OBJECTIVE To investigate the antimicrobial application in a hospital of traditional Chinese medicine(TCM).METHODS Data of antimicrobial application in patients who were discharged within a month were investigated.RESULTS The usage rate of antimicrobials was 62.62%,the surgical departments were higher in antibacterial use than departments of internal medicine;the pathogenic detection rate was 17.28%;the usage rate of combinations accounted for 34.14%;the duration of preoperative and postoperative antimicrobial use was long,some patients didn′t receive rationally preoperative prophylactic antimicrobials.CONCLUSIONS Management of clinical antimicrobial application in hospital of TCM should be strengthened,especially on the indication of antimicrobial and pathogenic detection.

Objective To investigate antimicrobial resistance and change trends ofUreaplasma urealyticum (Uu) from reproductive system of female patients at a traditional Chinese medicine hospital in three consecutive years. Methods Antimicrobial resistance of Uu isolated from gynaecology leucorrhea and cervical secretion specimens of patients of dermatology & sexually transmitted diseases department and gynaecology department from January 2011 to December 2013 were analyzed retrospectively.Results A total of 327 Uu strains were isolated,except resistance rates of Uu to doxycycline(5.23%-6.12%)and josamycin(0-1 .96%)remained at a relatively low level in three consecutive years,resistance rate to the other antimicrobials showed an upward trend year by year,but the difference was not significant (P >0.05).The resistance of Uu to ofloxacin,clarithromycin and sparfloxacin were relatively high(42.11 %-61 .40%),to josamycin,doxycycline and minocycline were lower(0-13.07%),and multidrug re-sistance was serious.Conclusion Antimicrobial resistanc of Uu isolated from reproductive system of female patients in this hospital is high.It is necessary to realize the status and change trends of antimicrobial resistance of Uu for the treatment of disease and control of the emergence of multidrug resistance pathogens.

Objective:To investigate the method of how to realize one stop payment service between hospitals, enrich its connotation, and expand its outreach.Methods: The establishment funds unified trading platform can realize the settlement of one stop payment service between hospital, and at the time achieve a unified account management, real-time account transactions, and perfect reconciliation.Results: Through the research, we can conclude that we can realize the one stop payment service between hospitals, and will improve the usage and satisfaction of the system, achieve better results.Conclusion: With the deepening of the one stop payment service model, it will play a greater role; achieve more satisfactory economic and social benefits.

Objective This study is to understand the interpersonal conflict management styles of head nurses and its related factors. Methods A cross- sectional survey was conducted in 440 head nurses in Shanghai Hospital, using"personal information table"and the "Rahim Organizational Conflict Inventory- Ⅱ"as the tools for data collection. Results When dealing with conflicts, "integrating"is the most commonly used approach of head nurses, while "dominating"the least used one. Age, education, work experience and other factors were statistically significant with the conflict management styles head nurses used. Conclusions The most commonly used conflict management style of head nurses tends to a winwin way. Age, education, work experience and other factors can affect the ways of managing conflict.

Objective To investigate the effect of ghrelin on PAI-1 secretion in HepG2 cells induced by TNF-αand the effect of p-38 MAPK.Methods HepG2 cells were cultured.The concentration of TNF-α used to treat the HepG2 cells wag selected.The effect of ghrelin on PAI-1 secretion induced by TNF-α was detected by ELISA,the p-38 MAPK expression was investigated by Western blot.Results The concentration of PAI-1 was increased when cells were exposed to different concentration of TNF-α.The p-p38 MAPK expression was increased when the cells were exposed to TNF-α,ghrelin could inhibit the increase of PAI-1 secretioN induced by TNF-α.The expression of p-p38 MAPK was decreased when the cells were pretreated with ghrelin.Conclusion PAI-1 secretion were increased after TNF-α in-creasing.Ghrelin could inhibit PAI-1 secretion via p38 MAPK.

Objective To investigate the clinical value of the combined detection of Golgi protein 73 (GP73),alpha-fetoprotein variant-L3 (AFP-L3)and transforming growth factorβ1(TGFβ1)in the early diagnosis of hepatocellular carcinoma (HCC).Meth-ods 48 cases of healthy control,42 cases of hepatitis B,50 cases of posthepatitic cirrhosis and 58 cases of HCC were selected and detected GP73,AFP-L3 and TGFβ1.The detection results were compared among 4 groups.Results (1)The levels of GP73,AFP-L3 and TGFβ1 had statistical differences among 4 groups(P <0.05 );(2 )The positive rate of the 3-marker combined detection reached 96.55%,which was higher than that of the 2-marker combined detection and the single marker detection.Conclusion (1) GP73,AFP-L3 and TGFβ1 may be used as the serum indicators for the early diagnosis of HCC;(2)Compared with the traditional HCC marker AFP,AFP-L3 has relatively high sensitivity and specificity and has the important role in the differential diagnosis of benign and malignant diseases of the liver,which is considered as a better serum marker in the HCC diagnosis;(3)The 3-indicator combined detection can significantly improve the positive detection rate of HCC and has better application value.

Objective To establish a duplex fluorescence PCR for detection of HIV proviral DNA and to evaluate its application for early diagnosis of HIV infection in infants .Methods A duplex fluores-cence PCR system was set up based on TaqMan technology for detection of human ribonuclease P ( RNase P) gene and long terminal repeat ( LTR) region of HIV.A recombinant plasmid containing the targeted gene fragment , pTG19-T, was constructed by TA cloning technique and used as the template for evaluation of sen -sitivity of the assay .Blood samples from 11 healthy individuals and 98 HIV-infected patients were collected and detected to validate the assay specificity .The assay of duplex fluorescence PCR was then carried out to detect 96 infant blood samples collected from several maternal and child health hospitals in Zhejiang province from January 2011 to September 2012 for early diagnosis of HIV infection .The results were compared with those by using the Roche HIV DNA qualitative detection kit .Results The established duplex fluorescence PCR could specifically detect HIV proviral DNA with a specificity of 100%and a detection sensitivity of 100 cps per reaction .The coincidence rate between the established assay and the Roche HIV DNA qualitative de -tection kit was 100%in the detection of 96 blood samples .Conclusion The duplex fluorescence PCR as-say showed advantages of cost-effectiveness , convenience , good specificity and accuracy with high sensitivi-ty.It could be used for early diagnosis of HIV infection in infants and also as a general technical platform for the detection of HIV proviral DNA .

Objective To study the roles of serum tumor necrosis factor-α (TNF-α),sTNFR-Ⅰ and sT-NFR-Ⅱ in asthmatic children.Methods The levels of serum TNF-α,sTNFR-Ⅰ and sTNFR-Ⅱ in 60 asthmatic children,including 30 cases of acute exacerbation group and 30 cases of clinical paracmasia group,and 22 cases of healthy children (control group) were detected by ELISA.Results (1) The level of serum TNF-α in acute exacerbation group was (98.87 ± 16.25) ng/L,it is significantly higher than the clinical paracmasia group (62.19 ± 15.85) ng/L and control group (44.25 ± 10.44) ng/L (F =94.78,P ＜ 0.05).The level of serum sTNFR-Ⅰ and sTNFR-Ⅱ in acute exacerbation group were (11.14 ±2.04) μg/L and (11.81 ±2.14) μg/L respectively,they were significantly higher than their own clinical remission group (8.91 ± 1.63) μg/L and (9.36 ± 1.72) μg/L,also significantly higher than the control group (5.03 ± 1.18) μg/L and (5.21 ±1.23) μg/L,(F =83.03 and 87.62,all P ＜ 0.05).The levels of TNF-α,sTNFR-Ⅰ and sTNFR-Ⅱ in clinical paracmasia group were significantly higher than that in control group (P ＜ 0.05).(2) The levels of sTNFR-Ⅰ and sTNFR-Ⅱ in asthmatic children,both acute exacerbation and clinical paracmasia,were positively correlated (r=0.908,P ＜ 0.05 and r =0.737,P ＜ 0.05).Conclusion The level of TNF-α maybe indicate the inflammatory severity of asthma,and the changes of serum sTNFR-Ⅰ and sTNFR-Ⅱ were closely related with asthmatic airway inflammation.

Objective To evaluate the effect of traditional Chinese medicine sputum discharge liquid on preventing ventilator-associated pneumonia(VAP).Methods A randomized double-blind,placebo-controlled study was con-ducted,according to the inclusion and exclusion criteria,patients with respiratory failure and mechanical ventilation in the intensive care unit (ICU)of a hospital in 2011 -2014 were selected and divided into treatment group and con-trol group.Treatment group received sputum discharge liquid in addition to conventional treatment,control group adopted simulation agent based on conventional treatment.The incidence,treatment effectiveness,occurrence time, and prognosis of VAP between two groups of patients were compared.Results A total of 139 patients were monitored,70 cases in treatment group and 69 in control group.The incidence of VAP in treatment group and con-trol group were 37.14% (n =26)and 57.97%(n =40)respectively;the average onset time of VAP in treatment group and control group were (76±3.2)hours and (45±8.9)hours after admission to ICU respectively;treatment effectiveness rates in treatment and control group were 88.46% and 55.00% respectively;the incidence,occurrence time,and treatment effectiveness rates of VAP between two groups of patients were both significantly different (all P <0.05).There were no significant difference in blood routine,liver and kidney function,urine routine,stool rou-tine,and electrocardiogram results between two groups of patients (all P >0.05 ).Conclusion Intervention in patients with mechanical ventilation by sputum discharge liquid can reduce the incidence of VAP,and has a positive effect on the prognosis of disease and pulmonary infection in patients.

Objective To investigate the quantitative expression of mRNA levels of human NOV and WT1 genes in renal cell carcinoma ( RCC). Methods Using quantitative real-time RT-PCR analysis, we quantified NOV and WT1 mRNA levels in the samples from 57 patients (40 men and 17 women; mean age,65 years) with RCC. Of them,39 cases had T1 stage tumor, 13 had T2 stage and 5 had T3a stage by UICC pathologic staging;and 14 cases had G1 tumor,23 had G2 and 20 had G3 by Fuhrman grading. The expression levels of NOV and WT1 genes,and their association were analyzed. Results The median level of NOV mRNA expression was significantly lower in RCC ( 1. 17) than in normal kidney tissue (4. 32, P