Objective: To discuss the essential aspects of per operation period nursing intervention in tooth extraction under electrocardiogram monitoring for the elderly patients, so as to improve the success rate of surgery. Methods:According to the physiology and psychology characteristics of the elderly patients, psychological intervention and correct cooperation were provided by nurse along with the electrocardiogram monitoring during the whole process. Results:Seven hundred and nineteen cases of elderly patients went through a smooth operation of tooth extraction under electrocardiogram monitoring. Conclusion: It is highly important that we combine professional medical team with tacit cooperation, appropriate psychological intervention as well as good management system to succeed in tooth extraction under electrocardiogram monitoring.

OBJECTIVE To review and analyze the change in the MICs of vancomycin,teicoplanin and linezolid in meticillin-resistant Staphylococcus aureus(MRSA) strains isolated in our hospital from 2003 to 2007. METHODS The MICs of vancomycin,teicoplanin and linezolid were tested by Etest method on a sample of randomly selected MRSA strains. RESULTS The incidences of MRSA increased from 52.2% in 2003 to 74.5% in 2007.MIC of vancomycin increased from 1.85 ?g/ml in 2003 to 2.15 ?g/ml in 2007,and teicoplanin MIC geometric mean increased even more markedly from 1.28 ?g/ml in 2003 to 2.07 ?g/ml in 2007.The linezolid MIC remained almost unchanged. CONCLUSIONS The incidences of MRSA were increasing from 2003 to 2007.There is a upward trend in MIC of glycopeptide over the years,in which the increase for teicoplanin is higher than others two.

OBJECTIVE To investigate the changes in pathogenic bacteria and drug resistance in nosocomial(septicemia).METHODS The blood samples of inpatients were cultured with blood culture apparatus,VITEK-AMS were used to identify the pathogenic bacteria and conduct drug resistance test.RESULTS The proportion of(Gram-positive) cocci had been increasing,coagulase negative staphylococcus increased significantly,but the(proportion) of Staphylococcus aureus decreased significantly.The proportion of Gram-negative bacteria and fungi decreased too.Vancomycin and imipenem were the highest susceptible to Gram-positive and Gram-negative(bacteria),respectively.CONCLUSIONS Gram-negative bacteria are the major pathogens in nosocomial septicemia.But Gram-positive cocci had been increasing in the past years.Coagulase negative staphylococcus is the main pathogen in nosocomial septicemia.pathogenic bacteria are higher resistant to the commonly used antibiotics.

OBJECTIVE To investigate characters of molecular epidemiology of meticillin-resistant Staphylococcus aureus(MRSA) outbreak strains in an emergency intensive care unit(EICU),to follow-up the possible sources,understand transmission for infection,and determine preventive strategies.METHODS Pulsed-field gel electrophoresis(PFGE) was used to analyze the homology of MRSA strains,isolated from clinical patients′ infection sites and environment,and carried by patients and healthcare workers in EICU of our hospital in December,2004.RESULTS Six of 17 patients were infected by MRSA,and 7 strains were isolated((including) 2 strains from different sites of the same patient).Surveillance cultures of ward′s environments,(patients)′ nares and healthcare workers′ nares and hands were performed in the outbreak period.Five MRSA strains were isolated,including a strain from nares of a patient,a strain from a table-board of a procedure room,a strain from hand of a nurse,a strain from a bed bar,and a strain from ward′s air.PFGE typing of the 12 MRSA strains showed that all 7 strains isolated from patients′ infection sites and two strains from nares of a patient and hand of a nurse were of type A.Strains from a procedure room,bed bar and air were of types B,C and D,respectively.CONCLUSIONS MRSA′s source and its transmission route are elucidated by genotyping.MRSA appears to come from a patient′s nares and has been transferred in ward by hand of healthcare workers.

By using the image processing function and programming tomography,the following functions are realized: the contour line,edge line and gradation histogram of medical images are displayed;the selected regions of medical images are freely zoomed;the gray level of discretional regions is displayed using medical image processing tool and the distance of the given points is freely measured.

BACKGROUND: Neonatal hypoxic ischemic encephalopahty(NHIE) is a common neonatal disease, which could cause cerebral palsy, inferior intelligence and convulsion. At present, usual examinations for this disease are CT.MRI and single photon emission computed tomography(SPECT), etc.OBJECTIVE: To investigate the character of SPECT image of NHIE, and compared with CT and MRI as well to provide a theoretical gist for function surveillance and early intervention of NHIE.DESIGN: An observatory comparative study based on NHIE patients and normal neouates as control.SETTING: Department of nuclear medicine in a medical university hospital.PARTICIPANTS: Thirty neonates hospitalized in the Department of Pediatrics, Affiliated Hospital of Jining Medical College between September 1998 and October 2000 were selected as observation group with 23 males and 7 females. Another 10 normal neonates including 7 males and 3 females were randomly selected from same period into control group.METHODS: SPECT brain blood perfusion was conducted in the subjects of two groups and the results were compared with that of CT and MRI.MAIN OUTCOME MEASURES: ① comparison of SPECT brain blood image features between NHIE and normal neonates; ② comparison of SPECT images and CT, MRI results. RESULTS: In 22 NHIE cases who received SPECT, CT and MRI simultaneously, mild group had 7 cases, and positive cases of SPECT, CT or MRI was 7, 3 or 5; moderate group had 10 cases, and positive cases of three methods was 10, 8 or 9; severe group had 5 cases, the all of them were positive in all three examinations. The total positive detectable rate of SPECT, CT or MRI was 100, 72.73% or 86. 36%. There was no significant difference of sensitivity between SPECT and MRI in mild group, while there was significant difference between SPECT and CT(x2 = 3.95, P ＜ 0.05);there was no significant difference among three methods in either moderate group or severe group(x2 =0. 83, P ＞ 0.05).CONCLUSION: SPECT brain blood perfusion image is a quite sensitive method for the surveillance of NHIE, which can provide imageological reference for the evaluation of its prognosis and early intervention.

Objective To investigate jugular vein morphological changes with three dimension phase contrast magnetic resonance venography(3D PC MRV),and to explore hemodynamic features using MR phase contrast cine (MR PC cine).Methods Sixty-five healthy volunteers performed 3D PC MRV and MR PC-cine sannings.MRV ranged from torcular herophili to brachiocephalic veins, and the raw data of PC-cine was acquired at cervical 2-3(C2-C3)level perpendicular to the Jugular veins(JVs)with the maximum encoding velocity of 50 cm/sec.Jugular vein showing absent or tip shape(cross-sectional area less than 12.5 mm2 )was considered abnormal,and flat,crescent,oval,round shapes were considered normal.Data of PC-cine was processed by computer to evaluate the hemodynamic features.Results Nine (13.85%)of 65 cases were abnormal that unilateral jugular vein showing needle-pointed narrow or absent,and 8 cases on the left,and one case on the right;Weak correlation was found between jugular veins pattern and the age.The right sided values in volunteers were higher than that of the left side.Conclusion The morphology and hemodynamics of jugular veins in volunteers showed significant difference between sides,and weak correlation is found between the morphology and aging.

Objective To investigate the clinical outcome of correction of unilateral delayed orbitozygomatic complex fractures with digital guide plates.Methods The study involved 14 cases of unilateral delayed orbitozygomatic complex fractures treated between September 2007 and March 2012.Craniofacial structures were measured by thin-section CT before operation,followed by data input to the image processing software.Before and after the processing of images,three dimensional skull models were produced using rapid prototyping technique and applied to have surgical simulation.Digital guild plates were produced for guiding the reduction of fractures and orbital walls were reconstructed as well.Results All cases were followed up for a period of 6-11 months,which showed basic restoration of facial structure and significant correction of diplopia and enophthalmos,with no infection or dislocation of implants buried in orbit floor.Mild ectropion of the lower eyelid occurred in one case and temporary decrease of frontal wrinkle in two cases,but all recovered in 3-6 months postoperatively.Conclusion Digital guide plate is easy in operation and reliable for treatment of unilateral delayed orbitozygomatic complex fractures.

Objective To investigate mupiroein resistance in Staphylococcus aureus (SAU) and the resistance to commonly used antibiotics in mupirocin-resistant strains. Methods Four hundred and ninety clinically isolated SAU strains froin January 2005 to May 2007 in the First Affiliated Hospital,Wenzhou Medical College were screened by mupirocin(5μg)disc diffusion method.Minimum inhibition concentration(MIC)and the amplification of mupA gene were performed to determine the resistance to mupirocin.Resistance to cefoxitin,gentamycin, levofloxacin, trimethoprim/sulfamethoxazole, rifampin, erythromycin, clindamycin, tetracycline and vancomycin in mupirocin-resistant strains was detected by disc diffusion method, and the amplification of mecA gene was performed to confirm the methieillin resistance among mupiroein-resistant strains.Results Twenty-seven mupirocin-resistant strains were obtained,in which 22(81.5%)were hish-level mupirocin resistant(MuH)and the rest were low-level mupirocin resistant(MuL).Among 27 mupirocin-resistant strains,24 were methicillin-resistant Staphylococcus aureus (MRSA)in which 21 were MuH and 3 were MuL strains.Drug sensitivity tests showed that the resistance to gentamycin,levofloxacin,trimethoprim/sulfamethoxazole,rifampin,erythromycin,elindamycin and tetracycline were hish among MuH and MuL strains,and most of these strains were multi-drug resistant.All strains were susceptible to vaneomycin.Conclusions Most of the clinical emerged mupirocin-resistant SAU strains are MuH and show hish resistance to commonly used antibiotics.Therefore,detection and drug sensitivity test of mupirocin-resistant strains should be strengthened in clinic practice in order to prevent it from dissemination.

OBJECTIVE To investigate the production of metallo-beta-lactamase in clinical isolates of multi-resistant Pseudomonas aeruginosa and evaluate the validity of the detection methods.METHODS The multi-resistant strains were selected by K-B method according to the standard Aloush et al recommended.The metallo-beta-lactamase phenotypes were detected by multi-disk-multi-inhibitors synergy test(MDMIST),and the genotypes of IMP and VIM gene were analyzed by PCR amplification.RESULTS A total of 192 strains of multi-resistant P.aeruginosa were selected from 1081 clinical strains.The antimicrobial agents test in these multi-resistance strains demonstrated that ciprofloxacin and piperacillin had the highest resistant rate(92.5%),and the next were aztreonam and trimethoprim-sulfamethoxazole(91.5%),the polymyxin showed sensitive in all of these strains.Sixty-seven strains of metallo-beta-lactamase phenotypes were positive and the amplification PCRs showed that 65 strains were IMP or VIM in these 192 multi-resistant strains.CONCLUSIONS The resistance mechanisms in multi-resistant P.aerugionsa present multiple and changeable.The clinical laboratory should enhance the detection of metallo-beta-lactamase in these multi-resistant strains.