[Summary] This article reviewed the clinical features in two diabetes cases complicated with nasal‐brain mucormycosis by pathology and pulmonary mucormycosis. In one patient with diabetes combined with pulmonary mucormycosis ,manifestations of chest pain and hemoptysis ,the right upper lung biopsy tip morphology was consistent with Mucor ,successfully cured with amphotericin and operation treatment. The other patient with diabetes‐complicated nasal mucormycosis with headache and nasal cavity clump , showed black caseous matter ,finally hemiplegia. A nasal cavity tumor was proved by pathological examination. After treatment with fluconazole and operation ,the patientdied. Mucormycosisis rare and may be secondary to diabetes and hypoimmunity disease. It needs rapid diagnosis and treatment.

The evaluation indexes are selected from the aspects of hospital behavior and user behavior based on the relevant theories on influence and the transmission characteristics of Wechat,with the data so acquired processed with the principal component analysis.In the end,the expression of evaluation was applied to the evaluation and analysis of the influence of the hospital Wechat.

rabbits were divided randomly into control group ( n =8),pseudo operation group ( n =8) and chitin group ( n =8) with the rabbit iliac artery restenotic models The chitin tubes were localized on the adventitia of restenotic iliac arteries in chitin group but not in pseudo operation group The determinations for the area of neointima,neointima/media area ratio,neointima/media thickness ratio and 3 H TdR incoperation demenstrate that chitin can inhibit intimal proliferation of restenotic iliac artery This findings suggest that local adventitial chitin administration may be effective for the prevention of restenosis

Objective To investigate the drug resistance situation and clinical distribution of multi‐drug resistance Acinetobacter baumannii(MDRAB) ,in order to provide references for clinical treatment and prevention of MDRAB infection .Methods The de‐partments ,types of specimens ,time of infection ,gender and age of patients with Acinetobacter baumannii(AB)infection from Janu‐ary to December 2014 were retrospectively analysed ,and drug resistance rates of MDRAB were analysed as well .Results A total of 123 strains of MDRAB were isolated ,which accounted for 44 .73% of all strains of AB .The antibacterial resistance rates were over 90% for MDRAB against 12 out of 15 common antibacterial agents ,while the antibacterial resistance rate for MDRAB against mi‐nocycline was relatively low(19 .23% ) .Distribution of AB and MDRAB infection concentrated to certain departments ,which shown that intensive care unit(ICU) ,departments of respiratory medicine and neurosurgery were the major departments of infection .The strains of AB and MDRAB isolated from sputum specimens accounted for 84 .00% and 93 .50% respectively .There was no signifi‐cant differences of MDRAB infection among 12 Months in 2014 .There was no statistically significant differences in constituent ratio of MDRAB infection and non‐MDRAB infection between patients in different gender and between patients in different age groups . Conclusion MDRAB strains are seriously resistant to commonly used antibacterial agents ,while minocycline could still be a signifi‐cant antibacterial agent for clinical treatment of MDRAB infection .Strengthening infection management in ICU and departments of respiratory medicine and neurosurgery ,and infection management of respiratory tract and wound could have significance for reduc‐ing the risk of MDRAB infection .

Objective To summarize imaging appearances of brain in AIDS patients,as to supply the evidences of imaging diagnosis for this disease . Methods CT or/and MRI appearances of brain in 19 patients with AIDS of nervous system type were reviewed . Results 3 cases showed the symmetry signal abnormal in bilateral whiter matter and 2 cases showed brain atrophy in 5 patients with HIV encephalitis.2 cases of toxoplasma encephalitis appeared multiple abnormal density or/and signal intensity in the brain and multiple ring enhancement . 3 patients with lymphoma displayed single or multiple nodule in the brain and nodular-enhancement or inhomogenous enhancement.3 patients with brain infarction displayed lower density in the basal ganglia on CT.2 patients with progressive multifocal leukoencephalopathy displaied multiple patch abnormal signal intensity of the white matter in frontal and parietal lobus.1 patient with cryptococcal infection showed abnormal signal and ring enhancement of the pons.1 patient with cryptococcal meningitis and 2 patients with intracranial hypertension had not abnormal imaging appearances.Conclusion Most lesions of the brain in AIDS patient may be detected by CT and MRI,but the definite diagnosis is still in need of combining with clinical appearances and other relative examination.

AIM:To establish an HPLC method for determining cinnamaldehyde,costunolide and dehydrocostuslactone in the supercritical carbon dioxide extraction of Cinnamomum cassia and Aucklandia lapp.METHODS:The assay was performed on an Agilent HC-C_(18)(150 mm×4.6 mm,5 μm)column by UV detector at the wavelength of 210 nm with acetonitrile-water(gradient elutio)as the mobile phase at the flow rate of 1.0 mL/min,and the column temperature was 30℃.RESULTS:There were good relationships between peak area and sample size of cinnamaldehyde in the range of 148.5-1 732.5 ng,between peak area and sample size of costunolide in the range of 69.42-809.9 ng,and between peak area and sample size of dehydrocostuslactone in the range of 70.32 to 820.4 ng.Average recoveries of them were in turn 99.65%(RSD 0.72%)-99.57%(RSD 1.28%),and 98.90%(RSD 0.81%),respectively.CONCLUSION:The present method is convenient,sensitive and accurate with good reproducibility and can be used for the quality control of the supercritical CO_2 extract of Cinnamomum cassia and Aucklandia lapp.

Objective To evaluate risk factors for multidrug-resistant Acinetobacter baumannii (MDRAB)infec-tion,so as to provide reference for making preventive and control measures of MDRAB infection.Methods Clinical data of patients with Acinetobacter baumannii (A.baumannii )infection in a hospital between April 2011 and Sep-tember 2012 were surveyed,distribution and specimen sources of A.baumannii and MDRAB were analyzed,and risk factors of MDRAB were assessed.Results Of 236 isolates of A.baumannii,74 (31.36%)were MDRAB .The isolation rate of MDRAB in intensive care unit and neurosurgery department was up to 60.00%(27/45)and 58.06%(18/31)respectively;MDRAB were mainly isolated from wound (45.45%),respiratory tract (34.27%),and urinary tract (17.65%).Univariate analysis revealed that difference in length of hospital stay,use of serum albumin,fiberbronchoscopy, coma days,tracheotomy,use of ventilator,incisional drainage,urinary catheterization,use of carbapenems,and antimicro-bial days in different groups were statistically different (P <0.05).Multivariate logistic regression analysis revealed that tracheotomy(OR95%CI :1.152-7.187),use of ventilator(OR95%CI :1.263 -7.664)were independent risk factors for MDRAB infection.Conclusion Tracheotomy and use of ventilator play an important role in the producing and sprea-ding of MDRAB ,management on drug-resistant bacteria is important in reducing MDRAB infection.

Objective To explore the continuous improvement to reduce the suctioning pediatrics lumen instruments return-cleaning rate of the first time washing, improve work efficiency and reduce the cost by applying root cause analysis. Methods Using causal analysis of fishbone diagram to analysis and verify the main reason of leading to high lumen instruments return-cleaning rate. According to the three terminal factors of continuous quality improvement, quality control group was set up, lumen instruments cleaning quality control standards was made, water flow mode of lumen instruments cleaning was changed, selected the appropriate cleaning tools and real picture show, synchronize quality control measures of publishing the quality and safety board. Compared before and after return-cleaning rate of three different detection methods and the different parts of the same suction lumen instruments. Results Before carrying out eye-measurement, cotton swab to wipe, ATP bioluminescence back washing rate was 0.89% (2/225), 7.11%(16/225), 27.11%(61/225), respectively after implementation of 0, 0.44%(1/226), 3.98%(9/226), visual observation before and after the return rate of washing was no statistically significant difference (χ2=2.018, P>0.05);Cotton swab to wipe, ATP bioluminescence back washing rate difference was statistically significant (χ2=13.820, 45.999, P<0.01). The lumen instruments total return-washing rate was decreased from 35.11% (79/225) to 4.42% (10/226). Among them, the return- washing rate of the inside surface of lumen instruments was decreased from 32.89% (74/225) to the 3.10% (7/226) and the difference was statistically significant(χ2=67.028, 67.915,P<0.01). By contraries, the thread interface and the outside surface of lumen instruments return- cleaning rate before and after the implementation has no statistical significance (P>0.05). Conclusions ATP bioluminescence assay has fine effects to detect the return-washing rate of the inner wall of the lumen instruments. The Root Cause Analysis method significantly reduced the return-washing rate of the inside surface of the suction lumen instruments, improve the efficiency, save the medical cost and reduce the hospital infection.

Objective:To explore the influence of mindfulness meditation intervention on the professional identity and turnover tendency of the second victim of nurses.Methods:The convenience sampling method was used to select the second victim of 46 nurses who experienced medical adverse events within six months from January to June 2019 in Zhongnan Hospital of Wuhan University, and then an 8 weeks of mindfulness meditation intervention was carried out for them. In the entire intervention process, a self-control study was conducted, the Second Victim Experience and Support Scale (SVSET) and the Nurse Occupational Identity Scale were used to assess nurses' turnover intentions, absence and professional identity before the intervention and at 2 hours, 4 weeks, and 8 weeks after the intervention.Results:By analyzing the data, the results showed that after the mindfulness meditation intervention, the second victim of the nurse before intervention, 2h, 4 weeks, and 8 weeks of intervention were 3.28±0.87, 3.20±0.83, 2.85±0.92, 2.71±0.87, the difference was statistically significant ( F time value was 6.609, P<0.05). Before and after the intervention of the sense of grasp in professional identity were 4.91±0.83, 5.47±0.81, 5.83±0.91, 5.94±0.80, the difference was statistically significant ( F time value was 20.973, P<0.01). Consensus before and after intervention were 4.61±0.78, 5.09±0.85, 5.54±1.12, 5.76±0.85, the difference was statistically significant ( F time value was 22.237, P<0.01). The meaningful sense before and after intervention were 4.38±1.03, 5.04±0.75, 5.44±0.86, 5.59±0.76, the difference was statistically significant ( F time value was 23.656, P<0.01). The self-efficacy before and after intervention were 4.71±0.82, 5.33±0.63, 5.83±0.84, 5.90±0.77, the difference was statistically significant ( F time value was 28.866, P<0.01). The self-determination before and after intervention were 4.43±0.97, 5.06±0.81, 5.59±0.91, 5.62±0.87, the difference was statistically significant ( F time value was 25.237, P<0.01). Before and after intervention, the influence of tissue was 4.17±0.96, 4.71±0.85, 4.96±0.99, 5.30±0.88, the difference was statistically significant ( F time value was 16.487, P<0.01). Before and after intervention, the patients' feelings were 4.59±0.96, 5.08±0.84, 5.70±0.83, 5.83±0.68, the difference was statistically significant ( F time value was 25.406, P<0.01). Conclusion:This article provides an effective method to help nurses' second victims out of their predicament which confirms that mindfulness meditation intervention can effectively reduce turnover tendency of nurses 'second victims and improve their professional identity.