OBJECTIVE To probe the risk factors of the secondary lung infection in patients of postoperative(cranio)-(cerebral) trauma as well as the ways to control them.METHODS A prospective and review study was carried out in 718 cases with cranio-cerebral trauma admitted in our hospital for operation from Jan 2002 to Dec 2004.RESULTS Among 718 cases,39(5.43%) developed lung(infection),occupied 65% of the total number of the hospital(infection) in the neurosurgery.After an integrated(total and systemic) treatment,the cure rate was(69.23%(27 cases);) effective: 15.3%(6);improved: 7.7%(3); died: 7.7%(3).CONCLUSIONS Oxygen(inhalation,) nasal(feeding),sputum drawing out,(cannular) tracheotomy,and use of respirator after operation are the causes of the lung infection and it can be controlled effectively if keeping the surroundings clean,keeping strict ness in disinfection-isolation institution,improving the mangement of respiratory tract and the care of oral cavity,proper use of antibiotics,and improving immunity.

Objective To investigate the status of safe injection practice in primary medical institutions.Methods 55 primary medical institutions in Hubei Province were randomly selected,questionnaire survey on status of safe injection in primary medical institutions was conducted.Results A total of 55 questionnaires were distributed,50(90.91％) valid questionnaires were obtained.All valid questionnaires were from primary level medical institutions of Hubei Province,16 of which were from community health centers,17 from township health centers,and 17 from village health clinics.None of 50 primary medical institutions repeatedly used syringe and hemostix,all used disposable sterile syringe,only 7(14.00％) medical institutions used retraction type self-destructing syringe.Only 5 (10.00％) medical institutions were equipped with hand hygiene facilities and sharps containers,32 (64.00％) medical institutions didn't provide sharps containers on treatment carts,21 (42.00 ％) injection rooms didn't install hand-drying facilities,18 (36.00 ％)medical institutions didn't provide alcohol-based hand rub on treatment carts and didn't install hand-drying facilities in treatment rooms.Of sharp injures among health care workers (HCWs) reported in 2015,114 HCWs sustained 117 times of injuries,74 cases(63.25 ％) were caused by ampoule.Of medical waste disposal,there existed some problems,such as leakage and repeated use of sharps box,didn't close sharps box timely,as well as without providing sharp containers in locations where sharps might be produced.Conclusion There are a variety of hidden risks of unsafe injection in primary medical institutions,like insufficient facilities and unsafe disposal of medical waste.

OBJECTIVE To develop the countermeasures how to strengthen disinfection and isolation in the basic(medical) and health institutions.METHODS Through investigation,to analyze the current situation and problem of disinfection and isolation in the basic medical and health institutions.RESULTS There were some problems of the(disinfection) and isolation in the basic medical and health institutions and some possibility for patient catching(nosocomial) infection.CONCLUSIONS It is very important for strictly observing Medical Instrument Surveillance and Management Regulations published by the State Council and Hospital Infection Management Standards,Disinfection Technology Standards and Disinfection Management Methods published by Ministry of Health,and strengthening the management of disinfection and isolation in the basic medical and health institutions.

Objective To explore the curative effect of stomatitis spray combined with 3M liquid dressing on degree II red buttocks in infants and summarize key points of nursing care. Methods From April 2012 to June 2016, 64 infants with degree II red buttocks were treated in our department. According to the admission time, the infants were divided into control and experiment groups in equal number. The control group was treated with zinc oxide ointment, and the experiment group with stomatitis spray combined with 3M liquid dressing. The curative effect, total effective rate, and wound healing time were compared after treatment between the groups. Results The curative effect and total effective rate of red buttocks in the experiment group were significantly better than those of the control group (P<0.05). Moreover, the wound healing time in the experiment group was obviously shorter than that of the control (P<0.05). Conclusions Compared to zinc oxide ointment, the stomatitis spray combined with and 3M liquid dressing is more effective in the treatment of severe red buttocks of the infants. Moreover, the latter is advantageous in wound healing time, compliance, treatment, and curative effect, which indicates its potential application in clinic.

Objective To study the clinical significances of serum lipoprotein (LP),high sensitivity C- reactive protein (hs CRP),cystatin (Cys-C),apolipoprotein (Apo) in type 2 diabetic mellitus (T2DM) patients with early renal impairment.Methods Totally 96 patients were divided into two groups:50 cases in simple diabetic group (DM) aged 60-73 years,46 cases in diabetic nephropathy group (DN) aged 61-72 years,and 50 healthy persons as normal control group aged 61-68 years.Serum levels of LP(a),hs-CRP,Cys-C,ApoA1 and ApoB were detected.Results Serum levels of LP (a) [(214.8±182.3) mg/L vs.(113.1±76.2) mg/L],Cys-C[(0.95±0.16)mg/L vs.(0.46±0.17) mg/L],hs-CRP (2.57± 1.84) mg/L vs.(1.07±0.38)mg/L] and ApoB [(1.12±0.18) g/L vs.(0.81 ±0.15) g/L ]were higher in T2DM patients than in normal control group(all P＜0.01),while ApoA1 level was lower than in control[(1.02±0.17)g/L vs.(1.27±0.14)g/L,P＜ 0.01].The levels of LP (a) (455.6 ± 263.5 ) mg/L,Cys-C (2.14 ± 0.68 ) mg/L,hs-CRP (7.24±4.55)mg/L and ApoB(1.22±0.17)g/L in DN group were increased compared with DM group (all P＜0.01).Serum levels of ApoA1 were decreased in DN group compared with DM group [(0.88±0.17) g/L vs.(1.02±0.17) g/L,P＜0.01].The serum levels of LP (a) (r=0.487,P＜0.05),Cys-C(r=0.55,P＜0.05),hs-CRP(r=0.478,P＜0.01) and ApoB(r=0.505,P＜0.05) were positively correlated with urinary mAlb in T2DM patients,while ApoA1 was negtively related with mAIb(r=-0.52,P＜0.05).Conclusions The serum LP (a),Cys C,Apo and hsCRP could be sensitive markers of early renal impairment,and their combinatorial measurement offers more value in patients with T2DM.

objective To investigate the clinical signiifcance of the changes of angiotensionⅡ(AngⅡ) in children with IgA nephropathy (IgAN). Methods Thirty children diagnosed as primary IgA nephropathy by renal biopsy (IgAN group) and 30 healthy children (control group) were recruited from May 2008 to December 2012. The serum and urine AngⅡwere measured by ELISA and compared between IgAN group and control group. The AngⅡexpression in the renal tissue of IgAN group was detected by immuno-histochemical method, and was correlated with other clinical data.. Results Urine AngⅡwas signiifcantly higher in the primary IgAN group than that of control group (P<0.05);AngⅡexpression in the urine is positively correlated with proteinuria (r=0.37, P=0.046), and is associated with the severity of clinical presentation; AngⅡexpression in kidney tissue increased with the severity of the renal histopathologic grading (r=0.69, 0.79, P=0.000), while AngⅡin blood and proteinuria, AngⅡexpression in kidney tissue were not signiifcantly correlated with the number of crescents. Conclusions Urine AngⅡin children with IgAN is signiifcantly correlated with the severity of the pathologic stage and the level of proteinuria. Urine AngⅡdetection may be useful to assess the progress and prognosis of chronic kidney disease.

Objective To perform the chromosome detection in 1 237 infertile patients for analyzing the karyotypes results and investigating the relationship between infertility and chromosome abnormalities .Methods The peripheral venous blood samples in 1 237 infertile patients in our hospital from March 2010 to December 2014 were collected ,performed the lymphocyte culture ,ob‐tained cells ,fixed under hypotonic condition ,prepared the section and observed them by microscope after G‐banding treatment .Re‐sults Among 1 237 patients ,111 cases abnormal karyotypes were detected with the total abnormal detection rate of 8 .9% ,in which ,57 cases were sex chromosomes abnormality ,54 cases were euchromosomes abnormality .Conclusion Chromosome abnor‐mality is one of the important causes leading to primary infertility .Infertility caused by chromosome abnormalities is irreversible ,so the chromosome cytogenetic examination is especially important in the diagnosis and treatment process of infertile patients .

Objective To investigate the changes and clinical significance of platelet parameters and the hemorheological parameters in patients with diabetic kidney disease(DKD). Methods One hundred and eight patients with diabetics were divided into simplicity diabetes mellitus ( SDM ) group with 41 cases, early diabetic nephropathy( EDN) group with 36 cases and clinical diabetic nephropathy( CDN) group with 31 cases according to 24 hours urine albumin excretion rate( UAER) ,and 26 healthy persons were included into this study as control group. The platelet parameters(including mean platelet volume(MPV),platelet volume distribution width(PDW),platelet volume(PCT),and PLT) and hemorrheology were measured in all groups. Results Levels of MPV,PDW,PCT and PLT in diabetics group were (9.80±1.14) fl,(18.00±0.99) fl,(0.21 ±0. 05)% and (186±47)×109/L respectively,in control group were(7. 70±1. 11) fl,(13. 90±1. 02) fl,(0. 16 ±0.05)% and (234±51)×109/L respectively,the differences were significant(P=0.043,0.039,0.040, 0. 035). Levels of MPV,PDW,PCT and PLT in SDM group were (8. 40±1. 07) fl,(16. 40±0. 79) fl,(0. 19 ±0. 04)% and (195±49)×109/L respectively,in EDN group were (10. 20±1. 23) fl,(18. 30±1. 02) fl,(0. 20 ±0. 06) % and (188±52)×109/L respectively,in CDN group were (11. 40±1. 14) fl,(19. 60±1. 21) fl,(0. 25 ±0. 05)% and (172±40)×109/L respectively,the differences were significant between the groups( P=0. 032,
0. 039,0. 041,0. 008). The levels of erythrocyte aggregation index,capillary plasma viscosity,low/medium/high shear viscosity of whole blood, low/medium/high shear reduced viscosity of whole blood and erythrocyte deformation index in diabetics group were 1. 86±0. 13,1. 40±0. 14,(13. 83±1. 62) mPa·s,(7. 79±0. 84) mPa·s,(6. 46±0. 77) mPa·s,7. 54±1. 03,4. 73±0. 74,4. 16±0. 69 and 0. 55±0. 03 respectively,in control group were 1. 38±0. 05,1. 21±0. 08,(9. 35±1. 22) mPa·s,(5. 88±0. 87) mPa·s,(5. 02±0. 86) mPa·s, 4. 00 ±0. 75,3. 12±0. 65,2. 76±0. 56 and 0. 68±0. 06 respectively,the differences were significant between the two groups( P=0. 034,0. 020,0. 018,0. 044,0. 016,0. 014) . Furthermore,the results of erythrocyte aggregation index, capillary plasma viscosity, low /medium/high shear viscosity of whole blood, low/medium/high shear reduced viscosity of whole blood and erythrocyte deformation index were significantly different in sub group of diabetes( P=0. 004,0. 002,0. 001,0. 004,0. 003,0. 041,0. 025,0. 009,0. 042) . Conclusion It is important to measure the platelet parameters and hemorrheology in diabetes kidney disease patients. The platelet parameters and hemorrheology may be the early indicators to diagnosis the diabetic nephropathy.

Objective To study the association of carotid atherosclerosis with high-sensitivity creative protein(hs-CRP),lipoprotein-a(Lp-a) and superoxide dismutase(SOD) in patients with chronic renal failure (CRF).Methods Seventy-one CRF patients were divided into Group A of 45 patients under maintenance hemodialysis and Group B of 26 patients without hemodialysis,and 20 healthy donor was Group C in this study.And 71 CRF patients were divided into carotid atherosclerosis group (43 cases) and non carotid atherpsclerosis group(28 cases) according to whether the carotid atherosclerosis plaque was detected out.Fortythree CRF patients presented carotid atherosclerosis including 17 patients with soft plaque,10 patients with hard plaque and the other 16 with mixed plaque.Color ultra-sound was used to measure the carotid intimal medial thickness(IMT) and define the type of plaque.Levels of hs-CRP,Lp (a) and SOD were detected and analyzed in this study.Results (1) Levels of hs-CRP,Lp-a,SOD and IMT were significantly different in group A ((7.39±2.25) ag/L,(428.43±102.25) mmol/L,(71.35±21.52) KU/L and (1.23±0.31) mm,respectively),group B((7.41±1.67) mg/L,(432.12±96.43) mmol/L,(68.14±15.25) KU/L and (1.18±0.26) mm,respectively),and group C ((2.11 ± 0.86) mg/L,(193.32 ± 62.31) mmol/L,(94.23 ± 21.13)KU/L and (0.61 ±0.22) mm,respectively),the differences were significant (F =2.998,2.783,2.032,2.802;P＜0.05).Plaque incidence was increased in group A(68.9％) and group B(69.2％) compared with group C (12.5％) with statistical significance (x2=17.863,17.989;P＜0.001).(2) Furthermore,for CRF patients,hsCRP and Lp-a were positively related to IMT in group A (r =O.436,0.279;P＜0.05) and group B (r =0.652,0322;P ＜ 0.05),SOD presenting negative relationship with IMT (r =-0.283,P ＜ 0.01 for group A,and r =-0.164,P＜0.05 for group B).(3) Level of hs-CRP and Lp-a in carotid atherosclerosis group were higher than those in non carotid atherosclerosis group((7.58±2.47) mg/L vs.(3.41±1.26) mg/L,(437.31±115.38) mmol/L vs.(256.24± 101.22) mmol/L),the differences were significant (t =2.917,2.583;P ＜0.05).Level of SOD in carotid atherosclerosis group was lower than that in non carotid atherosclerosis group ((68.43±13.36) KU/L vs.(76.22±17.12) KU/L),the difference was signifiant(t=2.156,P＜0.05).(4)Level of hs-CRP and SOD in patients with soft plaque and mixed plaque were statistically different from those in patients with hard plaque(F=4.210,2.056;P＜0.05).Conclusion The micro-inflammatory status,oxidative stress and disturbance of Lp-a metabolism are extensively existed in CRF patients and closely connect to each other.Therefore,they might correlate with the formation of plaques in carotidartery.

Objective To explore the clinical features and prognostic factors of breast cancer during pregnancy and lactation.Methods A retrospective analysis was performed on 77 patients admitted to the Tianjin Cancer Hospital from January 2002 to December 2012.According to when the cancer was found,these patients were divided into the pregnancy group (n =23) and the lactation group (n =54).Survival rate was calculated by life table,Multivariate factors for survival were analyzed by COX proportional hazards regression model.Results The mean maximum diameter of the tumor was 5.9 cm,49 cases had axillary lymph node metastasis.Compared with the lactation group,the patients in pregnancy group had larger tumor diameter,the mean diameter was 6.8 cm (P =0.031).The median follow-up time was 39 months and 5-year disease-free survival (DFS) rate and 5-year overall survival (OS) rate were 52.6％ and 61.8％,respectively.Multivariate analysis showed that the independent factors of DFS and OS were breastfeeding and tumor size.Conclusions Diagnosis of breast cancer daring pregnancy and lactation were usually delayed and often in late TNM stage.Breastfeeding and tumor size are independent prognostic factors.