A total of 180 community medical staff in Jiangning District of Nanjing received continuous education in practical emergency medicine through theory teaching,practice and scene simulation once a year from 2011 to 2013.And the training outcomes were evaluated before and after training and the feedbacks of community medical staff collected each time.The assessment results of theory and practical skills after training in 2013 were better than before training in 2011 [theory:(61.72 ± 5.03) vs.(92.11 ± 5.56) points ; operation skills (55.28 ± 6.18) vs.(93.33 ± 3.45) points] (P ＜ 0.05).And the total satisfaction rate was 98.0％.

Objective To explore the significance of sample cultivation and drug resistance of the patients in PICU with severe lower respiratory tract specimens.Methods 1 107 pathogenic bacteria of lower respiratory tract samples collected were analyzed and the drug resistance was kept watch on.Results A total of 1107 samples were cultured into 948 strains of pathogens,with the positive rate of 85.64%,and 616 strains of Gram negative bacteria accounting for 64.98%,of which 145 strains of Pseudomonas aeruginosa(15.30%),Klebsiella pneumoniae 135(14.24%),Acinetobacter spp 131(13.82%),large intestine Egypt Greek bacteria 89(9.4%);Gram positive cocci 129(13.61%),the main pathogen was staphylococcus aureus and Fungi 203(21.41%),the main pathogen was candida albicans.Carbapenems was the most active antibiotics for gram negative bacill,and vancomycin for gram positive cocci.Conclusion Infectious bacteria have high selectivity to the sensitive antibiotics,and doctors should carefully use antibiotic according to the susceptibility test results in order to reduce hospital infection and the emergence and spread of resistant strains.

AlM: To investigated the refraction and cycloplegic effects of 0. 5g/L tropicamide eye drops in various low myopia age groups, and provide clinical guidelines for proper usage of cyclopegic agent in different population.METHODS:Three low myopia age groups (n=45) were selected, non-cycloplegic and cycloplegic auto-refraction using “Shin-Nippon” auto-refractor were performed at various time point for refractive error. The subjective accommodation amplitudes were also collected at each time point.
RESULTS: The accommodation amplitude showed a similar but significant decline between 20~60min after the first cyclopegic drops in all three age groups. However, the decline of accommodation amplitudes were not statistically correlated with the results of “Shin-Nippon”auto-refraction results at different time points.
CONCLUSlON: The refraction time should be arranged according to the cycloplegic effects of tropicamide. Open-field auto-refractor could reduce the usage of cycloglegice drugs in low myopia groups, even for the youngest.

Objective To explore the effect of astragalus injection with heparin in treatment of children with nephrotic syndrome(NS) whose blood was high coagulable.Methods Seventy-two children suffering from NS, whose blood was high coagulable,were randomly divi-ded into 2 groups. The suffering children of 2 groups were given diuretic and anti-infective and hypotenive drugs, simultaneously taking prednisone 2 mg/( kg?d). In addition, the suffering children of therapeutic group was given astragalus injection 20 mL and heparin 100 IU/kg which were added in the glucose injection 200 mL absorbed by intravenous drop.They had blood test since they had taken the medicine once a day and maintained 2-4 weeks′ time.Results The suffering children′s PLT,febrinogen(Fbg) and prothrombin time(PT) of therapeutic group were all lowered down to normal quantity in 10 days but those of contrastive group in 2 weeks or more. The time of urinary protein′s vani-shing of the therapeutic group averages out to (8.9?4.1) d;but contrastive group became normal after 2 weeks and urinary albumen disa-ppeared in (12.8?6.2) d.Conclusions The astragalus injection with heparin is significant to shortening the course of treatment and redu-cing the relapse and preventing from thrombosis in the treatment of NS of suffering children whose blood is high coagulable.The treatment of anti-coagulation can be one of conventional plans.

Objective To study the clinical value of rapid prototyping oriented template for total hip replacement in patients with adult developmental dysplasia of the hip .Methods Totally 51 cases with adult developmental dysplasia of the hip who were admitted into our hos -pital from January 2014 to March 2015 were randomly divided into the observation group and the control group .The observation group were treated by total hip arthroplasty assisted with rapid prototyping oriented template , while the control group were treated with traditional surgical method for total hip replacement.The curative effect, operation time, amount of bleeding, hospitalization time and satisfaction rate were compared between the two groups .Results The operation time , intraoperative blood loss and length of hospital stay of the observation group were significantly lower than those in the control group , and the differences were statistically significant (P<0.01).The Harris hip function score and satisfaction rate of the observation group were significantly higher than those in the control group with statistically significant differ -ences (P<0.05).Conclusion Total hip arthroplasty assisted with rapid prototyping oriented template could shorten the operation time , re-duce the intraoperative blood loss , cut down the hospitalization time , quicken the hip joint function recovery , and improve the satisfaction rate of patients .

Objective To understand the distribution of the genotypes of ?-lactamases in Chryseobacterium/Flavobacterium spp.Methods Minimum inhibitory concentrations (MICs) of 43 Chryseobacterium meningosepticum strains,22 Chryseobacterium indologenes strains and 10 Chryseobacterium gleum strains against 15 antibiotics were determined by agar dilution method.3-D test and modified 3-D test were used to identify carbapenamase.2-mercaptopropionic acid inhibitory test was used to confirm metallo-?-lactamases (MBL).Genes of ?-lactamases were amplified with 6 pairs of primers special for Chryseobacterium/Flavobacterium spp.and the amplified genes were sequenced.Results MIC_(50) and MIC_(90) of quinolones were lower comparing to other antibiotics.MICs of C.gleum against 15 antibiotics were lower than other Chryseobacterium/Flavobacterium spp.Among 43 C.meningosepticum strains,26 strains (60.5%) produce MBL,but all strains (100%) produced extended-spectrum ?-lactamases (ESBLs);12 C.indologenes strains (68.8%) produced MBL;6 (60%) C.gleum strains had MBL.Genotypes of MBL in C.meningosepticum strains were Bla-B 1,2,3,5 and 11,and Bla-GOB 2,4,6 and 8,respectively.Only one genotype,namely CME-1,was identified for ESBL in C.meningosepticum.The genotype of MBL in 3 C.indolgenes strains was IND-1,and the 6 C.gleum strains contained CGB genotype.Meanwhile,there were 8 C.indolgenes strains and 3 C.gleum strains were confirmed to produce ?-lactamase,but their genotypes were unable to be detected using the current primers,implying that there were possible novel genotypes.Conclusions Investigation of genotypes distribution of ?-lactamase in Chryseobacterium/ Flavobacterium spp.can provide theoretical evidences and rational in the selection of antibiotics,control of noscomical infection and development of novel antibiotics.

Calcitonin ; metabolism ; Carcinoma, Medullary ; metabolism ; pathology ; Carcinoma, Papillary ; metabolism ; pathology ; Chromogranin A ; metabolism ; DNA-Binding Proteins ; metabolism ; Diagnosis, Differential ; Humans ; Male ; Middle Aged ; Neoplasms, Multiple Primary ; metabolism ; pathology ; Synaptophysin ; metabolism ; Thyroglobulin ; metabolism ; Thyroid Neoplasms ; metabolism ; pathology ; Transcription Factors

Objective To investigate the specific expression of endoplasmic reticulum stress-related GRP78 and CHOP in podocyte of MKR mice with diabetic nephropathy (DN);To discuss the intervention effect of Zuogui Jiangtang Yishen Decoction (ZGJTYS). Methods 8-week old MKR mice were randomly divided into five groups:blank group, model group, ZGJTYS group, 4-Phenylbutyric acid group, gliquidone+benazepril group, and normal control group consisting of wild type C57BC/6 mice, 10 mice per group. All mice from model group and each treatment group received high-fat diet feed and unilateral nephrectomy to make the DN model. Mice from treatment groups received medicine intervention for four weeks. The levels of FBG were detected by electrochemical detection method, and the UmAlb was detected by ELISA. The expressions of GRP78, CHOP mRNA, and protein were detected by RT-PCR and Western blot. The morphological structure changes of the podocytes were observed by transmission electron microscopes. Results Compared with blank group, FBG and UmAlb in the model group increased significantly (P<0.01);the expressions of GRP78 mRNA and protein markedly decreased (P<0.01);the expressions of CHOP mRNA and protein increased (P<0.01). Compared with the model group, FBG and UmAlb in each treatment group significantly decreased (P<0.01);the expressions of GRP78 mRNA and protein in the ZGJTYS group and 4-Phenylbutyric acid group increased (P<0.01), the expressions of CHOP mRNA and protein decreased (P<0.01). The renal pathological lesions of each treatment group were significantly improved compared with model group. Conclusion ZGJTYS Decoction can effectively improve the damaged podocyte induced by endoplasmic reticulum stress, delay DN progress.

To study the pharmacokinetic effect of different combined administration with monarch drug Ziziphi Spinosae Semen on its main components in rats. Sprague-Dawley (SD) rats were randomly divided into Ziziphi Spinosae Semen group, Ziziphi Spinosae Semen-Fructus Schisandrae Chinensis group, Ziziphi spinosae Semen-Salviae Miltiorrhize Radix et Rhizoma group and Zaoren Ansheng prescription group. After oral administration, HPLC was eluted with the mobile phase of acetonitrle-0.03% phosphate acid water in a gradient mode. The detection wavelength was 280 nm. The pharmacokinetic parameters of spinosin and ferulic acid were calculated by DAS 2. 0 software. Compared with Ziziphi Spinosae Semen group, Ziziphi Spinosae Semen-Fructus Schisandrae Chinensis group, Ziziphi Spinosae Semen-Salviae miltiorrhizae Radix et Rhizoma group showed a lower maximum plasma concentration (C(max)) and area under curve (AUC(0-t)) for spinosin and ferulic acid but higher clearance speed (CL/F); whereas the Zaoren Ansheng prescription group showed higher maximum plasma concentration (C(max)) and area under curve (AUC(0-t)) for spinosin and ferulic acid but lower clearance speed (CL/F). Compared with Ziziphi Spinosae Semen group, prescription group showed slower metabolism of spinosin and ferulic
Animals ; Chromatography, High Pressure Liquid ; Coumaric Acids ; administration & dosage ; blood ; pharmacokinetics ; Drug Interactions ; Drugs, Chinese Herbal ; administration & dosage ; analysis ; pharmacokinetics ; Female ; Flavonoids ; administration & dosage ; blood ; pharmacokinetics ; Humans ; Male ; Rats ; Rats, Sprague-Dawley ; Ziziphus ; chemistry

Objective To understand the distribution of pathogenic genes in uropathogenic Esche-richia coli (UPEC) from urinary specimen and to analyze the pathogenicity of UPEC and their mechanism of apoptosis to HeLa cells. Methods We have analyzed 6 pathogenic genes among the 28 strains of the clini-cally isolated E. coli from urinary tract infected patients. The 6 pathogenic genes were surveyed by using the PCR amplification of the target genes. The adhesion experiments and tryphan-blue staining was used to screen the phenotype of the pathogenic strains, while Annexin V/PI method was applied to study the strains to cause apoptosis of the HeLa cells, which was further confirmed with electronic microscopy. Results We have detected 6 strains that carried the usp gene. Phenotype screening identified two high virulent isolates (strain 6N and 27N) from the 6 strains. Strain 27N and 6N contained very similar virulence gene profile ex-cept that strain 27N did not contain usp gene. Both strains can destroy HeLa cell within 3 hours causing cell death. Results of apoptosis detected by flow cytometry revealed that strain 6N induced 20.75% of HeLa cells to an early stage apoptosis within 1.5 hours. On the other hand, strain 27N induced only 1.55% of HeLa cells to apeptosis. Conclusion High virulent UPEC strain carrying usp gene can induce HeLa cell rapid early apoptosis.