OBJECTIVE To investigate the distribution of commonly encountered pathogenic microbes during the last five years.METHODS A total of 9318 strains of NI pathogens during from Jan 2004 to Dec 2008 were surveyed and analyzed.RESULTS From them the percentage of Gram-positive cocci was 13.6%,the main pathogen was coagulase negative Staphylococcus,Gram-negative bacilli(28.8%).The predominant pathogens were Escherichia coli,Klebsiella pneumoniae and Pseudomonas aeruginosa.The drug resistance of NI pathogens was markedly increased.Especially,the rate of drug resistance of P.aeruginosa to imipenem was from 0 to 31.8% in 2005,and that of Enterococcus to vancomycin was 4.0% in 2007.The percentage of fungi was 26.4% and increased sharply year by year.CONCLUSIONS The Gram-negative bacteria play a dominant role in clinics and drug resistance of isolated pathogenic bacteria is a serious problem.Monitoring the trends of pathogenic bacteria′s distribution and drug resistance is very important in guiding the clinical administration of drugs and we should pay attention to fungal infection.

Objective To increase the sensitivity of residual leukemic cells detectin in chronic myelocytic leukemia(CML) patients with RT-PCR,the optional annealing temperature and PCR cycles were studied to confirm bcr-abl fused gene types,and bcr-abl mRNA transcripts were monitored by RQ-PCR to study the relation with CML at different phases. Methods Through changing the PCR conditions, the annealing temperature was measured from 55℃ to 60℃, and the number of reaction cycles was increased from 30 to 45.All 22 samples were examined, and bcr-abl mRNA transcripts were quantified by RQ-PCR kit. Results Bcr-abl fused gene types were found in 22 samples,of all 9 cases were b_2a_2 type, 13 cases were b_3a_2.When the annealing temperature was set for 58℃ and the number of reation cycles was set for 45,10~3 copies/ul standard samples was detected.18 samples were positive tested by RQ-PCR kit,and the value was between 10~2 to 10~6 copies/g.There were significant differce between the results of chronic phase samples and those of accelerated phase. Conclusions The RT-PCR is a reliable,sensitive and reproducible method of monitoring CML patients.The real-time RT-PCR is useful in evaluating leukemic burden,assessing response to treatment and predicating the prognosis of the disease.

Objective:To compare of the effects of laparoscopic and open radical hysterectomy on the serum Interleukin-4(IL-4),interleukin-10 (IL-10),tumor Necrosis Factor-α (TNF-α) and Interferon-γ (IFN-γ) levels of Patients with Cervical Cancer.Methods:64 patients of cervical cancer who were treated from March 2014 to September 2016 in our hospital were selected as research objects.The patients were randomly divided into the abdominal cavity group and open group.The operative time,blood loss,postoperative ventilation time and the levels of IL-4,IL-10,TNF-a and IFN-γin serum before and after treatment were compared between the two groups.Results:The intraoperative blood loss and postoperative ventilation time were significantly lower or shorter in the abdominal cavity group than in the open group (P＜0.05).There was no statistically significant difference in the operation time between the two groups (P＞0.05).There were no significant differences in the levels of serum IL-4,IL-10,TNF-α and IFN-γ between the two groups before operation(P＞0.05);The serum IL-4 level was significantly lower than that of the open group during the operation (P＜0.05).There was no significant difference in the other three index between the other three groups and the laparotomy group (P＞0.05).The serum levels of IL-4,IL-10,TNF-α and IFN-γ in the abdominal cavity group were significantly lower than those of the laparotomy group on the 1 st and 7th day after operation(P＜0.05).Conclusion:Laparoscopic radical mastectomy in cervical intraoperative less blood loss and more secure.The effect of IL-4,IL-10,TNF-α and IFN-γin the postoperative patients was more obvious.Conducive to the recovery of patients after surgery.

Objective To investigate the changes in high voltage-activated (HVA) calcium current in dorsal root ganglion (DRG) neurons isolated from rats with neuropathic pain. Methods Pathogen-free male SD rats aged 4-6 weeks weighing 180-220 g were used in this study. The animals were anesthetized with intraperitoneal pentobarbital sodium 50 mg/kg. Neuropathic pain was induced by ligation of L5 spinal nerve between DRG and sciatic nerve. The nerve was transected distal to the ligature. The animals which showed positive signs of neuropathic pain were decapitated on the 14th postoperative day. L5 and L4 DRGs were isolated and the neurons in the ganglia were enzymatically dissociated (group L5 and L4). The control group received no surgery (group C). The HVA Ca2+ current was recorded using whole-cell patch clamp technique. Results Peak calcium current density was significantly lower in group L5 and L4 than in group C, and was significantly lower in group L5 than in group L4 . Halfactivation value (Va 1/2) was also significantly lower in group L5 than in group C and L4 (P ＜ 0.05). The relative contribution of N-type to the total HVA Ca2+ current was significantly greater in group L5 than in group C and L4(P ＜ 0.05). There was no significant difference in the steady-state inactivation curves among the 3 groups. Conclusion In rats with neuropathic pain, the HVA Ca2+ current in the injured DRG neurons may play a key role in the induction of neuropathic pain.

Objective To investigate the effect of gabapentin on high voltage active calcium currents in the injured dorsal root ganglion (DRG) neurons in a rat model of neuropathic pain.Methods Pathogen-free male SD rats aged 4-6 weeks were used in this study. The animals were anesthetized with intraperitoneal pentobarbital soclium 50 mg/kg. L_5 spinal nerve was ligated between DRG and sciatic nerve and cut distal to the ligature. The animals were decapitated on the 14th postoperative day. L_5 DRG was isolated and the neurons in the ganglion were enzymatically dissociated. The high voltage active calcium current was recorded using whole-cell patch-clamp technique.Results Gabapentin inhibited the peak calcium current in the injured DEG neurons. Peak calcium current was decreased by gabapentin 100 μmol/L and both activation and steady-state inactivation curve shifted to more hyperpolarized potentials. Conclusion Gabapentin can inhibit high voltage active in the injured DRG neurons in a rat model of neuropathic pain. The alteration in the inactivation of the electrophysiological properties may be involved in the mechanism.

Objective To examine the application of On-Board Imaging (OBI) system-based image-guided radiotherapy (IGRT) in the improvement of the precision of intensity-modulated radiotherapy (IMRT) for nasopharyngeal carcinoma.Methods Ten patients with nasopharyngeal carcinoma were treated with IMRT using the OBI system. The IGRT images after positioning, position adjustment, and treatment were observed and recorded to investigate the image difference between CT simulation and IGRT. Results The deviations in the x (lateral), y (cranial-caudal), and z (ventral-dorsal) directions between CT simulation and IGRT images were 0.22±1.00 mm,-0.37±1.28 mm, and 0.04±1.36 mm, respectively, after positioning, 0.29±0.76 mm,-0.04±0.78 mm, and -0.01±0.92 mm, respectively, after position adjustment, and 0.20±0.78 mm, 0.16±0.80 mm, and 0.05±0.92 mm, respectively, after treatment. The probabilities of a ≤1 mm deviation in the x, y, and z directions were 81.0%, 77.6%, and 88.2%, respectively, after positioning, 92.5%, 96.4%, and 96.4%, respectively, after position adjustment, and 91.7%, 94.9%, and 96.8%, respectively, after treatment. Conclusions The application of OBI system-based IGRT is very important in the improvement of the precision of fractionated IMRT for patients with nasopharyngeal carcinoma. The position of the patient should be adjusted based on the IGRT image after positioning in order to correct set-up error and effectively increase the precision of fractionated IMRT.

Objective: To quantitatively evaluate dose accuracy of radiotherapy for cervical cancer. Methods: A CT image correction algorithm based on image transformation was proposed. Referring to CBCT images, CT images of radiotherapy plan for cervical cancer were corrected to obtain the corrected images which could reflect the actual body position of treatment. The clinical plan was transplanted to the corrected images for dose recalculation as a test plan, and the dosimetry parameters were statistically compared to evaluate the dose accuracy. Results: Both of the target coverage of contrast plans could meet the clinical requirements (>98%), and there was no significant difference in the homogeneity index (P=0.150). The conformability of the test plan was significantly worse than that of the clinical plan (P<0.05). The maximum dose of each organ at risk in the test plan was approximately 30 cGy higher than that of the clinical plan (P<0.05), V₅₀ was slightly higher than that of the clinical plan, whereas the average dose (D_mean) did not significantly differ. Conclusion The CT image correction algorithm based on image transformation can quantitatively evaluate the dose accuracy of radiotherapy for cervical cancer, which provides reference for resolving similar problems in clinical practice.

Objective:To propose a method of image similarity measurement based on structure information and intuitionistic fuzzy set and measure the similarity between CT image and CBCT image of radiotherapy plan positioning, aiming to objectively measure the setup errors.Methods:A total of four pre-registration images of a nasopharyngeal carcinoma patient on the cross-sectional and sagittal planes and a pelvic tumor patient on the cross-sectional and coronal planes were randomly selected. Five methods were used to quantify the setup errors, including correlation coefficient, mean square error, image joint entropy, mutual information and similarity measure method.Results:All five methods could describe the deviation to a certain extent. Compared with other methods, the similarity measure method showed a stronger upward trend with the increase of errors. After normalization, the results of five types of error increase on the cross-sectional plane of the nasopharyngeal carcinoma patient were 0.553, 0.683, 1.055, 1.995, 5.151, and 1.171, 1.618, 1.962, 1.790, 3.572 on the sagittal plane, respectively. The results of other methods were between 0 and 2 after normalization, and the results of different errors of the same method slightly changed. In addition, the method was more sensitive to the soft tissue errors.Conclusions:The image similarity measurement method based on structure information and intuitionistic fuzzy set is more consistent with human eye perception than the existing evaluation methods. The errors between bone markers and soft tissues can be objectively quantified to certain extent. The soft tissue deviation reflected by the setup errors is of significance for individualized precision radiotherapy.

Objective To discuss the nursing cooperation method in CT-guided pulmonary nodule localization using indocyanine green combined with methylene blue.Methods A total of 81 patients,who needed to receive pulmonary nodule localization before thoracoscopic resection,were enrolled in this study.The nursing cooperation measures,including the preparation and injection of indocyanine green combined with methylene blue,breathing mode coordination,position management,precise localization coordination,and psychological care,were analyzed.Results Successful nodule localization was accomplished in all patients.No statistically significant difference in the incidence of adverse events existed between the patients with different clinical characteristics(P＞0.05).The gender,age,lesion site,nodule size,nodule-pleura distance,posture during puncturing and needle path route were not the factors influencing the occurrence of adverse reactions in patients receiving CT-guided pulmonary nodule localization using indocyanine green combined with methylene blue.Conclusion In performing CT-guided pulmonary nodule localization using indocyanine green combined with methylene blue,the nursing cooperation method carries generality and stability,which is suitable for patients with different clinical characteristics.

Objective:To explore the status quo of knowledge, attitude and practice in the posture management of premature infants among nurses in Neonatal Intensive Care Unit (NICU) and related training needs.Methods:This study is a cross-sectional study. From March to April 2022, 207 NICU nurses from 6 ClassⅢ Grade A hospitals in Shandong Province were selected by convenient sampling. The nurses were investigated online by using the self-developed General Information Questionnaire, Premature Infant Posture Management Knowledge, Attitude and Practice Questionnaire for NICU Nurses and Premature Infant Posture Management Training Needs Questionnaire for NICU Nurses. Multiple linear regression was used to analyze the influencing factors of NICU nurses' knowledge, attitude and practice in the posture management of premature infants. A total of 207 questionnaires were distributed, and 201 valid questionnaires were recovered, with an effective recovery rate of 97.10% (201/207) .Results:Among 201 NICU nurses, the scores of premature infant posture management knowledge, attitude, practice and total score were (59.12±7.82) , (33.10±3.09) , (54.92±7.36) and (147.14±15.15) respectively. Multiple linear regression analysis results show that the nature of the working hospital, whether they received relevant training, and the importance of participating in relevant training were the influencing factors of NICU nurses' total score of knowledge, attitude and practice in the posture management of premature infants ( P<0.05) . 78.11% (157/201) of NICU nurses accepted the training of premature infant posture management, 98.01% (197/201) of NICU nurses were willing to accept the training of premature infant posture management, and 91.04% (183/201) of NICU nurses thought it was very important to participate in the training of premature infant posture management. NICU nurses believed that the main obstacle affecting the quality of posture management of premature infants was the lack of relevant knowledge. The most desired training content was the effect of different postures on premature infants. Conclusions:NICU nurses have a high level of knowledge, attitude and practice in posture management of premature infants. Managers should strengthen the training of NICU nurses in the posture management of premature infants, improve the ability of NICU nurses in the posture management of premature infants, and promote the improvement of the nursing quality of premature infants.