OBJECTIVE To investigate and analyze the cause of the cross infection of Methicillin-resistant Staphylococcus aureus(MRSA) in ICU patients,and to apporach its preventive and control measures.METHODS Eiological inspection and sanitary monitoring have been done in ICU where there were two MRSA patients from June 6th,2008 to August 1st,2008.RESULTS MRSA has been detected on the hands of the ICU medical staff,on the bed-desks,on the switches of the vacuum extractor and gas supply unit on the wall,and in the NS for inhaling sputum.The separation rate were 37.5%,20.0%,54.5%,37.5%,87.5%.CONCLUSIONS ICU patients are prone to be infected with MRSA,which has a strong drug resistance and the infection is difficult to be treated.The cross infection can be prevented and controlled by rational administration,sterile operation and insulation.

Objective To study the effect of evidence-based nursing on improving the nursing requirement of patients with ureter external drainage and inner stent drainage after urological operation. Methods 62 patients in department of urinary surgery from June 2009 to October 2011 were selected as research object,and they were randomly divided into the control group and the observation group with 31 cases in each group,the two groups adopted routine nursing mode and evidence-based nursing mode respectively.Then the nursing requirement and nursing effect before and three and five days after nursing were compared between two groups. Results All the patients existed needs of related knowledge guidance,unhealthy emotion adjustment and social support,and the needs of patients between ureter external drainage and inner stent drainage showed no significant differences,improvement level of each items of the observation group after nursing were all better than those of the control group. Conclusions The patients with ureter external drainage or inner stent drainage have needs of related knowledge guidance,unhealthy emotion adjustment and social support,and the evidence-based nursing mode can effectively improve the patients'demand situations of these items.

Objective To observe the clinical efficacy and sperm density of Bushen Yijing decoction and tamoxifen,zinc and vitamin E in treating oligospermia with kidney deficiency syndrome .Methods 450 patients with oligospermia were randomly divided into 3 groups.150 patients of the treatment group were treated by Bushen Yijing decoction,tamoxifen,zinc and vitamin E,150 patients of the control group I were treated by Bushen Yijing decoction , zinc and vitamin E,150 patients of the control group II were treated by tamoxifen ,zinc and vitamin E.3 groups were treated for 3 months,pregnancy terminating of treatment and otherwise continued to observe for 3 months after the end of treatment,the sperm density and other sperm parameters (sperm amount,pH,sperm motility,sperm survival rate, sperm normal modality rate ) were evaluated before and after treatment .Results The total effective rates of the treat-ment group,control group I and II were 90.21%,85.11%,72.22%respectively.The total effective rate of the treat-ment group was higher than that of the control group I (χ2 =9.53,P<0.05) and II(χ2 =23.38,P<0.01).The pregnancy rates of the treatment group ,control group I and II were 42.66%,25.53%,20.83%,respectively.The pregnancy rate of treatment group was significantly better than that of the control group I (χ2 =9.26,P<0.01) and II (χ2 =15.78,P<0.01).There were significant differences between before and after treatment on sperm density , sperm motility,sperm survival rate and sperm normal modality rate in the treatment group ( t=-22.22,-18.07,-33.48,-28.46,all P<0.01).Conclusion Bushen Yijing decoction combined with tamoxifen ,zinc and vitamin E can evidently improve the sperm density and other sperm qualities and conception rate of oligospermia with kidney deficiency syndrome .

Objective To evaluate the clinical effectiveness and the safety of the traditional chinese medicine named YanTing Medincinal Broth on retention enema treatment of chronic pelvic inflammatory disease.Methods The research method of random,multicentre and parallel contrast were used.There are 92 cases divided into retention enema group and suppository contrast group at random,there are 47 cases in retention enema group and 45 cases in contrast group.Respectively use retention enema method with YanTing Medincinal Broth and the other method with KangFu inflammation eliminated suppository to treat the chronic pelvic inflammatory disease.The course of the treatment are all 10 days.Traditional chinese medicine syndrome and clinical physical signs are observed before and after the treatment in every group,the contrast curative effect are observed at the same time.Results Traditional chinese medicine syndrome and clinical physical signs are all improved than before treatment(P

Objective To study the clinical value of PgCO_2 measurement on the patients in ICU.Methods PgCO_2 were continuous measured 24 hours by using air-automated tonometry for 50 cases admitted in ICU.The heart rate,blood pressure,MAP,CVP,SpO_2,artery blood gas were measured at the same time.According to acute physiologic and chronic health evaluation(APACH Ⅱ) and MODS mark,the patients were divided into 2 groups,high-risk group and light-risk group.20 cases suffered from malignant tumour without functional failure of the organs were looked on as compared group.The results of measurement of every group were compared.Results Comparing with the three groups,the results of PgCO_2,Pg-aCO_2,Pg-etCO_2 were significantly different,but the Pg-aCO_2 and Pg-etCO_2 were the same.Conclusion PgCO_2 is an effective index for observing the conditional change of the high-risk cases.PgCO_2≥45mmHg,Pg-aCO_2≥15mmHg may be considered as a predictive signal that the patient well appears functional failure or death.Pg-etCO_2 may substitute Pg-aCO_2 as a continuous measurement index.

Objective To study the clinical manifestation and MRI feature of toxic encephalopathy after inhaling caffeine and sodium benzoate. Methods Three patients with toxic encephalopathy induced by inhaling caffeine and sodium benzoate were observed clinically and with MRI. Results The 3 patients were male. They all had definite addiction histories (the time of addiction for 3 years to 7 years ). There were special language and retropulsive dystonia besides the common characteristics of toxic encephalopathy:reaction retardation and disturbance of intelligence. MRI showed the change of generalized demyelination in bilateral symmetrical cerebral hemisphere, posterior limbs of internal capsule, corpus callosum, medial lemniscus, and cerebellum hemisphere dentate nucleus. The clinical symptoms of 3 patients were significantly improved 40 days after the adrenocortical steroid and neurotrophic treatment. The mild mood disorder remained in case 1. Conclusion Clinical manifestation and MRI of toxic encephalopathy after inhaling caffeine and sodium benzoate are known, so we could diagnose the patients of the disease in time.

Objective To understand the risk factors of neurogenic pulmonary edema in the patients with severe hand foot and mouth disease(HFMD). Methods According to neurogenic pulmonary edema or not ,79 patients with severe HFMD were divided into two groups. The difference was analyzed on the clinical symptoms, signs,the outcomes of laboratory and electroencephalogram (EEG) examination between the two groups. Then the risk factors of neurogenic pulmonary edema was analyzed by logistic regression analysis.Results There were significant differences of the EV71 infection rate,high body temperature,myoclonia,limb weakness,the disability of eyeball regulation,tachycardia, hypertension or hypotension, the extension of capillary filling time, leucocytosist, creatine kinase isoenzyme, hyperglycaemia between two groups. However, there were no significant differences of fever, fever time, vomiting, somnolence, convulsion, limb tremor, c-reactive protein and EEG between two groups. Tachycardia, hypertension or hypotension, hyperglycaemia were significant risk factors for neurogenic pulmonary edema by logistic regression analysis. And hyperglycaemia was the most significant prognostic factor(odd ratio 27. 075, P = 0. 000 2). Conclusion Tachycardia, hypertension or hypotension,hyperglycaemia are the significant risk factors for neurogenic pulmonary edema. It is especially important for hyperglycaemia to predict neurogenic pulmonary edema.

Objective To discuss the influence of grading nursing care by physician-nurse cooperation decision-making on the quality of patient care and disease outcomes,and evaluate the application feasibility of nursing core system in this nursing mode.Methods 379 patients were admitted to departments of orthopedics and endocrinology from two hospital areas of our hospital from January 2011 to January 2012.Patients were divided into two groups according to nursing process.Patients who were given conventional grading nursing were set as the routine group,and patients receiving physician-nurse collaboration grading nursing were set as the collaboration group.The nursing quality and nursing efficiency,and the disease outcome of patients were compared between the two groups.Results The quality of care,the qualified rate of care plan implementation,the coverage rate of health education of patients and the patient satisfaction rate were higher in the collaboration group than those in the routine group.The performing rate of doctor's orders,the awareness rate of patient disease,the average length of hospital stay,compliance of medical orders and re-admission rate of patients with the same or a related disease within three months were significantly different between two groups.The collaboration group improved the matching degree of nursing grade with disease condition,understanding of professional knowledge,recording of nursing records,deficient nursing process,and communication ability of life knowledge,compared with those of the routine group.Conchusions Nursing grading mode by physician-nurse collaboration decision-making can obviously improve the defmition of grading nursing and the general treatment effect of patients,it significantly improved the quality of grading nursing.

Objective To explore the clinical features of mitochondrial encephalomyopathy lactic acidosis and strokelike episodes (MELAS) syndrome in fratemal twins brothers.Methods The clinical data,the results of laboratory examinations,electroencephalogram (EEG),imaging,and gene detection,and the process of diagnosis and treatment were retrospectively analyzed the fraternal twin brothers with MELAS syndrome.Results The proband,a 7-year-old male,had intermittent headaches,vomit and twitching at onset.He suffered from exercise intolerance,fatigue,accompanied by short stature and hairy.The fasting blood lactic acid level was increased.Multiple video EEG showed the slowdown of background activity.Head MRI showed recurrent lesions with the characteristics of migration and variation.The point mutation rate of mtDNA A3243G was 34.7％.The diagnosis of MELAS was confirmed.At the same time,his fraternal twin brother was screened and found that his point mutation rate of A3243G was 30.0％.Although there was no clinical symptom at that time,he was onset with convulsion after 3 years.Conclusions Gene detection and family screening are helpful for the early diagnosis of MELAS.The mutation rate of A3243G is very high,which can cause an early onset and serious clinical symptoms.