Objective To investigate the resistance to fluoroquinolones and amikacin in escherichia coti isolates. Methods ESBLs-producers were detected by CLSI phenotypic confirmatory test and susceptibilities were tested by agar dilution method. Results 33. 8% of 361 isolates were ESBLs-producers. The resistant rate of ciprofloxacin,levofloxacin, amikaxin was 93.4%, 90.9%, 13.1% in ESBLs-produeers, and that was 69.5%,68.6 %, 19.7 % in non-ESBLs-producers, respectively. Conclusion Amikaxin is active against most escherichia coli isolates; those isolates are highly resistant to fluoroquinolones, especially, in ESBLs-producers.

Objective To learn the relationship between working pressure and mental health for nurse of transfusion room in pediatric department.Methods 120 nurses of transfusion room whose working years above half a year were investigated by questionnaire from January 2010 to December 2011.Results The maximal score of working pressure was working environment and resource (3.27±0.47),while the minimum was interpersonal relationship (1.80±0.68).The score of SCL-90 of the research group was higher than domestic model.More working pressures of transfusion room in pediatric department were positive correlated with SCL-90.Conclnsions In order to keep nurse sound in body and mind,the working pressure should be desolved in many ways.

Objective:To analyze the clinical efficacy of POEM treating patient with achalasia of cardia and observe the risk factor of effecting curative efficacy.Methods: 66 patients with achalasia of cardia who were treated by using POEM were enrolled in this study, and series of indicators of esophagus dynamics including LESRP, LESP, LESRR and LESL were detected in pre and post operation. Clinical symptom score system(Eckardt score) of achalasia of cardia was adopted to evaluate the effect of surgical treatment for patients at the pre and post operation 7d, and the diameter of widest part of esophagus at pre and post operation 7d were detected. The incidence rate of pneumoderm, substernal ache, pulmonary infection, pleural effusion, tunnel bleeding, postoperative reflux and esophageal perforation and other complications were analyzed and the relative risk factors of effecting curative effect were observed.Results: The LESRP and LESP of patients with achalasia of cardia of post-operative 7d were significantly lower than that of pre-operative 7d(t=12.74,t=17.56,P<0.05), while the LESRR and LESL of post operative 7d were significantly higher than that of pre-operative 7d(t=9.10,t=14.86,P<0.05) , respectively. And the Eckardt score and widest diameter of post-operative 7d were significantly lower than that of pre-operation(t=19.49, t=7.83,P<0.05), respectively. Besides, the incidence rate of complication of patients in post-operation was 48.48％. As the results of Logistic regression, age, Chicago type and Ling type were the risk factors that affect curative effect of POEM for achalasia of chardia. And as the analysis, the prognosis was better when the patient's age was less than 60 years, Chicago II type and Ling type.Conclusion: POEM can significantly improve the indicators of esophagus dynamics, and the complication will be few and the curative effect will be exact in middle and short term of post-operation by using this method. Therefore, it is a safe and effective surgical mode.

Objective The national essential medicine select system is the core of Chinese medicine policy.How to select drugs fundamental for eyes scientifically is an important ring in establishing the Chinese essential drug system.The present study attempted to compare the National Essential Medicines List and National Essential Insurance List of China with that of the WHO in order to provide reasonable evidence for the adjustment of a new National Essential Medicines List of China. MethodsThe WHO Essential Medicine List (15th edition,Version in 2007),National Essential Medicine List (Version in 2009,China),2009 National Essential Medicine List Chemical Medicine Name (Version in 2009) and National Essential Insurance List of China (Version in 2004) were reviewed.The similarity and difference in the category and number of drugs in the National Essential Medicines List and National Essential Insurance List between China and WHO were compared and analyzed.A descriptive method was adopted to analyze the sorts and numbers of eye drugs in the lists mentioned above.The analysis of drug price was based on the summary sheet from Zhejiang Province. ResultsLittle difference was found in the numbers of eye drugs between the National Essential Medicines List of China and WHO Essential Medicines List.Differences in the sorts of eye drugs were observed in the lists,especially between the National Essential Medicines List of China and WHO Essential Medicines List.Except for levofloxacin,all of the drugs in the National Essential Medicine List of China were included in the National Essential Insurance List of China.ConclusionThe selecting principle and renewing procedure of the National Essential Medicines List and National Essential Insurance List of China should be further improved in China based on the list from WHO.More attention should be paid to the standard,dosage form,affordability,maneuverability etc.during the selecting procedure of eye essential drugs.

Objective To observe clinical curative effect of acupuncture combined with western medicine in treating acquired paralytic strabismus.Methods Randomly divided 60 patients with acquired paralytic strabismus into a treatment group and a control group,with 30 cases in each group.The control group accepted compound anisodine injection for subcutaneous injection beside superficial temporal artery and oral administration of neurotrophic drugs.The treatment group accepted acupuncture treatment in addition to the treatment of the control group.Both groups were treated for 4 weeks.Before and after treatment,measured the ocular symptom scores,including eye position deviation,eyeball movement obstacle,diplopia,the first squint angle being greater than the second,compensatory head posture and evaluated the clinical curative effect.Results The clinical curative rate in the treatment group was 40.0％ and the total effective rate was 93.4％,which in the control group were 10.0％ and 66.7％ respectively.The total effective rate and curative rate in the treatment group were significantly higher than those in the control group (P＜ 0.05).After treatment,the improvement in the total ocular symptom score and diplopia,deviation of eye position,eyeball movement disorder scores were superior to those in the control group (P ＜ 0.05).Conclusion Acupuncture combined with western medicine was superior to simple western medicine in treating acquired paralytic strabismus,and could significantly improve the eye symptom.

Objective:To discuss the application of water-aided colonoscopy in the enteroscopy, and compare with traditional air insufflations colonoscopy so as to analyze the efficacy and safety of clinical enteroscopy.Methods: 248 patients accepted with non-anesthesia colonoscopy were enrolled in this study and they were divided into two groups (water-aided group,n=124, air insufflations group,n=124) as the random number table. All clinical data of two groups were collected, and the bowel preparation statuses of patients was evaluated when the colonoscopes were taken out. During detection, the success rate of intubation, the entrance time of colonoscope, the withdrawal time of colonoscope and the total time of examinations were recorded. After detection, the pains score of patients were recorded and evaluated, and a series of auxiliary operation in the process, such as the change of body position, abdominal compression and the adjustment for hardness were recorded. Results: The differences of bowel preparation status scores of left colon, transverse colon, right colon and the whole colon between two groups were not statistically significant(t=0.98,t=0.85,t=1.07,t=1.51;P>0.05). The difference of success rate of intubation between two groups was no significant(x2=0.73,P>0.05). The entrance time, the withdrawal time of colonoscope and the total time of intubation of water-aided group were significantly higher than these of air insufflations group, while the VAS of water-aided group was significantly lower than that of air insufflations group(t=5.78,t=3.85,t=5.64, t=10.25;P<0.05). Besides, there were no significant differences in the usage rates of abdominal compression, hardness adjustment and total usage rate of auxiliary operation between two groups(t=0.92,t=1.58, t=2.07;P>0.05).Conclusion: The water-aided colonoscopy can relieve pain of patients, and it doesn't affect the success rate of intubation for cecum.

Objective To investigate the effects of pentoxifylline on the cell proliferation of, collagen synthesis and TGF-β1 expression by human fibroblasts derived from keloid. Methods Skin samples were obtained from the lesions of 3 patients with keloid and normal skin of 3 human controls followed by primary culture of fibroblasts. Fibroblasts of 5th to 8th generation were cultured with pentoxifylline of 0.1 to 3 g/L for various durations. Then, MTT assay was performed to detect the cell proliferation of fibroblasts, double antibody sandwich-enzyme linked immunosorbent assay (ELISA) to measure the expression of TGF-β1, and reversetranscription PCR to examine the mRNA expressions of procollagen Ⅰ and Ⅲ in these fibroblasts. Results The pentoxifylline of 0.1 to 2 g/L markedly inhibited the proliferation of fibroblasts derived from keloid lesions and normal skin, in a dose- and time-dependent manner, with the strongest effect observed in fibroblasts treated with pentoxifylline of 2 g/L. A significant reduction was induced in the TGF-β1 mRNA expression in keloidand normal skin-derived fibroblasts by pentoxifylline of 0.5 to 2 g/L (all P < 0.01), and in the mRNA expression of procollagen Ⅰ and Ⅲ by pentoxifylline of 1 and 2 g/L (P < 0.05 or 0.01). Concretely, the relative mRNA expression level of procollagen Ⅰ and Ⅲwas 0.873 ± 0.077, 0.571 ± 0.050 respectively in keloid fibroblasts respectively, and 0.473 ± 0.035, 0.370 ± 0.045 in the control fibroblasts, after treated with pentoxifylline of 1 g/L, 0.750 ± 0.036 and 0.433 ± 0.045 respectively in keloid-derived fibroblasts, 0.390 ± 0.030 and 0.250 ±0.123 respectively in the control fibroblasts, after treated with pentoxifylline of 2 g/L, significantly lower than that in the keloid-derived (1.216 ± 0.061 and 0.953 ± 0.060) and control (0.836 ± 0.080 and 0.776 ± 0.041) fibroblasts without treatment. Conclusion Pentoxifylline shows an evident suppressive effect on the cell proliferation of, as well as the expression of TGF-β1 and procollagen Ⅰ and Ⅲ in fibroblasts derived from keloid lesions and normal skin.

BACKGROUND:In recent years,pentoxifyIline has been found to have a wide range of anti-fibrosis capacity However,there are few studies explore the suppress effect of pentoxifyIline on fibroblasts in human keloid.and the maximum inhibitory concentration remains poorly understood.OBJECTIVE:To study the effect of pentoxifyIline on proliferation activity of human keloid fibroblasts and to select the maximum inhibitory concentrationMETHODS:Human keloid fibroblasts were used as original cells,passaged till the 5~(th) to the 8~(th) generations.and then divided into the experimental and control groups.PentoxifyIline with concentrations of 0.1,0.25,0.5,1.0,2.0 and 3.0 g/L were added to the experimental group.The effects of different concentrations of pentoxifylline on proliferation of keloid fibroblasts were detected by MTT chromometry.RESULT AND CONCLUSION:Compared with the control group,the inhibitory effect of pentoxifylline on the proliferation of keloid fibroblasts was more evident in the experimental group(P＜0.05)The inhibition rates of pentoxifylline on proliferation of keloid fibroblasts showed apparently time-and dose-effect relationships within the concentration of 0.1-2.0 g/L.which presented a greatest level at 96 hours after culture.The maximum inhibitory rate was 53 37%,and the concentration was 2.0 g/L in the experimental group.Consequently,pentoxifyIline plays a notable inhibitory role in the proliferation of human keloid fibroblasts with concentration of 2.0 g/L at 96 hours after culture.

Objective We determined the proportion of doctors in Haidian community participating in the training of secondary prevention of ischemic cerebrovascular diseases related knowledge and the knowledge level of doctors so as to make a new targeted training plan,and assessed the effect of the training.Methods We enrolled 80 doctors,who filled out the questionnaire on secondary prevention of ischemic cerebrovascular diseases related knowledge,from 22 Haidian community center from March to July in 2014 in Beijing.The primary outcome was the proportion of doctors with the training of secondary prevention of ischemic cerebrovascular diseases related knowledge and the improvement rate of new training.Results Seventy (87.5％) community doctors didn't accept ischemic stroke secondary prevention system training.The understanding of Chinese Ischemic Stroke Subclassification and three cornerstones of secondary prevention of ischemic stroke(anti-hypertention,anti-lipidemia,antithrombotic) after the training was significant improvement (20％ vs.82.5％,P ＜ 0.05;31.25％vs.90％,P ＜ 0.05),while according to different causes classification subtype the doctors could make corresponding strategies of secondary prevention of ischemic cerebrovascular diseases.The rates of all community risk factors identification,community health education,lifestyle intervention,antihypertension,aspirin use,statin use,hypoglycemic treatment were both above 60％ no matter before the training or after the trainig.Conclusion Our results suggest that the community doctors in Haidian District lack corresponding knowledge of ischemic stroke secondary prevention.Further training of ischemic stroke secondary prevention is needed.

Objective To evaluate the clinical effect of CEREC chairside on atypical porcelain inlay restoring class [[cavity.Methods 30 patients that required re-treatment because of resin restoration failure and early posterior proximal caries were selected randomly.The original fillings,secondary carious tissues and undercut parts were removed.The clear and round edge lines were prepared.With Sirona CEREC Blocs,35 atypical ceramic inlays were produced in accordance with CEREC AC CAD/CAM standard procedures.After clinical trial and modification,the inlays were bonded with 3M Veneer resin adhesive cement.Evaluation was done immediately and 3,6,12 and 24 months after restoration.Two senior prosthodontists did the evaluation according to the modified USPHS criteria.Results The evaluation results were all A when estimated immediately after restoration.None inlay falled off during the first two years.However,3 inlay were found to be damaged when reviewed at the 24th month.There exsited two patients having mild symptoms of dentine hypersensitivity which appeared at the beginning and died out gradually.Generally speaking,more than 90％ of inlay restorations had reached the USPHS criteria A.Color match and retention represented better effects.Conclusions CEREC atypical ceramic inlays can effectively restore Class Ⅱ cavity,short-term effect is good,but long-term effect still needs further observations.