ObjectiveTo evaluate the feasibility,effectiveness and safety of laparoscopic splenectomy combined with pericardial devascularization for the treatment of portal hypertension in cirrhotic patients. MethodsIn this study 16 cases underwent initial totally laparoscopic splenectomy and paraesophagogastric devascularization,with 10 cases undergoing upfront open surgery as controls by one treatment group.Clinical data including operative time,intraoperative blood loss,post-operative complications and hospitalization were compared between the two groups.ResultsIn the laparoscopic group the procedure was successfully performed in 12 cases.4 cases were converted to open surgery.The operative time in laparoscopic group and the open group was respectively (315 ± 77 ) min and (291± 31) min (P =0.384).The mean intro-operative blood loss was (409 ±216) ml and (980 ±402) ml (P ＜0.01).The post-operative stay was ( 10 ± 3 ) d and ( 17 ± 8 ) d ( P ＜ 0.01).Differences in post-operative complication rate between the two groups was not statistically significant ( 17％ vs.30％,P =0.525 ).ConclusionsLaparoscopic splenectomy and pericardial devascularization is feasible,effective and safe for cirrhotic patients with portal hypertension,it has the advantage of less intra-operative blood loss,less pain and shorter hospitalization than open surgery.

Objective To study of adenoirus Methods 114 fecal samples from dianhea infanes were teseea by PCR.The amplified procucts were analyzed by taqIand Rsa I endonuclease.Results The positive rate of adenovirus DNA in fecal samples was 14%(16/114). The amplified products products started with Taq I endonudease to identify the type of adenovirus,11 cleaved by Taq I yielded two fragments of 191 bp and 110 bp,the positive rate of entric adenovinus was 9.65% (11/114). Followed by Rsa I cleavage,two 45 bp fragments (Ad40), the positive rate of Ad40 was 1.75% (2/114), nine amplified products yielded 211 bp and 90 bp fragments (Ad41),the pos-itive rate of Ad41 was 7.89%(9/114).Conclusion The positive rate's of the adenovirus types 40 and 41 were 9.65% in feces of infants with diarrhea, and that of the other types of adenovirus was 4.35%.

Objective To analyze risk factors and antimicrobial use for hospital-acquired pneumonia (HAP)due to multidrug-resistant organisms (MDROs)in an intensive care unit(ICU),so as to perform risk assessment and guide antimicrobial use.Methods From January 2012 to December 2013,HAP patients were conducted retrospective co-hort study,risk factors for MDRO-HAP and rationality of antimicrobial use were analyzed.Results A total of 110 cases of HAP occurred in ICU,63 cases (57.27%)were MDR-HAP.Logistic regression analysis revealed that re-cent hospital stay ≥5 days (OR=19.94),transference from other hospitals (OR =19.33),infection type of late-onset HAP (OR=7.98),and antimicrobial use in recent 90 days (OR =3.42)were independent risk factors for MDR-HAP.Initial empirical anti-infective treatment revealed that there were no significant difference in timing of antimicrobial administration within 24 hours after clinical diagnosis was confirmed,and rationality of antimicrobial selection between MDR-HAP group and non-MDR-HAP group (both P >0.05);The isolation rate of pathogens in MDR-HAP group was lower than non-MDR-HAP group (73.02% vs 91 .49% P <0.05 ).Targeted antimicrobial therapy revealed that there were no significant difference in selection,dosage,and frequency of antimicrobial use be-tween two groups(all P >0.05 );the rationality rate of therapy course in MDR-HAP group was higher than no-MDR-HAP group,but rationality rate of combination use of antimicrobial agents was slightly lower than the latter (both P < 0.05 ).Conclusion Patients in ICU should be conducted risk factor assessment,and according prevention and control measures should be formulated,so as to reduce the occurrence of MDR-HAP,health care workers should standardized the initial empirical anti-infective treatment.

Objective To evaluate the effect of plan-do-check-act (PDCA)cycle method in improving disinfection efficacy of object surface in intensive care unit (ICU).Methods On the basis of management of healthcare-associat-ed infection (HAI)and prevention of multidrug-resistant organisms,disinfection efficacy of object surface in an ICU was intervened,data about surface object specimens taken before,during,and after intervention,HAI in patients, as well as detection of MDROs were collected.Results The total qualified rate of specimens taken before,during, and after intervention was 58.24%,76.74%,and 88.71 %,respectively,there was an increased tendency,the difference was significant (χ2 =17.41 ,P =0.009);the incidence of HAI was 3.72%,2.42%,and 1 .78%,respec-tively,there was a decreased tendency(χ2 =6.03,P =0.039),case infection rate was 4.36%,2.75%,and 2.37%respectively,there was a decreased tendency (χ2 = 7.24,P = 0.046 );detection rate of MDROs was 34.03%, 27.45%,and 14.05%,respectively,there was a decreased tendency (χ2 =33.84,P =0.007),the percentage of pa-tients who were detected MDROs and HAI caused by MDROs showed a decreased tendency(χ2 =6.14,6.02,both P<0.05).Conclusion The implementation of PDCA cycle can effectively improve disinfectant efficacy of ICU object surface,and reduce the incidence of MDRO HAI.

To identify the genotype and analyze the molecular characteristics of dengue virus strain SZ0524 isolated from serum samples of patients with early stage of dengue fever in Shenzhen in 2005 so as to explore its possible origin. The C6/36 cell line was cultivated with virus strain SZ0524 and its suspension was harvested. The type of isolated virus strain was determined by RT-semi-nested PCR and fluorescent PCR. E gene of isolated virus strain was amplified by RT-PCR and sequenced. Homology and phylogenetic tree of E gene of this dengue virus with the strains isolated from other areas were constructed. This SZ0524 strain was further identified by fluorescent PCR, and confirmed to be the type 4 virus after obtaining the 392bp band with type 4 specific primers. The homology of nucleotide sequence of E gene of SZ0524 strain with the standard type 4 dengue virus H241 strain were 99.7%, but the homology with the standard dengue virus 1,2,3 in the same fragment were 57.0%, 59.2% and 56.2% respectively. Analysis of the phylogenetic tree indicated that SZ0524 was more close to D4-73NIID and D4-61NIID strain, next to H241 strain, and they lied in the same branch of phylogenetic tree. The isolated dengue virus type 4 belonged to genotype Ⅰand the SZ0524 strain was proved to be dengue virus type 4 in the molecular level. Combined with epidemiology information, it is suggested that this case can be classified as an imported case and the SZ0524 strain may be transferred from the southeast asian region.

Objective We sought to develop Nurse Job Performance Scale and test its validity and reliability.Methods Initial version of Nurse Job Performance Scale was formulated by using literature review and qualitative interview.By cross-sectional investigating of 562 nurses in coastal cities by convenience sampling as well as screening and selecting items through item analysis,the validity and reliability was tested under the statistics.Results Three factors containing 14 items were extracted by using exploratory factor analysis:work coordination,working enthusiasm and work involvement.The average value of factor loading was between 0.643～0.839,the 3 factors explained 73.9％ of the total variance.The total Cronbach's α was 0.937 and the Cronbach's α coefficients of every dimension were between 0.767～0.930.Conclusions Nurse Job Performance Scale has good validity and variability.

Objective To compare and contrast the gene characteristic correspondence of hantaviruses(HV) carried by rats in natural epidemic areas of hemorrhagic fever with renal syndrome(HFRS) and infected among HFRS patients in Shenzhen,provide a reasonable scientific basis for controlling of HFRS.Methods We collected the patients serum specimens in acute stage and lung tissues samples of rats.ElISA and direct immunofluorescence were applied to screen the positive samples,respectively.The partial G2 fragments of M segment and S segment were amplified from the representative patients' serum positivesamples and lung tissues positive samples in different areas with reverse transcription-nested-polymerase chain reaction(RT-nested PCR) by the hantaviruses genotype specific primers.The amplified genes were then sequenced,and subjected to genotyping and homology analysis with other known hantaviruses.Results Four hundred and seventy-two rats were trapped in the main epidemic areas,and Hantavirus specific-antigens in lung tissues samples were identified in 47 out of the 472 by direct immunofluorescence.Twelve partial M and S segments were amplified from 60 patients serum specimens positive with specific IgM antibodies against hantavirus with ELISA by RT-nested PCR.The homology of M and S genome segments among 16 strains of Hantaviruses showed more than 95% and 96.5% at nucleotide level,respectively.And the deduced amino acid sequences homology was 98.0% -100% and 98.4%-100%,respectively.The genotype of hantavirus carried by rats and infected among patients were identified to the same subtype-SEO S2.Conclusion The genotype of Hantavirus carried by rats and infected among patients in Shenzhen all belongs to S2 SEOV.The nucleotide homology of SEO type of Hantavirus in the same or nearby areas is higher and the viruses are highly conserved.

Objective Analyzing epidemiological characteristics and etiology of hand,foot and mouth disease outbreaks from 2011 to 2012 in Shenzhen to provide the basis for prevention and control of hand,foot and mouth disease.Methods The data about epidemiology of hand,foot and mouth disease outbreaks was analyzed and Viral RNA was used for enterovirus type 71 (EV71),coxsackie virus type A16 (CA16) and Pan-enterovirus (PE) detection by real-time RT-PCR.Results A total of 501 specimens from 160 hand,foot and mouth disease outbreaks were collected and detected between 2011 and 2012.EV71 was responsible for 36 outbreaks (22.50％),CA16 was responsible for 52 outbreaks (32.50％) and other enteroviruses were responsible for 40 outbreaks (25％).84 outbreaks (52.50％) occurred in Nanshan District in Shenzhen and 36 outbreaks (22.50％) occurred in Luohu District in Shenzhen.Outbreaks occurred throughout the year except August between 2011 and 2012.There were two peak periods from March to July and September to November,respectively.The positive rates of male and female are 72.3％ and 73.4％,respectively.Conclusion There was variation in hand,foot and mouth disease outbreaks in different regions and months.There was no significant difference between gender.CA16 was the main causative agent of hand,foot and mouth disease in 2011,while non-EV71and non-CA16 human enterovirus were main pathogens of hand,foot and mouth disease outbreaks in 2012.

Objective:To analyze the research status of traditional Chinese Medicine (TCM) constitution identification for hypertension and discuss the research hotspots in this field.Methods:Based on China National Knowledge Infrastructure and Wanfang data knowledge service platform, the papers on TCM constitution identification of hypertension from 2010 to 2021 were retrieved. Bibliometric software Bicomb 2.01 and gCLUTO 1.0 were used to conduct a quantitative study of the retrieved literatures.Results:A total of 836 relevant articles were retrieved, and 42 high-frequency keywords such as "hypertension" "TCM constitution" "TCM constitution identification" and "phlegm-dampness constitution" were screened out. Research hotspots includes hypertension-TCM constitution identification, correlation between hypertension-TCM constitution and risk factors, hypertension-TCM differentiation of body and diet, hypertension-TCM body differentiation and treatment and hypertension-TCM health management.Conclusions:The number of papers on TCM constitution identification for hypertension is increasing year by year, but the regional development is uneven, the core author has not been formed, and there is less scientific research cooperation between regions.

Objective:To analyze the research status of traditional Chinese Medicine (TCM) constitution identification for hypertension and discuss the research hotspots in this field.Methods:Based on China National Knowledge Infrastructure and Wanfang data knowledge service platform, the papers on TCM constitution identification of hypertension from 2010 to 2021 were retrieved. Bibliometric software Bicomb 2.01 and gCLUTO 1.0 were used to conduct a quantitative study of the retrieved literatures.Results:A total of 836 relevant articles were retrieved, and 42 high-frequency keywords such as "hypertension" "TCM constitution" "TCM constitution identification" and "phlegm-dampness constitution" were screened out. Research hotspots includes hypertension-TCM constitution identification, correlation between hypertension-TCM constitution and risk factors, hypertension-TCM differentiation of body and diet, hypertension-TCM body differentiation and treatment and hypertension-TCM health management.Conclusions:The number of papers on TCM constitution identification for hypertension is increasing year by year, but the regional development is uneven, the core author has not been formed, and there is less scientific research cooperation between regions.