ObjectiveTo probe into the maternal care utilization by minority women, for the purpose of policy recommendations on better maternal care in minority areas. MethodsA combination of stratified random sampling and typical sampling was made on 445 married women of reproductive age in six counties in Yunnan, Guizhou, Qinghai and Tibet provinces, a field survey on their utilization of maternal care services. ResultsTheir average prenatal detection rate is 78.24％, a level lower than the national rural average of 93.7％ and grade-4 rural average of 81.2％ in 2008; their post partook rate is 30.7％, lower than the national rural average of 54.3％ and grade-4 rural average of 58.9％ in the same period; their average coverage rate is 52.18％, a level lower than the national rural average of 87.1％and grade-4 rural average of 64.3％ in 2008. ConclusionThe maternal care utilization is found to be low for women in minority areas. Effective solutions are expected for payment of indirect expenditure of hospital delivery; better health education for enhancing health knowledge and health awareness of minority women; effective incentive mechanism for village doctors, consolidating the base of the three-level healthcare network.

Objective To investigate the homology of methicillin-resistant Stphylococcusaureus(MRSA)from the neonatal intensive care unit(NICU)of a children's hospital,and evaluate routes and preventive strategies of MRSA healthcare-associated infection(HAI). Methods MRSA strains from neonates and environment of NICU between October and December 2014 were collected,and strains were identified by VITEK-2 microbial analysis system and cefoxitin Kirby-Bauer method,homology of MRSA was analyzed by pulsed-field gel electrophoresis (PFGE ). Results A total of 6 MRSA strains were isolated from NICU between October and December 2014,3 of which (bed-58,70,and 100)were detected MRSA from specimens,MRSA were isolated from neonatal incubator and nurse (nasal swabs and hands)who cared for neonate at bed 58. 5 of 6 MRSA strains were homology,antimicrobial susceptibility testing result showed that No. 1-5 strains were resistant to clindamycin and amoxicillin/clavulanic acid,No. 6 strain was slightly different from No. 1-5 strains,No. 6 strain was susceptible to both clindamycin and amoxicillin/clavulanic acid. PFGE results showed that No. 1-5 strains were of the same type,No. 6 strain was a different type. Conclusion The main route of this MRSA transmission is contact transmission,especially through the hands of health care workers,identification and analysis of epidemic strains by PFGE technique is an effective measures to prevent HAI outbreak and perform epidemiological study.

Objective: To explore influence of nursing health education on morning blood pressure surge (MBPS) fluctuations in aged patients with hypertension.Methods: A total of 100 outpatients and inpatients with non-dipper hypertension, who haven't been treated, were selected from Apr 2011 to Sep 2015.According to random number table method, patients were randomly and equally divided into routine treatment group and health education group (received nursing health education based on routine treatment group), both groups were treated for four weeks.MBPS, trough/peak(T/P) ratio and smoothness index (SI) were measured and compared between two groups after treatment.Results: Compared with routine treatment group after four-week treatment, there were significant reductions in systolic blood pressure (SBP) morning surge[(46.95±5.17) mmHg vs.(42.21±5.19) mmHg]and diastolic blood pressure (DBP) morning surge[(16.31±3.23) mmHg vs.(14.21±3.58) mmHg], and significant rise in SBP T/P[(59.22±6.65)% vs.(70.11±6.41)%], DBP T/P[(50.91±5.04)% vs.(56.97±5.12)%], SBP SI[(1.19±0.13) vs.(1.42±0.12)]and DBP SI[(1.11±0.09) vs.(1.29±0.08)]in health education group, P<0.05 all.Conclusion: Health education can effectively improve blood pressure fluctuations and may likely improve prognosis in patients with non-dipper hypertension, which is worth extending.

OBJECTIVE:To promote the supervision and management of clinical trial by institution. METHODS:The structure and function of clinical trial management system(CTMS)developed by our hospital and other enterprise together were analyzed to evaluate the application and operation result of CTMS. RESULTS & CONCLUSIONS:CTMS of our hospital is made up of foun-dation,efficiency and strategy. It is equipped with role allocation,information exchange and report,information warning,drug tracking,clinical trial process control,quality control of electronic record,electronic signature and integration and connection with other system,etc. Relevant operation procedure is established to promote standardization and institutionalization of CTMS. Due to the application of CTMS,the cooperation among departments become smoother,and management level have been enhanced in dai-ly management,pharmacy management,subjects and document administration. It also simplifies the work of researcher and reduc-es the human error by the autogeneration of trial records and tables with the system. Consequently,the monitor coveraged through-out all the trial process.

OBJECTIVE:To ensure the stability of electronic data capture(EDC)system in drug clinical trials and to improve the quality of drug clinical trials. METHODS:The quality control system for EDC system was established and introduced from the formulation of quality control process,establishment of data standard,trial project management,daily management,trial project design,system operation,system function,etc. RESULTS & CONCLUSIONS:Data standard have been achieved through estab-lishing EDC quality control system by our hospital based on attributable,legible,contemporaneous,original and accurate principle. The management of trial project and daily management are conducted through data registration,staff training,the formulation of da-ta management plan,fault emergency treatment,database backup;multiple verification of support data,data lock and export,trial report autogeneration and other functions have been realized by formulating related standard operation instruction,program file,op-eration manual and quality record. Those aspects improve facticity,accuracy and integrality of data in clinical trials,and lay a foun-dation for further data mining.

Objective To explore the clinical outcomes of Ligament reconstruction tendon interposition (LRTI) arthro-plasty for first carpometacarpal joint osteoarthritis. Methods From January 2008 to January 2011, 19 patients (21 thumbs) had surgery for thumb carpometacarpal arthritis using ligament reconstruction tendon interposition arthroplasty with flexor carpi radia-lis (FCR). There were 1 male and 18 were females with an average age of 60 years (range, 52-75 years);8 thumbs were on the left side and 13 thumbs on the right side. According to Eaton-Glickel classification, 1 thumb belonged to stageⅡ, 14 thumbs to stageⅢ, and 6 thumbs to stageⅣ. Pain level, grip strength, tip pinch strength, range of motion, and radiographic measurement were re-corded. According to the first metacarpal subsidence, the cases were classified in mild, moderate, and severe groups. Clinical out-comes of different group were evaluated and compared. Results All patients were followed up for 9-28 months with an average of 13.9 months. Comparision with the preoperative X-rays showed the first metacarpal had subsided 54.8% of the arthroplasty space after surgery. Grip strength improved from 18.6±10.1 kg to 20.5±11.9 kg, and tip pinch strength increased from 4.4±2.1 kg to 4.5 ± 1.9 kg after the surgery. Radial abduction increased from 55.7° ± 8.2° to 60.6° ± 7.2° and palmar abduction improved from 56.7° ± 8.5° to 63.5° ± 8.2° after the procedure. Patient pain levels (visual analogue scale, VAS) were significantly reduced, from 6.6 ± 1.4 to 0.5 ± 0.7. There was no difference of grip strength, tip pinch strength, thumbs range of motion, and VAS after LRTI in mild, moderate and severe groups. Conclusion LRTI resulted in excellent relief of pain and increase in range of motion. Howev-er, LRTI cannot sustain the arthroplasty space. Compared with the preoperative X-ray, the first metacarpal subsided more than 50%. Subsidence of the first metacarpal doesn't affect the pain relief, range of motion and strength improvement.

Objective To determine the effect of fast passage for patients' access to the emergency department of hospital on rescuing and triaging the traumatic casualties referred from the site of accident by collision between two bullet trains occurred at Wenzhou station on 23 July 2011 in order to accumulate experience of treating large number of traumatized casualties happened in a major accident or disaster.Methods A retrospective study was carried out to collect the data including the different courses of treatment for various types of injury in casualties and the length of stay of traumatized patients with different degrees of severity in the emergency department after casualties entered into the emergency department of hospital via fast passage.Results There were 136 traumatic casualties referred to hospital within 72 hours after the bullet train accident occurred at Wenzhou station.The average length of stay of patients with uncomplicated single injury in the hospital was 27min,and the average length of stay of 108 patients with multiple injuries in the emergency department was 62 min.In last year,the annually average length of stay of casualties in emergency department was 50 min longer when there was no fast passage available for patient to enter into.Conclusions The fast passage for casualties entering into emergency department not only guarantees the traumatized patients rescued in no time after bullet train accident but also shortens the length of stay in the Emergency Department.

Objective To explore the common safety concerns and effective nursing intervention in patients with intelligence score defect during hospitalization. Methods A total of 63 patients with intelligence score defect in nerve one ward in our hospital was carried out targeted safety management as the observation group,the common medical ward, the nursing assessment was carried out by head of department,the head nurse,the competent doctor, primary nurse, rehabilitation nurse and the health education. For personalized nursing measures, patients went through neurological nursing, safety management and rehabilitation guidance, etc. A total of 62 patients with intelligence score defect in nerve two ward were treated as the control group, nursing care in the traditional way of nursing. The Mini-Mental State Examination (MMSE) were assessed at the time of admission and discharge, and the occurrence of nursing accidents during hospitalization was observed, and the patient′s satisfaction with service was investigated. Results The occurrence of nursing accidents during hospitalization in the observation group was lower than that in the control group:4.76%(3/63) vs.1.77%(11/62), and there was significant difference, χ2=5.29,P < 0.05. MMSE score and patient′s satisfaction at the time of discharge in the observation group were higher than those in the control group:(25.12±1.59) points vs. (21.63±1.87) points,96.82%(61/63) vs. 85.48%(53/62), and there were significant differences, t=11.250,P < 0.01 and χ2=3. 87,P < 0.05. Conclusions Scientific assessment of safety risk and targeted nursing intervention are important means to ensure the safety of patients with intelligent scoring defect. These measures could improve patients quality of life and the improvement of the relationship between nurses and patients.

Objective To explore the feasibility of amide proton transfer (APT) MR imaging to detect cerebral abnormality of the substantia nigra and red nucleus in patients with Parkinson disease (PD). Methods Twenty-seven patients with PD and twenty-three age-matched healthy control subjects were recruited in this study. According to Hoehn&Yahr stages, PD group was divided into two subgroups:early-stage(n=14) and advanced-stage(n=13). PD with right limb onset were seen in 14 patients, and PD with left limb onset in 13 patients. All the PD patients and healthy controls underwent brain APT MR imaging. The magnetic resonance ratio asymmetry (MTRasym) values at 3.5 ppm of bilateral substantia nigra and red nucleus were measured on APT images. MTRasym(3.5 ppm)values of substantia nigra and red nucleus between PD patients and control subjects were compared with independent-samples t test. The difference of MTRasym(3.5 ppm)among normal controls, early-stage PD, and advanced-stage PD patients was assessed with one-way analysis of variance. Paired-samples t test was used to compare the difference of MTRasym (3.5 ppm) in substantia nigra and red nucleus between the side of onset and contralateral side in PD patients. Results Compared to normal controls, MTRasym(3.5 ppm) values of substantia nigra significantly decreased in PD patients[(0.96±0.35)%vs. (1.20±0.39)%respectively, t=-2.093 P=0.039]. No significant differences in MTRasym (3.5 ppm) values of red nucleus were observed between normal controls and PD patients[(0.97 ± 0.36)% vs. (1.09 ± 0.38)% respectively, t=-1.148, P=0.254]. Significant differences in MTRasym(3.5ppm) values of these cerebral structures were observed among normal controls, early-stage PD and advanced-stage PD [substantia nigra(1.20±0.30)%,(1.09±0.32)%and(0.81±0.37)%respectively, F=3.954, P=0.022;red nucleus(1.09±0.28)%,(1.21±0.35)%and(0.71±0.33)%respectively, F=7.563, P=0.001]. MTRasym(3.5 ppm) in substantia nigra showed a consistently decreasing tendency from normal controls to early-stage PD, to advanced-stage PD. MTRasym(3.5 ppm) values of sides of onset and contralateral sides of substantia nigra and red nucleus in PD patients had no significant statistically difference (substantia nigra(0.93 ± 0.33)% vs.(0.99 ± 0.30)%, t=-0.660, P=0.515; red nucleus(1.01 ± 0.36)% vs.(0.93 ± 0.29)%, t=0.545, P=0.590). Conclusions APT MR imaging can show sensitively the difference of MTRasym (3.5 ppm) in substantia nigra and red nucleus between early PD patients and normal controls, Thus, APT is a useful tool to diagnose PD and monitor the disease progression.

Objective To explore the feasibility of amide proton transfer (APT) MR imaging for the detection of basal ganglia abnormalities in patients with Parkinson' s disease (PD).Methods Twentyseven patients with PD and twenty-three age-matched normal control subjects underwent cerebral APT and structural MR imaging.The magnetic resonance ratio asymmetry (MTRasym) values at 3.5 ppm of bilateral globus pallidus,putamen and caudate were measured on APT images.MTRasym (3.5 ppm) values of cerebral structures between PD patients and control subjects were compared with independent-samples t test.Paired-samples t test was used to compare the difference of MTRasym (3.5 ppm) between the side of onset and contralateral side in patients with PD.The difference of MTRasym (3.5 ppm) among normal controls,early-stage PD,and advanced-stage PD patients was assessed with one-way analysis of variance.Results Compared to normal controls,MTRasym(3.5 ppm) values of globus pallidus,putamen and caudate were significantly increased in PD patients ((0.89 ±0.12)％ vs (0.57 ±0.16)％,(1.05 ± 0.11)％ vs (0.82 ± 0.15)％,(1.15 ±0.13)％ vs (0.78 ±0.19)％; t =3.311,2.562,3.277 respectively,all P values ＜ 0.05).Significant differences in MTRasym (3.5 ppm) values of these cerebral structures were observed among normal controls,early-stage PD and advanced-stage PD patients.And MTRasym (3.5 ppm) values in globus pallidus,putamen and caudate were significantly higher in early-stage PD patients than normal controls.In PD patients,even not statistically significant,MTRasym (3.5 ppm)values of sides of onset were slightly lower than contralateral sides.Conclusions APT MR imaging can sensitively identify the difference of MTRasym (3.5 ppm) in the basal ganglia between PD patients and normal controls.APT might be a useful tool to evaluate abnormal metabolite in basal ganglia of PD patients.