ObjectiveTo study the postoperative complications and nursing intervention of high myopia combining posterior scleral staphyloma macular rhegmatogenous retinal detachment. MethodsFrom January 2010 to December 2011,120 cases of patients with high myopia combining posterior scleral staphyloma macular rhegrnatogenous retinal detachment were selected as research objects.All patients were given vitrectomy combined with silicone oil filling operation,then we observed the postoperative complications. ResultsIn 120 patients,14 cases of patients occurred high intraocular pressure ( 11.67％ ),6 cases of patients were found bleeding(5.0％),68 cases of patients had great pain,all the postoperative complications alleviated after nursing intervention,the comparing difference had statistical significance between before and after nursing intervention. 31 cases of patients occurred cataract (25.83％),and 2 cases in intraocular infection (1.67％),the postoperative complications were properly handled. ConclusionsHigh intraocular pressure,internal bleeding of eyes,cataracts,postoperative pain,and intraocular infection are the postoperative complications of high myopia combining posterior scleral staphyloma macular rhegrnatogenous retinal detachment,targeted nursing intervention can effectively treat complications.

OBJECTIVE To investigate the antibiotic resistance pattern of MRSA,homology and carriage of Panton-valentine leukocidin(PVL) in 50 meticillin-resistant Staphylococcus aureus isolates to guide the clinical treatment.Results of homology provide the proof for molecular epidemiology.METHODS According to CLSI′s guideline,antimicrobial susceptibility tests were performed with disk diffusion method.PVL gene and mecA gene were detected by PCR.The homology was analyzed by repetitive estra-genic palindromic elements(Rep)-PCR method.RESULTS MecA gene was detected in all 50 MRSA isolates.All isolates MRSA were resistant to oxacillin and cefoxitin.But they were all sensitive to vancomycin and teicoplanin.The rates of sensitivity to clindamycin,ciprofloxacin,piperacillin and sulbactam,SMZ-TMP,gentamicin,cefazolin and erythromycin were 7.5%,1.9%,24.5%,92.5%,20.8%,1.9% and 3.8%,respectively.The resistance rates of MRSA were higher than that of MSSA.Twenty PVL genes were detected from 50 MRSA isolates.CONCLUSIONS The resistance rates of MRSA are higher than MSSA.There is no isolate resistant to vancomycin and teicoplanin.40.0% MRSA carry PVL gene and part isolates have high homology.

512 ?g/ml for vancomycin.Thirty seven VanA genes were detected in 37 VREFm.The drug resistance rates to erythromycin,ampicillin,levofloxacin,gentamicin,ciprofloxacin,nitrofurantoin(Euradantin) and chloramphenicol were 100.0%,100.0%,89.2%,86.5%,91.9%,59.5%,and 5.4%,respectively.The REP-PCR generated 3-14 bands between 100 and 2000bp.They were divided into six types.CONCLUSIONS There is 100.0% agreement between phenotypes and genotypes in VREFm.VREFm are multiresistant.REP-PCR method is simple,rapid,and with lower cost to detect the homology in enterococci.

Objective For decreasing the mistreatment and the excess treatment of Chlamydia trachomatis pneumonia,this article analyze Chlamydia trachomatis pneumonia clinic features in the infant.Methods Making review analysis to the clinic data of 64 infant age of 0 to 3 months old suffering from Chlamydia trachomatis pneumonia.Results The infection history of these babies is not identify in their perinatal period.The average age when they were ill is 32.77?19.03d;It happened more frequently in spring and winter.The patient's condition is gently with cough as their feature,following fever,gasping,fine crackles,or none of those.It does not prolong the course of disease by following the air tube virtue infection.The increase of the Blood white cell is 43.8% and that of the neutrophile is less than 20%.The level of Few CRP increase.The abnormal of the baenosome X-ray is on both sides.It can relieve symptom and physical sign,and shorten the time in hospital for using the macrolide medicine,and it surpass the cephalosporin.Conclusions The Chlamydia trachomatis infection does not result in the damage of the organ,even if jeopardizing the life.It is helpful to recognize the clinical course correctly for the analysis of the complicated clinical condition exactly.

OBJECTIVE To detect ?-lactamase of ampicillin-resistant Enterococcus in order to choose drugs for clinical treatment.METHODS According to CLSI's guideline,antimicrobial susceptibility tests were performed:to detect ?-lactamase with nitrocefin,to detect blaZ by PCR and to detect mutation of pbp4 by single-strand conformation polymorphism(SSCP).RESULTS The resistant rates of E.faecium and E.faecalis to ampicillin,penicillin,high level gentamicin,high level streptomycin,levofloxacin,erythromycin,tetracycline,and chloramphenicol were 100%,100%;86%,76%;46%,44%;84%,74%;100%,94%;54%,58%;and 42%,36%;to rifampicin 62%,58%;and to vancomycin both 0%,respectively.The positive rate of ?-lactamase in 50 E.faecalis strains with paper disk method and test tube method was 8% and 26%;and that of blaZ by PCR was 88%.But in 50 E.faecium strains the results were 0% and 2%,respectively.There was no significant mutation by SSCP and sequencing in E.faecalis.CONCLUSIONS The positive rate to ?-lactamase in E.faecalis is markedly higher than in E.faecium.The method of PCR is better than that of nitrocefin.The positive rate of test tube method is higher than paper disk method with nitrocefin.

Objective To evaluate the curative effect of stent angioplasty for treatment vertebral basilar artery stenosis. Methods 34 patients with vertebral basilar artery stenosis diagnosed by DSA were treated with cerebral angioplasty and stenting(CAS ) operation by flexible balloon expandable stents. Results 36 stents were placed in 34 patients. The achievement ratio of operation was 100%. All stenosis showed by DSA were successfully improved without complications.The mean stenosis rate of preoperation and postoperation were (78.3?6.2)% and (3.6?4.2)% respectively. During the further follow up period of 6～38 months, clinical symptoms were disappeared in 31 patients, relieved in 2 patients, recurred in 1 patient.There were no vertebro-basilar system transient ischemic attack and brain infarction onset in those patients.Conclusion Stent angioplasty is safe and effective in the treatment of symptomatic vertebral artery stenosis.

Objective To evaluate the application of Addenbrooke′s cognitive examination revised(ACE?R)scale to evaluate cognitive function in patients with chronic kidney disease(CKD). Methods We used ACE?R scale to evaluate the cognitive function on 205 cases of CKD patients received outpatient and inpatient treatment in renal Department of four hospitals in Nanjing. One?way ANOVA analysis ,receiver operating characteristic (ROC)curve and other statistical methods were adopted to compare differences. Results (1)There is significant difference of ACE?R scale scores among group NC?NCDs(89.18 ± 4.80),group Mild?NCDs(77.28 ± 5.80)and group Major?NCDs(55.90 ± 10.90)(F = 292.28,P < 0.01). There is significant difference between any two groups(all P<0.01).(2)(ACE?R)scale(AUC=0.944,P<0.01)showed significantly higher sensitivity than mini?mental state examination(MMSE)scale(AUC = 0.777,P < 0.01)on identifying Mild?NCDs patients with chronic kidney disease(P < 0.01);(3)The optimal cut?off value of total ACE?R score between group NC?NCDs and group Mild?NCDs was 83/84,(sensitivity 88.00%,specificity 85.90%,Youden index 0.739),the optimal cut?off value between group Mild?NCDs and group Major?NCDs was 83/84(sensitivity 89.70%,specificity 96.10%, Youden index 0.858). Conclusion ACE?R possesses a good ability in distinguishing different severity of cognitive impairment in patients with CKD. ACE?R can effectively identify early mild cognitive impairment ,which is suitable for clinical application as a tool to evaluating and studying of cognitive function in patients with CKD.

Objective To study dexamethasone and higher C-reactive protein(CRP) on effects of platelets concentrates(PC) transfusion for bleeding patients with thrombocytopenia.Methods To investigate peripheral blood platelets count,clinical bleeding before(CRP test simultaneously) and 12～16 hours after PC transfusion for 45 non-fever,non-splenomegaly and non-DIC(disseminated intravascular coagulation,DIC) patients with leukemia,aplastic anemia,or solid tumor chemotherapy,which had bleeding and needed PC transfusion.All cases were divided into two groups:CRP normal and CRP higher one according to their CRP results.Each group were also classified as non-dexamethasone and dexamethasone division(10mg dexamethasone intravenous injection before transfusions) respectively,in order to analyze the relationships between effects of PC transfusion and serum levels of CRP or dexamethasone.Results The peripheral blood platelets counts (33.2?9.2)?109/L after PC transfusions in CRP normal group were more than that (25.4?10.4)?109/L,in CRP higher group,with significant differences(t=4.42,P

BACKGROUND:With the introduction of related policies on organ procurement and distribution, the organ procurement and standards of the organ procurement have a clear operational criteria, as wel as how to al ocate organs. But the work processes and organizational positioning on organ procurement organization are not enough elaborated and normal. OBJECTIVE:To analyze the experience of Guangzhou General Hospital of Guangzhou Military Command as the organ procurement organization units in quality management, timely review working progress and explore areas for improvement, which provide the corresponding countermeasures for enhancing quality management and establishing the efficient and professional organ procurement organization. METHODS:A computer-based online search in CNKI database and PubMed database was performed with the keywords of“organ donation, organ transplantation, Organ Procurement Organization, quality management”in English and Chinese by screening titles and abstracts. RESULTS AND CONCLUSION:According to relevant laws and regulations, Guangzhou General Hospital of Guangzhou Military Command formulates a standard evaluation standard and sets up the team, thus achieving the reunification of the responsibilities and powers. At the same time, they improve the relevant organ donation,acquisition, preservation, registration, and design different quality management plans according to these different aspects. In addition, In addition, the hospital hold regular coordinator training and make it standardization. Through a series of quality management measures, the hospital organ procurement organization has gradual y regularized and achieved some results. It is recommended to further strengthen scientific research, achieve the unification of efficiency and effectiveness of scientific research;improve the awareness of the hospital leaders, consummate the mechanism of organ procurement;focus on personnel training, improve the professional quality of the organization members;enhance information management, achieve multi-disciplinary col aboration;build quality evaluation system, achieve the whole process of quality management;emphasize on medical ethics, and promote the harmony between the hospital and the patient.

Objective To investigate the distribution of T follicular helper(Tfh)cell subsets in hepa-titis B patients at different immune stages and to clarify the relationships between the level of CXCL13 and the distribution of Tfh cell subsets. Methods Flow cytometry analysis was performed to detect the distribution of Tfh cells. Enzyme-linked immunosorbent assay(ELISA)was performed to measure the levels of CXCL13 in ser-um samples collected from hepatitis B patients. RT-PCR and Western blot assay were used to analyze the expres-sion of CXCL13 in HepG2 and HepG2. 2. 1. 5 cells. Results The percentages of Tfh1 cells were significantly up-regulated at the immune activation(IA)stage,while those of Tfh2 cells were significantly raised at the im-mune tolerance(IT)stage. The percentages of Tfh17 cells in patients at the stage of IT were similar to those in patients at the stage of IA,but were higher than those in responders with HBsAg seroconversion(RP)or healthy controls(HC). The expression of CXCL13 was positively correlated with the percentage of Tfh2 cells. More over,hepatitis B virus(HBV)enhanced the expression of CXCL13 at both transcriptional and translational lev-els. Conclusion HBV might up-regulate the percentage of Tfh2 cells through promoting the expression of CXCL13,which resulted in the induction of immune tolerance. Elucidating the functions of Tfh1,Tfh2 and Tfh17 cells and understanding the type conversion mechanism among the three subsets are important for further researches on HBV-induced immunosuppression.