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.

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.

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 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.

According to the Organ Injury Scale Grading System of the American Association for the Surgery of Trauma (AAST-OIS),grade Ⅴ liver trauma is always complicated with retrohepatic inferior vena cava injury and less bile duct injury,and it is extremely severe and difficult to be treated.Timely and fast judgment,emergent exploration and effective repair of the injured bile duct are the key points for the treatment of bile duct injury.One patient with grade Ⅴ liver trauma combined with hilar bile duct transection injury was admitted to the Fuzhou General Hospital of Nanjing Military Command on August 30,2013.The rupture of left and right liver junction was detected by preoperative multidisciplinary consultation and emergency open surgery at admission hour 4.There was left and right hepatic duct bifurcation rupture at the first hepatic hilum.Non-functional liver tissues were excised.Breakage left and middle hepatic vein were sutured by polymer suture line.Liver traumatic bleeding and bile duct were sutured and ligatured individually.Left and right hepatic duct laceration was sutured by 6-0 PDS suture line.A hole in the stomach wall was opened fist,and then most part of the gastric contents was removed and the gastric wall was reparied by stapler.Patient received the postoperative symptomatic treatment with gradual recovery,and was discharged from hospital at admission day 26.The patient was readmitted to the hospital at 31 days of discharge due to outflow of purulent fluid from abdominal cavity drainage tube,and was treated by ceftriaxone sodium and tazobactam sodium according to the results of drug sensitive test and continuous peritoneal lavage.The abdominal cavity drainage tube and left and right hepatic duct drainage tube were removed at postoperative day 83.The patient was discharged from hospital at readmission day 28,and was followed up till December 2014 with good recovery and without complication.

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 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.

Abnormal proliferation of vascular smooth muscle cells (VSMCs) plays an important role in several pathological processes of cardiovascular diseases. In this study, the effects of XCT790, a potent and selective inverse agonist of estrogen-related receptor alpha (ERRalpha), on rat VSMCs proliferation and related signal pathways were investigated. The proliferative activity of VSMCs was determined by CCK-8 assay. The mRNA levels of ERRalpha, PGC-1alpha, OPN and MCAD were assayed by RT-PCR. The protein levels of ERRalpha, ERK2 and p-ERK1/2 were evaluated by Western blotting. ELISA was used to assess the protein expression of VEGF. The results showed that XCT790 (5-20 micromol x L(-1)) inhibited rat VSMCs proliferation, and the expression of ERRalpha and its target genes, as well as p-ERK1/2, were also inhibited. XCT790 inhibited VSMCs proliferation in a dose-dependent manner at the dose range from 5 to 20 micromol x L(-1) and in a time-dependent manner at the dose range from 10 to 20 micromol x L(-1). These findings demonstrate that XCT790 inhibits rat VSMCs proliferation by down-regulating the gene level of ERRalpha and thus inhibiting the ERK signal pathway, suggesting that ERRalpha may be a novel potential target for therapeutic approaches to inhibit VSMCs proliferation, which plays an important role in several cardiovascular diseases.