As the development of fast-tracking, the patient perception of readiness for hospital discharge is becoming more and more popular in discharge decision making. A lot of research indicates that the patient readiness of discharge can predict the satisfaction, the safety, readmission, death and compliance of the patients. This study is about to review the conception, research significances, measurements, and determinants of the discharge readiness. The primary objective was to analyze the determinants of hospital discharge, according to three aspects of patient factors, hospital factors and social support. This study is expected to offer theoretical support for the improvement of discharge readiness.

Objective To investigate the clinical value of color doppler ultrasonography(CDU) to extracranial vertebral artery stenosis before and after percutaneous transluminal angioplasty and stent(PTAS) treatment.Methods 61 patients with extracranial vertebral artery stenosis confirmed by digital subtraction angiography(DSA) were detected by CDU on both sides of extracranial vertebral artery before and 3 d,30 d after PTAS.The flow volume(FV),peak systolic velocity(PSV) and resistance index(RI) at the site of C5-C6 segment and stenosis were as analysis targets.Results Before PTAS,80 stenotic extracranial vertebral arteries were found by CDU(mild degree 17 cases,moderate degree 38 cases,severe degree 25 cases).Compared with DSA,coincidence was 86.9%(77.3%,95.0%,83.3%).Among them,the coincidence of moderate extracranial vertebral artery stenosis detected by CDU was excellent(P0.05).Conclusion CDU has the important value in diagnosing extracranial vertebral artery stenosis,and can be used to follow up the blood hemodynamics in the extracranial vertebral artery of patients treated by PTAS.It provided a method for observing the efficacy of PTAS treatment.

Objective: To explore the growth inhibition and apoptosis-inducing effects of apigenin in human gastric cancer SGC-7901 cells. Method: MTT and flowcytometry were used to detect the growth inhibition and cell cycle distribution in apigenin-treated SGC-7901 cells respectively. DAPI fluorescence staining and DNA ladder assay were applied to study the pro-apoptosis effects of apigenin. The expression of apoptosis relative proteins, caspase-3 and Bcl-2, were analyzed by using Western blotting. Results: Apigenin treatment significantly inhibited the growth of human gastric cancer cell SGC-7901 and markedly caused their apoptosis following activation of caspase-3 and downregulation of Bcl-2 protein expression. Conclusion: The activation of caspase-3 and downregulation of apoptosis relative protein Bcl-2 expression were the possible mechanism of apigenin induced growth inhibition and apoptosis in SGC-7901 cells.

Objective To investigate the clinical distribution characteristics of persisters isolated from the chronic infected pa-tients,so as to provide scientific basis for effective clinical measures to prevent,control and treat persister-associated chronic infection.Methods Clinical microbial samples cultured from Jan.2013 to Dec.2014 were analysed by WHONET5.6.Four bacteria species with the highest isolation rate were performed for screening of chronic infection.Concentration of bacteria were detected by viable plate count method and then the growth curve were drew of each sample under the presence of anti-biotics.Persisters were comfirmed according to the specific growth curve under the presence of antibiotics.Results Four highest isolated bacteria species of the clinical samples were Escherichia coli (1 3.2%),Klebsiella pneumoniae (9.6%), Pseudomonasaeruginosa (8%)and Staphylococcusaureus (6.6%).862 chronic infection samples were generated out of 14 216 microbial samples and 41 persisters (4 strains of Escherichia coli,23 strains of Klebsiella pneumoniae,8 strains of Pseudomonasaeruginosa and 6 strains of Staphylococcusaureus)were isolated finally.Conclusion With such a comprehen-sively retrospective analysis of the hospital clinical microbial samples,can tell that the ratio of persisters in chronic infection was not high.And chronic infections are mostly caused by gene-mutated drug-resistant bacteria.However,the isolation rate of Klebsiella pneumoniae was relatively high,of which more attention should be payed to the prevention and control.

OBJECTIVE To analyze the pathogenic distribution and antimicrobial resistance in our hospital in 2006 and provide the rational information to use antibiotics reasonably.METHODS Flora cultivation and isolation were operated with the methods described by the National Clinical Laboratory Operational Regulations.Flora was identified with the VITEK32 automatic identifier,and bacteria-susceptibility test was operated with Kirby-Bauer method.RESULTS Totally 967 strains of pathogenic bacteria were isolated;they comprised 326 strains of Gram-positive bacteria,541 strains of Gram-negative bacteria and 100 strains of fungi.The main Gram-positive microorganisms included Staphylococcus aureus and Enterococcus faecalis,et al.The main Gram-negative microorganisms included Escherichia coli,Klebsiella pneumoniae,Acinetobacter baumannii,Stenotrophomonas maltophilia and Pseudomonas aerugiinosa,et al.Specimen samples mainly isolated from sputum(43.85%),urine(22.34%),and secretion(10.03%).G+ microorganisms were sensitive to nitrofurantoin and vancomycin.G-microorganisms except A.baumannii and S.maltophilia were sensitive to cefoxitin,piperacillin/tazobactam,imipenem,and amikacin;the average resistant rates of A.baumannii and S.maltophilia to antibiotics were 68.20% and 64.43%,respectively.CONCLUSIONS The severe degree of bacterial multi-drug resistance is increasing,it is urgent to carry out surveillance of bacterial resistance for reasonabe use of antibiotics and decreasing the morbidity rate and the fatality rate.

Objective To explore the value of color Doppler ultrasonography(CDU)as preoperative diagnosing and postoperative monitoring in patients with stenosis of subclavian or innominate artery(SIA)before and after percutaneous transluminal angioplasty and stent(PTAS).Methods A total of 45 patients with stenosis of SIA were selected.Their extracranial vertebral artery and subclavian artery were observed with CDU.In 36 patients with one-sided stenosis of SIA.blood flow direction and spectrum of extracranial vertebraI artery were analyzed.Subclavian steal grade confirmed by spectrum change of vertebral artery was compared with the stenosis grade on quantitative angiography(QA).Among 45 patients with stenosis of SIA,PTAS was performed successfully in 36 patients(36 stents implanted).After stents implanted, hemodynamie parameters such as peak systolic velocity(PSV)in stent, follow-up velocity ratio in stem(VR)were measured.Restenosis in stent were observed.Results In 36 patients with one-sided stenosis of SIA,the ultrasonographic steal grade correlated with the QA stenosis grade significantly(r=0.752,P<0.01).Among 36 patients with stent implanted,follow up 8-12 months, 4 patients with restenosis in stent were found.Compared with the patients without restenosis in stent,PSV and VR in stent increased significantly(P<0.01).Conclusions As a fast and non-invasive imaging technique,CDU could allow diagnosis of stenosis of SIA before PTAS,and detection of restenosis after PTAS.

Objective To investigate the characteristics of persisters isolated from the chronic infected patients and clarify the relationship between the infection time and persistence as well as antibiotic drugs,so as to provide scientific basis for clinical effective measures to prevent,control and treatment of persister-associated chronic infection.Methods The tolerant ability of the 41 persisters (4 strains of Escherichiacoli,23 strains of Klebsiellapneumoniae,8 strains of Pseudomonasaeruginosa and 6 strains of Staphylococcusaureus)under differet kind and concentration of antibiotics and nutritional deficiencies cindi-tions were detected.In addition,analysis of the homologous strains isolated from the same patients with different infection time was performed.Results The study found that with the increase of concentration of antibiotics,the proportion of persis-ters would gradually decrease.The tolerance ability of the same persister strain to different antibiotics was dissimilar,and different species persisters also had various tolerance ability to the same kind of antibiotics.Persisters were more able to withstand the lack of nutrition.What’s more,there is no significant difference between the resistant ability of the homolo-gous strains isolated from the same patients with different infection time (P>0.05).Conclusion Persisters have different a-bility to stand the kill of different kinds and concentration of antibiotics and they can even be completely removed when ex-posed to sufficiently high concentrations of antibiotic.

OBJECTIVE To study the pathogenic bacteria and its resistance to antibiotics in chronic suppurative otitis media. METHODS Secretion from 132 cases with chronic suppurative otitis media were cultured. Drug sensitivity tests were done to separate pathogenic bacteria. RESULTS 152 strains pathogenic bacteria were isolated from middle ear secretion. The main pathogenic bacteria were staphylococcus aureus (49 strains), pseudomonas aeruginosa (25 strains) and fungus (5 strains). Staphylococcus aureus was sensitive to fluorquinolones, and the sensitivity rate was 79.6 %. Pseudomonas aeruginosa was sensitive to fluoroquinolones and floxacin, and the sensitivity rates were 84 % and 64 %. CONCLUSION Staphylococcus aureus and pseudomonas aeruginosa are main pathogens of chronic suppurative otitis media in our region. Both of them are sensitive to fluorquinolones. Meanwhile, pseudomonas aeruginosa is also sensitive to ceftazidime of the third cephalosporins. So doctors should choose the sensitive antibiotics for treatment of the chronic suppurative otitis media, that may avoid the bacteria with drug resistance come into being. The fungus can not be neglected as the pathogen in chronic suppurative otitis media.

Objective To investigate the status of the readiness for hospital discharge and pain degree in inpatients with thoracolumbar osteoporotic fractures, and the correlation between them.Methods A cross-sectional analysis of survey data from a sample of 252 patients with thoracolumbar osteoporotic fractures was conducted in a grade A tertiary hospital in Xi′an from January 1st, 2016 to June 30th, 2016. The status of the readiness for hospital discharge and pain level were investigated through the Readiness for Hospital Discharge Scale and Numerical Rating Scale (NRS) respectively. Pearson correlation coefficient method was used to detect the correlation between the two target factors. Results The average score of readiness for hospital discharge was 7.71±1.55. The mean NRS score decreased from 7.8 ± 0.8 at baseline to 2.7 ± 0.6 before discharge. The scores of each dimensions of readiness for hospital discharge from high to low were expected support, personal status, and coping capacity. There was a negative correlation between discharge readiness and pain degree in patients with thoracolumbar osteoporotic fractures (r =-0.537, P<0.05). Conclusions The status of the readiness for hospital discharge among the patients with thoracolumbar osteoporotic fractures is in a medium to high level before discharge. The pain degree is significantly decreased to a lower level. There is a negative correlation between the readiness for hospital discharge and the pain degree.

Objective To investigate the effects of acupoint massage on labor analgesia efficacy and it's related clinical factors,so to definite the analgesia mechanism and the relationship between the neurotransmitter dopamine and analgesia mechanism.Methods We choosed patients who have been hospitalized in No.1 hospital from March 2009 to September 2009,and divided them into two groups randomly: observation group and control group.Patients in the observation group were treated with acupuncture massage when the production process went into the active phase.Control group indicated that childbirth was naturally without any treatment.We observed the analgesic effect of point massage and the impact of pressure on the uterine contractions.We tested the dopamine level in the blood by fluorescent spectrophotometry before and afte the acupoint massage.We explored the effects of the point massage on the dopamine level in the puerpera.Results The observation group′s pain decreased more than that of the control group.The intensity of contractions in observation group was decreased more obvious than that of the the control group.The serum dopamine levels was significantly lower than that pre-massage(P