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.

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 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.

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: 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.

BACKGROUND:There is a lack of safe and effective modular lentivectors in differentiation regulation of embryonic stem cel s. OBJECTIVE:To construct a modular lentivector, Puro-Nanog-hrGFP, with Nanog promoter-control ed humanized renil a reniformis green fluorescent protein (hrGFP) and puromycin and to observe the expression of Nanog during the differentiation of Nanog-hrGFP-transfected mouse embryonic stem cel lines. METHODS:After PCR amplification, Nanog, hrGFP and entry vector were recombined into the pDest-puro vectors to generate the lentiviral expression vector, Puro-Nanog-hrGFP, by the LR reaction. Through lentivirus production, transduction and puromycin screening, the transduced cel lines with Nanog-hrGFP gene were generated and identified. Expression of Nanog during the differentiation of transgenic mouse cel lines was detected. RESULTS AND CONCLUSION:The lentiviral expression vectors Puro-Nanog-hrGFP were constructed successful y by Gateway technology, and then the transducted cel lines were obtained by lentiviral infection. The expression of Nanog was gradual y decreased during the process of transgenic cel lines differentiation, which provides a new tool for further investigation on regulation of stem cel differentiation.

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.

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.

OBJECTIVETo observe the effect differences on post-stroke dysphagia among acupoint injection combined with neural electrical stimulation, acupoint injection, neural electrical stimulation, and swallowing training respectively, so eligible intervention can be applied to this kind of disease.

METHODSOne hundred and eight-three patients of post-stroke dysphagia were randomized into a comprehensive treatment group (42 cases), an acupoint injection group (44 cases), a neural electrical stimulation group (49 cases) and a swallow training group (48 cases) and were treated with the comprehensive therapy of acupoint injection and neural electrical stimulation, acupoint injection, neural electrical stimulation and swallowing training separately. The treatments for 10 days made one session. There were 3 days at the interval among treatment sessions and 3 sessions were required totally. The cases in those treatment groups were blankly controlled with the other 47 patients of post-stroke dysphagia. All the patients received basic rehabilitation treatment. The modified water swallowing test was conducted to assess the efficacy before treatment, 10 days after treatment and 30 days after treatment in each group separately. The clinical efficacy, score of water swallowing test and improvement in water swallow test were compared among the groups.

RESULTSAfter 10-day treatment, the differences in efficacy and score of water swallow test were not significant in each group (all P > 0.05). After 30-day treatment, the effective rate (94.29%, 33/35) in the comprehensive treatment group was apparently better than 68.75% (22/32) in the acupoint injection group, 80.00% (32/40) in the neural electrical stimulation group, 67.50% (27/40) in the swallowing training group and 42.86% (12/28) in the blank group separately. The score in water swallow test in the comprehensive treatment group was lower than that in each of the other groups (1.37 ± 0.60 vs 2.03 ± 1.00, 1.90 ± 0.90, 2.20 ± 0.72, 2.71 ± 0.90, all P < 0.05). The differences in the effective rate and score in water swallow test were not significant among the acupoint injection group, neural electrical stimulation group and swallowing training group (all P > 0.05), which indicated that the improvement in swallowing function in the comprehensive treatment group was significantly superior to the other groups (all P < 0.05).

CONCLUSIONThe comprehensive therapy of acupoint injection and neural electrical stimulation achieves the much better efficacy on post-stroke dysphagia.

Acupuncture Points ; Adult ; Aged ; Combined Modality Therapy ; Deglutition ; Deglutition Disorders ; drug therapy ; etiology ; physiopathology ; therapy ; Electric Stimulation Therapy ; Female ; Humans ; Male ; Middle Aged ; Stroke ; complications ; Treatment Outcome ; Vitamin B 12 ; administration & dosage ; Young Adult

Qualitative research methods are becoming more and more important in medical research area. Some qualitative researches played important roles in the exploration and the spread of core ideas of Chinese medicine. The report of qualitative research should be transparent and credible according to the standardized report criterion. On the basis of 22 criteria, the Consolidated Criteria for Reporting Qualitative Research (COREQ) was developed and published in September 2007. This introduction to COREQ will be helpful to Chinese qualitative researchers and readers in the implementation of high quality of medical qualitative research in China.