Objective To realize the isolation of multidrug-resistant organisms (MDROs)from ward environment, and provide evidence for clinical prevention and control of MDRO transmission.Methods Patients with MDRO in-fection in a stomatology hospital from September 2012 to July 2014 were as trial group,12 randomly selected pa-tients without MDRO infection were as control group,environmental object surface in patients’ward were taken specimens and performed culture,isolated organisms were identified and performed antimicrobial susceptibility tes-ting.Results Of 44 patients with MDRO infection,13 patients’surrounding environment were detected MDROs,the total detection rate was 29.55%(13/44).The detection rate of methicillin-resistant Staphylococcus aureus (MRSA),multidrug-resistant Acinetobacter baumannii (MDRAB),and methicillin-resistant Staphylococcus epidermidis (MRSE)were 45.45%(5/11),66.67% (2/3)and 66.67%(6/9)respectively.Detection rates of MRSA from nasal cavity and hands of MRSA-infected patients were 72.73% and 54.54% respectively,from nasal cavity and hands of patients’caregivers were 36.36%and 18.18% respectively.The difference in bacterial count between trial group and control group was not significantly dif-ferent (all P >0.05).Conclusion Isolation rate of MDROs from ward environment of MDRO-infected patients is higher than that of non-MDRO-infected patients,monitoring,cleaning and disinfection for MDRO-infected patients’surrounding environment should be strengthened,so as to prevent the spread of MDROs in hospital.

0.05], whereas it is significantly decreased in ACEI group[(69.3?14.6)ml?min-1? (1.73 m2)-1 vs (63.5?16.4)ml?min-1?(1.73m2 )-1,P

Objective To discuss the feasibility and superiority of EST combined with LC in treating cholecystolithiasiswith common bile duct stones.Methods Patients underwent LC(laparoscopic cholecystectomy) preceded by EST(endoscopic sphincterotomy) and removal of common bile duct stones.ENBD(Endoscopic nasal biliary drainage tube)was placed if EST failure and then the patient underwent LC+laparoscopic biliary duct exploration(LCBDE),or open operative bile duct exploration.Results In 91 of the 99 cases,LC preceded by EST and stone removal was successful,while EST following LC was successful in 3 cases,and stone removal by EST was unsuccessful in 3 cases.Two cases less than 15 years of age underwentLC+LCBDE through the cystic duct and did not undergo EST.Three cases,who had EST failure,underwent LC+LCBDE with primary suture of the common bile duct or LCBDE with T-tube drainage of commonbile duct,or open bile duct exploration with primary suture of the common bile duct(ENBD was in place).All patients were discharged from hospital without serious complications.Conclusions EST combinedwith LC in treating cholecystolithiasis with common bile duct stones is a safe and effective method.Combination of endoscopic and laparoscopic procedures fully reflects the advantage of minimally invasive therapy.

Now medical undergraduates are faced with a series of problems in the clinical practice.Instructors should work well on students' education work to improve the effect and quality of clinical practice.

According to the training of all levels and all kinds of personnel during our hospital's digital construction and implementation process,this article discussed the training char-acteristic of computer skill and the teaching principle for doctors and nurses

Objective To explore the effect of sodium cantharidinate and vitamin B6 injection on plasma D-dimer level in patients of advanced esophageal cancer after chemotherapy and the relationship between plasma D-dimer level and clinical pathological parameters thereof. Methods Fifty-eight patients with advanced esophageal cancer confirmed by path-ological examination were randomly divided into two groups. Twenty-nine patients (experimental group) received chemother-apy (PF chemotherapy) combined with sodium cantharidinate and vitamin B6 (0.5 mg once daily). Twenty-nine patients (con-trol group) received same volume of saline. And there were 20 healthy volunteers as the normal control. The plasma D-dimer level was determined one day before the first cycle of chemotherapy and the third cycle of treatment. Results The plasma D-dimer level was significantly higher before chemotherapy in patients with advanced esophageal cancer than that in normal control group (P<0.05). There were no significant differences in plasma D-dimer level between patient gender, age, clinical stage and pathological levels. The D-dimer level was significantly down-regulated after chemotherapy. The D-dimer level was significantly lower in experimental group than that in control group (P<0.05). The incidences of digestive and hemato-logical adverse reactions were much lower in experimental group than those in control group. Conclusion The elevated plasma D-dimer level was found in patients with advanced esophageal cancer, and which was down-regulated by chemother-apy. The chemotherapy of sodium cantharidinate and vitamin B6 can further reduce the D-dimer level, and relieve the ad-verse reactions of chemotherapy.

Objective To investigate the change pattern of perioperative plasma D-dimer levels in patients with lung cancer, and the relationship between plasma D-dimer level and clinical pathological features thereof. Methods A to-tal of 64 patients with lung cancer were taken as cancer group, and 15 cases of benign lung disease were used as control group. The plasma levels of D-dimer were determined 2 days before operation, 1 day, 5 days and 9 days after operation in two groups. The clinical pathological parameters and type of surgery were evaluated at the same time. Results Plasma D-dimer levels were significantly higher in patients with lung cancer than those in control group (t=3.087, P<0.05). D-dimer levels were significantly lower in patients of TNM stageⅠthan those in patients of stageⅡorⅢ(P<0.05, respectively). Plas-ma D-dimer levels were significantly higher in patients with small cell cancer than those of patients with non-small cell can-cer (P<0.05). The perioperative plasma levels of D-dimer changed with time trends (P<0.001). In cancer group, D-dimer levels increased on the first day after operation, and then significantly decreased on the fifth and ninth day after operation (P<0.05). In control group, D-dimer levels increased on the first day after operation. The level of D-dimer was the same lev-el on the fifth day and the first day after operation (P=0.174). The level of 9 days after operation decreased to the level before operation (P=0.631). There was significant difference in overall data between cancer group and control group (P=0.005). D-dimer levels were significantly higher in cancer group than those of control group except for the fifth day after operation. Con-clusion Plasma D-dimer levels were much higher before operation in patients with lung cancer than those of controls. Plas-ma D-dimer levels were associated with TNM stage and cell type. D-dimer levels were significantly increased from the first day after operation, and then decreased significantly until the 9-day after operation, which were lower than that before opera-tionin lung cancer patients. But the level was still higher than that in patients with benign lung diseases.

Objective To study the effect of Shuanghuanglian injection on CRP, PCT and IL-6 in pneumonia children.Methods 68 cases of pneumonia children were selected and divided into the control group and the experiment group.33 case in the control group and 35 cases in the experiment group.The two groups were treated with conventional symptomatic treatment and anti infection treatment for the two groups were implemented routine symptomatic treatment and anti infection treatment.The control group were treated with cefotaxime sodium injection, the experiment group were treated on the base with Shuanghuanglian injection.CRP, PCT and IL-6 in serum were compared before and after the treatment.Results Compared with the control group, the level of CRP in serum was lower(P<0.05), the level of PCT in serum was lower(P<0.05), the level of IL-6 in serum was lower(P<0.05).Conclusion Shuanghuanglian injection has a good clinical effect on children’s pneumonia.It is speculated that the mechanism is related to the decrease of serum CRP and IL-6 level.

Acupuncture was frequently used for alternative treatments in Parkinson's disease because of its safety,but there was an argument whether acupuncture improves motor symptoms or not.Besides,few electrophysiological studies were designed for acupuncture combined with Parkinson's disease Using the technique of paired transcranial pulse magnetic stimulation,we measured the excitability of corticocortical inhibitory circuits to investigate effects of scalp acupuncture from 9 patients with Parkinson's disease.Although patients didn't take any short-term benefit in motor symptoms through the treatment of scalp acupuncture,there was no any adverse event,and some electrophysical effects developed in patients.The enhanced corticocortical inhibition on motor cortex possibly developed at longer interstimulus intervals,and there was a relatively increase in later part of motor-related cortical potentials on the central part and right-side near vertex around over sensory cortex,but was not significant in early potentials.So a further long-term study is essential to ascertain the physical mechanism and clinical effects in scalp acupuncture.

Objective To explore the diagnosis,treatment and nursing of the patients complicated with pneumocystis carinii pneumonia (PCP) after renal transplantation,and to enhance the treatment effect of the disease.Methods The treatment and nursing processes of 37 patients complicated with PCP after renal transplantation in department of organ transplantation were retrospectively analyzed in the First Affiliated Hospital of China Medical University from May 1992 to July 2011.And the key points during nursing work were summarized.Results Of the total 37 patients,10 patients occurred respiratory failure,they were all treated by noninvasive ventilation,among which 6 patients were converted to tracheal intubation or tracheotomy mechanical ventilation.5 patients appeared rising serum creatinine(Scr) during treatment,but recovered to normal level after discontinuing SMZco for 1 week.4 patients died unfortunately,and the others were cured and discharged.Conclusions The occurrence of PCP after renal transplantation is closely related to the immune state of the patients,thus the priority of treatment for PCP should be prevention.Once happened,nursing care in aid is particularly important,then nurses should encourage patients to cooperate with treatment,relieve symptoms after infection,and promote recovery as well.