This article briefly introduces how to rationally use antibiotics in patients with strokeassociated pneumonia from the aspects of etiology,disease,and antibiotic use.A great importance should be attached early to the standard pathologic examination,and the initial empiric treatment should be timely and adequate.The complex preparation of broad-spectrum penicillin/β-lactamase inhibitor is generally recommended,on this basis,the etiological examination results should be sought actively.Selecting the highly targeted or sensitive antibiotics improve the efficacy and reduce adverse reactions.

Objective To establish a management information system for bacteria ( virus ) preservation in order to improve the management efficiency and quality of bacteria ( virus) preservation organizations to the largest possible extent . Methods Client/Server(C/S) structure was adopted to design the system with Visual Basic 6.0 and SQL Server2000 as the platform of development .A bacteria ( virus) information database was established with the E-R model and 3NF.The system was developed by face to object language program .Results Devices needed were supplied .Functional modules of bacteria ( virus ) information management , scientific research project management , user management and system maintenance were constructed .Visiting permission was installed on the platform and database to maximize the protection of bacteria ( virus ) information safety .Conclusion Bacteria ( virus ) information flow management , involving storage , classification, preservation, collection and record, is achieved.All the resources of the preservation organization are integrated.Bacteria (virus) management efficiency is increased and bacteria (virus) information safety is ensured.

In order to learn the tissuse perfusion and oxygenization in the patient with septic shock (SS) in Qinghai plateau,25 cases having suffered from SS in Xining,the capital of Qinghai province, were divided into death group (group D) and survival group(group S), and the data of oxygen dynamics, determined by Swan-Ganz cathter and thermodilution methods,were analyzed retrospectively. The results showed that the oxygen delivery (DO_2) and oxygen consumption (VO_2) increased to varying degrees in all of cases;VO_2 was positively correlated with DO_2, and in group D the correlation remained significant during whole duration of disease,but in group S it became unsignificant as DO_2 was above 700 ml?min~(-1)?m~(-2); the oxygen extraction rate decreased markedly in both groups,but much more in group D. These suggest that the insufficient oxygenization of general tissuse in patient with SS results from the dysfunction of oxygen extraction,and increasing DO_2 is helpful for the shock resuscitation except VO_2 is persistently and positively correlatded with DO_2.

Objective To study the effects of IFN-?on expression of B7 molecules in human lung adenocarcinoma cell line cultured in vitro.Methods Human lung adenocarcinoma SPC-A-1 cells were incubated in the medium with IFN-?respectively.Cell proliferation effect was measured by MTT assay;apoptosis was detected with flow cytometry assay;expression of B7-1 and B7-2 mRNA was determined by RT-PCR.Results Compared with those of control group,MTT shows that IFN-?could reduce the SPC-A-1 cell proliferation.FCM shows the apoptosis rate in the IFN-? group was significantly higher,but there is no different changes in each concentration group.Compared with the control group,expression of B7-1 and B7-2 significantly increased in the IFN-?group,and the expression was not correlated with the concentration of IFN-?in each control group.Conclusion IFN-?can inhibit cell proliferation and induce apoptosis in SPC-A-1 cell line.IFN-?markedly enhance the expression of B7-1 and B7-2 in SPC-A-1 line.The apoptosis may be mediated by up-expression of gene B7-1 and B7-2.

AIM: To elucidate the change in TFF3 mRNA in the lung tissue in chronic obstructive pulmonary disease (COPD) rats. METHODS: A model of rat COPD was established by passive cigarette smoking and intratracheal instillation of lipopolysaccharide. The expression of TFF3 mRNA in the lung tissues was detected by reverse transcription-polymerase chain reaction (RT-PCR). RESULTS: Through a semi-quantitative pathological analysis, mean lung internal lining interval (MLI) in COPD model group was significantly increased compared with healthy control groups; mean alveolar number (MAN) in COPD model group was significantly decreased compared with healthy control group. The expression of TFF3 mRNA decreased significantly in the lung tissue in COPD model group compared with healthy control group. CONCLUSION: The level of TFF3 mRNA expression is possibly related with lung tissue lesion in COPD rats. [

Objective:To investigate the therapeutic effect of different prone position ventilation (PPV) on patients with severe acute respiratory distress syndrome (ARDS) at high altitude.Methods:The severe ARDS patients who met the Berlin standard admitted to the department of intensive care unit (ICU) of Qinghai Provincial People's Hospital from January 2017 to January 2020 were enrolled. The patients with classic PPV treatment (i.e. alternate prone supine position, about 16 hours per day) were included in the discontinuous PPV group; the patients with modified PPV treatment (i.e. alternate left and right prone positions 20°-30°, every 4 hours and continuous treatment for 24 hours per day) were included in the continuous PPV group. The oxygenation index (PaO 2/FiO 2), mechanics of breathing, ventilator parameters before treatment and 72 hours after treatment, and mechanical ventilation time, the length of ICU stay, and related complications between the two groups were analyzed. Results:Eighteen cases were treated with continuous PPV and 20 cases were treated with discontinuous PPV. There were no significant differences in gender, age, acute physiology and chronic health evaluation Ⅱ (APACHEⅡ), PaO 2/FiO 2, lung compliance, driving pressure (ΔP) and positive end expiratory pressure (PEEP) before treatment between the two groups. Compared with before treatment, PaO 2/FiO 2 in discontinuous PPV group and continuous PPV group was increased significantly after 72-hour treatment [mmHg (1 mmHg = 0.133 kPa): 99.7±15.4 vs. 55.5±6.3, 121.8±25.3 vs. 55.1±7.1, both P < 0.05], lung compliance was improved significantly (mL/cmH 2O: 36.8±2.4 vs. 28.0±2.0, 43.4±6.7 vs. 27.7±2.1, both P < 0.05), and ΔP was decreased significantly [cmH 2O (1 cmH 2O = 0.098 kPa): 10.5 (10.0, 12.0) vs. 13.0 (12.3, 14.0), 10.0 (8.0, 12.0) vs. 13.0 (12.0, 14.0), both P < 0.05], PEEP was also decreased [cmH 2O: 12 (12, 14) vs. 14 (13, 14), 10 (8, 10) vs. 14 (12, 15), both P < 0.05], and the indexes in continuous PPV group were improved more significantly than those in discontinuous PPV group [PaO 2/FiO 2 (mmHg): 121.8±25.3 vs. 99.7±15.4, lung compliance (mL/cmH 2O): 43.4±6.7 vs. 36.8±2.4, ΔP (cmH 2O): 10.0 (8.0, 12.0) vs. 10.5 (10.0, 12.0), PEEP (cmH 2O): 10 (8, 10) vs. 12 (12, 14), all P < 0.05]. The duration of mechanical ventilation and the length of ICU stay in the continuous PPV group were significantly shorter than those in the intermittent PPV group [days: 6.0 (5.0, 7.3) vs. 8.0 (7.0, 9.0), 9.7±1.5 vs. 12.1±2.2, both P < 0.01]. During the PPV treatment, there were 3 cases of cheek skin damage and 2 cases of ear skin damage in the continuous PPV group, and 3 cases of facial skin damage in the intermittent PPV group. There was no significant difference in the incidence of complications between the two groups ( χ2 = 0.321, P = 0.571). All patients were repaired normally after PPV, without adverse consequences. Conclusion:Continuous PPV is more effective than discontinuous PPV in the treatment of severe ARDS patients at high altitude, and the related complications are did not increased in prolonged time of PPV.

As a weapon of mass destruction ,the biological weapon , composed of biological warfare agents and their re-lease devices,is characterized by strong pathogenicity , large pollution areas, various routes of infection, low cost, user-friendliness and a large number of impact factors .Although the United Nations has banned the use of biological weapons , there are still some countries and regions that continue biological weapon researches .In addition, illegal use of biological warfare agents in the field of terrorism and non-military arena poses a serious threat to public safety .Early detection of bio-logical warfare agent use and determination of its type are crucial to biological weapon defense and epidemic control .There-fore, to enhance researches on rapid detection and early warning of biological warfare agents is of great significance .This paper reviews the main technologies currently applied to the field of biological warfare agent detection and their progress .

Purpose: The influence of fasting blood glucose (FBG) and cholesterolemia primary liver cancer (PLC) in china was analyzed via a large prospective cohort study based on a community population, and the combined effects between them were investigated. Materials and Methods: Overall, 98,936 staff from the Kailuan Group who participated in and finished physical examinations between 2006 and 2007 were included in the cohort study. Their medical information was collected and they were followed up after examination. The correlations of serum FBG or TC with PLC were analyzed. Then, we categorized all staff into four groups: normal FBG/ non-hypocholesterolemia, normal FBG/hypocholesterolemia, elevated FBGon-hypocholesterolemia, elevated FBG/hypocholesterolemia and normal FBG/ non-hypocholesterolemia was used as a control group. The combined effects of elevated FBG and hypocholesterolemia with PLC were analyzed using the Age-scale Cox proportional hazard regression model. Results: During 1,134,843.68 person*years follow up, a total of 388 PLC cases occured. We found the elevated FBG and hypocholesterolemia increases the risk for PLC, respectively. Compared with the non-hypocholesterolemiaormal FBG group, the risk of PLC was significantly increased in the non-hypocholesterolemia/elevated FBG group (HR=1.19,95%CI 0.88–1.62) and hypocholesterolemiaormal FBG group (HR=1.53,95%CI 1.19–1.97), and in the hypocholesterolemia/elevated FBG group (HR=3.16 95%CI2.13-4.69). And, a significant interaction effect was found of FBG and TC on PLC. All results were independent from the influence of liver disease. Conclusion Elevated serum FBG and hypocholesterolemia are risk factors for PLC, especially when combined. Thus, for the prevention and treatment of PLC, serum FBG and TC levels should be investigated.

Objective:To analyze the classification characteristics of nurses ′ perception of management care in tertiary Class A hospital in Tianjin and the differences in demographic characteristics among different categories, and provide reference for care managers to provide targeted care intervention. Methods:Totally 456 nurses from 6 tertiary Class A hospitals in Tianjin were selected by convenience sampling way from May to July 2020, and carried out surveys through the online questionnaire star platform. The content included general subject and the Chinese version of Caring Assessment Tool-administration Scale.Results:According to nurse management care perception totally 456 nurses were divided into 4 Latent groups: low decision-making respect and low care group (C1) 20.5% (94/456), moderate decision-making respect and high care group (C2) 35.6% (162/456), high decision-making respect and low care group (C3) 18.9% (85/456), high decision-making respect and high-care group (C4) 25.0% (115/456). Single factor analysis showed that there were statistically significant differences in the distribution difference of different categories of nurses in departments, working years, department atmosphere and family support ( χ2 values were 19.119-55.947, P<0.01). Multiple Logistic regression analysis showed that departments, working years, department atmosphere had an effect on the level of nurses management, care and perception ( P<0.05 or 0.01). Specifically, nurses in the internal medicine, obstetrics and gynecology and intensive care unit were more close to C2 group ( OR values were 2.435, 5.224, 22.291, P<0.05 or 0.01); nurses in the surgery were more close to C4 group ( OR values were 4.146, P<0.01); nurses with seniority of≤5 years were more close to C1 and C2 groups ( OR values were 0.326, 3.811, P<0.05 or 0.01); nurses with ordinary atmosphere were more close to C1 group ( OR value was 0.057, P<0.01). Conclusions:Nurses ′perception of management care is in the upper middle level, which can be divided into four potential categories. Nurses who are in the surgical department with high seniority or harmonious atmosphere or supportive families have good perception of management care; nurses who are in the department of internal medicine, obstetrics and gynecology, intensive care unit or a department with ordinary atmosphere or low seniority have an average level of management, care and perception, which need to be improved. Care managers could formulate targeted care management measures according to the characteristics of different categories of nurses.

Purpose: From the perspective of positive psychology, our study aimed to explore depressive symptomsand psychological well-being among Chinese nurses, as well as analyze the impacts of characterstrengths, self-efficacy and social support on the mental health of nurses. Methods: A cross-sectional and descriptive design using five self-reported questionnaires was used toinvestigate a cohort of 4238 nurses during 2018. A structural equation modeling analysis was used toverify a hypothetical model linking character strengths, self-efficacy, social support, depressive symptoms,and psychological well-being. Results: The prevalence of depression among this cohort of Chinese nurses was 58.1%. The mean scoresfor caring, inquisitiveness, and self-control were 19.93 (SD = 2.82), 15.94 (SD = 3.00), and 16.34(SD = 2.95), respectively. The hypothesized model was a good fit of the data (x2/df = 1.77, p = .183, rootmean square error of approximation = 0.04, goodness of fit index = 1.00, comparative fit index = 1.00,TuckereLewis index = 1.00). Except for the path from self-control to depression, the other hypotheticalpaths investigated were statistically significant. Conclusion Character strengths were directly and positively associated with psychological well-being.Inquisitiveness was the strongest direct protective factor for depression. In addition, characterstrengths indirectly alleviated depression and increased psychological well-being through mediatingvariables of social support and self-efficacy. This study should alert nurse managers that more attentionshould be paid to the character strengths and mental health of nurses. This study provides evidence forinterventions based on character strengths as a management strategy to support the mental health ofnurses.