OBJECTIVE To investigate the distribution and drug-resistance of Pseudomonas aeruginosa(PAE) in nosocomial infections to provide the scientific evidence for the clinical use of the antibiotics.METHODS PAE was cultured and identified according to the National Rules of Procedures Clinical Laboratory.Drug resistance was analyzed by K-B methods.RESULTS A total of 318 strains of PAE were mainly isolated from intensive care unit(ICU),departments of cerebral surgery and chest surgery.Drug-resistance of PAE to 14 kinds of antibiotics showed that SXT(91.2%),cefotaxime(89.9%),aztreonam(70.1%),gentamicin and ciprofloxacin(69.8%),respectively.And the resistance to piperacillin,levofloxacin and cefepime was 50.0%.CONCLUSIONS Drug-resistance status of P.aeruginosa is very serious.Hospital should strengthen monitoring and controlling of it.

Objective To discuss the opportunity of transurethral resection of prostate (TURP) after transrectal prostate biopsy.Methods We analyzed 60 cases of benign prostatic hyperplasia(BPH) who underwent TURP after transrectal prostate biopsy from September 2013 to September 2015.All the patients were divided into either group A or group B in chronological order, with 30 cases in each group.There were no significant differences in age, prostate specific antigen (PSA), prostate volume, hemoglobin level, and international prostate symptom score (IPSS) between the two groups.The group A and group B were treated by TURP at 1 week and 4 weeks after transrectal prostate biopsy, respectively.The parameters including operation time, excised prostate weight, intraoperative total blood loss, bladder irrigation time, and IPSS at 3 months after operation were recorded.Results The operation time, intraoperative total blood loss, bladder irrigation time, and IPSS in the group B were significantly lower than those in the group A [(58.3±6.0) min vs.(62.0±3.3) min, t=2.952, P=0.005;(154.1±15.8) ml vs.(167.4±29.5) ml, t=2.181, P=0.035;(19.2±0.8) h vs.(20.6±2.3) h, t=3.034, P=0.004;(18.3±2.5) points vs.(20.3±2.0) points, t=3.419, P=0.001].The excised prostate weight in the group B was significantly higher than that in the group A [(37.1±4.0) g vs.(33.3±7.8) g, t=-2.341, P=0.024].Conclusions TURP performed at 4 weeks after transrectal prostate biopsy can significantly increase the excised prostate weight, reduce intraoperative total blood loss volume, shorten the operation time and postoperative bladder irrigation time, and improve urinary symptoms.In brief, we recommend that TURP be executed at 4 weeks after transrectal prostate biopsy.

Objective:To explore the diagnostic value of serum procalcitonin (PCT) level combined with Quantitative Computed Tomography (QCT) in elderly women with painful osteoporosis and its correlation with disease severity.Method:This study is a prospective study. From Jan. 2019 to Apr. 2020, 596 elderly women who underwent physical examination in our hospital were selected as the research subjects. All of them underwent dual-energy X-ray, PCT examination, and QCT examination serum. The diagnostic value of PCT and QCT in elderly women with painful osteoporosis was analyzed; Pearson correlation was used to analyze the correlation between the bone mineral density of lumbar vertebral 1, 2 vertebra, PCT and the severity of painful osteoporosis.Result:Among 596 elderly women, painful osteoporosis patients accounted for 50.84% (303/596) , bone mass reduction accounted for 21.98% (131/596) , and normal bone mass accounted for 27.18% (162/596) . Compared with the results of the diagnosis of painful osteoporosis by DAX, the diagnostic coincidence rates of PCT, QCT, QCT+PCT were 81.88% (488/596) , 93.62% (558/596) , and 97.31% (580/596) . QCT examination, QCT+PCT diagnosis coincidence rate is higher than PCT examination ( χ2=43.650, 83.187, P<0.05) ; QCT+PCT diagnosis coincidence rate is higher than QCT examination ( χ2=9.388, P=0.002) . The sensitivity, specificity, positive predictive value, and negative predictive value of QCT+PCT in the diagnosis of abnormal bone mass are higher than those of PCT ( P<0.05) ; the specificity and negative predictive value of QCT+PCT in diagnosing abnormal bone mass are higher than QCT Check ( P<0.05) . The bone density detected by QCT in the osteopenia group and the painful osteoporosis group was lower than that in the normal bone mass group, and the serum PCT level was higher than that in the normal bone mass group, the difference was statistically significant ( P<0.05) ; the painful osteoporosis group was in QCT detection of bone. The density was lower than that of the osteopenia group, and the serum PCT level was higher than that of the osteopenia group, the difference was statistically significant ( P<0.05) . The severity of painful osteoporosis was negatively correlated with bone mineral density detected by QCT ( r=-0.54, P<0.05) , and positively correlated with serum PCT ( r=0.59, P<0.05) . Conclusion:QCT vertebral bone mineral density determination combined with serum PCT detection has high accuracy, sensitivity, and specificity in the diagnosis of painful osteoporosis, and is closely related to the severity of painful osteoporosis, and can be used for clinical evaluation of the condition of painful osteoporosis patients.

70% for 9 patients;the positive rate was between 30-70% for 4 patients;the positive rate 0.05). Conclusion Tamm-Horsfall detection of RBC in urine could be used as one of the Identification indicators for DN hematuria, and it can provide a basis for diagnosis and treatment of DN.

Objective Under the guidance of graduate education evaluation theory,to establish the comprehensive quality evaluation standard of medical graduate students and apply it in the research of the scholarship evaluation.Methods Byusing literature study,brainstorming,expert advice and other research methods,we established comprehensive quality assessment scale.In the work of graduate scholarship,the scale was used to carry out the evaluation work,and the application of the scale,the use value and the effect of moral evaluation were studied.Results A comprehensive quality assessment scale for medical graduate students,which included 4 dimensions of moral education,training process,scientific research and social activities was established so that the students' daily performance was quantified and evaluated,which,to a certain extent,eliminated the influence of the subjective judgment to the evaluation work,and had good guidance and practicality.Conclusion Establishing comprehensive quality quantitative evaluation mechanism of the graduate students and conducting the dynamic evaluation to graduates' moral education,their academic and social activities are conducive to stimulating the development of postgraduates' comprehensive quality and improving the quality of training.

Objective To research the clinical application effect of thrombela-stogram(TEG) for anticoagulant therapy to prevent deep venous thrombosis(DVT) in perioperative period of Orthopedics Department.Methods Sixty-eight cases of fracture patients treated with surgery in the Orthopedicsin Department of Jiangning Hospital of Nanjing were selected as the research subjects,and 42 healthy volunteers for a physical examination at the same period were selected as the control group.All fracture patients were treated with anticoagulant therapy after surgery,according to the different anticoagulants,the fracture patients were divided into the low molecular weight heparin(LWMH) group and the rivaroxaban group.On the day of the investigation,the control group was detected by TEG,and the TEG test was performed on all the patients during the perioperative period.Results There was no significant difference on the TEG test results between fracture patients and the control group(P>0.05),the TEG test results of fracture patients were normal,and the blood was not in the high coagulation state.On the 7th d of anticoagulant therapy and the end of anticoagulant therapy,the R value in the LWMH group and in the rivaroxaban group were the highest positive rate,were all more than 50%.At the end of the anticoagulant therapy,the abnormal detection rate of α angle,maximum thrombus(MA) and integrated coagulation index(CI) in the rivaroxaban group were 35.29%,32.35%,41.76%,respectively,were significantly higher than those in the LWMH group(8.82%,17.65%,11.76%),the differences were statistically significant(χ2=6.9283,5.7566,7.5556,P<0.05).After the end of the anticoagulant therapy for Doppler ultrasound,9 cases were diagnosed as DVT,and the incidence rate was 14.06%.Compared and founded,at the end of the anti coagulation therapy,the great value of the diagnostic indicators were α angle,MA and CI,the sensitivity was 64.71%,76.47%,73.53% respectively,and the specificity was 79.41%,73.53%,82.35% respectively.Conclusion After fracture surgery,the coagulation function of the patients are changed,using TEG dynamic detection can accurately understand the change of blood state in real time,and it has important reference value for the evaluation of blood coagulation function.With MA was equal to 68.35 mm as a clinical diagnosis of critical point.

Objective To explore the effects of acupuncture-rehabilitation therapy on neurological function recovery and extracellular signal-regulated kinase 1/2 (ERK1/2) signaling pathway activation after permanent focal cerebral ischemia in rats. Methods Ninty male Sprague-Dawley rats were divided into five groups, namely sham group, model group, acupuncture group, rehabilitation group and acupunc-ture-rehabilitation group, and 18 in each group. Each group was further divided into 3 days, 7 days and 14 days subgroups (n=6). Their mid-dle cerebral arteries were occluded except those of sham group. The sham and model groups accepted no treatment, while the acupuncture group accepted cluster needling of scalp acupuncture, rehabilitation group accepted treadmill training, and the acupuncture-rehabilitation group accepted both acupuncture and treadmill training. They were assessed with modified Neurologic Severity Score (mNSS) 3, 7 and 14 days after modeling, while the expression of ERK1/2 and p-ERK1/2 were determined with Western blotting. Results The neurologic severi-ty score reduced in all three treatment groups (P<0.05) compared with that of the model group at every time point, and was the least in the acupuncture-rehabilitation group (P<0.05) 7 and 14 days after modeling among the treatment groups. Meanwhile, the expression of p-ERK1/2 increased in all three treatment groups (P<0.05), and was the most in the acupuncture-rehabilitation group (P<0.05), as well as the rate of (p- ERK1/2)/(ERK1/2) (P<0.05). Conclusion Acupuncture- rehabilitation therapy can promote the neurological function recovery, which may be associated with activation of ERK1/2 signaling pathway.

Objective To investigate the effect of electroacupuncture or exercise preconditioning on neurological function after focal ce-rebral infarction in rats and the possible mechanism. Methods A total of 24 male Sprague-Dawley rats were randomly divided into model group (n=6), sham group (n=6), exercise preconditioning group (n=6) and electroacupuncture preconditioning group (n=6). The model group and the sham group did not accept any treatment, while the exercise preconditioning group and the electroacupuncture precondition-ing group accepted treadmill training and electroacupuncture for two weeks, respectively. Their middle cerebral arteries were occluded with modified Longa's approach, except the sham group that was ligated the same arteries but did not result in infarction. They were evaluated with Neurologic Severity Scores (NSS) 24 hours after modeling, and the laminin expression in the ischemic area was detected with Western blotting. Results There was no neurological deficit in the sham group. The NSS was lower in both preconditioning groups than in the model group (P<0.05), but was not significant different between preconditioning groups (P>0.05). The expression of laminin was the most in the sham group, and was more in both preconditioning groups than in the model group (P<0.05), but was not significant different between pre-conditioning groups (P>0.05). Conclusion Preconditioning with exercise or electroacupuncture can both reduce the neurological deficits in rats after focal cerebral infarction, which may associate with the protection of laminin from inhibition in early stage.

To increase the effective rate of treatment of dental injuries. Self-etching adhesives, flat steel wire and resin were used to make adhesive splints and to fix the dislocated teeth. The effect of treatment was excellent.

Objective Analyzing risk factors for gastrointestinal bleeding(GIB) after coronary artery bypass grafting(CABG). Methods 582 cases undergoing CABG from August 2001 to May 2005 were divided into two groups (GIB group ,n=6 ;control group,n=576) . Preoperative , operative and postoperative clinic data were com-pared. Results The ratio of over-aging(age greater than 70), hypertension, cerebrovascular disease, myocardial in-fraction,heart function (NYHA) over Ⅲ and postoperative low output syndrome (LOS) in GIB group were signifi-cantly higher than that in control group;age, blood transfusion and hospitalized time were significantly higher and left ventricular ejective fraction was significantly lower in GIB group than that in control group. Age over 70,history of myocardial infraction and heart function (NYHA) over Ⅲ were selected as risk factors of GIB after CABG by step-wise logistic regression analysis. Conclusions It is very useful for precaution, early diagnosis and early therapy of GIB after CABG to evaluate if patients have the risk factors of GIB after CABG before operations.