Objective To investigate the epidemiological characteristics and risk factors for healthcare-associated infection(HAI)in a newly built rehabilitation hospital.Methods A prospective survey was adopted to monitor HAI among all patients admitted to a newly built rehabilitation hospital between January 2011 and December 2014, related data were collected and analyzed statistically.Results A total of 22 126 patients (male,n=12 023;female, n=10 103)were monitored,age were 4 months-100 years old.HAI rate was 3.25%(n=720),HAI case rate was 3.34% (n=738).Patients in department of spinal rehabilitation had the highest HAI rate (9.76%);the main HAI site was lower respiratory tract (n = 388,52.57%);a total of 186 pathogenic isolates were detected,154 (82.80%)were gram-negative bacteria,25 (13.44%)were gram-positive bacteria,and 7 (3.76%)were fungi. Multivariate logistic regression analysis showed that paralysis (OR,1 .77 [95% CI ,1 .24 - 2.53 ]),length of hospital stay ≥60 days(OR,4.62 [95% CI ,3.28 -5.10]),age ≤ 10 years old (OR,1 .55 [95% CI ,1 .33 -2.93]),age ≥60 years old (OR,4.59 [95% CI ,1 .02-20.59]),chronic underlying diseases(OR,1 .56 [95% CI , 1 .37-11 .34]),invasive procedure (OR,3.33 [95% CI ,1 .21 -6.86]),and coma(OR,6.77 [95% CI ,5.41 -7.05])were major risk factors for HAI in patients in the rehabilitation hospital.Conclusion Investigation on newly built rehabilitation hospital is helpful for realizing the occurrence status of HAI,health care workers can carry out the corresponding prevention and control measures.

Objective: To develop a general module of self-administered quality of life instrument for Chinese patients with chronic disease. Methods: Using the structured group (nominal group and focus group) methods and the qualitative and quantitative theory and methodology in developing rating scales Items were preliminary screened, evaluated and modified, and the QoL data measuring from 201 cases of patients of 8 different chronic diseases were analyzed by the methods of coefficient of variation?factor analysis, clustering analysis and correlation analysis. Result: General module of quality of life instrument for patients with chronic disease (QLICD-GM) was developed and evaluated. It consists of three domains: physical function, psychological function and social function, 32 items. Conclusions: QLICD-GM possessed a reasonable good content validity for it reflect WHO 's definition and connotation of QoL, and also common issues of patients with chronic disease.

Objective To investigate the status quo of job-family and family-job conflicts among the nursing of the operating room nurses.Method A total of 190 nurses from an operating room participated in the survey by demographic questionnaire and work-family conflict scale.Results The average score on job-family was (3.15 ± 0.48) and there were significant differences between family-job conflict and job-family (2.75 ± 0.27 vs.3.55 ± 0.61) (t =-10.349,P＜0.05).There were significant differences in job-family conflict scores (P ＜0.05) in view of different age,working years,professional titles,number of night shifts per month,marital status and daily working hours.There were significant differences in family-job conflict subscale scores (P＜0.05).Conclusions The job-family conflicts of the nurses in the operating room is at the middle level.The perceived job-family conflict is higher than that of the family-job conflict.Such factors as age,length of work,professional tide,number of night shifts per month,marital status and daily working hours can lead to job-family conflict among the operating room nurses.The nursing administrative should displace nursing personnel and optimize the shifts so as to reduce the rate of job-family conflicts.

Objective To develop and evaluate the Quality of Life Instruments for Chronic Diseases -Osteoarthritis ( QLICD-OA). Methods The QLICD-OA was evaluated by testing 140 in-patients with Osteoarthritis. The statistical methods used included correlation analysis, factor analysis, paired t test and Generalizability coefficient. Results The rest-retest reliability γ of QLICD-OA was 0.91, Cronbach’s α for overall scale was 0.98 and Generalizability coefficient was 0.94. Correlation and factor analysis demonstrated good construct validity. After treatment, statistically significant scores were found in the tested group for Specific module and total instrument. Conclusions The QLICD-OA has good validity, reliability and responsiveness. The QLICD-OA may serve as the QOL measurement scale for patients with Osteoarthritis in China.

Objective To investigate the efficacy of two different methods of catheter balloon dilatation therapy in treating cricopharyngeal achalasia and benign strictures,and to correlate balloon capacity with improve-ments in swallowing function. Methods Twenty-three cricopharyngeal achalasia patients and 7 with benign stric-tures of the cricopharyngeal muscles were diagnosed using videonuoroscopic swallowing study(VFSS).All cases re-ceived active dilatation or passive balloon dilatation therapy,combined with manipulation,indirect training,direct training and feeding instruction.Efficacy and the correlation were evaluated using VFSS and a swallowing function scale. Results Passive and active dilatation had the same efficacy.The correlation coefficient between balloon ca-pacity and swallowing function was 0.92 1.Re-evaluation using VFSS showed that opening of the cricopharyngeal muscles had improved significantly.Conclusions Balloon catheter dilation is an effective treatment for cricopha-ryngeal achalasia and benign strictures.The improvement in swallowing function is highly correlated with balloon ca-pacity in balloon dilatation therapy.Comprehensive treatment for dysphagia would provide better outcomes.

Objective To conduct a prospective,randomly controlled trial,evaluating the combination of tacrolimus,corticosteroids and entecavir for the treatment of adult patients with biopsyproven hepatitis B virus-associated membrane nephropathy (HBV-MN).Methods A total of 38 patients with biopsy-confirmed HBV-MN were randomized to the tacrolimus group (n=19) and the control group (n=19).Patients in tacrolimus group received combination therapy of tacrolimus (0.05 mg·kg-1 · d-1),corticosteroids (prednisone acetate,0.5 mg· kg-1 · d-1) and entecavir (0.5 mg/d),whereas patients in control group received entecavir mono-therapy (0.5 mg/d).The primary end point was the percentage of patients reaching complete remission (CR) or partial remission (PR).Results The probability of remission in the treatment group was 88.89％ and 94.44％ after 6 and 12 months,but only 38.89％ and 58.82％ in the control group,respectively.The decrease in proteinuria was significantly greater in the treatment group.Entecavir was used for the treatment of hepatitis in all patients,which caused the disappearance of serum hepatitis B viral DNA(HBV-DNA) and the normalization of ALT and AST levels in 3 months.Notably,two patients in the control group and one patient in the treatment group reached the secondary end point.One patient in the tacrolimus-treated group showed a relapse during the taper period.Conclusion This treatment protocol not only can control the replication of HBV-DNA but also can reduce proteinuria and preserve renal function,it is one of useful therapeutic options for patients with HBV-MN.

Objective To analyze temporal and kinematic parameters of video fluoroscopic images of swallowing using a digital acquisition and analysis system and to verify the reliability of this method.Methods Eighteen patients with dysphagia were requested to completed six swallows (3 ml and 5 ml of thin liquid, thick liquid, and paste mixed with 600 kg/m3 barium sulfate suspension) in the natural sitting position.Video fluoroscopy was used to measure the oral transit times, soft palate elevation times, hyoid movement times, laryngeal closure times, cricopharyngeal muscle opening times, hyoid anterior movement (HAM) , hyoid superior movement (HSM) , cricopharyngeal muscle opening diameter and pharyngeal constriction rate.Each was extracted from the videos four times by two raters working separately with an interval of 4 weeks between the sets of evaluations.Results Reliability varied among the different observations.HAM and HSM showed inter-rater reliability between 0.41 and 0.60 and intra-rater reliability between 0.61 and 0.80.The other observations all demonstrated acceptable reliability.Conclusion The self-designed digital acquisition and analysis system tested showed acceptable reliability and could be applied to analyze swallowing function clinically.

Objective To investigate the correlation between eigenvalues(λ∥ andλ⊥)of sciatic nerve and limb function in a rabbit model of acute nerve traction inj ury for finding the role ofλ∥ andλ⊥ on diagnosis of nerve inj uries.Methods The right sciatic nerves of 32 Newland rabbits were selected to be performed as traction injury,and then left sciatic nerves were treated as control for the sham operation side.MRI DTI scan was performed before and after the operation on 1 day ,3 day,and 1 week,2,3,4,6 and 8 weeks respectively.Theλ∥ andλ⊥ of inj ured sciatic nerves and sham operated nerves were measured,meanwhile functional exami-nations were evaluated,and then analyzing the correlation betweenλ⊥ of inj ured sciatic nerves and the score of inj ured limb function in the periods of 3 days to 8 weeks;finally different portions of sciatic nerve were removed for histological examinations.Results Theλ⊥ of inj ured sciatic nerves in the proximal portion was slightly increased at 3 days and recovered to the normal at 2 weeks.Theλ⊥ of inj ured sciatic nerves in the traction portion and distal portion were slightly raised at 1 day,reached to its maximum value at 3 days,and then decreased gradually after 1 week and dropped to the pre-operation level after 4 weeks.Theλ⊥ of inj ured sciatic nerves in the proximal portions was significantly higher than that of the sham-operated nerves from 1 day to 1 week(F=7.275,P=0.000). Theλ⊥ of inj ured sciatic nerves in the traction portion and distal portion were significantly higher than that of the sham-operated nerves from 1 day to 3 weeks(F=5.851,F=3.794,P=0.001,P=0.000).However,there was no significantly difference between theλ∥ of inj ured nerves in each portion and sham-operated nerves .The negative correlation between theλ⊥ of inj ured sciatic nerves in the distal portion and the score of the nerve function in the injured limb was found (r=-0.938,r=-0.897,P<0.01).Conclu-sion Theλ⊥ of inj ured nerves in the traction portion and distal portion could monitor the process of degeneration and regeneration of sciatic nerve in traction inj ury,while theλ∥ plays no obvious role in diagnosis of nerve inj uries.

Objective To evaluate the relationship between the level of AMP-activated protein kinase (AMPK) in hippocampus and cognitive dysfunction after splenectomy in aged rats.Methods Sixty-three male aged Sprague-Dawley rats,weighing 480-550 g,were randomly divided into 3 groups (n =21 each):control group (group C),anesthesia group (group A),and surgery group (group S).Morris water maze (MWM) test was performed to evaluate the spatial learning and memory ability before surgery and at 1,3 and 7 days after surgery.The escape latency and swimming distance were recorded.Seven rats were chosen after MWM test was performed at 1,3 and 7 days after surgery and sacrificed.Their hippocampi were removed for detection of the expression of AMPK and phosphorylated (p-AMPK) (by Western blot).Results Compared with the baseline,the escape latency and swimming distance were significantly prolonged at 1 and 3 days after surgery in group S (P ＜ 0.05).Compared with group C,the escape latency and swimming distance were significantly prolonged at 1 and 3 days after surgery,the expression of AMPK was up-regulated at 1,3 and 7 days after surgery,and the expression of p-AMPK was up-regulated at 1 and 3 days after surgery in group S (P ＜ 0.05),and no significant changes were found in the indices mentioned above in group A (P ＞ 0.05).Conclusion Increased AMPK level in hippocampus is the regulatory mechanism of the body adapting to the development of cognitive dysfunction after splenectomy in aged rats.

Objective To investigate the efficacy and safety of Tripterygium wilfordii Hook F (TwHF) combined with renin-angiotensin system (RAS) blockers in chronic kidney disease (CKD) stages 2~3 of IgA nephropathy. Methods 109 patients were randomized into the observation group and the control group. On the basis of taking RAS blockers, patients in the observation group received TwHF, and patients in the control group received methylprednisolone. The proteinuria, renal function and adverse effect were observed during treatment. Results At 3, 6, 9 and 12 months of treatment, proteinuria in the two groups was lower than the baseline(P <0.05). During follow-ups, there was no significant difference of eGFR between the two groups and baseline (P >0.05). Besides, there was no significant difference in terms of proteinuria, eGFR and effective rate in the two groups. The occurrence rate of adverse effects was 9.8% vs 27.4% and there was significant difference in the two groups (P < 0.05). Conclusions TwHF combined with RAS blockers can decrease proteinuria, protect renal function and have less adverse effects, and it is a useful therapeutic options for CKD stages 2 ~ 3 of IgAN.