Objective To evaluate the effect of comprehensive intervention measures on preventing and controlling surgical site infection (SSI)in patients undergoing total abdominal hysterectomy.Methods Patients undergoing total abdominal hysterectomy in a hospital between January 2011 and December 2014 were investigated retrospec-tively,patients in 2011 were as control group,from January 2012,a prospective monitoring on SSI was initiated, comprehensive intervention measures were taken,patients between January 2012 and December 2014 were as inter-vention group,SSI before and after the intervention was compared.Results A total of 1 052 patients undergoing to-tal abdominal hysterectomy were investigated,267 cases were monitored before intervention,25 patients (9.36%) developed healthcare-associated infection (HAI),12(4.49%)of whom were with SSI;785 cases were monitored af-ter intervention,13 (1 .66%)of whom were with SSI,incidence of SSI in 2012,2013,and 2014 were 2.31 %, 1 .89%,and 0.77% respectively,there was a decreasing tendency(χ2 =7.30,P <0.01 ).Conclusion Prospective monitoring on SSI and comprehensive intervention can reduce the incidence of SSI in patients undergoing total abdominal hysterectomy.

Objective To study the voice rest treatment after laryngomicrosurgery in patients with vocal fold polyps .Methods Eighty -five patients with vocal fold polyps were divided into two groups randomly :Group A (48 cases) and Group B ( 37 cases) ,receiving 1 or 2 weeks voice rest postoperation ,respectively .Vocal acoustic analy-sis and fiberlaryngoscopy were performed in all patients before the surgery and 1 ,2 ,3 and 4 weeks after surgery . Results When compared with the preoperative data ,there were no significant differences in jitter ,shimmer and NHR 1 week after surgery in patients of two groups (P>0 .05) .Two weeks after surgery ,all the parameters im-proved significantly in Group B(P<0 .05) ,but only jitter improved in Group A (P<0 .05) .All the data in two groups returned to normal 4 weeks after surgery .Laryngoscopic examination showed varying degrees of vocal fold hyperemia and edema one week after surgery ,which then gradually subsided and gone .At 4 weeks after surgery , the appearance of the operative vocal fold completely returned to normal .Conclusion Patients with vocal fold polyps should be treated with complete voice rest for 2 weeks after surgery ,followed by 2 weeks of relative voice rest .This is beneficial to the voice recovering and the wound healing .

Objective To study the changes and significance of the hyaluronic acid (HA) and collagen in the larynx of old guinea pig.Methods Six young guinea pigs (4 months old) and 6 old guinea pigs (2 years old) were selected as control group and aged group for this study (n=6 for each)The expressions of HA and collagen in the larynx of guinea pigs were detected using Alcian blue and Masson trichrome methods,respectively.The images were managed using Image-Pro Plus 6.0 For Window.Results The optical density (expression level) of HA in the larynx was lower in aged group than in control group (0.69 vs.0.80,F=13.45,P＜0.05).The optical density(expression level) of collagen in the larynx was higher in aged group than in control group (0.71 vs.0.63,F=9.56,P＜0.05).Conclusions The content of HA in larynx is decreased and collagen in larynx is increased in old guinea pig which may result in presbyphonia change through higher viscoelastic properties of vocal cords.

Objective To observe the clinical sedativelefficacy of Tianwang-Buxin Dan treating chronic obstructive pulmonary disease patients undergoing mechanical ventilation.Methods 97 patients with chronic obstructive pulmonary disease undergoing mechanical ventilation were randomly recruited into a treatment group (47 cases) and a control group (50 cases).The control group was treated with midazolam and fentanyl,and the treatment group were treated by Tianwang-Buxin Dan on the basis of the control group.The amount of medazolam and fentanyl,duration of MV,and incidence of side-effects such as hypotension,bradycardia,delirium,nausea,etc were observed in both groups.Results The expected sedative and analgesia scores were obtained in patients of both groups.Compared with the control group,the patients in the treatment group were easier to be aroused and be kept in sedation and analgesia state,besides the dose of midazolam (μg/kg·h-1) (9.51 ±5.87 vs 20.01 ±6.24,P＜0.01)and fentanyl (μg/kg·h-1) was significantly fewer (0.22 ±0.13 vs 0.32±0.12,P＜0.05),duration of MV (days) was shorter(7.13±6.25 vs 12.85±9.13,P＜0.01),duration of disable sedatives for extubating (hours)was shorter (4.35 ± 2.57 vs 8.79±4.02,P＜0.01),the rates of hypotensionand brdycarcardia were significantly lower,the rates of delirium and nausea were clearly lower(both P＜0.05)in the treatment group.Conclusion Sedative effect of Tianwang-Buxin Dan is satisfactory for patients with chronic obstructive pulmonary disease undergoing mechanical ventilation,with the property of easier arousal,lower hypotension rates,lower brdycarcardia rates,lower delirium rates nausea rates,and fewer dosage of midazolam (by 50％) and fentanyl (by 30％) administration.

Objective To investigate the effects of cardiopulmonary bypass (CPB) with mild hypothermia on the pharmacodynamics of rocuronium in infants undergoing cardiac surgery.Methods Fifty ASA Ⅰ or Ⅱ and NYHA class Ⅰ or Ⅱ infants,aged 6 months-3 yr,weighing6-15 kg,undergoing repair ofventricular septal defect or atrial septal defect under CPB,were randomly divided into 2 groups ( n =25 each):profound hypothermia group and mild hypothermia group.The target temperature was controlled at 28-30 ℃ during CPB in profound hypothermia group,and at 32-34 ℃ during CPB in mild hypothermia group.Neuromuscular block was assessed by TOF-stimulation of ulnar nerve using with TOF-Watch accelerometer.Anesthesia was induced with midazolam O.1 mg/kg,propofol 2 mg/kg,fentanyl 6-8 μg/kg and rocuronium 600 μg/kg,and maintained with intermittent iv boluses of fentanyl and midazolam.The patients was tracheal intubated and mechanically venti1ated when the maximal depression of T1 was achieved.PETCO2 was maintained at 30-40 mm Hg.When T1 returned to 75％ of the control twitch,rocuronium 200 μg/kg was injected intravenously.The onset time,maximal N-M block time,clinical muscle relaxation time,and recovery index were recorded before CPB,during CPB and after CPB.Results Compared with profound hypothermia group,the onset time,maximal N-M block time and clinical muscle relaxation time were significantly shortened during CBP in mild hypothermia group ( P ＜ 0.05).Conclusion Compared with profound hypothermic CBP,mild hypothermic CBP can shorten the onset time and muscle relaxation time of rocuronium in infants undergoing cardiac surgery.

China ; epidemiology ; Humans ; Occupational Diseases ; epidemiology ; prevention & control

[Objective]To investigate the diagnostic methods and clinical effects of the management of spondylolithesis with adjacent segment degeneration.[Method]Between October 2000 and October 2005,16 consecutive patients(3 males and 13 females) aging 42 to 76 years(mean 59.1 years) received instrumented lumbar interbody fusion procedure using traditional posterior approaches for spondylolithesis with adjacent segment degeneration.Lumbar functions were assessed using Prolo system.Preoperative and follow-up lateral lumbar radiographs were studied for reduction of spondylolithesis,disc heights,lumbar lordosis,fusion rates and complications.[Result]Fourteen patients were followed up,with an average duration of 28(16–53) months.Clinical outcomes in terms of Prolo system was 7 points in 3 patients,8 in 7 patients,9 in 2 patients,and 4 in 2 patients at 3 months after operation with 85.7% being graded as good or excellent.Seven points in 4 patients,8 in 6 patients,and 9 in 4 patients at last follow-up(graded as 100% good or excellent).Fusion rate was 66.7%(8/14)at 6 months and 92.9%(13/14)at 12 months after operation.Ten patients(71.4%) fully recovered from spondylolithesis,4 had partial reduction,and their reduction status was unchanged according to plain radiographs at 12 months and last follow-up.The operative wound healed without complications in all patients.The mean Lordosis was 26.64??6.67?,33.29??3.39?and 32.71??2.80?before and at 3-month,or last follow-up after operation.The mean of fused Lordosis was 15.64??6.21?,28.29??3.28?and 32.36??3.91?before at 6 months or at last time follow-up after operation.The disc heights were 6.54?1.13mm and 9.62?0.81mm before and after operation.Statistics showed significant difference(P

[Objective] To evaluate the histocompatibility of nano hydroxyapatite-zirconia composite bioceramic.[Methods]According to the standard of ISO 10993-1,cytotoxicity experiment,acute toxicity test,hemolysis test and in vivo implantation(90 days)test were conducted to evaluate the histocompatibility of nano hydroxyapatite-zirconia composite bioceramic.[Results]The score of cytotoxicity experiment was lower than grade I,and there was no significant inhibition of cell growth,no acute toxic reaction or hemolytic reaction.And the in vivo implantation met the requirements of the biological evaluation of implant materials.[Conclusion]Nano hydroxyzpatie-zirconia composite bioceramic showed a good histocompatibility.It has a broad prospect as a biomaterial scaffold in the bone tissue engineering.

Objective To optimize the extraction process of Euphorbia hirta L.by Central composite design/response surface methodology with ethanol by the ultrasonic extraction technology.Methods Based on the single factor experiment and central composite design-response surface methodology,the content of quercitroside was regarded as evaluation index,select ethanol concentration,extraction time,and solid-liquid ratio as three evaluation factors to achieve the purpose. Results The results indicated that the optimal extraction process was obtained as follows:10 times the amount of 60% ethanol under ultrasound for 2 times,50 min each;the average content of the quercitroside was 2.39 mg/g.Conclusion The method to optimize the extraction process is simple and reasonable.