Objective To investigate the influence of participation of healthcare-associated infection (HAI)man-agement department in ward round presided over by hospital director on hand hygiene compliance of health care workers (HCWs)in a basic-level hospital.Methods Implementation of hand hygiene in January-June 2012 (control group :HAI management department didn’t participate ward round)and January-June 2013 (trial group :HAI management department participated ward round)were investigated,the compliance of hand hygiene of two groups of HCWs and consumption of hand hygiene products of each department were compared.Results HAI case rate in trail group was significantly lower than control group (1.49% vs 2.01% )(χ2= 4.31,P<0.05);HCWs’hand hy-giene compliance rate was significantly higher than control group (71 . 56% [3 249/4 540 ]vs 44. 00% [1 914/4 350]),hand hygiene compliance rates in nurses were higher than doctors of both groups(χ2= 151.30,179.92, respectively,bothP<0.001),hand hygiene compliance rate in trial group from high to low was department of pedi-atrics,obstetrics and gynecology,surgery,and internal medicine. The consumption of rapid hand disinfectant of trail group and control group was 5.38mL/bed-day and 1.88 mL/bed-day respectively,the consumption of hand sanitizer was 11.51 mL/bed-day and 7.03 mL/bed-day respectively.Conclusion Hand hygiene checked during the ward round presided over by hospital director can improve HCWs’hand hygiene compliance,reduce the incidence of HAI,and ensure medical safety.

Flexible bronchoscopy has become an important diagnostic and therapeutic technique in the neonatal intensive care unit.With the improvement of the instrument and operating techniques of the bronchoscopists,flexible bronchoscopy has been applied in the preterm infant that weighted 600 grams.In this article,a review of application of flexible bronchoscopy in neonates,including diagnostic and therapeutic indications,security in the neonatal applications would be presented.

Objective To investigate the effect of multi-channel minimally invasive percutaneous nephrolithotomy in combination with Yag laser in complex renal calculi operation. Methods Eighty six complex renal calculi patients were divided into two groups, study group (46 cases) was treated with multi-channel minimally invasive percutaneous nephrolithotomy combined with Yag laser, control group was treated with single-channel minimally invasive percutaneous nephrolithotomy combinated with extracorporeal shock wave treatment. Comparison of gravel removed time, stone clearance rate,postoperative hemoglobin decreasing rate, blood transfusion rate of surgery,length of stay time and operative complications were done between the two groups, the results were analysed statistically. Result The gravel removed time was (102±23) min in study group, and ( 121 ± 28) min in control group, there was no significant difference between the two groups(P ＞ 0.05 ). In study group, postoperative hemoglobin decreasing rate was 6.5%(3/46), blood transfusion rate of surgery was 17.4% (8/46), stone clearance rate was 82.6%( 38/46 ), length of stay time was (5.6 ± 1.7) d,while those in control group was 12.5%(5/40),22.5%(9/40),72.5%(29/40), (7.4 ± 1.8) d,respectively. There was statistical significance between the two groups(P＜ 0.05 ). Conclusion Multi-channel minimally invasive percutaneous nephrolithotomy in combination with Yag laser in the treatment of complex renal calculi has the shorter operation time, less blood loss,less complications and higher stone clearance rate, and is worthy of promotion.

Objective:To compare transvaginal ultrasonography and hysteroscopy in diagnosis of intrauterine adhesions.Methods: One hundred and one cases of infertile women were treated by transvaginal ultrasound and hysteroscopy.Results: One hundred and one cases of infertility by hysteroscopy diagnosis of 87 cases of intrauterine adhesions, transvaginal ultrasound 68 cases of intrauterine adhesions, 78.16% sensitivity, sensitivity and different degree of intrauterine adhesions without significant difference. The diagnosis coincidence rate of intrauterine adhesions was consistent with transvaginal ultrasonography and hysteroscopy.Conclusion: In the clinical diagnosis and treatment of intrauterine adhesions, transvaginal sonography has the value of irreplaceable hysteroscopy. Vaginal ultrasonography can be used as the first choice for intrauterine adhesions.

Objective:To observe the therapeutic effect of Xiaoshui Formula Ⅱ on malignant ascites.Methods:60 cases of malignant ascites were randomly divided into a treatment group and a control group.The treatment group was treated with external application of Xiaoshui Formula Ⅱ and the control group with intraperitoneal injection of DDP.The therapeutic effect of Xiaoshui Formula Ⅱ was observed.Results:The total effective rate of ascites resolution was 87.1% in the treatment group and 58.6% in the control group.There were significant differences in improvement of clinical symptoms,Karnofsky score and correlative indexes between the two groups.Conclusion:Xiaoshui Formula Ⅱ has better therapeutic effect than intraperitoncal injection of DDP,with no side effect.

Background:The incidence of chronic constipation is increasing in recent years,which seriously affects the quality of life of patients. Aims:To investigate the therapeutic efficacy of lactulose combined with Bacillus subtilis and Enterococcus faecium preparation on chronic constipation. Methods:A total of 112 patients with chronic constipation from Jan. 2011 to Jan. 2014 at Emeishan Hospital of TCM were enrolled,and were randomly divided into observation group and control group. Patients in both groups accepted the guidance of diet. In addition,patients in control group were orally administrated with lactulose while patients in observation group were orally administrated with lactulose combined with Bacillus subtilis and Enterococcus faecium preparation. After 4 weeks of treatment,therapeutic efficacy in the two groups was compared,patient assessment of constipation quality of life scale(PAC-QOL)was used to evaluate the quality of life. Results:The overall therapeutic efficacy rate in observation group was significantly higher than that in control group (98. 2% vs. 72. 2% ;χ2 = 12. 399,P < 0. 05). Score of every factor and the total score of PAC-QOL were significantly lower after treatment than those before treatment in both groups(P < 0. 05),while physical discomfort score and the total score in observation group were significantly lower than those in control group( P < 0. 05). Conclusions:Lactulose combined with Bacillus subtilis and Enterococcus faecium preparation can effectively improve the symptoms of difficulty in defecation,hard stool,and improve the quality of life in patients with chronic constipation.

Objective To explore the status of the English learning among nurses and influencing factors. Method A self-designed questionnaire was used to investigate the status on English learning of 282 clinical nursing from 3 first-class hospitals in Beijing. The influencing factors were analyzed. Results The clinical nurses were in a poor condition and low interest and they had a poor setting for learning English. The influencing factors were found to be their English competency, education level, professional title and medical department (P < 0.05). Conclusions The clinical nurses are at lower level concerning English learning situation, learning interest, settings, learning motivation and a platform for training and practice. Therefore, hospitals should actively enhance their interest in English learning, learning motivation and learning settings and provide them with a platform for English training and practice so that they can increase their nursing professional English level.

Objective Pancreatic duodenal homeobox-1 ( PDX-1) plays an important role in the occurrence and development of diabetes.More importantly,its potential application in insulin resistance (IR) improvement is attracting further attention .Berberine has been shown to improve glucose metabolism and insulin resistance .In this study,rat models of type 2 diabetes mellitus ( T2DM) were established by combination of intraperitoneal injection of low -dose streptozotocin and highg-lucose-high-fat diet induction .The effect of berberine on fasting glucose , fasting serum insulin , homeostasis model assessment of insulin resistance ( HOMAI-R) , and ex-pression of PDX -1 of islet in T2DM rats were analyzed .The present study aimed to evaluate the anti-diabetic efficacy of berberine and study the mechanism of its preliminary therapeutic effects .Methods Twenty healthy adult male Sprague Dawley ( SD) rats were di-vided by random number table into the normal control group ( n =6) feeding with a standard diet ,and the experimental group ( n =14 ) given an intraperitoneal injection of streptozotocin .The rats with fasting blood glucose ( FBG) greater than 13.8 mmol/L were ran-domly divided into diabetes mellitus group feeding high sugar high fat diet for two weeks and then continuing with a standard diet , and the berberine group given berberine [180 mg /(kg· d)] every day.The normal control group and diabetes mellitus group were given physiological saline for every day 6 weeks.At the end of 6th week, the rats were executed , and the levels of fasting glucose, fasting se-rum insulin, HOMA-IR, and expression of PDX-1 in pancreas islet of each group were detected .The expression of PDX1-in pancreas islet was examined by immunohistochemistry .The image pro plus 6.0software was used to calculate the integrated optical density ( IOD) of positive expression .Results Compared with the normal control group , FBG, fasting insulin levels ( FINS) , and HOMA-IR of the diabetes mellitus group and berberine group were significantly increased ( P <0.05 ) .Compared with the diabetes mellitus group, FBG, FINS, and HOMA-IR of the berberine group were statistically significantly decreased [ ( 13.11 ±6.87 ) mmol/L vs (18.45 ±4.69) mmol L/, (2.58 ±0.34) μIU/ml vs (2.98 ±0.40) μIU/ml, 1.60 ±0.91 vs 2.75 ±0.28, P <0.05].Compared with the normal control group , the expression of PDX-1 of the islet in the diabetes mellitus group and berberine group was statistically significantly decreased ( P <0.05).After treatment with berberine, FBG, FINS, HOMA-IR, and IOD of PDX-1 in pancreas islet of berberine treatment rats were significantly increased compared with the diabetes mellitus group ( 9.14 ±1.51 vs 6.79 ±0.98 , P <0.01 ) .Conclusions The increases of PDX-1 in islet may be one of the mechanism in the improvement of hyperglycemia .

Objective:This study aimed to analyze the factors affecting the outcome of cancer pain in patients with moderate and severe chronic cancer pain for clinical decision making. Methods: Data were collected from 426 cancer patients with moderate and severe chronic cancer pain, and the factors affecting pain treatment were analyzed. Results:A total of 85.6%of patients had good pain control in 3 days (NRS≤3). Multivariate logistic regression models showed that the pain of patients with bone metastases (P=0.026), breakthrough pain after stable pain control (P<0.001), and high MEDD (P<0.001) was poorly controlled. Moreover, age, sex, TNM stage, cause of pain, and medication ladder were not risk factors of pain control (P>0.05). Opioid combination with NSAIDs contributed to easier pain control (P=0.024). Digestive system tumors, pain intensity, limb pain, neuropathic pain, use of transdermal fentanyl matrix patch, multiple metastases in stage-IV patients were suggested to be risk factors of pain control in univariate logistic regression models (P<0.05). Conclusion: Bone metastases, breakthrough pain after pain relief, and high dose of MEDD were independent risk factors. Opioid combination with NSAIDs was a protective factor of pain control.

Objective To observe the expression of acid-sensing ion channel la (ASICla) and to investigate the effect of intracellular Ca2 + concentration on focal cerebral ischemia in diabetic rats.Methods 108 male Wistar rats were divided into three groups:group A [rats with middle cerebral artery occlusion (MCAO)],group B [rats with MCAO and diabetes (DM + MCAO)],group C [rats with MCAO and diabetes treated with fasudil intervention (DM+ MCAO+ fasudil)] (n=36 each).Samples were obtained at the time points of 1,3,6 and 24 h after ischemia respectively (n=9).Models of MCAO and DM+MCAO were prepared.Rats in DM+MCAO+Fasudil group were treated with fasudil 1 mg/Kg by caudal vein injection after half an hour when DM+MCAO model successfully prepared.ASICla expressions were detected at different time points of ischemia in the 3 groups respectively.Ca2+ concentration in ischemia cortex cells were determined at different time points of ischemia in group B and C.Results ASICla expressions were gradually increased along with the ischemia time in group A and B (group A:0.71±0.10,0.80±0.11,0.86±0.08,0.93±0.09;groupB:0.86±0.11,1.05±0.51,2.42±0.08,2.78±0.04; all P＜ 0.05),and ASICla expressions at different time points were higher in group B than in group A (all P＜ 0.05).Ca2-concentration were gradually increased along with the ischemia time in group B (106.32± 18.6,137.84±14.32,151.94± 18.38,183.61±7.96,all P＜0.05).Compared with group B,the levels of ASICla expression and calcium current were reduced in group C.Conclusions The activation of ASICla increases calcium ion flow internal pathway leading to intracellular calcium overload,which may be one of the reasons for the aggravation of focal cerebral ischemia in diabetes.