AIM: To study the effects of indapamide and nifedipine in treating the patients with mild to moderate hypertension and the affect to the living quality.　METHODS: One hundred and twenty seven patients with mild to moderate hypertension were divided into two groups, indapamide group 67 patients (M 30, F 37; age 63 a± s 12 a) received indapamide 2.5 mg, po, tid ×2 mo; nifedipine group 60 patients (M 30, F 30; age 61 a±12 a) received nifedipine 10 mg, po, tid× 2 mo.　RESULTS: Both above medicines could reduce blood pressure effectively (P>0.01), and there was no obvious affect to the lipid, renal function, uric acid, electrolyte. Indapamide group had the results of getting living quality improved; while nifedipine group had that of increasing some self testing sonse symptoms and ling quality reduced.　CONCLUSION: Both indapamide and nifedipine have definite effects in treating hypertension, while no obvious bad affect on blood lipid, renal function, et al. But the indapamide is less adverse reaction, and superior to nifedipine on the aspect of improving living quality.

In order to understand the resistance against common antibiotics in clinic and macrolide antibiotic-resistant mechanism of Streptococcus pneumoniae (S.pneumoniae) isolates in Zhejiang area,both K-B slip method and E-test were applied to determine the sensitivity of 138 S.pneumoniae isolates to nine antibiotics,and the ermB and mefE genes in those isolates which associated with macrolide antibiotics-resistance closely were detected by PCR.Subsequently,correlation among ermB and mefE genes and the erythromycin resistance were analyzed.For these 138 S.pneumoniae isolates,93.5% (129/138) of the strains were resistant to erythromycin,but only 2.9%～4.3% strains were resistant to cefotaxim,cefuroxime,amoxicillin and levofloxacin.The positive rate of ermB gene in the isolates (91.3%,126/138) was significantly higher than that of mefE gene (33.3%,46/138) (P<0.05).Both of these two genes existed in 27.5 % (38/138) of the strains and all of the strains without ermB and mefE genes were sensitive to erythromycin.The erythromycin resistance rate (62.5%) of mefE gene positive strains was remarkably lower than that of the mefE&ermB gene positive strains (100%) and the ermB gene positive strains (97.7%) (P<0.05).All the data mentioned above demonstrated that erythromycin is not an appropriate antibiotic to treat the infectious diseases caused by S.pneumoniae.Moreover,ermB is the predominant erythromycin resistance gene in S.pneumoniae isolates and ermB gene could inspire stronger erythromycin resistance than mefE gene.

Objective To analyze prevalence and determinants of medical adhesive-related skin injury (MARSI) in peripherally inserted central catheter implanted patients with lung cancer,to create evidence for improved clinical care.Methods A cross-sectional observational study design was adopted.Skin pictures and electronic medical records of 200 lung cancer patients who visited Shanghai Chest Hospital for PICC between June 2017 and September 2017 were analyzed to calculate prevalence of MARSI and identify related factors.Results The prevalence of MARSI was 31.5％ (63/200),and mechanical trauma accounted for 50.8％ of all cases (32/63).Age,diabetes and anaphylaxis were significantly related to MARSI.Conclusion Analysis of MARSI in PICC implanted patients with lung cancer provided evidence for improved clinical care of such patients.

Objective To explore the application of PDCA cycle in health education in e-mergency department.Methods A total of 50 patients were randomly selected from our hospital from April to June 2013 before applying PDCA cycle management as traditional health education group,another 50 patients were randomly selected from our hospital from July to September 2013 after applying PDCA cycle management as PDCA health education group,health education aware-ness and patient satisfaction rate of the two groups were compared.Results Health education awareness and patient satisfaction rate in PDCA health education group were better than traditional health education group,and the difference was statistically significant(P <0.05).Conclusion PDCA cycle management method can meet the needs of emergency patients’health education,and effectively improve patients’awareness of emergency health education and satisfaction rate.

Objective To explore the application of PDCA cycle in health education in e-mergency department.Methods A total of 50 patients were randomly selected from our hospital from April to June 2013 before applying PDCA cycle management as traditional health education group,another 50 patients were randomly selected from our hospital from July to September 2013 after applying PDCA cycle management as PDCA health education group,health education aware-ness and patient satisfaction rate of the two groups were compared.Results Health education awareness and patient satisfaction rate in PDCA health education group were better than traditional health education group,and the difference was statistically significant(P <0.05).Conclusion PDCA cycle management method can meet the needs of emergency patients’health education,and effectively improve patients’awareness of emergency health education and satisfaction rate.