Objective Correctly identify Streptococcus pneumoniae resistant to optochin and other alpha hemolytic streptococcus susceptible to optochin.Methods Optochin susceptibility test, bile resolution test, latex agglutination test as well as some biochemical methods (VITEKCC4-GPI identifying cards,API-Strept identifying bar, VITEK TWO-GPC identifying cards) were applied.Results It was observed that 2 strains(0.3%)of Streptococcus pneumoniae out of 630 were resistant to optochin and 31strains of Streptococci, classfied as alpha hemolytic streptococci, susceptible to optochin, including 13 of S. mitis, 6 of S.oralis, 6 of S. twin, 3 of S. acidominimus, 2 of S.intermedius and 1 of S. constellatus. The inhibition zone of these alpha hemolytic streptococci susceptible sensitive to optochin was within the range of 14-17mm in diameter, in not 20 mm or more than 20 mm, compared with the inhibition zone of most strains of S.pneumoniae. Most of these alpha hemolytic streptococci (93.5%) susceptible to optochin showed highly resistance to benzoxazolecillin,to which most Streptococci (94%) showed sensitivity . Conclusion S.pneumoniae can be effectively identified by bile resolution test and latex agglutination test because of its high specificity with credible test results. API-Strept identifying bar and VITEK TWO-GPC identifying cards can be applied to identify S. pneumoniae resistant to optochin.

Objective To observe the expression of induced nitricoxide synthase(iNOS)in ligustrazine against cisplatin-induced ototoxicity.Methods Fifty white guinea pigs with normal hearing were randomly divided into the control group,ligustrazine group and traditional Chinese drug(TCD)group.The alternations of hearing function were evaluated by the examination of auditory brainstem response(ABR).Some specimens were perfused by AgNO3 and observed the damage of bristle cell.And some were sent for immunohistochemistry to detect the expression of iNOS.Results Compared with the control group,the threshold of ABR in ligustrazine group and TCD group were significantly different.There was a significant difference between the ligustrazine group and TCD group.There was no expression of iNOS in Cortis',spiral ganglion cell and stria vascularis in normal cochlear(control group).In the ligustrazine group,the expression became stronger in spiral ganglion cell,stria vascularis,spiral ligament and Cortis'.INOS also expressed in TCD group.Conclusion Ligustrazine can antagonize cisplatin-induced ototoxicity by inhibiting the expression of iNOS.

Objective To develop questionnaires to indentify research motivation and its related psychological factors for medical postgraduates.Methods The questionnaire was developed based on previous literature and case interview by using self-determination theory as the theoretical framework.Delphi method and stratified factor analysis were used to examine the reliability and validity of the questionnaire.Results The questionnaires included 2 sections:research motivation questionnaire and related psychological factors questionnaire.The Cranach's α of each questionnaire was 0.89 and 0.90 and test-retest reliability coefficient was 0.74 and 0.80.The content validity (CVI) of each questionnaire was 0.958 and 0.935,and stratified factor analysis demonstrated that the items of each dimension could account for more than 40％ of the accumulated variance.Conclusion The questionnaires have good reliability and validity and could be applied.

This paper introduces the mechanism of Linux device drivers,analyzes the features of driver development in embedded Linux and illustrates the methods for design,compiling and test based on small medical apparatus.

The reverse problem of Electrical impedance tomography(EIT) is a highly ill-posed problem.It is concluded that spatial prior information could improve the final image quality.This paper proposes a new method for obtaining prior information.By this method,the inspected cross-section contour and internal structure for EIT can be achieved.

Objective To investigate the nursing points of endoscopic full-covered self-expanding removable metal stents (FCSERMS) implantation for bile duct anastomotic strictures after liver transplantation. Methods The clinical data of patients who were treated by endoscopic full-covered self-expanding removable metal stents implantation for bile duct anastomotic strictures after liver transplantation from January 2013 to July 2015 were retrospectively analyzed, and the nursing process were summarized. Results The group of 9 patients were successfully placed and removed with FCSERMS. There was no postoperative complication, such as stent migration, acute pancreatitis, biliary bleeding and intestinal leakage. All the bile duct strictures were relieved after FCSERMS removement. Followed up for 10-32 months, there was no symptom and sign of bile duct anastomotic stricture recurrent. Conclusions The key in nursing points of FCSERMS implantation for bile duct anastomotic strictures after liver transplantation are introducing the function of FCSERMS and therapeutic process to improve patient compliance, mastering the endoscopic operations, the placement and removal method of FCSERMS to short operation time, strengthening postoperative nasal bile duct care, paying attention to the observation, detection and treatment of postoperative complications after the metal stent placement and removement, as well as the continuing care during the period between placement and removment of FCSERMS.

Objective To investigate the value and nursing of persistent balloon dilatation for anastomotic stricture after choledochojejunostomy. Methods The clinical data of 14 cases of anastomotic strictures after choledochojejunostomy accepted the treatment of persistent balloon dilatation were analyzed retrospectively. The effect, adverse reactions and approriate nursing were evaluated. Results Five patients were performed with persistent balloon dilatation thorough the output loop of intestine after choledochojejunostomy and 9 patients through percutaneous transhepatic cholangiography. There was no hemobilia, bile leak or other serious complications. There were 2 cases of balloon dilatation catheter damage, 5 cases of pressure pump damage and 4 cases of balloon migration with 25.0% (7/28) instrument damage rate and 4 cases of balloon migration. After persistent balloon dilation for 6 to 8 months, no anastomotic stricture was found by choledochoscopic examination. Follow up for 6 to 18 months, 2 cases had recurrent anastomotic stricture. Conclusions Persistent balloon dilatation by percutaneous transhepatic cholangiography is a simple, safe and effective method for anastomotic stricture after choledochojejunostomy. In the course of nursing, the balloon catheter and pressure pump damage, and balloon migration should be noted.

ObjectiveTo observe effect of estradiol on respiratory of ovariectomized rats.Methods30 adult female rats were randomly divided into ovariectomy group (group A), estradiol group (group B) and sham ovariectomy group (group C). Rats of group B were injected with 17-β estradiol (20μg/kg/d), that of group A and group C were injected only with normal saline (0.1ml/d). After 6 weeks, effect of estradiol on respiratory of ovariectomized rats was assessed with testing level of rats' serum estradiol and discharge frequency and integrated amplitude of phrenic nerve. ResultsThe level of serum estradiol of group A was significantly decreased compared with group B and group C (P<0.01). Discharge frequency and integrated amplitude of phrenic nerve of group A were decreased compared with group B and group C (P<0.05).ConclusionEstradiol can excite respiratory responses in ovariectomized rats.

Objective Multiple carboxylase deficiency(MCD) is an autosomal recessively inherited defect of organic acid metabolism.The underlying mechanism is biotinidase(BT) or holocarboxylase synthetase(HLCS) deficiency.The authors reported 15 cases of MCD(clinical characteristics,diagnosis and treatment) and outcomes of long-term follow-up.Methods The clinical data of 15 patients with MCD admitted to Guangzhou Women and Children's Medical Center between Aug.2001 and Feb.2013 were analyzed.The diagnosis was confirmed by urinary organic acid analysis with gas chromatography/mass spectrometry (GC/MS),blood enzymatic determination and gene analysis.The patients consisted of 12 male and 3 female.The onset age ranged from newborn infants to 16 months.Results 1.Remarkable elevations of urinary lactate,3-oxy-butyric acid,3-OH-isovalerate,methylcitrate,3-methylcrontonylglycine,3-OH-propionate were detected in all of 15 cases.Fourteen cases with HLCS deficiency and 1 case with BT deficiency were confirmed by gene analysis.2.Most of patients with HLCS deficiency presented in the neonatal period or early infancy.The main clinical manifestations were skin rash (14 cases),tachypnea (9 cases),developmental retardation (8 cases),vomiting(5 cases),poor feeding (3 cases),developmental regradation (1 case),convulsion (1 case).Laboratory evaluation showed persistent metabolic acidosis and varied degree of ketosis,lactic acidosis,hyperuricacidemia,ammoniemia and hypoglycemia.Biotin was given to 13 patients in 10 mg/d and their metabolic disorders were corrected within 48 h,except one who gave up treatment and died.Treatment with Biotin in 5 mg/d provided clinical stability and normal neurodevelopmental outcome on follow-up for 3-11 (6.47 ± 2.70) years.3.One patient with BT deficiency presented with severe neurological symptoms(impaired consciousness,limbs trembling,tachypnea with irregular respiratory rhythm) at 16 months old.Demyelination of corpus callosum was evident on magnetic resonance imaging.Biotin treatment was given to him on the second of onset,and 1-year follow-up indicated significant improvement of his clinical symptoms,but the right limb weakness did not completely recover.Conclusions The main clinical features of HLCS deficiency include frequent skin rash,tachypnea,and metabolic disorders.BT deficiency may produce variable neurologic manifestations including demyelination of corpus callosum.Urinary organic acid analysis with GC/MS is critical to the early diagnosis of MCD.Prompt biotin treatment is recommended to correct metabolic derangements and continued therapy is essential to the improvement of long-term prognosis.Delayed commencement of therapy in BT deficiency can result in irreversible neurological damage.

Objective To explore the characteristics and clinical significance of CD+4 CD+25 Regulatory T lymphocytes and T cell subsets in peripheral blood and malignant pleural effusion from lung cancer patients. Methods Flow cytometry was used to detect the percentage of CD+4 CD+25 regulatory T cells and T cell subsets in peripheral blood from 68 lung cancer patients and 56 healthy persons, and in pleural effusion from 32 lung cancer patients with malignant effusion. Results T lymphocyte subsets in peripheral blood of lung cancer patients in different periods were expressed differently. The percentage of CD+4 CD+25 regulatory T cells in peripheral blood were (19.52±3.32)%, (27.28±8.26)% and (32.31±15.60)% in Ⅰ+Ⅱ, Ⅲ and Ⅳ period lung cancer patients, respectively, and were higher than that of healthy volunteers (11.12±3.32) % (t =31.0040, -7.9688, -4.9770, P ＜0.05). In the lung cancer patients with malignant effusion, the percentage of CD+4 CD+25 regulatory T cells in the pleural effusion was higher than that in the peripheral blood [(34.12±18.63) % vs (26.36± 16.25)%, t =21.164, P＜0.05]. In the lung cancer patients with malignant effusion ,the percentages of CD+4 in peripheral blood and pleural effusion were (25.32±13.45) % and (34.68±12.34) %, were lower than that in healthy volunteers (t =7.3104, 4.8818, P＜0.05), the percentages of CD+56 were (8.24±7.38) % and(11.23± 7.65) %, CD+4/CD+8 were (1.02±0.56) % and (1.32±0.82)%, were lower than (18.23±9.23) % and (1.89± 0.32) % in healthy volunteers, respectively, (CD+56: t =-14.7549, -11.7216; CD+4/CD+8: t =-24.78,-4.4564, P＜0.05). Conclusion The relative increase of CD+4 CD+25 Regulatory T cells may be related to immunosuppression and tumor progression in patients with lung cancer. Conclusion The relative increase of CD+4 CD+25 regulatory T cells may be related to immunosuppression and tumor progression in patients with lung cancer.