Objective To study the homology and clinical characteristics of healthcare-associated infection(HAI) due to Pseudomonas aeruginosa (P.aeruginosa)in medical intensive care unit (MICU),so as to guide the clinical prevention of P.aeruginosa transmission and improve therapeutic effect.Methods 55 P.aeruginosa strains isola-ted from 25 patients with HAI in the MICU of a hospital in January-December 2014 were performed pulsed-field gel electrophoresis (PFGE)homology analysis and clustering analysis,clinical characteristics,antimicrobial resistance, and transmission characteristics were analyzed.Results A total of 25 patients were investigated,with an average age of (69.62±2.13)years,mean hospital stay (49.34±3.18)days;prior to the isolation of P.aeruginosa, 84.00% of patients were treated with broad-spectrum antimicrobial agents for >2 weeks,76.00% of patients had been admitted to MICU,and 52.00% had a ventilator-assisted ventilation.55 strains of P.aeruginosa were mainly A,F,H,K,N,V,and W,which were the main epidemic strains;patients infected with A,F,H and K strains all had cross in their hospital stay;PFGE profiles of isolates from 4 patients during different periods showed different strain patterns;resistance rates of P.aeruginosa to ceftazidime (72.73%), piperacillin/tazobactam (70.91%),and imipenem(70.91%)were all high,resistance rate to amikacin was the lowest(25.45%).Conclusion Management of antimicrobial agents should be strengthened in medical institutions,HAI control meas-ures should be strengthened,so as to prevent the transmission of multidrug-resistant and extensively drug-resistant bacteria in hospitals.

Endoscopic nasobiliary drainage (ENBD), a minimal invasive treatment technique that can relieve biliary obstruction quickly, reduce biliary pressure and clear biliary tract, is widely used in clinic. The study reviewed the application scope, features, methods of intubation and fixation, indwelling time, common complications and relevant nursing interventions of nasobiliary duct. The purpose of the study was to provide references for clinical nursing of nasobiliary duct, which was helpful to offer the high quality nursing service.

Objective? To investigate and explore actual help-seeking behaviors for depressive symptoms among college students. Methods? By convenience sampling, a total of 871 undergraduate students from the whole Wuhan university from November 2016 to March 2017 were selected and investigated by using the self-designed General Information Questionnaire, Family APGAR Index(APGAR), Center for Epidemiologic Studies Depression Scale(CES-D),Comprehensive International Diagnostic Interview(CIDI 2.1) Actual Help Seeking Questionnaire(AHSQ). Results? Totally 348(43.3%)college students reported that they had depressive problems and the situation about actual help-seeking behaviors had been reported over the part 12 months. Among those 348 respondents, 94(27.0%)students reported that they had never sought for help; 254(73.0%) reported they had sought for help. There was statistical difference of "whether had been through major life events in the past one year" in seeking help from "close companion","friends", and "teachers and classmates" (P＜0.05), the college students with better family function tend to seek help from their parents, the difference was statistically significant (P=0.005), there was statistical difference of "whether discomfort existed caused by psychological problems" in seeking help from "professional personnel in mental health", "hotline/internet resource"(P＜ 0.05); the college students with higher CES-D scores tend to seek help from "hotline/internet resources",the difference was statistically significant (P＜0.05). Conclusions? There is a high prevalence of depressive symptoms in college students, and they seek help mainly from "other nonprofessional personnel" and"hotline/internet resources". Their ability of making use of the public psychological health services should be improved.

Objective The objective is to probe into the effects of astragaloside Ⅳ (AS-Ⅳ) on activity and proliferative function of endothelial progenitor cells (EPCs),which lays a foundation for further study on the effects of AS-Ⅳ on vascular neovascularization mediated by endothelial progenitor cells.Methods The mononuclear cells were isolated by the density gradient centrifugation in umbilical cord blood of full-term healthy infants,and EPCs were obtained by subculture and cell identification when the cells presented spindle shapes.The obtained EPCs were randomly divided into the experimental group and the control group.In the experimental group,EPCs were cultured by AS-Ⅳ with different concentration gradients (25 mg/L,50 mg/L,100 mg/L,200 mg/L and 400 mg/L),while in the control group,they were treated with the same amount of phosphate buffer saline (PBS) solutions.The effects of AS-Ⅳ on the proliferation of endothelial progenitor cells was studied by cell counting kit-8 (CCK-8) cell proliferation experiment,and the activity rate of EPCs cells was measured at the optimum concentration of EPCs proliferation.Results EPCs were successfully obtained after confirming nuclear staining test of CD31 antibody and 4',6-diamidi-no-2-phenylindole (DAPI).Further study showed that AS-Ⅳ can promote the proliferation of EPCs,and its optimal concentration of EPCs proliferation is 100 mg/L.Compared with the normal control group,the activity rate of endothelial progenitor cells after intervention of AS-Ⅳ was 98.7％,higher than 98.12％ in the control group,with significant difference (x2 =49.59,P ＜0.01).Conclusions AS-Ⅳ can enhance the activity of human EPCs and promote their proliferation in vitro.

ObjectiveTo explore the clinical selection and application of cell suspension examination (CSE) or histopathological technique (HPT) in detecting sperm in the testis tissue obtained by testicular sperm aspiration (TESA) in patients with non-obstructive azoospermia (NOA).

METHODSTotally, 1 006 NOA patients underwent TESA and their testis tissues were subjected to CSE or HPT for sperm detection. Based on the results of CSE, the testicular tissue samples were divided into groups A (with sperm, n = 567) and B (without sperm, n = 439) and the results were compared with those of HPT.

RESULTSHPT showed 508 cases with but 59 without sperm in group A, and 403 with and 36 without sperm in group B. The consistency rate of CSE with that of HPT was 90.56% (Kappa =0.809), and CSE exhibited a significantly higher rate of sperm detection than HPT (56.36% vs 54.08%, P=0.023).

CONCLUSIONSCSE combined with HPT for detecting sperm in the testis tissue of NOA patients undergoing diagnostic TESA helps clinical diagnosis and treatment. The results of CSE have a decisive significance for assisted reproductive therapy, while those of HPT may provide some definite etiological evidence for drug therapy or surgery.

Azoospermia ; Humans ; Male ; Reproductive Techniques, Assisted ; Sperm Retrieval ; Spermatozoa ; Suspensions ; Testis

Since the concept of patient versions of guidelines （PVGs） was introduced into China， several PVGs have been published in China， but we found that there is a big difference between the concept of PVG at home and abroad， and the reason for this difference has not been reasonably explained， which has led to ambiguity and even misapplication of the PVG concept by guideline developers. By analyzing the background and purpose of PVGs， and the understanding of the PVG concept by domestic scholars， we proposed the term patient guidelines （PGs）. This refers to guidelines developed under the principles of evidence-based medicine， centered on health issues that concern patients， and based on the best available evidence， intended for patient use. Except for the general attribute of providing information or education， which is typical of common health education materials， PGs also provide recommendations and assist in decision-making， so PGs include both the patient versions of guidelines （PVG） as defined by the Guidelines International Network （GIN） and "patient-directed guidelines"， i.e. clinical practice guidelines resulting from the adaptation or reformulation of recommendations through clinical practice guidelines.