OBJECTIVE To investigate the profile of pathogen of infection in emergency intensive care unit(EICU). METHODS Pathogen of infection in EICU of our hospital from Jan to Apr 2005 were retrospectively investigated. RESULTS A total of 25 species from 119 pathogen strains were isolated from 45 cases. Among them, nonfermenters Gram-negative bacilli had great advantage, about 42.9% (51/119). Pseudomonas aerugionosa was the most one , counted for 16.8%. 65.9% of isolates were from sputum, 9.2%from blood. 81.4%(35/43) of cases were caused by multi-bacterial infection. CONCLUSIONS The pathogen of infection in EICU is mainly P. aeruginosa. The isolates are multi-resistant to biotics.

Objective To investigate the protective effect of somatostatin (SS)combined with growth hormone (GH) in treatment of intestinal mucosal barrier injury in rabbits with severe acute pancreatitis (SAP), as well as its clinical significance. Methods Seventy-two rabbits were equally assigned into model group (SAP group), SS treated group (SS group) and SS combined with GH treated group (SS + GH group). SAP models were induced by retro-injection of 5% sodium taurocholate into the pancreatic duct. After modeling, all rabbits were given 5 % glucose saline daily.The rabbits in SS group and SS+GH group were continuously Given SS (3.5μg·kg-1·h-1)for 48 hours. Besides, the rabbits in SS+GH group were subcutaneously injected with 0.15 IU/kg of GH at the 1st and the 24th hours after modeling. The levels of serum amylase, serum tumor necrosis factor-α (TNF-α) and plasma diamine oxidase were measured at the 6th, 12th, 24th and 48th hours after modeling. The pathological changes of pancreatic tissue and ileal mucosa were observed. Survival rate was calculated. Data were analyzed using SPSS 16.0 software. The univariate analysis was used to compare the difference among groups. Results In SS+GH group, the levels of serum TNF-α and plasma diamine oxidase were (2. 43 ± 0. 14) pg/ml and (4. 61 ± 0. 45) U/L at the 24th hour respectively, and were (2.08±0.23) pg/ml and (3.75±0.47) U/L at the 48th hour, respectively,which were lower than those in SAP group and SS group [(2.80 0.30) pg/ml and (8.74 ± 1.77)U/L, respectively, at the 24th hour; (2. 45±0.12) pg/ml and (5. 02±0.95) U/L, respectively, at the 48th hour)]with significant difference (P＜0.05). The inflammation in pancreas and ileal mucosa was alleviated, and the integrity of bowel mucosa was improved. Survival rate of SS+GH group was significantly higher than SAP group and SS group. There was no significant difference in level of serum amylase between SS+GH group and SS group. Conclusion The combination of SS with GH may enhance the function of intestinal mucosa barrier and improve the prognosis of SAP in rabbits.

Objective To study the feasibility and security about misoprostol combined with fentanyl and propofol applied in visualization of artificial abortion.Methods 1270 cases of pregnant women who requested termination of pregnancy and voluntarily accepted abortion were selected.In the observe group,634 cases of pregnant women received oral misoprostol about 600 mg 90 minutes before surgery.After anesthetized by fentanyl and propofol,painless artificial abortion using visual abortion instrument was carried out.In the control group,636 cases of pregnant women anesthetized by fentanyl and propofol via the venous were carried out artificial abortion.The degree of cervical relaxation,loss of blood,total dose of propofol,surgical time,recovery time,the incidence of abortion complications and so on were observed.Results In the observation group and the control group,the average dosage of propofol are( 14.15 ± 2.37) ml and (16.90 ± 4.52) ml respectively;The average time required for surgery are ( 146.1 ± 38.2) s and ( 199.7 ± 37.3 ) s respectively;the average time required for awakening are ( 6.01 ± 1.90 ) min and ( 8.81 ± 2.02 )in;In the observation group,there are 405 ( 63.9% ) cases of cervical laxity markedly,in the control group,including 145 ( 22.8% ) cases of cervical laxity markedly,there is statistical significance ( P ＜ 0.05 ) between the observation group and the control group.There are no abortion syndrome in both groups.Conclusion Misoprostol combined with fentanyl and propofol was the first choice for painless artificial abortion using ultrasound visualization.

OBJECTIVE To investigate the prevalence of PER-1 type ESBLs-producing Enterobacteriaceae and their antimicrobial-resistance profile. METHODS Totally 167 strains of Escherichia coli, 154 strains of Klebsiella pneumoniae and 67 strains of Enterobacter cloacae were tested. All of them were isolated from all kinds of clinical specimens in four hospitals of Nanchang city from Aug 2003 to Jun 2004. Antimicrobial susceptibility test(AST) was determined by K-B disk diffusion test. double-disk test(CTX, CTX/CA and CAZ, CAZ/CA)and three- dimension extract test were used to determine ESBLs. PER-1 genes were amplified by PCR. The products of PCR were sequenced to identify its ?-lactamase encoding gene. RESULTS Sixteen isolates were PER-1 gene positive. The PER-1 gene positive rates of E. coli, K. pneumoniae and E. cloacae were 3.6%, 3.2% and 9.0% , respectively . The antimicrobial-resistant rates of isolates harboring blaPER-1 to cefotaxime, ceftaxidime, amikacin , cefoxitin , cefepime and imipenem were 100%,100%, 56%, 94%, 31% and 0%, respectively. CONCLUSIONS blaPER-1 is detected in E. coli, K. pneumoniae and E. cloacace, and has diffused in Enterobacteriaceae . Imipenem and amikacin may be used to treat the infection caused by bacteria harboring blaPER -1.

Objective To explore the effects of mirror therapy combined with Tongdu Xingshen acupuncture on the upper extremity function of stroke survivors.Methods Sixty stroke survivors were randomly divided into a mirror group (n =20),an acupuncture group (n =20) and a combined group (n =20).In addition to routine rehabilitation treatment,those in each group received mirror therapy,acupuncture or both for 4 weeks.Before the treatment and after 2 and 4 weeks of treatment,all of the patients were assessed using the Fugl-Meyer motor function assessment (FMA),Brunnstrom upper limb and hand staging (BSULH),the Barthel Index (BI) and in terms of the active range of motion in the wrist contralateral to their hemiplegia (AROM).The combined group was also evaluated using functional magnetic resonance imaging (fMRI) before treatment and after the 4 weeks.Results After 2 and 4 weeks of the treatment,the average BI,AROM,FMA and BSULH results had improved significantly compared with before the treatment.The improvements in the combined group were significantly greater than in the other groups after 2 and 4 weeks.The fMRI demonstrated that there were high-intensity signals in the primary motor area,the premotor area and the supplementary motor area on the affected side after 4 weeks of treatment.Conclusions Mirror therapy combined with Tungdu Xingshen acupuncture can improve the functional performance of the upper extremities of stroke survivors.

Objective To investigate the prevalence of aac(6')-Ib-cr in clinical isolates of Klebsiella pneumoniae.Methods A total of 337 isolates of Klebsiella pneumoniae were isolated from clinical specimens in our hospital from Jan,2006 to Sep,2007.Gentamycin,amikacin or tobramicin was used to screen the isolated with aac(6')-Ib-cr.aac(6')-Ib and class 1 interase gene(intl1)was determined by PcR All PCR products of aac(6')-Ib were sequenced for determination of aac(6')-Ib-cr. MICs of antibiotics were determined by agar dilution method.The ESBLs-producing isolates were determined by the CLSI-recommended confirmatory tests.Conjugation test was used to detect the transfer of plasmid.Results Of the 337 clinical isolates of Klebsiella pneumoniae,64(19.0%),28(8.3%)and 55(16.3%)isolates were resistant to gentamycin,amikacin and tobramycin,respectively.Among 64 gentamycin-resistant isolates,24(37.5%)were positive for aac(6')-Ib-cr,including 13 ciprofloxacin-resistant isolates and 11 ciprofloxacinsusceptible isolates.The prevalence of aac(6')-Ib-cr in ciprofloxacin-resistant and-susceptible isolates were 54.2%(13/24)and 27.5%(11/40).The positive rates of ESBLs and intl1 in the 24 isolates carrying aac(6')-Ib-cr were 79.2%(19/24)and 91.7%(22/24).Plasmids carrying aac(6')-Ib-cr of 13 isolates were successfully transferred to E.coli J53.Plasmids of all transconjugants were positive for aac(6')-Ib-cr and intl1.All transconjugants were ESBL producing strains.Conclusions aac(6')-Ib-cr exists widely in clinical isolates of Klebsiella pneumoniae.aac(6')-Ib-cr and ESBL gene usually coexist in a selftransmissible conjugative plasmid by class 1 integron.

Proteomic analysis of core needle biopsy (CNB) sample from patient populations is critical to our understanding of human disease,but has been hindered by its particular small size.Here,we present a method for the proteomic analysis of CNB sample based on the two dimensional electrophoresis.Proteins were extracted directly from 3 rat liver CNB specimens and a human prostate CNB sample.respectively.24 cm Immobiline DryStrip (pH 3-10NL) and 12.5% SDS-PAGE were introduced to separate the proteins.Interesting spots were analyzed by MALDI TOF/TOF mass spectrometry after tryptic digestion.With this method,consistent electrophoretic patterns of more than 2 500 protein spots were reproducibly obtained after silver staining,from rat liver CNB specimens.Qualitatively and quantitatively reproducible results also yield when the method was applied to a human prostate CNB sample.57 stochastically selected protein spots were analyzed by MALDI TOF/TOF moss spectrometry.and were identified with high confidence including faint ones.This simple and reproducible approach raises the opportunity of defining key molecular events of human disease pathologies.

Objective:To determine the effect of Notch1 signaling pathway on the differentiation and function of Th17 cells in murine psoriasis model.Methods: BALB/c mice were randomly divided into psoriasis model group and control group.Murine psoriasis model was established by topical 5% imiquimod application in combination with intraperitoneal injection of α-2b interferon.The CD4+ T lymphocytes were isolated by magnetic activated cell sorter (MACS).Flow cytometric analysis (FCM) was performed to detect the percentage of Th17 cells.Real-time RT-PCR was employed to measure the mRNA levels of RORγt,IL-17A,Notch1 and Hes-1.The CD4+ T lymphocytes were then divided into γ-secretase inhibitor DAPT groups and control group,and the expression differences of Notch1 signaling molecule and its target gene Hes-1 mRNA levels,Th17 cell percentage,RORγt and IL-17A mRNA levels,and IL-17A concentrations in cell-free supernatant were detected.Results: The expression levels of Th17 cell percentage and RORγt,IL-17A,Notch1 and Hes-1 mRNA in CD4+ T lymphocytes of murine psoriasis model were significantly higher than control mouse[(2.97±0.86)% vs.(0.65±0.11)%,t=15.083;(5.75±0.61) vs.(1.57±0.43),t=21.630;(7.83±0.97) vs.(1.63±0.31),t=25.348;(7.10±1.37) vs.(1.47±0.34),t=17.386;(7.30±1.15) vs.(1.67±0.48),t=18.840,respectively,all P<0.01].Compared with control group,Th17 cell percentage,mRNA expression levels of Notch1,Hes-1,RORγt and IL-17A,and IL-17A concentrations in cell-free supernatant from cultured CD4+ T lymphocytes of murine psoriasis model were dramatically decreased in DAPT treated groups in a dose-dependent way (F=74.368,89.719,126.572,94.558,124.323 and 123.231 respectively,all P<0.01).Conclusion: Notch1 signaling pathway can regulate the differentiation and function of Th17 cells in murine psoriasis model,and may have potential value for the target immunotherapy of psoriasis.

Objective To explore the effect of social support and coping style on posttraumatic growth of ostomy patients. Methods A total of 237 patients with ostomy from Affiliated Hospital of Qingdao University were investigated using General questionnaire, Perceived Social Support Scale, Medical Coping Modes Questionnaire and Posttraumatic Growth Inventory by cross-sectional survey method from September 2017 to March 2018. The path of social support and coping style on post-traumatic growth was established by correlation analysis and structural equation model. Results The total score of posttraumatic growth in patients with ostomy was (66.76±12.20) points, which was at the upper-middle level. Correlation analysis showed that posttraumatic growth was positively correlated with comprehension of social support (r=0.551, P<0.01), positively correlated with face style (r=0.580, P<0.01), negatively correlated with avoidance style and resignation style (r=-0.334, P<0.01;r=-0.449, P<0.01). Structural equation model showed social support had directly positive effect on posttraumatic growth, path coefficient were 0.44. Face style, avoidance style, and resignation style had a partial mediating effect between social support and posttraumatic growth, and mediation effects account for 20.01％, 5.21％, 9.25％of the total effect, respectively. Conclusions The posttraumatic growth level of patients with ostomy needs to be improved. Medical staff should strengthen social support for patients and guide patients to adopt the positive coping styles, reduce the avoidance and resignation coping styles, and promote patients to get more posttraumatic growth, furthermore, improve their social adaptability and quality of life.

Objective:To prepare a discharge readiness scale suitable for patients with enterostomy and to test the reliability and validity, so as to provide an effective measurement tool for the assessment of discharge readiness of patients.Methods:On the basis of the existing Chinese version of the discharge readiness scale, items related to enterostomy nursing problems were added to form the scale entry pool, and a draft of the scale was formed by expert consultation. 132 patients with preventive enterostomy admitted to the Affiliated Hospital of Qingdao University were pre-investigated with the original scale to test the reliability and validity.Results:The discharge readiness scale of enterostomy patients contained 18 items. The content validity of the scale was 0.969, and the content validity of each item was 0.824 - 1.000. Four common factors were extracted from the scale, and the cumulative variance contribution rate was 79.503%. Cronbach alpha coefficient of the total scale was 0.923, and each dimension was 0.806 - 0.947.Conclusions:The discharge readiness scale of patients with enterostomy has good reliability and validity, which can be used as an evaluation tool for patients at discharge.