OBJECTIVE To estimate the current situation about nosocomial infections(NI),and find possible reasons to improve measures.METHODS A point-prevalence survey of NI in all inpatients was made on June 11,2007.RESULTS Of the 755 patients investigated,the prevalence rate of NI was 4.77%(36 cases).In all of the NI occurred,the common sites of NI were respiratory tract(69.30%),superficial surgical incision(13.80%),and skin soft tissue(8.33%).The usage rate of antibiotics was 57.40%,The single usage rate of antibiotics was 60.70%,double antibiotics usage 38.30%,and triple antibiotics usage 0.90%.CONCLUSIONS The departments of nephrology and neurosurgery are with high NI rate.Strengthening the management of severe patient and rational using antibiotics can help to reduce prevalence rate of NI.

OBJECTIVETo explore the surgical method and its effects of adjacent spinal segment degeneration after anterior cervical fusion.

METHODSFrom March 2000 to March 2011, 27 patients with spinal segment degeneration who had accepted the operation of anterior cervical fusion were treated with surgical treatment. There were 16 males and 11 females with an average age of 55.3 years (ranged from 48 to 72 years). JOA scores and image examination were used to evaluate the clinical effects.

RESULTSAll patients were followed up for 1.8 to 7.2 years with an average of 3.6 years. All pathological segments obtained fully decompression with good spinal bombe, no internal fixation loosening and cervical spine instability were found. Nerve root pain had disappeared and nerve function had significantly improved. Before operation, 3 days after operation and at last follow-up, JOA scores were 9.15 +/- 3.46, 13.96 +/- 2.79 and 13.52 +/- 2.91, respectively, and there was significant difference between preoperation and postoperation (P < 0.05). Intervertebral height and physiological curvature improved obviously than preoperation (P < 0.05).

CONCLUSIONIn order to relief spinal compression and rebuild spinal stability, a surgical treatment will be recommend to adjacent spinal segment degeneration combining spinal nerve symptoms and physical sign as soon as possible. Selecting an appropriate surgery to treat different compressed segment would receive satisfactory results.

Aged ; Cervical Vertebrae ; surgery ; Decompression, Surgical ; methods ; Female ; Humans ; Male ; Middle Aged ; Spinal Fusion ; adverse effects

OBJECTIVETo investigate the application of the expanding forming under the plate through cervical spatium intermusculare approach to treat multi-segmental myelopathic cervical spondylosis.

METHODSFrom July 2005 to June 2013, 25 patients with multi-segmental myelopathic cervical spondylosis were treated by the expanding forming under the plate through cervical spatium intermusculare approach including 16 males and 9 females with an average age of 56.5 years old ranging from 35 to 78 years old. Among them, 10 cases were onset without causes slowly, 7 cases were onset without causes suddenly, 8 cases were onset after mild trauma or tired. JOA scoring, incidence of postoperative axial symptoms and imaging studies were used to evaluate the effect.

RESULTSTwenty-five cases were followed up for 6 months to 7 years and 6 months with an average of 2 years and 9 months. There were no infection, cerebrospinal fluid leakage after the operation, and complications such as nerve damage were occurred. The operation time was 120 to 150 min, the bleeding was 300 to 500 ml. Imaging examination showed vertebral canal sagittal diameter increased, the vertebral canal increased significantly in the cross sectional area of the spinal cord, cervical curvature was straighten in 4 cases (2 cases of them became normal sequence). There were no more cases of cervical protruding and segmental instability increased. Postoperative walking ability enhanced, the finger activity of majority of patients improved on flexibility, grip strength, and accuracy of using chopsticks improved, numbness and chest waist band feeling had different degree of reduce, preoperative urine impairment were improved to varying degrees. Preoperative JOA scores were 3 to 13 points with an average of (8.86 ± 4.25) points; Postoperative 12 months' JOA scores were 7 to 17 points with an average of (13.76 ± 3.56) points, period was 60.19% in average, JOA score had statistically difference between before and after operation (P < 0.05). The result were excellent in 14 cases, good in 6 cases, and fair in 4 cases and poor in 1 case.

CONCLUSIONApplication of the expanding forming under the plate through cervical spatium intermusculare approach to treat multi-segmental myelopathic cervical spondylosis, through muscular clearance, can retain complete cervical back muscle, maintain stability of cervical spine, and vertebral canal can get effective decompression at the same time.

Adult ; Aged ; Bone Plates ; Cervical Vertebrae ; Female ; Humans ; Laminectomy ; Male ; Middle Aged ; Postoperative Complications ; etiology ; Spondylosis ; surgery

Objective To investigate a wide range of uterine cervical cancer after hysterectomy for lower urinary tract urinary dynamics characteristics.Methods Cervical cancer Ib Ⅱ a via ablominal extensive hysterectomy in 25 cases were analyzed retrospectively,which had the type of operation in 7 cases,type Ⅲ Procedures for 18 cases,respectively,at 1 month after operation and 1 urethral urodynamic studies.Results The patients showed varying degrees of voiding dysfunction and urine storage dysfunction,maximum urinary flow rate decreased significantly (10.01 ml/min),the average decrease in urinary flow rate(6.44ml/min),voiding time 77.63s,residual urine volume 103.16ml,maximum bladder capacity 288.68ml,postoperative beard had the aid of abdominal pressure urination.Conclusion Extensive hysterectomy can occur after different degree of voiding dysfunction and urine storage dysfunction,and duration is longer,the main manifestation of impaired detrusor function,bladder sensory dysfunction,urethral dynamics can contribute to early diagnosis,early treatment,to prevent serious complications of the urinary system.

The aim of the study was to investigate the effect of Omeprazole on the intragastric pH and the prevention of upper gastrointestinal bleeding in patients undergoing brain surgery. Twenty patients who received brain surgery were randomly divided into two groups. 72 hour intragastric pH monitoring was carried out in all these patients beginning 4 hours before the operation. After the operation, 10 patients in the control group received therapy, the other 10 patients in Omeprazole group received Omeprazole 40 mg intravenously once daily in addition to routine therapy. In brain surgery patients, the intragastric pH increased during the operation ( P

Bilingual education is developing in the our country. Bilingual teaching faculty will directly determine the quality of bilingual education. To understand the needs of bilingual teachers,a survey was executed. Bilingual teaching team was established by teachers of school of public health of Peking University. The team investigated on related teaching faculty based on domestic development needs of bilingual education thus to provide training for bilingual teachers. Based on practice of teach-er training ,this paper aimed to explore the effective methods for improving teacher's quality and bilingual teaching ability from the training methods and contents.

OBJECTIVE:To provide reference for rational allocation of earth quake medical rescue drugs. METHODS:The number and types of drugs used by Chinese government medical detachment in Nepal earthquake in 2015 were analyzed statistical-ly. RESULTS:Top three kinds of drugs were antipyretic analgesics,Chinese patent medicine for activating meridians to stop pain and antihypertensive drugs;among which,Yunnan baiyao capsule,Ibuprofer sustained release tablet,Nifedipine sustained release tablet were more used;main dosage form was oral preparation,followed by external application and topical preparation. CONCLU-SIONS:Foreign aid relief teams can foresee the quantity and type of rescue drugs depending on station sanitary conditions,medica-tion habits,the characteristics of patients to guarantee the medical detachment work and avoid medical resources waste.

In this study, a closed-loop controller for chest compression which adjusts chest compression depth according to the coronary perfusion pressure (CPP) was proposed. An effective and personalized chest compression method for automatic mechanical compression devices was provided, and the traditional and uniform chest compression standard neglecting individual difference was improved. This study rebuilds Charles F. Babbs human circulation model with CPP simulation module and proposes a closed-loop controller based on a fuzzy control algorithm. The performance of the fuzzy controller was evaluated and compared to that of a traditional PID controller in computer simulation studies. The simulation results demonstrated that the fuzzy closed-loop controller produced shorter regulation time, fewer oscillations and smaller overshoot than those of the traditional PID controller and outperforms the traditional PID controller in CPP regulation and maintenance.
Algorithms ; Arterial Pressure ; Cardiopulmonary Resuscitation ; instrumentation ; Computer Simulation ; Coronary Vessels ; physiopathology ; Humans ; Models, Theoretical ; Perfusion ; Thorax

Objective To study the risk factors of MRI for the prediction of collapse in patients with avascular necrosis of the femoral head.Methods Twenty-two patients (39 hips) diagnosed avascular necrosis of femoral head by MR were enrolled in our study.The following MR appearances were evaluated:bone marrow edema,joint fluids,signal intensity and location of the lesion.The volume and surface area of the necrosis zone were calculated.The time of follow-up was 18-84 months (median,25 months).Logistic regression analysis was used to predict the risk factors by SPSS 13.0.The maximum value of Youden index was selected as the critical point to predict the collapse of femoral head and to define the sensitivity,specificity and accuracy.Results In the 39 hips with femoral head necrosis,21 hips had collapse.Bilateral collapse occurred in 5 cases.In 25 hips with the necrosis surface larger than 25％,collapse occurred in 21 (84％); In 8 hips with the volume of femoral head necrosis larger than 30％,collapse occurred in all cases; 1n 33 hips with the necrosis locating at the superolateral quadrant,collapse occurred in 21 (63.6％); In 22 hips with necrotic areas showing heterogeneous signal intensity,collapse occurred in 18(81.8％) ;In 25 hips with large amount of joint effusion,collapse occurred in 16 (64％) ;in 18 hips with bone marrow edema,collapse occurred in 13 (65％).Joint fluid,heterogeneous signal intensity and lesions in the superolateral quadrant,volume ratio,and area ratio were the high risk factors,while bone marrow edema was a relatively low risk factor.The area under ROC curves for area ratio of NASA was greater than that for volume ratio (0.987 vs 0.902).When the critical value for area ratio was 26.7％,the true positive rate was 95.2％,true negative rate was 94.4％,and Youden's index was 0.896.Conclusions The collapse of necrosis of femoral head may result from many factors.The femoral head was easy to collapse when it had large enough area of necrosis and mixed signal intensity,a large amount of joint effusion,bone marrow edema,and superolateral quadrant location.The critical value for area ratio to predict the collapse of femoral head was about 26.7％.The area ratio is more accurate than volume ratio in predicting the collapse of necrosis of femoral head.

Objective To evaluate the correlation between sonographic features of papillary thyroid microcarcinoma(PTMC) and cervical lymph node metastasis.Methods Preoperative sonographic features of 379 papillary thyroid microcarcinoma in 341 patients were retrospectively reviewed,and were divided into two groups,lymph node metastasis and lymph node non-metastasis according to pathology.Univariate and multivariate analyses were performed to analyze the sonographic features relevant to lymph node metastasis.Results Univariate analysis revealed that unclear border,microcalcification and multifocal PTMC were statistically significant(all P ＜0.05).Multivariate analysis revealed that microcalcification and multifocal PTMC were statistically significant (both P ＜0.05).Conclusions Microcalcification and multifocal PTMC are closely relevant to cervical lymph node metastasis.