OBJECTIVE To prevent nosocomial infection by strengthening the nursing administration.METHODS An effective system to prevent nosocomial infection,which included the further education for nurses on nosocomial infection and a normalized operation sequence,was established.The system was made to be well carried out.RESULTS The system worked normally and effectively.As a result,nosocomial infection could be well prevented.CONCLUSIONS Normalizing nursing administration is an effective method to prevent nosocomial infection.

OBJECTIVE To analyze the nosocomial infection cases,which were failed to be reported,and to grope for countermeasure to lessen the rate of nosocomial infection cases in disguise.METHODS The clinical data of the inpatients who were getting treatments in Oct 2004 and in Oct 2005 in the hospital were reviewed and analyzed.RESULTS The understanding and the recognition of nosocomial infection,the standards for judgement,the quatification of the medical workers,the medical cost and economic benefit ratio were all the causes that prevented nosocomial infection cases from being reported.CONCLUSIONS Propagandize the nosocomial infection management to make our medical workers attach importance to it,implement an objective obligation,constitute a hortative system,to exert the director's function and the workers′ enthusiasm,and choose high qualified workers to take charge in the nosocomial infection management,thus can prevent nosocomial cases from being reported.

Objective To explore the clinical features and treatment of polycythemia vera(PV)complicating stroke.Methods Clinical data of 27 cases of PV complicating stroke were analysed retrospectively.Results(1)Among all the cases,PV complicating cerebral infarction were 22 cases(81.5%),among the 22 cases,18 cases(66.7%)of multiple cerebral infarction,2 cases(7.4%)of transient ischemic attack,2 cases(7.4%)of cerebral hemorrhage,1 case(3.7%)of subarachnoid hemorrhage(SAH).The patients's clinical manifestation,physical sign,hemogram,marrow characteristic were consistent with that of PV diagnosis criteria.(2)Imageology check show that small infarction focus were common(66.7%).Lobe of brain,basal ganglia,capsula interna were common place of cerebral infarction.The density of hemorrhagic focus was asymmetrical,there was obvious edema around the hemorrhagic focus.(3)Applied vein blood-letting and small dose chemotherapy,8 cases were recovery,18 cases were obviously improved,1 case of stroke was invalid.Conclusion The cerebral infarction are common in PV complicating stroke.Among all the PV complicating stroke cases,multiple cerebral infarction are the most common,cerebral hemorrhage and subarachnoid hemorrhage are few,vein blood-letting and small dose chemotherapy has a good curative effect for the patients.

Objective: To prepare the conjugate of supcrantigen (SAg) staphylococcal enterotoxin A (SEA) and monoclonal antibody (McAb) against human hepatocellular carcinoma HAbl8 F(ab' )_(2) fragment and to investigate the anti-human hepatoma effect of peripheral blood mononuclear cells (PBMC) targeted by HAbl8 F(ab' )i-SEA. Methods: McAb HAbl8 was extracted and its F(ab' )_(2) fragment was prepared with papain; the conjugate HAblS F(ab' )_(2)-SEA was prepared with N-succinimidyl-3-(2-pyridyldithio) propionate (SPDP); eveny collected peak after purification was identified with gel chromatography; the activity of antibody in the conjugate was identified with immunohistocheinical ABC method; the anti-hepatoma effect of PBMC targeted by HAbl8 F(ab' )_(2)-SEA was observed with MTT method. Results: The conjugate HAbl8 F(ab' )_(2)-SEA was prepared successfully and it had obvious effect of targeting PBMC to kill hepatoma cells, and this effect is correlated positively with the dose of HAbl8 F(ab')_(2)-SEA. Control groups had no such effect. Conclusion: Targeting therapy of hepatoma with McAb-SAg conjugate might be a kind of hopeful model of hepatoma im-munotherapy.

OBJECTIVE To investigate the cause,diagnosis and treatment of the empyema of the anastomotic fistula after esophageal cancer resection.METHODS The clinical data of 624 cases after esophageal cancer and cardia cancer resection from Jan 2000 to Dec 2006 were analyzed retrospectively which included 14 cases of the empyema of the anastomotic fistula.RESULTS All the cases were treated with the closed thoracic drainage,in which 9 cases were cured with closing double-tube chest douching technique,3 cases were succeeded to operate secondary thoracotomy for anastomosis,1 case died after being sent to the higher grade hospital,1 case died for toxic shock and respiratory failure without the chance of reoperation.CONCLUSIONS The key measures of prevention of empyema of post-operative esophagogastrostomy anastomotic fistula inside thorax are strictly distincting between indication and contraindication,carefully preparating before operation,commanding operative time and technical skill,strengthening nursing management,and fulfilling the oral manipulation and nursing prcedures about the drainage tube after operation.

Trastuzumab is a specific inhibitor against human epidermal growth factor receptor-2 (HER-2). Trastuzumab is widely used in the neo-adjuvant treatment of HER-2 breast cancer. Large-scale randomized and controlled clinical trials have demonstrated that pathologic complete response rates (pCRs) were significantly increased with neo-adjuvant trastuzumab therapy plus chemotherapy than with regular chemotherapy. The use of trastuzumab plus chemotherapy with lapatinib supplements could further improve pCR rates. An-thracycline and non-anthracycline drugs could both be used concurrently with trastuzumab. Endocrine therapy could be used as an alter-native for estrogen receptor-positive patients. pCR is a powerful predictor of long-term outcomes in HER-2 positive patients under neo-adjuvant therapy with trastuzumab. However, patient loss of HER-2 expression with residual disease after neo-adjuvant therapy with trastuzumab is a poor prognostic factor. This study paper will provide a review of related research.

Objective To explore the clinical effect of small incision extracapsular cataract extraction combined with implantation of artificial lens and phacoemulsification combined with implantation of artificial lens for patients with cataract.Methods One hundred and ten patients (142 eyes) with cataract were selected,55 patients (69 eyes) were treated with small incision extracapsular cataract extraction combined with implantation of artificial lens (observation group),and 55 patients (73 eyes) were treated with phacoemulsification combined with implantation of artificial lens (control group).After treatment,the corrected vision and quality of life were observed 1-week,1-and 3-month after operation,and the complications were recorded.Results The vision 0.6-1.0 of 1-week,1-and 3-month in observation group were 34 eyes (49.3％,34/69),61 eyes (88.4％,61/69) and 63 eyes (91.3％,63/69) respectively,in control group were 37 eyes (50.7％,37/73),64 eyes (87.7％,64/73) and 65 eyes (89.0％,65/73) respectively,there were no statistical differences (P ＞0.05).The quality of life score 1-week,1-and 3-month in observation group were (87.5 ± 10.7),(91.2 ± 5.3),(94.3 ± 5.8) scores respectively,in control group were (85.9 ± 11.5),(90.6 ± 6.7),(94.5 ± 6.0) scores respectively,there were nostatistical differences (P ＞ 0.05).The rate of complications in observation group was 23.2％ (16/69),in control group was 37.0％ (27/73),there was statistical difference (P ＜ 0.05).Conclusions The vision recovery and quality of life in cataract patients treated with small incision extracapsular cataract extraction combined with implantation of artificial lens are similar to treated with phacoemulsification combined with implantation of artificial lens.However,with fewer complications,small incision extracapsular cataract extraction combined with implantation of artificial lens is a more safe and reliable treatment method.

Adjuvant treatment, which includes chemotherapy and endocrine therapy, for early breast cancer may impair bone den-sity, resulting in bone loss. The third generation bisphosphonate-zoledronic is an anti-resorptive agent that inhibits osteoclast-mediated bone resorption. This drug can be mainly used in the treatment of hypercalcemia caused by bone metastases of the cancer. The Zome-ta-Femara Adjuvant Synergy Trial revealed that immediate zoledronic acid and endocrine therapy not only prevents bone loss, but also reduces recurrence. The Austrian Breast and Colorectal Cancer Study Group-12 (ABCSG-12) also confirmed that zoledronic acid, when combined with endocrine therapy, could reduce the risk of cancer disease progression and death. Moreover, preclinical studies and clini-cal trials have demonstrated the synergistic antitumor effects of chemotherapy and zoledronic acid. Neo-adjuvant zoledronic acid to re-duce recurrence trials showed that the addition of zoledronic acid to adjuvant chemotherapy significantly reduced the risk of disease pro-gression and death in postmenopausal women more than five years postmenopause at the beginning of the study or over 60 years of age at the baseline. The ABCSG-12 subgroup analysis based on age (≤40 years or>40 years) also showed that zoledronic acid can signifi-cantly improve the prognosis in women who were over 40 years at the study entry. These results suggest that zoledronic acid administra-tion in patients with lowered estrogen levels (naturally or as a consequence of adjuvant treatment) easily exerts anti-tumor effects. How-ever, the optimal dose and duration of zoledronic acid requires further studies. More clinical trials should be performed to provide suffi-cient evidence to support the effectiveness of zoledronic acid in the treatment of early breast cancer.

Hemophagocytic syndrome is a group of fatal immune function disorder,which can be divided into primary and secondary HPS.The disease is complex,lacking of specificity,difficult in diagnosis with quick progress,high mortality and poor prognosis.The diagnosis is mainly based on the HPS-2004 diagnostic criteria,etoposide,dexamethasone and cyclosporine would be first chosen for treatment.This article reviews the clinical advances on etiology,diagnosis,treatment and prognosis of hemophagocytic syndrome.

Objective To evaluate the diagnosis and treatment of primary breast lymphoma(PBL).Methods Clinical data of 49 PBL cases diagnosed in our center from 1997 to 2011 was retrospectively analyzed.Results 1 case was male,48 cases were female.Most patients were at the age of 35-55 years.Painless mass was the most common symptom which was most often seen on the upper-outer quadrant of the right breast,accounting for 61.11％ in this group.Preoperative misdiagnosis rate was high by mammography,B ultrasonic and hollow needle pathologic examination.Final diagnosis could only made by postoperative histopathologic examination.In this group 1 case was Hodgkin lymphoma and 48 cases were non-Hodgkin lymphoma(NHL) originating from B cells.46 patients underwent surgery and chemotherapy followed by radiotherapy in 16 cases.Median time of follow up was 40 months,5-year overall and disease free survival was 48％ and 28％ respectively,and bone marrow was the most common metastatic organ.Conclusions The prognosis of PBL is poor.The image diagnosis lacks specificity.Paraffin sections and immunohistochemistry were the main means to make a definite diagnosis.Chemotherapy-based comprehensive treatment is the strategy in the management of PBL instead of radical mastectomy.