Objectives To consider the reliability of using flucloxacillin (FCC) and clavulanic with extended spectrum cephalosporin synergy method (double inhibitors diffuse synergy test, DIDST) to detect AmpC ? lactamases (AmpC BLA) and extended spectrum ? lactamases (ESBLs). Method The FCC and clavulanic were regarded as the inhibitors of AmpC BLA and ESBLs respectively. The disks of ceftriaxone and cefepime were placed 20 mm away from the inhibitors, the disks of cefotaxime and the inhibitors were 25 mm apart. DIDST with a double disk synergy test, a cefoxitin three dimensional test, and a double disk enhancement test detected AmpC BLA and ESBLs in 56 strains of gram negative bacilli at the same time. Results 20 (35.71%) strains of ESBLs, 12 (21 43%) for AmpC BLA and 1 (1.78%) for ESBLs+AmpC BLA were found using DIDST, in 56 strains of G - B. During the double disk synergy test was used for ESBLs, 15 strains were found when the distance of the disks was within 25 mm, another 5 strains were found when the distance decreased to 20 mm. Twenty strains of ESBLs were found using the double disk enhancement test, and 12 strains of AmpC using the cefoxitin three dimensional test. The result of DIDST was similar to that of other three kinds of test. Conclusions DIDST is an accurate and reliable method using one plate to detect ESBLs and AmpC BLA of the same time. It is suitable for different levels of hospitals.

ObjectiveTo investigate the clinical effect of EaLeSu on cervical intraepithelial neoplasia(CIN Ⅱ~Ⅲ)patients with HPV infection treated with loop electrosurgical excision procedure(LEEP). Methods 165 cases of CIN Ⅱ~Ⅲpatients with HPV infection who underwent LEEP operation were randomly divided into observation group(n=83)and control group(n=82). In the observation group,patients were given a piece of EaLeSu in cervical wound at once in postoperative and two vaginal EaLeSu per day from the first postoperative day for eight consecutive days. The patients in the control group were treated with routine debridement and wound dressing with iodine. We observed the vaginal drainage times within 4 weeks after operative,bleeding rate,cervical wound repair,and cervical HPV DNA infection after 6 months. Results There were significant differences in the bleeding rate,vaginal drainage time,cervical wound repair and HPV DNA infection between the two groups(P < 0.05). Conclusion EaLeSu showed a definite effect on cervical intraepithelial neoplasia(CIN Ⅱ~Ⅲ)patients with HPV infection treated with LEEP.

Objective To construct a home-care service package for the urban disabled elderly that satisfy their demands and improve the efficiency of service. Methods From August to October, 2014, a total of 285 disabled (mild, medium and severe) elderly from a cluster sampling were investigated with the self-designed questionnaire about home-care demands among them. An initiatory service package was drawn to meet the demands reported by 40% of them or above. The package was consulted by a group of 15 experts using Delphi method. Results The final service package included 11, 19, 20 items of care for the mild, medium and severe disabled elderly, respectively. Conclu-sion The disabled elderly home-care package in Zhengzhou has been created based on the demands among disabled elderly.

Objective To investigate the clinical effects of Kangfuxin Solution used together with Baofukangshuan on chronic cervicitis after having been processed cervical LEEP circumcision.Methods Retrospective analysis was made among 176 out-patients diagnosed of chronic cervicitis from November 2007 to January 2009.Of all these patients,90 patients were treated with Kangfuxin Solution and Baofukangshuan after LEEP circumcision(the treatment group),and 86 patients were treated with simple cervical LEEP circumcision(the control group).The wound healing,vaginal discharge,bleeding volume,and side effects were observed in both groups.Results The method in the treatment group significantly reduced the amount of vaginal discharge and the duration,decreased the amount of bleeding and the duration;excluded wound infection and adverse reactions,and facilitated cervical wound recovery.The curative rate(98.89%)in the treatment group was significantly higher as compared to the control group(86.05%)after 8 weeks of the treatment.Conclusion Cervical LEEP circumcision surgery supplemented by Kangfuxin solution and Baofukangshuan therapy has better efficiency than treated by simple cervical LEEP circumcision.

Objective To investigate the efficacy and safety of tirofiban for emergency interventional therapy in patients with acute ST segment elevation myocardial infarction.Methods The 96 acute ST segment elevation myocardial infarction patients having accepted emergency percutaneous coronary intervention (PCI) were divided into treatment group and control group according to the treatment method with 48 cases each.The treatment group was given conventional standard treatment combined with tirofiban treatment [tirofiban intracoronary injection 10 μ g/kg and then intravenous 0.15 μ g/(kg· min) for 24-48 h].The control group was given conventional standard treatment only.The postoperative 60 min electrocardiogram ST segment recovery,the coronary blood flow TIMI grade,the major adverse cardiac events (angina,myocardial infarction,heart failure,death) and postoperative bleeding in 4 weeks were compared between the two groups.Results The patients having postoperative 60 min electrocardiogram ST segment recovery in treatment group was 45 cases (93.8％,45/48),in control group was 35 cases (72.9％,35/48),and there was statistical difference (P ＜ 0.05).The incidence rate of infarction vascular TIMI grade ≥ 3 grade flow in treatment group was 95.8％ (46/48),in control group was 75.0％ (36/48),and there was statistical difference (P ＜ 0.05).The incidence rate of the major adverse cardiac events 4 weeks in treatment group was significantly lower than that in control group,and there was statistical difference (P ＜ 0.05).There was no statistical difference in the incidence rate of bleeding between the two groups (P ＞ 0.05).Conclusion In patients with acute ST segment elevation myocardial infarction,the emergency interventional therapy with tirofiban is efficacy and safety.

Objective To evaluate the performance of ACL TOP coagulation analyzer system in the laboratory of children′s hospital. Methods According to the documents of CLSI, the analytic characteristics including precision, accuracy, linearity, interference and carryover rate were examined; specimens from healthy children were collected and assayed to determine the reference range of Prothrombin Time (PT), Activated Partial Thromboplastin Time (APTT), Thrombin Time (TT), Fibrinogen (FIB) and D-Dimer (D-D) from children on ACL TOP. Results The within-run and between-day coefficient of variability (CV) were within an acceptable range; The accuracy deviation of PT , APTT and FIB were less than 1/2 allowed total errors; The results of determination of FIB linearity test were correlated with the results of calculation: Y = 1.002 1X-0.122, R2 =0.998 2; The extent of influence of low to middle grade of jaundice , fat and hemolysis on each test were all less than 1/2 allowed total error; The carryover rates were lower than 1.81% and within an acceptable range; The reference range of PT, APTT, TT and FIB were PT (9.1-13.1 s), APTT (24.9-42.1 s), TT (12.6-21.1 s), FIB (1.924-4.011 g/L). Conclusion The ACL TOP coagulation analyzer has good repeatability, stability, linearity and capability of anti-interference and anti-carryover.

As one of the important methods that impact the recovery of the stroke patients,music therapy has become a research highlight at present.Based on this background,literature about the impact of the recovery of the stroke patients and related interventions were reviewed.By drawing the experience from the research,we aimed to innovate perfect intervention for expansion of the research thoroughly in order to improve the quality of life of the patients.

OBJECTIVE To study the bacterial infections in ICU,pathogens distribution and their drug-resistance characteristics,so as to offer a reference to the prevention and control of hospital infection.METHODS Specimens from ICU from Jan 2003 to Dec 2004 were underwent a process of germ culture,identification and drug-sensitivity test.Germ culture-positive cases were confirmed by Diagnostic Standards of Hospital Infections.RESULTS Ninety three pathogens were identified from ICU in two years.Of all cases,63.44% were Gram-negative,30.1% were Gram-positive,and 9.68% were epiphyte.Among them,19.35% were Pseudomonas aeruginosa and it was the main one of Gram-negatives;9.68% were Staphylococcus aureus and it composed the most of Gram-positives;6.45% were epiphyte.Of all 93 pathogens,60 gained from respiratory tract,and 23 gained from urinary tract.CONCLUSIONS To emphasize on the strictly control of ICU,hospital infections and high risk disease,and to adopt certain preventive measures are the ways to control and decrease hospital infections.

Objective To investigate the postmortem redistrib ution of morphine in rat model of chronic morphine poisoning. Methods Samples including cardiac blood, liver, heart, kidney, lung and brain tissues were collected in the rats with chronic morphine poisoning at 0～96 h after death, respectively. The morphine amount was measured with solid phase ext raction-gas chromatography. Results The study showed an increase in morphine concentrat ion of postmortem cardiac blood. Significant increase in morphine level was also observed 24～96 h after death in liver, heart and brain tissues, while the kid ney morphine levels decreased at 96 h after death. In the liver there was the g reatest increase (25-fold) in morphine levels 96 h after death. All the sample s showed marked alterations in morphine concentration within 96 h after death c ompared with cardiac blood at time of death. The postmortem morphine levels in b rain were closely related to those in the heart blood. Conclusion The postmortem redistribution of morphine exists in rats with chronic morphine poisoning. The brain tissues may better represent morphine levels in heart blood at the time of death.

Objective To compare the specificity, sensitivity, titers, and rapidity of four methods including papain technique, anti-globulin technique, polybrene test, and micro-column gel test for determination of IgG red blood cell antibodies. Methods Twelve kinds of IgG red blood cell antibodies such as anti-D, anti-E, anti-C, anti-c, anti-e, anti-Jk a, anti-Jk b, anti-Fy a, anti-Fy b, anti-k, anti-S, and anti-s were checked by the four methods. Results Seven kinds of IgG red blood cell antibodies including anti-D, anti-E, anti-C, anti-c, anti-e, anti-Jk a, and anti-Jk b were detected using papain technique (7/12). All of the 12 kinds of IgG antibodies were detected by anti-globulin technique (12/12). Eleven kinds of IgG red blood cell antibodies except anti-k were examined with polybrene test (11/12) and all the antibodies were also determinated by micro-column gel test (12/12). The titers of the antibodies determination suggested that papain technique was less sensitive than other three methods, while the micro-column gel test was more sensitive than other three methods in examination of all the antibodies. The lasting time of four techniques were: papain technique 45 min, anti-human globulin technique 60 min, polybrene test 5 min, and micro-column gel test 30 min. Conclusion Papain technique has some limitation in determination of IgG antibodies and anti-globulin technique is complicated because of long period incubation and multiple wash of red blood cells. Polybrene test is the most simple and convenient technique for determination of IgG antibodies. Micro-column gel test is the most sensitive method in determination of IgG antibodies.