OBJECTIVE To investigate ?-lactamase coding genes and oprD2 gene in multidrug-resistant Pseudomonas aeruginosa isolated.METHODS Polymerase chain reaction(PCR) was used to detect various ?-lactamase coding genes including TEM,SHV,OXA,PER,GES,IMP,VIM,plasmid type AmpC ?-lactamase DHA,MIR and oprD2 in 20 strains of P.aeruginosa.RESULTS The detection rate of ?-lactamase coding genes plasmid type AmpC,VIM,TEM,SHV,OXA and IMP were 15%,5%,15%,10%,10% and 5%,respectively,the loss rate of oprD2 was 25%,but PER and GES genes were negative.CONCLUSIONS The study indicated that the P.aeruginosa is carrying genes of DHA,TEM,SHV,OXA,VIM,IMP and being lost oprD2 gene,the latter is the essential resistance mechanism of P.aeruginosa to beta-lactam antibiotics in local area.

Objective To evaluate the effect of Sengstaken-Blakemore tube in assisting cyanoacrylate injection combined with sclerotherapy and variceal ligation under emergency endoscopy in treating escophageal and gastric variceal bleeding. Methods 60 patients were randomly selected, and were evenly divided into 2 groups single blindly. Endoscopic cyanoacrylate injection, sclerotherapy and variceal ligation were performed in control group, and additional Sengstaken-Blakemore tube were used in experimental group. Results All the 30 patients in study group got effective hemostasis (30 of 30, 100.00 %), whereas only 23 patients in control groups stopped bleeding (23 of 30, 76.67 %) (P < 0.05). escophageal and gastric variceal were cured 19 patients in the experimental group (19 of 30, 63.33 %) , and only 4 were cured in the control group (4 of 28, 14.28 %) (P < 0.05). Meanwhile, occurence of fever, chest pain, hospital days and hospitalization costs of experimental group was significantly lower than that in control group (P < 0.05). Conclusions Treating the escophageal and gastric variceal bleeding, using endoscopic cyanoacrylate injection, sclerotherapy; and variceal ligation under emergency endoscopy combined with Sengstaken-Blakemore tube could significantly increase the therapeutic efficiency as well as reduce complications and therapy cost.

ObjectiveTo explore the influence of 3C bolus wizard on postprandial glucose levels in diabetic patients. MethodFifty-eight patients with type 2 diabetes in our hospital were monitored with continuous glucose monitoring system(CGMS), continuous subcutaneous insulin infusion(CSII)and CareLink(3C for short)for 6 days.The function of “3C” bolus wizard was applied during treatment and all the patients were given dietary nursing and health education.The glucose level was observed.ResultThe level of P2hBG of the 58 patients was between 6.4~10.7mmol/L in 3~6 days.ConclusionsBolus wizard plays an important role in “3C” treatment.It can make the postprandial glucose of patients satisfactorily controlled in a short time only to avoid insulin hypoglycemia because of large doses of insulin.At the same time,health education on patients can achieve remarkable results as well.

Objective To explore a new mode for self-printing by a doctor station.Methods A self-printing program was developed with Delphi 6.0,which obtained the information on the hospitalized and discharged patients from oracle database of HIS first,then inquired the examination results and printing identification in SQL database of LIS and printed the laboratory report finally.Results The new mode saved the workload for laboratory report printing and distribution,shortened the time consumed for pasting the report,reduced the ratio for missed and false pasting,avoided the pathogen transmission due to the report and increased the report quality.Conclusion The new mode realizes data sharing and raises working efficiency,and thus is worthy promoting practically.

Objective To observe the efficacy of finasteride and M-receptor antagonist (tolterodine tartrate release tablet) in patients with benign prostatic hyperplasia (BPH) with overactive bladder (OAB).Methods 40 patients with BPH and OAB were treated with finasteride (5 mg,Qd) and tolterodine tartrate release tablet (4 mg,Qd) for 6 months.The clinical effects were evaluated by the International Prostate Symptom Score (IPSS),Overactive Bladder Symptom Score (OABSS),urgency rating scale,maximum flow rate,voiding volume,prostate volume before and after treatment.Results Compared with before treatment,the IPSS,OABSS,urgency rating scale,maximum flow rate,voiding volume,prostate volume were improved [(11.8±1.4) vs.(19.2±2.1),(4.6±2.6) vs.(9.3±1.8),(1.2±1.9) times/week vs.(4.7±1.0) times/week,(14.5±2.7) ml/s vs.(10.2±2.2) ml/s,(25.2±2.6) ml vs.(34.6±3.2) m1,(46.2±2.2) ml vs.(57.6±1.3) ml,all P＜0.05] after treatment.No urinary retention and other adverse reactions were found.Conclusions Finasteride combined with M-receptor antagonist (tolterodine tartrate release tablet) is an effective and safe therapeutic method for patients with BPH and OAB.

Objective To explore the clinical effects of tension-free vaginal tape obturator system inside-out (TVT-O) for the treatment of female stress urinary incontinence.Methods A retrospective analysis of 102 patients with stress urinary incontinence who were performed TVT-O surgery in our hospital from October 2011 to June 2012.The postoperative follow-up time was 1 to 8 months.Results 102 patients with stress urinary incontinence were effectively controlled after surgery,the subjective satisfactory rate was 96.1％ (98 cases),the objective of efficiency was 93.1％(95 cases).After a mean follow-up of 1-8 months,no symptoms were in recurrence.The average surgery time was (35.0± 2.1) min and the average blood loss was (25.0± 6.4) ml.International consultation on incontinence questionnaire short form (ICIQ-SF) score was 16.2 ± 3.4 beforc operation and reduced to 8.7±2.6 after 4 weeks (P＜0.05).Incontinence quality of life questionnaire score (I-QOL) preopcratively was 40.2±19.5,and 88.7±12.3 after 4 weeks (P＜0.05).One hour urine pad test:the mean preoperative urine leakage was (27.6±8.2) g,and became (5.5± 1.3)g 4weeks after operation (P＜0.05).Two patients had dysuria 3 days after surgery and became recovery after keeping catheterization one week.Eight patients had groin thigh pain which remitted two days to one week later.One patient was diagnosed overactive bladder firstly and three patients had suffered current urinary infection after surgery.Conclusions TVT-O is an effective treatment method for female stress urinary incontinence because of its high level of standardization,small trauma,few complications and fast recovery.

An auxiliary training system was explored for the development of creativity of long-termsystem medical undergraduates through scientific researches in spare time.In practice,professionals from research groups of different disciplines were recruited for developing wide-scope theoretical and technical bases of the undergraduates through training among these research groups followed by focused researches on topics of the running projects of these professionals.The undergraduates were engaged in a serial of research activities,including the discovery of problems for reasoning out scientific research projects,the writing of their project proposals,the summary of their data and the writing of reports,to develop their creativity and their qualification for scientific researches.

Objective The purpose of this study was to explore the impact of consistency primary nursing model on improvement of obstetric nursing care quality.Methods The sample consisted of 230 postpartum women in the intervention group and the other 240 postpartum women in the control group of non-intervention.The intervention is the use of new model of consistency primary nursing.Women finished the scale of overall patient satisfaction before their delivery.The other data of obstetric nursing care quality score were collected by study staff for three months.Data were analyzed using t test.Results Score of patients' overall satisfaction and obstetric nursing care quality in the invention group were much higher than that of the control group except for first-aid articles and disinfection and isolation.Conclusions The consistency primary nurs-ing model resulted in higher satisfaction and nursing care quality standard.It is suggested to extend this new nursing model in most maternity and infant hospitals and other general hospitals.

Objective: To analyze influencing factors of in-stent restenosis after coronary artery stent implantation, to provide theoretical support for clinical prevention of restenosis. Methods: Clinical data of 123 patients, who received coronary artery stent implantation in our hospital from Mar 2011 to Sep 2013 and received coronary angiography follow-up one year after operation, were retrospectively analyzed. In-stent restenosis was regarded as stenosis of inner diameter of implanted stent≥50%, so patients were divided into restenosis group (n=35) and non-restenosis group (n=88). Multi-factor Logistic regression analysis was used to analyze influencing factors of coronary in-stent restenosis. Results: Compared with non-restenosis group, there were significant reductions in serum level of total bilirubin [(14.02±6.76) μmol/L vs. (10.90±4.51) μmol/L] and stent diameter [(3.06±0.86) mm vs. (2.87±0.44) mm] in restenosis group, P<0.01 both. Multi-factor Logistic regression analysis indicated that blood glucose level was independent risk factor for restenosis after coronary artery stent implantation (OR=2.545, P=0.035), while stent diameter and serum level of total bilirubin were its protective factors (OR=0.857, 0.850, P<0.05 both). Conclusion: Blood glucose level is an independent risk factor for restenosis after coronary artery stent implantation, while stent diameter and serum level of total bilirubin are its protective factors.

Emergency in public health is one major issue relating to the national economy and the people's livelihood.In dealing with the key technologies of detects,diagnosis,disinfection,prevention and control,it is wise to syncretize the correlated subjects in nucleus,chemistry and biology,improve the support condition of teaching,strengthen the reform of teaching contents,add some lessons of emergency treatment,make emergency equipments,and form the ability of rapid diagnosis on the spot and precise identifying in lab,for cultivating the students'capability of spot handling,organization and command,and furthermore exploring and practicing the training pattern of the public heath talent with high quality and emergency ability in our country.