Objective To discuss the application of scenario simulation technique in emergency rescue training of hospital grave pubic health events.Methods Based on the simulate function in the scenario simulation technique,we designed the emergency drill script of hospital grave pubic health events,set the simulate scene,communication system and indicators measuring emergency rescue,drilled and trained the hospital rescue crews,compared with the rescue crews trained in routine method.40 nurses were selected before or after the application of scenario simulation technique separately.Results The qualified rate of indicators such as communication and medical rescue system that were trained by scenario simulation method was higher than the rescue crews trained in routine method.Conclusions Scenario simulation technique would improve the training effect of emergency rescue in hospital grave pubic health events.

Objective To investigate the distribution and antimicrobial resistance of pathogens isolated from surgi-cal patients with infection.Methods Distribution and antimicrobial resistance of 1 208 pathogens isolated from sur-gical patients with infection from January 2013 to January 2014 were analyzed retrospectively.Results Of 1 208 pathogenic isolates,gram-negative bacteria,gram-positive bacteria and fungi accounted for 64.57% (n = 780 ), 24.92%(n = 301 )and 10.51 % (n = 127 )respectively.The main specimens were sputum (44.78%),urine (21 .11 %),blood(11 .51 %),and pus(10.26%).Antimicrobial susceptibility testing results showed that the produ-cing rate of extended-spectrumβ-lactamases (ESBLs)of Escherichia coli and Klebsiella pneumoniae was 62.60%and 33.61 % respectively,resistant rate to imipenem was 0.76% and 15.57%,respectively.The resistant rate of Pseudomonas aeruginosa and Acinetobacter baumannii to imipenem was 38.93% and 75.80% respectively.Methi-cillin-resistant Staphylococcus aureus and methicillin-resistant coagulase negative Staphylococcus was 71 .68% and 87.93% respectively.Conclusion The major pathogens isolated from surgical patients with infection are gram-neg-ative bacteria,the main infection sites are respiratory tract and urinary tract in this hospital;multidrug resistance is serious,especially carbapenem resistance,which should be paid attention.

Objective Investigate the effect of insomnia on cardiovascular disease factors and offer the experimental evidence for treating cardiovascular disease with traditional Chinese medicine tranquillization methods. Methods Sixteen Wistar rats were randomly divided into two groups named sleep deprivation ( SD ) group and normal control check( CC) group.Body weight and electrocardiogram were recorded and serum concentrations of melatonin ( MT) , endothelin-1 (ET-1), IL-6 and TNF-αwere tested before SD and 2 days, 5 days, 7 days after SD.Results Body weight decreased in SD group while increased in CC group.Compared with CC group, body weight of SD rats decreased significantly in 5 days and 7 days after SD( P <0.05) .Compared with CC group, TNF-αincreased significantly in 5 days (P <0.05).With the time, heart rate accelerate and QTc were prolonged, MT decreased while ET-1, IL6, TNF-αincreased significantly in 7 days after SD (P <0.05).Conclusion Long term insomnia would decrease body weight and MT, while increase heart rate, QTc, ET-1 and inflammatory factors, which increase cardiovascular disease factors.It provided the experimental evidence for the study on traditional Chinese medicine tranquillization methods in the treatment of cardiovascular disease.

Objective To develop the improved monitoring and evaluation system of adverse drug reaction during infusion in clinic and emergency department,and investigate the effect of this system.Methods To develop monitoring and evaluation system of adverse drug reaction,which was consistent with the medical safety (adverse) event reporting,and running it.The system consisted of organizational structure,knowledge training,event reporting and processing,data analysis,quality control and continuous improvement.We collected the observed indicators of the cases of adverse drug reaction,quality and network reporting time pass rate,which were compared with those of the conventional system.Results One year during the improved system running,the cases of adverse drug reaction in clinic and emergency department infusion was reduced,the quality of reporting and handling significantly improved,network report pass rate increased.Conclusions Improved monitoring and evaluation system of adverse drug reactions has some significance in safety management of clinic and emergency department infusion,which is worthy of promotion in clinical work applications.

Objective To compare the target dosimetric distribution and clinical outcome in patients with stage Ⅲ non-small cell lung cancer (NSCLC) treated with three-dimensional conformal radiotherapy (3DCRT) and intensity-modulated radiotherapy (IMRT).Methods The clinical data of 419 patients with stage Ⅲ NSCLC treated with either 3DCRT or IMRT were retrospectively analyzed.Among them,there were 338 male and 81 female patients,and the median age was 63 years (range:32-84 years).There were 340 patients treated with 3DCRT and 79 with IMRT,and the median prescribed dose was 60 Gy (range:50-76Gy).One hundred and forty patients were treated with radiotherapy alone and 279 were treated with chemoradiotherapy.The target dosimetric distribution was evaluated with dose-volume histogram (DVH)parameters.The overall survival (OS) rate was calculated using the Kaplan-Meier method and analyzed by the log-rank test.Results When comparing the clinical data,the patients treated with 3DCRT were in older ages,and had advanced N and clinical stages (P =0.01,0.00,and 0.00,respectively).When comparing the target DVH parameters,the patients treated with IMRT had larger planning target volume (PTV) (P =0.01),significantly lower clinical target volume (CTV) D CTV D90,PTV D and PTV V65-V60 (P =0.05-0.01),significantly higher V5-V20 in both lungs,higher esophagus D longer esophagus in the radiation field,higher linear energy transfer between 45 and 55 keV/μm (LET45-LET55),and higher spinal cord Dmean(P =0.03-0.00).The follow-up rate was 97.4％.After radiotherapy,the 1-,3-,and 5-year OS rates were 65.5％,26.1％,and 18.5％,respectively,and the median survival time was 20 months.There were no significant differences in OS rate and the incidence of acute radiation pneumonitis and radiation esophagitis between patients treated with IMRT and 3DCRT (P =0.06,0.73,0.13).Stratified analysis showed that,when comparing the patients treated with IMRT with those treated with 3DCRT,the survival rate was only lower in male patients,patients in stage T3-T4 or N0-N2,and those without chemotherapy (P =0.04,0.04,0.02,0.00).Conclusions The treatment outcomes of patients with stage Ⅲ NSCLC undergoing IMRT and 3DCRT are comparable.IMRT shows a potential dosimetric advantage,but the result needs further investigation.

OBJECTIVE:To provide reference for improving the homogeneity and stability of domestic cefetamet pivoxil hydro-chloride oral solid preparation and its control standrads. METHODS:105 batches of cefetamet pivoxil hydrochloride preparations (tablets,granules,dry suspensions and dispersible tablets)were tested by statutory inspection test in respects of property,identifi-cation,weight difference or load difference,moisture,microbiological limits,related substances,dissolution degree and content, etc.,and results were analyzed. Exploratory research was conducted for its impurity sources,dissolution consistency evaluation, the correlation between the remaining validity period with relative substance and content,etc. RESULTS:Statutory tests showed, 103 batches were qualified in the 105 batches of samples(98.1%). The unqualified items were property and related substances,the other items met relevant regulations. Besides,the determination method for related substances in dispersed tablets was quite differ-ent with other preparations. Results of exploratory research showed the related substances in preparations originated from raw materi-als,degradation reaction in manufacturing or storage. Compared with domestic reference tablets and granules,f2 of dissolution of other products were mostly less than 50;there was no correlation in related substances,content with the remaining validity period. CONCLUSIONS:The 105 batches of domestic oral solid preparation of cefetamet pivoxil hydrochloride are basically qualified;cur-rent standard is basically feasible for tablets,granules and dry suspensions,while the standard for dispersible tablets needed to be improved immediately.

Objective To investigate the difference between nodular gastritis and atrophy gastritis.Methods During 2004.4～2005.3, the clinical, endoscopic and pathological findings of nodular gastritis and atrophy gastritis were analysed.Results Nodular gastritis is usually classified as nodular type A(nodular gastritis) and type B(atrophic gastritis with nodular changes). The endoscopic appearance of nodular gastritis was characterized as uniform miliary pattern and predominantly affected young women. The incidence of dyspeptic symptom was higher in patients with nodular gastritis than in atrophy gastritis. Nodular gastritis in adults is caused by Helicobacter pylori infection. Antral biopsy specimens showed lymphoid follicle formation and/or marked lymphoid aggregates. The prevalence of lymphoid follicle formation in the antrum was higher in patients with nodular gastritis than atrophy gastritis. Moderate to severe atrophy gastritis also usually has the same nodular endoscopic appearance,but that is not uniform and intensive.Conclusion Nodular gastritis is a very special gastritis with Helicobacter pylori infection and is different from atrophy gastritis.It is worth to be noticed.

Objective To study genotyping and molecular epidemiology distribution of GBS pathogenic strains of GBS positive pregnant women in Guangzhou,for GBS pathogenic strains of rapid molecular diagnosis and epidemiological surveillance pro-vide certain theoretical basis and method.Methods In the Guangzhou area,used multi stage stratified sampling method col-lecting GBS positive pregnant women’s reproductive tract specimens from January to December 2015,drug sensitivity quality control standard strains:Streptococcus pneumoniae (ATCC49619)and Staphylococcus aureus (ATCC25923),took culture of bacterial,strain,identification,DNA extraction,PCR,gene detection method,through the relevant software for data analy-sis,analyzed GBS strains of gene and molecular epidemiology.Results In the study,collected 2 812 samples of secretions,af-ter identification of strains isolated from 178 strains of pathogenic GBS strains,the detection rate was 6.33%.GBS patho-genic strains to linezolid vancomycin,penicillin,nitrfurantion and other antimicrobial drug resistance rate was 0,GBS parho-genic strains to ampicillin,ciprfloxacin moxifloxacin and levofloxacintesistant parts,the restance rates were 1.1%,16.9%, 18.0% and 22.5%,but GBS pathogenic strains to erythromycin,clindamycin tetracydine antibiotics showed a high resistance rate,the resistance rates were 50.6%,47.8%(of which 20 cases of erythromycin induced clindamycin resistance accouted for 23.5%)and 73.0%.Among them,65 strains of GBS detected the mreA gene,56 strains of GBS detected the ermB gene,36 strains of GBS detected the mefA gene,28 strains of GBS detected the mefE gene,5 strains of GBS detected the ermA gene, ermC gene was not detected in the gene.Among them,carried five multidrug resistance gene of 3 strains (1.6 9%)and 4 kinds of resistant gene carried with 15 strains (8.43%),carried three resistance genes of 19 strains (10.67%),2 kinds of resistant gene carrying a 25 strains (14.04%),carried the resistance gene of 5 strains (2.81%),did not carry resistance gene of 1 strain (0.56%).The nucleotide sequences of the five drug resistance genes were 100%,and no gene mutation oc-curred.Conclusion The main GBS disease resistant gene was mreA,ermA,ermB,mrfA,mefE and its nucleotide sequence homology was 100%.The clinical need to strengthen the detection of resistant gene and molecular level and guide clinical more scientific and rational drug use.

Objective To observe the effect of muscone on the blood-brain barrier and neuropathological changes after complete cerebral ischemia/reperfusion of rats.Methods The global cerebral ischemia/reperfusion injury model was established by the four-vessel occlusion(4VO) method,and then the model animals were given high-,middle-and low-dose muscone.Meanwhile,sham-operation group,model group,and positive control group were also set up.The rats neuroethology behavior,and the contents of superoxide dismutase(SOD),malondialdehyde(MDA) and excitatory amino acid(EAA) in ischemic brain tissue were examined.Results Muscone increased SOD content,lowered MDA content,reduced the increase of EAA content caused by ischemia and hypoxia,and inhibited the excitatory neurotoxicity caused by EAA.Conclusion Muscone has obvious protective effect on rats with complete cerebral ischemia/reperfusion injury.

Objective To study the influence of different placing time of child peripheral blood on blood routine parameters in order to increase the working efficiency of clinical blood routine test.Methods Each 300 μL of peripheral blood was collected from the right hand ring finger in 50 healthy children in our hospital from January 2015 to January 2016.The blood routine was performed by using the whole blood cells analyzer at instantly after blood collection,at 0,5,10,15,30 min after blood collection under the room temperature (20 to 25 ℃).Results With the measured results at 15 min as the control,the detection results at the other times points had no statistical difference (P>0.05).Compared with the detection results at 5 min,the white blood cell count(WBC) and platelet volume distribution width (PDW),lymphocyte absolute value (LYM),neutrophil percentage absolute value (NEU),platelet count (PLT),red blood cell volume distribution width (RDW),hemotocrit (HCT) and plateletcrit(PCT) were statistically different (P<0.05).Conclusion Reasonably arranging time,eliminating pre-analysis error and reducing the influence of peripheral blood placing time on blood routine parameters have an important significance to accurately judge the clinical dat.It is recommended that the blood routine detection time should be controlled within 10-30 min in order to increase the working efficiency of clinical detections.