The major pathogenic bacterium of catheter-related bloodstream infection is gram-positive bacteria.The occurrence of catheter-related bloodstream infection is related with exogenous factors and endogenous factors.It is suggested that catheter-related bloodstream infection should be diagnosed without removing the catheter.It is shown that the catheter should be removed and the patient should use antibiotics as soon as possible if catheter-related bloodstream infection occurred.Buliding a detection system,using antimicrobial dressings and antimicrobial central catheters,and improving patient's nutritional status can decrease the morbidity of catheter-related bloodstream infection.The authors summarize the epidemiology,diagnosis,treatment and prevention strategies of catheter-related bloodstream infection.

Objective:To investigate the changes of lymphocyte subsets and the serum levels of IgE in the children with allergic rhinitis,and to analyze the relationship between lymphocyte subsets and IgE.Methods:CD3+,CD4+,CD8+CD19+,CD4+CD25+,CD16+56+lymphocyte subsets were measured by flow cytometry ,IFN-γ,IL-4,IL-5 of serum were detected by enzyme linked immunosorbent assay(ELISA)and the serum level of total IgE was detected by immuno turbidimetric assays in 86 cases of children with allergic rhinitis and 76 cases of healthy children.Results:CD19+B lymphocyte subsets ,the ratio of CD4+and CD8+,IL-4 ,IL-5 and the serum levels of IgE were increased in the children with allergic rhinitis groups as compared with healthy children , the difference has statistical significance(P<0.05);CD3+,CD4+,CD8+,CD4+CD25+,CD16+56+lymphocyte subsets and IFN-γwere lower than the control group ( P<0.05 );there was a correlation between B lymphocyte subsets and IgE in the children with allergic rhinitis.Co nclusion:Lymphocyte dysfunction and Th1/Th2 ratio imbalance may be related to the pathogenesis of allergic rhinitis ,and IgE,IFN-γ,IL-4 and IL-5 play important roles in children with allergic rhinitis.

Objective To investigate the method to prevent the displacement of tissue expander implanted between the panniculus carnosus and deep fasia in rabbits .Method 40 rabbits were divided into two groups randomly: the experimental group and the control group .Through an incision on the back , a pocket was made by dissecting between the rabbit panniculus carnosus and deep fasia .The panniculus carnosus at the pocket boundary were sutured with the deep fascia inside the pocket by interrupted 3-0 sutures.A 50 mL kidney-shaped tissue expander was implanted .The expander was inflated with 10 mL saline after the wound was sutured .7 days after implantation , black tattoos were made on the skin around the expander to mark the site of expander .Two months after implantation , the expanders in the experimental group were inflated with 10 mL saline weekly to a total of 140 mL.7 days after implantation the expanders of control group were inflated with 10 mL saline weekly to a total of 140 mL.The incidence of expander displacement , dehiscence of incision , reversal of injection pot and death were recorded .Results There was no expander displacement in the 19 rabbits of experimental group .All the expanders were located within the tattoo area .There was no expander displacement in 11 rabbits of the control group .4 expanders of the control group moved from the back to belly .The difference between them was statistically significant ( P <0.05 ) .The incidence of dehiscence of incision in the experimental group was not significantly lower than that in the control group ( P >0.05 ) .Meanwhile there was no significant difference in the incidences of reversal of injection pot , infections and deaths ( P >0.05 for all ) .Conclusions Sutures between the panniculus carnosus and the deep fascia at the pocket boundary asisted by delayed inflating can prevent the displacement of tissue expander implanted between the panniculus carnosus and deep fasia in rabbits , thus to obtain effective expansion .

Objective To study the diagnosis and treatment of syncope by analyzing its etiology.Methods Ninety-six syncope patients admitted to our hospital from 2014-01-01 to 2016-12-21were included in this study.The etiology of syncope was analyzed.Results Of the 96 syncope patients included in this study,50 (52.1 ％) were diagnosed with nerve-mediated reflex syncope,31(32.3％) with orthostatic hypotensive syncope,10 (10.4％) with cardiogenic syncope due to arrhythmia,coronary atherosclerotic cardiopathy or pulmonary embolism,5 (5.2％) with other diseases.Conclusion Nerve-mediated reflex,orthostatic hypotension and cardiogenic factors are the causes of syncope.Attention should thus be paid to syncope caused by nervous system diseases.Clarification of the risk factors for syncope helps to reduce its potential risk.

Objective To investigate the psychological state of high-risk pregnancy mothers af-ter being separated from their newborns and discuss the influencing factors of psychological state. Methods Nonexperimental descriptive study was used in this study. The investigation adopted state-trait anxiety inventory (STA-Ⅰ) and Edinburgh postnatal depression scale (EPDS). Results The moth-ers' anxiety score was significantly higher than normal women in China, and postnatal depression inci- dence rate was 57.9%. Mothers' psychological state was correlated with gestational age of new-borns, trait anxiety and pregnancy complications. Conclusions The psychological state of high- risk pregnancy mothers after being separated from their newborns should be paid more attention to, and cor-related nursing methods should be taken to improve their mental health.

OBJECTIVE To investigate the relationship between state trait anxiety and behavioral status in patients with sudden deafness. METHODS From April 2015 to June 2016, 140 cases of hospitalized patients with sudden hearing loss were selected as the observation group, and 140 healthy volunteers in our hospital for medical examination were selected as the control group. Average data, state trait anxiety, quality of life, and behavior survey were investigated in the two groups and correlation analysis was conducted. RESULTS The state trait anxiety score of the observation group was 51.20±4.19 points, and the control group was 34.40±3.49 points, and the state trait anxiety score of the observation group was significantly higher than that of the control group(t=12.949, P<0.05). The scores of physical, compulsive, interpersonal sensitivity, hostility and depression in the observation group were significantly higher than those in the control group(P<0.05). The problem solving and help scores in the observation group were significantly lower than that of the control group, while the fantasy and self accusation scores was significantly higher than that of the control group(P<0.05). In the observation group, Pearson correlation analysis shows anxiety scores were significantly correlated to the dimensions scores of quality of life, fantasy and self accusation scores(P<0.05), and were significantly negative correlated to the problem solving and help scores (P<0.05). CONCLUSION The patients with sudden deafness is accompanied by state trait anxiety and fantasy, self accusation and other bad behavior, it can seriously affect the patient's quality of life and form vicious circle, so the nursing intervention should be strengthened in clinical practice.

Objective To evaluate fluid distribution in patients on maintenance hemodialysis (HD) by bioimpedance analysis and on the effect of adjusting the dry weight in hemodialysis patients.Methods Forty maintenance HD patients from the dialysis center of the Second Affiliated Hospital of Dalian Medical University were enrolled as study group.One hundred and two individuals who were tested of physical examination in the same hospital were enrolled as the control group.Sex and age of the two groups were recorded.Body weight,body high,blood pressure,bioimpedance of HD patients (pre-dialysis and post-dialysis) and controls were measured.Bioimpedance was measured by multifrequency segmental bioimpedance analysis,including right arm (RA) bioimpedance,trunk (TR) bioimpedance and right leg (RL) bioimpedance.Bioimpedance ratio (BIR) of three parts was calculated as of 100kHz and 20kHz including RA-BIR,TR-BIR and RL-BIR.Then eight HD patients who had high RA-BIA or TR-BIA according to the reference range which were obtained from 102 controls were chosen for dry weight adjustment.Post-dialysis body weight,blood pressure,and bioimpedance of the eight HD patients were measured again after adjusting the dry weight.Results (1) BIR of three parts in pre-dialysis HD patients were all significantly higher than that in the control group (P ＜ 0.05).BIR of three parts of the post-dialysis HD patients were still higher than that of the control group,but RL-BIR was not significantly (P ＞ 0.05).BIR of three parts of the post-dialysis HD patients were lower than BIR of three parts of the pre-dialysis HD patients,and there was significant different (P ＜ 0.05) with RA-BIR and RL-BIR.(2) After adjusting the dry weight,BIR of three parts of the post-dialysis HID patients were still higher than that of the control group,but none of them was significantly (P ＞0.05).BIR of three parts of the HD patients after adjusting the dry weight were lower than BIR of three parts of the HD patients before adjusting the dry weight,but there was no significant different with TR-BIR(P ＞ 0.05).After adjusting the dry weight,systolic blood pressure of the post-dialysis HD patients were significantly decrease[(150.00 ± 29.28) vs (140.63± 20.78) mm Hg,P＜ 0.05].Conclusions Bioimpedance analysis may be an effective method for adjusting dry weight in hemodialysis patients,and the bioimpedance of arms is the most effective method.The bioimpedance reference range of hemodialysis patients can be according to the reference range of normal individuals.

Field practice teaching is an important part in pharmaceutical botany. According to the problems in the traditional field practice, an innovative system of field practice teaching was built. A series of reform and innovation was integrating and rationally allocating the existing resources. Combining the tra-ditional cognitive practice teaching and self-study, image-text card of medicinal plant was edited to enrich the teaching content, and the diversification of evaluation methods was proposed. This method could mobi-lize the enthusiasm of the students, improve the comprehensive quality of students and obtain good teaching effect.

Objective To investigate the causes and mechanism of preterm birth through analysis of the relationship between histological chorioamnionitis (HCA) in placental tissue and preterm birth.Methods Totally,327 preterm birth cases with report of placental pathologic examination were retrospectively collected from those women who delivered from December 1,2009 to December 1,2012 in Peking University First Hospital.According to the etiology of preterm birth,three groups were assigned:iatrogenic group (n=106),spontaneous contraction group (n=56) and premature rupture of membranes (PROM) group (n=165).According to the gestational age at delivery,three subgroups were further divided:early-preterm group (≥ 28-＜ 32 weeks),mid-preterm group(≥ 32-＜ 34 weeks) and late-preterm group (≥ 34-＜ 37 weeks).HCA was confirmed when ≥ 5 neutrophil infiltration identified on the chorionic plate and amniotic membrane under high power light microscope after HE staining.The relationship between HCA and the different types of preterm birth and the different delivery gestational age were analyzed.Besides,the consistency between clinical chorioamnionitis and HCA was also analyzed.Chi-square test was applied for statistics.Results The incidence of HCA in the spontaneous contraction group was significantly higher than in the iatrogenic group and PROM group [66.1％ (37/56) vs 25.5％ (27/106) and 33.3％ (55/165),x2=25.27 and 18.44,both P ＜ 0.01],but no significant difference was found between the latter two groups (P ＞ 0.05).Among the three subgroups,the early-,midand late-preterm subgroup,the incidence of HCA in the iatrogenic group was 24.0％ (6/25),33.3％ (8/24) and 22.8％ (13/57) (P ＞ 0.05),and 13/17,5/7 and 59.4％ (19/32) in the spontaneous contraction group (P ＞ 0.05).However,significantly higher incidence of HCA was shown in the early-preterm subgroup than in the mid-and late-preterm subgroup [70.0％ (20/29) vs 41.2％ (14/34) and 20.6％ (21/102),X2=4.87 and 24.58,both P ＜ 0.05] in the PROM group.Among the subjects in PROM group,those with the latency ≥ 72 h after the rupture of membranes had a higher incidence of HCA than those with the latency less than 72 h [68.6％ (24/35) vs 23.8％ (31/130),x2=24.82,P ＜ 0.01].For all 327 cases in this study,the incidence of clinical chorioamnionitis was 15.9％ (52/327),among which 31 cases [59.6％ (31/52)] were diagnosed as HCA.Conclusions The occurrence of HCA is closely associated with spontaneous contraction preterm.Some iatrogenic preterm birth might cause HCA.The earlier the preterm birth and the longer the latency after PROM,the higher the incidence of HCA.Differential diagnosis is necessary as the inconsistency between clinical chorioamnionitis and HCA.