OBJECTIVE To explore the risk factors of lower respiratory tract nosocomial infection in geriatrics patients after abdominal operation and the measures of prevention and control.METHODS The medical records of the 470 cases with abdominal operation from Jan 2003 to Sep 2006 were investigated retrospectively with prospective monitoring.RESULTS Among 470 cases,119 suffered from hospital infection,62 suffered from lower respiratory tract hospital infection,the infection rate being 13.19% and occupied 52.10% of the total number of the hospital infection in the abdominal operation.CONCLUSIONS Invasive operation,such as nasogastric tube,intubation,inhaling oxygen,sputum drawing out,cannulization,tracheotomy,and use of respirator after operation,lying in bed,vomit,using proton pump inhibitors,and underlying diseases are the causes of the lower respiratory tract hospital infection.To enhance the monitoring and control of the risk factors,we can decrease the rate of lower respiratory tract infection and mortality in geriatrics patients after abdominal operation.

OBJECTIVE To evaluate distribution and resistance of pathogens in patients with pulmonary infection after abdominal operation by stages,and provide reference to select antibiotics in clinics.METHODS Forty five patients with pulmonary infection after abdominal operation were included from Jan 2004 to Sep 2007.Their course was divided into 3 stages: onset stage,middle stage and last stage,at every stage to identify pathogens and to test drug sensitivity and the sputa and broncho-alveolar lavage fluid(BALF) were sampled.RESULTS A total of 189 strains of pathogens were isolated,from them 110(58.2%)were Gram-negative bacilli including Pseudomonas aeruginosa,Escherichia coli and Klebsiella pneumoniae;and 59(31.2%)were Gram-positive cocci including Staphylococcus aureus and Enterococcus;and 20(10.6%)were fungi,Candida albicans was the main fungus.At onset stage the most pathogens were Gram-negative bacilli;at middle stage the Gram-positive cocci increased distinctly;and the fungi were detected at middle and last stages.The mixed infection rate was high.The result of drug sensitive test showed that there were high rates of multidrug resistance in P.aeruginosa.The resistance rates of all isolates of Enterobacteriaceae to imipenem or meropenem were 0.The resistance rates of all Gram-positive cocci to linezolid or vancomycin were 0.CONCLUSIONS Distribution of pathogens in patients with pulmonary infection after abdominal operation is different at each stage.The most are multidrug resistant,and rationl use of antibacterial drug in clinics must be based on the distribution and drug-resistance of pathogens.

Objective To discuss the therapeutic effect of uterine arterial embolization in treating adenomyosis.Methods Uterine arterial embolization was performed in 80 patients with adenomyosis.The patients were followed up for 3,6,12 and 24 months after the operation.After the treatment the degree of dysmenorrhea,the menstrual flow and the uterine volume were observed and were compared with those before the treatment.Results After uterine arterial embolization the clinical symptoms were relieved in all 80 patients.The menstrual flow was markedly decreased,the anemia was obviously improved and the uterine volume was significantly reduced,while the ovary functioning was not apparently affected.The symptom of dysmenorrhea completely disappeared one month after the therapy in 76 cases and four months after the therapy in the remaining 4 cases.Conclusion Uterine arterial embolization is a mini-invasive and safe therapy with remarkable therapeutic results and few side-effects.Therefore,this treatment can significantly improve the patient's living quality.

Objective To analyze the clinical feature of the patients with anti -N -methyl -D -aspartate receptor (NMDAR)encephalitis and feature of brain MRI and electroencephalogram (EEG)in children.Methods We reviewed the clinical manifestations,brain MRI and EEG features of 10 patients who were diagnosed anti -NMDAR encephalitis.Results Of the 10 patients,3 cases were male and 7 cases were female.The age was ranged from 13 months to 14 years (6 years and 11 months on average).No tumor was found in those patients.Main symp-toms included seizure in 9 cases,psychiatric symptoms in 10 cases,consciousness disturbance in 4 cases,involuntary movements in 8 cases,autonomic nerve instability in 5 cases,and sleep disorders in 10 cases.7 patients of MRI exami-nation were normal,2 patients revealed abnormal signal of temporal lobe,frontal,and parietal cortex.One patient revealed brain atrophy.All patients had abnormal EEG with diffusive slow waves,and some with focal spikes or sharp waves,left side abnormal more than right side.Conclusion Anti -NMDAR encephalitis can be found in children, even young boys may be affected.They have a lower incidence of tumors.Its predominant clinical features are psychi-atrics symptoms,seizures,involuntary movements and consciousness alteration.EEG was considered more significant than brain MRI.

Objective To know the blood lead level of children in Handan city and the influence factors. Methods In Oct. 2004,211 children aged 2-6 years,living in Handan city for more than one year and without eliminating lead medicine treatment in recent three months,were chosen from a kindergarten. The blood lead was determined by WFC atomic absorption spectrometer. The influence factors were investigated by questionnaire.Results The blood lead level was(89.2?13.6) ?g/L,the prevalence of lead poisoning was 11.85%,no significant difference was seen between boys and girls. As for the blood lead level,the children living in the industrial areas or near traffic road was higher,the children living in the newly decorated house was higher,the children often eat preserved eggs was higher,the children whose parents engaged in the work of lead exposure was higher,the children whose parents smoke heavily at home everyday was higher,the children whose parents had lower education was higher. Conclusion More attention should be paid to prevent and control child lead poisoning in Handan city.

Objective To discuss the therapeutic effect of uterine arterial embolization in treating adenomyosis.Methods Uterine arterial embolization was performed in 80 patients with adenomyosis.The patients were followed up for 3,6,12 and 24 months after the operation.After the treatment the degree of dysmenorrhea,the menstrual flow and the uterine volume were observed and were compared with those before the treatment.Results After uterine arterial embolization the clinical symptoms were relieved in all 80 patients.The menstrual flow was markedly decreased,the anemia was obviously improved and the uterine volume was significantly reduced,while the ovary functioning was not apparently affected.The symptom of dysmenorrhea completely disappeared one month after the therapy in 76 cases and four months after the therapy in the remaining 4 cases.Conclusion Uterine arterial embolization is a mini-invasive and safe therapy with remarkable therapeutic results and few side-effects.Therefore,this treatment can significantly improve the patient’s living quality.

BACKGROUND: Unilateral spinal epidural anesthesia with ropivacaine can reduce the perioperative pain in the elderly undergoing hip or knee arthroplasty, but choosing which concentration of small dose hypobaric ropivacaine is an issue of concern.OBJECTIVE: To explore the anesthetic and analgesic effects of unilateral spinal epidural anesthesia with different concentrations of low dose hypobaric ropivacaine in senile knee or hip replacement.METHODS: Ninety patients undergoing knee or hip replacement in the Henan Province Hospital of TCM from August 2014 to December 2015 were enrolled, and randomized into 0.15%, 0.5% and 0.25% ropivacaine groups (n=30 per group), followed by spinal epidural anesthesia at L3-4 or L2-3 lumbar interspace, respectively.RESULTS AND CONCLUSION: (1) The order of the flat subsided time and motor block recovery time was as follows:0.15% ropivacaine group < 0.25% ropivacaine group < 0.5% ropivacaine group; the onset time of motor block was longest in the 0.25% ropivacaine group, followed by 0.5% ropivacaine group, and shortest in the 0.15% ropivacaine group (all P < 0.05). (2) The order of the visual analogue scale scores at 1, 5, and 10 hours after anesthesia and 24 hours postoperatively was as follows: 0.5% ropivacaine group < 0.25% ropivacaine group < 0.15% ropivacaine group (P < 0.05). (3) The change levels of heart rate and blood pressure were highest in the 0.5% ropivacaine group, followed by 0.15% ropivacaine group, and lowest in the 0.25% ropivacaine group. (4) The incidence of adverse events was highest in the 0.5% ropivacaine group, followed by 0.15% ropivacaine group, and lowest in the 0.25% ropivacaine group (P < 0.05). (5) To conclude, 3 mL of 0.25% ropivacaine exhibits desired anesthetic effect.

Objective To develop national norms of nursing soft skills, and provide a basis for the evaluation of the nursing soft skills for new nurses.Methods With the stratified cluster sampling, 2816 new nurses were choosed from across China, and nursing soft skills evaluation scale was used to investigate.The general descriptive statistics, reliability analysis and confirmatory factor analysis of sample data were done.Results Developed the total national norms of nursing soft skills for new nurses ( the total soft skills was 150.31 ± 15.47,interpersonal skills was 28.28 ± 3.75, organizational management was 33.74 ± 4.10, self-management was 37.50 ±4.58 ,career sentiment was 28.10 ±3.52 ,cognitive kills was 22.70 ±3.11 ) and established a T-rough and percentiles-rough score conversion tables.The level of nursing soft skills of new nurses was divided into five levels: T-score ＜ 30 was poor for the soft skill, T-score at the 30 to 39 for the somewhat less, T-score at the 40 to 59 for the general level, T-score at 60 to 69 for good,T-score ≥ 70 for the best.Conclusion These norms can be used as evaluating standards of nursing soft skills for new nurses.

OBJECTIVE: To study the effect of total flavonoids from Alpinia officinarum on gastrointestinal motility.METHODS: Gastric emptying method was applied to observe the effect of total flavonoids from A.officinarum on gastric emptying of normal mice and sthenic gastric emptying induced by pyridostigmine bromide.Effect of total flavonoids from A.officinarum on gastric smooth muscle of rats was observed through in vitro test and small intestine advancement was used to observe the influence of total flavonoids from A.officinarum on intestinal motility.RESULTS: Total flavonoids from A.officinarum had no significant influence on gastric emptying of normal mice,but distinctly inhibited sthenic gastric emptying induced by pyridostigmine bromide(P

Objective To explore the corrective effect of traumatic eyeball depression through bone grafting without extra facial skin incision.Methods Six cases of traumatic fracture of all around eye socket with obvious eyeball depression deforming were treated.Under the local anaesthesia,the corresponding conjunctiva approaching was chosen according to the site of orbital fracture.Bone grafting with medial conjunctiva approach was chosen to the medial eye socket wall fracture,the lateral conjunctiva approach was chosen to the lateral wall fracture,and the inferior conjunctiva approach was chosen to the inferior wall fracture.The size and the shape of bone transplant should be estimated by the CT films previously.Results All the six cases were obviously improved.As the surgery was performed under the local anaesthesia,the movement of eyeball and the vision could be adjusted and be kept watch on timely.The surgery was less trauma and easy recovery,without new skin incision and eyeball functioning affection for all six cases.Conclusions The surgical approach is one of a way of reforming eyeball depressing.