OBJECTIVE To understand the situation of hand hygiene in our hospital to explore effective measures for implementation.METHODS 258 medical personnel,were investigated for the hand-washing,before and after the implementation of the hands of our health system to compare the nosocomial infection rate.RESULTS The low rate 35.02%~49.42% of medical personnel washed their hands before the normal operation in and out the Ⅱ area.Hand-washing compliance rate was only 54.17%;and after the implementation of our health system in hand,nosocomial infection rate decreased 30%.CONCLUSIONS Washing hands is important to prevent nosocomial infection,Medical personnel generally do not have a strong sense and we should start and strengthen the supervision and improve the supporting facilities to ensure the compliance of medical staff.

Objective To determine whether the extent of airflow obstruction is associated with left ventricular function in mild-to-moderate chronic obstructive pulmonary disease (COPD) patients.Methods Left ventricle end diastolic volume ( LVEDV ),left ventricle end systolic volume ( LVESV ),left ventricle stroke volume( LVSV),left ventricle ejection fraction( LVEF),heart rate ( HR),cardiac output ( CO) and cardiac index (CI) were measured by ultrasonic cardiogram.Thirty-one patients with chronic bronchitis,42 mild-to-moderate COPD patients and 16 controls with normal lung function were recruited.The relations between the extent of airflow obstruction and the impairment of left ventricular function were analyzed.Results There were no significant differences of LVEDV,LVESV,LVSV,HR,CO or CI between the control and chronic bronchitis groups.LVEDV,LVESV,LVSV,CO and CI of chronic bronchitis group were significantly higher than those of mild-to-moderate COPD group while HR was lower.LVEDV,LVESV,LVSV,CO and CI had a positive correlation with forced expiratory volume in 1 second ( FEV1 ),forced vital capacity (FVC) and FEV1/FVC ratio.And HR had a negative correlation with FEV1 and FEV1/FVC.LVEF was positively correlated with FVC,but not with FEV1 and FEV1/FVC.LVEDV,LVESV,LVSV,HR,CO and CI were linearly related with FEV1.Conclusions Left ventricular function is maintained in chronic bronchitis patients. Left ventricular function,especially left ventricular end diastolic filling,deteriorates among the mild-to-moderate COPD patients.The extent of airflow obstruction may reflect the impairment of left ventricular function in COPD patients.

Objective To investigate the factors that related to acute biliary pancreatitis including size and the location of the common bile duct stone. Methods Clinical data from 3497 patients with common bile duct stone admitted to the hospital between Jan. 2002 and Dec. 2008 were retrospective analyzed. All patients were grouped according to the size and the location of the bile duct stones. The incidence of acute pancreatitis was compared among groups. Results In patients with common bile duct stone accompanying the acute pancreatitis,common symptoms were fever, bellyache and jaundice, as well as elevated serum amylase. There was a negative correlation between size of the common bile duct stone and the severity of acute hiliary pancreatitis, which was easily induced by the stone in the Vater's ampullar or distal common bile duct. Conclusion Early endoscopic treatment should be carried out in patients with microlith located in the Vater's ampullar or distal common bile duct in order to prevent the acute biliary pancreatitis.

Objective To explore the long-term efficacy of endoscopic sphincterotomy (EST) for choledocholithiasis and to evaluate the necessity of cholecystectomy after EST. Methods Two hundred and fifty seven patients who underwent EST for choledocholithiasis in 2006 were followed up for an average period of 34. 8 months (26-48 months). According to the existence of cholecystolithiasis, the patients were divided into group A (combined with cholecystolithiasis, n = 151) and group B (without cholecystolithiasis, n = 106) , and group A was further divided into group A1 as undergoing cholecystectomy after EST (n =56) and group A2 as not having cholecystectomy after EST ( n = 95). Results Of the 257 patients, late complications occurred in 31 patients (12. 1% ) , including recurrent choledocholithiasis in 25 (9.7% ), cholangitis in 27 (10. 1% ) , acute pancreatitis in 2 (0. 8% ) and cholangiocarcinoma in 1 (0.4% ). The rates of late complications and recurrent choledocholithiasis were significantly higher in group A2 than those in group A1 (P<0.05). Conclusion EST is safe and effective for choledocholithiasis. Cholecystectomy after EST is necessary in patients with cholecystolithiasis.

Objective To estimate the long-term efficacy of endoscopic sphincterotomy (EST)in treatment of choledocholithiasis and to analyze the potential risk factors for disease recurrence.Methods A total of 154 patients with choledocholithiasis,who underwent EST between January 2006and December 2006, were enrolled. Multivariate analysis was used to evaluate the association of clinical features and experimental parameters with recurrence of choledocholithiasis. Results Longterm complications developed in 22 patients (14.29%) including recurrent choledocholithiasis (18/154,11.69 % ) and combined cholangitis (16/154). Cholangitis without calculi was found in 1 case (0.65%), acute pancreatitis in 2 cases (1.30%) and cholangiocarcinoma in 1 case (0.65%). High body mass index and serum cholesterol were proved to be risk factors for recurrence of choledocholithiasis. Whereas the incision size (0.5 cm-1.5 cm) of vater's papilla was the protective factor for recurrence of choledocholithiasis. Conclusions Body mass index, serum cholesterol and the incision size of vater's papilla are related to recurrence of choledocholithiasis.

0.05). EBV DNA positive were found in gastric mucosa of 40.0% in control group, 73.1 %(19/26) in GC tissue(P

Objective To observe the effect of balance training on cerebral cortex and balance function of mouse.Methods Forty-five C57BL/6J female mice were randomly divided into the control group, two-week training group and four-week training group with 15 animals in each group. An new model of balance function training was copied. The balance function, brain index, and the content of malondialdehyde (MDA) and activity of superoxide dismutase (SOD) in the mouse cerebral cortex were tested after training.Results The total time passing balance beam of the four-week training group significantly shorten compared with the control group and two-week training group ( P<0.01). Compared with the control group, the brain index of two-week training group increased ( P<0.05), and four-week training group also increased significantly ( P<0.01). Compared with the control group, the SOD activity of cerebral cortex significantly increased (P<0.01), and MDA decreased ( P<0.05) in the four-week training group.Conclusion This new balance training can improve balance function, increase the brain index and decrease lipid peroxidation level in the cerebral cortex of the mice.

BACKGROUND: Deep vein thrombosis (DVT) of the lower limbs is one of the severe complications of total hip replacement (THR)during the perioperative period. The incidence rate was high. The effect of primary disease on the DVT after THR in the elderly remains poorly understood.OBJECTIVE: To explore the effect of primary disease on DVT after THR in the elderly.METHODS: 147 cases with unilateral THR aged 64-93 years, were included and divided into two groups. Fracture group contained 68 cases, which of them were all traumatic femoral neck fracture ones. Osteopathia group contained 79 cases, and they had no traumatic injury. We selected total hip prostheses according to their physiological age, preoperative socialization ability,substantia ossea and life expectancy. Biological prosthesis in 5 cases and mixed prosthesis in 12 cases were used, while the others used bone cement prosthesis. If the patient had pain and/or swelling on the injured limb, with or without Homans/Neuhofs sign, we did the pressurized ultrasonic Doppler to examine whether the patient had got DVT.RESULTS AND CONCLUSION: In the fracture group, 32 cases had swelling in the injured limbs, and 20 cases with pain, 15 cases with Homans/Neuhofs sign, and 29 DVT cases were confirmed by the pressurized ultrasonic Doppler. One femoral neck fracture case of THR had no DVT clinical signs and was dead 17 days later. The autopsy found that it was an mixed type combined of pulmonary embolism; Osteopathia group: 20 cases had swelling in the injured limbs, and 11 cases of pain, 9 cases of Homans/Neuhofs sign, 20 DVT cases were confirmed by the pressurized ultrasonic Doppler. The blood coagulation state was greater, and the incidence rate of DVT in the lower limbs was greater in the fracture group compared with osteopathia group (P ＜ 0.05). These indicated that femoral neck fracture is a high risk factor for DVT development in lower limb affer THR in the elderly.

ObjectiveTo explore the safety and efficacy of endoscopic treatment for choledocholithiasis in patients with decompensated cirrhosis.MethodsA total of 104 cases of choledocholithiasis with decompensated cirrhosis were treated by ERCP in our hospital between January 2001 and March 2011.ChildPugh grading and model for end stage liver diseases (MELD) were investigated pre-ERCP and 2 weeks post-ERCP.Complication and mortality during the follow-up were recorded.ResultsThe success rates of complete stone retrieval was 92.3％ (96/104),and plastic stent was placed in other 8.Major complications ineluded post-ERCP bleeding in 9 cases (8.7％) and pancreatitis in 8 (7.7％ ).MELD score valuated 2weeks after ERCP ( 10.1 ± 6.3 ) was significantly lower than that of pre-ERCP ( 1 1.9 ± 6.2,t =2.22,P ＜0.05).The Child-Pugh grading before ERCP of 104 patients were 28 in grade A (26.9％ ),52 in grade B (50.0％ ) and 24 in grade C (23.1％ ),which was significantly different from those of 2 weeks after ERCP (40/52/12).No death was recorded during hospital stay for choledocholithiasis,and 2 patients of Child-Pugh grade C died in 3 months after discharge.ConclusionERCP is an effective method for choledocholi-thiasis in patients with decompensated cirrhosis.The main severe complication was post-ERCP bleeding.Those patients with decompensated cirrhosis would benefit from ERCP if we took effective measures.

Objective To investigate the value of new microvascular pattern of contrast-enhanced ultrasonography (CEUS) in the diagnosis of peripheral lung lesion.Methods A total of 72 peripheral lung lesions which had been proved by clinical and pathology results underwent conventional ultrasound,CEUS and new microvascular pattern examination.Two independent readers (Reader 1 and Reader 2) blindly and retrospectively analysised and classified the characteristic of microvascular patterns respectively,and Kappa test was used for evaluating the concordance between the two readers.The diagnosis accuracy of CEUS was calculated,and the CEUS diagnostic scores were compared with conventional ultrasound.Results 16 benign lesions and 56 malignant lesions were enrolled in this study.The microvascular patterns in benign lesions included branch enhancement(43.8 ％,31.3％),point and patchy enhancement (18.8％,25.0％) and rim-like enhancement (18.8％,18.8％).The microvascular patterns in malignant lesions included vascular enhancement (46.4％,57.1％),cotton enhancement (26.8％,25.0％) and dead wood enhancement (19.6％,8.9％).There was significant difference between benign and malignant lesions.Kappa result showed that the two readers had a good diagnosis concordance(Kappa=0.759,P =0.000).According to the different types of microvascular pattern,the diagnostic accuracy,sensitivity,and specificity rates of two readers were 92.9％,91.1％;81.3％,75.0％ and 90.3％,87.5％,respectively.Before CEUS,59.7％ and 68.1％ of lesions were diagnosed as 3 by two readers respectively,while only 1.4％ and 6.9％ of lesions were diagnosed as 3 after CEUS.Further analysis demonstrated that there was significant difference in the microvascular pattern between squamous carcinoma and adenocarcinoma,and also between squamous carcinoma and small cell lung carcinoma.Conclusions Contrast-enhanced ultrasound could significantly increase the differential diagnosis of peripheral lung lesions.New microvascular pattern helped to display patterns of vascular perfusion.of peripheral lung lesions,and provide new diagnostic clue for differential diagnosis.