Objective:To establish a new method to detect Amp C?-lactamase by PCR. Methods:The amp C and amp D gene fragments of E. cloacae were amplified by the amp C and amp D primers to detect Amp C ?-lactamase, especially the enduring and highly productive enzymes. Results:Totally 193 of 214 strains of E. cloacae were positive for amp C gene , implicating most strains of E. cloacae had the ability to produce the enzyme. Sixteen of the 193 strains (amp C positive) were negative for amp D genes, implicating these 16 strains could produce the enduring and highly productive enzymes. The results were confirmed by cefoxitin three-dimensional test. Conclusion:The new method to detect Amp C ?-lactamase, especially the enduring and highly productive enzymes,by amp C and amp D primers is a rapid and accurate method.

Objective To explore the mechanism of VEGF treating cerebral ischemia. Methods A rat model of middle cerebral artery occlusion (MCAO) was set up by nylon suture embolization. The naked plasmid DNA encoding vascular endothelial growth factor(pUCCAGGS/hVEGF 165 ) was directly injected through skull into the ischemic areas of brain. After seven days the rats were killed. RT-PCR was used to measure the expression of VEGF mRNA in the brain tissues, and immunohistochemistry was appllied to detect the expression of VEGF, Fas and Fas L in the brain tissues. Results Compared with control group, VEGF expression significantly increased in the therapeutic group(P

Objective To investigate blood flow dynamics adjacent to regional myocardial segments in coronary artery disease(CAD) patients and to explore the association of the two CAD features.Methods In 43 CAD patients,velocity vector imaging (VVI) was used to evaluate the wall motion and classify normal myocardial segments (NS),relatively abnormal and obviously abnormal wall motion segments (RS and OS) by systolic peak strain (Ss).Vector flow mapping (VFM) was used to show blood flow dynamics in the heart chamber,including blood flow (Q) heading towards or away from the apex during a heart beat and time to every peak flow (T).Results Compared with NS,both RS and OS showed a higher systole Q + (blood flow heading towards the apex during systole) and lower diastole Q + (blood flow heading towards the apex during diastole) and shortened T2 (adjusted time interval between E and A peaks).Systole Q + was positively correlated with Ss but negatively with segmental ejection fraction (SEF).Diastole Q + was negatively correlated with early and late diastolic peak velocity (Ve and Va) but positively with Ve/Va.T2 was negatively correlated with Ve but positively with Ve/Va and early diastolic peak strain rate (SRe).Conclusions VFM might be a new tool to quantitatively assess change in regional blood flow dynamics in patients with CAD.

Objective To investigate the relationship between cancer-related fatigue (CRF) and quality of life (QOL) of the colorectal cancer patients.Methods In this study,patients diagnosed definitely as colorectal cancer were enrolled from November 2010 to January 2011 in this hospital.Piper Fatigue Scale was used to assess the CRF and QLQ-C30 was used to assess the QOL.Results 74 patients were enrolled in this study,and among them 28 patients had CRF(37.84％).Patients with CRF was significantly worse in QOL than patients without CRF.Physical function,role function,emotional function,social function and the general health subscale had a negative correlation with CRF,while pain,fatigue and loss of appetite had a positive correlation with it.Conclusions CRF had an impact on QOL,and this study will provide some reference information when the nurses take measures to intervene CRF and improve QOL of the colorectal cancer patients.

Objective To evaluate the therapeutic efficacy of transcather arterial chemoembolization for hepatic carcinoma and its influence on hepatic function. Methods Patients with HCC were divided into three groups according to repeated TACE times. The therapeutic efficacy was assessed with survival rate, car-cionma size and biologic response (AFP). Hepatic function was evaluated according to some hepatic param-eters(ALT,AST,ALB,DB,TB,PT). Results All three groups responses rates were 4.3%, 23.1% and 31.6% ;srespectively,liver function in group 1 and group 2 returned to its pretreatment level(P <0.05) ,but in group 3, liver function did not return to its pretreatment level associated with more repeated TACE times. The 1-,2-and 3-year survival rates of group 1 were 27.0%, 10.8%, 5.4% ; respectively, while those of group 2 were 57.1%, 33.3%, 19.0% ; respectively, which were not significantly different from those of Team 3 ,which was 62.5%, 37.5%, 18.8%, respectively. Conclusions (1) three to four repeated times TACE was an effective palliative treatment that prolongs survival of patients with HCC,while 1 to 2 re-peated times had a limited benefit; (2) Irreversible hepatic impairment induced by TAEC could affect its therapeutic efficacy.

Objective To analyze on the efficacy and toxicity of MAAE (MIT ,Ara-C,AMSA,VP16)regimens on treating refractory and relapsed acute leukemia in adult patients. Methods MAAE (MIT, Ara-C,AMSA, VP16) regimen, which consisted of MIT 10mg/d (d1～3), intravenousdrop, Ara-C 200mg/d (d1～7),intravenousdrop, AMSA 75 mg/d (d1～3), intravenousdrop VP16 100 mg/d(d1～4), intravenousdrop were used to treat 25 cases of adults with refractory and relapsed acute leukemia (AL). G-CSF 5 μg/kg were used every day when WBC＜0.5×109/L. Results In the 25 cases with refractory and relapsed acute leukemia, 14 cases (56 %) reached complete remission, 5 patients(20 %) reached partial remission, the total effective rate was 76 %. Conclusion MAAE regimen was a very effective alternative treatment for CR induction in adult patients with refractory and relapsed AL and low toxicity.

Objective To explore the effects of two-dimensional code on nursing instruments management.Methods Information regarding nursing instruments were edited and corresponding two-dimensional codes were generated which would be pasted on both the instruments and the registration book,and nurses were notified about the twodimensional codes.The effects of the application of two-dimensional code were assessed among 145 nurses using questionnaires,and 40 nurses were evaluated for theoretical and operational skills of the instrument.Results After applying two-dimensional code in management of nursing instruments,nurses' scores for utilizing,maintenance,addressing malfunction,storage and counting were higher than previous management method for instruments(P＜0.05),and the performance of theoretical and operational skills of 40 nurses were increased significantly(P＜0.05).Conclusion Two-dimensional code provides valuable benefits for information storage,instrument tracking,etc.,shows great convenience and efficiency to nursing instruments management,and helps to improve nurses' application skills of instruments.

AIM:To explore the clinical therapeutic effect and safety of cervical cancer treated with neoadjuvant chemotherapy with gemcitabine hydrochloride.METHODS:60 patients with cervical cancer were randomly divided into the intervention group(30 cases) and control group(30 cases).The intervention group were treated with neoadjuvant chemotherapy with gemcitabine hydrochloride and cisplatin,the control group were treated with mitomycin and cisplatin.The status of clinical symptoms,size of tumor,side effect of chemotherapy and postoperative pathological analysis were observed and compared.RESULTS:Comparing the re- sults of two groups of patients,the intervention group was significantly higher than control group(P

Objective To investigate the relationship between antipituitary antibodies (APAs) and hypopituiarism following traumatic brain injury (TBI),as well as the severity of brain injury.Methods The study included 73 patients who suffered TBI 9 to 12 months ago and were diagnosed with hypopituitarism during the follow-up.Based on their Glasgow Coma Scale (GCS) on admission they were categorized into three groups:A (3-8),B (9-12) and C (13-15).Levels of plasma pituitary hormones (GH,TT,FT3 and FSH/LH) and APAs were measured in all patients with chemiluminescence assays and ELISA,respectively.Results Patients in group A had higher levels of APAs and lower levels of hormones compared with those in group B(P＜0.001) or group C(P＜0.001),while no significant difference was found between group B and group C for levels of either APAs (P＞0.05) or hormones (P＞0.05).Levels of APAs were negatively correlated with both GH (r=-0.64071,P＜0.001) and GCS (r=-0.50132,P＜0.001).Conclusion The present investigation provides preliminary evidence that APAs may be associated with the development of TBI-induced hypopituiarism.It suggests that the severity of hypopituiarism following TBI could be predicted by measuring the level of APAs.

Objective To investigate the characteristics of pathogen distribution and drug resistance of pulmonary infection in hemorrhagic brain injury patients from neurosurgical intensive care unit (NICU).Methods Clinical data of 234 patients with hemorrhagic brain injury hospitalized in NICU from March 2013 to September 2014 were retrospectively analyzed.According to the incidence of pulmonary infection,the patients were divided into pulmonary infection group and non-pulmonary infection group.Parameters estimated were admission GCS,sex,age,history of smoking,time of coma,duration of mechanical ventilation,NICU length of stay.Patients in pulmonary infection group were analyzed on the distribution of pathogens and incidence of drug resistance.Results A total of 158 patients (67.5％) had pulmonary infection.Among them 60 cases (38.6％) were found to be co-infected including infection with two pathogens in 26 cases (16.5％),three pathogens in 19 cases (12.0％),and four and more pathogens in 16 cases (10.1％).Age and smoking increased the incidence of pulmonary infection (P ＜ 0.05).Time of coma,duration of mechanical ventilation,and NICU length of stay were prolonged in pulmonary infection group than in non-pulmonary infection group (P ＜ 0.05).A total of 219 strains of pathogens were isolated from the patients in pulmonary infection group.Specifically,there were 193 strains of gram negative bacteria (88.1％),13 strains of gram positive bacteria (5.9％),and 13 strains of fungi (5.9％).Gram negative were sensitive to amikacin,imipenem,cefoperazone/ sulbactam and ciprofloxacin.Staphylococcus aureus isolated were 100％ sensitive to vancomycin,linezolid and teicoplanin,and were completely penicillin resistant.Fungi were not resistant to voriconazole,itraconazole,ketoconazole,fluconazol,and amphotericin B.Conclusions High incidence of pulmonary infection is noted among the hemorrhagic brain injury patients in NICU,and the pathogens are diverse dominated by Gram negative bacteria.Incidence of multi-drug resistant pulmonary infection is high,indicating that the key point is to choose antibiotics rationally based on drug sensitivity test.