Objective To investigate risk factors for healthcare-associated infection(HAI)in patients with craniocerebral operation,and provide reference for the prevention and control of HAI.Methods A total of 4 246 cases of craniocerebral surgery in a neurosurgery department from January 2010 to December 2012 were enrolled in the study,the risk fac-tors for HAI were analyzed.Results Of 4 246 cases of craniocerebral surgery,393 patients developed 446 times of post-operative HAI,HAI incidence rate was 9.26%,case infection rate was 10.50%,which were higher than inci-dence (2.02%)and case infection rate (3.02%)of HAI of all hospital during the same period,the difference was statistically significant (χ2 =811 .06,629.30,respectively,P <0.001).The major infection site was central nervous system (56.50%),followed by respiratory system (27.36%).Unconditional univariate logistic regression analysis showed that sex,age,community-acquired infection,primary disease,operative time,length of stay in intensive care unit (ICU)before infection,the number of surgery,invasive procedures and nasogastric tube,the difference was statistically significant (all P <0.05 ).Multivariate logistic regression analysis showed that sex,elderly pa-tients,congenital brain diseases,stay in ICU>7 d,antimicrobial use >7 d,central venous and urinary tract cathe-terization,invasive ventilator were risk factors for HAI in patients with craniocerebral operation.Conclusion The incidence of HAI in patients with craniocerebral operation is high,effective preventive and control measures accord-ing to risk factors should be strengthened to reduce the incidence of HAI.

Humanization is becoming increasingly significant inpatient-nurse collaboration. In China,the bed-nurse ratio is unbalanced,the medical dispute is serious and the patient′s satisfaction is not high.Narrative medicine which exertnalizing one′s experiences and emotion,are beneficial to patients′physical and mental rehabilitation. In narrative nursing, nurses entered into patients′ feeling and feel empathy,then provided higher quality nursing care.Narrative nursing effectively makes up for the lack of humanistic care. This article shows the development and shorts of humanistic care. Then discussed the practical application and limitations of narrative nursing as well as it′s significance of strengthening humanistic care.

Objective To explore the clinical value of the combination of procalcitonin (PCT) and hypersensitive C-reactive protein (hs-CRP) detection for the assessment of bacterial pneumonia.Methods Fifty bacterial pneumonia patients were randomly selected and included into the observation group,another fifty healthy subjects were selected as the control group in the same period.The levels of hs-CRP and PCT in the two groups were detected,and the detection results were comparatively analyzed.Results The PCT level [(3.13 ± 0.43) μg/L] and hs-CRP level[(55.37 ± 9.64)mg/L] in the observation group before treatment were significantly higher than those in the control group [PCT level (0.04 ± 0.01)μg/L,hs-CRP level (6.46 ± 0.89)mg/L],and the differences were statistically significant (t =50.7993,36.3980,all P ＜0.05).There were no significant differences in the PCT and hs -CRP levels between the two groups after treatment (t =0.5000,0.9444,all P ＞ 0.05).The PCT level (3.11 ±0.85) μg/L and hs-CRP level (20.31 ± 3.96) mg/L in the patients with CURB-65 score of 4-5 were significantly higher than those in patients with CURB-65 score of 0-1 and 2-3 [PCT level (1.19 ± 0.42) μg/L and hs-CRP level (1.86 ± 0.53) mg/L in patients with CURB-65 score of 0-1,PCT level (1.82 ± 0.54) μg/L and hs-CRP level (9.85 ± 1.21)mg/L in patients with CURB-65 score of 2-3],and the differences were statistically significant (t =8.3565,5.0788,20.8283,10.9947,all P ＜ 0.05).Conclusion The levels of serum PCT and hs-CRP are significantly increased in the patients with bacterial pneumonia,but the levels are decreased significantly after treatment.The combination of hs-CRP and PCT detection has significant value for the assessment of bacterial pneumonia,which is helpful to evaluate the condition of the disease,and has great clinical significance.

Objective To explore the main factors of the medical communication between physicians and nurses in gynecological emergency treatments. To evaluate the function of SBAR communication mode in enhancing communication skills and to explore the countermeasures of promotion. Methods Totally 18 gynecological physicians and nurses were selected as the subjects in this study,and semi-structured interviews were conducted. After the establishment of coding and archiving system, the collected information was extracted and analyzed. Results The factors that affect gynecologic emergency medical staff effective communication included assessment of the patients′ condition, the limitation of communication conditions,the different concerns between doctors and nurses,the differences of medical communication training degree,seniority,experience and knowledge reserve,the medical team consciousness. Conclusion The effective communication of gynecologic emergency care can be promoted by improving professional levels of medical care personnel,strengthening the cultivation of the health care team,using communication skills,to ensure the accurate transfer of key information.