Objective To explore the effect of process quality monitoring for hospital infection control of ICU. Methods A total of 265 critically ill patients admitted to ICU were chosen as the control group from April 1, 2014 to March 31, 2015, who were strictly enforced three cluster strategies to prevent catheter related blood stream infection (CRBSI), catheter-associated urinary tract infection (CAUTI) and ventilator–associated pneumonia (VAP) with periodical data monitoring in ICU. Another 292 critically ill patients admitted to ICU were chosen as the observation group from April 1, 2015 to March 31,2016, who were added 3 measures of process quality monitoring on the basis of implementation method of the control group. The incidence of CRBSI, CAUTI and VAP time were compared between two groups. Results There was statistically significant difference on the incidence rate of the CRBSI between the two groups (χ2=4.504, P=0.034), which was respectively 1.79%(5/280) and 5.10%(13/255). There was statistically significant difference in the incidence rate of CAUTI between the two groups (χ2=5.708, P=0.017), which was respectively 3.48% (10/287) and 8.27% (21/254). There was statistically significant difference on the incidence rate of VAP between the two groups (χ2=8.291, P=0.004), which was respectively 3.48% (10/287) and 8.27% (21/254). Mean time of mechanical ventilation in the observation group and the control group was respectively (2.14±1.40) days and (3.37±2.01) days, there was no significant difference (P=0.073). Mean time of ICU stay in the observation group and the control group was respectively (6.04±1.04) days and (11.92±1.90) days, there was statistical significance (t=-1.840, P=0.024). Number of qualified central venous catheter maintenance, perineum clean and oral care had negative relevance with number of patients with CRBSI, CAUTI and VAP, correlation coefficient in the observation group was respectively-0.701,-0.618,-0.677, there was statistical significance (P<0.05). Conclusions The implementation of quality monitoring can reduce the number of patients with CRBSI, CAUTI and VAP, which suggests wide application in ICU.

Objective To investigate the effects and mechanisms of bone marrow mesenchymal stem cells (BMSCs) on pancreatic fibrosis in rats of chronic pancreatitis. Methods Thirty healthy male SD rats were randomly divided into three groups:control group, model group and transplanted group (n=10 for each group). Chronic pancratitis rat model was induced by retrograde injection of oleic acid into the biliopancreatic duct. The sham operation group was treated only with solvent. Transplanted group was given BMSCs through caudal vein injection at 1 week and 5 weeks after the model induction. All rats were weighed at 1 week, 4 weeks and 8 weeks in three groups. After 8-week feeding,pancreatic tissues were harvested for HE and picric-sirius staining. The contents of transforming growth factorβ1 (TGF-β1), typeⅠcollagen and typeⅢcollagen were detcted by using ELISA. Results Compared with the control group, the weights of rats were decreased at 4 weeks and 8 weeks in model group and transplantated group (P<0.05). There were no significant differences in body weights between model group and transplantated group (P>0.05). The pancreatic fibrosis score and pathological injury were ameliorated signicantly in transplanted group. The contents of TGF-β1, typeⅠcollagen and typeⅢcollagen in pancreas were increased in model group than those of control group and transplanted group (P<0.05). Conclusion BMSCs transplantation can reduce the collagen secretion and reduce the degree of pancreatic fibrosis in rats with chronic pancreatitis, which may be related to the inhibition of the release of TGF-β1.

Objective To explore the prevalence of depression in diabetes foot ulcer patients , and to an-alyze the correlation between depression morbidity and various factors such as age , HbA1c level, and quality of life etc.Methods 73 diabetes foot ulcer patients admitted from Sep .2012 to Sep.2014 were enrolled.Depres-sion was assessed using the 9-item patient health questionnaire (PHQ-9).Data such as the age, sex, duration of diabetes and foot ulcer , HbA1C level, smoking were recorded .The severity of foot ulcer was evaluated by Wagner's classification.The quality of life was scored by short form(SF-36)health survey questionnaire.Results The morbidity of depression in diabetes foot ulcer patients was 49.3%in total and 17.8% in the moderate to severe depression group .The prevalence in patients with HbA 1c≥7.0%was significantly higher than that in pa-tients with HbA1c<7.0%(66% vs 35%,P<0.01).Higher occurance of HbA1c≥7.0% was found in the moderate to severe depression group compared to that in the mild depression group .The prevalence of depression was 39.1%in grade 1 in wagner classification , 48.6% in grade 2 to 3 in wagner classification and 69.2% in grade 4 to 5 in wagner classification , showing the two was positively correlated .When duration of foot ulcer lasted more than 6 months, the morbidity of depression(58.1%)was significantly increased(P<0.05).The quality of life was significantly declined in patients with depression by SF-36 questionnaire ( P<0.05 ) .No association was found between the depression morbidity and the age , duration of diabetes , amount of complications or smoking (P>0.05).Conclusions This study shows a high prevalence of depression symptom in diabetes foot ulcer pa -tients.Depression is associated with HbA1c level, the extent and duration of foot ulcer .

Objective To examine the expression and clinical significance of E26 transformation specific-1 in premature rupture of fetal membranes. Methods Fetal membranes from 75 women in the following categories were analyzed for Ets-1 expression: preterm and term premature rupture of fetal membranes; 70 women (control group) with term cesarean sections and without complications. Ets-1 protein was localized with the use of immunohistochemical S-P method. Results Ets-1 protein was expressed in both the nucleus and cytoplasm of trophoblast of human fetal membranes, with more obvious expression in the nucleus. Ets-1 protein's expression was up-regulated in the trophoblast of fetal membranes with premature rupture, which differed significantly from the control group (P<0.05). Ets-1 protein's expression was up-regulated in the trophoblast of fetal membranes with preterm premature rupture, which did not differ significantly from the control group (P>0.05). Conclusion Ets-1 is expressed in human fetal membranes and its expression is up-regulated with premature rupture of fetal membranes, suggesting a role for Ets-1 in extracellular matrix remodeling of the membranes. This study provides an evidence to predict premature rupture of fetal membrances.

Objective To compare the efficacy of peginterferon (Peg-IFN) α-2a in HBeAg positive chronic hepatitis B (CHB) patients with mildly elevated alanine aminotransferase (ALT) level [ALT＜2× upper limit of normal (ULN)] and active hepatic inflammation(G≥2).Methods Fiftyfive HBeAg positive CHB patients with mildly elevated ALT (＜2×ULN) and active hepatic inflammation (G≥2) were enrolled in this randomized,open-label,controlled study.These patients were treated with either Peg-IFN α-2a 180 μg once weekly (n=27) or entecavir 0.5 mg once daily (n=28) for 48 weeks.The data were analyzed using chi-square test and t test.Results After 24 weeks of treatment,8 cases (29.6%) achieved HBeAg loss and 6 cases (22.2%) achieved HBeAg seroconversion in Peg-IFN α-2a group while none in entecavir group (χ2=9.71,P＜0.01;χ2=6.98,P＜0.0 1).Besides,two patients (7.4%) in Peg-IFN α-2a group achieved HBsAg loss.Compared with baseline level,the mean HBeAg titer at week 24 decreased (1 179.8±582.6) PEIU/mL in Peg-IFN α-2a group and (441.5±258.8) PEIU/mL in entecavir group (t=2.66,P=0.01),respectively.At week 24,the serum HBV DNA reduction in entecavir group was more dramatic than that in Peg-IFN α-2a group [(4.520±0.694) lg copy/mL vs.(3.520±1.442) lg copy/mL,t=2.45,P=0.029].In PegIFN α-2a group,the rate of HBeAg loss in patients with G=3 was higher than that in patients with G=2 (χ2=4.23,P=0.041).Conclusions Twenty-four-week treatment with Peg-IFN α-2a is more effective in term of HBeAg loss,HBeAg seroconversion and HBeAg titer reduction than entecavir,while entecavir is more effective in term of serum HBV DNA reduction.Patients with higher baseline hepatic inflammatory activity scores are more possible to achieve HBeAg loss when treated with Peg-IFN α-2a.

OBJECTIVE To investigate the current status,the clinical features and the pathogens of invasive fungal infections in hospital in order to provide clinical treatment based on identification and susceptibility test.METHODS The fungus-cultured positive cases among the discharged patients from Jan 2004 to Nov 2006,were analyzed according to their definite diagnosis of invasive fungal infections under the items,such as the patients age,underlying disease,sample,strain,and species distribution.RESULTS The rates of invasive fungal infections were 4.26%.There were 2221 fungus strains belonged to 8 species in all samples;the patients age was 7-96 years with 2 kinds of various underlying diseases;the age of 2221 cases was 60 years old,mainly senile patients with various diseases accounted for 68.29%.Lower respiratory tract was the most frequent infection site.The main pathogens of invasive fungal infections were Candida spp(93.38%).Strains of Candida albicans were the most frequent organism isolated accounted for 66.19% of all the isolates.C.glabrata,C.krusei and C.tropicalis accounted for 9.19%,8.10% and 4.50%,respectively,the others accounted for only 6.32%.The main infected sites were lower respirtory tract,urinary tract and digestive tract.CONCLUSIONS Candida spp are still the main pathogens of invasive fungal infections.The epidemiological properties of invasive fungal infections is changed.The incidence of non-C.albicans and the Aspergillus strains that arouse invasive infections is increasing recently.

Objective To explore the effect of modified Zexie Decoction on renal aquaporin-2 (AQP2) expression in high-salt hypertensive rat. Methods Hypertensive rats model was established by feeding rat with 8%high salt. Rats (n=50) were divided into model group, modern medicine group, traditional Chinese medicine groups of high, medium, low dose, with 10 rats in each group. The other 10 rats were fed with ordinary diet as normal group. Rats in traditional Chinese medi?cine of high, medium, low groups were given Zexie Decoction suspension of 16.2, 10.8 and 5.4 g/(kg·d) respectively;Rats in modern medicine group was given Valsartan hydrochlorothiazide 16.65 mg/(kg·d);the model group and normal group was ad?ministered with equal volume of distilled water. Animals were feed with medications at 1 mL/100 g by gavage for 4 weeks. On the 1st , 4th , 7th , 14th and, 28th day of administration, we measured SBP and collected 24 h urine. We employed immunohis?tochemistry to detect renal AQP-2 protein expression level and RT-PCR to detect renal AQP-2 mRNA transcription level. Results The rank of SBP from high to low is:model group>traditional Chinese medicine medium and low dose groups>traditional Chinese medicine high dose group and western medicine group>normal group. The rank of urine volume from high to low is:Western medicine group and traditional Chinese medicine high dose group>traditional Chinese medicine me?dium and low dose group > normal group, the difference was not statistically significant between traditional Chinese medi?cine medium and low dose group , or between western medicine group and traditional Chinese medicine high dose group. The renal AQP-2 in epithelial cells along the collecting duct wall of rats in model group show brown particles which are darker and wider distributed than those in normal group and traditional Chinese medicine of high, medium, low dose groups. RT-PCR results show that AQP-2 mRNA expression is highest in rats of model group and lowest in rats of traditional Chi?nese medicine high dose group (P<0.05). No statistical significance of AQP mRNA level was found between traditional Chi?nese medicine low group and model group (P < 0.05). Conclusion Modified Zexie Decoction can lower blood pres?sure by inhibiting the expression of AQP-2.

OBJECTIVE To investigate the risk factors and to take some useful measures to prevent and reduce infection in order to enhance medical quality,to ensure medical security,to strengthen hospital infection manangement and to prevent hospital infection effectively. METHODS We investigated the prevalence rate of hospital infection among our hospitalized patients in 2001,2003 and 2005, respectively. RESULTS The hospital infection rate was 4.6-6.42% in these years.Risk factors and the abuse of antibiotic were decreasing. CONCLUSIONS In order to control hospital infection rate,mensures should be taken including intensively monitoring the departments with high infection rate,strengthening hospital operation,rationally using the antibiotics,and studying the management for hospital infection.

Objective To investigate the expression of Notch4 protein and to analyze its correlation with the clinical parameters and the microvessel dentisty in renal cell carcinoma. Methods The expression of Notch4 was examined in 60 cases of renal cell carcinoma and the para-carcinoma tissue by SP immunohistochemical stain-ing ,and CD34 detection was used for counting microvessel density. Statistical analysis was performed to reveal the correlation with clinicopathological parameters ,microvessel density and prognosis. Results The positive rate of Notch4 protein expression was 75%(45/60)in para-carcinoma tissue,and was 43.3%(26/60)in renal cell car-cinoma,with significant difference on tumor grade and Lymph node metastasis(P<0.05). The microvessel densi-ty in Notch4 positive tissues was significant lower than that in the negative samples(P<0.05). The survival time of patients with Notch4 positive expression was significantly longer than that of patients with Notch4 negative expres-sion(P<0.05). Conclusion Notch4 protein plays an important role in the development of renal cell carcinoma. Notch4 expression might both attenuate the malignant biological characteristics and suppress the angiogenesis dur-ing tumor development.

Objective To analyse the effect of octreotide combined with compound coenzyme on Th17/CD4 +CD25 +Foxp3 + regulatory T cells imbalance in patients with purulent appendicitis.Methods 150 patients with acute suppurative appendicitis were randomly divided into experimental group and control group, 75 cases in each group.Patients of two groups underwent appendicitis laparoscopic resection, then the control group were given conventional treatment and experimental group were given subcutaneous injection of octreotide on the basis of conventional treatment.Th17, CD4 +CD25 +Foxp3 +regulation T cells ( Treg) , and Th17 /Treg balance were analyzed.ResuIts Compared with control group, Th17/Treg imbalance of experimental group recovered better: the proportion of Th17, Treg, and Th17/Treg ratio decreased (P<0.05); the expression levels of related transcription factor, RORγt and Foxp3 mRNA decreased (P<0.05); serum cytokine (IL-4, IL-6, IL-10, IL-17, IL-23 and TGF beta) and C-reactive protein (CRP) content decreased (P<0.05);serum interferon gamma (IFN-gamma) content increased (P<0.05).ConcIusion Octreotide combined with compound coenzyme could correct Th17/Treg imbalance in suppurative appendicitis patients, improve the immune function of patients and affect the prognosis of patients.