Objective To understand the distribution of detected pathogens in blood culture specimens in our hospital and the drug resistance to provide the basis for clinical reasonable selection of antibacterial drugs.Methods The blood culture results in our hospital from January 2011 to June 2012 were analyzed retrospectively.Results Among 3 164 blood culture samples,418 cases were positive,accounting for 13.21%,176 strains were Gram-positive bacteria(42.11%),Staphylococcus aureus and coagulase neg-ative staphylococcus were predominant;235 stains were Gram-negative bacteria(56.22%),Escherichia coli and Klebsiella pneumon-iae were predominant;7 stains were Candida(1.67%).The most of submitted specimens were the neonatology department(627 specimens),hematology department (367 specimens),respiratory department (272 specimens),paediatric department (207 speci-mens),neurology department(185 specimens)and ICU(158 specimens).The top departments in the strain separation rate were the hepatobiliary surgery(22.22%),endocrinology(18.18%),spinal surgery(16.36%),ICU(15.96%),neurosurgery(15.62%),neu-rology(15.13%),oncology(13.92%),urological surgery (12.23%),burns and pediatric surgery (12.15%),and bone surgery (10.25%).Among mainly Gram-positive bacteria,Staphylococcus had the high resistance to penicillin,erythromycin,clindamycin and trimethoprim-sulfamethoxazole,coagulase-negative staphylococci had the high resistance to quinoiones,but vancomycin-resistant and linezolid-resistant Staphylococcus was not found.Among Gtam-negative bacilli,Enterobacteriaceae had the strong sensitivity to imipenem,ertapenem and amikacin;Escherichia coli had the higher resistance to penicillins,cephalosporins,aztreonam,quinolones, cotrimoxazole,gentamicin and tobramycin,which was more than 40%,the resistance rate to ampicillin,ampicillin/sulbactam was a-bout 90%,but Escherichia coli was more sensitive to piperacillin / tazobactam,the resistance rate was less than 5%;Klebsiella pneumoniae had the low drug resistance,only the resistance rates to ampicillin and nitrofurantoin were more than 90%,the others were 30 % or less;Enterobacter cloacae had the higher resistance to ampicillin,ampicillin/sulbactam,third generation cephalospo-rins,tobramycin,cefotetan and nitrofurantoin and the low resistance to the fourth generation cephalosporins,piperacillin / tazobac-tam and quinolones.Conclusion The pathogenic bacterial species of blood culture are complex and dominated by the conditional pathogens with strong drug resistance.Therefore,the detection of clinical blood culture specimens in the patients with suspected septicemia should be strengthened for accurately and rationally using antibacterial drugs as early as possible and increasing the cure rate.

Objective To detect the mRNA expression of KPNA2 in hepatocellular carcinoma(HCC) tissue and to investigate its relationship with the clinicopathological features of HCC so as to provide the basis for predicting HCC infiltration ,metastasis and early treatment .Methods The HCC tissue and paracarcinoma normal tissue from 30 operative cases of HCC in the hepatobiliary surgery department of this hospital from January 2011 to November 2013 were collected and detected KPNA2 expression at the transcriptional level by RT-PCR .The correlation between the mRNA expression of KPNA2 with the clinicopathological factors of HCC was analyzed by consulting the medical record data .Results Among 30 cases of HCC ,the ratio of KPNA2 mRNA in the HCC tissue and the paracarcinoma normal tissue in 25 cases(83 .33% ) was up-regulated (grey value >2 times) .Therefore ,the KP-NA2 gene exhibited the high expression in the HCC tissue and low expression in the paracarcinoma normal tissue .Conclusion KP-NA2 is highly expressed in the HCC tissue and lowly expressed in the paracarcinoma normal tissue ;the high expression of KPNA2 is positively correlated with the stage and pathological grading of HCC ;KPNA2 may be used as an important indicator for early di-agnosing HCC and judging the malignant degree and potential metastais ability of HCC .

Objective To analyze the clinical outcomes of a patient with thrombotic thrombocytopenic purpura(TTP)as the starting performance who was considered as systemic lupus erythematosus(SLE)under multiple abnormal autoantibod-ies,and summarize the treatment experience through the clinical outcomes of plasma exchange combined with high-does ster-oid pulse therapy.Methods A middle-aged female patient presented with initial symptoms of fever,bleeding and hemolytic thrombocytopenia.Laboratory tests showed decreased activity of thrombospondin type 1 motif no.13(ADAMT13)and abnor-mal autoantibodies.The diagnosis was considered SLE with TTP,and the patient underwent continuous plasma exchange combined with high-dose steroid pulse therapy.The patient's platelet recovery was dynamically observed.Results The pa-tient responded well to plasma exchange combined with high-does steroid pulse therapy,with platelet count raising to normal in a short period of time and hormone gradually decreasing.There was no recurrence during the follow-up period.Conclu-sion TTP combined with lupus is not common,but when both occur simultaneously,plasma exchange combined with high-does steroid pulse therapy may effectively alleviate symptoms.This treatment approach can serve as a valuable reference for similar clinical cases.

In order to promote the informatization construction of medical education and further enhance teachers' cognition of informatization, Zunyi Medical University actively promotes digital teaching tools, innovates education and teaching management, and promotes the deep integration of information technology and education. For this reason, the systematic anatomy of clinical specialty was selected to establish the network course system, and the network course of systematic anatomy was created by using video software such as Camtasia studio 9, Adobe After Effects CS6 and format factory, and the exclusive network course system of systematic anatomy was created on the superstar learning platform to explore the online teaching mode. Through the evaluation of online and offline teaching, we know that the online teaching reform has achieved the expected teaching effect, stimulated the students' autonomy in learning, and realized the teaching requirements of systematic anatomy. However, there are still many problems, such as how to better integrate online and offline, which needs further exploration.