Objective To investigate the clinical characteristics of hospital infection and the pathogen type,distribution and drug resistance,in the intensive care unit of our hospital,to direct proper antibiotics use and supply the scientific basis for hospital infection control. Methods The clinical data of 392 inpatients in our intensive care unit from April 2008 to March 2010 were monitored prospectively and analyzed retrospectively. Results Of the 392 impatients,78 cases had hospital infection (19.89% 78/392),112 time-case infection (28.57% 112/392). The most common infection was the main respiratory tract infections accounted for 54.46% (61/112) ,followed by urinary tract infections accounted for 15. 19% ( 17/112 ), blood infection accounted for 11.61% (13/112). 152strains pathogens were identified in the study,in which G- bacilli accounted for 69.7%, G+ bacteria accounted for 17. 8% and fungi accounted for 12.5%. Main pathogens such as acinetobacter baumannii ,pseudomonas aeruginosa,klebsiella pneumoniae, staphylococcus aureus showed multiple drug resistance in different degrees. Conclusions Intensive care unit has a high nosocomial infection rate,lower respiratory tract infection is the most frequent type and the main pathogens have different degrees of multi-drug resistance. Standardized, rational use of antibiotics,prevention of the multi-drug resistant bacteria spread may help to reduce the occurrence of hospital infection in intensive care unit.

OBJECTIVE To investigate the problems and countermeasures in the chemical disinfectants application.METHODS To analyze the existing problems in the chemical disinfectants application from 8 hospitals of different care levels at the same city and provide corresponding measures.RESULTS There were many problems in the use of chemical disinfectants,therefore the key points were enhencing the leadership and management standards,staff training,of corresponding knowledge and the correct methods,and strengthening the guidance,inspection and supervision by functional departments.CONCLUSIONS Medical personnel must properly use the chemical disinfectants to ensure the medical safety and prevent hospital infection effectively.

Objective To sum up the clinical experience in diagnosis and treatment of spinal primitive neuroectodermal tumor (PNET). Methods Thirteen patients with spinal PNET were included in the study from 1999 to 2009. There were 8 males and 5 females with the mean age of 26.9 years. The lesions involved the cervical spine in 6 cases, the thoracic segment in 1 case, the lumbar segment in 5 cases and the sacrum in 1 case. The diagnosis of PNETs was made in nine patients by postoperative pathological examination. Among them, 6 patients received a preoperative CT-guided percutaneous biopsy. The other four patients were diagnosed only by CT-guided percutaneous biopsy. Osteolytic bony lesions and obvious neurological deficit were found in ten patients, while the other 3 had complained of local pain only. Nine patients had received operation followed by chemotherapy and radiotherapy. The other 4 underwent only chemotherapy and radiotherapy. The changes of symptoms and time of survival were recorded. Results Eleven patients were followed up with the mean of 21.8 months. The back pain in 7 patients who underwent operation relieved one month after the operation. The bladder and bowel function returned to normal condition after the operation. Among them, four patients died postoperatively. The mean survival time was 11.3 months. The otherthree patients survived with an average of 36 months. Three patients who had only received chemotherapy and radiotherapy died with an average of 7 months, while the other patient survived for 5 months. Conclusion The diagnoses of spine PNET mainly depend on pathological examination. Percutaneous CT-guided biopsy is a reliable method to confirm diagnose of tumor before surgery. The mortality rate of spinal PNET which is a highly malignant tumor is high. Operation can relieve clinical symptoms and improve patients' life quality, but not prolong the survive time.

Objective To understand the nucleotide and amino acid differences of glycoprotein gene (G gene) between isolated rabies viruses in Henan Province and rabies vaccine strains used for human and animals. Methods G gene sequences of nine rabies viruses isolated from dogs in Xinyang city of Henan Province in December 2006 were amplified by reverse transcriptase (RT)-heminestedpolymerase chain reaction (PCR), and then were cloned and sequenced. The phylogenetic trees were constructed for analyzing the genetic characteristics of these rabies viruses. Results The homology of G gene among the nine isolates from Henan Province was 97.6% - 98.9% at nucleotide level and 99.2%-99.8% at amino acid level. The similarities between these isolates and CTN vaccine strain were 85.6%-93.0% and 91.9%-92.9% at nucleotide and amino acid level, respectively, which were higher than those between these isolates and other vaccine strains (80.4% - 83.3% and 87.7% - 92.5% at nucleotide and amino acid level, respectively). The nine isolates had several amino acid substitutions when compared to other genotype 1 rabies virus strains. Conclusions The nine rabies viruses strains isolated from Henan Province all belong to genotype 1. CTN may be an effective vaccine for preventing rabies in Henan Province.

Objective To observe the perioperative complications for metastatic cervical tumor,and explore their possible risk factors.Methods From January 2012 to January 2016,57 patients undergoing surgery for cervical spine metastasis were retrospectively analyzed,who were followed-up for at least 12 months or until death.Data collected included pain (a 10-point visual analogue scale,VAS),Karnofsky performance status score,neurologic status according to Frankel scale,perioperative complications,postoperative mortality and so on.Results The VAS score decreased significantly postoperation (P＜0.001).The Frankel grade was significantly improved (P=0.025).The Karnofsky score was also significantly improved (P＜0.001).The rate of local recurrence was 12.3％.Perioperative mortality rate (30 days after surgery) was 3.5％.Perioperative complication incidence was 24.6％.Univariate analysis found that comorbidity,preoperative Karnofsky score ＜60,multisegmental resection,and intraoperative blood loss ＞300ml were significant risk factors for the complication.Multivariable analysis showed that iIntraoperative blood loss ＞300ml and preoperative Karnofsky score ＜60 were the independent predictors for the complication.Conclusions Surgical management for cervical spinal metastasis is effective in terms of neurological recovery,pain control,and performance status recovery.However,the surgery had a high risk of complications that special attention should be paid to.Furthermore,complications might be related to preoperative Karnofsky score and intraoperative blood loss.

Objective To explore the postgraduate tutor assessment system in order to provide suggestions to improve the quality of postgraduate education. Methods Assessment indexes of post-graduate tutor were screened and assigned by methods of questionnaire investigation, interview, kruskal wallis H-test, taking a total of 109 students and professors in medical colleges in the south-western part as research objects. Results Different populations had different cognitions on the important degree of each index, P<0.05. Primary indexes of assessment system were determined based on the importance of indicators and the influence of different cognitive levels, including tutor personal accom-plishment, teaching ability, scientific research quality and guiding ability (P<0.05). Conclusions Assessment system and method fined by this study covers majority aspects of tutors and can provide feasible suggestions for tutor evaluation.

Objective To study the risk factors of intracranial hemorrhage after endovascular therapy of cere-bral arteriovenous malformations embolization.Methods the clinical records and images of 230 patients with cAVMs were retrospectively reviewed.Patients with intracranial hemorrhage after endovascular therapy in 3 days were recorded and the risk factors of hemorrthage by using multivariate logistic regression for guiding the treatment strategy were studied.Results There were 15 patients occurred intracerebral hemorrhages.After treatment the area of cAVMs was significantly smaller than that before treatment[(2.18 ±0.91)cm vs (6.67 ±1.56)cm],the difference lvas a statis-tically significant (t =9.627,P <0.05).A partial AVM reduction of ≥36.5%(P =0.031)and hypertension(P =0.025)were considered as risk factors for hemorrhage after endovascular therapy of cAVWs.Conclusion Patients receives a partial AVMreduction of ≥36.5% or with hypertension history have a tendancy of increasing hemorrhage after endovascular therapy of cAVMs.It's helpful for preventing intracerebral hemorrhage if the arterial blood pressure maintains after endovascular therapy.

Objective To detect the expression of ARK5 in hepatocellular carcinoma (HCC)tissue and hepatoma SMMC-7721 cells,and to investigate its effect on the growth of hepatoma cells.Methods The expression levels of ARK5 mRNA and protein were determined by RT-PCR and Western blotting in 30 cases of HCC tissue, paracarcinoma tissue,SMMC-7721 cells,and hepatic cells LO2.The SiRNA of ARK5 and negative control (NC) siRNA were constructed and transfected into the SMMC-7721 cells,and used as experimental group and negative control group;at the same time blank control group was set up. The proliferation activity and apoptotic rate of transfected cells were detected by MTT assay and flow cytometry (FCM).Results The PCR and Western blotting results showed that the expression levels of ARK5 mRNA and protein in HCC tissue and SMMC-7721 cells were significantly higher than those in paracarcinoma tissue and LO2 cells (P<0.05 ). The MTT assay results demonstrated that the inhibitory rates of growth of transfected cells in experimental group at 24,48 and 72 h were (19.39±5.42)%, (23.19±0.53)%,and (20.74±1.23)%;there were significant differences compared with blank control group and negative control group (P<0.01).The FCM results indicated that the apoptotic rate of the transfected cells in experimental group was (15.017±0.945)%,there were significant differences compared with blank control group (8.770%± 0.656 )% and negative control group (8.763%± 1.201%) (P<0.05 ). Conclusion The ARK5 expression level is significantly increased in HCC tissue and hepatoma SMMC-7721 cells;the inhibition of ARK5 expression could suppress the growth of hepatoma cells and induce apoptosis. So ARK5 maybe act as a cancer-promoting gene and induce hepatocellular carcinogenesis.

Background Aneurysmal bone cyst (ABC) is a benign lesion with the potential to be locally aggressive.The optimal treatment of cervical spine lesions remains controversial.This retrospective study was designed to evaluate the different treatments for primary ABCs of the cervical spine.Methods This series included eight men and six women diagnosed between 2002 and 2012.A retrospective review of the hospital charts,operating room reports,office charts,and radiographs was performed.The data collected included patient age,sex,radiological features,pathology,treatment method,outcomes,and complications from biopsies and treatments.The mean age at diagnosis was 17.5 years old with a range of 6-35 years.All patients had experienced local pain for a mean of 7.3 months (range,0.5-18.0 months),and three patients had neurological deficits (one with radiculopathy and two with myelopathy).The Frankel classification before treatment was E in 12 cases,D in one case,and C in one case.Results Four patients received radiotherapy alone.Ten patients underwent surgery,including five total spondyiectomies,two local resections,and three curettages.Three patients received preoperative selective arterial embolization,and four received adjuvant radiotherapy.The mean follow-up time was 44.5 months (range 12-96 months),and no recurrence was identified.Three patients with neurological deficits achieved complete recovery,as noted at the final follow-up examination.One patient received radiotherapy without appropriate immobilization as prescribed and developed C1-C2 subluxation with severe spinal cord compression but without myelopathy.He refused further treatment.Conclusions The results can be achieved by different treatments (surgical resection/curettage,selective arterial embolization,and radiotherapy) for ABC of the cervical spine.Reconstruction of stability is also important for the treatment of cervical ABC.

Background Differentiated thyroid cancer (DTC) is a common primary cancer for spinal metastases (SM).The treatments for DTC spinal metastases (SM) have evolved from simple surgery and radiotherapy to a multidisciplinary comprehensive therapeutic strategy of combined spinal surgery,general surgery,radiotherapy,nuclear medicine and endocrinology.The purpose of this study was to discuss the efficacy and prognosis associated with different surgical treatments of SM patients with DTC.Methods A total of 21 consecutive patients with SM of DTC that were treated between 1999 and 2013 were studied.Biopsy was routinely performed to achieve the pathological diagnosis before treatment.Three patients underwent total spondylectomy intralesionally or piecemeally,and 18 had curettage.Postoperative recurrence and survival times were analyzed by the Kaplan-Meier methods.Results Nineteen patients (90％) had an average of 42.7 months (range,7-170 months) follow-up.The median visual analogue scale for pain reduced from 5 points to 1 point (P ＜0.01),and the median Karnofsky performance score increased from 70 to 90 points after surgery (P ＜0.01).Seventeen patients with neurological deficits attained improvements after surgeries,of at least one level according to the Frankel classification (P ＜0.01).Eight patients with curettage had recurrence.Four patients died of DTC,12 patients lived with disease,and three patients were disease-free.No significant effects on postoperative recurrence or survival were observed between surgery combined with conservative treatment,total spondylectomy,the number of bone metastases and visceral metastasis.Conclusions DTC-SM have a relatively favorable prognosis,and curettage and stabilization can effectively relieve the pain and improve the quality of life and neurological status of the patients.For patients with Tomita scores of ＜3,total spondylectomy may have better clinical outcomes.Comprehensive therapeutic strategies including surgery,radioiodine,external beam radiation therapy and embolization should be considered for most patients.