OBJECTIVE To determine distribution of pathogens and resistance characteristic in urinary infection and to provide basis for clinicians to select antibiotics correctly.METHODS A total of 272 strains of pathogens were identified and ESBLs-producing G-bacilli were detected.RESULTS Among 272 strains,68.4% of G-bacilli,19.1% of G+cocci,12.5% of fungi,41.1% of Escherichia coli and 18.2% of Klebsiella pneumoniae strains produced ESBLs.CONCLUSIONS G-bacilli are major pathogens of urinary infection and their resistance is raised.Much attention should be paid to resistance detection.It is important to control nosocomial infection and select antibiotics correctly.

The process of diagnosis and nursing of a case with human granulocytic anaplasmosis who was confirmed by etiological diagnosis and molecular biology analysis was analyzed.The matters needing attention in nursing and nosocomial infection control were discussed and analyzed.To avoid misdiagnosis and mistreatment,cross infection,reduce pain and economic burden of the patients,to provide references for future diagnosis and treatment of human granulocytic anaplasmosis.

Objectives To study the characteristics of clinical distribution of enterococci, to test its sensitivity to antibiotics recommended by NCCLS, and to promote rational use of antibiotics. Methods A total of 381 strains of enterococci isolated from Hubei during January to December 2001 were tested for their sensitivity to antibiotics and production of beta-lactamases with paper disk diffusion method. Results Among 381 strains of enterococci, there were 78.0% of E. faecalis, 19.4% E. faecium, 1.6% E. durans, 0.53% E. avium, 0.3% E. hirae and 0.3% E. solitarium , and beta-lactamases-producing enterorocci accounted for 3.2% of the total. And, 46.5% of the strains were isolated from uroreproductive tracts samples, ranking the first of the total, possibly because of some samples from a hospital specialized in urology, 35.4 % from respiratory tract, ranking the next, and 11.0% form skin pustule and infected wound, ranking the third. Proportions of the strains resistant to varied antibiotics were 5.8%, 7.9%, 11.0%, 24.7%, 26.8%, 38.6%, 54.6%, 54.6%, 52.5% and 79.3% to vancomycin, teicoplanin, nitrofurantoin, ampicillin, penicillin, ciprofloxacin, chloromycetin, high concentration gentamycin, high concentration streptomycin, and tetracycline, respectively. Drug-resistant rate of E. faecium was higher than that of E. faecalis. Conclusions Enterococci, most of them identified as E. faecalis and E. faecium, were isolated from samples of uroreproductive and respiratory system, and the most susceptible to vancomycin. E. faecium was more resistant to antibiotics than E. faecalis.

Objective To evaluate the high?risk factors for brain metastases after prophylactic cranial irradiation ( PCI), and to provide a basis for personalized treatment. Methods A retrospective analysis was performed in 188 patients with limited?stage small?cell lung cancer who received PCI in our hospital from 2005 to 2010. The Kaplan?Meier method was used to calculate the cumulative rate of brain metastases. The log?rank test and the Cox model were used for the univariate and multivariate analyses of the potential factors for the cumulative incidence of brain metastases, respectively. Results In the 188 patients, 31 ( 16?5%) had brain metastases. The 1?, 2?, and 3?year cumulative incidence rates of brain metastases were 4%, 15%, and 20%, respectively. The univariate analysis showed that staged Ⅲ disease before treatment, elevated levels of tumor markers, incomplete remission after chemoradiotherapy, and local?regional relapse were risk factors for high incidence of brain metastases ( P= 0?044, 0?037, 0?005, 0?007) . The multivariate analysis revealed that incomplete remission after chemoradiotherapy and local?regional relapse after chemoradiotherapy were risk factors for high incidence of brain metastases after PCI ( P= 0?003, 0?040 ) . Conclusions Patients with incomplete remission or local?regional relapse after chemoradiotherapy have high incidence of brain metastases after PCI. For those patients, a frequent follow?up of the central nervous system plus salvage cranial irradiation might provide an alternative to PCI.

Three weeks’ training, visiting and demonstrating classes in Michigan State University gave us an opportunity to understand the education system, the teaching characteristics and the “students centered”teaching principle of USA. Some reasonable teaching methods were applied in the class which may embody the student-oriented teaching aim and develop the students’ subjective initiative. The teaching effect showed that most students were fond of the teaching strategies and they also did good job in final tests.

The purpose of education is to cultivate talents who can master the ability of self-learning lifelong. With the rapid development of multimedia technology, the knowledge carrier represented by micro curriculum plays a very important role in improving students' self-learning ability. In traditional Chinese medicine college, due to the short of time, weak learning foundation, the ability of self-learning is hard to improve in the modern medical courses such as biochemistry. This is not conducive to the cultivation of modern talents of Chinese medicine. In this paper, we chose the biochemistry teaching in TCM college as an example, and discuss how we can make the application of micro courses reasonably in the teaching process. This study was regarded as a starting to improve the students' self-learning ability effectively.

Objective To investigate the relationship between high-sensitivity C-reactive protein(hsCRP), pulse pressure(PP) and microalbuminuria(MAU) in patients with essential hypertension.Methods Consecutive 60 patients with essential hypertension were classified based on the MAU level:patients with MAU(n=30) and the group of patients with normoalbuminuria(NMAU,n=30) with 30 healthy subjects as control.MAU,hsCRP,PP were determined.Results The level of hsCRP and pulse pressure in MAU group were higher than those in NMAU patients and healthy subjects (P

Objective To explore the factors and correlation between working pressure and psychological health and its influence of nurses.Methods A cross-sectional study design was applied.Totals of 270 nurses in a three level of first-class comprehensive hospital were selected as the research object,using the General Health Questionnaire (GHQ-12) and stress response scale to evaluate nurses' mental health level,working pressure and their influence factors and relationship.Results Among 270 nurses,69 had poor health status,with a rate of 25.50％.There were significant differences in GHQ-12 scores of different ages,gender,department,title,education and marital status (P ＜ 0.05).There was a positive correlation of working pressure and psychological health of medical staff.The more pressure the nurses suffered,the poorer psychological health status was detected.Conclusions The mental health of nurses was at an unfavorable high detection rate,and the adverse psychological health level was higher than that of the general population.The nurses of professional technology college,primary title,age less than 30 years old,and unmarried nurses were more serious.The mental health of nurses is highly related to the working pressure.

Objective To explore the influence factors and the status of anxiety and depression in main caregivers with cerebral palsy children , improve caregivers psychological health status , and offer references for improving the rehabilitation level of cerebral palsy children .Methods A total of 145 caregivers of cerebral palsy children were selected by cluster sampling to carry on the investigation by using SAS , SDS, WHOQOL-BREF. Results The incidence of anxiety and depression was 42.76%and 53.79%, respectively.The score of anxiety was 47.73 ±10.96, which was higher significantly than domestic routine norm (29.78 ±0.46) with a statistical difference (t =19.730; P <0.01).Anxiety and depression score increased as the life quality score of increased.The single factor analysis results indicated that there was a statistical significance in rate of anxiety among different jobs, education levels,ages,monthly income,and with complications or not (χ2 =11.695, 10.787, 3.919, 5.133, 9.942, respectively; P<0.05), so did the depression among different genders ,and age groups (χ2 =10.393 and 8.919; P<0.05).Multivariate Logistic stepwise regression analysis found the results as following:female caregivers , with complications , and half-paidcombining with New Rural Cooperative Medical System (NRCMS) were easier to have the depressed mood .Workers, peasants, and course of disease above 10 years appeared anxiety easily .Conclusions The caregivers of cerebral palsy children psychological status are relatively poor in hospital , which exists seriously anxious and depression .Medical workers should pay attention to the psychological changes of main caregivers , offering health education and psychological care during the treatment.For there have been mental illness caregivers , it is recommended for them to receive timely psychological treatment , thereby improving the rehabilitation level of cerebral palsy children in an all -round way.

Objective To investigate and analyze the reasons for the omission of adjuvant radiotherapy after breast-conserving surgery (BCS) in patients with breast cancer.Methods The clinicopathologial characteristics and socioeconomic data of 55 breast cancer patients undergoing BCS without postoperative adjuvant radiotherapy in our hospital from 2012 to 2016 were retrospectively analyzed.Results Among the 55 patients who did not receive radiotherapy,25 patients were due to low local recurrence risk,12 patients were due to economic or family reasons,12 patients were due to fear of adverse reactions of radiotherapy,and 5 patients were not recommended by primary physicians for radiotherapy.In addition,3 cases with multiple distant metastases and 3 cases with concomitant thyroid cancer didn't received radiotherapy.Conclnsions Low risk local recurrence is the main reason for the omission of adjuvant radiotherapy,followed by the fear of radiation-induced toxicity and poor financial support.Patient education and medical insurance may improve the adjuvant radiotherapy compliance.