Objective To investigate the common pathogenic bacteria distribution and drug resistance in children with lower respiratory tract infection,which guide how to use antibiotics and decrease the progress of drug resistance.Methods Nine hundred and ninety-seven cases of lower respiartory tract infection were analyzed retrospectively in the Department of Pediatrics of the First Hospital of Lanzhou University from Jan.2008to Dec.2010.The sputum samples were collected for routine bacterial cultivation.The antibiotic sentivity test were used for pathgen.Results The phelm cultivition amount is 997,bred and separated 498 bacteria of 425samples,the check rate is 42.73％.There were 151 Gram Positive Bacteria,which had a rate of 30.32％,and 321 Gram Negative Bacteria,which had a rate of 64.46％,and 26 fungi whose rate is 5.62％.The main bacteria was changed during the three years.There were significant differences in detection rate of pseudomonas aeruginosa(PA) and haemophilus parainfluenzae(HPI) during the three years.PA was declining while HPI was rising.There were no significant differences in detection rate of streptococcus pneumoniae( SP),staphylococcus aureus ( SA),escherichia coli( E.coli ),klebsiella pneumoniae ( K.pn ),haemophilus influenzae ( HI ) and fungi.There were no significant differences in detection rate of PA between different age groups.With the increasing of age,the detection rate of SP,HI and HPI trended to rise,whereas the detection rate of SA,E.coli and K.pn trended todecline.The resistance phenotype of SA,E.coli and HPI in detection rate had significant difference in each year.SP and SA were most sensitive to linezolid and vancomycin.Ecoli and K.pn were most sensitive to carbapenems.HI and HPI were relatively sensitive to common antibiotics.Conclution In the past three years,the main pathogen in children with lower respiartory tract infection were Gram Negative Bacteria.Among the bacteria,SP and Ecoli was the most,followed by SA,HI,K.pn,and HPI.These bacteria had signifeicant difference in dectection rate between different age groups.SP and SA were most sensitive to vancomnycin and linezolid.E.coli and K.pn were most sensitive to carbapenems.HI and HPI were relatively sensitive to common antibiotics.So clinical doctors should use antibiotics based on the microorganism cultivation and sensitivity test m order to decrease the drugresistance strain.

Objective To investigate the relationship of blood pressure variability(BPV) and heart rate variability(HRV) with prostatic volume (PV) in patients with benign prostatic hyperplasia (BPH).Methods A total of 133 patients admitted to our department between January 2011 to April 2013 were analyzed retrospectively.The patients were divided into BPH group and non-BPH group according to the PV value.The ambulatory blood pressure monitoring was used to measure the blood pressure parameters,including 24-hour systolic blood pressure (SBP),24-hour diastolic blood pressure (DBP),day time systolic blood pressure(DSBP),day time diastolic blood pressure (DDBP),night systolic blood pressure (NSBP),night diastolic blood pressure(NDBP),the standard deviation of DSBP(DSBPSD),DDBPSD,NSBPSD,and NDBPSD.At the same time,heart rate variability was measured by 24 hours Holter monitor.The ambulatory electrocardiogram was used for calculating normal to normal intervals (SDNN),standard deviation of the averages of R-R internals in all 5-minute segments(SDANN),rate mean square of the differences of successive RR intervals(RMSSD),percentage of RR intervals differing ＞50 ms (PNN50％).The differences of the ambulatory blood pressure parameters or heart rate variability were compared between the two groups.Results The levels of 24-hour SBP,DSBP,and DSBP-SD were higher in the BPH group than in the non-BPH group[(126.03±14.66)mmHg (1 mmHg=0.133 kPa) vs.(118.88 ±10.79) mmHg,(126.97±14.46)mmHg vs.(119.94±11.24)mmHg,(12.52±3.85)mmHg vs.(11.04±2.44)mmHg,all P＜0.05].All the parameters of HRV were significantly different between the two groups [(97.22±38.14)mmHg vs.(119.23±36.16)mmHg、(90.11±34.4)mmHg vs.(107.1144.4)mmHg、(19.11±2.76)mmHg vs.(31.96±21.10)mmHg、(2.31±2.87)％ vs.(5.02±4.88)％,all P＜0.05]Conclusions The BPV and HRV are the important influencing factors for PV in BHP patients.

Through the analysis on different development paths of western and Chinese medical ethics, this article proposed to construct the Chinese medical ethical review system. Although the medical ethical review system was originated in western countries, due to different origins of medical ethical thoughts, different cultures and beliefs among races, as well as different medical and science development models, the application of western medical eth-ical review system should not be mechanically used in China. The application should follow the idea of har-monization with differences. This article discussed on current status and significance of the construction of an ethical review platform which is suitable to the national conditions of China. It was also emphasized on the im-portance of ethics training among researchers.

Objective To investigate the expressions of vascular endothelial growth factor (VEGF)-C,-D and VEGF receptor-3 (VEGFR-3/Flt-4) in pN0 early gastric cancer (ECG) and their relationship with lymph node micrometastasis.Methods From January 2005 to January 2010,the paraffin-embedded specimens of 61 pN0 ECG were collected.The expressions of VEGF-C,VEGF-D and VEGFR-3 in 61 pN0 early gastric cancer tissue,25 adjacent tissue and CAM5.2 expression in 868 hematoxylin-eosin staining negative lymph nodes were detected by immunohistochemical assay.The rate of lymph node micrometastasis of 61 pN0 ECG was evaluated.According to the data type,t test,x2 test or Fisher exact probability were performed for the relationship analysis between the expressions of VEGF-C,VEGF-D and VEGFR-3 in pN0 stage ECG and lymph node micrometastasis.Results The high expressions of VEGF-C,VEGF-D and VEGFR-3 in the 61 pN0 ECG were 34.4％ (21/61),34.4％ (21/61) and 44.3％ (27/61) respectively,which were higher than those of adjacent tissues [12.0％ (3/25),8.0％ (2/25) and 16.0％ (4/25) respectively] (x2=4.433,6.321 and 6.144 respectively,all P＜0.05).There were 10 cases (16.4％) of pN0 ECG with lymph node micrometastasis.In pN0 ECG,the low expressions of VEGF-C and VEGFR-3 in negative Flt-4 vascular invasion (FVI) were common than positive FVI (x2 =15.828,6.879 and 9.244,all P＜0.05).The high expressions of VEGF-C and VEGFR-3 were related to the depth of tumor invasion (x2 =5.561 and 5.678,both P＜0.05),the density of VEGFR 3 positive vascular (FVD) (t=2.987and 5.652,both P＜0.01) and lymph node micrometastasis (x2 =6.705 and 6.192,both P＜0.05),but not related to the degree of differentiation (P＞0.05).However,the high expression of VEGF-D was not related to depth of tumor invasion,FVD and lymph node micrometastasis (all P＞0.05),but related to the degree of differentiation (x2 =8.472,P =0.004).The high expressions of VEGF-C,VEGF-D and VEGFR-3 were not related to gender,age,tumor location,macroscopic type and tumor size (all P＞0.05).Conclusions The high expressions of VEGF-C,VEGFR-3 were related to lymph node micrometastasis in pN0 ECG.Although the high expression of VEGF-D was not related to lymph node micrometastasis,it could indirectly affect lymph node micrometastasis through VEGF-C-VEGFR-3 axis in pN0 ECG.

Objective To investigate the expression differences of mRNA and protein of early B-cell factor 3(EBF3) in the tissues between hepatocellular carcinoma(HCC) and distant noncancerous tissues and the clinical significance.Methods The expression levels of EBF3 mRNA in 18 pairs surgical specimens of HCC and their distant noncancerous tissues were detected by real-time fluorescence quantitative polymerase chain reaction(FQ-RT-PCR).Western blotting was used to detect the expression levels of EBF3 protein in 5 pairs surgical specimens of HCC and distant noncancerous tissues.Results The ratios of EBF3 mRNA tobeta2 microglobulin mRNA in eighteen liver cancerous tissues(0.52?0.17) were significantly higher than those in distant liver noncancerous tissues(0.28?0.23,t=3.56,P=0.0011).The average gray scale level of EBF3 in five liver cancerous tissues(26.35?14.06)were significantly higher than those in distant noncancerous tissues(7.86?8.47,t=2.52,P=0.036).Conclusion Theexpression levels of EBF3 mRNA and protein up-regulated in primary hepatocellular carcinoma,suggestting that EBF3 may contribute to occurrence of primary hepatocellular carcinoma.

Objective To investigate whether sex,age-of-onset,education and asymmetry affect non-motor symptoms (NMS)in Parkinson disease,and to analyze the relationship between motor symptoms and NMS in Parkinson's disease.Methods The detailed clinical information of 157 patients with idiopathic Parkinson's disease(PD)was recorded and followed up.The data was calculated with SPSS statistic software.Sex had an impact on sleeping disorder (P＜ 0.05).Sleep disorder in female was more prominent.Cognitive disorder was affected by age-of-onset and education duration.The pain and sensory disorder were affected by age-of-onset (P ＜ 0.05).Differences in the effects of asymmetry on NMS were not statistically significant (P＞ 0.05).The higher the scores of postural instability and gait difficulty (PIGD)were,the lower the Mini-Mental State Examination (MMSE)score was(β=-1.837,P =0.004).The higher the tremor score was,the higher the Hamilton Depression Scale(HAMD) score was(β=3.460,P =0.001).The higher the rigidity akinesia score was,the higher the autonomic dysfunction score was(β=0.104,P=0.006).Conclusions The non-motor symptoms of Parkinson's disease are affected by the age,sex and cultural level.Symmetryor-not does not affect Parkinson's disease.Non-motor symptoms and motor symptoms are closely linked.The encountered posture and gait abnormalities of patients should trigger physician alerts to focus on patients' cognitive function.The encountered tremor of patients should trigger physician alerts to focus on their emotional changes.Facing to the patient with rigidity and less moving,physician should alert to the occurrence of autonomic symptoms.

Objective To study polymorphism of phosphatase and tensinhomologue (PTEN)-induced kinase 1(PINK1) gene of exon 5 in Parkinson patients who located in Guangxi ,and its relationship with Parkinson disease (PD) .Methods PCR ,single strand conformation polymorphism (SSCP) and sequencing analyze were conducted to analyze the PINK 1 gene′s exon 5 polymorphism in 28 cases of early-onset PD patients ,22 cases of late-onset PD patients(early-onset PD patients + late-onset PD patients = PD group) and 55 of control group .Results The intronic intervening sequence 5-5G-A (IVS5-5G-A ) polymorphism and G12164A polymer-phism which were located on PINK1 gene of exon 5 were chain relation .The G/A ,A /A genotype frequency was significantly higher in PD group (42 .0% ) than that in control group (23 .6% ) (χ2 = 4 .034 ,P= 0 .045) .The frequency was also significantly higher in late-onset PD patients (45 .5% )than that of 38 cases who were older than 50 years old in control group(21 .1% )(χ2 = 3 .951 ,P=0 .047) .There were no significant differences in alleles .Conclusion This research suggests that chain relation polymerphism at IVS5-5G-A and G12164A in PINK1 gene may be a susceptible factor for PD patients in Guangxi .

ObjectiveTo investigate the clinical value of serum cystatin C(CysC) and urinary microalbumin(MA) in the diagnosis of early renal function injury in patients with essential hypertension.MethodsOne hundred and twenty patients with essential hypertension(hypertension group) were divided into three groups by the results of blood pressure:grade 1 with 48 cases,grade 2 with 47 cases,grade 3 with 25 cases.Thirty healthy subjects were selected as control group.Serum CysC,urinary MA and serum creatinine (Cr) were detected in all subjects.ResultsThe serum CysC and urinary MA in grade 1,2 and 3 hypertension group [(1.57 ±0.48),(2.12 ±0.72),(2.91 ± 1.09) mg/L and(18.12 ±5.43),(29.01 ±8.07),(46.06 ± 13.21 ) mg/L] were obviously higher than those in control group [ (0.71 ± 0.23 ),(9.35 ±5.17)mg/L](P＜ 0.05).The serum Cr had no significant difference between grade 1,2,3 hypertension group and control group (P ＞ 0.05 ).Serum CysC was positively correlated with urinary MA in hypertension group (r =0.613,P ＜ 0.05),serum CysC and urinary MA were both negatively correlated with estimated glomenlar filtration rate (eGFR)(r=-0.635,-0.563,P＜0.05).ConclusionsSerum CysC and urinary MA are sensitive indexes of early renal function injury in patients with hypertension.The combined determination of serum CysC and urinary MA can improve the detection rate of early renal function injury.

Objective:To analyze the causes of death of elderly inpatients,so as to provide direction for the precaution of geriatrics.Methods:The first page data of hospitalized medical records of elderly inpatients in medical department in the Second Hospital of Dalian Medical University from 2102 to 2019 were extracted, and the causes of death were analyzed. The statistical analysis was performed by Excel and SPSS 21.0 statistical software.Results:The number of deaths of elderly inpatients in medical department from 2012 to 2019 was 5 249. The proportion of deaths in ICU was 34.43%(1 807/5 249), in oncology department was19.03%(999/5 249), and in cardiovascular department was12.08%(634/5 249). The average age was (78.52 ± 7.82) years. Besides, the age of men was younger than women: (78.18 ± 8.00) years vs. (79.02 ± 7.52) years, and the differences was statistically significant ( P<0.01). Men(59.1%, 3 099/5 249) were more than women (40.96%, 2 150/5 249). The largest number of deaths was in the age of 75-84 years (42.56%, 2 234/5 249). The number of cases with combined above five diseases was 4 552(86.72%, 4 552/5 249). The top three causes of deaths of elderly inpatients in medical department from 2012 to 2019 were cardiocerebrovascular diseases (27.21%, 1 428/5 249), malignant tumor (25.74%, 1351/5 249) and respiratory system diseases (22.10%, 1160/5 249). From 2012 to 2015, the top three causes of deaths were malignant tumor, cardiocerebrovascular diseases and respiratorysystem diseases. From 2016 to 2019,the top three causes of deaths were cardiocerebrovascular diseases, malignant tumor, and respiratory system diseases. The most common cause in cardiocerebrovascular diseases of death was coronary heart disease (51.47%,735/1 428), cerebrovascular disease (43.70%,624/1 428),and hypertension(4.34%, 62/1 428). Among the patients with malignant tumor death, first cause of death waslung malignant tumor (37.53%, 507/1 351), the others in turn were gastric carcinoma (11.10%,150/1 351) and intestinal cancer (11.10%,150/1 351). Among the patients with respiratory system diseases, first cause of death was pulmonary infection (69.66%,808/1 160), the others in turn were chronic obstructive pulmonary disease (15.43%, 179/1 160) and interstitial lung disease (5.09%, 59/1 160). Conclusions:The average age of elderly inpatients in medical department is (78.52 ± 7.82) years. The death age of male is less than that of female, and the number is slightly more than that of female. The top three causes of deaths of elderly inpatients in medical department are cardiocerebrovascular diseases, malignant tumor, respiratorysystem diseases. From 2012 to 2015 the first cause of deaths is malignant tumor. From 2016 to 2019, the cardiocerebrovascular diseases rise to the first.

Objective To investigate the curriculum construction and evaluation of teaching effectiveness of simulation and comprehensive experiment for clinical nursing. Methods Based on the investigation of hospital, taking working progress and working task of nurses as orientation, we constructed the curriculum of simulation and comprehensive experiment for clinical nursing, and unfold in junior class (before clinical practice) for student nurses. The teaching effect was evaluated. Results Unfolding simulation and comprehensive experiment could effectively enhance the nursing students' ability to transform theoretical knowledge into clinical nursing practice, and was favorable to change the role of nurses and improve the satisfaction degree of clinical practice.Conclusions Unfolding simulation and comprehensive experiment for clinical nursing for student nurses before clinical practice is practicable and essential.