Objective:To explore the accuracy of determination of the pathogen in children with lower respiratory infection according to sputum properties and the selection of corresponding antibiotics.To analyze the relationship between children's age, length of hospital stays and sputum culture positive rate.Methods:From March 2015 to November 2016, 300 children with lower respiratory infection in the Seventh Affiliated Hospital of Guangxi Medical University were selected.The isolated sputums through the nasal cavity were cultured, the sputum properties and antibiotics used at the beginning and 3-4 days later(after sputum culture) were recorded.Results:The sputum culture showed that 110 of 300 cases with lower respiratory infection were positive.Main pathogens were streptococcus pneumoniae, E.coli, staphylococcus aureus, klebsiella pneumoniae subspecies.Compared with the children with positive sputum culture, for white phlegm sputum and yellow phlegm sputum, the children with sputum culture negative had higher accuracy of antibiotic use(white phlegm sputum: 64.4%, yellow phlegm sputum: 57.1%), the difference was statistically significant (χ 2=36.04, P<0.01). The bacteria positive rate and multiple resistance rate had no statistically significant differences in length of treatment time prior to admission(all P>0.05). However, the bacteria positive rate (hospital stay ≤7 d: 24.7%, hospital stay>7 d: 48.1%, χ 2=17.66) and multiple resistance rate (hospital stay≤7 d: 13.9%, hospital stay>7 d: 35.1%; χ 2=5.40) had statistically significant differences in the length of hospitalization(all P<0.05). The bacteria positive rates in different age groups were as follows: 1-6 months: 48.1%, >6-36 months: 28.3%, >36 months: 25.0%.Compared with the two others, the positive rate of 1-6 months was higher and had statistically significant difference (χ 2=13.64, P<0.05). Conclusion:Accuracy of antibiotics use has a certain relationship with sputum color or properties and the result of sputum culture, for white phlegm sputum and yellow phlegm sputum, the accuracy of antibiotics use is higher.Once identified pathogen, sensitive antibiotics should be adopted.Probably, bacteria positive rate and multiple resistance rate have a certain relationship with the length of hospital stay and age.

Objective To probe into the clinical nurse′s ethical cognition of Kazakh Medicine Hospital of Altay Region in Xinjiang,so as to provide basis for improving the level of nursing ethical cognition in minority area.Methods The self-designed questionnaire was used to investigate 51 clinical nurses of Kazakh Medicine Hospital of Altay Region in Xinjiang,and the result of investigation was used nonparametric statistics method and was analyzed by software SPSS 16.0.Results The overall level of ethical cognition in 51 clinical nurses maintained low level,with lowest score 30 and highest score 51 and median score 37;there were 21 nurses acquired score range from 30-36,and 30 nurses acquired over 36.The differences were statistically significant in comprehensive ethical cognition score of different departments′nurses (H=16.916,P <0.05).Conclusions The overall level of ethical cognition in 51 clinical nurses was low,so we should pay attention to its education,encourage multi-channel learning,strengthen ethics training,establish ethical norms,narrow the gap among each departments′nurses ethical cognition,improve the overall quality of nurses,and provide quality service for patients.

Objective: To study the effects of nerve growth factor (NGF) on the proliferation, osteogenic differentiation and mineralization of type 2 diabetic mice bone marrow stromal cell (BMSC), providing basis for clinical application of NGF. Methods: Three 8-week-old male db/db mice and two 8-week-old male C57BL/6J mice were used in the study. BMSC derived from femur were cultured though adherence method. BMSC of C57BL/6J mice and db/db mice was divided into normal group and diabetic group to conduct the osteogenic potential experiment, named experiment one. In experiment two, diabetic BMSC was divided into 3 groups: diabetic control group, NGF group, and K252a+NGF group [K252a was the inhibitor of tyrosine kinase A (TrkA), which was the high affinity receptor of NGF], to investigate effect of NGF on osteogenic potential of diabetic mice BMSC. After seeding BMSC, K252a was added into K252a+NGF group, then NGF was added 30 min later. NGF was added into NGF group and K252a+NGF group, but not diabetic control group. The proliferation of BMSC at 1, 3, 5 and 7 d in experiment one and the proliferation of BMSC at 1, 2 and 3 d in experiment two were evaluated through methyl thiazolyl tetrazolium, and the level of alkaline phosphatase (ALP) at 3, 5 and 7 d in both experiments were measured. After being osteogenic induced for 14 d, mineralized nodules in both experiments were quantitated by alizarin red calcium stain. Five holes were set in every group, and all experiments were repeated 3 times. Results: The BMSC proliferation of diabetic group was significantly higher than that of the normal group at 3, 5 and 7 d (P<0.05). After being osteogenic inducted for 3, 5 and 7 d, ALP level of diabetic group were significantly lower than that of normal group (P<0.05). After being osteogenic inducted for 14 d, calcium nodule count of diabetic group [(23.1±6.4) nodule/field] were significantly lower than that of normal group [(36.9±7.9) nodule/field](P<0.05). At 1, 2 and 3 d, BMSC proliferations of diabetic control group, NGF group and K252a+NGF group were not statistically different (P>0.05). After being osteogenic inducted for 3 and 5 d, ALP level of NGF group was significantly higher than that of diabetic control group (P<0.05). After being osteogenic inducted for 3, 5, and 7 d, ALP level of K252a+NGF group was significantly lower than that of NGF group (P<0.05) and diabetic control group (P<0.05). After being osteogenic induced for 14 d, calcium nodule count of NGF group [(45.2±6.8) nodule/field] was significantly more than that of diabetic control group [(23.1±6.4) nodule/field](P<0.05); while calcium nodule count of K252a+NGF group [(18.0±4.5) nodule/field] was significantly less than that of NGF group (P<0.05) and diabetic control group (P<0.05). Conclusions The differentiation and mineralization of type 2 diabetic mice BMSC was significantly reduced. NGF promoted the osteoblastic differentiation and mineralization of diabetic mice BMSC in viro though combining with TrkA.

Coronary artery bypass grafting (CABG) is one of the most effective revascularization treatments for coronary heart disease. Secondary prevention strategies, which rely on antiplatelet and lipid-lowering drugs, are crucial after CABG to ensure the durability of revascularization treatment effects and prevent adverse cardiovascular and cerebrovascular events in the medium to long term. Previous research conducted by Professor Zhao Qiang's team from Ruijin Hospital of Shanghai Jiao Tong University, known as the DACAB study, indicated that dual antiplatelet therapy (DAPT, specifically ticagrelor+aspirin) after CABG can enhance venous graft patency. However, it remains uncertain whether DAPT can further improve the medium to long-term clinical outcomes of CABG patients. Recently, the team reported the medium to long-term follow-up results of the DACAB study, termed the DACAB-FE study, finding that DAPT administered after CABG can reduce the incidence of major cardiovascular events over five years and improve patients' medium to long-term clinical outcomes. This article will interpret the methodological highlights and significant clinical implications of the DACAB-FE study.