Objective To study the knowledge,attitude and behavior of six-step hand-washing procedure in the infectious department.Methods Questionnaires were used to investigate the knowledge,acceptability and compliance of six-step hand-washing procedure in the clinical workers in four class a tertiary hospitals of Guangdong province.Results 168 medical staff all knew the six-step hand-washing procedure(100%).However,the rates of acceptability and compliance varied from one occasion to another.The knowledge about hand-washing scored(4.36±2.08),(26.08±6.14)for attitude,The correlation coefficient was 0.358.Conclusions Though the importance of hand-washing has been confirmed and accepted by the medical staff,their compliance of hand-washing during work is not very optimistic.

A questionnaire survey on knowledge of chronic kidney disease (CKD) was conducted among 168 medical staff in suburban Shanghai on March 2016.The results showed that the average score was 53.53±13.35,with the lowest score of 17.5 and the highest score of 82.5;the score of 118 participants (70.2%) was <60.There were significant differences in CKD knowledge levels among medical staff with different age,job positions and job titles (P<0.01);however,there were no significant differences in CKD knowledge between males and females or between doctors and nurses (P>0.05).

Objective To analyze the operation time,radiation exposure time and the screw placement accuracy of a newly-developed guiding chunnel-assisted percutaneous pedicle screw placement technique for thoracolumbar vertebral fractures not accompanied by nerve injury.Methods The clinical data of 35 patients with thoracolumbar vertebral fractures not accompanied by nerve injury,who were treated with newly-developed guiding chunnel-assisted percutaneous pedicle screw placement technique during the period from July 2010 to October 2012,were retrospectively analyzed.A total of 178 procedures of pedicle screw placement were performed in the 35 patients by the one and the same surgeon.The operation time and radiation exposure time of each pedicle screw placement procedure were recorded,and based on the findings of postoperative consecutive two CT scans of the operated vertebrae the screw placement accuracy was graded and evaluated.Results The technical success rate of screw placement was 100％.The mean time used for a single pedicle screw placement was (11.35±2.82) minutes,the average radiation exposure time was (8.06± 2.15) seconds.Screw placement accuracy of grade A was obtained in 156 screws (87.64％),grade B in 20 screws (11.24％),grade C in one screw (0.56％),and grade D in one screw (0.56％).Conclusion The newly-developed guiding chunnel-assisted percutaneous pedicle screw placement technique is very helpful in localizing the puncture point,in improving the screw placement accuracy,and in reducing both operation time and radiation exposure time.

Objective To investigate the drug resistance and prevalence of integrons in clinical isolates of Pseudomonas aerugino‐sa(PA) and to analyze the correlation between presence of integrons and drug resistance .Methods A total of 260 non‐repetitive clinical isolates of PA were obtained from this Hospital;antimicrobial susceptibility testing was performed by using the K‐B disk diffusion methods;statistical analysis was performed by using the WHONET5 .0 software .Integrons were detected by using poly‐merase chain reaction(PCR) .Results Among the 260 clinical isolates of PA ,the resistance rates against 14 antibacterial agents from low to high were imipenem(18 .5% ) ,amikacin(18 .8% ) ,cefepime(20 .3% ) ,piperacillin/tazobactam(21 .5% ) ,ceftazidime pen‐tahydrate(22 .6% ) ,aztreonam(31 .9% ) ,tobramycin(31 .9% ) ,cefoperazone(38 .1% ) ,gentamicin(38 .8% ) ,piperacillin(41 .9% ) , ciprofloxacin(49 .2% ) ,cefotaxime(61 .9% ) and sulfamethoxazole/trimethoprim(70 .4% ) ,respectively .A total of 109 isolates pres‐ented Class Ⅰ integrons and 4 isolates presented class Ⅱintegrons ,while no class Ⅲ integrons were found in any isolates .Except for polymyxin ,the resistance rates of class Ⅰ integrons positive isolates against antibacterial agents examined in this study were significantly higher than those of class Ⅰ integrons negative isolates (P<0 .05) .Conclusion The classⅠand class Ⅱ integrons are the prevalent types in the local region ,which might be closely related to the drug resistance in clinical isolates of PA .

Objective To investigate elder′s subjective well‐being(SWB) before they move into nursing home ,so as to pro‐vide reference for personalized care plan .Methods Basic information scale ,Memorial University of Newfound land Scale of Happi‐ness(MUNSH) ,Activities of Daily Living (ADL) ,UCLA Loneliness Scale (UCLA) ,and Center for Epidemiologic Studies Depres‐sion Scale(CES‐D) were used to investigate 162 aged people .Results There was no significant difference in gender ,career ,educa‐tion background and pension(P> 0 .05) .In 71 and above age group ,the SWB was higher than in the 60 - 70 age group(P< 0 .05) and in marriage group ,it was higher than the divorced group and widowed group (P< 0 .05) .SWB was positively related to self‐care ability ,in completely normal group and decreased function group were also statistically higher than what in obvious function obsta ‐cle group(P< 0 .05) .The score of SWB was negatively correlated with loneliness and depression scores .In normal group ,it was higher than loneliness group(P< 0 .05) .As the depression score increased ,the score of SWB gradually decreased .Compared with the normal group ,SWB in depression group ,maybe depression group and critical group decreased markedly (P< 0 .05) .Conclusion Elders′ SWB is influenced by many factors .Besides providing life care ,more attention should pay to the mental health of old people , giving them personalized care .

BACKGROUND: Bone joint immobilization is often used to prevent the injured tissue from secondary injury.OBJECTIVE: To investigate the effects of knee immobilization on biomechanical changes in rabbit patellar tendon and ultrastructure morphology. METHODS: Twenty adult rabbits were assigned into two groups. The left hindlimbs of rabbits in the immobilized group (n = 10) were immobilized by plaster of paris and two adjustable aluminium splints for 6 weeks, while those left hindlimbs in the control group (n = 10) served as controls. Rabbit knees were immobilized in extension and the ankle was immobilized at 90°flexion for 6 weeks. Then the patellar tendon-bone complex was harvested to observe the biomechanical properties and ultrastructure changes of patellar tendon. RESULTS AND CONCLUSION: After 6-week immobilization, the tensile strength and tangent modulus of patellar tendon-bone complex were decreased to 64.44% and 53.08% of the control values (P < 0.01). However, there was no significant difference in the elongation at failure and the maximum load between the immobilized and control groups. The curves of stress and strain of patellar tendon based on the average material constant were greatly different. The cross-sectional area of patellar tendon was significantly larger in the immobilized group than in the control group (P < 0.01). Smaller collagen fibrils took the predominance in the immobilized group. These results showed that immobilization of knee joint could result in biomechanical changes of patellar tendon and produce influence on patellar tendon.

Objective To investigate the therapeutic efficacy of tiotropium bromide powder inhalant combined with meglumine adenosine cyclophosphate in the treatment of acute exacerbation of chronic pulmonary heart disease.Methods A total of 148 cases of acute exacerbation of chronic pulmonary heart disease were divided into observation group (n =74) and control group (n =74).The observation group received tiotropium bromide powder inhalant combined with meglumine adenosine cyclophosphate,while the control group was given meglumine adenosine cyclophosphate.Results Before treatment,the forced expiratory volume in one second(FEV1),forced vital capacity(FVC),arterial oxygen tension(PaO2),arterial carbon dioxide partial pressure(PaCO2) and pH of the observation group were no significant differences [(1.27 ±0.44)L vs (1.24 ±0.47)L,(2.49 ±0.74)L vs (2.43 ±0.77) L,(51.6 ±6.6) mmHg vs (51.2 ±6.7) mmHg,(69.1 ± 8.4) mmHg vs (69.5 ± 8.7) mmHg,7.27 ± 0.03 vs 7.26 ± 0.04,P ＞ 0.05].After treatment,The FEV1,FVC,PaO2,PaCO2 and pH were significant differences between the 2 groups[(1.45 ±0.39)L vs (1.31 ±0.41)L,(2.71 ±0.63)L vs (2.49 ±0.54)L,(72.8 ±5.3) mmHg vs (62.5 ±6.2)mmHg,(47.7±5.7)mmHgvs (56.2±7.2)mmHg,7.34±0.02 vs7.31±0.03,t =2.13,2.28,10.86,-12.65,7.16,P ＜0.05].Before treatment,the Ⅰ ～ Ⅳ NYHA cardiac functional grading were no significant differences between the 2 groups(0,17.6％,47.3％,35.1％ vs 0,18.9％,44.6％,36.5％,P ＞0.05).After treatment,theⅠ ～ Ⅳ NYHA cardiac functional grading of the observation group were 25.7％,44.6％,20.3％,9.4％ respectively,and the NYHA cardiac functional grading of the observation group was significantly better than that of the control group(20.3％,27.0％,36.5％,16.2％,t =2.27,P ＜0.05).Conclusions The tiotropium bromide powder inhalant combined with meglumine adenosine cyclophosphate showed good therapeutic efficacy in the treatment of acute exacerbation of chronic pulmonary heart disease,and this combined treatment program is able to improve the heart and lung function simultaneously.

Objective To study the effect of the continuous pulsing water ball in preventing infection in the multi-level posterior lumbar interbody fusion(PLIF).Methods From June 2016 to December 2016,thirty patients who were treated with multi-level posterior lumbar interbody fusion in our hospital were randomly divided into two groups.The 15 patients in the observation group were given continuous pulsing water ball,and the other 15 patients in the control group were given conventional dumping.The items including the time of intraoperative washing,the C-reactive protein(CRP),the time of suture clearing,postoperative fever cases and postoperative incision healing were oberved and compared between the two groups.Results The time of intraoperative washing was (2.13±0.15)min in the observation group and (5.59±1.24)min in the conrtrol group,and the difference was statistically significant (P<0.05).The postoperative CRP of 1st,3rd, and 5th day in the observation group was declining,whileas the control group was increasing.The time of suture clearing in the oberation group was 11.57 d, which was significantly less than 14.29 d the control group.The temperature of 3rd and 5th day after opreation in the obervation group was (37.1±2.26)℃ and (37.0±0.12)℃ respectively, which were significantly lower than (38.2±3.34)℃ and (37.5±0.25)℃ respectively the control group,and the difference was statistically significant(P<0.05).Conclusion Compared to the the conventional dumping,the continuous pulsing water ball has the some advantages in the multi-level posterior lumbar interbody fusion (PLIF),such as decreasing the washing time and reducing the local inflammatory reponse.

Most of the current medical humanities education focuses on the moral aspects without good theoreti-cal basis and specific practices on the medical institution and daily life.The article dates back to the origins of So-cial Science based on the concept caregiving put forward by the medical anthropologist Arthur Kleinman,and states that the ultimate purpose of Social Science is to make response to the social suffering and provide caregiving for it.Caregiving as moral experience is response to social suffering and attracts much importance,because it pro-vides both the theoretical basis and practical means for the current medical humanities education.Its characteristics of caregiving as moral experience to social suffering and caregiving as reciprocity meet the demands of current notion of Big health in China.

Objective To investigate effect of hs-CRP,IL-6, TNF-αand ICAM-1 in patients with coronary heart disease by Guanxinshengmaiyin. Methods 120 patients with coronary heart disease were selected and randomly divided into two groups.60 cases in control group were treated by routine treatment, 60 cases in experiment group were on the base of control group with Guanxinshengmaiyin,1 month for a course.hs-CRP, IL-6, TNF-αand ICAM-1 levels, clinical efficacy, electrocardiogram ( ECG ) and adverse reactions were compared after treatment.Results Compared with before treatment, hs-CRP, IL-6, TNF-αand ICAM-1 levels were lower(P<0.05).Compared with control group, the serum hs-CRP, IL-6, TNF-αand ICAM-1 levels were lower ( P<0.05 ) , the total efficiency ( 80.00%) was higher ( P<0.05 ) , the depth of T wave of lead II and lead III were lower (P<0.05),the adverse reactions occur rate was lower(P<0.05).Conclusion Guanxinshengmaiyin can reduce serum hs-CRP, IL-6, TNF-αand ICAM-1 levels in patients with coronary heart disease, and has good clinical curative effect, less adverse reaction.