OBJECTIVE To investigate the distribution and drug resistance of the bacteria encountered from the(clinical) infection,and provide reference for the rational use of agents in clinics.METHODS To culture the(specimens) from inpatient and outpatient clinic from Dec 2004 to Mar 2005,and perform the drug (sensitivity) test.RESULTS In 1584 isolated strains,the first four were coagulase negative Staphylococcus((15.6%),) Klebsiella(13.0%),Escherichia coli(10.0%),and Candida albicans(9.9%).The highest resistance of Gram(-negative) bacilli was to ampicillin(86.7%),then to cephalothin(79.5%),and mezlocillin(75.7%);G~-bacilli were(sensitive) to meropenem(2.3%),piperacillin/tazobactam(19.0%),and fosfomycin(29.1%).Gram~+ cocci had drug(resistance) to 18 antibacterials except vancomycin,MRSA was higher than MSSA;(Enterococcus) faecium showed poor sensitive rate to penicillin and erythromycin.CONCLUSIONS We should give more attantion to the Rules on Antibacterials in Clinical Application and use drugs reasonably.

Objective:To explore the effect of targeted nursing with evidence-based support in the treatment of craniopharyngioma via the transsphenoidal approach.Methods:A total of 70 patients with craniopharyngiomas who were admitted to the Department of Oncology of Beijing Tiantan Hospital, Capital Medical University from June 2018 to June 2019 were selected and all received transsphenoidal surgery in the hospital. The patients were divided into 2 groups according to the lottery method, 35 cases in the control group, using conventional nursing; 35 cases in the observation group, using targeted care with evidence-based support; comparing the two groups of patients before and after care, the incidence of complications, and the length of hospital stay.Results:The scores of anxiety and depression (6.05±1.24 and 5.78±1.48) in the observation group 2 weeks after nursing were lower than those in the control group (9.95±1.73 and 10.52±1.87). The difference was statistically significant ( t value was 10.036, 10.886, P<0.05). The postoperative high fever, electrolyte imbalance, diabetes insipidus, epilepsy remission time and hospital stay in the observation group were (5.49±0.84)h, (5.46±0.39)d, (1.03±0.21)h, (6.24±2.78)d, (12.51±1.48)d, which were shorter than those in the control group (8.78±1.05)h, (8.51±0.47)d, (2.49±0.35)h, (8.97±2.80)d, (15.26±1.52)d. The difference was statistically significant ( t value were 4.093-29.545, P<0.05). The incidence of postoperative complications in the observation group was 17.14% (6/35), which was lower than 37.14% (13/35) in the control group, and the difference was statistically significant ( χ2 value was 4.786, P=0.029). Conclusion:Targeted nursing with evidence-based support can reduce the incidence of postoperative complications in patients with craniopharyngioma through the transsphenoidal approach, shorten the length of hospital stay, and achieve significant application results.

Nursing students in junior college have less class time and weaker foundation com-pared with nursing undergraduates, therefore it is more difficult for them to learn pathphysiology. In order to improve the teaching effect, we adopt the following strategies in pathophysiology teaching:①Guiding clinical nursing practice combining with specific situation in order to give students a deep understanding of pathophysiology knowledge and its significance. ②Urging students to review relevant basic knowledge before class and teacher to briefly introduce the basic knowledge before initiating class in order to reinforce the knowledge. ③Examples of daily life should be combined to make the abstract theory knowledge vivid. Teaching should revolve around the main line and key points should be highlighted. ④Dividing pathophysiology course into three units, and summary must be executed at the end of each unit.

Objective The purpose of this study was to examine the relationship between acute mountain sickness ( AMS) and AMS susceptibility indices before ascent to high altitude and to evaluate their predictive value for AMS. Methods A total of 314 healthy male a-dults were voluntarily enrolled. Their 22 physiological and mental indices of AMS susceptibility were obtained before exposure high altitude. The diagnoses of AMS were based on the Lake Louise score ( LLS) ,an international standard scoring system for AMS. According to the char-acteristics of selected AMS susceptibility indices and the strong fault tolerance of neural network theory, the learning vector quantization ( LVQ) neural network method was adopted to build the prediction model of susceptibility to AMS. Results The results showed the sensitiv-ity of the LVQ model which distinguishes subjects with no-AMS reached 95. 00%,the average correct-prediction precision ultimately reached 72. 22%. The result of prediction is believable. Conclusion The builded LVQ model provide a scientific method for screening crowd who quickly ascend to high altitude,and also can lead to an effective preliminary screening of susceptibility to AMS.

AIM: To study the changes in capillarity of skeletal muscle during acclimation to high altitude, and explore the effects of a certain extent physical activity under hypoxia on capillary formation and the role of vascular endothelial growth factor (VEGF) in this process. METHODS: 48 Wistar rats were divided into 3 groups: Ⅰ normoxic control; Ⅱ hypoxia and Ⅲ hypoxia+exercise. Rats of Ⅱ and Ⅲ groups were subjected to hypobaric hypoxia for 5 weeks (23 h/d). They were first brought to simulated 4 000 m altitude, where rats of the Ⅲgroup were forced to swim for 1 h/d (6 d/week). Then the animals were ascent to 5 000 m. Biomicrosphere method was used to determine blood flow of skeletal muscle. The mean fiber cross-sectional area (FCSA), capillary density (CD) and capillary/fiber ratio (C/F) of red portion of the lateral head of the gastrocneminus were assayed by myofibrillar ATPase histochemistry. VEGF and its receptor KDR were assayed with immunohistochemistry method.RESULTS: By comparison with the normoxic control, 5-week hypoxic exposure resulted in a decrease in cross-sectional area of skeletal muscle fiber and an increase in CD, but the C/F remained unchanged. The blood supply to the gastrocnemius was not changed. After 5-week-exercise at high altitude, the muscle fibers did not undergo atrophy. CD, C/F, and the blood flow at rest increased significantly. VEGF protein was found primarily in the matrix between muscle fibers; KDR were shown mainly in endothelial cells of capillary. VEGF was more strongly stained in the skeletal muscle of hypoxia-exercise rats.CONCLUSION: Hypoxia itself can not induce neovascularization. While exercise during hypoxic exposure can lead to capillary formation. VEGF and KDR may play roles in it. New capillary formation benefits the blood supply, oxygen delivery and working performance at high altitude.

This paper summarized the nursing experience of one infant with right lower limb ischemia caused by amniotic band syndrome. The nursing key points included:careful observation of the infant condition,exposing the wound,raising the affected limb,wound disinfection,and removing necrotic tissues at the surface skin,applying topical drugs for promoting tissue growth and antibiotics,selecting appropriate dressing to provide suitable environment for tissue regeneration;debridement of inguinal skin,dressing change,assessing pain and providing corresponding care during debridement;infection prevention. After 29 days of treatment and careful nursing care,the skin damage was repaired on the right lower limb,swelling subsided,the necrotic tissues at right inguinal region were completely cleared,granulation tissue was formed,and the infant was discharged smoothly.

Objective To observe the changes of brain oxygenation in patients with extremely severe craniocerebral injury and the therapeutic effect of early normobaric hyperoxia.Methods Sixtyeight patients with extremely severe craniocerebral injury treated from January 2011 to January 2013 were assigned to two groups according to the random number table:50％ oxygen breathing for one week in control group (34 cases) and 80％ oxygen breathing for one week in treatment group (34 cases).Blood samples from jugular vein and radial artery were collected at 1,3,5,and 7 days to measure indices of blood gas analysis,i.e.,PaO2,PjvO2,CaO2,CjvO2,Da-jvO2,CERO2 and Djv-a Lac.GCS and content of neuron-specific enolase (NSE) were recorded as well.Results Values of PaO2 at each time point and GCS at 5 and 7 days were significantly higher in treatment group than in control group (P ＜0.05).Djv-a Lac at 3,5 and 7 days and NSE at 7 days revealed significantly higher levels in treatment group than in control group(P ＜ 0.05).Whereas at each time point,there were no significant differences between the two groups in aspects of PjvO2,CaO2,CjvO2,Da-jvO2 and CERO2 (P ＞ 0.05).Conclusion Early use of 100％ oxygen in patients with extremely severe craniocerebral injury may be beneficial to the prognosis.

Animal experiment is a primary part of medical education. At present , medical students are lack of education about laboratory animal ethics and they do not usually treat animals fol-lowing rules of laboratory animal ethics. To solve this problem, we focused on the education of labora-tory animal ethics and 3R theory (reduction, replacement, refinement) in order to help the medical students treat laboratory animals nicely. We enforced the construction of the laboratory rules and regu-lations, and improved animal experiments conditions. With these efforts, we successfully standardized and scientized our experiment classes.

Objective To evaluate the accuracy and value of ventricular function in conotruncal defects(CTD)by three-dimensional echocardiography(3DE).Methods Fifty-two children with CTD and forty-three children with normal hearts were examined by 3DE.The measurements of left ventricular volume and wall mass were outlined and calculated.The measurements of left ventricular volume and wall mass of 3DE in preoperative CTD were compared with those of 2D biplane Simpson-method in preoperative CTD,3DE in control group and 2D biplane Simpson-method in control group.The results of 3DE and 2DE preoperative measurements were also compared with their postoperative clinical cardiac conditions.Results From the findings of analysis of variance and Student-Newman-Keuls(SNK)test,there was no significant difference between 3DE and 2DE measurements of left ventricular function in normal children,but there was significant difference between 3DE and 2DE measurements of left ventricular function in children with CTD.2DE measurements of left ventricular volume and wall mass in the CTD group were significant underestimated and less correlated with their postoperative clinical cardiac conditions(r=0.20,P=0.2086)than 3DE measurements(r=0.39,P=0.0090).Furthermore,left ventricular function in the CTD group was poorer than that in the control group.Stroke volume and effective function were reduced due to increasing end-systolic volume.while left ventricular wall mass was increased due to the possible compensation of its ventricular muscle.With the lower end-diastolic volume,stroke volume and effective function,patients were more likely to have the occurrence of postoperative low cardiac output.Conclusions By making a precise quantitative assessment,3DE is very useful in providing more information for preoperative diagnosis in CTD and predicting such postoperative prognoses as the occurrence of postoperative low cardiac output.

Melamine is a kind of triazine compound and the fluorescence of it can get enhanced in the presence of cationic surfactant in weak alkaline medium. A new fluorescent spectrophotometry based on this principle) has been developed to determine melamine under the optimum conditions such as Tris-HCl buffer solution), pH 8.0 and with CTMAB as sensitizing agent. The linear range, detection limit and relative standard deviation were 25-1000 μg/L, 19 μg/L and 1.6%,respectively. The samples were pretreated according to the solid phase extraction monolithic column to carry out the detection of real milk. This method is simple, rapid and accurate. It can be used to screen and detect the milk samples primarily.