Objective To investigate the distribution and drug resistance situation of clinical isolated bacteria in our hospital to provide the basis for rational selection of antibacterial drugs in clinic .Methods The pathogenic bacteria isolated from the clinical sepcimens in our hospital from January 2012 to December 2013 were performed the idenitification and drug susceptibility test by a‐dopting the the bioMerieux VITEK‐2 compact automatic bacterial analyzer .The detection results were judged according to the standard of the Clinical and Laboratory Standard Institute (CLSI) .The WHONET5 .6 software was used for conducting the statisti‐cal analysis .Results 2 274 strains were isolated during 2012-2013 ,in which 1986 strains (72 .4% ) were Gram‐negative bacteria , 675 strains(24 .6% )were Gram‐positive bacteria and 94 ccases(3 .0 % ) were fungi .The top 3 of Gram‐negative bacteria were Esch‐erichia coli(694 strains ,25 .3% ) ,Klebsiella pneumoniae (303 strains ,11 .0% ) and Pseudomonas aeruginosa (266 strains ,9 .7 % ) respectivley .The top 3 of Gram‐‐positive bacteria were Staphylococcus aureus (184 strians ,.6 .7% ) ,coagulase negative staphylococ‐cus(146 strains ,5 .3% )and enterococcus faecium (119 strians ,4 .3% ) .The respiratory tract infection ,urinary tract infection and blood infection were predominant .The detection rate of methicillin‐resistant Staphylococcus aureus (MRSA) was 45 .7% ,while which of methicillin‐resistant coagulase negative Staphylococcus (MRCNS) was 84 .6% .MRSA showed the multiple resistance to fluoroquinolones and aminoglycosides antibcatieral drugs ,the resistance rate> 90 .00% ,but resistance rate macrolide antibiotic was<50 .0% ;no vancomycin‐and linezolid‐resistant Staphylococcus was found ;the resistance rate of enterococcus faecium to vancomy‐cin was 1 .7% and no linezolid‐resistant enterococcus faecium was detected .The detection rates of extended‐spectrum β‐lactamase‐producing K .pneumoniae and E .coli were 65 .2% and 39 .9% respectively ,and which of E .coli and K .pneumoniae to imipenem were 0% and 6 .3% respectively .The resistance rate of Acinetobacter baumannii to commonly used antibacterial drugs was more than 50% .The resistant rate of pseudomonas aeruginosa to common antipseudomonal drugs was <40 .0% .Conclusion The drug resistance phenomena of pathogenic bacteria isolated from our hospital is relatively universal ,especially multi‐drug resistant non‐fer‐mentative bacteria ;the enzyme‐producing mechanism leads to increase the detection rate of multi‐antibacterial resistant Enterobacte‐riaceae bacteria ,which causes the enormous difficulty for clinical anti‐infection therapy .Conducting the bacterial drug‐resistance mo‐nitoring has an important significance for guiding clinically rational drug use ,reducing the nosocomial infection rate and controlling the bacterial drug resistance .

Objective To investigate the main risk factors influencing the pre-hospital delay of patients with acute ischemic stroke (AIS) for preventing methods.Methods A retrieval was done across the epidemiologic studies on pre-hospital delay of AIS patients during 2004 to 2015 using the key words of ischemic stroke,prehospital delay,treatment delay.According to the inclusion and exclusion criteria,the literature was collected and the literature quality was assessed.The data were extracted for meta-analysis by RevMan software.Results Sixteen epidemiologic studies were included.Totally,there were 2,966 cases of prehospital delay and 2,468 cases of non-delay.The pooled OR values and 95％ CI by multivariate analysis were as follows:the degree of awareness of stroke was 0.5 (0.3,0.82),emergency medical service (EMS) was 0.49 (0.29,0.85),National Institute of Health Stroke scale (NHISS) score 0.58 (0.36,0.95),outpatient visit as first visit 4.28 (1.44,12.74),distance 0.76 (0.61,0.95),medical history of ischemic stroke 0.37 (0.18,0.79) (with significant differences in OR value,P＜0.05).Conclusions The protective factors for pre-hospital delay of acute ischemic stroke patients include:strengthened awareness of stroke,effective EMS,high NHISS score,short distance,medical history of ischemic stroke.The main risk factor is that their outpatient visit is their first visit for medical treatment.Therefore,we need to enhance the health education to the patients and their families about awareness of stroke,improve the use of EMS and build complete and efficient green path for the stroke patient.

Objective To explore the effect of multiple-formed nursing teaching ward-round.Methods Trainings and practices about muhiple-formed nursing teaching ward-round were executed to clinical instruction teachers.Results 95.9%of nursing students were satisfied with the quality of nursing teaching ward-round.After training ang practices,the evaluation to the nursing teaching ward-round and the scores of theoretic and operation examination of nursing students raised significantly(P＜0.05).Conclusions The trainings and practices improve the teachers' ability of utilizing multiple-formed nursing teaching ward-round,which not only enhance the students' study initiative,but also improve the query of nursing teaching teaching ward-round.

[Objective] To screen and identify the new Y-STR loci from the Y chromosome and examine the polymorphism of these Y-STR loci. [Method] To seek and locate the position of 5 Y-STR loci, including DYS709, DYS720, DYS721, DYS722, and DYS723, and perform sequencing of these 5 Y-STR loci. Then to investigate the polymorphism in unrelated Chinese Han males. [Results] Five Y-STR loci were identified from Y chromosome sequence. By scrutinizing the physical position on Y chromosome of previously reported Y-STRs, we found that three loci were novel and two loci overlapped with two loci published only online. All loci could be male-specifically amplified with a product size ranging from 185 bp to 278 bp. After 108 males of the Chinese Han Population (Guangzhou) were examined, we found 5 DYS709, 11 DYS720 alleles, 4 DYS721 alleles, 6 DYS722 alleles, and 6 DYS723 alleles. A total of 95 haplotypes were identified, 84 of which were unique, and with a haplotype diversity of 0.997 2±0.001 2(HD±SE). [Conclusion] This set of Y-STRs can be used as Y chromosome genetic makers in related fields.

Objective To estimate the iron level in the patients with thrombocytosis for differential diagnosis.Methods A retrospective analysis on 98 thrombocytosis patients was performed by studying hemogram,iron staining in bone marrow and serum iron and ferritin level.Results In the patients whose platelet count were between 400?10(9)/L and 800?10(9)/L 40.8% were diagnosed as iron-deficient anemia,while in the patients whose platelet count were higher than 800?10(9)/L 81.5% were diagnosed as essential thrombocytosis(ET).Of 27 ET cases 2 had lower serum ferritin values but their serum iron levels were in normal range.Conclusion The patients with platelet count between 400?10(9)L and 800?10(9)/L may be secondary thrombocytosis,while the patients with platelet count higher than 800?10(9)/L may be diagnosed as ET,but other conditions such as iron deficiency should be excluded.

Objective To explore the causes of negtive results on emergency CT and prevent method in craniocerebral trauma.Methods 51 cases of craniocerebral trauma with negtive results on emergency CT were analyzed respectively during 2002 to 2004.Results The causes of negtive results on emergency CT in craniocerebral trauma were:the insufficient experience for technicians and doctors (12.8%);the atypical signs in early phase(48.6%);the delayed lesions after injury(16.2%) and the limitation of CT (24.2%).Conclusion CT technicians and doctors should be well trained primarily. Furthermore, CT images, clinical manifestations and other examinations should be combined with to obtain precise diagnosis. Finally, uncertaint cases should be examined again with CT or MRI.

0.05);the epididymal indexes were significantly increased 6,24 and 72 hours after formalin injection(P

Objective To observe the application of ultrasound-guided femoral nerve block (FNB) and lateral femoral cutaneous nerve block (LFCNB) for patients undergoing hip fracture surgery.Methods 60 patients scheduled for hip fracture surgery undergoing LMA general anesthesia were randomly divided into 3 groups,20 cases in each group.Before transfer patients from bed to operating table,A group received dezocine 5mg iv,B group received fascia iliaca compartment block(FICB),C group received FNB combined with LFCNB.40mL of 0.375％ ropivacaine was injected guiding by ultrasound in B group and C group.The time of sufficient sensory block and awake,the dosage of propofol and remifentanil,MAP and HR at pre-block (T1),20min after block (T2),transfer bed (T3),LMA insert (T4),skin incision(T5),LMA remove(T6) and sober(T7) were recorded.Pain was assessed using visual analogue scale(VAS) pre-and post block.The incidence of using vasoactive drugs,agitation,pain and adverse reaction were also recorded.Results The time of sufficient sensory block and awake,the dosage of propofol and remifentanil in A,B and C groups were as following:A group (not measured),(20.3 ± 1.3) min,(835 ± 6.7) mg,(1 285 ± 18) μg;B group (i2.2 ±2.7)min,(13.3 ± 1.4)min,(610 ±9.9)mg,(835 ± 15) μg;C group (9.7 ± 2.4)min,(12.8 ± 1.5) min,(555 ± 6.5) mg,(785 ± 16) μg.The time of awake,the dosage of propofol and remifentanil in B group and C group were significantly lower than those in A group(F =2.62,2.41,2.45,all P ＜ 0.05).The time of sufficient sensory block in C group was lower than that in B group (p ＜ 0.05).The MAP and HR at T2,T3,T5 and T7 in A,B and C groups were:A group (115 ± 4) mmHg,(90 ± 8) beats/min,(135 ± 6) mmHg,(98 ± 8) beats/min,(104 ±6) mmHg,(87 ± 4) beats/min,(120 ± 5) mmHg,(88 ± 8) beats/min;B group (102 ± 3) mmHg,(81 ± 6) beats/min,(112 ± 5)mmHg,(82 ± 8)beats/min,(89 ±6) mmHg,(72 ± 3) beats/min,(100 ±6)mmHg,(76 ± 8) beats/min;Cgroup (100 ± 3) mmHg,(80 x 6) beats/min,(109 ± 6) mmHg,(83 ± 5) beats/min,(86 ± 5) mmHg,(70 ± 3) beats/min,(99 ± 5) mmHg,(75 ± 5) beats/min.The levels of MAP and HR in B group and C group were significantly lower thanthose in A group(F =2.25,2.85,2.87,2.91,all P ＜ 0.05).The VAS scores at T2,T3,and T7in A,B and C groupswere:A group (3.9 ± 0.7) points,(8.2 ± 0.3) points,(6.0 ± 0.8) points;B group (2.3 ± 0.4) points,(4.1 ±0.4) points,(2.2 ± 0.7) points;C group (2.1 ± 0.5) points,(2.4 ± 0.4) points,(1.2 ± 0.4) points.The VAS scoresin B group and C group were significantly lower than those in A group (2.36,2.82,2.88,all P ＜ 0.05).The VASscores at transfer bed and sober in C group were significantly lower than those in B group (F =2.32,2.38,all P ＜0.05).The incidence of using ephedrine/atropine,urapidil/esmolol,PONV,agitation,pain and incision pain in A,Band C groups were:A group 30％,30％,25％,25％,40％;B group 10％,10％,0％,0％,10％;C group 10％,5％,0％,0％,0％.The number of patients who required vasoactive drugs and adverse reaction in B group and C group were significantly lower than those in A group(x2 =7.58,8.81,9.11,9.11,8.89,all P ＜0.05).The incidence of incision pain at sober in C group was lower than that in B group(x2 =9.21,P ＜ 0.05).Conclusion The ultrasound -guided FNB and LFCNB can obviously shorten the onset time,reduce the dosage of general anaesthetic and maintain the stability of henodynamics during the perioperative period.It has effective analgesia during transfer of patients from bed to operating table and sober.

AIM: To study the role of polymorphonuclear neutrophile(PMN) in lipopolysaccharide (LPS)- induced acute lung injury (ALI) and the protective effect of interleukin - 10(IL - 10) on ALI. METHODS: LPS alone (100 ?g) or LPS+ IL-10 (l ug) was instilled intratracheally into rats. PMN numbers, protein content and malondialdehyde (MDA) content in bronchoalveolar lavage fluid (BALF) were measured. Histological change of lung was also observed. RESULTS: LPS increased significantly PMN numbers, protein content and MDA content in BALF. Histological finding shows PMN accumulation in lung. IL - 10+LPS reduced remarkably PMN numbers ,pro- tein content and MDA content in BALF than those caused by LPS. PMN decreasing was also identified by light microscopy. CONCLUSION: LPS instilled intratracheally causes PMN accumulation in lung and ALI, while IL - 10 could alleviate ALI through reducing PMN accumulation.

Objective To explore the effect of intravenous infusion flow rebuilt on the patients’safety and nursing quality in intravenous infusion center.Methods Risk safety factors about intravenous infusion process in intravenous infusion center were analyzed and the work flow were rebuilt and optimized?The satisfaction rate,the reception time and the disinfection time for tourniquets were compared before and after work flow rebuilt.Results After work flow rebuilt,the satisfaction rate raised from 92?5%to 94?5%?There were significant differences among the reception time and the disinfection time for tourniquets before and after work flow rebuilt (all P<0?05)?After work flow rebuilt,both the reception time and the time for dealing with tourniquets are shorter than before. Conclusions The rebuilt work flow can make nurses work efficiently and enhance the patients’nursing quality?