To perfect the medical ethics archives,we should stress the filling system of medical ethics evaluation,the detailed check and registration of medical staff's medical ethics condition.It could form the right think leading and normative professional criterion of medical staff,developing their work potential and decrease the conflict between doctors and patients.The main purpose and significance to establish and perfect the medical ethics archives is that it could bring the guidance,self-discipline,awards and punishments and regulation role in the medical ethics construction.

Objective To investigate the clinical efficacy and safety of alteplase thrombolysis in the treatment of patients with acute ischemic stroke.Methods 42 patients with acute ischemic stroke were randomly divided into the control group and the study group.1 8 cases in the control group were treated by urokinase thrombolysis, and 24 cases in the study group were treated by alteplase thrombolysis.The clinical efficacy and safety were compared between the two groups.Results The total effective rate of the study group(91 .7%)was higher than that of the con-trol group(77.8%),and the difference was statistically significant(χ2 =9.7,P <0.01 ).Compared with the control group,the total vascular patency rate was higher,the difference was statistically significant(χ2 =97.6,P <0.01 ).The NIHSS score was lower in the two groups after treatment(t =1 0.1 58,1 5.962,all P <0.05),and that in the study group was more lower,the difference between the two groups was statistically significant(t =1 0.564,P <0.05 ). Conclusion Alteplase thrombolysis in the treatment of acute ischemic stroke patients,thrombolytic therapy for patients,in the use of drugs within the time window patients can get good clinical curative effect,no more than drug use the most extensive restrictions rarely cause patients with intracranial hemorrhage,and being suitable for populari-zation and application.

OBJECTIVE To investigate the antibiotic resistant phenotyping of Acinetobacter spp on NC21 panel. METHODS A total of 275 strains were isolated from clinical specimens.Acinetobacter were identified and antimicrobial susceptibility test performed.Phenotyping was according to David Livermore.Resistance phenotyping analysis included 13 antibiotics. RESULTS The susceptible results of 13 antimicrobial agents in 275 strains of Acinetobacter spp showed imipenem,amikacin,ampicillin-sulbactam,ciprofloxacin,tobramycin,ceftazidime,cefepime,gentamicin and trimethoprim had the greatest susceptibility(97.8%,88.4%,86.6%,82.2%,81.9%,9.6%,76.8%,73.8% and 73.6%,respectively).Beta-lactam agent-resistant phenotypes Ⅰto Ⅴ(wild type,penicillinase,cephalosporinase,penicillinase+cephalosporinase,multi-drug resistance mechanism) and nontyping were 67.3%,1.8%,1.8%,19.6%,0.7% and 8.8%,respectively.74.2% of 275 strains were susceptible to gentamicin,amikacin and tobramycin.Aminoglycosides resistant phenotype(gentamicin-resistant,gentamicin-amikacin-resistant,gentamicin-amikacin-tobramycin-resistant) and nontyping were 7.3%,1.1%,10.9% and 6.5%,respectively.8.7% were the penicillinase-cephalosporinase and gentamicin-amikacin-tobramycin-resistant phenotyps,those strains were all susceptible to imipenem and half to ampicillin-sulbactam. CONCLUSIONS Resistance phenotyping system should be useful in epidemiological studies of Acinetobacter and avoiding unnecessary antibiotics treatment,ampicillin-sulbactam as imipenem shows high antibacterial activities,aztreonam has a lower antimicrobial susceptibility than other 12 antibiotics.

To examine the role and effect of nitric oxide synthase type II (NOS II) in cirrhotic rats, expression of NOS II mRNA was detected by real time RT-PCR. The enzymatic activity of nitric oxide synthase and the circulating levels of NO, systemic and portal hemodynamics and quantification of cirrhosis were measured. Chinese traditional medicine was used to treat cirrhotic rats and the effect of NO was evaluated. Double-blind method was used in experiment. Our results showed the concentration of NO and the enzymatic activity of NOS increased markedly at all stages of cirrhosis and iNOSmRNA was strongly expressed. Meanwhile, the portal-venous-pressure (PVP) and portal-venous-flow (PVF) were significantly increased. NO, NOS and iNOSmRNA were positively correlated to the degree of hepatic fibrosis. Tetrandrine significantly inhibited NO production and the expression of iNOSmRNA. Our results suggested that increased hepatic expression of NOS II is one of the important factors causing cirrhosis and portal hypertension. Tetrandrine can significantly ameliorate cirrhosis and portal hypertension.

OBJECTIVE To apply the clinical pathway in hospital infection control in order to cut down the development of hospital infection.METHODS To take clinical pathway combined with clinic,to establish scientific,effective and standard measures to reduce hospital infection.RESULTS To practice clinical pathway could raise medical quality,rationally utilize the health resources,decrease economy burden of the patient and control hospital infection.CONCLUSIONS It′s of practical importance to promote the hospital infection management through clinical pathway.

Physical constraints is a commonly protective medical measure in clinic. if lack of humanistic nurs-ing in the use of the process,then it will give the patient a physical,psychological and ethic issues. This paper sum-marized the research status of humanistic nursing and physical constraints and concluded the humanistic nursing measures before, during, and after physical constraints, and thus to provide a reference for the further implementa-tion of humanistic nursing.

Objective To study the role of calcitonin-gene-related peptide (CGRP) and substance P (SP) in the pathogenesis of prurigo nodularis. Methods SABC immunohistochemical technique was used to examine the expression of CGRP and SP in lesional skin and uninvolved skin of 30 cases of prurigo nodularis and in skin of 15 normal controls. Results The strong expression of CGRP and SP was observed in the whole epidermis of lesional skin in 30 cases, with the expression surrounding cell membranes. The weak expression of CGRP and SP was observed in nonlesional and normal epidermis. CGRP and SP expression levels had significant differences in the lesional skin and in normal and uninvolved skin (P

Objective To discuss the value of double tunnel separation technique in the application of laparoscopic radical resection for rectal carcinoma. Methods A retrospective analysis of clinical data of 67 cases of laparoscopic radical resection for rectal carcinoma from September 2010 to July 2014 was made.There were 37 cases of Miles operation and 30 cases of Dixon operation, with laparoscopic double tunnel separation technique which refered to under the sigmoid colon mesentery space and under the mesorectum space. Results All cases of laparoscopic radical resection were completed.The duration of operation was 100-240 min, with an average of 158 min.The intraoperative blood loss was 50-200 ml, with an average of 110 ml.The hospitalization time was 8-15 d, with an average of 10 d.Complications included postoperative anastomotic leakage in 1 case, small intestinal obstruction induced by intestine pelvic adhesion in 1 case, and lower extremity deep venous thrombosis in 1 case, all of which were cured with conservative treatment. Conclusions Double tunnel separation technique in laparoscopic radical resection is helpful to application of total mesorectal excision, thus effectively protects blood vessels, nerves, and ureters.Meanwhile, the lymph nodes and extranodal tumor deposits can be cleaned to the greatest degree.

Objective:To evaluate color doppler ultrasound diagnosis value of cesarean scar pregnancy.Methods: Using color doppler ultrasound probe belly and vaginal probe, faceted searches in patients with suspected scar pregnancy, observe suspicious gestational sac or clutter echo of the location, size, shape, and presence of complications, and radiography, video records, follow-up.Results: The abdominal and vaginal color to exceed cesarean scar pregnancy can make a definite diagnosis.Conclusion: Color doppler flow imaging (CDFI) in cesarean scar pregnancy has a characteristic ultrasonographic performance, ultrasound can accurately make a clear diagnosis. It is the first choice for clinical diagnosis.

Autophagy is a dynamic process which subcellular membranes undergo morphological changes that lead to the degradation of cellular cytoplasmic organelles and macromolecules.It is regulated by themammalian target of rapamycin ( mTOR ) -dependent or -independent signaling pathways.It has been demonstrated that autophagy is induced or inhibited in various tumor cells,and it is closely related with cell survival and drug resistance.Because of the complex relationships with cell death,the roles of autophagy in cancer developnent,treatment,and drug-resistance are not the same,and thus controlling autophagy properly may become one of new means of cancer therapy.