OBJECTIVE To investigate the trends of susceptibility of Staphylococcus isolates to antimicrobial agents analyzed by the Shandong provincial nosocomial infection surveillance system.METHODS The data from Jan 2002 to Dec 2005 were summarized and analyzed by the Shandong provincial nosocomial infection surveillance system.RESULTS During this period,1644 strains of first isolate from each patient were collected.Major specimens were sputum,wounds,skin soft tissue and urine,which were 39.72%,22.08%,9.43% and 7.54% in total specimens,respectively.The drug-resistant rates of Staphylococcus isolates to antimicrobials were high,except to vancomycin.CONCLUSIONS Antimicrobial resistance of clinical isolates threatens the success of infectious disease treatment.It is very important to promote the rational use of antimicrobial agents for control of resistance and to take effective measures for the prevention of infections.

OBJECTIVE To study characteristics of hospital infection and bacterial resistance in our neurosurgery ward to make us reasonable antibiotics use and supply the scientific basis for hospital infection control.METHODS The data of 1100 inpatients in our neurosurgery ward in 2007 were analyzed prospectively and retrospectively.RESULTS The hospital infection rate was 11.91%,the case-time infection rate 12.55%,the lower respiratory tract infection rate 69.57%,the G-infection rate 54.44%,the G+ infection rate 30%,and the fungus infection rate was 15.56%,These pathogens were resistant to antibiotics in various degree.CONCLUSIONS It is significant to continuously monitor hospital infection and bacterial resistance in our neurosurgery ward to guide reasonable antibiotics use and control hospital infection effectively.

OBJECTIVE To investigate which method for endoscope sterilization more convenient,qualified and with effectively elongating lifetime of endoscope usage.METHODS We used low temperature plasma hydroxide peroxide sterliization and 2% glutaraldehyde solution to sterilize endoscope and compared their effects.RESULTS Two methods were qualified for the requirements of serilization.Endoscope sterilization time with glutaraldehyde solution and low temperature plasma hydroxide peroxide was 10h and 55min,respectively.Sterilization-related endoscope attrition rate was 0.17% and 0,respectively,and showed significant difference(P

OBJECTIVE To find out the hand hygiene compliance among medical staff of our hospital,and discuss how to reduce the hospital infection.METHODS The questionnaires designed by ourself were used to observe the hand hygiene compliance on the scene and the hand hygiene knowledge among 120 Medical persons from 30 clinical departments and offices.RESULTS 81.7% Of the medical staff had accepted the education of the hand hygiene knowledge;89.2% of the medical staff considered washing hands could reduce the hospital infection.Only 2.5% of them considered hand hygiene had no relation to clinical treating result.30.8% Of medical staff washed their hands before contacting patients and 49.2% of them washed their hands after contacting patients.It showed significant difference between the two groups(P

OBJECTIVE To realize the timeliness of the mobile phone and network during the application of the infectious disease reporting and supervision,and the preciseness of the infectious disease forecast,thus build the automatic reporting and supervision system of the infectious disease in hospital with the military and local features.METHODS Using the existing iatrical data and computer resources with telecommunication wide band network and the special mobile phone resources to construct the reporting and supervision system of the epidemic situation.Adopting B/S framework,the downstage supporter adopted the comprehensive technology with Net,J2EE,and Java,the backstage supporter adopted the large scale database of Oracle,using software and NTFS with code technology to make epidemic situation reporting and supervise the network.RESULTS This system might realize the most important function of the infectious disease with timely reporting,precise filling,automatic alarming,dynamic supervision and automatic statistical calculation.CONCLUSIONS This system may provide the important practical value for the epidemic situation reporting and supervision and the abrupt public medical accidents forecast.

Objective: To explore the changes of pulmonary function in type 2 diabetes and its related factors.Methods: The pulmonary functions of 72 patients with type 2 diabetes and 22 healthy objects were measured,and the related factors,such as duration of DM,HbA1c,BMI,were analysed with linear regression analysis.Ninteen of them underwent a 12-week-long intensive insulin therapy and pulmonary function tests before and after the treatment.Results: Vital capacity(VC),forced vital capacity(FVC),forced expiratory volume in the first second(FEV1),total lung capacity(TLC) and carbon monoxide diffusion in the lung(DLco) were significantly decreased in the diabetes patients.Correlation analysis revealed that DLco was negatively correlated with the duration of DM.which was shown by linear regression analysis to be the only significant predictor.After a 12-week-long intensive insulin therapy,DLco and DLco/VA decreased significantly.Conclusion:Patients with type 2 diabetes have abnormal pulmonary ventilatory function and impaired pulmonary diffusive function,and the latter is related to the time of hyperglycemia,and can not ameliorated by short-term glycemic control.

Objective To observe the foveal contour characteristic of idiopathic epiretinal membrane (iERM).Methods A total of 53 eyes in 52 patients with iERM who underwent pars plana vitrectomy with epiretinal membrane and inner limiting membrane peeling were enrolled in this retrospective study.All eyes received the examination of optical coherence tomography (OCT) and minimum resolution angle in logarithmic (logMAR) best corrected visual acuity (BCVA).Foveal contour grading was according to the ratio of central macular thickness (CMT) to the thickness of the retina 1 mm away on OCT line scan:Grade 0,depressed;Grade 1,flat;Grade 2,elevated.Baseline foveal contour grade was as follows:28 eyes with Grade 1 (Group 1),and 25 eyes with Grade 2 (Group 2).The mean logMAR BCVA was 0.40±0.26 in Group 1,and 0.60±0.27 in Group 2 respectively.The mean CMT was (433.52± 133.05) μm and (571.70± 85.40) μm respectively.The logMAR BCVA and CMT both demonstrated significant difference between the two groups (t=-2.825,-4.512;P＜0.05).OCT images and BCVA at 1,3 months after surgery were collected and analyzed.The change in foveal contour,BCVA and CMT were evaluated.The relationship between surgical outcome and different preoperative grading was analyzed.Results Foveal contour grade at 3 months after surgery was as follows:15 eyes with Grade 0,21 eyes with Grade 1,and 17 eyes with Grade 2,demonstrating significant difference compared with baseline (Z=-3.588,P＜0.05).In Group 1,there were 12 eyes with Grade 0,10 eyes with Grade 1,and 6 eyes with Grade 2 postoperatively.In Group 2,there were 3 eyes with Grade 0,11 eyes with Grade 1,and 11 eyes with Grade 2 postoperatively.The postoperative foveal contour grade was significantly different between the two groups (Z=-2.466,P＜0.05).The logMAR BCVA at 1,3 months after surgery both improved significantly compared with baseline (P＜0.05) in Group 1 (t=3.226,5.439) and Group 2 (t=-4.137,5.919).The logMAR BCVA at 1,3 months after surgery demonstrated significant difference between the two groups (t=-2.231,-2.291;P＜0.05).The CMT decreased significantly at 1,3 months after surgery in Group 1 (t=-2.674,4.090) and Group 2 (t=-9.663,-9.865) compared with baseline (P＜0.05).TheCMT at 1,3 months after surgery demonstrated significant difference between the two groups (t=-2.825,-3.003;P＜0.05).The improvement of logMAR BCVA 3 months after surgery was negatively correlated (P＜0.05) with preoperative logMAR BCVA (r=— 0.758) and preoperative CMT (r 0.359).Conclusion In iERM eyes,flat foveal contour had better surgical prognosis than elevated ones.

Objective To investigate the clinical and pathological characteristics of normotensive pheochromocytomas ( NP) . Methods This retrospective study included 97 patients with a pathological diagnosis of pheochromocytoma at the Drum Tower Hospital Affiliated to Nanjing University Medical School during January 2004 to December 2013. All available clinical, biochemical, and radiological records were reviewed in these patients who were then categorized into hypertensive pheochromocytomas (HP) (n=64) and NP (n=33) groups. 97 cases of Adrenal Gland Scale Score of pheochromocytoma were examined, including tissue microscopic pathology assessment, ki67 and phenylethanolamine-N-methyltransferase ( PNMT ) immunohistochemistry and catecholamine type. Biochemical examinations of 95 subjects with primary hypertension ( PH) were recorded for comparative study. Results The patients with NP showed lower proportion of clinical triad than HP, inapparent metabolic disorders, and lower urinary catecholamine levels than HP, but showed higher results than primary hypertension. The weight of tumor was positively correlated with 24 hour urinary norepinephrine level in patients with HP(Y=1. 376+0. 653X,R2=0. 118, P=0. 028), but not in patients with NP;and the size or diameter of the tumor was negatively correlated with PNMT immunohistochemistry in patients with NP(Y=0. 940-0. 356X, R2=0. 494, P=0. 005), but not in patients with HP, indicating that NP may be misdiagnosed clinically. Conclusion Patients with NP have distinct clinical, biochemical, and pathological phenotypes; the phenotypic changes are closely related with the expression levels of catecholamine pathway products during the occurrence and development of the tumors.

Objective To investigate the expression of MUC-1 and CD44v6 in breast carcinoma and its diagnostic value.Methods 93 cases of breast carcinoma were examined by immunohistochemical method for MUC-1 and CD44v6.Results The positive rates of MUC-1 and CD44v6 were 71.0 ％ (66/93) and 63.4 ％ (59/93),respectively.The expression of MUC-1 in breast carcinoma was correlated with histologic differentiation (14.3 ％,69.4 ％,100.0 ％) and lymph node metastasis (22.9 ％,100.0 ％) (x2 =36.147,63.047,both P ＜ 0.0001),but had no relationship with the type of breast carcinoma,tumor clinical stages,and tumor size (all P ＞ 0.05).The expression of CD44v6 in breast carcinoma was correlated with tumor clinical stages (6.3 ％,64.6 ％,93.1％) and lymphnode metastasis (20.0 ％,89.7 ％) (x2 =9.507,45.662,both P＜0.05),but had no relationship with tumor type,tumor clinical stages and tumor size (all P ＞ 0.05).Conclusion MUC-1 and CD44v6 may play important roles in the development of breast carcinoma and the biologic behavior of breast carcinoma may be closely related with over expression of MUC-1 and CD44v6 protein.MUC-1 and CD44v6 can be used to predict the prognosis and direct the treatment of breast carcinoma.

ObjectiveTo explore the effect of computer-aided acetabular evaluating and operation designing before total hip arthroplasty (THA) for Crowe Ⅳ developmental dysplasia of the hip (DDH).MethodsFrom March 2011 to October 2011,10 patients (13 hips) diagnosed as DDH (Crowe Ⅳ) underwent THA.Before operation,all 10 patients underwent three dimensional (3D) CT scanning and the information was inputted into the Superlmage system to reconstitute the 3D anatomic models of pelvis and acetabulum.Then the position and size of the true acetabulum,the thickness of the anterior and posterior columns,and the degree of bone defect were evaluated or measured exactly with computer assisted design(CAD) software.After inputting the information of the test model of the acetabulum and material for repairing bone defect into the CAD software,the implantation of the acetabular prosthesis was simulated to determine the size and position of the acetabular prosthesis.Then the bone defect was evaluated after implantation of the acetabulum to perform simulation test of restoration of bone defect.Eventually,orthopedic surgery was performed precisely.ResultsThe size of acetabular prosthesis implanted in the operation was coincident with that got by preoperative computer aided technology in 9 patients(12 hips),and one acetabular prosthesis was larger than that designed preoperatively.All the cups were implanted in the anatomic acetabular location.The bone defect in the acetabular roof was reconstructed with tantalum augments in 4 hips,with Harris autograft using autologous femoral head in 7 hips,which were coincident with that designed preoperatively.ConclusionThe preoperative CAD is useful in THA for Crowe Ⅳ DDH,because it can exactly evaluate the developmental condition of the true acetabulum.