Objective To characterize clinical features,antimicrobial susceptibility and the outcome of nosocomial Acinetobacter baumannii meningitis.Methods All patients with nosocomial meningitis due to Acinetobacter baumannii in 2nd Affiliated Hospital Medical School of Zhejiang University between January 2010 and October 2011 were retrospectively reviewed.Results During the study period,40 patients of this nosocomial infection were identified,who came from neurosurgery ward (19 cases,47.5％),neurosurgieal intensive care unit (18 cases,45.0％),emergency intensive care unit (2 cases,5.0％) or intensive care unit (1 case,2.5％).All the patients had a history of recent neurosurgical procedures. Fever and disturbance of consciousness were the major manifestations,and cerebrospinal fluid examination showed elevated white blood ceil count and protein,and reduced glucose.All isolated pathogens were resistant to the first line antibiotics.The fatality rate was high. Conclusions The most common risk factor for nosocomial Acinetobacter baumannii meningitis is neurosurgery. Resistance to the first line antibiotics is common among all pathogens isolated.The prognosis of the meningitis is poor.

The process of writing graduation thesis is an important pathway of cultivating clinical thoughts and research skills for medical students.But these are some problems,such as understanding insufficiently in the importance of writing graduation thesis,unsuitable selection of graduation thesis,ineffective institution of encourage and management.Strengthening the management,improving the levels of instruction,advocating the group of study,examining report in intermediate stage and enhancing the encouragement are beneficial for improving the quality of the graduation thesis.

Objective To investigate the effect of dysphagia screening and prospective interventional nursing in reducing the aspiration pneumonia in stroke patients.Methods 186 patients with acute stroke were randomly divided into control group and interventional group,93 cases in each group.The Watian drinking water test was used to screen dysphagia,and the routine nursing was used in the control group.The combined screening of Watian drinking water test and oxygen desaturation monitoring was used to screen dysphagia,and prospective intervention nursing in addition to the routine nursing was used in the interventional group.The detection rate of dysphagia and the incidence of aspiration pneumonia in 4 weeks were compared between the two groups.Results The detection rate of dysphagia in the intervention group was higher than that in the control group (41.9% vs 19.4%,χ2 =11.16,P <0.01),and the incidence of aspiration pneumonia was lower than that in the control group (12.9% vs 4.3%,χ2 =4.38,P <0.05).Conclusion The detection rate of dysphagia can be improved by using the combined screening of Watian drinking water test and oxygen desaturation monitoring.The incidence of aspiration pneumonia can be reduced by using combined screening with additional prospective interventional nursing.

Objective To evaluate the effect of methylene blue and visible light by FQ-PCR assay on the inactivation of plasma hepatitis B virus,and to establish a direct and impersonal basis for the surveillance of cural inactivation.Methods Four samples of plasma of HBV-DNA positive were added with methylene blue. Then the plasma was processed with visible light radiation(30 000 Lux) for 0, 5, 10, 15,30 min respectively. Moreover,the concentration of HBV-DNA samples was quantitatively detected by the method of FQ-PCR and compared with untreated samples to evaluate the effect of HBV inactivation and its relationship with the time of radiation.Results The original concentration of HBV-DNA was 5.6?107, 3.2?106, 1.8?106,3.5?105 copies/ml respectively. After being added with methyene blue, the concentration of HBV-DNA was significantly decreased(P

OBJECTIVE:To emphasis the importance to unceasingly upgrading of drug quality standard for drug quality and to arouse the attention of the related enterprises, medical institutions and governmental department to this matter. METHODS: The correlation between quality standard and drug quality was expounded systematically by citing examples and reviewing the pertinent literature, and the current status of drug quality standard in China was analyzed briefly. RESULT & CONCLUSION: Great importance should be attached to the evaluation of drug quality standard to improve drug quality standard level step by step and to ensure efficacy and safety of drugs.

Objective:To analyze the podocalyxin (PCX) expression in the kidney and the number of urinary podocytes in different pathological grades of Henoch-Sch(o)nlein purpura nephritis (HSPN),and to determine whether the number of urinary podocytes reflects the renal damage in HSPN.Methods:Fifty-six children diagnosed with HSPN in our hospital were enrolled in the study and classified into 4 groups by renal pathology:grade Ⅱ (Ⅱa+Ⅱb) (n=10),grade Ⅲ (Ⅲa+Ⅲb) (n=21),grade Ⅳ (n=16),and grade Ⅴ (n=9).Four kidney autopsy specimens without histomorphologic lesions and 8 urine samples from healthy children served as controls.With immunofluorescence assay,the PCX expression in 4 normal renal tissues and in the renal tissues of the 56 HSPN children was detected and quantitatively analyzed.Positive rate and the number of urinary podocytes were detected in the 8 healthy children and 56 HSPN children.Results:In the renal tissues of the normal control group and grade Ⅱ (Ⅱa+Ⅱb) HSPN group,the PCX expression was complete.The percentage of the PCX positive area out of the total glomerular area in the renal tissues of 2 groups had no significant difference (P＞0.05).In the renal tissues of grade Ⅲ (Ⅲa+Ⅲb),Ⅳ,and Ⅴ HSPN groups,the PCX expression showed various degrees of loss,decreasing in turn from grade Ⅱ (Ⅱa+Ⅱb),Ⅲ (Ⅲa+Ⅲb),Ⅳ to Ⅴ,with significant differences between each group (P＜0.01).For HSPN with grade Ⅲ (Ⅲa+Ⅲb) or higher,positive PCX expression was found in the urine,suggesting the presence of enough podocytes in the urine.The percentage of fluorescence positive area out of the total glomerular area of PCX in the renal tissues was negatively correlated with the total number of urinary podocytes (r=-0.637,P＜0.01).Conclusion:Podocyte injury plays a certain role in the pathological progression of HSPN.The urinary detection ofpodocytes can reflect the degrees of pathological damage in HSPN.

Objective To observe the effect of nursing intervention on caesarean section rate in grass-roots hospitals. Methods 240 parturient women who were to infanticipate were divided into the experimental group and the control group with 120 patients in each group according to hospitalization sequence. Parturient women in the experimental group received nursing intervention with new nursing model during the delivery, while women in the control group just finished parturition using routine procedures. The caesarean section rate of the two groups were compared with χ2 test. Results The caesarean section rate of parturient women in the experimental group was significantly lower than that in the control group. Conclusions Nursing inter-vention has certain effect on decreasing the caesarean section rate in grassroots hospitals.

Objective To study the impact of lung volume reduction surgery on inflammatory factors, pulmonary function and quality of life in patients with severe chronic obstructive pulmonary emphysema. Methods 57 cases patients with severe chronic obstructive pulmonary emphysema received lung volume reduction surgery from May 2009 to December 2013 were divided into observation group 32 cases and control group 25 cases, the control group were given open chest surgery, the observation group received video-assisted thoracoscopic surgery. Then compare the operation indicator, serum inflammatory factor content, pulmonary function and life quality score between the two groups. Results Operation indicators: Observation group: Intraoperative blood loss, thoracic drainage, hospital stay were significantly lower than that in control group (P< 0.05); Inflammatory factor: 3 d after surgery, observation group serum TNF-α, IL- 6, IL- 1 content were significantly lower than that in control group (P<0.05);Pulmonary function: 12 months after surgery, there were no statistical difference of FEV1, TLC, RV between two groups (P>0.05); SGRQ score: 12 weeks after the surgery, observation group respiratory symptoms, activity ability, disease im﹣pact, SGRQ total score were significantly lower than the control group (P< 0.05). Conclusion Video assisted tho﹣racic surgery helps to reduce surgical trauma, and alleviate inflammatory reaction, then improve the quality of life.

Aim To investigate the effect of the extract of Averrhoacarambola L.root (EACR)on renal func-tion in diabetic mice and its anti-oxidative action. Methods Diabetic mice were established by tail vein injection with 120 mg·kg-1 streptozotocin (STZ)and were divided into 5 groups:model control group,val-sartan control group,and low-,middle-,high-dose of EACR groups (300,600,1 200 mg·kg-1 ).And 10 normal mice consisted of normal control group.The fasting blood glucose (FBG)of mice was detected be-fore and after administration of drugs.After last admin-istration,the blood and urine samples were collected for creatinine (Cr),urea nitrogen (BUN),urine and 24 h urinary protein determination.The activities of superoxide dismutase (SOD ),glutathione peroxidase (GSH-Px)and malonaldehyde (MDA)content were determined using kits.HE staining was conducted to observe the pathological changes of kidney tissues. ELISA method was utilized to detect the contents of catalase (CAT)and reactive oxygen species (ROS ). The expressions of Cyto-C,AIF and caspase-3 proteins in kidney tissues were analyzed by Western blot.Re-sults Compared with model group,the serum bio-chemical indexes and 24 h urinary protein of valsartan and moderate-,high-dose of EACR groups were de-creased with statistical significance (P<0.05 ).After the treatment, the MDA content was decreased by EACR treatment,and SOD,GSH-Px and CAT activities were enhanced.Meanwhile the expressions of ROS, Cyto-C,AIF and caspase-3 were down-regulated.The pathological changes of kidney tissues were ameliorated by EACR through HE results.Conclusions The ex-tract of Averrhoacarambola L.root can decrease the se-rum levels of Cr and BUN,reduce the MDA and ROS contents in kidney tissue and enhance the activities of SOD,GSH-Px and CAT,down-regulate the expres-sions of Cyto-C,AIF and caspase-3 proteins in kidney tissues,elevate the anti-oxidative effect of kidney. Therefore,the renal function of diabetic mice is melio-rated.

OBJECTIVE To investigate the risk factors and to take some useful measures to prevent and reduce infection in order to enhance medical quality,to ensure medical security,to strengthen hospital infection manangement and to prevent hospital infection effectively. METHODS We investigated the prevalence rate of hospital infection among our hospitalized patients in 2001,2003 and 2005, respectively. RESULTS The hospital infection rate was 4.6-6.42% in these years.Risk factors and the abuse of antibiotic were decreasing. CONCLUSIONS In order to control hospital infection rate,mensures should be taken including intensively monitoring the departments with high infection rate,strengthening hospital operation,rationally using the antibiotics,and studying the management for hospital infection.