OBJECTIVE To perform a surveillance study in order to investigate the change in antimicrobial resistance of Klebsiella pneumoniae,especially extended-spectrum ?-lactamases(ESBLs)-producing strains isolated.METHODS A total of 1986 strains of K.pneumoniae isolated during the last six years were analyzed.RESULTS Among 1986 K.pneumoniae strains,908(45.7%) were ESBLs-producing strains.The sensitive rate of ESBLs-producing K.pneumoniae to imipenem was 100%,and to meropenem was 99%.There were 636 strains isolated from ICU,accounted for 32%;and 480 strains isolated from Department of Respiratory Medicine,accounted for 24.2%.There were 1630 strains isolated from sputum,accounted for 82.1%.CONCLUSIONS K.pneumoniae is the major pathogen.Detecting ESBLs-producing strains rate and their susceptibility to antibiotics is very important in guiding the clinical administration of drugs.

Objective To investigate the relationship between gallbladder carcinoma (GBC) and anomalous arrangement of pancreaticobiliary ductal system (AAPB) through studying the proliferation of gallbladder epithelial cells. Methods ABC Immunohistochemical staining was employed. Results Ki 67 And proliferating cell nuclear antigen PCNA labeling indexes of the non cancerous mucosa in the patients with AAPB and GBC were significantly higher than those in patients with GBC alone (P

To investigate the influence of recombinant human augmenter of liver regeneration (hALR) on stromelysin 1 gene expression in rats with fibrotic liver. CCl 4 or albumin induced liver fibrosis in rats was established, and different dosages of recombinant human augmenter of liver regeneration were given to rats with liver fibrosis.Liver specimens were obtained at different intervals of treatment , total RNA of liver tissues were isolated and stromelysin 1 gene expression was measured by reverse transcription polymerase chain reaction (RT PCR) . The results showed that in both rat models of experimental liver fibrosis , stromelysin 1 gene expression levels were significantly higher in hALR treated rats than those without the treatment at various intervals. Stromelysin 1 gene expression levels in high dose hALR treatment group were significantly higher than that in low dose hALR treatment group. It suggested that recombinant human augmenter of liver regeneration may enhance stromelysin 1 gene expression in rats with fibrotic liver.

To explore the changes of anti-thyroid drug (ATD) on bone mineral density and bone turnover parameters in patients with Graves disease (GD).Compared with the healthy controls during the same period,the serum levels of alkaline phosphatase (AKP) and bone gla protein (BGP) in GD patients significantly increased at pre-treatment and after normal thyroid by treatment (P ＜ 0.05,P ＜ 0.01).AKP and BGP of GD patients reduced to normal level at Month 6 after normal thyroid (P ＞ 0.05) ; BMD significantly decreased at pre-treatment and Month 12 after normal thyroid (P ＜ 0.05,P ＜ 0.01).And it dropped to normal level at Month 18 (P ＞ 0.05).GD could affect bone metabolism and thyroid hormone might accelerate bone metabolism directly.

Objective To investigate the influence of recombinant human augmenter of liver regeneration (hALR) on gelatinase A(MMP 2) gene expression in experimental liver fibrosis. Methods Two kinds of animal model of rat experimental liver fibrosis induced by CCl 4 and albumin were established and different dosage of hALR (10,50 ?g?kg -1 ?d -1 )was given during the process of model making. Total RNA of liver tissues was isolated and MMP 2 gene expression levels were measured by reverse transcription polymerase chain reaction (RT PCR). Results In both rat models of experimental liver fibrosis, MMP 2 gene expression levels in two hALR preventing group were significantly lower than those of model group in different periods of model forming. MMP 2 gene expression levels in high dose of hALR treating group were significanfly lower than those of low dose hALR treating group. Conclusion hALR may have an effect on inhibiting gene expression of MMP 2 in experimental liver fibrosis.

Objective To explore the effect of dressing techniques under Orem self-care theory on the ability of daily living of stroke patients with hemiplegia. Methods About 96 stroke patients with hemiplegia were randomly divided into an experimental group and a control group, 48 cases in each group. The patients in the experimental group received training on dressing techniques under Orem self-care theory, while those in the control group received routine training on dressing techniques.The daily life ability of both groups was comfared. Result After one month, the Barthel scores in the experimental group were higher than those of the control group (P<0.05). Conclusion Dressing techniques under Orem self-care theory can improve the ability of daily living of stroke patients with hemiplegia.

Objective To investigate the influence of recombinant human augmenter of liver rege neration (hALR) on stromelysin 1 gene expression in experimental liver fibrosis. Methods Two kinds of rat model of experimental liver fibrosis induced by CCl 4 and albumin were established and different dosages of recombinant human augmenter of liver regeneration were given during the process of model making. Total RNA of liver tissues was extracted and stromelysin 1 gene expression levels were measured by reverse transcription polymerase chain reaction (RT PCR). Results In both rat models of experimental liver fibrosis, stromelysin 1 gene expression levels in hALR treating group were significantly higher than those of model groups in different periods of model forming. Stromelysin 1 gene expression levels in high dose hALR treated group were significantly higher than those of low dose hALR treated group.Conclusion Recombinant human augmenter of liver regeneration may have effects of promoting gene expression of stromelysin 1 in experimental liver fibrosis.

Objective: To investigate the nicotine dependence of patients with chronic obstructive pulmonary disease (COPD) who smoke and analyze its influencing factors, so as to provide insights into targeted smoking cessation interventions for smoking COPD patients. Methods: The smoking COPD patients were selected from three hospitals in Lanzhou City using the convenience sampling method from October 2022 to April 2023. Demographic data, smoking status, and willingness to quit smoking were collected using questionnaire surveys. Nicotine dependence was assessed according to Fagerstrom Test for Nicotine Dependence. The influencing factors of nicotine dependence in smoking COPD patients were analyzed using a multiple linear regression model. Results: A total of 200 questionnaires were distributed, and 171 valid questionnaires were collected, with a response rate of 85.50%. The median age was 48.00 (interquartile range, 10.00) years. There were 158 males, accounting for 92.40%; 53 cases with a college degree or above, accounting for 30.99%. The median smoking duration was 15.00 (interquartile range, 11.00) years. There were 73 patients (42.69%) smoking 21 to 30 cigarettes per day, and 159 patients (92.98%) with the willingness to quit smoking. The median nicotine dependence score was 3.00 (interquartile range, 1.00) points. There were statistically significant differences in nicotine dependence scores among smoking COPD patients with different ages, educational levels, occupations, interpersonal relationships, smoking duration, daily cigarette consumption, awareness of smoking hazards and willingness to quit smoking (all P<0.05). Multiple linear regression analysis revealed that nicotine dependence was related with educational level (β=-0.251), interpersonal relationship (β=-0.246), smoking duration (β=0.038), daily cigarette consumption (β=0.518) and willingness to quit smoking (β=-0.173) among smoking COPD patients (all P<0.05). Conclusion The nicotine dependence among smoking COPD patients was influenced by educational level, interpersonal relationships, smoking duration, daily cigarette consumption and willingness to quit smoking.

Objective To explore the relationship of peritoneal transport patterns and the nutritional status in continuous ambu-latory peritoneal dialysis(CAPD) patients .Methods 89 patients who took CAPD in 2010 January to December 2012 in the perito-neal dialysis center of our hospital were selected in this study .According to the ratio of creatinine in peritoneal dialysis solution and in blood(D/Pcr)of the peritoneal equilibrium test(PET) ,all CAPD patients were divided into HA group(high average transport) and LA group(low average transport) .Nutritional status including serum albumin(ALB) ,prealbumin(PA) ,transferrin(TF) ,hemo-globin(Hb) ,Lean body mass(LBM) ,subjective global assessment(SGA)and normalized Protein Equivalent of Nitrogen Appearance (nPNA) were compared in both groups .The relationship of D/Pcr and the nutritional status were analyzed .Results D/Pcr in HA group were significantly higher than in LA group(P<0 .01) .ALB ,PA ,TF ,Hb and SGA in HA group were significantly higher than in LA group(P<0 .01) ,but nPNA in two groups has no statistical differences (P>0 .05) .D/Pcr was negative related to ALB , TF ,Hb and SGA(P<0 .01) ,but not related to nPNA ,PA and LBM (P>0 .05) .Conclusion The nutritional status is related to peritoneal transport patterns in peritoneal HA patients ,it is necessary to strengthen nutritional guidance ,as the nutritional status is worse compared to LA ones .

The authors probed systematically into the delicacy management measures adopted by the hospital in its internal mechanism reform, innovative medical service model, human resource optimization, and its performance appraisal system reform. Discussions in the paper include such topics as flat management for hospitals,intensification,centralization and integration in diagnose and treatment, as well as vertical nursing management, and the outsourced logistic services. The methods and paths to achieve these goals are summarized as “preciseness, accuracy, carefulness, and strictness”.