Objective To apply cervical pedicle screw system (CPSS) to treat cervical disorders and discuss its surgical indications, techniques and clinical effectiveness. Methods A total of 52 patients with middle and lower cervical spine lesions who underwent cervical transpedicular fixation were analyzed retrospectively. There were 41 males and 11 females aging from 16 to 62 years. The diagnosis of the patients were fractures and dislocations of cervical spine accompanied by complete paralysis (28 cases) or incomplete paralysis (19 cases) in 47 cases, and metastatic bone tumor in 5 cases. Prior to surgery, anteroposterior and lateral radiographs, CT scan through bone windows, and/or magnetic resonance images were carried out in all patients. During surgery, all screws were inserted into the pedicle under the guidance of lateral or oblique image intensifier to confirm the direction and insertion depth of screws. In 7 to 14 days after surgery, physical examination and roentgenograms evaluations were performed in all patients, and CT scans were obtained in 31 patients, the location of screws were evaluated with the radiographic examinations and CT scan. The follow-up period averaged 13 months (range, 1 to 36 months) in 38 patients. The authors experiences in achieving accurate pedicle screw insertion was introduced, the clinical value of using cervical pedicle screw system to manage cervical lesions was summarized, the possible complications of CPSS were analyzed, the candidates of using CPSS were discussed as well. Results Pedicle screws were inserted successfully in all cases, 9 cases were found to have nerve irritating symptoms by 10 pedicle screws when which were introduced into pedicles, however, by changing the direction of the screws, all symptoms disappeared and screws were successfully inserted. Postoperative radiographic evaluation confirmed proper insertion of screws except 2 screws perforating the lateral pedicle wall but without injury of the vertebral artery demonstrated on CT scans. In the followed-up, no screw breakage and loosening was observed. By applying distractive force between the screws placed into pedicles, the space between the affected vertebrae and discs could be increased, displaced anterior fragments of bone or disc could also be indirectly reduced from the spinal canal, and additional anterior decompression interventions might be avoided. Conclusion CPSS can be considered as one of alternative in posterior cervical internal fixation systems. However, specific caution must be taken. The candidates of utilizing CPSS should be properly selected.

Objective To train health care workers (HCWs)by method of conventional training plus survey of hand contamination status,the influence of two kinds of methods in hand hygiene compliance of HCWs was evalua-ted.Methods From November 2013 to April 2014,all HCWs in a cardiovascular internal medicine department were as trained subjects,they were divided into two groups (trial group and control group).Hand hygiene compli-ance status was investigated 1 month before training.In the first month after training,conventional training method was adopted by both groups,from the second to fifth month,conventional training plus hand contamination survey was adopted by trial group,hand hygiene compliance between two groups were compared.Results Hand hygiene compliance rates of trial group and control group was 42.63% (107/251 )and 41 .80% (102/244)respectively be-fore training,there was no significant difference(P >0.05 ).In the first and second month after training,hand hygiene compliance rate of trial group was 55.70% (132/237)and 63.11 % (154/244)respectively,control group was 56.52% (130/230)and 62.61 % (149/238)respectively,compared with pre-training,the differences were sig-nificant (both P <0.05),but the difference was not significant between two groups(P >0.05);From the third to fifth month,hand hygiene compliance rates of trial group was 60.73%(150/247),61 .44%(145/236),and 61 .22%(150/245)respectively,control group was 51 .68%(123/238),51 .02%(125/245 ),and 52.32% (124/237)respec-tively,there was significant difference between two groups(P <0.05).Conclusion Conventional training combined with survey of hand contamination status can promote hand hygiene compliance of HCWs.

Objective To study the influence of long-term home noninvasive positive pressure ventilation (HNPPV) on respiratory muscle strength in patients with stable severe chronic obstructive pulmonary disease (COPD).Methods Sixty-four patients with stable severe COPD discharged from Huabei Oil-field Hospital,Renqiu,Hebei were divided into two groups,one (n=24) with HNPPV plus conventional therapy,and the other (n=40) with conventional therapy plus long-term oxygen therapy as controls.All parameters were followed-up for one-year and compared for the two groups,including maximal iuspiratory pressure (MIP),transdiaphragmatic pressure (Pdi),maximal transdiaphragmatic pressure (Pdimax),ratio of Pdi/Pdimax,arterial partial pressure of carbon dioxide (PaCO2),forced expiratory volume in one second (FEV1),6-min walking distance (6MWD),mortality and re-hospitalization rate.Results Age,gender,course of the disease,body mass index (BMI),arterial PaCO2,PaO2,MIP,Pdi,Pdiraax,ratio of Pdi/ Pdimax,FEV1,ratio of FEV1/FVC%,6MWD and re-hospitalization rate of the patients between the two groups were all comparable (P>0.05).In one-year follow-up,PaCO2averaged (52±8)mm Hg,MIP (64±7) cm H2O,Pdi (33±5) cm H2O,Pdimax (101±9) cm H2O,Pdi/Pdimax (0.31±0.04),FEV1 (35±4) %,FEV1/FVC% (44±4) %,6MWD (272±26) m and (2.6 ± 0.8) admissions per year in the HNPPV group,significantly different from those in the control group [ (57 ± 6) mm Hg,(59 ± 6) cm H2O,(31±4) cm H2O,(84±7) cm H2O,(0.35±0.05),(33±3)%,(41±4)%,(212±28) m,and (3.7±0.8) admissions per year] (P<0.05).One death was observed in the HNPPV group (1/24) and three in the control group (3/4 0) in one - year follow - up,with no statistically significant difference (X2=0.00,P>0.05).Conclusions Long-term use of HNPPV for patients with stable severe COPD could efficiently improve their respiratory muscle strength and endurance,thus improving their pulmonary ventilation and treatment efficcacy.