Objective To investigate bacterial distribution and antibiotic resistance pattern in NICU of Central Hospital of Anshan,Liaoning province of China.Methods We conducted a retrospective analysis of all the cases admitted to the neonatal intensive care unit(NICU) between November 2011 and November 2013.Culture and sensitivity data of organisms isolated were documented as well.Antimicrobial susceptibility of the isolated pathogens was determined with the use of the Kirby-Bauer disk-diffusion test.Results A total of 73 bacterial strains were isolated from 310 specimens with a 23.5％ positive rate.In total,37 Gram-negative strains were detected and Escherichia coli was the predominant infective organism,far more common than Klebsiella pneumoniae and Pseudomonas aeruginosa.Gram-positive organisms were isolated in 32 cases and the most common pathogen was Staphylococcus aureus,followed by Staphylococcus epidermidis.Fungal isolates were recovered in 4 cases and Candida albicans was the most frequently isolated fungal organism.Carbapenem-resistant was not encountered and Vancomycin-resistant Staphylococcus aureus was not detected.Staphylococcus epidermidis isolates were significantly more resistant than Staphylococcus aureus.Conclusion Escherichia colis,Staphylococcus aureus and Staphylococcus epidermidis were the major pathogens in NICU of our hospital,showing a steep increase in antibiotic resistance.Regular monitoring and rational evaluation of drug resistance may help reduce the spread of antibiotic resistance,and provide the basis for empirical antimicrobial use.

Objective To investigate the safe model to prevent and treat complications caused by various artificial liver support system(ALSS).Methods The complications in 191 patients with severe hepatitis during the ALSS(Including plasma exchange、plasma exchange associated with continuous venovenous hemofiltration、plasma exchange associated with hemodiafiltration、plasma exchange associated with plasma absorption、molecular absorbents recycling system) treatment were observed and analyzed. Results During the treatment 287 episodes occurred and the rate of complications was 50.44%(287/569).The clinical manifestation included rash,numbness/tetany,hypotension,blood clotting in the channel,chest distress, disequilibrium syndrome,errhysis on dwell catheter,effusion on dwell catheter.75.61% of these complications was caused by plasma exchange.The rate of complications was the lowest during the treatment of plasma exchange associated with hemodiafiltration.All of these complications got better after prompt sypotomatic therapies were taken.Conclusions Although the rate of complications was high during the treatment of ALSS,all of the complications got better after prompt sypotomatic therapies were taken.This therapeusis must be performed by intensive care.It is more safe than others during the treatment of plasma exchange associated with hemodiafiltration.

OBJECTIVE To investigate the significance of Epworth sleepiness scale(ESS)and modified Epworth sleepiness scale(MESS),and evaluate the feasibility of MESS in assessment of obstructive sleep apnea hypopnea syndrome(OSAHS).METHODS The ESS and MESS of 232 patients with OSAHS was recorded in their first visiting.The scores of ESS and MESS were analyzed with the parameters of polysomnography(PSG). RESULTS Both ESS and MESS can reflect the degree of sleepiness and anoxemia in OSAHS patients,but the MESS was more efficient than ESS.The difference of MESS score between normal group and severe OSAHS group was greater than that of ESS score.CONCLUSION MESS is concerned the living habit of Chinese,and can partly reflect the station of patient with OSAHS.MESS can also be a primary screening method for suspected patients with severe OSAHS.

Objective To observe the protective effect of ulinastatin (UTI) on the intestinal barrier function of septic rats.Methods Septic rat model was established using Sprague-Dawley rats by cecal ligation and puncture (CLP) method.Thirty Sprague-Dawley rats were randomly divided into 3 groups (n =10 for each grop) : sham group, septic group and UTI group.All rats received intraperitoneal injections of 0.9％ saline (10 mL/kg) after and 8 h after surgery.In UTI group, UTI (10 × 104 U/kg in 10 mL/kg saline) was injected after and 8 h after surgery.Collect blood samples after 0, 8, 12 h after surgery to examine levels of procalcitonin (PCT), intestinal fatty acid binding protein (iFABP) and diamine oxidase (DAO) by enzyme-linked immunosorbent assay (ELISA) method.Rats were killed 12 h after surgery to collect intestine tissue samples.Pathological changes of intestine were observed under microscopy, and the expression of tight junction protein-1 (ZO-1) and occludin were analyzed by Western blot.Results In sham group, the mucosa structure was complete and the shape was normal, and villi stood neatly.In septic group, intestinal was expanded, intertinal mucosal was atrophic, villi were scanty.An inflammatory infiltrate with numerous nuetrophils was found in the mucosal.In UTI group, the level of severity was relatively slight.The relative optical density of Western blot images were decreased on ZO-1 and occludin in CLP and UTI groups, and decreased more in CLP group (F =43.15 and 52.23, P ＜ 0.05).At 0h after surgery, the plasma values of PCT, iFABP and DAO were similar in three groups (F =11.17, 22.45 and 13.58, P ＞ 0.05).At 8h and 12h after surgery, values of PCT, iFABP and DAO in septic and UTI groups were much higher than those in the sham group, and those in UTI group were also significantly higher than those in septic group (F8h=85.26, 44.59 and 101.47, F12h =59.44, 49.26 and 69.57, all P＜0.05).PCT, iFABP and DAO levels were first increased and then fell down in sham group, those in septic group were keeping increasing, and those in UTI group were first increased and then kept stable.Conclusion UTI shows protective effect to intestinal barrier function in rats with sepsis.

Objective To evaluate the decreased level of serum inhibin B(INHB)treated by gunadotropin releasing hormone agonist(GNRH-a)in predicting ovarian response and pregnancy in in vitro fertilization-embryo transfer(IVF-ET).Methods The prospective study enrolled 124 women given by GnRH-a+recombine follicle stimulating hormone(rFSH)+human chorionic gonadotrophin(hCG)long term stimulation protocol undergone their first cycle of IVF-ET treatment.The following predictive factors were collected and analyzed,such as age,basal level of follicle stimulating hormone(FSH),the ratio of FSH/luteinizing hormone(LH),the concentration of INHB after down-regulation,total number of antral follicle count(AFC)and mean ovarian volume. Ovarian response was evaluated by the number of oecytes obtained.A multiple regression analysis and logistic regression model were used for all possible prognostic variables to evaluate the value of difierent hormones in predicting ovariall response and pregnancy after IVF-ET.Receiver operating characteristic(ROC) analysis was used to evaluate the level of INHB in predicting the number of oocytes obtained.The sensitivity and specificity were calculated at the discriminating cut-off point Results The concentration of INHB after down-regulation showed a highly significant positive correlations with the number of oocytes obtained(r=0.435,P<0.01).The multiple regression analyses showed INHB was the most significant predictor of the number of retrieved oocytes,but INHB was not associated with IVF-ET outcome significantly(P>0.05).ROC analyses showed INHB after down-regulation had the largest area under curve(AUC)0.933(95%CI:0.878-0.988).When a threshold of 15 ng/L of INHB was established,95.5%sensitivity and 50.0% specificity in ovarian response were observed.Conclusions The level of INHB Was the best factor in predicting ovarian response in IVF-ET.Decreased level of INHB Was the early sign of ovarian reserve function failure,however,useless in predicting IVF-ET outcome.

Objective To explore the psychological stress of young nurses facing patients' death. Methods Young nurses in emergency department, ICU and hospice care ward (96 cases, research group) and young nurses in other departments(94 cases,control group)from 8 general hospitals were investigated by self-rating anxiety scale (SAS)and serf-rating depression scale (SDS).The results underwent comparison and analysis. Results SAS and SDS score,incidence of anxiety and depression in the research group were higher than those of the control group (P ＜ 0.05). Conclusions Young nurses who face patients' death frequently have high incidence rate of psychological stress.They show low psychological health level which deserves the close attention of nursing managers.

Objective To study the effect of calcium gluconate oral solution combined with psychological intervention on preventing the advertise reaction in blood donation by plateletpheresis.Methods From February 2015 to February 2016, 114 cases were collected in Shaoxing downtown blood bank, and were divided into the control group and the experimental group 57 cases in each group.In the blood collection process, the control group were not given any treatment, the experimental group was given calcium gluconate oral liquid combined with psychological intervention.The total incidence adverse reactions and SAS scores in the two groups was compared.Results Before blood donation, Before blood donation, SAS scores in the two groups has no statistically significance.After blood donation, the SAS scores and the total incidence of adverse reactions in the experimental group were significantly lower than those in the control group, the differences in the two groups were statistically significant.(P<0.05).Conclusion Calcium gluconate oral liquid combined with psychological intervention can prevent the adverse reactions in the process of blood donation by plateletpheresis, which is worthy of promotion in the process of plateletpheresis.

Objective To compare the effects of honey dressing and silver sulfadiazine dressing for wound healing in burn patients by Meta-analysis.Methods All the randomized controlled trials were collected by searching many kinds of databases in or out of the country to compare honey dressing with silver sulfadiazine dressing for wound healing in burn patients.Review Manager 5.2 was used to analyze the effects.Results Six randomized controlled trials (RCT) were included.Honey dressing was much better than silver sulfadiazine dressing for burn wounds,while there were no significant differences in positive rate of wound swab culture and healing days.Conclusions It can be proved that honey dressing has an advantage over silver sulfadiazine dressing in the wound healing days within 21 and final outcome.Whether honey dressing is superior to silver sulfadiazine dressing in antibacterial effects and healing days remains to be studied with adequate,powerful,high quality randomized controlled trials.

Objective To establish mathematical model for the differential diagnosis of endoscopic gastric ulcerative lesions with the help of image processing software and statistical analysis method. Methods The microscopic images of 25 gastric ulcers and 25 gastric peptic cancers were collected from January 2013 to December 2013.Then the Photoshop CS4 software was used for image processing and representative measurements gathering(area,perimeter,roundness,height,width,gray scale,involving the density,color,lightness,pixels).Then the principal component analysis,the scatter plot and cluster analysis were performed by SPSS 16.0.Results According to the results of principal component analysis, Z1 showed a strong positive correlation with area,perimeter,height,width,cumulative density,pixel,which represented the shape statistics of ulcer.And Z2 showed a strong positive correlation with gray scale,color, lightness,which represented the color statistics of ulcer.On the Scatter plot,gastric peptic cancer images showed a stronger positive correlation with the principal component Z1 and Z2 .Clustering analysis results showed that for the majority of patients,there was a pattern in its incidence.In the gastric ulcer diagnostic models,the effective information should include area≤10 000;perimeter≤250;height≤90;width≤60;gray scale≥90;cumulative density≤190 000;color≥110;and lightness≥110(unit:pixel).In the gastric ulcera-tive cancers,the effective information should include area≥38 000,perimeter≥690,height≥300,width ≥ 426,gray scale ≤ 100,cumulative density ≥ 14 000 000,color ≤ 125,and lightness ≤ 130 (unit:pixel). Conclusion Among the endoscopic image data,area,perimeter,roundness,height,width,gray scale, cumulative density,color,brightness,pixels are important indices,which can contribute to the differential diagnosis of gastric ulcerative lesions.The established mathematical model based on the ten indices can be applied to predict and diagnose gastric ulcerative lesions.

Objective To study the clinical characteristics,pathogens,drug sensitivity and prevention measures in malignant hematological disease combined with septicemia.Methods The clinical data of 95 malignant hematological disease combined with septicemia patients from January 2009 to June 2013 were retrospectively analyzed.Results One hundred and ten episodes of septicemia occurred in all the 95 patients,among which acute leukemia patients accounted for 69.1％ (76/110),patients with neutrophil counts ＜0.5 × 109/L accounted for 82.7％ (91/110),and patients with agranulocytosis time ＞7 days accounted for 66.4％(73/110).Major pathogenic bacteria was gram negative bacteria,including Escherichia coli 30.9％(34/110),Klebsiella pneumoniae (14.5％,16/110),Pseudomonas aeruginosa (12.7％,14/110).Carbapenems and amikacin was the most sensitive in susceptibility testing.Ninety-eight episodes of septicemia cured or improved,and 12 patients died,with a mortality of 12.6％ (12/95).Fifteen patients had septic shock,of whom 7 patients were dead.Conclusions Septicemia is very serious for malignant hematological patients,which may lead to rapidly progress,high incidence to septic shock and high mortality.Early prevention and treatment is important for patients,and strong anti-infection and supportive treatment is needed.