OBJECTIVE:To study the risk factors of nosocomial infection(NI)in surgery of a hospital.METHODS:By a retrospective study,a total of 835 surgical medical records in 2007 of a hospital were analyzed statistically.RESULTS:Of the 835 cases reviewed,95 had NI which was related to 13 factors(P

Evidence-based medicine(EBM) is a new medical model,which is an inevitable tendency of modern clinical education.This article analyses the advantages and disadvantages of the evidence-based medical education(EBME) and emphasizes the great significance of EBM in paediatrics teaching.

Objective To investigate the risk factors for heart failure in pregnant women with heart disease. Methods A retrospective analysis was made from 340 cases of pregnant women with heart disease in our hospital from January 2008 to December 2013. The pregnant women who presented heart failure were categorized in the observation group (n=65), and others were in the control group (n=275). Data was used to analyze by univariate and multivariate logistic regression for heart failure in pregnant women with heart disease. Results The total 340 cases of heart disease included 132(38.8%) of congenital heart disease, 86(25.3%) of rheumatic heart disease, 63(18.5%) of arrhythmia, 33(9.7%) of hypertensive heart disease and 26(7.6%) of peripartum cardiomyopathy. 65 cases (65/340, 19.1%) presented with heart failure, there were 4 cases resulted in death (1.2%). Multivariate logistic regression analysis showed that age≥35, the baseline parameters of New York Heart Academy (NYHA)≥Ⅱ, pulmonary artery pressure>50 mmHg (1 mmHg=0.133 kPa), baseline heart rate>100 bpm, cardiac events occurred before pregnancy were the independent risk factors for heart failure. Prenatal counseling and antenatal examination were the protective factors for heart failure. Conclusions There are a variety of influencing factors for the heart failure in pregnant women with heart disease. It is necessary to take targeted intervention measures in response to the influencing factors so as to reduce the development of heart failure.

Abortion, Induced ; Adult ; Chorionic Villi ; blood supply ; Endarteritis ; pathology ; Female ; Humans ; Pregnancy ; Pregnancy Complications ; pathology ; Stillbirth

Shoulder-hand syndrome is a common complication in patients with stroke.This paper would review the therapies or approaches for the shoulder-hand syndrome.

Objective To analyze the clinicopathologic features of primary cutaneous CD30 positive lymphoproliferative disorders. Methods A clinical, pathological and immunohistochemical analysis was carried out in 4 cases of lymphomatoid papulosis and 5 cases of primary cutaneous anaplastic large cell lymphoma. Results Lymphomatoid papulosis was divided into 3 subtypes, A, B and C. The lymphomatoid papulosis of subtype A was pathologically characterized by pleomorphic anaplastic large cells or Steinberg-reed cells scattered or patchly distributed among many inflammatory cells; subtype B showed pathological changes characteristic of granuloma fungoides, and manifested as a broad infiltration zone of lymphocytes in dermis with scattered small- to middle-sized atypical gyrus-like lymphocytes; subtype C was characterized by a diffuse distribution of anaplastic large cells and could clinically subside spontaneously. Primary cutaneous anaplastic large cell lymphoma clinically manifested as subcutaneous nodules or papules, and was pathologically characterized by large, pleomorphic, round or ellipse cells with plentiful, eosinophilic or bicolor cytoplasm, large nuclei and obvious nucleoli. The neoplastic cells characteristically expressed CD30 antigen in both lymphomatoid papulosis and primary cutaneous anaplastic large cell lymphoma, and all the cases showed a favorable prognosis.Conclusions Primary cutaneous CD30 positive lymphoproliferative disorders are a spectrum of cutaneous T cell lymphoma with favorable prognosis, and a synthetic analysis of clinical, histopathological and immunohistochemical findings is beneficial to the diagnosis of these entities.

Objective To study the application of total intravenous anesthesia(TIVA) in patients with larp-aroscopic cholecystectomy(LC). Methods 100 cases with LC were randomly and evenly assigned to two groups: the combined intravenous with inhalation anesthesia(CIIA) group(n = 50) and the TIVA group(n = 50). The maintain anesthesia. BP, HR and SpO2 at all stages and time for extubation,the consciousness were recorded. Results The pneumoperitoneum after 10 min HR(96.8±13.5)times/min,SBP(142.5±14.3) mmHg、DBP(93.0±14.3) mm-Hg in A group higher than before induction of anesthesia(82.3±12.5) times/min, (129.0±21.7) mmHg, (77.3±13.5) mmHg(P < 0.05～0.01) ; The pneumoperitoneum after 10 min HR (84.0±11.0) times/min, pneumoperito-neum comphte(76.3±9.0) times/rain in B group lower than the(96.8±13.5) times/min, (84.1±11.0) times/min in A group(P >0.05); B group patients completed the opening time(6.5±1.5) min、extubation time (11.5±1.4) min、pestoperative nausea and vomiting in 3 cases,after 8 h VAS value of (2.8±1.1) in group B were lower than the (10.5±2.8) min,(25.2±9.5)min,12 cases(5.4±2.1) in group A(t =2. 411, P <0.05). Conclusion The application of TIVA to LC anesthetic effect is satisfaction.

Objective To observe the analgesic effect after cesarean section with different paregoric meth-ods. Methods 100 cesarean patients were randomly divided into A and B group. A group adopted patient controlled epidura analgesia(PCEA) micro-injection pump;B group using patient controlled intravenous analgesia(PCIA) mi-cro-injection pump,patients were observed and recorded for their pain, vomit disgustingly, exsufflation and the time of first urination or accidentally tube pull-out. Results The time of average surgery for A, B group were (53.5±8.5) min, (54.7±8.2) min, between the two groups was not significant (t=1.524, P>0.05) ; A group of visual Analog score (1.49±0.43) points were significantly higher than B group (1.13±0.56) points(t=2.119,P<0.05) ;the incidence of headache, dizziness, nausea and vomiting, skin itching(30.0%, 16.0% ,6.0%) in A group were signifi-candy higher than B group(16.0%,8.0% ,2.0%) (t=2.223, t=2.313, t=2.283, all P>0.05) ; the time of A first exhaust,voiding time[(24.56±8.77) h, (6.51±1.57) h] in A group were significantly higher than B group [(19.29±8.16)h,(4.06±1.76)h](t=2.445,t=2.415,P<0.05). Conclusion PCIA method was safe,effec-tive and allowed patients to have early activities after treatment and to promote early rehabilitation. It should be promo-ted for cesarean section.

Objective To investigate the effect and safety of Compound codeine phosphate syrup with Ambroxol treatment in the stable phase of chronic obstructive pulmonary disease. Methods 100 patients with stable COPD were divided into Compound codeine phosphate syrup with Ambroxolt treatment group (Group A) 50 cases and Compound codeine phosphate syrup treatment group( Group B) 50 cases,drug were given for 3 ～ 7d. The symptom score and efficacy of two groups before treatment and after treatment were compared. Results The symptom score of cough,sputum volume,sputum viscosity ,wheeze,sleep after treatment 8th day were improved significantly ( χ2 = 3. 891 ,χ2 =3. 992, χ2 = 4. 198, χ2 = 3.981, χ2 = 3. 879, allP < 0. 05; Total effective rate of cough, sputum volume, sputum viscosity,wheeze in group A(92. 0% ,94. 0% ,90. 0% ,90. 0% ) higher than that in group B(80.0% ,86.0% ,80. 0%,78.0% ) ( χ2 = 3.991, χ2 = 4. 012, χ2 = 3. 998, χ2 = 3.971, allP < 0. 05); The adverse reactions of A、 B group were 12.0% and 14.0%(χ2 =1.971,P>0.05). Conclusion Compound codeine phosphate syrup with Ambroxol is an effective and safe antitussive in the stable phase of chronic obstructive pulmonary disease.

ObjectiveTo study the effect of implantation of the bone marrow cells into infarction myo cardium on the secretion of basic fibroblast growth factor (bFGF), insulin-like growth factor 1 (IGF-1), transforming growth factor-?1 (TGF-?1 ), interleu kin-1 (IL-1), and interleukin-8 (IL-8).MethodsBone marrow cells were implanted into the region of acute myocardial infarct via topical injection. Specimens were harvested at first, 2nd, 4th, 8th week after implantation for the expression of cytokines and vascular density examination by immunohistochemical analysis and the levels of cytokines by radioimmunoassay. ResultsAt first, 2nd, 4th, 8th week after transplantation, the vascular density in the bone marrow cell implant group was significantly higher than that in the control group (P