OBJECTIVE To estimate the prevalence of nosocomial infections(NI)and the use of antibacterials in pediatric department,find the problems in management of hospital infection and provide the scientific basis for formulating prevention and control measures.METHODS By bed-visiting and patients' medical records checking,we filled out unified case questionnaire.All patients were investigated on August 22,2007.RESULTS Of the 86 patients investigated,the prevalence rate of NI was 4.65%.There were 19 kinds of antibiotics used daily.The daily antibiotics use rate was 95.35%;all of the infection sites were in upper respiratory tract and delivering rate of bacterial culture was only 14.63%.CONCLUSIONS Management and training should be strengthened on antibacterial drug in the pediatric department.The reasonable use of target antibiotics could prevent the abuse ment.

Objective To explore influence of norm-setting three-stage rehabilitation training on hemiplegic stroke patients with movement and cognitive dysfunction. Methods A prospective randomized controlled study and stepwise linear regression analysis was carried out to investigate the early variation factors, which affected the integrated functional recovery of stroke patients. According to variation factors we established our norm-setting three-stage rehabilitation training program. 200 patients were randomly selected, according to the cerebral infarction and cerebral hemorrhage classification, and then randomly divided into the rehabilitation group and the control group with 100 patients in each group. All patients accepted general neurology routine nursing. The rehabilitation group was given an extra norm-setting three-stage rehabilitation training. The improvement of motor and cognitive function were observed. Results The early variation factors of integrated functional outcome were treatment programs, CNFD score, age, diabetes, SFMA score, smoking and the intensity of labor within six months since stroke onset. Movement and cognitive function of the rehabilitation group significantly improved than the control group as well as upon admission on the first, 3rd and 6th months since stroke onset. Conclusions The norm-setting three-stage rehabilitation training obviously promotes the improvement of motor and cognitive function at all stages.

Objective To investigate the efficacy of postoperative concurrent chemoradiotherapy for early-stage cervical adenosquamous carcinoma and adenocarcinoma.Methods A total of 62 patients with cervical adenosquamous carcinoma,149 patients with cervical adenocarcinoma,and 2687 patients with cervical squamous cell carcinoma,all of whom were in stage Ⅰ B-Ⅱ A and were treated from 2006 to 2012,were enrolled,and some of them received postoperative pelvic radiotherapy ± para-aortic extended field radiation ±afterloading radiotherapy.The chemotherapy regimen consisting of DDP,TP,and FP was given to these patients.The chi-square test was used for comparison of general clinical data,the Kaplan-Meier method was used for calculating survival rates,and the log-rank test was used for survival difference analysis.Results Cervical adenosquamous carcinoma and adenocarcinoma had no significant differences in clinicopathological features (P=0.107-0.639).The high-risk patients with adenocarcinoma had a higher recurrence rate than their low-risk counterparts even after adjuvant radiotherapy or chemoradiotherapy (P=0.000).In the patients treated with surgery and radiotherapy,those with adenosquamous carcinoma had the shortest median survival time,followed by those with adenocarcinoma and squamous cell carcinoma (P =0.134,0.787);in the patients treated with surgery and concurrent chemoradiotherapy,those with adenocarcinoma had the shortest median survival time,followed by those with adenosquamous carcinoma and squamous cell carcinoma (P=0.131,0.643),and the median survival time showed a significant difference between the patients with adenocarcinoma and those with squamous cell carcinoma (P =0.000).In the patients with adenosquamous carcinoma and adenocarcinoma,the patients treated with postoperative concurrent chemoradiotherapy had higher incidence rates of short-term adverse reactions than those treated with postoperative radiotherapy (P=0.037,0.003),but the incidence rates of long-term adverse reactions showed no difference between the two groups of patients (P=0.861,0.655).In the patients with adenosquamous carcinoma,the patients treated with postoperative concurrent chemoradiotherapy had a lower rate of distant metastasis (P =0.003) and prolonged median overall survival and disease-free survival (both increased by 17 months) (P=0.811,0.799),as compared with those treated with postoperative radiotherapy,while in the patients with adenocarcinoma,the median overall survival and disease-free survival were reduced by 11 and 9 months,respectively (P=0.330,0.115).Conclusions Compared with postoperative radiotherapy,postoperative concurrent chemoradiotherapy for early-stage high-risk cervical adenosquamous carcinoma can reduce the rate of distance metastasis.Compared with radiotherapy,postoperative concurrent chemoradiotherapy for adenosquamous carcinoma and adenocarcinoma cannot improve survival time.

Objective To evaluate the biological effect of tumor necrosis factor-α(TNF-α) on the proliferation and multi-directional differentiation of stem cells from rat apical papilla(SCAP).Methods SCAP was extracted by combining enzyme digestion method with tissue block method.The cells were divided into control group(TNF-α 0 ng/mL) and experimental group(TNF-α 5,10,20,50 ng/mL).The ability of proliferation of SCAP was measured by MTT method.The ability of osteogenic/dentinogenic differentiation of SCAP was measured by alizarin red staining and quantitative real-time PCR.The ability of adipogenic of SCAP was measured by oil red O staining.The expression of vascular related genes of SCAP was measured by quantitative real-time PCR.Results SCAP was consistent with the characteristics of mesenchymal stem cells and possessed the ability of multi-directional differentiation.The MTT results showed that experimental group promoted the proliferation of SCAP in comparison with the control group.The difference was statistically significant(P<0.05),and 10 ng/mL was the optimum concentration.The results of alizarin red staining showed that with the increase of the concentration of TNF-α,the mineralized nodules in the experimental group gradually became smaller,and the number of the formation decreased gradually.The results of quantitative real-time PCR showed that the expression of OC,DMP-1 and DSPP in the experimental group was significantly lower than that of the control group at 3 and 7 days,in which the expression of OC was statistically significant different(P<0.05);at 14 days,the expression of OC,DMP-1 in the experimental group was significantly lower than that of the control group(P<0.05).The result of Oil red O staining showed that with the increase of the concentration of TNF-α,the lipid droplets formation in the experimental group gradually decreased.The result of quantitative real-time PCR showed that the expression of ANGPT1,VEGFA,PECAM-1 in the experimental group was significantly lower than that of the control group(P<0.05).Conclusion TNF-α might promote the proliferation and inhibit the multi-directional differentiation of SCAP.

Objective To evaluate the clinical diagnostic significance of clinical laboratory indexes of anti-CCP,rheumatoid factor (RF),C reactive protein(CRP)and erythrocyte sedimentation rate(SR)in rheumatoid arthritis.Methods Anti-CCP,RF and CRP were quantitatively tested in 90 patients confirmed as rheumatoid arthritis(RA)and 93 patients with non-rheumatoid arthritis(non-RA)diseases by the electrochemiluminescence immunoassay(ECLIA),immunization rate scattering turbidimetry,etc.T test results were performed the statistical and comprehensive analysis by using the ROC curves.Results The levels of anti-CCP and RF had statistical differences between the RA group and the non-RA group(P <0.05 ),while there was no statistically significant differ-ences in the levels of CRP and SR(P >0.05 ).The areas under ROC curves(AUC)of anti-CCP,RF,CRP and SR were 94.0%, 84.0%,51.7% and 56.5% respectively;the sensitivity of anti-CCP and RF was 90.0% and 74.4% respectively,while the specifici-ty was 94.6% and 86% respectively;the Youden indexes were 84.6%and 60.4% respectively;the diagnostic sensitivity of CRP was only 52.2% and the diagnostic specificity of SR was only 50.5%.Conclusion Anti-CCP and RF have the good diagnostic value for RA,moreover the diagnostic performance of anti-CCP is better than RF;CRP and SR have the poor diagnostic preformance,the combination of above indexes has more clinical significance for diagnosing RA.

Ku is a heterodimeric protein which is composed of Ku70 and Ku80.DNA dependent protein kinase is composed of Ku and DNA dependent protein kinase catalytic subunit (DNA-PKcs).DNA double strands break is the main method that radiation kill tumor cell,which will restraint DNA repair,and induce cell apoptosis.Ku protein is the key point in the repair of DNA.Blocking Ku protein will increase the radiosensitivity of tumor cell.

Objective To investigate the diagnosis and treatment of idiopathic chronic colonic pseudo-obstruction(ICCPO). MethodsIn this study 69 patients admitted for “constipation” were finally found falling into one of the 4 groups: 11 cases of outlet obstructive constipation, 16 cases of slow transit constipation, 26 cases of mixed type, and 16 of ICCPO. ResultsThe main symptoms of these 16 ICCPO cases were intractable constipation, compared with that in other entities ICCPO tends to affect patients at younger age, with shorter clinical course, and often needs surgical intervention due to intractable bowel obstruction, usually total colectomy. ConclusionsICCPO, STC and mixed constipation are different clinical entities. The differentiation of ICCPO from other entities is sometimes very difficult especially when patients are suffering from acute onset of bowel obstruction.

Objective To introduce an effective nursing practice for patients with Grave's ophthalmopathy(GO) undergoing endoscopic trans-ethmoid orbital decompression(ETOD). Methods The treatment and nursing experience of 31 cases (57 eyes) undergoing orbital decompression through endoscopic trans-ethmoid approach were reviewed and analyzed. Results Three months after operation, exophthalmos was corrected in all 31 cases (57 eyes) with satisfying result, and the visual acuity was improved in all 9 cases (16 eyes),who complained of visual loss preoperatively. At the 3-months' review, 2 patients presented diplopia on the primary eye position due to newly on-set global displacement. Conclusions Advanced treatment and careful nursing are very important to improve the surgical safety and decrease the complications.

OBJECTIVEWe explored the expressions of the Notch and Wnt signaling pathways and their significance in the repair process of alveolar bone defects by establishing animal models with a composite of autologous bone marrow mesenchymal stem cells (BMSCs) and platelet-rich fibrin (PRF) to repair bone defects in the extraction sockets of rabbits.

METHODSA total of 36 two-month-old male New Zealand white rabbits were randomly divided into four groups, and the left mandibular incisors of all the rabbits were subjected to minimally invasive removalunder general anesthesia. BMSC-PRF compounds, single PRF, and single BMSC were implanted in Groups A, B, and C. No material was implanted in Group D (blank control). The animals were sacrificed at 4, 8 and 12 weeks after surgery, the bone defect was immediately drawn, and the bone specimens underwent surgery after four, eight, and twelve weeks, with three rabbits per time point. The expressions of Notch1 and Wnt3a in the repair process of the bone defect were measured via immunohistochemical and immunofluorescence detection.

RESULTSImmunohistochemistry showed that the expressions of Notch1 and Wnt3a in Groups A, B, and C were higher than that in Group D at the fourth and eighth week after operation (P<0.05). By contrast, the expressions of Notch1 and Wnt3a in Group D were higher than those in Groups A, B, and C at the twelfth week (P<0.05). Immunofluorescence showed that the expressions of both Notch1 and Wnt3a reached their peaks in the new bone cells of the bone defect after four weeks following surgery and gradually disappeared when the bone was repaired completely.

CONCLUSIONNotch1 and Wnt3a signaling molecules are expressed in the process of repairing bone defects using BMSC-PRF composites and can accelerate the healing by regulating the proliferation and differentiation of BMSCs. Moreover, the expressions of Notch and Wnt are similar, and a crosstalk between them may exist it.

Alveolar Bone Grafting ; methods ; Animals ; Blood Platelets ; Bone Marrow Cells ; cytology ; Bone Transplantation ; methods ; Bone and Bones ; abnormalities ; Cell Differentiation ; Fibrin ; administration & dosage ; Male ; Mesenchymal Stem Cell Transplantation ; methods ; Mesenchymal Stromal Cells ; Platelet-Rich Plasma ; Rabbits ; Random Allocation ; Receptor, Notch1 ; metabolism ; Tissue Engineering ; Wnt Signaling Pathway ; Wnt3A Protein ; metabolism ; Wound Healing

Objective To explore the safety and feasibility of single-incision laparoscopic cholecystectomy without using titanium-clips. Methods Data of 1016 patients(group A) undergoing single-incision laparoscopic cholecystectomy without using titanium-clips were compared to that of 874 patients(group B)undergoing two-port laparoscopic cholecystectomy without using titanium-clips by t test and chi square test for operating time,operative hemorrhage,the length of postoperative hospital stay and postoperative pain.Results In group A,1001 cases were successfully operated on with single-incision laparoscopic cholecystectomy,with conversion to classic four-port laparoscopic cholecystectomy in 15 cases,while 874 cases in group B were operated on with two-port laparoscopic cholecystectomy.There were no bile leakage,biliary tract injury or death in both groups.There were no difference in operating time[(34.5 ±5.2) min vs (32.0±7.4)min,t=0.063,P=0.526],the length of postoperative hospital stay[(3.1±0.8)d vs(3.2±0.7)d,t=1.073,P=0.326]and operative hemorrhage[(56.5±17.8)ml vs (55.2±15.9)ml,t=0.812,P=0.425](P>0.05) between the two groups,but the postoperative pain was less severe in Group A than that in group B (P=0.000<0.05). Conclusions The single-incision laparoscopic cholecystectomy is feasible,safe,less traumatic and more cosmetic.