Objective To explore the risk group,distribution and pathogen of nosocomial pneumonia.Methods All the in-patients from May 2004 to May 2005 admitted to Southwest hospital were involved for the investigation of nosocomial pneumonia.Results Among 61 404 cases investigated,454 cases were diagnosed as nosocomial pneumonia(0.74%),accounting for 31.33% of all nosocomial infection cases.According to prevalent characteristics,male and elderly patients had a higher incidence rate of nosocomial pneumonia,mainly occurred in ICU,department of thoracic surgery and department of oncology.The occurrence time within 7 days accounted for 31.72% and within 7 to 14 days for 35.09% after admission.Among the isolated pathogens,Candida was the top one(26.97%),then P.aeruginosa(18.96%),followed by S.aureus(5.20%).Conclusion Nosocomial pneumonia,which mainly occurred in the male and the elderly patients in 2 weeks after hospitalization,is still an important nosocomial disorder,and Candida is the most common pathogen.

Objective To investigate the effect of continued nursing education manual on surgical nursing education.Methods A continued nursing education manual was designed and applied to surgical nursing education.The effects were assessed by comparing the nursing training results before and after intervention by the manual in terms of nursing theory test,nursing techniques test.Results After the application of manual,the training coverage rate increased from 94.59%to 100.00%(P<0.05),the pass rate of theory test increased from 87.57%to 94.21%(P<0.05),and the pass rate of nursing skills test increased from 90.27%to 96.14%(P<0.05). Conclusion The continued nursing education manual is effective in improving the educational effect of surgical nursing.

Objective To observe the changes of SOD and MDA after the rabbits were exposed to acute hypoxia when cured by oxygen therapy.Methods New Zealand rabbits underwent hypoxia imitating the 4500-meter sea level in altitude chamber(group E,n=6),then some received oxygen therapy,the volume ratio of oxygen-nitrogen mixture was 25%,30% and 35% respectively for 10,5 and 3 hours as group B,C and D.Another 5 rabbits received no treatment as normal group.The rabbits samples were collected at the time points of 1,3,5,10 and 24 hours after the oxygen therapy started to detect serum biochemical indicators.Results Comparing with normal control group,serum SOD activity in simple hypoxia group noticeably decreased and the content of MDA noticeably increased;in three oxygen therapy groups,serum SOD activity in 25% oxygen therapy group was highest and the content of MDA was lowest.Serum SOD activity in 25% oxygen therapy group had ascendant tendency and the content of MDA had descendant tendency.Conclusions Low concentration oxygen therapy can prevent acute hypoxia-induced injury in rabbits,besides increase oxygen partial pressure,oxygen therapy may improve superoxide dismutase activity.

Objective To investigate the genotype and antifungal susceptibility of AspergiIlus species isolated from clinical settings and environmental sources. Methods Random amplification of polymorphic DNA (RAPD) analysis was performed to profile the genotypes of 48 Aspergillus fumigatus strains, 59 Aspergillus flavus strains and 30 Aspergillus niger strains isolated from clinical settings and environmental sources. NCCLS M38-A protocol was carried out for antifungal susceptibility testing of these Aspergillus isolates. Results As RAPD analysis showed, the 48 Aspergillus fumigatus strains were classified into 8 genotypes, 59 Aspergillus flavus strains into 12 genotypes, and 30 Aspergillus niger strains into 5 genotypes. A significant difference was observed in the susceptibility to terbinafine among the 8 genotypes of Aspergillus fumigatus (χ2 = 33.092, P ＜0.01 ) as well as in that to amphotericin B among the 5 genotypes of Aspergillus niger (χ2 = 15.185, P＜ 0.05).No statistical difference was found in the susceptibility to amphoteriein B, itraconazole, fluconazole or flucytosine among the 8 genotypes of Aspergillus fumigatus or in that to terbinafine, itraconazole, fluconazole or flucytosine among the 5 genotypes of Aspergillus niger. Conclusion There is some difference in the susceptibility to some antifungal agents between different genotypes of Aspergillus fumigatus and Aspergillus niger.

Objective To explore the cognitive status of community-dwelling older adults with subjective memory complaints (SMC).Methods A total of 262 older adults with SMC were included based on convenience sampling.Face-to-face interview was conducted for demographic information collection and cognitive assessment.Statistical analyses Were undertaken using SPSS version 19.0.Results The participants with SMC had a low level of general cognitive function,with a mean score of 22.18±4.21 on the MoCA; the two cognitive domains of abstraction' and deIayed memory had the lowest scores,with an average score of 0.85±0.82 and 2.91± 1.50 respectively,and the average scoring rate lower than 60.00％.About 54.20％ of the older adults with SMC presented with cognitive impairment.The scores ofabstraction were low in the participants with and without cognitive impairment.In addition,the scores of visuospatial/executive function, language and delayed memory were low in the participants with cognitive impairment.The cognitive impairment of persons with SMC may be associated with age and marital status.The people over the age of 70 years and widowed ones are more likely to suffer from cognitive dysfunction.Conclusion The older adults with SMC have a low level of general cognitive function,and cognitive imPairment detection rate is higher.Advanced age and widowhood are important factors affecting their cognitive function.

Discoidin domain receptor 1(DDR1)is a kind of receptor tyrosine kinases(RTKs),which is expressed abnormally in many tumors. It is involved in the development,invasion and metastasis process of tumors and may become a potential target of tumor therapy. This article reviewed the expression and significance of DDR1 in tumors of digestive system.

ObjectiveTo explore the effect of guided learning in the eye optical applied optics teaching.Methods30 students of Grade 2013 were chosen as experimental group which was given guided learning teaching, and other 30 students of Grade 2013 were chosen as control group which was given used traditional teaching. In the guided learning teaching, self-study and practice students were re-quired to master the key and found the difficulties in the course firstly, answering questions after the group discussion. Then teachers focused on parsing the teaching materials. By the repeated communication and practice students mastered knowledge finally. The control group used the traditional teaching method which was based on the teacher's lecture. Through comparing the theory examination scores, practical as-sessment grades and questionnaire of the students self-assessment, teaching effect based on guided learn-ing was evaluated. Normal distribution measurement data was showed by standard deviation, T test was used in two independent sample measurement data; The count data was showed by rate, using Chi-squared test whichα=0.05.ResultsIn experiment group,the theoretical examination average score was(78.35±7.14) points, while in control group, the average score was(69.15±8.88)points. There were significance differ-ences between the two groups(t=-4.339,P=0.000). The experimental group practical assessment grades and the self-assessment score were superior to control group, and the difference has statistical sig-nificance (P<0.05).ConclusionGuided learning teaching can guide the students to obtain and master relevant knowledge independently, fully arouse their initiative of learning and improve their ability to analyze and solve problems, which can help reach a good teaching effect.

Objective To study the clinical features of alveolar soft part sarcoma (ASPS) and assess its prognostic factors.Methods The clinical data of 28 ASPS patients from January 2006 to January 2009 were analyzed retropectively,and were followed up to get their prognosis.The survival analysis and risk factors were analyzed and compared.Results Two cases with soft tissue primary ASPS got recurrence after the first resection,the recurrence rate was 8.0％ (2/25).After re-resection,no postoperative recurrence occurred.Three cases with bone primary ASPS did not have postoperative local tumor recurrence,but 2 cases appeared tumor progression and got pulmonary metastasis.All the patients had poor overall prognosis,11 cases survived without tumor,8 cases survived with tumor,9 cases died.The median survival time was 38.5 months,5-year survival rate was 46.4％ (13/28),5-yeax survival rate of male patients was 50.0％ (5/10),female patients was 44.4％(8/18),5-year survival rate between male and female patients had no statistical significance (P =0.260).The 5-year survival rate of patients without distant metastasis was 81.8％ (9/11),while the rate of patients with distant metastasis (pulmonary,brain or bone metastasis) was only 23.5％(4/17),and the rates had significant difference (P =0.036).Age,gender had no significant relation with the prognosis,while tumor size,location and distant metastasis were the important factors affecting the prognosis.Conclusions ASPS commonly occurs in young persons.The hips and thighs are the most common sites ofsofte tissue primary ASPS.Prognosis has relation with distant metastasis,tumor size and part or thorough resection.The risk of recurrency and metastasis can be decreased through assessing disease condition as soon as possible,developing a reasonable treatment plan and wide resection of the primary tumor.

Objective: To evaluate the malignant potential of oral lichen planus (OLP) by measuring and analyzing the dimensions of spinous cell in mucosal epithelium.Methods:Paraffin-embedded samples of oral mucosa, including normal (N,7 cases), OLP(16 cases), oral leukoplakia(12 cases) with mild and moderate epithelial dysplasia (LK) and well differentiated oral squamous cell carcinoma (SCC,10 cases), were analyzed by MIAS-99 System.The planar and stereoscopic dimensions of spinous cells were measured and compared.Results:The values of morphometric and stereologic parameters in OLP were between those in normal mucosa and in LK, significantly different from those in SCC and not significantly different from those in normal epithelium.Conclusion:Based on the changes of cell morphometric parameter value, OLP is generally a benign lesion with some degree of malignant potentiality that is less than LK.Nucleus/cytoplasm volume ratio and volume density of cell nucleus of spinous cells in mucosal epithelium are of value in distinguishing benign from maliganant lesions.

Objective To investigate the effects of chronic fluorosis on the expressions of matrix metalloproteinase-9 (MMP-9) mRNA and protein and the differentiation and maturation process of bone cell in the osteoclast of bone tissue of rats.Methods According to body weight,thirty-six healthy SD rats(body mass 100-120 g) were divided into three groups by random number table,twelve in each group,half male and half female.The rats of control group were given tap water(NaF ＜ 1 mg/L),and rats of low-fluorine and high-fluorine groups were fed with tap water containing 5 and 50 mg/L NaF to establish chronic fluorosis model.Rats were sacrificed after eight months; the contents of urinary fluoride in 24 hours and bone fluoride were analyzed by fluoride selective electrode.Serum content of tartrate resistant acid phosphatase 5b(TRACP5b)was detected by enzyme-linked immunosorbent assay (ELISA).The paraffin section of bone tissue was stained by hematoxylin-eosin (HE) and pathological morphometry was observed under optical microscope.The protein and mRNA levels of MMP-9 in the osteoclast of bones were detected by immunohistochemistry (IHC) and in situ hybridization (ISH),respectively.Results The differences of fluoride contents of urine and bone in rats were statistically significant between groups(F =400.612,48.229,all P ＜ 0.05).Fluoride contents of urine and bone were increased in lowfluorine and high-fluorine groups[(6.09 + 0.56),(7.69 + 0.64)mg/L,(12.65 ± 3.07),(26.53 + 5.88)mg/kg] compared to the control groups[(1.36 ± 0.51)mg/L,(0.67 ± 0.16)mg/kg,all P ＜ 0.05],and the fluoride contents of urine and bone were gradually increased with increasing fluoride doses(all P ＜ 0.05).The difference of TRACP5b content in serum was statistically significant between groups (F =9.607,P ＜ 0.05),in low-fluorine and high-fluorine groups,the TRACP5b contents[(1.86 ± 0.13),(1.92 ± 0.22)U/L] were higher than that of control group [(1.57 + 0.20)U/L,all P ＜ 0.05].The pathological examination showed osteosclerosis in fluoride exposed groups.The differences of MMP-9 mRNA and protein expressions were statistically significant between groups (F =365.727,331.382,all P ＜ 0.05).Compared to the control groups(97.22 ± 2.24,78.51 ± 1.16),the expressions of MMP-9 protein(108.18 ± 1.97,119.28 ± 1.76) and mRNA(89.44 ± 2.86,102.14 ± 2.39) were increased(all P ＜ 0.05),and the expressions of MMP-9 mRNA and protein were gradually increased with increasing fluoride doses (all P ＜ 0.05).Conclusions Chronic fluorosis might influence osteoclast differentiation and maturation process through regulating the expression levels of MMP-9 protein and mRNA.