The major pathogenic bacterium of catheter-related bloodstream infection is gram-positive bacteria.The occurrence of catheter-related bloodstream infection is related with exogenous factors and endogenous factors.It is suggested that catheter-related bloodstream infection should be diagnosed without removing the catheter.It is shown that the catheter should be removed and the patient should use antibiotics as soon as possible if catheter-related bloodstream infection occurred.Buliding a detection system,using antimicrobial dressings and antimicrobial central catheters,and improving patient's nutritional status can decrease the morbidity of catheter-related bloodstream infection.The authors summarize the epidemiology,diagnosis,treatment and prevention strategies of catheter-related bloodstream infection.

Objective To investigate the method to prevent the displacement of tissue expander implanted between the panniculus carnosus and deep fasia in rabbits .Method 40 rabbits were divided into two groups randomly: the experimental group and the control group .Through an incision on the back , a pocket was made by dissecting between the rabbit panniculus carnosus and deep fasia .The panniculus carnosus at the pocket boundary were sutured with the deep fascia inside the pocket by interrupted 3-0 sutures.A 50 mL kidney-shaped tissue expander was implanted .The expander was inflated with 10 mL saline after the wound was sutured .7 days after implantation , black tattoos were made on the skin around the expander to mark the site of expander .Two months after implantation , the expanders in the experimental group were inflated with 10 mL saline weekly to a total of 140 mL.7 days after implantation the expanders of control group were inflated with 10 mL saline weekly to a total of 140 mL.The incidence of expander displacement , dehiscence of incision , reversal of injection pot and death were recorded .Results There was no expander displacement in the 19 rabbits of experimental group .All the expanders were located within the tattoo area .There was no expander displacement in 11 rabbits of the control group .4 expanders of the control group moved from the back to belly .The difference between them was statistically significant ( P <0.05 ) .The incidence of dehiscence of incision in the experimental group was not significantly lower than that in the control group ( P >0.05 ) .Meanwhile there was no significant difference in the incidences of reversal of injection pot , infections and deaths ( P >0.05 for all ) .Conclusions Sutures between the panniculus carnosus and the deep fascia at the pocket boundary asisted by delayed inflating can prevent the displacement of tissue expander implanted between the panniculus carnosus and deep fasia in rabbits , thus to obtain effective expansion .

Objective To investigate the psychological state of high-risk pregnancy mothers af-ter being separated from their newborns and discuss the influencing factors of psychological state. Methods Nonexperimental descriptive study was used in this study. The investigation adopted state-trait anxiety inventory (STA-Ⅰ) and Edinburgh postnatal depression scale (EPDS). Results The moth-ers' anxiety score was significantly higher than normal women in China, and postnatal depression inci- dence rate was 57.9%. Mothers' psychological state was correlated with gestational age of new-borns, trait anxiety and pregnancy complications. Conclusions The psychological state of high- risk pregnancy mothers after being separated from their newborns should be paid more attention to, and cor-related nursing methods should be taken to improve their mental health.

Objective:To investigate the changes of lymphocyte subsets and the serum levels of IgE in the children with allergic rhinitis,and to analyze the relationship between lymphocyte subsets and IgE.Methods:CD3+,CD4+,CD8+CD19+,CD4+CD25+,CD16+56+lymphocyte subsets were measured by flow cytometry ,IFN-γ,IL-4,IL-5 of serum were detected by enzyme linked immunosorbent assay(ELISA)and the serum level of total IgE was detected by immuno turbidimetric assays in 86 cases of children with allergic rhinitis and 76 cases of healthy children.Results:CD19+B lymphocyte subsets ,the ratio of CD4+and CD8+,IL-4 ,IL-5 and the serum levels of IgE were increased in the children with allergic rhinitis groups as compared with healthy children , the difference has statistical significance(P<0.05);CD3+,CD4+,CD8+,CD4+CD25+,CD16+56+lymphocyte subsets and IFN-γwere lower than the control group ( P<0.05 );there was a correlation between B lymphocyte subsets and IgE in the children with allergic rhinitis.Co nclusion:Lymphocyte dysfunction and Th1/Th2 ratio imbalance may be related to the pathogenesis of allergic rhinitis ,and IgE,IFN-γ,IL-4 and IL-5 play important roles in children with allergic rhinitis.

OBJECTIVE To investigate the relationship between state trait anxiety and behavioral status in patients with sudden deafness. METHODS From April 2015 to June 2016, 140 cases of hospitalized patients with sudden hearing loss were selected as the observation group, and 140 healthy volunteers in our hospital for medical examination were selected as the control group. Average data, state trait anxiety, quality of life, and behavior survey were investigated in the two groups and correlation analysis was conducted. RESULTS The state trait anxiety score of the observation group was 51.20±4.19 points, and the control group was 34.40±3.49 points, and the state trait anxiety score of the observation group was significantly higher than that of the control group(t=12.949, P<0.05). The scores of physical, compulsive, interpersonal sensitivity, hostility and depression in the observation group were significantly higher than those in the control group(P<0.05). The problem solving and help scores in the observation group were significantly lower than that of the control group, while the fantasy and self accusation scores was significantly higher than that of the control group(P<0.05). In the observation group, Pearson correlation analysis shows anxiety scores were significantly correlated to the dimensions scores of quality of life, fantasy and self accusation scores(P<0.05), and were significantly negative correlated to the problem solving and help scores (P<0.05). CONCLUSION The patients with sudden deafness is accompanied by state trait anxiety and fantasy, self accusation and other bad behavior, it can seriously affect the patient's quality of life and form vicious circle, so the nursing intervention should be strengthened in clinical practice.

Objective To study the diagnosis and treatment of syncope by analyzing its etiology.Methods Ninety-six syncope patients admitted to our hospital from 2014-01-01 to 2016-12-21were included in this study.The etiology of syncope was analyzed.Results Of the 96 syncope patients included in this study,50 (52.1 ％) were diagnosed with nerve-mediated reflex syncope,31(32.3％) with orthostatic hypotensive syncope,10 (10.4％) with cardiogenic syncope due to arrhythmia,coronary atherosclerotic cardiopathy or pulmonary embolism,5 (5.2％) with other diseases.Conclusion Nerve-mediated reflex,orthostatic hypotension and cardiogenic factors are the causes of syncope.Attention should thus be paid to syncope caused by nervous system diseases.Clarification of the risk factors for syncope helps to reduce its potential risk.

Objective To evaluate fluid distribution in patients on maintenance hemodialysis (HD) by bioimpedance analysis and on the effect of adjusting the dry weight in hemodialysis patients.Methods Forty maintenance HD patients from the dialysis center of the Second Affiliated Hospital of Dalian Medical University were enrolled as study group.One hundred and two individuals who were tested of physical examination in the same hospital were enrolled as the control group.Sex and age of the two groups were recorded.Body weight,body high,blood pressure,bioimpedance of HD patients (pre-dialysis and post-dialysis) and controls were measured.Bioimpedance was measured by multifrequency segmental bioimpedance analysis,including right arm (RA) bioimpedance,trunk (TR) bioimpedance and right leg (RL) bioimpedance.Bioimpedance ratio (BIR) of three parts was calculated as of 100kHz and 20kHz including RA-BIR,TR-BIR and RL-BIR.Then eight HD patients who had high RA-BIA or TR-BIA according to the reference range which were obtained from 102 controls were chosen for dry weight adjustment.Post-dialysis body weight,blood pressure,and bioimpedance of the eight HD patients were measured again after adjusting the dry weight.Results (1) BIR of three parts in pre-dialysis HD patients were all significantly higher than that in the control group (P ＜ 0.05).BIR of three parts of the post-dialysis HD patients were still higher than that of the control group,but RL-BIR was not significantly (P ＞ 0.05).BIR of three parts of the post-dialysis HD patients were lower than BIR of three parts of the pre-dialysis HD patients,and there was significant different (P ＜ 0.05) with RA-BIR and RL-BIR.(2) After adjusting the dry weight,BIR of three parts of the post-dialysis HID patients were still higher than that of the control group,but none of them was significantly (P ＞0.05).BIR of three parts of the HD patients after adjusting the dry weight were lower than BIR of three parts of the HD patients before adjusting the dry weight,but there was no significant different with TR-BIR(P ＞ 0.05).After adjusting the dry weight,systolic blood pressure of the post-dialysis HD patients were significantly decrease[(150.00 ± 29.28) vs (140.63± 20.78) mm Hg,P＜ 0.05].Conclusions Bioimpedance analysis may be an effective method for adjusting dry weight in hemodialysis patients,and the bioimpedance of arms is the most effective method.The bioimpedance reference range of hemodialysis patients can be according to the reference range of normal individuals.

Hepatitis B virus (HBV)-related liver failure is an end-stage liver disease with a high mortality.Biomarkers,which are of interest,are helpful for diagnosis and treatment of liver failure.The purpose of this review is to highlight the recent advances in this field.Although many new biomarkers can improve the prognostic efficacy,the dynamic biochemical function of liver and kidney as well as the function of coagulation are still the most practical and common indexes for the development and prognosis evaluation of liver failure.

Objective To investigate the correlation between thrombelastogram (TEG)parameters and plasma D-dimer (D-D) and platelet aggregation rate (PAgT)in patients with acute cerebral infarction (ACI).Methods From January 2015 to Jan-uary 2016,120 patients with ACI (ACI group),and 60 healthy subjects (healthy group)were enrolled in the study.The TEG parameters were detected by thromboelastography,including blood coagulation time (R),blood clotting time (K),rate of blood clotting (αangle),coagulation comprehensive index (CI)and the maximum intensity of blood clotting (MA).Blood coagulation indexes also were detected,including prothrombin time (PT),fibrinogen (FIB,detected by automatic coagulation analyzer),plasma D-D (detected by colloidal gold method)and PAgT (detected by blood aggregation tester).Results R (5.36±0.95 min),K (2.34±0.98 min)and PT (11.88±1.67 s)in the ACI group were shorter than those in the healthy group (6.20±1.28 min,2.87±0.87 min,12.40±1.82 s),(t=4.962,3.547,1.911,all P<0.05).Theαangle (61.65± 7.84)degrees,CI (-0.21±1.11),MA (58.94±6.14 mm),D-D (0.34±0.08 mg/L),PAgT (66.9±6.8)% and FIB (4.41±0.96 g/L)in the ACI group were higher than those in the healthy group [(56.02 ± 6.94)degrees,(-1.50 ± 1.30),(53.86±7.85 mm),(0.24±0.06 mg/L),(55.4±7)%,(2.87±0.88 g/L)],(t=4.714,6.209,5.583,8.550, 10.592,7.039,all P<0.05).In ACI group,D-D,PAgt and the TEG parameters (αangle,CI,MA)were significantly nega-tively correlated (r=-0.481,-0.470,-0.504,-0.488,all P<0.05).D-D,PAgt and the TEG parameters (αangle,CI, MA)were significantly positively correlated (r=0.338,0.395,0.427,0.391,0.436,-0.482,all P<0.05).Conclusion TEG parameters can reflect the severity of ACI to some extent,and they were significantly correlated with plasma D-D and PAgt.