Objective:To analyze the epidemic characteristics and gene type of the Extended-Spectrum ?-Lactamases(ESBLs)-producing Gram-negative bacterium in Chong-qing area from 2002 to 2004,and investigate its distribution of gene typing and drug resistance.Methods:There were 4022 Gram-negative bacterium isolated in clinic from 2002 to 2004,and they were identified and done the drug sensitivity by the microscan walkaway-4.0.ESBLs-producing strains were detected by K-B method and amplified by PCR.The DNA of 108 chosen ESBLs-producing strains were genotyped by Tripure Isolation Reagent.Results:1468 ESBLs-producing strains were detected.The rates of Escherichia.coli and Klebsiella.pneumoniae were 52.5% and 65.8% respectively.The general positive rate of ESBLs-producing was 58.0%.And the rates in year 2002,2003 and 2004 were 68.2%,56.9% and 50.8% 2002 to 2004 respectively.The result of PCR showed that 3 types of gene typing,TEM,SHV and CTX were detected in 108 chosen ESBLs-producing strainsThe TEM type was the main type in E.coli(56/59),E.asburiane(12/13)and P.aeruginosa(6/7)while the SHV type was the main type in K.pneumoniae(28/29).TEM type was the main type for year 2002(75%),both TEM(40%)and SHV(57.1%)for 2003,and TEM for 2004(90.9%)with CTX as infrequent type(3.7%).The resistance rates of ESBLs-producing isolates against penicillins,aztreonam and the third generation cephalosporins were about 56.2%-100%,and almost multi-resistant.Conclusion:The incidence of ESBLs-producing isolates was decreasing by year,and ESBLs-Producing isolates mainly carried TEM and SHV types of ?-Lactamases with the TEM one as the major.Their drug resistances were not so good.Those indicated that it is necessany to strengthen the understanding about bacterium resistance and gene type change,administer medicines reasonably to decrease the resistant ones and control the infection in hospital better.

The effective therapy of limited stage-small cell lung cancer( LS-SCLC) is combined chemotherapy and thoracic radiotherapy(TRT). Early thoracic irradiation is better than later one. Start of any treatment and end of radiotherapy less than 30 days is associated with improved survival in LS-SCLC patients. Concurrent chemoradiotherapy results in longer survival time than sequential and alternating chemoradiotherapy. There are no clear answers on optimal irradiation dose. Hyperfractinated irradiation may have therapeutic benefit compared with conventional irradiation.

Objective To investigate the clinical application value and feasibility in the dynamic ECG moni-toring in the diagnosis on patients with sleep apnea syndrome complicated with arrhythmia .Methods A total of 80 cases of sleep apnea syndrome confirmed by polysomnography diagnosis were randomly divided into the two groups,40 cases in each group .The patients in the control group were received routine ECG monitoring ,the observa-tion group were underwent dynamic ECG monitoring ,the arrhythmia detection rate in the two groups were compared . Results The ventricular premature beat ,atrial premature beat,ventricular in patients with Beckoning tachycardia , paroxysmal ventricular tachycardia , paroxysmal atrial tachycardia , first degree atrioventricular block , second degree atrioventricular block,premature atrial arrhythmia with sinoatrial block detected in the control group were 6 cases, 7 cases,9 cases,6 cases,5 cases,1 cases,1 cases,5 cases,respectively.However,21 cases,19 cases,25 cases, 16 cases,19 cases,7 cases,8 cases,14 cases were confirmed in the observation group ,the positive detection rate in cardiac arrhythmias in the observation group were significantly higher than that in the control group (χ2 =19.700, 17.000,13.700,21.200,22.600,53.000,50.500,26.100,all P<0.05).Conclusion Dynamic electrocardiogram can improve the positive rate of arrhythmia ,and have important clinical value in the diagnosis and treatment of sleep apnea syndrome complicated with cardiac arrhythmias ,which is worthy of clinical application .

This article discusses the ethical problem about functional appliance in orthodotic treatment. The problem mainly includes:(1)aacuate diagnosis cant be obtained and exhaustive plan for treatment cant be established. (2)It is lacked to devote your cause, so that making appliance is not normative and meticulous.(3)moral responsibility is not strong when doctors are inquired.The author brings forward some suggestions:(1) it is so hard to study professioinal knowledge,and improving level of treatment and culture.(2)moral responsibility must be strong enough when facing with patients.(3)doctors should attach importance to young patients so as to build a good relation of doctors and patients.

OBJECTIVE:To provide reference for rational use of TCM injection in the clinic. METHODS:The utilization of TCM injections in 34 hospitals from Nanjing area during 2012-2014 was analyzed statistically in respects of consumption sum, DDDs,DDC. The occurrence of ADR induced by TCM injections was also analyzed statistically in the First Affiliated Hospital of Nanjing Medical University. RESULTS:The consumption sum of TCM injections in 34 hospitals from Nanjing area during 2012-2014 increased year by year;top 10 kinds of TCM injections mainly were anti-tumor drugs and cardio-cerebrovascular drugs in 2014,and each of them involved 4 categories and their consumption sum accounted for 46.08% and 32.59%,respectively. Total consumption sum of anti-tumor TCM injections increased slowly,while those of cardio-cerebrovascular drugs,antibiosis and anti-phlogosis increased rapidly. Lentinan injection steadily took up the top in the list of consumption sum and DDDs of single type,its DDC was the lowest and B/A=1.00. In the First Affiliated Hospital of Nanjing Medical University,most of ADR was induced by Xiyanping injection (27 cases,45.00%). CONCLUSIONS:The type of TCM injections keep stable in 34 hospitals from Nanjing area during 2012-2014,mainly involving anti-tumor drugs and cardio-cerebrovascular drugs which were used widely. Clinic should strengthen dialectial therapy close monitoring and attch improtance to the rational use of TCM injections.

Diabetic retinopathy(DR) is characterized by retinal edema,macular edema,eye sight degeneration,etc.and it can cause blindness .Etiopathogenisis and pathogenesis studies of DR was gradually deep and good curative effects were achieved. The author reviewed by consulting DR relevant treatment literature of traditional Chinese medicine in recent years.In order to provide reference for clinical treatment of DR.

ObjectiveTo explore help-seeking behavior and treatment towards people with mental illness,so as to provide evidence for intervention measures.Methods 1988 mental disorders in outpatient were selected with a self-developed questionnaire randomly,and regression analysis was carried out.ResultsUnstable marriages and the lack of mental health knowledge were risk factors for actively professional help-seeking contact after first onset of a mental disorder.Median delays of seeking help and treatment in depression,schizophrenia,anxiety disorders and somatoform disorders were 113.5 days,34.0 days,86.5 days,309.0 days and 6.0 months,3.0 months,3.0 months,5.5 months orderly.There were notable difference for primary treatment contact between the four mental disorders ( x2 =46.317,P =0.029 ).No-professional recognition ratio was 17.8％.The ratio of correctly diagnosed and rationally cured with drugs ratio was 10.5％.89.5％ of outpatients had not been given rational drugs then they sought to psychiatry.ConclusionThe delay of help-seeking and treatment in mental illnesses are serious,so it should be taken effective measures to promote the popularization of mental health knowledge and train no-professional doctors in order to improve the behavior of seeking help and provide the ratio of recognition and treatment.

Objective To observe the clinical effect of treating humeral supracondylar fracture in children with manual reduction combined with oral medicinal herbs and fumigation.Methods 80 children with humeral supracondylar fracture were involved in clinical observation.Patients with Gartland Type Ⅰ and Type Ⅱ were selected and treated with manual reduction and plaster external fixation.Gartland Type Ⅲ cases were selected and treated with Kirschner-wire transfixion.All of patients were treated with oral medicinal herbs and fumigation.Results All children with humeral supracondylar fracture recovered.Based on the clinical function test,39(48.75%)cases had excellent effects,39(48.75%)cases had good effects,and 2(2.50%)cases had fair effects.No Volkmann contracture or cubitus varus deformity occurred.Conclusion The treatment of humeral supracondylar fracture in children with manual reduction combined with oral medicinal herbs and fumigation has a good effect.

44 obstructive sleepapnea-hypopnea syndrome ( OSAHS) patients were Supplemented by an controlla-ble appliance in their intervene treatments. The data of polysomnography ( PSG) , Epworth sleepiness scale( ESS) and quality of life-Quebec sleep questionnaire( QSQ) before and 3 treatment period months after oral appliance were recorded. Correlations between subjective and objective measure before treated with OA and subsequently investi-gate treatment mechanism of oral appliance( OA) . Correlations indexes between before and after 3 treatment with an controllable appliance, and evaluation had statistically significance ( P <0. 05 ) . Absolute correlations between PSG indexes and subjective measures before oral appliance ranged from 0. 321 ~0. 433 , and 3 treatment period months after oral appliance ranged from 0. 306~0. 437 . Both PSG indexes and quality of life improved significantly after oral appliance(P<0. 05).

Objective To investigate the effect of Platelet-activating factor(PAF)in pathogenesy of asthma in high altitude Methods ELISA and other methods were used to detect the quantity of platelet(PLT)and the level of serum platelet-activating factor(PAF)in the plain control group、the plateau control group and the plateau asthma patients group.Results The quantity of PLT in plain control group and plateau control group were significantly lower than that of plateau asthma patients group.(P