Objective To investigate the distribution and antibiotic resistance of pathogenic bacteria in PICU and to provide evidence for use of antibiotics rationally.Methods All the basic clinical features and pathogenic bacteria isolated from patients in PICU of our hospital from October 2009 to September 2012 were analyzed retrospectively.Results A total of 672 pathogenic bacterial strains were isolated (positive rate 16.7％ 672/4 020),75.1％ and 24.9％ were gram negative bacteria and gram positive bacteria,respectively.Pseudomonas aeruginosa was the most common bacteria isolated in gram negative bacteria,followed by Klebsiella pneumonia and Escherichia coli in this order.And Staphylococcus was the main strain in gram positive bacteria.Positive specimens were mainly from lower respiratory tract and bloodstream infection.Most Staphylococcus were resistant to penicillin,oxacillin and erythromycin but susceptible to vancomycin,teicoplanin and linezolid.Gram negative bacteria were resistant to ampicillin,ampicillin-sulbactam,piperacillin and cephalosporin,but susceptible to imipenem,cefoperazone-sulbactam,piperacillin-tazobactam,ciprofloxacin and amikacin.Conclusion Gram negative bacteria is the prevalent strains in PICU of our hospital,Pseudomonas aeruginosa,Klebsiella pneumonia and Escherichia coli are common bacterium isolated.Most isolates are highly drug-resistant.Analysis of pathogenic bacteria and drug-resistance surveillance are of vital importance to guide treatments for critically ill children and reduce drug-resistant bacterial strains.

Compared with the traditional teaching methods,multimedia teaching has specific advantages and has been widely used. Meanwhile,the defects in multimedia teaching must be attached great importance to. This paper focuses on some problems widely existing in the multimedia teaching and sets forth several proposals of promotion in the use of multimedia teaching.

Objective:To investigate the effect of gegenqinlian on serum TNF-αlevel in rats with chronic periodontitis and athero-sclerotic.Methods:40 healthy male Wistar rats were randomly divided into control group(N,n =10)and model group(D,n =30).After model establishment and identfication the rats in model group were divided into D1,D2,D3,D4 and D5 groups(n =5) and were administered with saline,metronidazole,atorvastatin,metronidazole combined with atorvastatin and gegenqinlian respec-tively for 4 weeks.Periodontal indexes(PD and AL)were measured,the maximum intima-media thickness of abdominal aorta(IMT) was pathologically examined,TNF-αlevel was detected by ELISA.Results:After treatment PD,AL and serum TNF-αlevels in D2,D3,D4 and D5 groups were significantly lower than those in D1 group(P <0.05),There was no difference of lipid and TNF-αlevels between D4 and D5 groups(P >0.05).Conclusion:Gegenqinlian can reduce serum level of TNF-αin rats,suggesting that the drug is effective in the treatment of periodontitis with atherosclerosis.

Objective To systematically observe the damage of pancreas and changes of serum amy-lase and lipase in septic rat at different time points after the septic rat model being established. Methods Fifty-four male rats were randomly divided into sham group,sepsis group and normal control group. In the sepsis group,rats were given cecal ligation and puncture so as to produce a model of the rat′s intestinal septic shock. In sham group,after opening the abdominal cavity of the rats,only the cecum was pulled out of the abdominal cavity,then the abdominal cavity was satisfied and stitched. The arterial blood and pancreatic tis-sues of the rats in both sepsis and sham groups were collected for detection of serum amylase and lipase and observation of damage of pancreas by light and electron microscopy at 3 h,6 h,12 h,24 h after the model be-ing established. Results The levels of serum amylase of sepsis group showed a rising trend over time,and peaked at 24 h(2 779. 83 U/L), which showed no difference among 4 time points. There was no significant difference of serum amylase among 3 groups at each time point except for 12 h value. The levels of serum li-pase in both sepsis and sham group were higher than that in normal control group at 3 h(P<0. 05),while de-creased to the level of normal control group at 24 h. By light microscope,pathological changes of pancreas in the sham groups were that lobule was slightly widened; mild interstitial edema,vasodilation and a little in-flammatory cell infiltration were occasionally found;most of the lobular structure was complete. In the sepsis group,pancreatic pathological changes aggravated with time prolonged. Pancreatic lobules gap widened,inter-stitial were infiltrated by the inflammatory cell,flocculus brim structure was fuzzy,focal necrosis was found occasionally,islet structure was complete at 3 h. Pancreatic lobule was significantly wider,more inflammatory cell infiltrated,necrosis enlarged at 6 h,and pancreatic lobule was obvious edema,more inflammatory cell in-filtration and focal necrosis were found at 12 h. Vascular of pancreatic lobule was dilatation and congestion, pancreatic lobule and islet edge blurred,more lobular necrosis at 24 h. The modified Schmidt scoring of sham group and sepsis group at 3 h,6 h,12 h,24 h were 2. 0,3. 6,3. 4,3. 6 and 4. 6,6. 0,6. 8,7. 6,respectively. By transmission electron microscope,the ultrastructure of pancreatic cell in sham group was normal,mitochondri-al and lysosomal swelling were found occasionally. When in the sepsis group,the nucleus was normal,some mitochondria was swelling and cracking, lysosomes was swelling at 3 h, nucleus was complete, a part of swelling mitochondria and lysosomes appeared vacuolated necrosis at 6 h,and karyopyknosis and chromatin condensation were found,more mitochondria and lysosomes were swelling necrosis and vacuolar degenerated, rough endoplasmic reticulum was swelling at 12 h,cell karyopyknosis and chromatin condensation were obvi-ous,a large number of mitochondria and lysosome, endoplasmic reticulum were swelling, dilatation and vacuolar necrosis at 24 h. The modified Schmidt scoring showed no significant correlation with the levels of serum amylase and lipase in sepsis group(r=0. 472,P=0. 199;r=0. 260,P=0. 499). Conclusion The pancreas was damaged in the septic rat. The pathological changes of pancreas were obvious at 6 h after sepsis onset. The characteristics of the pancreas ultrastructure change includes the changes of the mitochondria and lysosome in the early period,clear vacuoles necrosis of mitochondria and lysosome,and destruction of nucleus and the endoplasmic reticulum. There is no significant correlation between pancreatic pathological changes and serum amylase as well as lipase,serum amylase and lipase can′t indicate the extent of pancreas damage in sepsis.

The subject service platform was constructed for nursing science using Drupal according to the low edu-cation level, high work load, much fragmentary time, and low information literacy of nursing staff.Web 2.0 infor-mation service was provided for nursing staff,such as literature pushing, cloud tag revealing and personal customiza-tion by integrating the library-holding resources ( including paper literature resources , electronic literature re-sources and literature resources on networks ) .The literature literacy level and scientific research ability of nursing staff were improved by making the full use of their fragmentary time.The new service mode in hospital libraries was studied in Web 2.0 environment .

Objective To assess volume state precisely and rapidly by ultrasonography of internal jugular vein (IJV) in healthy blood donor.Methods The values of the sonographic IJV collapse index and corrected IJV longitudinal length (cIJVLL) of 46 healthy blood donors were compared before and after blood donation.The correlations between IJV collapse index and cIJV LL were analyzed.Results The value of cIJV LLs before and after blood donation were significantly difference (6.56 ± 0.32 vs.6.11 ± 0.41,P ＜ 0.01).IJV collapse index before blood donation was not differently significant after blood donation (33.12 ± 2.21 vs.39.01 ± 3.83,P＞ 0.05).There was correlation between the value of cIJV LLs before and after blood donation (r =0.81).The value of IJV collapse index before and after blood donation,as well as cIJVLL was not well correlated (r =0.24,r =0.13,respectively).Conclusion The IJV collapse index is not a useful parameter for evaluation of hypovolemia,cIJV LL is more valuable marker for the detection of blood loss in emergency.

Objective To investigate the effects of propofol on lipopolysaccharide (LPS)-induced brain injury in rats.Methods Fifty-four pathogen-free SD rats of both sexes, aged 6 weeks, weighing 200-250 g, were randomly divided into 3 groups: control group (group C, n = 6) ; LPS group (group L, n = 24) ; propofol group (group P, n = 24) . Brain injury was produced by injection of LPS 1 mg/kg via the left internal carotid artery in L and P groups. Propofol 100 mg/kg was injected intraperitonealry immediately after the LPS administration in group P, while the equal volume of normal saline was given instead of propofol in group L. The equal volume of normal saline was given instead of LPS and propofol in group C. Six rats in each group were sacrificed and the brain tissues were immediately removed at 24 h after intraperitoneal administration in group C, and at 6, 24, 48 and 72 h after intraperitoneal administration in L and P groups for determination of brain water content, high-mobility group box 1 ( HMGB1) expression and NF-κB activity, and microscopic examination. Results The brain water content and NF-kB activity were significantly increased, and HMGB1 expression was up-regulated in group L as compared to group C (P ＜ 0.05) . The brain water content, expression of HMGB1 and NF-kB activity were significantly lower in group P than in group L ( P ＜ 0.05) . The microscopic examination showed that brain injury was attenuated in group P compared with group L. The brain water content was positively correlated with the HMGB1 expression and NF- κB activity (r = 0.692 and 0.769 respectively, P ＜ 0.05). Conclusion Propofol can reduce the LPS- induced brain injury by reducing inflammatory response of the brain tissues.

Elemene is a novel universal non-cytotoxic antitumor drug. Based on downregulation of VEGF expression, induction of apoptosis of vascular endothelial cells and suppression of growth of tumor cell, elemene is becoming helpfully a promising inhibitor of angiogenesis, however, the detail mechanisms remains unclear and needs to be further elucidated.

Objective To investigate the effect of mucolytic agents during endoscopic sinus surgery.Methods 84 patients of chronic rhinosinusitis were employed in the study,which were randomly divided into the control group(41 subjects) and study group(43 subjects) according to the digital table.The patients in the control group adopted regular therapies,and study group were received regular therapies as well as mucolytic agents(eucalyptol-limonene-pinene soft capsule,300 mg,three times a day) application for 8 weeks.Followed visiting lasted for 6 months.The VAS scores,Lund-Mackay scores and efficient rate were compared.Results The VAS scores and Lund -Mackay scores in the control group after treatment were (3.63 ± 1.71)points and (8.34 ±4.68) points,and which in study group were (2.03 ± 1.67) points and (6.48 ± 3.59) points,and the difference was statistic significant (t =4.338 and t =2.049,P ＜ 0.05).According to CPOS-2012,in the control group,19 cases were controlled,14 cases were partly controlled,and 8 cases were uncontrolled,the whole efficient rate was 80.5％.in the study group,24 cases were controlled,17 cases were partly controlled,and 2 cases were uncontrolled,the whole efficient rate was 95.3％.Compared to the control group,the efficient rate of the study group was higher,the result showed statistical significance (x2 =4.420,P ＜ 0.05).Conclusion Using mucolytic agent after surgery can improve the controlled rate and affect the success of treatment of chronic rhinosinusitis.

Objective To study the related factors of stress of parents of children with intellectual disabilities and autism. Methods 45 parents of children with intellectual disabilities and 45 with autism were surveyed. Results and Conclusion The stress level was very high in the parents of both 2 kinds of children, especially in the parents with autism children (P<0.01). The stress level of parents of both 2 kinds of children correlated positively with the level of disability, and correlated negatively with the family income.