Objective Design the "Nursing Obstetrics and Gynecology" network courses, and then observe the teaching effect of it. Methods The rational design of technical solutions, development and application of information resources and modem educational technology. Results The "Nursing Obstetrics and Gynecology" network courses prompt satisfaction teaching more than 90%. Conclusions "Nursing Ob-stetrics and Gynecology" network courses make our teaching program is brand new, as "Nursing Obstetrics and Gynecology" network courses of discipline and quality building a solid foundation, especially for the cultivation of young teachers to provide direct help.

OBJECTIVE To analyze the bacterial distribution and drug resistance in lower respiratory tract nosocomial infection(NI).METHODS To investigate 351 patients suffered from lower respiratory tract NI using the prospective monitoring methods,and doing the pathogenic bacterium cultivation for sputums of 351 patients and then taking the susceptibility test.RESULTS Totally 346 pathogenic bacteria were found in sputums of 351 patients.The major pathogenic bacteria were Pseudomonas aeruginosa,Escherichia coli,Klebsiella and Staphylococcus aureus.ESBLs were 36.0% and 40.0%,respectively in E.coli and Klebsiella,and MRSA were 82.1% in S.aureus.Drug resistances were common in Gram-negative bacilli(GNB) and Gram-positive cocci.Piperacillin/tazobactam and cefoperazone/sulbactam and imipenem were the most sensitive for GNB,S.aureus,S.epidermidis and Enterococcus were all sensitive to vancomycin.CONCLUSIONS Drug resistance of the pathogenic bacteria in lower respiratory tract NI is common,so it′s necessary to emphasize pathogenic bacterium monitoring and use the antibacterials exactly.

OBJECTIVE:To isolate and purify three principal degraded impurities of mitiglinide calcium (impurity A,B,C) and identify their structures,establish HPLC method for content determination of impurity A,B,C. METHODS:Mitiglinide calci-um was used as raw material and reacted with acid;3 impurities were then separated by HPLC and their structures were elucidated by IR,MS,1H NMR,13C NMR,LC-ESI-MS and ORD. 3 impurities of 3 batches of mitiglinide calcium were determined,and the determination was performed on Agilent Extend-C18 column with mobile phase consisted of 0.01 mol/L sodium acetate solution-ace-tonitrile-triethylamine(60:40:0.1,pH=3.0)at the flow rate of 1.0 ml/min. The detection wavelength was set at 210 nm and sam-ple size was 20 μl. The response tests of 3 impurities and mitiglinide calcium were conducted. RESULTS:After treated with acid, impurity A,B,C had been obtained,and their purity were 99.05%,98.87%,99.98%,respectively after isolation and purifica-tion;after identifying the structure, 3 impurities were S-2-bezylsuccinic acid, S-2-bezylsuccinic acid-4-methyl ester, methyl (2S)-2-benzyl-3-(cis-hexahydroisoindolin-2-ylcarbonyl) propionate;methodological study of content determination of impurities were all up to the requirement. The linear range of impurity A,B,C were 0.387 5-3.875,0.395-3.95 and 0.392 5-3.925 μg/ml(all r were 1.000 0). The response value of impurity A,B,C and mitiglinide calcium were 2.316 1,2.636 1,2.617 8 and 2.620 4,re-spectively. CONCLUSIONS:The structures of 3 principal degraded impurities of mitiglinide calcium have been identified and con-firmed;the content of them can be determined by HPLC main component self-comparison method.

OBJECTIVE To investigate the characteristics and risk factors of nosocomial infection(NI) in patients with hematological malignancies(HM),and provide the bases for making the controlling measures of NI.METHODS Using the targeted monitoring to study NI in patients with HM,and recording 14 factors such as the time of hospitalization,chemotherapy,count of leukocyte and absolute neutrophil count(ANC) and so on.The data were analyzed with unifactorial ?2 test and multifactorial Logistic-regression analysis.RESULTS Among 242 patients with HM the prevalence of NI was 35.5%(86/242) and the prevalence of NI time-cases was 52.9%(128/242).Among 86 patients of NI there were 27 patients occurred multiple sites NI(31.4%).The main infection sites were upper respiratory tract,gastrointestinal tract,lower respiratory tract,oral cavity and blood.66.7% Of NI happened in the period of chemotherapy and 7 days after chemotherapy.The time of hospitalization and ANC were independent risk factors of NI in patients with HM.CONCLUSIONS The patients with HM are susceptible population of NI,and NI often occurs in the period of chemotherapy and 7 days after chemotherapy.So medical staff should strengthen monitoring,and shorten the time of patient hospitalization and of recovery of ANC to reduce the prevalence of NI efficiently.

OBJECTIVE By investigating the incidence of nosocomial infection with objective monitoring method and prospective overall monitoring method, to analyze the advantage and significance between two methods. METHODS Using the objective monitoring method to study the incidence of nosocomial infection of patients after neurosurgical operation from May to December in 2003 and using the prospective overall monitoring method to study the incidence of nosocomial infection of patients after neurosurgical operation from May to December in 2002. All data were analyzed with Stata 7.0 soft. RESULTS There were 100 cases occurring nosocomial infection in 267 neurosurgical operation patients. The patient incidence of nosocomial infection was 37.5% and the rate of nosocomial infection cases was 50.9% with objective monitoring method, that was significant higher than those data coming from May to December in 2002 with 248 cases under prospective overall monitoring method, with which the patient incidence of nosocomial infection and the rate of nosocomial infection cases were 20.2%(50 cases ) and 21.4%(53 cases), respectively . Statistically significant difference was found (P

0.05).The average rate of three times NI prevalence surveys was 5.23% and that of NI prospective overall(monitoring) method in the same months was 6.60%,the statistical difference between them was found(P

Objective To observe the anti-fibrosis therapeutic effect and mechanism of Qingshen granule for treatment of patients with chronic renal failure (CRF) accompanied by damp-heat syndrome.Methods Sixty-eight patients with CRF accompanied by damp-heat syndrome were randomly divided into a control group and a observation group, and the study was completed only in 61 patients, 31 in the control group and 30 in the observation group. Thirty subjects having taken physical health examination were assigned in a healthy control group. All the patients in both treatment groups were treated with conventional western medical therapy and traditional Chinese medicine (TCM) retention enema, and for patients in observation group, Qingshen granule was given additionally, 1 bag (10 g) thrice a day taken orally. The therapeutic course was 8 weeks. The clinical therapeutic effect, the levels of serum creatinine (SCr), the glomerular filtration rate (eGFR), serum interleukin-17 (IL-17), collagen type Ⅲ (Col-Ⅲ) and nuclear factor-κB p65 (NF-κB p65) in peripheral blood mononuclear cells (PBMC) were measured before and after treatment in the two treatment groups, and the above results were compared with those in healthy control group.Results Clinically, the total effective rates of the disease and of the TCM syndrome in observation group were significantly higher than those in the control group (86.67% vs. 58.06%, 83.33% vs. 45.16%, bothP < 0.01). In the observation group, the level of SCr was obviously lower, and the level of eGFR was markedly higher after treatment, and compared with the control group, the changes in above data after treatment in observation group were more significant [SCr (μmol/L): 250.62±164.97 vs. 393.72±183.64, eGFR (mL·min-1·1.73 m-2): 33.42±17.24 vs. 39.72±23.85, bothP < 0.05]. After treatment, the levels of serum IL-17, Col-Ⅲ and NF-κB p65 in PBMC were obviously lowered in both treatment groups compared with those before treatment, the therapeutic effect in observation group being superior to that in the control group [IL-17 (ng/L): 17.47±8.87 vs. 25.51±16.69, Col-Ⅲ (μg/L): 17.06±8.76 vs. 23.77±10.44, NF-κB p65 (μg/L): 0.58±0.34 vs. 0.83±0.30, allP < 0.05].Conclusion The Qingshen granule can ameliorate the clinical symptoms, improve renal function, decrease the levels of serum IL-17, Col-Ⅲ and NF-κB p65 in PBMC, intervene renal fibrosis in patients with CRF and damp-heat syndrome, ultimately delaying the progress of CRF.

Objectives To evaluate the lung function in patients of severe secondary hyperparathyroidism caused by uremia and to analyze related factors.Methods The pulmonary function of 70 patients with uremia ( 40 patients with severe secondary hyperparathyroidism, 30 MHD patients without SHPT) and 30 healthy people was determined.Correlative analysis was performed between parameters such as pulmonary function indexes and clinical or laboratory parameters. Results Lung function was significantly different between patients with uremia and healthy subjects(P<0.05, respectively). A number of lung function indicators were negatively correlated with iPTH,C reactive protein( CRP) ,dialysis age but were positively correlated with hemoglobin (Hb) and albumin(Alb) (P <0.05).Conclusion Patients with SHPT show impaired lung function.IPTH, dialysis age, Hb, Alb and CRP can be used as important indicators of lung function.

Abatract:Objective To study the relationship of the processes of chronic hepatitis B infection with the degree of depression and the level of serum Brain-derived neurotrophic factor (BDNF).Methods 126 patients with different processes of CHB infection were divided into 3 groups,which were asymptomatic HBV carriers (ASC group),liver cirrhosis (LC group)and hepatic cell carcinoma (HCC group).40 healthy volunteers were selected as normal control.Questionnaire was used to study demographic data and the degree of depression was assessed by using Hamilton Depression Rating Scale (HAMD-17).The levels of the serum BDNF were detected by ELISA.Results The ratio of divorced or widowed in LC and HCC groups was higher than that of the control (χ2 = 6.354,11.972;P < 0.01).Severity of depression in ASC,LC and HCC groups was higher than that of the control (χ2 = 16.151,42.150,49.636;P <0.01).Severity of depression in ASC and LC group was lower than that of HCC group (χ2 = 14.345,28.772;P <0.01).The role of BDNF (x ±s,ng/ml)in ASC,LC,HCC and control group were 11.10±3.26,8.66 ± 3.11,7.39 ±2.52 and 12.18±2.59.The levels of serum BDNF in LC and HCC group was lower than ASC group and the control (P <0.01).The process of CHB infection had positive correlation with the score of HAMD (r=0.719,P <0.01),but had negative correlation with thelevels of serum BDNF (r=-0.504,P <0.01). There was negative correlation relationship between the score of HAMD and the levels of serum BDNF (r=-0.526,P <0.01).Conclusion The process of CHB infection can obviously aggravate the degree of depression,and reduce the levels of BDNF gradually.The levels of serum BDNF can be suggested as a psychological laboratory reference basis for the CHB pa-tients with depression.It is expected to improve the level of clinical diagnosis and treatment in CHB with depression.

To investigate the effects of manual acupuncture at Shenmen (HT7) or Taiyuan (LU9) on the attention function of the brain, and to lay an experimental foundation for researching brain function and integration mechanisms of the human brain in relation to acupuncture stimulation.