Objective To discuss the position nursing for neonates with type three congenital esophageal atresia after operation. Methods We selected 10 patients with type three congenital esophageal atresia from September 2004 to May 2007.The respirator, trachea catheter was removed after operation and the SpO2 was lower than 95% through head mask.Then the SpO2 was compared in different positions of patients,that is face forward,face lateral, face forward with hypsokinesis,face lateral with hypsokinesis. Results All the ten patients survived the operation.The Sp02 in the four positions under oxygen inhalation were (90.30±0.95)%, (89.90±0.74)%, (96.80±1.48)%, (95.90±0.88)%.The former two results were statistically different from the latter two results (P ＜ 0.01). Conclusions The position of face forward with hypsokinesis and face lateral with hypsokinesis facilitated the transition to natural respiration for patients with type three congenital esophageal atresia after remove of respirator and trachea catheter.This could prevent the incidence of complications and the probability of reuse of respirator.

Objective To approach a simple identification method for clinical Burkholderia cepacia isolates.Methods Thirty eight clinical isolates and 5 referenc strains were identified by phenotypic and genotypic methods. A simple method presented here included TSI agar, oxidase test, pigmentation test, catalase test and antibiograms.Results All but one B. cepacia isolate identified by phenotypic and genotypic methods were identified correctly by our method. One non B. Cepacia isolate identified by the genotypic method was identified as Burkholderia spp. by phenotyic and our methods.Conculsion The method we presented here was simple, practical for identification of clinical B. cepacia isolates.

Objective To learn the current obstetric beds allocation,obstetric service delivery and access in midwifery institutions at various levels in the localities and nationwide as well as the trends,and assess the equity of obstetric beds allocation,for the purpose of recommending on a reasonable adjustment of obstetric beds allocation in these institutions.Methods Random sampling made in 44 cities in China for questionnaire survey on obstetric beds allocation,service delivery and utilization in 2008～2010 at all midwifery institutions in these cities.Interview of health administrators and medical workers at obstetric of midwifery institutions in 6 counties.Results Every thousand square kilometers in China average 5.9 midwifery institutions,and every thousand people average 0.24 obstetric beds.During 2008 ～ 2010,the number of beds and midwifery service delivery kept a growing trend while in townships obstetric service deliveries maintain a falling trend.The fairness index of maternity beds layout nationwide is 0.021283.Obstetric beds supply and demand ratio in different regions ranges among 0.97～ 1.41.The number of deliveries made in county level hospitals is 54.1％,but the beds in such hospitals account for but 48.1％.Conclusion The equity of obstetric beds allocation is good in terms of population layout.The quantity of obstetric beds meets the current needs nationwide,while the allocation of obstetric beds is less than reasonable among obstetric institutions of various levels in the country.The authors recommend a better control and adjustment of midwifery institutions layout,especially more such hospitals at the township level to meet the need of women delivery in hospital in remote areas.

Objective To explore the risk factors of chronic cough in children.Methods A hospital-based case-control study was conducted.A total of 60 children with chronic cough and 120 non-chronic cough children were interviewed with standard questionnaires.Non-conditional multivariable logistic model was performed to analyze the risk factors.Results Among 192 children that were performed questionnaire survey,180 cases were obtained the complete data with a questionnaire response rate of 93.75％.No significant difference in age,gender,and permanent residence was found between chronic cough and control groups,respectively (P ＞0.05).As shown in multivariable logistic model,parents with sensitive history (OR =1.924),mother or father smoking (mother:OR =1.989 ; father:OR =2.156),poor ventilation (OR =27.906),and interior decoration less than 3 months stay (OR =4.652) increased the risk of chronic cough in children.Conclusions Many factors,even the domestic environmental factors,are associated with chronic cough in children.It's time to strengthen the intervention of risk factors for reducing the occurrence of chronic cough in children.

Objective To discuss the influence of preoperative family purge care for the quality of life of patients with long type of congenital Hirschsprung′s disease (HD) who had enterocolitis history in neonatal period. Preoperative family purge care, which can shorten the HD postoperative treatment, improve the quality of life. Methods A total of 40 cases of patients with long type of congenital HD who had enterocolitis history in neonatal period received 1-stage radical preoperative by family phone call. Nineteen cases from January 2010 to February 2013 were as normal group and 21 cases from March 2013 to April 2016 were as improved group. Routine family purge nursing care 3-6 months were used in both the groups, while the combined nursing care of expanding anus were used in the improved group in addition. Evaluated the effects of postoperative observation indicates: the first defecation time, length of hospital stay, time needed for expanding anus, patency rate of defecation and not patency rate in 9-12 days, need enema intervention to assist defecate rate after postoperative 1 year, the recurrence of enterocolitis at 1-3 years after operation. Results The first defecation time, length of hospital stay, time needed for expanding anus were (39.15±8.23) h, (7.89±0.82)d, (5.17±0.98) min in normal group, (23.79± 7.54) h, (7.10± 0.29) d, (3.15±0.73) min in improved group, and there were significant differences between two groups (t=6.13, 5.46, 15.54, all P<0.01). The patency rate of defecation and not patency rate in 9-12 days were 12/19, 7/19 in normal group, 100.00%(21/21), 0 in improved group, and there were significant differences between two groups (χ2=9.38, P<0.01). The intervention rate of no need for enema, occasionally enema, often enema were 2/19, 12/19, 5/19 in normal group, 76.19%(16/21), 23.81%(5/21), 0 in improved group, and there were significant differences between two groups (χ2=18.25, P<0.01). There was no significant difference in the recurrence of enterocolitis at 1, 2, 3 years after operation between two groups (χ2=2.33, P>0.05). Conclusions Patient with long type of congenital HD who had enterocolitis history in neonatal period neonatal period,received family enema and expanding anus in 3- 6 months before 1-stage radical preoperative can shorten the postoperative HD treatment, improve the quality of life.

Objectiev To explore the use of different nebulizer to establish mice model that have airway eosinophilic inflam -mation without airway hyperresponsiveness .Methods Female BALB/c mice were obtained and divided randomly into 3 groups:eo-sinophilic airway inflammation group ( experimental group ) , asthma group, and control group .Mice were immunized with ovalbumin ( OVA) .The experiment group and asthma group were challenged with an aerosol of 1% w/v OVA using a PARI TIA and PARI LC STAR nebulizer on day 28, 29, 30, respectively.The control mice were received saline sensitization and challenge .Airway respon-siveness was measured .Cell different counts in bronchial alveolus lavage fluid ( BALF) were performed and a pathologist performed histopathological evaluation of the trachea and lung .Results Airway responsiveness in the experimental group was not significantly different compared with the normal saline ( NS) group but was significantly different compared with the asthma group .Eosinophils in BALF were increased significantly in experimental group compared with the NS group , and significant difference was observed between experimental group and asthma group .The intensity of airway inflammation in experimental group was milder than that in the asthma model .Conclusions We established an eosinophilic bronchitis mice model without hyperresponsiveness successfully .Our model es-tablished a foundation for the further research in airway hyperresponsiveness .

Objective To investigate the expression of blood CD +4 CD +25 Treg GITR,CD +4 T cell GITRL in children with asthma,and the role of them in asthmatic inflammation.Methods 50 cases of severe asthma were selected,and were controlled with thirty two healthy children.The venous blood was collected both in the period of acute episode and clinic remission.The mean fluorescence intensity of CD +4 CD +25 Treg GITR and CD +4 T cell GITRL was detected by flow cytometry.Results The expression of CD +4 CD +25 Treg GITR in the asthma acute period group was (24.2 ±8.2)MFI,which was significantly lower than (28.5 ±6.0)MFI in the control group(t =2.5,P <0.05).While there was no significant difference of CD +4 T cell GITRL expression between the asthma acute period group[(5.2 ±3.6)MFI]and the control group[(4.6 ±1.0)MFI](t =1.1,P >0.05).Moreover,the expression of CD +4 CD +25 Treg GITR in the asthma in remission group after treatment was (29.5 ±8.3)MFI,which was significantly higher than that in acute period group before treatment(t =-9.9,P <0.01 ).Whereas,there was no significant difference of CD +4 T cell GITRL expression in asthma group between in remission after treatment[(5.7 ±3.6)MFI] and in acute period before treatment(t =-1.6,P >0.05).Furthermore,there was no significant correlation between levels of CD +4 CD +25 Treg GITR and CD +4 T cell GITRL.Conclusion The level of CD +4 CD +25 Treg GITR in acute period asthmatic patients was decreased,but it was increased in remission,but no changes of CD +4 T cell GITRL expression were observed.GITR/GITRL signal system might be involved in the asthmatic inflammation procession.

Objective To investigate the quality control and quality assurance of the SPECT/CT system.Methods The energy peak,energy resolution capacity and the intrinsic uniformity of the device's detector were regularly examined, and the quality control was performed. Results The daily hardware maintain could reduce the rate of system's trouble. The device's energy peak,energy resolution capacity were consistent during half year's observation period. The two detector's intrinsic uniformity were better after calibration than before. [ detector Ⅰ: ( 2.71 ± 0.28 ) vs (2.37±0.11)(t=2.489,P<0. 05);detector Ⅱ:(2.68 ±0.12)vs(2.38 ±0. 19)(t =6.421,P <0.01) ] .Conclusion Regular quality control and maintain could keep the function stabilization,enhance the availability rate of the SPECT/CT system.

Objective To investigate the effects of compound bifonazole solution for the treatment of superficial mycosis.Methods The study groups were treated with compound bifonazole solution and the control group with clotrimazole solution in a double-blind controlled clinical trial.The solutions were applied to skin lesions once a day.The course of treatment was two weeks for tinea corporis and tinea cruris and four weeks for tinea manus and tinea pedis.The patients were followed up weekly for two weeks after cessation of treatment and evaluated with regard to erythema,papule,blister,scale,keratinization and pruritus.Mycologic examinations were performed before,during and right after treatment and two weeks after treatment.Results A total of434patients participated into the study.The clinical cure rates of study group were82.25%in tinea corporis and tinea cruris,and68.75%tinea manus and tinea pedis,with a total response rates of95.85%and92.5%in tinea corporis and tinea cruris,and92.5%in tinea manus and tinea pedis,respectively.The clinical cure rates of control group were58.6%in tinea corporis and tinea cruris,and44.7%in tinea manus and tinea pedis,with a total response rates of83.0%and87.2%in tinea corporis and tinea cruris,and in tinea manus and tinea pedis,respectively.The MICs to350clinical isolates of pathogenic fungi were1.6~2.5mg/L for compound bifonazole solution,and3.125~25mg/L for clotrimazole solution.Conclusions Compound bifonazole solution is a high-effective,broad-spectrum anti-fungal agent.It is keratolytic,well permeable and safe for relatively long term application.

OBJECTIVE To study the phenotypic existence,genetic type and gene transfer of extended spectrum beta-lactamases(ESBLs) and AmpC beta-lactamase from Klebsiella pneumoniae and K.oxytoca. METHODS Disk confirmation test and 3-aminophenylboronic acid(APB) disk potentiation test were used to detect ESBLs and AmpC beta-lactamase.The genetic types of these two kinds of beta-lactamases were examined by gene chip technology and sequence analysis.The transfer of resistance genes was conducted by conjugation. RESULTS From 72 strains of K.pneumoniae and 20 strains of K.oxytoca which were not susceptible to cefoxitin,coexistence of AmpC(beta-lactamase) with ESBLs together was very common,accounted for 54.2% and 75.0%,single ESBLs accounted for 22.2% and 25.0%,respectively.There were 12.5% single AmpC in(K.pneumoniae).DHA type ampC gene and SHV type ESBLs gene were the main molecular types.These genes could be transferred from clinical isolates to recipient E.coli J53. CONCLUSIONS ESBLs as well as AmpC(beta-lactamase) are the most important resistance mechanism in K.pneumoniae and K.oxytoca.The resistance could be transferred through the bacterial conjugation.