Objective To evaluate effect of care bundle on preventing neonatal ventilator-associated pneumonia (VAP). Methods Eighty neonates who met the inclusion criteria were selected and randomly divided into trial group and control group,two groups of neonates were both given routine nursing care,trial group were implemen-ted care bundle to prevent VAP on the basis of routine nursing care. Incidence of VAP,average length of neonatal intensive care unit (NICU)stay,and average hospitalization expense were compared between two groups of neo-nates.Results A total of 80 neonates were monitored,trial group and control group were both 40 cases. Incidence of VAP in trial group and control group were 21.21‰ and 35.04‰ respectively(P<0.05);average length of NICU stay in trial group and control group were (17.84±4.03)d and (23.50±4.81)d respectively(P<0.05);average hospitalization expense in trial group and control group were(26200.71 ±389.45)yuan and (38506.36±582.13) yuan respectively(P<0.05).Conclusion Care bundle can effectively prevent the occurrence of VAP,reduce the length of NICU stay,decrease hospitalization expense,and improve nursing quality and satisfaction.

Three Chinese adult brains were selected for the study of the histological struc-ture of the cerebral cortex of the Broca's area with a comparison between thecorresponding parts of both hemispheres.Nissl's staining,Weil's and Golgi's techniqueswere employed for the microscopic examination.The results are as follows:(1)The thickness of the cortex of the Broca area in the specimen stained byM?lligan's method is in the range of 3.5 mm to 5.0 mm.(2)The thickness measurements of the six layers in the thickest cortex are 0.17mm(Ⅰ),0.11 mm(Ⅱ),1.06 mm(Ⅲ～Ⅴ),1.52 mm(Ⅵ)and in total 2.86 mm inthe left hemisphere,and 0.15 mm(Ⅰ),0.10 mm(Ⅱ),0.87 mm(Ⅲ～Ⅴ),1.50 mm(Ⅵ),and in total 2.62 mm in the right hemisphere respectively.(3)The ratio of height/width of pyramidal cells in the second layer are 16.84?4.46 ?m/9.50?2.32 ?m in the left hemisphere and 15.60?4.56 ?m/8.88?2.03 ?min the right hemisphere respectively.(4)The ratio of the height/width of the pyramidal cells in the fifth layer are56.90?7.99 ?m/14.79?3.26 ?m in the left hemisphere and 49.80?9.08 ?m/14.67?7.88 ?m in the right hemisphere respectively.There is a very significant difference(P0.05)betweenthe widths of the pyramidal cells of the two hemispheres.(5)Within an area of 6400 ?m~2 of a section 10 ?m in thickness,in the firstmolecular layer,there are 13.0 cells in the left hemisphere and 11.7 cells in the righthemisphere respectively.(6)In this area all of the pyramidal cells are not exceeding 60 ?m in height,hence there is no Betz cells.In addition to the large population of pyramidal cells,there are cajal horizontal cell,Martinotti cells,fusiform cells,etc.

Objective To explore the therapeutic effect of treating uterine muscle tumor conservatively with the use of Guizhifulin capsules and mifepristone.Methods 36 outpatients suitable for conservative therapy after gynecological and B ultrasonic checking were studied.Each patient took orally 3 capusles of Guizhifulin each time,three times a day.Meanwhile each one took orally 12.5mg mifepristone once a day,three months as a course of treatment.The size of uterine muscle tumor and the variations of symptom were observed.Results 2 cases were totally recovered,11 cases had obvious effects,22 cases had some effects,the whole effective rate was 97%.Conclusion It is an ideal,safe,convenient,medicament therapy to treat uterine muscle tumor by using Guizhifulin capsules combined with mifepristone,which has apparent curative effects but little side effects or low tate of recurrence.

Objective To discuss the microsurgical treatment for tethered cord syndrome (TCS) caused by intraspinal lipomas. Methods Thirty-two patients with intraspinal lipoma TCS were treated microsurgically. On surgery the tethering lesions of lipoma were excised and anomalies restricting the spinal cord were removed. Results Following the operation, cerebrospinal fluid subcutaneous leakage had occurred in 3 patients, who were cured by expectant treatment. The patients were followed for 3~12 months (mean, 6 months). Five patients were cured, 21 got improved, and 6 had no change. Conclusions Application of microsurgical technique for intraspinal lipoma TCS has advantages of fewer complications and better improvement of nerve functions.

Objective To investigate advantages and disadvantages of unilateral hemilaminectomy for the microsurgical removal of cervical intraspinal tumors. Methods Twenty-three patients with cervical intraspinal tumors were treated microsurgically with unilateral hemilaminectomy. In condition that the vertabral lamina was kept intact in bony structure, an opening (key-hole) was made in the unilateral lamina by using a drill or a small-sized bone rongeur. Then cervical intraspinal tumors were removed via the “key-hole”. Results Tumors were completely removed in all the 23 patients and no symptoms relating nerve injuries were observed. Postoperative follow-up for 3~16 months (mean, 8 months) revealed no recurrence and spinal deformity. Conclusions Unilateral hemilaminectomy for the treatment of cervical intraspinal tumors is a mini-invasive procedure which benefits the spinal stability. The pitfall of the technique lies in limited surgical field.

As the most common pathogen for healthcare -associated infection in European and American countries, Clostridium difficile has become increasingly popular in China and has posed a great threat to public health.Based on evidences retrieved from the PubMed and CNKI databases , this article reviews biological characters and dissemination patterns of C.difficile, epidemiology, burden and risk factors of C.difficile infection, and the surveillance, contact precaution, hand hygiene, antimicrobial stewardship, environment cleaning, use of probiotics and vaccine for the prevention of C.difficile infection.

Objective To explore the examination methods about stability of carotid atherosclerotic plaque and evaluate the curative effect of medicine on carotid atherosclerosis.Methods 150 patients with carotid atherosclerotic plaque in acute stage ischemic stroke were divided into treatment group and control group at random.Stable or instable plaques were assessed and carotid artery intima-media thickness(IMT) were measured according to the characteristics of carotid atherosclerotic plaque on supersound imagin.The treatment in treatment group were different from that in control group.The therapeutic efficacy was observed respectively.Results After the treatment 1 month and 3 months,in treatment group carotid artery IMT decreaced more than that at accidence of treatment group and that of control group,the carotid atherosclerotic plaques stabilizese increasingly.Conclusion The stability of carotid atherosclerotic plaque may be evaluated through the ultrasound imagin.Statin and aspirin can lighten carotid atherosclerosis and stabilize the plaque.

ObjectiveTo compare the effect of amiodaron and propafenone on the cardioversion of paroxysmal auricular fibrillation (PAF). Methods58 PAF (≤48 h) cases were radomly divide into two groups: 30 cases who accepted amiodaron 150 mg intravenous injection, and 0.6～1.0 mg/min intravenous drip afterwards in amiodaron group, other 28 cases who accepted propafenone 1.4～2.0 mg/kg vein injection, and 0.28 mg/min intravenous drip afterwards in propafenone group.If propafenone was not effective, the cases in propafenone group were given amidoaron. ResultsThe successful reversion rate was 86.7% (26/30) in amidoaron group while 57.1% (16/28) in propafenone group(P<0.05). The mean time of recovering was (101±95) min (6～508 min) in amidoaron group, while (172±148) min (11～608 min) in propafenone group(P<0.05). ConclusionIt is more rapid and effective of amidoaron on the cardioversion of paroxysmal auricular fibrillation than propafenone is.

Objective To assess characteristics of coronary artery lesions and risk factors of coronary heart disease (CHD) in young people with coronary arteriography.Methods 192 patients with CHD diagnosed by coronary arteriography were divided into the young group (91 cases, 25—40 years old) and senile group (101 cases, 41—84 years old). Characteristics of coronary artery lesions and risk factors of CHD of two groups were analyzed, and risk factors were especially tested with logistic regression.Results Coronary artery lesions in the young group were characterized in most patients by singles vessel lesion (64%), while by multi vessels lesion (71%) in the senile group. Multiple logistic regression analysis showed that risk factors such as male, smoking, hyperlipemia, family history and increassed C-reactive protein (CRP) were highly related with CHD(P<0.01).Conclusion Single vessel lesion is a feature of young patients with CHD, and independent and related risk factors of CHD in the young group are male, smoking, hyperlipemia, CHD family history and CRP.

Objective To explore the ultrasound images features of breast infiltrating ductal carcinoma. Methods Retrospective analysis of operation pathology ,55 patients diagnosed preoperatively infiltrating ductal carcinoma of color Doppler ultrasound diagnostic information. Results Before operation, 55 patients with breast tumors had color Doppler shows in 49 cases,no color doppler showed 6 cases,color Doppler shows with pathologic diagnosis is 89.1%. An infiltrating ductal carcinoma ultrasound image characteristics:the larger mass was irregular form,no coated, posterior acoustic attenuation,burr levy ,and crabs foot shape more inside,bump such change for not uniformity hypoechoic,with tiny clusters of calcified or irregular flare,shadow,blood flow distribution after silent for AlderⅡmore performance level Ⅲ,axillary lymph node enlargement,a different level hilus structure was clear,the peak systolic velocity in 12-80cm/s (average 35.1 cm/s ) , resistance index in 0.62-0.92 (average for 0.79 + 0.10). Conclusion Color doppler ultrasonography had important value in early diagnosis of infiltrating ductal carcinoma.