Objective To learn the prevelance of Acinetobacter baumannii and its drug resistance related with Ⅰ class integron. Methods 22 kinds of antibiotics commonly used in our hospital were used to detect the sensitivity of the clinically separated Acineto-bacter baumannii.Methods PCR was used to detect Ⅰ class integron enzyme gene of Acinetobacter baumannii,and then parts of variable region of Ⅰ class integron enzyme gene were amplified and analyzed for gene sequence.Results The drug resistance of Acinetobacter baumannii phenomenon was very serious,which was multiple drug resistance.The resistance rate of Acinetobacter baumannii to CPZ/SB was 1.2%.And the resistance rates to tigecycline,ofloxacin,imipenem,biapenem,and amikacin were 1 5.4%-69.5%,but the resistance rates to other antibiotics were above 71%.There were 72 of 102 strains including Ⅰ class integron (positive rate was 70.2%).The resistance of strains with Ⅰ class integron was stronger than that of the strains without.The varia-ble area of Ⅰ class integron produced the same enzyme bands when analyzed with double enzyme,suggesting the Acinetobacter bau-mannii was homologous.The gene sequence analysis of Ⅰ class integron showed that the Ⅰ class integron of the Acinetobacter bau-mannii carried kinds of resistant genes such as aacA4,catB8 and aadA13.Conclusion From 2010 to 2013,the Acinetobacter bau-mannii in our hospital is highly resistant to cephalosporins,broad-spectrum penicillin,aminoglycosides and fluoroquinolones and is severely multiple drug resistant.So the antimicrobial drugs for the treatment of infections caused by Acinetobacter baumannii are limited.Ⅰ class integron is closely related to the multiple drug resistance of Acinetobacter baumannii.

Objective To observe the effect of Succinate injection combined with Bifico on the myocardial enzymes changes of the children with rotavirus enteritis.Methods A total of 146 children with rotavirus enteritis were enrolled and included in this study. Children were randomly divided into the control group (n=73) and the observation group (n=73). The control group was received Bifico on the basis of routine treatment, and observation group was received Succinate injection combined with Bifico. The IL-17, IL-6, TNF-?, LDH, CK, and CKMB was detected by ELISA. The rates of clinical effects was compared.Results After treatment, the IL-17 (22.35 ± 4.21 ng/mlvs. 30.24 ± 6.07 ng/ml,t=2.395), IL-6(31.26 ± 6.14 ng/mlvs. 43.72 ± 8.22 ng/ml,t=2.347), TNF-? (35.62 ± 6.24 ng/mlvs. 49.18 ± 8.72 ng/ml,t=2.421), LDH (135.16 ± 31.25 U/Lvs. 174.08 ± 40.22 U/L,t=2.373), CK (37.82 ± 7.39 U/Lvs. 50.21 ± 11.16 U/L,t=2.385), and CKMB (90.14 ± 11.63 U/Lvs. 113.22 ± 18.35 U/L,t=2.392) in the observation group were lower than those in the control group (P<0.05). The rates of clinical effects was 94.5% (69/73) in the observation group and 83.6% (61/73) in the control group. There was significant difference between the two groups (χ2=2.352,P=0.047).Conclusions The Succinate injection combined with Bifico could reduce the inflammatory indices and alleviate the myocardial injury in the RVE patients.

Objective To explore the effect of I kappa B kinase (IKK) on liver during hepatic ischemia reperfusion (HIR) in rats.Methods Wister rats were divided randomly into HIR group in which hepatic reperfusion was given after 60 minutes of ischemia by interruption of the arterial and portal venous blood supply to the left lobes and middle lobes of the liver; HIR + PDTC treatment group in which PDTC (120 mg/kg) were injected via the dorsum vein of penis before ischemia reperfusion; and sham control group in which midline laparotomy was performed without vascular occlusion and treatment.Expression levels of IKK were measured with In situ hybridization(ISH).The NF-κB activities were determined with EMSA.Expression levels of TNF-α were measured with immunohistochemistry (IH).Serum levels of ALT were measured.Results Expression level of IKK was increased markedly from 0 to 12h and peaked 6h after reperfusion in HIR group.NF-κB was activated 0 ～ 12h after reperfusion and activities of NF-κB were maximal 6h after reperfusion in HIR group rats compared with sham control group.Expression level of TNFα was increased markedly from 0 to 12h and peaked 6h after reperfusion in HIR group.Serum levels of ALT were increased significantly after reperfusion in H1R group.Expression level of IKK was lowered markedly in HIR + PDTC group from 0 to 12h after reperfusion.NF-κB activities were significantly lower in HIR +PDTC group than in HIR group from 0 to 12h after reperfusion.Expression level of TNF-α was lowered markedly in HIR + PDTC group as compared with HIR group from 0 to 12h after reperfusion.Serum level of ALT was decreased significantly after reperfusion in HIR + PDTC group as compared with HIR group.Conclusion HIR can activate IKK-β which promotes the activation of NF-κB,then NF-κB results in upregulation transcription of TNF-α gene which gives rise to the release of other inflammatory cytokines and triggers uncontrolled inflammatory response,and induces hepatic injury.Blocking IKK-NF-κB pathway may be an effective approach to checking the generation and development of ALI,PDTC plays important prophylaxis and treatment roles in hepatic injury after HIR.

Objective To analyze the impact of the declining balance rate in military hospitals during new healthcare reform.Methods A military medical expense model was established,the parameters of the model were changed and the impact of the declining balance rate was analyzed.Results and Conclusion Military hospitals have to face up to the negative influence caused by the declining balance rate,actively promote expenditure compensation mechanism reforms,increase funding,enhance supervision,and separate revenues from expenditures.

Object:To create a practicable and valid scale used to evaluate postgraduate tutors in medical universities.The scale will be applied to tutor evaluation in order to activate the tutors in their responsibility for postgraduate education.Method:Some mature scales and questionnaires offered by some oversea'universities such as University of Michigan were offered for reference.The scale designed for tutor evaluation in medical universities was applied to evaluate most of the master tutors in Capital Medical University.All of the data was analyzed by SPSS 11.5,and the scale was modified according to the results of statistic analysis.Conclusion:The modified scale showed satisfactory reliability and validity.

There are many factors which can affect the quality of graduate student education,such as management,tutors,and individuals,which are usually the main aspects.Scientific management is the essential factor for high quality of education.This article introduced the experiences of graduate education in Capital Medical University,and discussed some problems which should be coped with.

Objective:To evaluate graduate student tutors in medical universities using an available scale to improve graduate education management.Method:Graduate students in Grades 2006 and 2007,who had passed thesis defense,were investigated online.The results were analyzed by statistics.Conclusion:Most of graduate students were satisfied with their tutors.The results proved very helpful for the innovation of graduate education management.

With the popularization and internationalization of higher education,the quality of higher education has been more and more attented to. The article has reviewed the overseas system of evaluation of graduate education,discussed the system in China,and advanced some suggestions on self-evaluation of graduate education in China.

Objective To explore the application of a system dynamics(SD) model to military medical expenses in PLA hospitals.Methods According to relevant theories of SD, the study has selected some important variables and defined the primary function relations in order to establish a military medical expenses SD model.Results and Conclusion The SD model is suited to modeling the PLA medical expenses and can serve as a theoretical basis for the policy innovation of the PLA medical system.

The reform in cultivating professional-degree programs in Clinical Medicine Education contributes to the transformation of training mode, which surpasses the connotative bounds of the inherent education management. The personalized training of students has made it more challenging for both the tutor and the faculty to involve in education management, the effectiveness of which is highly valued due to the pressing need for sound medical ethics. Furthermore, the development of information technology calls for the reform of education management as well as the emphasis of student-centered approach. This article summa-rizes the existing problems of current education management mode for master degree programs of profes-sional clinical medical education. In addition, a three-level management system composed of medical experts is brewed and put forth. This system, based on compensation and restraint, assessment and incentive, ser-vice as well as security, is meant to facilitate the training of application-oriented medical talents.