Objective To investigate the distribution and antimicrobial resistance in Enterococcus species isolated from Ordos Central Hospital.Methods The Enterococcus strains were isolated from clinical specimens from January 2010 to June 2013.The identification and antimicrobial susceptibility testing were completed on VITEK 2 Compact.WHONET 5.6 software was used to analyze the data.Results A total of 271 strains of Enterococcus were collected,including E.faecium (50.6%,137/271), E.faecalis (29.5%,80/271),and other Enterococcus (19.9%,54/271).The Enterococcus isolates were mainly from urine (25.5%,69/271 ),pus (14.8%,40/271 )and wound secretion (12.5%,34/271 ).The E.faecalis strains were highly susceptible to vancomycin and linezolid.Only 1 .3% and 1 .5% of the strains were resistant to vancomycin and linezolid, respectively.No strains of E.faecalis were resistant to nitrofurantoin.The percentage of E.faecalis resistant to penicillin and ampicillin was 11.8% and 2.6%,respectively.About 31.0% and 22.9% of E.faecalis strains were resistant to gentamicin (high level)and streptomycin (high level),respectively.The E.faecium strains were more resistant to most antibiotics tested than E.faecalis.The drug-resistance rate of E.faecium strains to vancomycin was 4.4%.But no strains were found resistant to linezolid.Only 19.1% of these strains were resistant to nitrofurantoin.Also 44.8% and 26.4% of E. faecium isolates were resistant to gentamicin (high level)and streptomycin (high level),respectively.However,E.faecium was less resistant to tetracycline and quinupristin-dalfopristin than E.faecalis.The resistance rate was 58.3% and 0, respectively.Conclusions The E.faecium strains are more resistant to most drugs tested than E.faecalis.Some strains are resistant to vancomycin.The resistance of Enterococcus varies widely with region and species.Antimicrobial therapy for such enterococcal infections should be based on the results of antimicrobial susceptibility testing.

Objective To study the application effect of nursing pathway in maternal midwifery in perinatal period.Methods A total of 120 cases were randomly divided into study group and control group according to the random number table method.The control group was treated with routine nursing care, while the study group was treated with nursing pathway intervention.After nursing, the vaginal delivery and cesarean section, and the first, second, third stage of labor and total labor of the two groups were investigated and recorded.After the operation, the postpartum hemorrhage, hospitalization time and hospitalization expenses of the two groups were recorded and analyzed, and the maternal SAS and SDS score were evaluated and analyzed.The pregnancy outcomes of the two groups were recorded.Results he vaginal birth rate was significantly higher than the control group (88.33% vs.66.67%,P<0.05);The first, second stage, third stage of labor and total labor time were shorter than the control group (P<0.05).The hospitalization time of the study group was significantly shorter, the cost of hospitalization was significantly lower, the amount of postpartum hemorrhage was significantly less than that of the control group (P<0.05).After nursing, SAS and SDS scores of two groups were significantly lower than nursing before, and the study group was significantly lower than the control group (P<0.05);Maternal urinary retention, postpartum hemorrhage and the incidence of adverse outcomes of perineal incision in the study group of were significantly lower than he control group, neonatal fetal distress and the incidence of neonatal asphyxia was significantly lower than the control group;the Apgar score was significantly lower than the control group;differences in the two groups were statistically significant(P<0.05).Conclusion Pathway nursing measures in the perinatal period can significantly improve the outcome of pregnancy;and it is worthy of popularization.

Objective To study the application effect of nursing pathway in maternal midwifery in perinatal period.Methods A total of 120 cases were randomly divided into study group and control group according to the random number table method.The control group was treated with routine nursing care, while the study group was treated with nursing pathway intervention.After nursing, the vaginal delivery and cesarean section, and the first, second, third stage of labor and total labor of the two groups were investigated and recorded.After the operation, the postpartum hemorrhage, hospitalization time and hospitalization expenses of the two groups were recorded and analyzed, and the maternal SAS and SDS score were evaluated and analyzed.The pregnancy outcomes of the two groups were recorded.Results he vaginal birth rate was significantly higher than the control group (88.33% vs.66.67%,P<0.05);The first, second stage, third stage of labor and total labor time were shorter than the control group (P<0.05).The hospitalization time of the study group was significantly shorter, the cost of hospitalization was significantly lower, the amount of postpartum hemorrhage was significantly less than that of the control group (P<0.05).After nursing, SAS and SDS scores of two groups were significantly lower than nursing before, and the study group was significantly lower than the control group (P<0.05);Maternal urinary retention, postpartum hemorrhage and the incidence of adverse outcomes of perineal incision in the study group of were significantly lower than he control group, neonatal fetal distress and the incidence of neonatal asphyxia was significantly lower than the control group;the Apgar score was significantly lower than the control group;differences in the two groups were statistically significant(P<0.05).Conclusion Pathway nursing measures in the perinatal period can significantly improve the outcome of pregnancy;and it is worthy of popularization.

Objective To evaluate the value of medical treatment in the management of SAP.Methods From January 2000 to December 2011,a total of 1064 cases out of 931 SAP patients were admitted and retrospectively analyzed.The etiologies,severity score,complication rates,therapies,effectiveness and costs of those SAP cases were summarized.Results There were 559 males and 372 females with a mean age of (51 ± 15)years old.The main cause was biliary tract disease (58.3％),followed by fat-rich diet (31.2％),hyperlipidemia (13.6％) and alcohol (7.1％).At the time of admission,95.5％ of SAP patients presented with level D disease according to Balthazar CT severity index,26.0％ had a Ranson score ≥3 and 30.1％ had an APACHE Ⅱ score ≥ 8.There were 42.7％ cases complicated with systemic inflammatory response syndrome (SIRS).Acute lung injury and acute respiratory distress syndrome (ARDS),acute kidney injury,shock or heart failure,acute liver dysfunction,and diffuse intravascular clotting (DIC)occurred in 24.0％,8.1％,5.4％,3.2％,and 1％ of all patients,respectively.Other complications of SAP included abdominal cavity bleeding (n =17),pseudocyst bleeding (n =9),pancreatic abscess (n =78) and gastrointestinal fistula (n =33).Totally 25 (2.3％) patients died in hospital and 36 (3.4％) patients were discharged against advice,with an overall treatment success rate of 94.3％.The mean hospital stay was (23.7 ± 19.2) d,and the average cost was 52.3 thousands of RMB.Conclusions A comprehensive treatment pathway relying on medical treatment,focusing on organ function support and assisted by miniinvasive intervention may improve the treatment success rate of SAP,which is worth of further application.