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.

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.

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 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.

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 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.

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.

The "student-centered" concept highlights the dominant position of students in the teaching process and makes up for the deficiency of traditional teaching mode.Based on the above idea,the teaching team of the author's department tried to improve teaching effect through effective teaching design in biochemistry.Firstly,the teaching goal (the goal of knowledge,ability and emotion) and the important situational factors the learning situation analysis,the characteristics of the course and the class,etc)should be identified.suitable teaching strategies he inspiration strategy,exploration strategy and problem solution strategy,etc.),teaching method (discussion,case study,problem based learning,etc.) and proper assessment (such as the summative assessment with formative evaluation) should be determined to organize classroom teaching.At the end of the class the timely feedback and the teaching reflection should be carried outto extend classroom teaching to extra-curricular class.The results showed that effective teaching designismore likely to stimulate students' learning enthusiasm,promote students' deep learning and achieve better teaching effects.

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.

Background: Esophageal mucosal injury induced by gastroesophageal reflux is a key link to the development of Barrett's esophagus-associated adenocarcinoma. However, the molecular mechanism is still not elucidated. Aims: To investigate the role of differentially expressed genes (DEGs) after stimulating esophageal cells with acid and bile acid in the development of esophageal adenocarcinoma (EAC). Methods: The DEGs were obtained through bioinformatics methods after stimulating esophageal cells with low pH and deoxycholic acid, and GO, KEGG enrichment analysis were performed. Protein-protein interaction (PPI) network was performed to screen the hub genes, and their relationships with prognosis and tumor stage of EAC patients were analyzed. The role of co-expressed genes of GADD45B in EAC was also analyzed. Results: Thirty-one overlapping DEGs were obtained after stimulating esophageal cells with low pH and deoxycholic acid, which mainly enriched in the cytokine-cytokine receptor interaction, transcription factors activity, and regulation of cell proliferation and apoptotic process. High expression of GADD45B was correlated with the survival prognosis and tumor stage of EAC patients. GADD45B and its co-expressed genes were involved in the production of tumor necrosis factor. Conclusions: The high expression of GADD45B induced by acid and bile acid is correlated with the prognosis and tumor stage of EAC patients, and is a potential diagnosis and treatment target for Barrett's esophagus-associated adenocarcinoma.