OBJECTIVE To investigate the drug resistance status of Klebsiella pneumoniae,Escherichia coli and(Enterobacter cloacae) for reasonable use of antibiotics. METHODS After genus identification,drug resistance profile was analyzed by K-B method. RESULTS The predominant isolates from Enterobacteriaceae were(K.penumoniae) and E.coli.The resistant rate of the three commonly encountered bacteria in Enterobacteriaceae to antibiotics ascended yearly,with increasing isolates harboring ESBLs from 16.5%(2000) to 32.4%(2004). CONCLUSIONS Rational use of antibiotics should be obey the results of laboratory antibiotics susceptibility test to control the increasing trend and forbid outbreak of resistance.

OBJECTIVE To investigate drug resistance status of common bacteria to ciprofloxacin in hospital for reasonable use of antibiotics.METHODS After genus identification,drug resistance profile was analyzed by K-B method.RESULTS The resistant rate of common bacteria to ciprofloxacin ascended yearly from 40.8%(2000) to(51.7%)(2004),which predominated with Escherichia coli,coagulase negative Staphylococcus and S.aureus,respectively.CONCLUSIONS Rational use of fluoroquinolones should be obey the results of laboratory antibiotics suceptibility test to control the increasing trend of resistance.

BACKGROUND:In the clinical treatment of diabetic retinopathy, the therapeutic effects of different filers on the retina and optic nerve after the removal of the vitreous are lack of comprehensive and detailed reports. OBJECTIVE:To observe the changes of retina and optic nerve in patients with diabetic retinopathy after filing cyclic polydimethylsiloxane. METHODS: Totaly 147 patients with diabetic retinopathy undergoing vitreous removal were enroled, including 77 males and 70 females, aged 35to70 years. The vitreous from 74 patients with diabetic retinopathy was filed with cyclic polydimethylsiloxane (test group). The cyclic polydimethylsiloxane was taken out at 3 months post-operation. The vitreous from another 73 patients with diabetic retinopathy was filed with the whole fluorine propane (control group). The changes of retina, optic nerve, intraocular pressure, and the occurrence of vitreous re-hemorrhage and cataract after operation were observed in these two groups. RESULTS AND CONCLUSION: After 7 days of folow-up, the intraocular pressure of patients in the test group was higher than that in the control group (P < 0.05). After 6 months of folow-up, there was no significant difference in the intraocular pressure between these two groups. After 6 months of folow-up, cyclic polydimethylsiloxane was successfuly removed in the test group, retinal blood vessels became thinning with the presence of white sheath, and the number of optic nerves was higher than the control group (P < 0.05). The incidence of vitreous re-hemorrhage and cataract in the test was higher than the control group (P < 0.05). These results demonstrate that after the removal of the vitreous, cyclic polydimethylsiloxane filing can lead to optic atrophy in patients with diabetic retinopathy.

Objective To study the influence of preoperative splenectomy on liver transplantation for portal hypertension and the management of complications.Methods From January 2008 to January 2013,a total of 136 patients underwent liver transplantation for portal hypertension (PHT) in Hepatobiliary Surgery Center,Fuzhou General Hospital of PLA Nanjing Military Region.Pre-liver transplantation splenectomy was carried out in 19 patients.We randomly selected according to the operation time 50 cases of liver transplantation as the control group.The operation time,bleeding,blood transfusion,infection,the incidence of acute rejection,biliary complication rate,survival rate,postoperative platelet recovery and arteriovenous thrombosis were analyzed.Results The preoperative group has longer surgical time,intraoperative blood loss,blood transfusion volume increased obviously,infection rate increased significantly compared with the control group.The accumulate survival rate of preoperative splenectomy group was significantly lower than that of the control group.The platelet count of the preoperative splenectomy group was significantly higher than that of the control group.The platelet count of both groups experienced the process of first rise after falling.Although the platelet count of the preoperative splenectomy group was higher than that of the control group,but there was no statistically significant difference.Conclusions Liver transplantation in PHT patients with previous splenectomy may lead to some unfavorable consequences including increases of technical diffculty of surgery,operative duration,intraoperative bleeding,postoperative infection and other serious complications,and surgical mortality.Therefore,splenectomy should be performed cautiously for the patients who may receive liver transplantation in the future.

Objective: To investigate the status of physical fitness among children at ages of 3 to 6 years in Chaoyang District, Beijing Municipality, so as to provide insights into improvements in children's physical fitness. Methods: Physical fitness test data were collected from children at ages of 3 to 6 years in Chaoyang District based on the Fifth National Physical Fitness Monitoring Program, including basic characteristics, body shape, physical function and quality. The physical fitness test results were compared among children with different genders and ages, and factors affecting the physical fitness were identified among children at ages of 3 to 6 years using a multiple linear regression model. Results: Totally 988 children at ages of 3 to 6 years were enrolled, including 490 boys (49.60%) and 498 girls (50.40%), and 300 children at an age of 3 years (30.36%), 329 children at an age of 4 years (33.30%), 297 children at an age of 5 years (30.06%) and 62 children at an age of 6 years (6.28%). The participants had a mean height of (109.46±7.31) cm, body weight (18.98±3.82) kg, sitting height of (61.99±3.39) cm, chest circumference of (52.87±4.04) cm, static heart rate of (98.04±9.61) beats per minute, grip strength of (4.78±2.22) kg, standing long jump of (75.01±21.89) cm, seated forward bend of (10.07±4.51)cm, double-foot continuous jump of (7.54±3.84) s, 15-meter obstacle run of (8.73±1.66) s and balance beam walking of (8.54±4.72) s. Boys had greater sitting height, chest circumference and grip strength and lower 15-meter obstacle run and static heart rate than girls (P<0.05), while girls had higher seated forward bend than boys (P<0.05). There were significant differences in all test items among children at different ages (P<0.05). Multiple linear regression analysis identified non-only child (β'=0.064), non-overweight/obesity (β'=0.192), 2 hours and longer daily indoor physical activity (β'=0.156), exercise intensitby (adequate, β'=0.218; generally, β'=0.151), father's height of 170 cm and shorter (β'=-0.075), mother's height of 160 cm and shorter (β'=-0.081), and parents' educational level (undergraduate, β'=0.017; postgraduate, β'=0.084) as factors affecting physical fitness among children at ages of 3 to 6 years in Chaoyang District. Conclusions The body shape development is relatively good among children at ages of 3 to 6 years in Chaoyang District; however, the physical quality remains to be improved. The only child, overweight/obesity, duration of indoor physical activity, exercise intensity, parental height and parental educational level are factors affecting physical fitness among children.

Objective To investigate the effects of celastrol on the cell growth and apoptosis of human gallbladder cancer NOZ cells,and explore its potential molecular mechanism.Methods NOZ cell were cultured in vitro.And CCK-8 assay,Annexin V-FITC/PI staining method,cell cycle analysis were conducted to investigate the effects of celastrol on the growth and apoptosis of NOZ cells after being treated with drugs.The mitochondrial membrane potential and Bax and Bcl-2 protein expression level were determined by Rhodamine 123 and Western blot,respectively.Results Celastrol could inhibit NOZ cell growth,and the IC50 value was 5.3 μmol/L.Annexin-V/PI staining showed that cell apoptosis of NOZ cells were induced as the celastrol concentration increased,and the apoptosis ratio of control group was 4.4％,while the apoptosis rates of the test groups (2,5,10 p mol/L) were 7.4％,27.1％ and 43.4％,respectively.In addition,cell cycle analysis revealed that celastrol could induce G1-phase arrest.The G1-phase rate of control group was 25.6％,while the G1-phase rates of the test groups (2,5,10 μmol/L) were 36.5％,45.7％ and 92.5％,respectively.The mitochondrial membrane potential was measured after treatment with celastrol and the results indicated that the mitochondrial membrane potential was significantly decreased.Western Blot showed that the protein expression of Bax increased and Bcl-2 decreased in a time-dependent manner after treatment with celastrol.Conclusions Celastrol may inhibit cell proliferation of human gallbladder cancer NOZ cells and induce cell apoptosis partly by inducing the loss of mitochondrial membrane potential.

Objective To investigate radiation-related human plasma metabolic features by using metabonomics method and to analyze relative metabolic pathway .Methods The plasma samples of 40 patients pre-and post-total body irradiation (TBI) from January 2012 to May 2014 were collected, and the effect of TBI on human plasma metabolites was studied by gas chromatography mass spectrometry ( GC-MS) , and the differential plasma metabolic features related to irradiation damage were screened . Results The levels of glucose, myristic acid, oxalic acid, 3-hydroxy butyric acid, urea, aspartic acid, valine, leucine, lysine and threonine in plasma were significantly (P<0.05) increased after TBI, while the levels of cholesterol, pyruvic acid, propionic acid, lactic acid, alanine, glycine, inositol, sorbitan, ethylene glycol and hypoxanthine were decreased drastically (P<0.05).Conclusions TBI could cause significant changes in the levels of human plasma metabolites including amino acid metabolism , glucose metabolism, lipid metabolism and so on.

Objective To apply Plato analysis method to clinical cases which were reported from clinical nursing, finding out the key link of the risks which were related to the cases:the key age, the key period, the key spectrum of disease and the key projects, etc. To carry out the feedforward control of the quality of care, and ensure the quality and safety of nursing. Methods A database were set up including clinical special cases, high-risk cases, security hidden danger cases and emergency cases. Thetwo eightprinciple of Plato analysis method was used to find out the main factors, the principal contradiction, the key hazard and the key problems of the cases, etc. The aim was to provide guidelines of risk analysis, risk prevention and risk aversion for nurses, and improve their consciousness of security hidden danger, and reduce security hidden danger cases. Results The results of 207 cases collected from 2014 to 2015 showed that the main risks involved the age groups were 41-80 years old and 21-30 years old. The major risks involved the spectrum of disease were the nervous system, cardiovascular disease, surgical anesthesia related problems, kidney disease, cancer and respiratory system. The major risks involved the time were the midnight, morning and afternoon. The major risks involved the locations were sickroom, emergency room, auxiliary inspection departments and outpatient. The major risks involved items were disease mutation, psychological problems, medication safety and instrument safety, among the disease mutation, timely discovered, rescued 13 patients with heart and breathing pause, stop 13 patients who attempted suicide. Since the Plato analysis method was applied to identify the security risks of the clinical cases, the number of falling, all kinds of pipe shed, skin problems and suicides were decreased from 6, 6, 7, 5 in 2014 to 2, 2, 2, 1 in 2015, declining trend year by year. Conclusions Applying the Plato analysis method to identify the security risks of the clinical cases which can find out the main problems of cases and improve nursing quality and management efficiency.

Objective To evaluate the efficiency of different interventional mode in treating primary hepatocellular carcinoma with decompensated liver cirrhosis.Methods 132 cases with hepatocellular carcinoma accompanied by decompensational liver cirrhosis were undertaken transcatheter arterial chemo-embolization(TACE,Group A,n=36),segmental transcatheter arterial chemo-embolization(S-TACE,Group B,n=54)and S-TACE + radiofrequency ablation(RFA) + percutaneous ethanol injection(PEI)(multi-interventional therapy,Group C,n=42).Univariate analysis and multivariate COX proportional hazard regression model were used to analyze the factors affecting the prognosis.Results All patients of A,B,C groups had been followed up for 3 months to 48 months,with median survival times of 4.1 months,9.4 months(P 50%) demonstrated as 8.3%,31.5%(P