ObjectiveTo explore the effective measures to prevent and control the hospital infections.MethodsThe hospital infections'data of 27 129 inpatients were retrospectively studied and retrospectively analyzed.ResultsThe nosocomial infection rate was 3.40％. The major sites of the infection were lower respiratory tract (50.05％ ). The most common pathogens were mainly Gram-negative bacteria (41.91％ ). The infection mainly occurs in old peple(75.34％ ). The highest infection rate is in organ transplantation unit( 14.62％ ). The factors of high risk included antibiotics(53.47％ ), immunocompromise and invasive therapies. ConclusionTo improve the pathogen detective rate and the monitoring of antibiotic resistance ,to decrease the use of invasive therapies and to keep high risk areas under surveillance were the effective measures to control hospital infection and to reduce the incidence rate of hospital infection.

Objective To study the prevalence and the distribution of several chronic diseases which affect the life quality and the health of the Shanghai elderly people. Methods Stratified cluster sampling method was used in the survey of the prevalence rate of several common chronic diseases (self reported) in 12 590 residents ≥60 years of age in 22 urban and 14 rural communities in Shanghai. Results The total prevalence rate of several chronic diseases in the elderly is 60 3%, with male being 59 4% and female being 61 9%. The total prevalence rate in the urban elderly was 66 5%, significantly higher than that of the rural elderly(53 9%). In urban areas, female's prevalence was higher than the males. While in rural area no difference between male and female was observed. In urban areas, the prevalence from high to low stood hypertension(33 6%), cataract(18 3%), chronic obstructive pulmonary disease (COPD)(11 9%), coronary heart disease(9 1%), other heart diseases(7 9%), diabetes mellitus(5 9%). In rural areas, the prevalence from high to low stood hypertension (20 9%), COPD(15 2%), cataract(7 0%), deafness(5 7%), other heart diseases(4 3%), osteoideformed or osteoporosis(4 2%). Conclusions The distribution and the status of the chronic diseases in rural areas are significantly different from that of urban areas. We should carry out different strategies according to different conditions for enhancing the health and life quality of the elderly.

Objective To investigate the characteristics and patterns of lymph node metastasis in lung cancer and to provide evidence for determining the range of lymph node dissection.Methods One hundred and eighteen patients with lung cancer received complete resection combined with systematic lymph node dissection according to the mapping system developed by Naruke.Results A total of 835 lymph nodes were dissected from 118 lung cancer patients.The positive ratios of N1 and N2 were 15.6% and 17.4% respectively.Fifteen patients were found with skipping N2 which were located in 2,4,5,6 and 7 lymph node groups respectively.There was no significant relationship between the size of primary tumor and lymph node metastasis.Small cell lung cancer showed the highest risk of lymph node metastasis.The metastatic rate of lymph node in adenocarcinoma was markedly higher than that of squamous cell carcinoma.Skipping mediastinal lymphatic metastasis was found more frequently in lower lobar tumors than that in upper lobar ones.Conclusion Lymph node metastasis of lung cancer may occur in multiple groups and regions,even in a skipping pattern.Systematic lymph node dissection may be routinely performed in pulmonary resection for lung cancer.

Objective: To evaluate the effect of open-chest surgery for cancer patients in advanced stage, in aged and with respiratory insufficiency. Methods: From May 1992 to December 2002, 637 patients with lung cancer underwent thoracotomy in out hospital. 118 of the 637 patients fit in with the standards of advanced, aged or respiratory insufficiency. RVEF was consecutively assessed in 118 before pulmonary resection by echocardiography. According to right ventricular function, the 118 patients were dicided into group A(n=77, RVEF

Objective To compare the field molluscicidal effects of 25%suspension concentrate of nielosamide ethanolamine salt(SCNE),50% wettable powder of niclosamide ethanolamine salt(WPN),40% META-Li and 50% Rongbao powder,so as to provide scientific basis for choosing the safe and highly effective molluscicide in field.Methods Four snail habitats with the similar snail status were selected and sprayed with the four molluscicides mentioned above,respectively.Then the snail status in the four fields was surveyed 3,7 and 17 d after the spraying and the moiluscicidal effects of difierent molluscieides were cornpared.Results The corrected mortalities of snails in the field sprayed with SCNE 3,7 and 17 d afterthe spraying were the hiishest among the four fields,with the rates of 93.13%,91.85% and 85.28%,respectively.Conclusion SCNE has a high molluseieidal effect in the field and can be further used in snail-infested areas.

Objective To investigate CT features and its diagnostic value of traumatic cerebral lacunar infarction. Methods Axial CT scan was performed in 26 cases of brain injury with clinical manifestation of different degree of hemiplega.Results The infarction appeared as small lacunar focuses which were located mainly in the regions of lenticular nucleus,caudate nucleus and internal capsule.Conclusion CT scan is of significant value in diagnosing the traumatic cerebral lacunar infarction and assessing its prognosis.

Objective To observe the pathological changes of major organs in rats with acute Dysosma versipellis poisoning and investigate the toxic mechanismand the injuries of target tissues and organs. Methods Forty Sprague-Daw ley (SD) rats were random ly divided into three experimental groups, which were given the gavage with 0.5, 1.0 and 2.0LD50 doses of Dysosma versipellis decoction, and one con-trol group, which was given the gavage with 1.0LD50 dose of normal saline. The rats were sacrificed 14 days after Dysosma versipellis poisoning and sam ples including brain, heart, liver, lung, and kidney were taken. After pathological process, the pathological changes of the major organs and tissues were observed by light microscope and electron microscope. The experimental data were statistical analyzed by x2 test. Results The observations of light microscopy: loose cytoplasmof neurons with loss of most Nissl bodies;swelling of m yocardial cells with disappearance of intercalated disk and striations;hepato-cellular edema with ballooning degeneration; and swelling epithelial cells of renal proximal convoluted tubule with red light coloring protein-like substances in the tube. The observations of electron microscopy:the structures of cell mem brane and nuclear mem brane of neurons were destroyed;cytoplasmof neurons, obvious edema;and most organelles, destroyed and disappeared. The mortalities of rats after acute poi-soning of the four groups increased with doses (P<0.05). Conclusion Acute Dysosma versipellis poisoning can cause multi-organ pathological changes. There is apositive correlation between the toxic effect and the dosage. The target tissues and organs are brain (neurons), heart, liver and kidney.

Objective: To summarize the experience of valve replacement for multiple valve insufficiency in patients with giant left ventricle and the operative indication. Methods: Multiple valvular operations were performed in 62 patients with giant left ventricle between 1991 and 2002. Combined mitral and aortic valve replacement was performed in 56, tricuspid valve annuloplasty in 43, left atrium placation surgery in 12, and mitral valve replacement in 5. Results: The early postoperative complication and mortality rate were 45.2% and 17.7%, respectively .The late mortality rate was 6.5%. The main factors influencing the early surgical results were preoperative severe left ventricular enlargement (ESD ≥6.0cmand EDD ≥8.0cm) and systolic dysfunction (EF ≤0 40 and FS ≤0 25), perioperative ventricular fibrillation, postoperative low cardiac output and multiple organal failure. The main factors affecting long term survival were postoperative severe ventricular arrhythmia and left ventricular enlargement with depressed systolic performance. Conclusion: The keys to improve the early and late results of multiple valve replacement in these patients with giant left ventricle are the choice of optimum surgical timing, the proper management of the high risk factors mentioned above during perioperative and follow up periods.

Objective:To study the influence of protein transduction domain (PTD)-oligomerization domain (OD)-HA fusion proteins on apoptosis of bcr/abl-positive cell lines. Methods:bcr/abl-positive cells were treated with PTD-OD-HA protein. The apoptoses of the cells were detected by flow cytometry (FCM), DNA ladder and transmission electron microscopy (TEM), and the levels of apoptosis-related genes bax and bcl-2 were detected by RT-PCR and Western blotting. Results:FCM examination demonstrated that PTD-OD-HA protein induced the apoptosis of bcr/abl-positive cells; DNA ladder showed that the classic DNA ladders appeared in BaF3-P210 and K562 cells after 48 h treatment with PTD-OD-HA proteins; the apoptoses of BaF3-P210 cells were observed by TEM; the levels of bax in mRNA and protein increased in BaF3-P210 and K562 cells, and bcl-2 decreased. Conclusion:PTD-OD-HA proteins specifically induced the apoptosis of bcr/abl positive cells.

OBJECTIVE To explore the treatment measure of pulmonary infection after liver transplantation.METHODS The clinical data of 78 cases of pulmonary infection after liver transplantation in our hospital were analyzed retrospectively.RESULTS The incidence of pulmonary infection in this group of patients was 48.8%.The mean onset time of the first pulmonary infection after operation was(9.56?5.53)days after surgery.Forty four patients were diagnosed as right pneumonia,14 as left pneumonia,and 20 bilateral pneumonia.Long operation time,mechanical ventilatory time,abdominal bleeding,intraoperative total fluid perfusion and renal dysfunction after liver transplantation were risk factors of pulmonary infection.87.2% Of these patients improved,and 12.8% died.CONCLUSIONS The mortality of pulmonary infection after liver transplantation is high.Bacteria and fungi are the major pathogens.The key of prevention and cure of pulmonary infection after liver transplantation wis included of cutting down operation time,lessening abdominal bleeding,controlling intraoperative fluid perfusion,extubating as soon as possible,protecting renal dysfunction and raising pathogeny to check.