Objective To evaluate effect of care bundle on preventing neonatal ventilator-associated pneumonia (VAP). Methods Eighty neonates who met the inclusion criteria were selected and randomly divided into trial group and control group,two groups of neonates were both given routine nursing care,trial group were implemen-ted care bundle to prevent VAP on the basis of routine nursing care. Incidence of VAP,average length of neonatal intensive care unit (NICU)stay,and average hospitalization expense were compared between two groups of neo-nates.Results A total of 80 neonates were monitored,trial group and control group were both 40 cases. Incidence of VAP in trial group and control group were 21.21‰ and 35.04‰ respectively(P<0.05);average length of NICU stay in trial group and control group were (17.84±4.03)d and (23.50±4.81)d respectively(P<0.05);average hospitalization expense in trial group and control group were(26200.71 ±389.45)yuan and (38506.36±582.13) yuan respectively(P<0.05).Conclusion Care bundle can effectively prevent the occurrence of VAP,reduce the length of NICU stay,decrease hospitalization expense,and improve nursing quality and satisfaction.

OBJECTIVE:To provide reference for medical costs control in China. METHODS:Based on main characteristics of the United States health service system,information asymmetry,principal-agent theory and Freedman’s consumption theory were used to analyze the advantages of restrictive relationship among doctors,hospitals and health insurance institutions in control-ling medical costs and improving the quality of diagnosis and treatment. The growth rate of medical cost,the percentage of drug ex-penditure and other aspects were compared between China and the United States;the effect of restrictive relationship on medical cost control was demonstrated. RESULTS & CONCLUSIONS:In the United States,there are hierarchical medical system and two-way referral system;for-profit hospitals and non-profit hospitals are mutually complementary;different natures of health insur-ance system,different payment methods and strict“commercial bribe”monitoring system are carried out;doctors,hospitals and health insurance restrict each other. Not only there are many advantages in theory,but also in practice the growth rate of medical cost and the percentage of drug expenditure are superior to our country. Finally it controls the rapid growth of medical cost to a cer-tain extent. Combined with our national conditions,learning from the United States experience,restrictive relationship among doc-tors,hospitals and health insurance institutions is established to control the increase of medical cost in China through reducing infor-mation asymmetry and standardizing payment audit;establishing a scientific pattern of mixed payment;strengthening the indirect impact of the health insurance institutions on doctors and hospitals,etc.

AIM To observe the synergical effects of ginsenoside of stem and leaf(GSL)in combination with choline on learning and memory of Alzheimers disease(AD). MEHODS AD animal models were made by damaging nucleus basalis of Meynert with quinolinic acid. One time training passive aviodance step-down and water-maze spatial localization task were used to observe the ability of learning and memory.RESULTS Treatment with combination of GSL(400 mg?kg -1 ?d -1 ,ig) and choline(200 mg?kg -1 ?d -1 ,ig) on AD rats decreased significantly the number of errors on step down (ig for 13 days) and the training times to reach the criterion on water maze (ig for 16 days). The effect of GSL in combination with choline was more remarkable than that of GSL or choline and proved no obvious difference compaired with that of 1,2,3,4-tetrahydroacridine (10 mg?kg -1 ?d -1 ,ig). Value Q was more than one after administrition of both GSL and choline. CONCLUSION GSL in combination with choline may synergically improve the impairement of learning and memory of AD.

Objective To explore the relation of gamma knife radiation of different doses with trigeminal nerve radiation damage by investigating the pathologic changes of trigeminal nerve roots after different doses of gamma knife radiation.Methods Fifteen New Zealand rabbits were randomly divided into 60 Gy radiation group,80 Gy radiation group,100 Gy radiation group,120 Gy radiation group and control group (n=3).Bilateral trigeminal nerves of all New Zealand rabbits,excepted for the control group,were irradiated;and a 4-mm isocenter was placed at trigeminal nerver root entry zone.All New Zealand rabbits for pathological observation were sacrificed after six months.The roots were examined by light microscopy,immunohistochemistry,and electron microscopy.Integrated optical density of the myelin staining and immunohistochemistry staining results of the four groups were examined by Image-pro plus 6.0 image processing system,and analyzed using method of statistics.Results Pathological observation showed the result of 60 Gy group after irradiation did not differ significantly as compared with the result of control group;in 80 Gy group,there was part nerve fiber fragmentation and degeneration,and demyelination;in 100 Gy group,there was nerve fiber fragmentation,degeneration and demyelination,and part of nervous necrosis;in 120 Gy group,there was almost all nerve fiberdissolution,disappearance and demyelination,and most of nervous necrosis.The integrated optical density of the myelin staining and immunohistochemistry staining results of 60 Gy group did not differ significantly as compared with that of the control group (P＞0.05);the results of 80 Gy,100 Gy and 120 Gy group differed significantly as compared with that of control group (P＜0.05) and decreased following the increase of irradiation doses.Conclusions The histopathological changes of the trigeminal nerve irradiated by gamma knife have significant correlation with irradiation doses.The result of 60 Gy group after irradiation does not change significantly;the radiation injury of 80 Gy-120 Gy group aggravates with the increase of irradiation doses;irradiation of high dose (100 Gy and 120 Gy) can cause nervous necrosis.

The vagina contains at least a billion microbial cells,dominated by lactobacilli.Here we perform metagenomic shotgun sequencing on cervical and fecal samples from a cohort of 516 Chinese women of reproductive age,as well as cervical,fecal,and salivary samples from a second cohort of 632 women.Factors such as pregnancy history,delivery history,cesarean section,and breastfeeding were all more important than menstrual cycle in shaping the microbiome,and such information would be necessary before trying to interpret differences between vagino-cervical micro-biome data.Greater proportion of Bifidobacterium breve was seen with older age at sexual debut.The relative abundance of lactobacilli especially Lactobacillus crispatus was negatively associated with pregnancy history.Potential markers for lack of menstrual regularity,heavy flow,dysmenor-rhea,and contraceptives were also identified.Lactobacilli were rare during breastfeeding or post-menopause.Other features such as mood fluctuations and facial speckles could potentially be predicted from the vagino-cervical microbiome.Gut and salivary microbiomes,plasma vitamins,metals,amino acids,and hormones showed associations with the vagino-cervical microbiome.Our results offer an unprecedented glimpse into the microbiota of the female reproductive tract and call for international collaborations to better understand its long-term health impact other than in the settings of infection or pre-term birth.