OBJECTIVE To investigate the risk factors of postoperative nosocomial infection in esophageal cancer patients,and to provide evidences for controlling nosocomial infection.METHODS The data of 466 cases with esophageal cancer,from Jan 2002 to Dec 2005,were studied retrospectively.RESULTS The nosocomial infection rate of patients with esophageal cancer was 21.03%.The main locations of infection were operation incision,lower respiratory tract and thorax.The nosocomial infection rate had increasing trend as lengthening the hospitalization duration.CONCLUSIONS The nosocomial infection with esophageal cancer is related to age,hospitalization duration and postoperative time.To take measures for infective factors,for example,intraoperative aseptic operation,postoperative drainage tube unblocked and rational use of antibiotics,is important to control and decrease the nosocomial infection.

OBJECTIVE To find out the epidemiology of Salmonella aberdeen outbreaks in NICU and the ways to preventing and treating this nosocomial infection. METHODS The 22 cases who developed S.aberdeen in NICU from Mar 26 to Apr 20 2007 were studied prospectively to find out the reasons of the epidemic and treatment s based on the fecal sample culture results. RESULTS These 22 inpatients fecal samples cultures were tested positive for S.aberdeen,but 14 of 22 inpatients were developed infectious diarrhea. CONCLUSIONS S.aberdeen is confirmed as the cause to this infectious diarrhea outbreak,which is mainly transmitted by close contacts.The occurrence of infection outbreak can be reduced or controlled by emphasizing the hands hygiene and aseptic operation of medical workers,attaching importance to surface disinfection of environment and equipments,and establishing the early warning mechanism.

One hundred patients were diagnosed with cervicalspondylotic radiculopathy definitely by symptoms, signs and X-ray examination. The therapeutic method was acupuncture of Jiaji(Ex-B 2) on the affected segment and the upper and lower vertebrae close together. After the arrival of qi, the needles were connected to acupuncture therapeutic instrument. Meanwhile, the numb, heavy and uncomfortable area on the shoulder and upper limb, where something like cord could be touched, was selected as Ashi point. The needle was inserted perpendicularly into the skin on the place that the cord was most obvious and inserted obliquely and deeply along the cord. After 3-4 courses of treatment, 90 cases got marked effectiveness and 10 cases got effectiveness.

OBJECTIVE To observe bacterial distribution in urinary infection and trend of drug resistance in Shangdong Province.METHODS The patients with urinary infection monitored by Shandong Provincial Nosocomial Infection Surveillance System from Aug 2001 to Jul 2005 were analyzed and summarized.RESULTS Among 933 isolates,524 strains(56.16%) were Gram-negative bacilli,214(22.94%) were Gram-positive cocci and 195(20.90%) fungi.The most common pathogens were Escherichia coli(311),Candida albicans(74),and Enterococcus spp(62).Most of them were multidrug resistant.Most strains of Gram-negative bacilli were highly susceptible to imipenem,while most strains of Gram-positive cocci were highly susceptible to vancomycin.CONCLUSIONS Resistance detection of bacteria periodically has an important significance to clinical treatment with drugs.

OBJECTIVE To study the effect of different antibiotic and nursing care in the treatment of patients with malignant tumor complicating with infection,analyze the high-risk factors and provide the dependable basis for controlling infection in hospital.METHODS In the retrospective investigation of our department,there were 82 times of 68 patients complicating with infection from Jan 2006 to Jun 2007.We analyzed the constituent proportion of infection and risk factors.The patients were divided into 4 groups,group A treated with broad-spectrum antibiotic,group B treated with narrow-spectrum antibiotic,group C treated with de-escalation therapy and group D treated with escalation therapy.We observed the course of therapy and the clinical effect.RESULTS The respiratory tract infection was 68.29%(56/82)and it was the highest one.The difference between groups C and D was significantly in susceptible factors(P

OBJECTIVE To analyze the impact of clinical application sheets for special antibiotics on clinical medication and the existing questions in implementation and irrational phenomena caused by the use of antibiotics.METHODS All the applications sheets for the first month clinical use of special antibiotics in our hospital were analyzed retrospectively,and their used dosage before and after of was compared monthly.RESULTS It was indicated that the partial application sheets were filled out incompletely;the dosage of special antibiotics after clinical application was declined obviously,while the pathogen test rate for the sample was too low and the starting point of the preventive use of antibiotics in some departments was too high.CONCLUSIONS The applications sheets for special antibiotics promote the rational usage of antibiotics in some extent;however,there is still deficiency in operation.Meanwhile,there are some problems in the clinical medication in our hospital and need to take the comprehensive preventive measures to manage it.

BACKGROUND:Currently, it is stil controversial about the border, surrounding fascia, space of pelvic cavity, distribution of nerves and lymph nodes of the mesorectum, and the development of new technologies makes a progress in related anatomic research.
OBJECTIVE:To summarize the previous studies so as to describe clearly the progress of mesorectal anatomy and to discuss its clinical value.
METHODS: Using “rectum; mesentery; fascia; space; nerve; lymph node; total mesorectal excision (TME); clinical anatomy” as key words, a computer-based search of PubMed was done for articles related to the mesorectum and surrounding fasciae, space of pelvic cavity, distribution of nerves and lymph nodes.
RESULTS AND CONCLUSION:Fresh or frozen specimens are often used for studying the mesenterium, fascia, nerves and lymph nodes by using traditional pelvic and perineum anatomical methods. Computer-assisted anatomical dissection can combine immunostaining with computer imaging. A three-dimensional model can wel reflect the relationship among the different anatomical structures, as wel as nerve traveling and spatial location. Mesorectum is located behind the denonviliers and in the front of the sacral fascia of the rectum. Pelvic splanchnic nerve of the mesorectum is derived from the anterior sacral nerve root, runs through the presacral fascia, and enters into the neuro-fascial layervia the pesacral space, which is divided into the upper and lower parts according to the peritoneum. There are more folds in the rear of lymph nodes within the mesorectum within and near the peritoneum. There are stil a lot of controversies about anatomical relationship between the mesorectum and surrounding structures, and to elaborate these issues can provide an objective basis for guiding clinical work.

Objective To analyze the incidence of hospital-acquired infection and the distribution of pathogens through data from the hospital infection surveillance networks in Shandong. Methods A meta-analysis was made of the data submitted by the hospitals involved in the provincial surveillance networks from August 2001 to July 2004. Results The surveillance data involved 1 776 030 hospitalized patients, of whom 43 355 had a hospital-acquired infection, the incidence of hospital-acquired infection being 2.44‰. Respiratory-tract infections were most frequent, followed by gastroenteric-tract infections, urinary-tract infections and surgical-site infections. A total of 6 251 strains of pathogens were isolated, the most commonly identified pathogens being Escherichia coli, Pseudomonas aeruginosa, Staphylococcus aureus, Klebsiella pneumoniae, Candida albicans and Staphylococcus epidermidis. Conclusion It is imperative to reinforce the sterilization of air and medical instruments, strictly abide by aseptic manipulation, and promote the rational use of antimicrobials. Hospital infection surveillance ought to be conducted by the combined method of prevalence surveys and the targeted surveillance of key sectors.

BACKGROUND:The pelvic nerves innervate the pelvic viscera as wel as bring sensory information to the central nerve system, including splanchnic nerves and spinal nerves. Each of them comprises both motor fibers and sensitive fibers. Mostly, the key part of splanchnic plexus is pelvic plexus. Total mesorectal excision proposed by Heald in 1982 has been the “gold standard” for diagnosis and treatment of colorectal cancer. However, it carries a high risk of nerve damage during surgery, which results in urinary retention, sexual dysfunction and other complications. OBJECTIVE:To summarize the former researches so as to get a precise understanding of the pelvic fascia and nerve structure. METHODS:Using “splanchnic nerves, superior hypogastric plexus, pelvic plexus, pelvic splanchnic nerve, total mesorectal excision (TME), clinical anatomy” as key words, a computer-based search of PubMed was done for articles related to the pelvic nerves, including its pathway, consistent, ganglia, and reflection in pelvic viscera, published from 2000 to 2015. RESULTS AND CONCLUSION:The main splanchnic plexus in the pelvic cavity includes superior hypogastric plexus (it is located in the triangle formed by left and right common iliac artery and the sacral promontory), and pelvic plexus (hypogastric nerve, pelvic splanchnic nerve and sacral splanchnic nerve converge at the bottom of rectum, formed pelvic plexus, also known as the inferior hypogastric plexus). It is flattened against the lateral aspect of the rectum, the dorso-lateral bladder wal and the seminal vesicles. Nerves come from the plexus contain the sympathetic nerve, parasympathetic nerve and sensory nerve. They are in charge of the motions and sensations of the pelvic organs. The definite knowledge on the anatomy of pelvic fascia and nerve structures can avoid nerve damage during operation, which can help to improve the life quality of patients.

Relative deficiency of serum insulin and insulin resistance of tissues are the main causes of postburn hypercatabolism.In order to evaluate the clinical effects of tolbutamide to improve postburn hypermetabolism,9 burn patients were given tolbutamide and observed for 10 days after the drug had gone through animal experiments.It was found that tolbutamide could improve postburn hyper-metabolism through following ways:1.To stimulate the secretion of insulin and enhance the effect of insulin.2.To reduce the insulin resistance of tissues and promote glucose utilization of skeletal muscles.3.To inhibit the secretion of glucagon.