Objective To monitor the incidence of catheter-associated infection (CAI)in patients in general inten-sive care unit (ICU),and provide basis for taking proper prevention and control measures.Methods Targeted monitoring method was conducted,incidence of healthcare-associated infection (HAI)among patients receiving urinary catheterization,intravascular catheterization,and tracheal intubation in the general ICU of a tertiary hospital between January 2012 and December 2013 were surveyed.Results A total of 299 ICU patients with catheterization were investigated,the overall hospitalization days were 2 700 days,41 patients developed 48 episodes of HAI, incidence of HAI was 13.71%,case incidence was 16.05%,incidence of HAI per 1 000 catheter days was 15.19‰,37 patients developed 44 episodes of CAI;the other types of HAI were blood stream infection(n=1),skin and soft tissue infection(n = 1 ),antibiotic-associated diarrhea(n = 1 ),and herpes zoster(n = 1 ).Incidence of catheter-associated urinary tract infection (CAUTI),catheter-related bloodstream infection (CRBSI),and ventilator-associated pneumonia (VAP ) per 1 000 catheter days were 2.94‰,2.12‰,and 15.72‰ respectively. Conclusion CAI is the main HAI type in ICU patients with catheterization,and the major is VAP.

Objective To explore the effect and lung function of the budesonide combined with montelukast for treatment of chronic obstructive pulmonary disease(COPD)and the effect on serum IL-6,IL-8 and TNF-α.Methods 120 patients with COPD in our hospital from April 2012 to December 2013 were randomly divided into observation group and control group (n =60 ).Observation group was given budesonide combined with montelukast on the basis of general routine treatment and control group was given budesonide on the basis of general routine treatment.The lung function and the level of IL-6、IL-8 and TNF-αin serum were detected berore and after treatment.Results The efficacy in observation group was significantly better than that in control group(P<0.05).The forced vital capacity(FVC),forced expiratory volume in one second(FEV1),maximal mid expiratory flow(MMEF),and peak expiratory flow(PEF)in the observation group were significantly higher than those in the control group(P<0.05 ).In addition, after treatment the levels of IL-6,IL-8 and TNF-αexpression in serum of the observation group and control group were significantly lower than before treatment,but the levels of the observation group after treatment was significantly lower than the control group,the difference were statistically significant (P<0.05).Conclusion The efficacy of the budesonide combined with montelukast for treatment of COPD is exact by reducing cytokine release, controling airway inflammation to improve the lung function.It is worthy to be popularized.

Objective To measure Tei index in patients with idiopathic or ischemia dilated cardiomyopathy, and to evaluate its correlation with other conventional indexes of echocardiography of left ventricular(LV) function,and its applicability in assessing cardiopulmonary exercise capacity in those patients.Methods Seventy consecutive patients (53?14 years) with heart failure(New York Heart Association [NYHA] class, Ⅱ to IV) who had received echocardiographic diagnosis, and believed to be suffering from dilated or ischemia cardiomyopathy were studied. Echocardiography were performed; LV volume as well as ejection fraction were measured from the apical view of the two-dimensional echocardiogram using a modified Simpson’s rule algorithm in all patients. The following variables: peak early transmitral filling velocity (E), late transmitral filling velocity (A), their ratio (E/A), the deceleration time of E (DT), and Tei index were measured by spectral Doppler echocardiography. Furthermore, all patients underwent a cardiopulmonary exercise using 6min walk test. Results Advanced NYHA class was associated with higher Tei index values. A positive correlation was found between Tei index and early /late filling velocity ratio, while a negative correlation was found between Tei index and A wave, E wave, DT, and LV EF. Tei index showed no correlation with heart rate, blood pressure or age. Compared with the parameters of left ventricular function Tei index had a closer relation to the distance of 6min walk. Stepwise regression analysis revealed that the Tei index and the late LV filling velocity were the only independent predictors for cardiopulmonary exercise capacity.Conclusion Tei index correlates inversely with LV performance and reflects disease severity, which is a useful complimentary variable in the assessment of cardiopulmonary exercise performance in patients with heart failure.

Objective:To explore the best bathing posture in neo nates.Methods:Normal mature neonates 664 total were randomly seperated into two groups .The bathing posture was the traditional upwards from face to back in the control group,but upwards from back to face in the experimental group .The noise and comfort levels of the neonates were observed.Results:Uncomfortableness in the experimental gr oup was markedly lowerthan in the control group(χ2=45.78，P<0.0001).Bathing style,i.e.in basin or in shower,did not have an effect on the postures (P> 0.05).Conc lusion:The bathing posture of upwards from back to face is better than upwards from face to back.In this position,the neonates feel safer and more comfortable,and can be stroked while being bathed by the neonates' parents.

Objective To explore the effects of electro-acupuncture combined with surface gastric pacing on gastrointestinal dysfunction for patients with spinal cord injury (SCI).Methods Seventy-five SCI patients with gastrointestinal dysfunction were divided randomly into an electro-acupuncture group (group A),a gastric pacing treatment group (group B) and a group for which electro-acupuncture was combined with gastric pacing (group C).There were 25 cases in each group.Members of group A were given 30 minutes of electro-acupuncture per day ; those of group B had 30 minutes of gastric pacing treatment twice per day ; group C was provided with both 30 minutes of electro-acupuncture and one 30-minute gastric pacing treatment per day.All of the interventions lasted ten days.Before and after the treatment,all patients were assessed using a clinical symptoms score and with electrogastrograms,and any adverse effects were observed.Results There was a significant improvement in upper abdominal pain and epigastric discomfort,bloating and early satiety,nausea,vomiting,as well as belching and loss of appetite in each group after treatment.Before treatment there was no significant difference in the average clinical symptom scores of the three groups.After treatment the values had decreased,and those of group C were significantly lower than group A or B.The average scores of groups B and A were not significantly different.The electrogastrogram results showed than after treatment there was significant improvement in N％ and T％ in groups A and B,and also significant improvement in N％,B％ and T％ in group C compared to before treatment.Group C's improvements were all significantly greater than those observed in groups A and B.Conclusion Electro-acupuncture or gastric pacing alone can give some improvement in gastrointestinal function and its electrophysiological indicators,but their combined effects are better than when either is used alone.

Objective To investigate the role of infiltrating inflammatory cells in photoaging process by comparing the type and number of these cells in sun-exposed and-unexposed skin.Methods The expression of CD3,CD45RO and CD68 were detected by immunohistochemieal staining in 46 paraffin-embeded skin samples from the extensor forearms(sun-exposed)and upper-inner arms(sun-unexposed) of 23 healthy female volunteers.The number of positive cells in sun-exposed and -unexposed sites was counted and statistically tested by paired samples t test,and Pearson correlation analysis was performed to assess the relationship between the number of positive cells and age of these volunteers.Results The number of cells positive for CD3,CD45RO and CD68 per square millimetre in sun-exposed skin was significantly higher than that in sun-unexposed skin(48.91±13.173 vs.40.61±11.571,46.83±12.915 vs.38.00±10.109,85.43±22.346 vs.73.48±16.208,respectively,P<0.01 or 0.05).The number of cells positive for CD3 and CD45RO increased significantly with age (r=0.557,0.555,respectively,both P<0.01) in the sun-exposed skin but not in sun-unexposed skin,and the number of CD68-positive cells was uncorrelated with age in either sunexposed or -unexposed skin.Conclusion T lymphocytes and macrophages may play a role in the process of photoaging.

Objective To explore the role of problem-based learning(PBL) nursing ward round on critical thinking capacity of nurses from surgical departments. Methods All nurses from surgical depart-ments were randomly divided into the experimental group(86 nurses) and the control group(85 nurses) by drawing lots. Objects from the experimental group received PBL nursing ward round training twice a week for 8 months, while those from the control group used the traditional nursing ward round training. The influ-ence of the different teaching methods on the critical thinking capacity of the nurses was assessed before and after the training, using critical thinking disposition inventory-Chinese version (CTDI-CV). Results Total critical thinking capacity was improved significantly in the experimental group after the training. All sorts of critical thinking characteristics were strengthened in different degree. Conclusions PBL nursing ward round training can effectively facilitate the critical thinking capacity of surgical nurses.

Objective To develop and evaluate the reliability and validity of evaluation criterion for continuing health education in very low birth weight premature infants.Methods The literature review,theoretical analysis,qualitative research and Delphi technique were conducted to identify the evaluation criterion for continuing health education.The reliability and validity of evaluation criterion was tested in 112 parents of very low birth weight premature infants.Results The evaluation criterion which was based on the frame of KABP Model and Nursing Outcomes Classification as well as Nursing Interventions Classification consisted of 3 projects with 29 specific items.The content validity index for the scale was 0.950.Three common factors were extracted by the principal components extraction analysis and the cumulative contribution rate was 49.70％,73.25％ and 46.90％ respectively.The Cronbach' s alpha coefficient was 0.934,the retest reliability was 0.865 and the ICC was 0.940 for the total scale.Conclusion The evaluation criterion for continuing health education in very low birth weight premnature infants has good reliability and validity and can be used as a measurement tool for health education effect of continuing health education.The design of the scale provides basis for making transitional care model as well.

The incidence of struma ovarii(SO) is low, accounting for 5% to 15% of ovarian teratoma.Huge SO, pleural effusion and ascites with elevated carbohydrate antigen 125 are rare.There is no perfect clinical treatment guideline for the diagnosis and treatment of SO.MRI of patients with SO showed " Black Pearl" appearance.Appendectomy can be selected as the operation method.Postoperative pathology can confirm the diagnosis, and the prognosis is good.

The nurse's multiple-sites practice is currently being implemented,but there are debates regarding advantages and disadvantages.This review analyzed the background and advantages of the nurse's multiple-sites practice,and its main obstacles encountered in China,and put forward our opinions and suggestions about nurse's multiple-sites practice connecting with the practical situation.