Objective To evaluate the correlation between serum procalcitonin concentration and systemic inflam-matory response syndrome (SIRS)score in patients with bacterial bloodstream infection.Methods In January-De-cember,2012,96 patients with bacterial bloodstream infection in a hospital were selected as trial group,and these patients were divided into three groups(group A,B and C)according to SIRS score;84 patients without bacterial in-fection was as control group,PCT concentration of all patients were detected,and the correlation between PCT con-centration and SIRS score was analyzed.Results Among 96 patients with bacterial bloodstream infection,7 (7.29%)died (4 were in group B and 3 in group C);there was no death case in control group.PCT concentration in control group,group A,B and C of trial group were (0.28±0.09)ng/mL,(0.63±0.13)ng/mL,(3.68±1.01)ng/mL,and(7.45±1.53)ng/mL,respectively,the difference between each group was significant(P<0.01).Pairwise comparison of four groups showed statistical difference (P<0.001).Spearman correlation analysis on PCT concen-tration and SIRS score was conducted,correlation coefficient r=0.874(P<0.001)suggested positive correlation be-tween serum PCT concentration and SIRS score.Conclusion PCT concentration in patients with bacterial blood-stream infection and SIRS score is positively correlated,PCT concentration and SIRS score can be used as two mark-ers for assessing the extent and prognosis of bacterial bloodstream infection.

Objective To investigate the distribution and the antibiotic resistance genes carried by classⅠintegron and insertion sequence common region(ISCR1)among clinical isolates of Acinetobacter baumannii. Methods Fifty-one clinical isolates of multidrug-resistant Acinetobacter baumannii were collected. Polymerase chain reaction method was used to detect the classⅠintegrase gene, variable region of classⅠintegron, ISCR1 and genes related to antibiotics resistance lo-cated downstream of ISCR1 in 51 multidrug-resistant Acinetobacter baumannii. Antibiotics resistance genes carried by classⅠintegron and ISCR1 were performed by DNA sequencing. The relationship between classⅠintegron and ISCR1 was detected by PCR-mapping. Results Among 51 multidrug-resistant Acinetobacter baumannii isolates, 45 strains were found con-taining classⅠintegrase genes, 32 strains were found containing variable regions. Sequencing results showed that the gene cassette arrays were aacA4-catB8-aadA1, aacC1-orfA-orf-B-aadA1 and blaPSE-1-aadA2-cmlA1-aadA1. Twenty-two strains were found containing ISCR1 and 5 strains were found containing resistance genes located downstream of ISCR1. DNA sequencing results showed the resistant gene of qnrA1-ampR. The results of PCR-mapping showed that ISCR1 located directly downstream of 3' conserved segment of classⅠintegron in 20 Acinetobacter baumannii strains. Conclusion ClassⅠintegron and ISCR1 play an important role in mechanisms of drug resistance of Acinetobacter baumannii. ClassⅠintegron and ISCR1 could connect in series in Acinetobacter baumannii.

Objective To study the application effect of health education guided by the theory of cross-theoretical model in the training of the first aid training in the basic units of the plateau. Methods Choosing 386 long-term presence of plateau soldiers, and divided them into the control group and the experimental group, the control group was educated by traditional method, in the experimental group, the health education was carried out with the trans-theoretical model, nursing experts gave them targeted intervention. The number of groups at each stage was analyzed in different stages, the same to examination results and pass rate. Results After 6 months of intervention, there was a significant improvement in the mastering of the battlefield Five emergency technology of the experimental group and the scores were better than those of the control group (P<0.05). Theoretical results showed that pass rate of the control group was 89.1%(172/193), the experimental group was 99.5%(192/193), the difference between the two groups was statistically significant (χ2=7.129, P=0.039). In the survey of technical operation, ventilation, hemostasis, bandaging, fixing and handling examination pass rate of the control group respectively were 88.1%(170/193), 89.1%(172/193), 89.1%(172/193), 88.1%(170/193), 88.6%(171/193), the experimental group were 99.5%(192/193), 97.9%(189/193), 99.5%(192/193), 96.9%(187/193), 97.4%(188/193), there were significant differences between the two groups (χ2=7.896-12.759, P=0.001-0.043). Conclusions Cross theoretical model has good effect on the application ofFiveemergency technology training in the high altitude troops battlefield, and can effectively improve the troops self- help and mutual aid capabilities, it is worthy of popularization and application.

Objective To explore the perioperative nursing of patients from high altitude earthquake-stricken regions. Method The perioperative nursing histories of 18 patients from high altitude earthquake-stricken regions were retrospectively analyzed to summarize the nursing experience.Results No wound infection,crush injury or complications occurred.Sixteen patients had good functional recovery,1 patient was at the stage of recovery about limb movement and another one was also at the recovery period from lumbar vertebral burst fracture complicated with nerve injury.Conclusion Close observation,psychological nursing and functional exercise are important for improved success rate of treatment for the patients from the earthquake-stricken regions.

Objective To analyze MRI features of breast intraductal papilloma,to improve the acquaintance of this disease.Methods The preoperative MRI images (T2 WI-SPAIR,DWI,ADC,TIC and MIP)of eight patients with breast intraductal papilloma confirmed by surgery were reviewed retrospectively,which were compared with the postoperative pathology.The morphology,distribution, enhanced methods and signal characteristics of the lesion were summarized.Results Of 8 cases,the lession was dormant,and MRI revealed three patterns:the first type was occult papilloma,which presented distention of ducts and no solid nodule in 3 cases (37.5%);the second type showed tiny nodules in bar-like dilatation of ducts in 3 cases (37.5%);and the third type presented small round nodules scattering distribued in terminal ductules in 2 cases (25%).The maximum diameter of nodular lesions was 0.4-1.0 cm(average 0.7 cm).The lesions on T2 WI-SPAIR showed equal signal intensity or mixed signals with isointensity/hypointensity,and dilatation catheter.enhancement. The ADC and TIC value were various,therefore,diagnosis of the tumor should be combined with morphology and associated symptoms. Conclusion At early stage,the occult focus of breast intraductal papilloma can be sensitively detected and localized on MRI.It reveals that MRI has advantage in showing morphology of lesion and functional imaging,which is of important value in clinical diagnosis and early treatment.

Objective To investigate the related factors of clinical stage and prognosis in the patients with endometrial carcinoma and their relation with proto-oncogene Wip1 expression level.Methods The paraffin samples of resected endometrial carcinoma in 120 cases of endometrial carcinoma in our hospital from January 2002 to January 2012 were collected as the experimental group,the samples were verified by pathology.Contemporaneous 120 samples of biopsy normal endometrial tissue served as the control group.The expression leve of Wipl were detected in turo groups.Results (1) In the Wip1 immunohistochemical staining results:Wip1 immunohistochemical staining was negative or weak in normal endometrial tissue cells,while showed pale yellow to yellowish-brown in endometrial cancer tissue.The positive expression rate of Wip1 protein in endometrial carcinoma tissue was 77.5%(93/120),which was higher than 22.5%(27/120) in normal endometrial tissue,the difference was statistically significant (P<0.05).(2)In the Western blot results of Wip1 protein in endometrial cancer tissue and normal endometrial tissue:the relative amount of Wip1 protein in endometrial carcinoma tissue was 0.635±0.023,which was significantly higher than 0.325±0.018 in normal endometrial tissue,the difference between the two groups was statistically significant (P<0.05).(3)In the real time quantitative qRT-PCR results of various samples:Wip1 mRNA expression level was higher than that in normal endometrial tissue,which were 0.628±0.053 and 0.191±0.009 respectively,the difference between the two groups was statistically significant(P<0.05).(4) The expression level of Wip1 had no correlation with age,estrogen and progesterone status,HER2,lymph node status and TNM stage,but had correlation with P53 expression level.Conclusion (1) The Wip1 expression amount is high in endometrial carcinoma and low in normal endometrial tissue.(2)The Wip1 expression level has no relation with age,estrogen and progesterone status,HER2,lymph node status and TNM stage,while has association with P53 expression level.

Objective By virtual screening in MDL,to search for a novel γ-secretase inhibitor.Methods A series of compounds were designed,synthesized,and evaluated based on pharmacophore model of γ-secretase inhibitors by virtual screening in MDL.Results The drug-likeness analytic data synthesized indicated that target compounds had drug-likeness.Each svnthesized compound was checked by IR spectroscopy,~1H and ~(13)C-NMR spectroscopy.Conclusion The designed compounds had better activity by model prediction.And the optimal compound showed a significant estimated activity value of 0.025 nmol/L and can be used as a lead for further drug development.

ObjectiveTo explore the effect of nursing management emergency project in the treatment of batches of wounded persons in sudden disasters.Method The overall emergency system was set up,the emergency project on nursing management was made including non-stop nosocomial transmission mode,standardization of nursing management in the wards,specialized nursing and individualized nursing for critically ill patients.Result All 139 injured were successfully rescued and discharged after a quick pre-hospital care and effective in-hospital care,with effective rescue time (33.5±19.6)min and the rescue success rate 100.0%. Conclusion The nursing management emergency project for sudden disasters is effective for rescuing batches of wounded persons and improving the success rate of rescue.

Antiphospholipid Syndrome ; pathology ; physiopathology ; Child ; Female ; Follow-Up Studies ; Humans

[Abstract ] Objective To understand the identification and in vitro antifungal susceptibility of Penicillium marneffei(PM)in yeast phase,and guide clinic antifungal application.Methods Strains isolated from blood and bone marrow of 23 patients infected with PM in a hospital between 2009 and 2016 were collected,colony morpholo-gy of PM in yeast phase was observed,susceptibility to itraconazole,voriconazole,amphotericin B,and fluconazole were detected with E-test method.Results Colony morphology of PM were as follows:direct microscopic examina-tion of Wright’s staining of tissue specimens found visible oval or round spore with apparent septum,and mainly lo-cated in macrophage;Gram staining of blood culture specimens found that strains were with bulbous and slightly curved ends,occasionally branched and with septum. PM was dimorphic fungi,presented mycelium at 28° C,pro-duced red pigment and diffused into medium;PM presented yeast form at 35° C,there were typical colony morpholo-gy. Minimum inhibitory concentrations (MICs)of itraconazole,voriconazole,amphotericin B,and fluconazole to PM in yeast phase were 0.002-0.016,0.012-0.125,0.002-0.500,and 0.500-16.000μg/mL respectively. Conclusion Typical colony morphology and fungal spore of PM in bone marrow and peripheral blood are important features for identification. PM is most susceptible to itraconazole,followed by voriconazole and amphotericin B, while fluconazole is less susceptible.