSI). Methods A total of rabbit oocytes were collected and thawed after vitrification cryopreservation. Among all oocytes were cultured for 1 hour followed by ICSI. 156 Survived oocytes were divided into 5 groups randomly. I0634 single activation: 30 oocytes were added with calcium ionomycin ( I0634 ) at 5 μmol/L for 5 minutes;SrCl2single activation: 26 oocytes were added with strontium chloride at 10 mmol/L for 10 minutes;10634 double activation: 33 oocytes were activated by I0634 twice;SrCl2 double activation: 28 oocytes were activated by strontium chloride twice. Control group: 39 oocytes were not added with any activators. The rate of fertilization, cleavage and blastocysts formation were observed and compared between various groups. Result The rates of fertilization, cleavage and blastocysts formation were in group of SrCl2 single activation were higher than those of I0634 single activation group without statistical difference (54% vs. 33%, 27% vs. 17%, 8% vs. 3%, P <0.05 ). However, those above rates in double activation by I0634 were higher significantly than those of single I0634 activation (82% vs. 33%, 55% vs. 17%, 15% vs. 3%, P < 0.05). The rates of fertilization (61%) was higher and the rate of cleavage (21%) and blastocysts formation (7%) were lower in group of SrCl2 double activation in comparison with group of SrCl2 single activation without reaching statistical difference (P<0.05 ). Notably, the rates of fertilization, cleavage and blastocysts formation in I0634 double activation group were higher than those in group of SrCl2 double activation with statistical difference (82% vs. 61%, 55% vs. 21%, 15% vs. 7%, P<0.05). Conclusion It might enhance the potential of fertilization of oocytes and early embryo development treated by double activation following ICSI, however, those activated oocytes demonstrate rapid cleavage.

0bjectlve To examine the metaphase II spindle and chromosome configurations of human oocytes cultured for different times after thawing.MethodsUsing slow.cooling and raid—thawing protocol combined with 0.3 mol/L sucrose and 1.5 mol/L 1,2-propanedio 1(1,2-PROH)to cryoprotect human mature oocytes(n=102),the 64 survival oocytes without abnormal zona pellucida and cytoskeletal were randomly assigned to three groups after thawing:group A:culture 1 hour(n=20),group B:culture 3 hour(n=22),group C:culture 5 hours(n=22),the flesh oocytes served as control group(n=18).Immunocytochefifical staining and fluorescence microscopy were used to assess the morphology of the metaphase II spindle and chromosome.Results(1)The normal spindle rates of groups A,B and C were 10％(2/20),46％(10/22)and 41％(9/22)respectively,significantly decreased compared with control group(83％,15/18;P<0.05).The rates of absent spindle in group A(45％,9/20)was significantly higher than control group(6％,1/18;P<0.01).Also,the rates of absent spindle in group A was higher than groups B(14％,3/20)and C(14％,3/20;P<0.05).However,no significant differences were observed in groups B and C(P>0.05).(2)A significant increase in abnormal chromosome rate was observed in group A(30％,6/20)compared to groups B(68％,15/22),C(64％,14/22)and control group(78％,14/18;尸<0.05).No differences in chromosome morphology were observed in groups B,C and control group(P>0.05).Conclusions The cryoproteetant protocol leads to a deleterious effect on the organization of the meiotic spindle and chromosome at MI stage.The 3—5 hours post—thawing incubation could permit restoration of the meiotic spindles and chromosome.

Objective To investigate the feasibility of simplified intensity-modulated radiotherapy (sIMRT) and concurrent chemotherapy against neck and upper thoracic esophageal carcinoma with lymph node metastasis.Methods sIMRT plans were designed for 44 patients of neck and upper thoracic esophageal carcinoma with lymph node metastasis, 20 of which underwent high dose sIMRT (hsIMRT group) and 24 underwent conventional dose sIM RT (csIMRT group).Three target volumes were defined:PGTVnd, target volume of lymph node lesion, irradiated to 68.1 Gy ( 2.27 Gy × 30 fractions ) for the hsIMRT group, and 60 Gy (2.0 Gy ×30 fractions) the csIMRT group; PTV1, the target volume of primary lesion, to be irradiate to 63.9 Gy (2.13 Gy × 30 fractions) for the hsIMRT group and 60 Gy (2.0 Gy × 30fractions) for the csIMRT group; PTV2 , the prophylacticly irradiated volume, to be irradiated to 54 Gy (1.8 Gy ×30) for both groups.The sIMRT plan included 5 equiangular coplanar beams.All patients received DDP + 5-FU regimen concurrently with radiotherapy at 1 -5 d and 29- 33 d, respectively.Chemotherapy was repeated for two cycles 28 days after the radiotherapy was finished.Results The treatment was completed for all patients within 6 weeks.During the treatment only one patient with grade 3 acute bronchitis was observed in the hsIMRT group.The complete response (CR) rate for the lymph node lesion of the hsIMRT group was 75% ( 15/20 ), significantly higher than that of the csIMRT group [45.8% ( 11/24), x2 = 3.84, P ＜ 0.05].The 1-, 2-, and 3-year progression-free survival rates of the hsIMRT group were 60%, 40%, and 25% , respectively,all significantly higher than those of the csIMRT group (41.7%, 25%, and 8.3% respectively, x2 = 4.11,P ＜ 0.05).However, there were not significant differences in the total survival rate, and the CR and PR of the esophageal lesion between these 2 groups.The major toxicity observed was grade Ⅰ -Ⅱ leukoctyopenia.Conclusions sIMRT generates desirable dose distribution for neck and upper thoracic esophageal carcinoma.hsIMRT has a better short-term efficacy than csIMRT.High dose radiotherapy toward metastatic lymph nodes helps increase progression-free survival.

Objective To analyze and compare efficacy and safety of different chemotherapy regimens in the treatment of elderly patients with advanced gastric cancer. Methods 60 elderly patients admitted to our hospital with advanced gastric cancer were selected as research subjects , and divided into experimental group and control group depending on the treatment of chemotherapy. The experimental group were treated with Gio oxaliplatin (SOX), and patients in the control group accepted Olivier Elizabeth, leucovorin and fluorouracil (FOLFOX6) treatment. Compare and analyze the efficacy of the two groups after two cycles of therapy. Results By chemotherapy, recent efficiency and disease control rate were not significantly different (P>0.05) between the two groups;and there was also no significant difference in the incidence of adverse reactions,such as adverse reactions, fatigue weakness, gastrointestinal reactions, hand-foot syndrome, oral mucositis (P > 0.05). Conclusion The efficacy was equivalent between FOLFOX6 chemotherapy SOX test group and the control group in the treatment of elderly patients with advanced gastric , and there was no significant difference in the incidence of adverse reactions.