Objective To analyze distribution and drug resistance of MRSA separated,to probe into a treat method for MRSA infection and offer scientific gist for reasonable use of clinical antibiotic. Methods 568 MRSA separated from clinic were measured and a drug sensitivity test was performed by means of Kirby-Bautr agar diffusion method. Results 370 individual plants were filtered, the rate of inspection was 65.1%. MRSA was 36.2 % among them,MRSCON was 77.5% ,the drug resistance of MRSA to quinolones(21% ～48% ) was below MRSCON(84 %～89 % ). The drug resistance of MRSA and MRSCON obviously excelled MSSA and MSSCON ( P＜0.05 ). VRS was undiscovered. Conclusion Severe infection caused by MRS should choose vancomycin resistant enterococci to cure at fist. Staphylococcus was one of primary pathogenic bacterium caused infection in hospital, MRS had multiple drug resistance and measure range about drug resistance should be extended, which would advance the cognition about the drug resistance of antibiotic and cut off the transmitted path, reduce the drug resistance of bacteria and the infection rate in hospital.

Objective To explore the relationship between the critical thinking disposition and the innovation behavior in nurses. Methods A total of 360 clinical nurses were questionnaired by the critical thinking disposition inventory and innovation behavior scale. Pearson correlation analysis and hierarchical regression analysis were used to explore the effect of critical thinking disposition on the innovation behavior in nurses. Results The total scores of critical thinking disposition and innovation behavior in nurses were respectively 290.68±33.46 and 4.12±0.96. There was significant difference of the score of innovation behavior in nurses with different professional titles and working years(F=6.257, 4.802, P<0.05). The score of innovation behavior was positively correlated with the scores of seek truth, open mind, analysis ability, systematic ability, self-confidence, learning desire and cognitive maturity(r=0.367-0.514, P<0.05). Hierarchical regression analysis showed that the seek truth, open mind, analysis ability, systematic ability, self-confidence, learning desire and cognitive maturity were the influencing factors of innovative behavior in nurses. Conclusions The critical thinking disposition and innovation behavior were in medium level in nurses, and the critical thinking disposition was the influencing factors of innovative behavior in nurses.

Objective:To observe the influence of emotional stress on the temporomandibular joint(TMJ) of SD rats. Methods:Standard animal model of emotional stress was created by emotion communication emergency box technique in 30 SD rats and foot-shocked in another 30. Control rats were 30 without treatment. The microstructure and ultrastructure of the disc surface, condylar surface and external pterygoid muscle were observed 1, 3 and 5 weeks after emotional stress treatment. Results:Obviously pathological changes were observed in the experimental animals, especially at 3 weeks, involving the fissures on the disc and condylar surface, the collagen fibers were disordered. Electron microscopy observation showed that condylar collagen was exposed. The mitochondria edema and vacuolar degeneration in the external pterygoid muscle were found.At 5 weeks, the condylar cartilage started to recover. Conclusion:Long term emotional stress may lead to pathological changes of the temporomandibular system. The changes can be partly recovered after a certain time of adaption of TMJ.

Objective To observe the efficacy of naloxone combined with Buyanghuanwu decoction on cong -nitive function of multi -infarct dementia(MID) patients.Methods 46 patients with MID were treated with Nalox-one Hydrochloride and Buyanghuanwu decoction .Mini -mental state examination ( MMSE ) , activity of daily living ( ADL) scale and hachinski ischemic scale score ( HIS) were used to estimate the therapeutic effect after the treatment for 30 days.Results Compared to 30 days before,the MMSE score and ADL score improved after the treatment (t=3.247,3.469,all P<0.05),and the score of HIS declined (t=3.384,P<0.05).Conclusion Application of nal-oxone combined with Buyanghuanwu decoction can significantly improve congnitive level and ADL function in multi -infarct dementia patients .

Objective To identify the critical indicators of nursing practice environment in China, as a reference for related studies. Methods Descriptive systematic review was used to retrieve literature of nursing practice environment, collect all potential indicators and design questionnaires based on those indicators. In the end, 39 potential indicators were identified, for a questionnaire survey of nurses from cooperating medical institutions in 30 provinces in China, with the data subject to statistical analysis in multiple linear regression model. Results Questionnaire items of higher mean score were usually found with a smaller 95% confidence interval, while coefficient of variation tended to be lower. Seventeen indicators were recommended as key indicators for nursing practice environment in China, including proper working hours and intensity, opportunities for nurses to participate in hospital management, good working relationship with doctors within a department,nursing managers′support for nurses′right decisions. The remaining components turned out to be insignificant in the analysis. Conclusions The influencing factors for the nursing practice environment in China are different from other countries. In this consideration, nursing managers should further explore and focus on such special indicators, and proactively improve the quality of nursing practice environment for better nursing service.

Objective To evaluate the value of application of the digital 3-D reconstruction pelvic on anatomical teaching. Methods The digital 3-D from 1 case non-pelvic-disease CT imaging were reconstructed, and name of structure were marked. A total of 90 students were randomly selected from two classes of clinical medical undergraduates of Grade 2011, and were randomly divided into experiment group (EG) and control group (CG), with 45 students in each group. Digital 3-D recon-struction pelvic and traditional teaching methods were applied in EG, while only traditional teaching methods were applied in CG, and the teaching effect was evaluated through questionnaires and the results of the examination. The questionnaires included how students grasped knowledge and whether or not they were interested in class and satisfied with the teaching methods etc., and the examination included identification specimen test(20 points) and theoretical knowledge examination on pelvic bone knowledge points(80 points). Comparison between two groups was performed using two sets of com-pletely randomized design t test. Results Clear three-dimensional reconstruction of the angular orien-tation of the various models of the pelvis was made. Experimental class' survey results were better than the control class’ and the differences were statistically significant(P<0.05). EG's scores of experimental test and theoretical knowledge examination were (18.69 ±1.32) points and (60.35 ± 5.12) points, respectively, while CG's scores were(17.23±1.52) points and (56.32±6.25) points. Difference be-tween the two groups was statistically significant(P<0.05). Conclution The application of digital 3-D reconstruction pelvic on anatomical teaching can increase the performance record of students, and it can be applied to anatomical teaching as a new method.

Abstract A new method was established to determine the free inorganic cadmium ion ( Cd2+) in marine bivalves using high performance liquid chromatography and inductively coupled plasma mass spectrometry ( HPLC-ICP-MS) . The free Cd2+ in shellfish was ultrasonic extracted for 40 min by 10 mmol/L Tris buffer solution ( with 0. 1 mol/L NaCl, pH=7. 5), and the separation of Cd2+ was achieved using an IonPac CS5A analytical column with an IonPac CG5A guard column. The mobile phase consisted of 50 mmol/L C2 H2 O4 and 95 mmol/L LiOH. The new method had a good linear relationship with the correlation coefficient of 0. 999 and the standard recoveries of Cd2+ were all above 84. 6%. The free Cd2+ content in several kinds of marine bivalves was determined using the method and the results showed that the percentage of free inorganic Cd2+ to the total Cd content in samples with high Cd content was higher than those with low Cd content.

Enteral nutrition plays an irreplaceable role in the nutritional treatment of critically ill patients. In order to help clinical medical staff to manage the common complications during the implementations of enteral nutrition for critically ill patients, the consensus writing team carried out literature retrieval, literature quality evaluation, evidence synthesis. Several topics such as diarrhea, aspiration, high gastric residual volume, abdominal distension, etc. were assessed by evidence-based methodology and Delphi method. After two rounds of expert investigations, Expert consensus on prevention and management of enteral nutrition therapy complications for critically ill patients in China (2021 edition) developed, and provided guidance for clinical medical staff.

Objective:To evaluate the efficacy and safety of focused radiofrequency in facial wrinkle and laxity.Methods:Seventeen female patients (47.71±1.56 years of age) were involved in our study during January to June 2018, treated with focused radiofrequency on the whole face. The treatments were performed monthly for three consecutive months. Their photographs were taken before treatment and one week after the last treatment, and then the wrinkle severity rating scale (WSRS) and global aesthetic improvement scale (GAIS) were evaulated.Results:After three times＇ treatment, the wrinkle was improved, WSRS of 1 week after the last treatment (2.71±0.47) was much lower than the baseline (3.00±0.79) ( P<0.05). 88.24% patients were satisfied with the improvement. There was no severe adverse effects during this whole procedure. Conclusions:Focused radiofrequency therapy for facial wrinkle and laxity is effective and safe.

Model informed precision dosing for warfarin is to provide individualized dosing by integrating information related to patient characteristics, disease status and pharmacokinetics /pharmacodynamics of warfarin, through mathematical modeling and simulation techniques based on the quantitative pharmacology. Compared with empirical dosing, it can improve the safety, effectiveness, economy, and adherence of pharmacotherapy of warfarin. This consensus report describes the commonly used modeling and simulation techniques for warfarin, their application in developing and adjusting dosing regimens, medication adherence and economy. Moreover, this consensus also elaborates the detailed procedures for the implementation in the warfarin pharmacy service pathway to facilitate the development and application of model informed precision dosing for warfarin.