OBJECTIVE:To monitor the antimicrobial resistance of Enterococcus faecalis and Enterococcus faecium in our hospital from 2006 to 2008 in order to provide reference for clinical rational use of antibiotics.METHODS:The susceptibility of isolated enterococci was determined by K-B paper diffusion method,and the antibiotic resistance rates of Enterococcus faecalis and Enterococcus Faecium were analyzed using Whonet 5 software.RESULTS:Vancomycin was the most sensitive antimicrobial against Enterococcus faecalis and Enterococcus faecium.E.faecalis had low resistance rates to penicillin G,high concentration gentamicin,ciprofloxacin and rifampicin,while E.faecium had low resistance rates to high concentration streptomycin,tertracycline,chloromycetin,and qinupristin/dalforpristin.CONCLUSION:E.faecalis and E.faecium are multi-drug resistant.Antimicrobials should be used rationally based on the susceptibility test of E.faecalis and E.faecium.

Objective: To investigate the factors affecting the development of malnutrition among the elderly patients with type 2 diabetes mellitus (T2DM), so as to provide insights into the prevention of malnutrition among the elderly patients with T2DM. Methods: Elderly T2DM patients at ages of 60 years and older admitted to Hangzhou First People's Hospital affiliated to Zhejiang University School of Medicine from June 2022 to June 2023 were recruited. Patients' demographics, number of medicines administered and comorbidities were collected using questionnaire surveys, and glycosylated hemoglobin (HbA1c), serum albumin (ALB) and hemoglobin levels were collected from medical records. The nutrition status was assessed with the new version of the Mini Nutritional Assessment Short Form (MNA-SF). Factors affecting the development of malnutrition were among the elderly T2DM patients identified using a multivariable logistic regression model. Results: A total of 382 elderly T2DM patients were enrolled, including 226 men (59.16%) and 156 women (40.84%) and with a mean age of (70.06±8.41) years. The prevalence of malnutrition was 22.25% among participants. Multivariable logistic regression analysis identified age (70 to 79 years, OR=1.261, 95%CI: 1.007-1.158; 80 years and older, OR=3.285, 95%CI: 1.618-6.662), three and more types of comorbidities (OR=2.790, 95%CI: 1.254-5.191), use of multiple medicines (OR=3.501, 95%CI: 1.841-6.658), sleep disorders (OR=1.613, 95%CI: 1.120-2.322), regular exercises (OR=0.280, 95%CI: 0.115-0.614), serum ALB of 35 g/L and greater (OR=0.272, 95%CI: 0.102-0.560) and HbA1c of 7% and higher (OR=2.914, 95%CI: 1.445-5.881) as factors affecting the development of malnutrition among elderly patients with T2DM. Conclusions The risk of malnutrition is associated with age, types of comorbidities, use of multiple medicines, sleep disorders, regular exercise, HbA1c and ALB among the elderly patients with T2DM. Periodical nutrition screening and intensified health education are recommended for T2DM patients.

Objective To investigate the clinical significance of ultrasonography in the diagnosis of simple polyhydramnios . Methods 186 singleton pregnancies cases of inpatient and outpatient diagnosed with simple polyhydramnios were divided into three groups with a two-dimensional semi-quantitative method ,separate amniotic fluid index (AFI)> 20cm (A group) ,separate maxi-mum amnionic fluid volume(AFV)>8 cm(B group) ,AFI≥20 cm and AFV≥8 cm(C group) ,and the changes were dynamically monitored .Results Occurrence rates of persistent polyhydramnios and fetal malformations in C group was higher than in the other two groups ,and the difference showed no statistical significance(P<0 .05);No correlation was found between recurrent polyhydr-amnios and fetal malformation among these three groups(P>0 .05);Among the 84 .4% of simple polyhydramnios ,no fetal malfor-mation was found .Conclusion Ultrasound diagnosis of simple polyhydramnios shows clinical value in assessment of fetal malfor-mation ,fetal outcome ,perinatal morbidity and prognosis ,and is good for prenatal counseling and treatment .

Objective To study the teaching effect in physical evaluation by application of item teaching method for high occupation nursing students. Methods 249 high occupation nursing students of grade 2008 from four class were divided into the experimental group and the control group randomly. 123students of the control group were taught by traditional method, 126 students of the experimental group were taught by item teaching method, that is, listing teaching emphasis, examining item and standard for evaluation, preparing the lesson for students, teaching theory for teacher, teaching medical examination in groups,simulated training, testing item. The practical operation results and various capabilities were compared between two groups. Results The practical operation results and various capabilities of the experimental group was better than the control group. Conclusions Constructing evaluation system of physical evaluation by application of item teaching method is a beneficial attempt for high occupation nursing students. It improves the students' general ability and is beneficial to the justice and fair of teaching evaluation. So it is worth popularizing.

Objective To explore the clinical value of fetal syetem ultrasound union real-time three-dimensional ultrasound to diagnose the abnormalities of fetal palms and feet in medium-term pregnancy.Methods The results of fetal syetem ultrasound u-nion real-time three-dimensional ultrasound in 23 675 cases during dmedium-term pregnancy in our department from January 2009 to November 2013 were retrospectively analyzed,including 47 350 palms and feet.Results If using the fetal syetem ultrasound u-nion real-time three-dimensional ultrasound to examine fetal palms and feet more than three times,the display rate of palms and feet was 100.0%,while the first-time display rate of finger and toes was 81.2%,second-time display rate was 97.2% and the third-time and more display rate more thatn 99.8%.136 cases hand-foot deformity were diagnosed,including 37 cases of hand gesture abnor-malities,6 cases of finger abnormalities,93 cases of food abnormalities,and the main abnormality was strephexopodia.Of all the 136 cases,there were 2 cases also with Trisomy 18,4 cases with Trisomy 21.Conclusion Malformations of fetal palms and feet can be detected by fetal system ultrasound combined with real-time three-dimensional ultrasonography during the second trimester,which is important indicators of prenatal screening for chromosomal abnormalities.

Azone ( 1桪odeylazacyclohenptan-2-one) is one of the best skin penetration enhancers. It can increase the permeability of skin for some hydrophobic compounds, so that it is possible to be admi-nistrated through skin. The effects of Azone on permeability of skin of a-Asarone, Nicorandil and Nitroglycerin were studied by flow through diffusion cell with radioactivity tracer.The results showed that the different concentrations of Azone gave different enhancement. The penetration of the 3 drugs was enhanced about 1-fold by

Objective To investigate the affect of body positions on biochemical indexes. Methods By autogenous contrast and cross matched survey, 107 volunteers divided into 3 season patches of winter, spring and summer, blood samples were drawn from the same part in both standing and lying positions。From19 persons, blood samples were collected respectively after standing and sitting for 15 min, lying for 15 min and 30 min and then sitting for another 15 min。 The blood samples were analyzed for 32 biochemical indexes on analyzer。Results 25 biochemical indexes in sitting position were significantly different from those in lying position (P0。05)。Conclusions Changing body position can result in obvious physiological variation of 28 biochemical indexes, particularly of those related to protein. Such result may lead to abnormality in some marginal values. It suggests body position should not be neglected in analyzing laboratory data.

Objective To improve the understanding,the incidence and imaging findings of tuberous sclerosis complex (TSC) combined with cardiac rhabdomyomas (CRs) in fetuses and infants.Methods The imaging findings of 9 infants with TSC combined with CRs and 4 fetuses with TSC combined with CRs from our hospital between June,2006 and November,2013 were retrospectively reviewed.Results The brain MRI of 9 with TSC combined with CRs showed bilateral subependy-mal nodules,subcortical white matter and cortical tubers.Subependymal nodules were isointense or hypointense on spin-echo T1WI and hypointense or hyperintense on spin-echo T2WI.Subcortical white matter and cortical tubers were hypointense or hyperintense on T1WI and hypointense or hyperintense on T2WI.There was varying contrast enhancement.Three of 9 infants presented single cardiac tumor and 6 of 9 infants presented multiply cardiac lesions.CRs on contrast cardiac MRI showed round solid masses in ventricular septums,ventricular outflow tract,ventricle or atrial free walls.The masses were isointense relative to the cardiac muscles on T1WI,T2WI and B-TFE sequence.There was varying contrast enhancement.Four fetuses with TSC on ultrafast MRI showed bilateral multiply subependymal nodules,the nodules were isointense or hyperintense on TFE T1WI and isointense or hypointense signals on SSTSE or B-FFE sequence,Four fetuses with CRs showed isointense to hyperintense solid masses in ventricular septums on ultrafast MRI,ventricle or atrial free walls on B-FFE sequence and SSTSE sequence images.Conclusions TSC in infant and fetus is a kind of neurocutaneous syndrome,usually combines with CRs.Fetal ultrafast and routine MRI is a useful method to make a definite diagnosis for cranial and cardiac lesions.The development of MRI might improve the timeliness and accuracy of the assessment for this disease.

Objective To evaluate the effects of nurse-led team management on self-management and hyperten-sion control for community-dwelling hypertensive patients. Methods A quasi-experimental study design was adopt-ed,two communities were elected as the intervention group and the control group in Wuhou District,Chengdu,and 102 hypertensive patients were recruited from each group. The intervention group received nurse-led team manage-ment for 2 years,and intervention methods included individual management,phone or home follow-up,collective inter-vention and so on. While the control group received doctor-led hypertension management. The patients' self-man-agement behaviors and hypertension control were evaluated before the intervention and 6,12,24 months after the intervention. Results After 24-month nurse-led team management,scores of self-management behaviors and hyper-tension control rate of patients in the intervention group were significantly higher than those of patients in the con-trol group(P<0.05). Conclusion Nurse-led team management could significantly improve self-management behaviors and the rate of hypertension control for hypertensive patients.

OBJECTIVE: To investigate the protective effects of fibronectin (Fn) on vascular endothelial cells. METHODS: Block reticuloendothelial system model compound with injury of tail vein and femur fractures in rats were used. The level of plasma Fn and surface Fn of peritoneal macrophage cells, the numbers of circulating endothelial cells and the injured tail vein were observed. RESULTS: Fn increased the level of plasma Fn and peritoneal macrophage cells surface Fn,but decreased the number of circulating endothelial cells after infusing Fn 1.7 mg/10 g before injury. Under the scanning electron microscope, only a local focus injury to vascular endothelial cells in the rats was observed after Fn was infused, but a piecemeal injury and detachment of vascular endothelial cells were observed in rats without giving Fn. CONCLUSIONS: Fn has obvious protective effects on vascular endothelial cells in rats.