Objective To investigate the resistance of Staphylococcus aureus (S.aureus) to vancomycin and linezolid in Sichuan Province, and provide reference for clinical anti-infection treatment.Methods S.aureus and methicillin-resistant S.aureus(MRSA) from 71 hospitals in Sichuan Province in 2011-2015 were collected, minimum inhibitory concentration(MIC) values of vancomycin and linezolid against S.aureus and MRSA in each year were calculated.Results A total of 51 976 strains of S.aureus were collected in 5 years, 14 361 of which were MRSA, isolation rate of MRSA decreased from 36.02％ in 2011 to 25.56％ in 2015, which showed a downward trend (x2=160.72,P<0.05).From 2011 to 2015, MIC50 of vancomycin against S.aureus were 1, 0.5, 0.5, 1, and 1μg/mL respectively,MIC90 increased from 1μg/mL to 2μg/mL;the mean MIC50 of linezolid was 2μg/mL,MIC90 increased from 2μg/mL to 4μg/mL.Change in MIC50 and MIC90 of vancomycin against MRSA in 2011-2015 were obvious, which increased from 0.5, 1μg/mL to 2μg/mL respectively;the mean MIC50 of linezolid was 2μg/mL,MIC90 increased from 2μg/mL to 4μg/mL.Conclusion The isolates rate of MRSA had a decreasing trend,but there is a upward trend of MIC50 and MIC90 of vancomycin and linezolid against MRSA, bacterial resistance surveillance needs to be strengthened to provide evidence for rational clinical antimicrobial therapy.

Objective To provide basis for the formulation of policies and measures that will reduce the work pressure on nurses and to provide them with a better working environment. Methods An investigation was made via questionnaires into 942 nurses working in designated SARS hospitals and a comprehensive analysis was conducted by means of multivariant stepwise regression. Results The major factors affecting the pressure on nurses include: lack of support from and communications with families, arduousness of tasks to an unbearable point, extreme strictness in management, and unsoundness of treatment and living conditions. Conclusion Good communications with families are of great significance to nurses working in isolated areas. It is imperative to rationally allocate the human resources of nurses, show more concern for them, encourage them to participate in management, and strengthen scientific prevention so as to create a better working environment.

Objective To investigate multiparametric immunophenotypic features in patients with acute myelocytic leukemia(AML)-M_2 bearing AML-1/ETO gene rearrangements and its predicting value.Methods A multiparametric flow cytometry was used in the study of phenotypic characterization of the subtype of AML.Immunophenotype of 30 patients with AML(M_2/ETO~+)was analyzed by fluorescence in situ hybridization(FISH).The results were compared with 36 patients of AML-M_2 with AML-1/ETO~- (M_2/ETO~-)and 34 acute promyelocytic leukemia(APL)patients.Results There were a population. 15.89%-68.53% the blast cell and a population of more differentiated and heterogeneous myeloid cells in the marrow of 30 patients with M_2/ETO~+.The blast cells had a myeloid phenotype(CD_(33),CD_(13)and MPO) and showed a characteristic pattern of antigen expression.The fluorescent intensity of CD_(33)in patients with M_2/ETO~+ was less than in patients with M_2/ETO~-and APL [ mean fluorescent intensity(MFI):98?75 v. 244?184 and 845?523,both P

[ABSTRACT]AIM:Toobservetheeffectsofpuerarincombinedwithsaxagliptinonrenalfibrosisintype2dia-betic rats.METHODS:Fifty male Wistar rats were used, of which 8 rats were randomly chosen as normal control group , and the remaining rats were used to establish the type 2 diabetic model.The rats that met the criterion for the diabetic mo-del were randomly divided into model group , puerarin treatment group , saxagliptin treatment group , puerarin combined with saxagliptin treatment group and metformin combined with saxagliptin treatment group .The above-mentioned drugs were ad-ministered for 8 weeks.After that period, all rats were sacrificed.The kidney index (kidney weight/body weight),and blood glucose and HbA1c were examined in all the rats.The morphological changes were observed by HE and Masson stai-ning.The levels of TNF-αand macrophage migration inhibitory factor (MIF) in the serum were measured by ELISA .The mRNA expression of TNF-α, MIF and CD68 was examined by RT-PCR.RESULTS: Compared with normal group , the kidney index, blood glucose and HbA1c, the levels of TNF-αand MIF in the serum and the mRNA expression of TNF-α, MIF and CD68 were increased (P<0.05) in the kidney tissues of model group .Compared with model group , the kidney index, blood glucose and HbA1c, the levels of MIF and TNF-αin the serum and the mRNA expression of TNF-α, MIF and CD68 were decreased ( P<0.05) in puerarin combined with saxagliptin treatment group .CONCLUSION:Puerarin com-bined with saxagliptin reduces blood glucose , decreases MIF and TNF-α, and down-regulates the mRNA expression of TNF-α, MIF and CD68 in the kidney tissues of type 2 diabetic rats, which may contribute to the inhibition of renal fibrosis .

Adult ; Female ; Humans ; Rectal Neoplasms ; diagnosis ; pathology ; Rectum ; pathology ; Sarcoma, Myeloid ; diagnosis ; pathology

Objective:To understand the anxiety and depression status of junior standardized training nurses and its influencing factors,to explore the humanistic care strategies for anxiety and depression,and thus to provide the basis for improving the psychological state of the nurses and the content of standardized training.Methods:Across-sectional questionnaire survey were conducted among 161 standardized training nurses in one Three-A hospital using Self-rating Depression Scale (SDS) and Self-rating Anxiety Scale (SAS).Results:The positive rate of depression and anxiety in 161 standardized training nurses were 51.60％ and 34.70％,respectively.The coarse average scores of depression and anxiety were (39.73 ± 8.55) and (37.21 ± 8.64),respectively,which were higher than Chinese norm (33.46 ± 8.55) and (29.78 ± 6.46) (P ＜ 0.05).Family burden,clinical profes-sional knowledge and skills and work environment had influences on depression;family burden and the differences of rotation departments had influences on anxiety.Conclusion:The formulation of content of standardized train-ing should consider the different characteristics of rotation department.We should create a good working atmo-spherefor standardized training nurses,improve the training of professional knowledge and skills on the basis of paying attention to humanistic care,strengthen the training of psychological quality and psychological counseling.

Objective To construct a scientific,valid evaluation system for excellent clinical nurses.Methods Based on the framework of competency theory,systematic literature reviewing,nursing experts discussion and the Delphi method were used to determine the primary indexes for the evaluation system.The evaluation system was determined from three perspectives,doctors',nurses' and patients'.Analytic Hierarchy Process (AHP) was then used to determine the weight of each index.Results The weight of doctors',nurses' and patients' perspective was 0.2,0.4,0.4 respectively.Doctors' and nurses' perspective(hereinafter referred to as staff's perspective) had the same evaluating indexes,which both consisted of 5first-dimensions,22 second-dimensions.The patients' perspective contained 3 first-dimensions,14 seconddimensions.In two-round Delphi technique,the rates of questionnaire retrieve were 91.2％ (31/34),100.0％(31/31),respectively;the colleagues' coordination coefficients were 0.784,0.858,respectively,and the patients' coordination coefficients were 0.05,0.216,respectively.Conclusions A evaluation system of high reliability and validity for excellent clinical nurseshas been successfully constructed.It may be utilized as a tool to for nursing administrator selection,training,assessment of excellent clinical nurses.

Objective To discuss the effect of operations for comminuted patella fractures with cable cerclage and revised tension band. Method Retrospective study of clinical effects of 120 patella fractures cases which used cable(cable group,55 cases) or NT-PC (NT-PC group,65 cases) to internal fix.Results At 10 to 38 ( 19.50 ± 1.15 ) months follow-up, all cured well in 12 weeks. Compared with the operative time, the amount of blood loss, length of hospitalization, time for cure, the incidence of complications,there were no significant differences between two groups (P ＞ 0.05 ). The B (o)stman score of cable group [(27.0 ±0.2) scores] was better than that of NT-PC group [(25.1 ±0.6) scores](P＜0.05). Conclusion Using cable cerclage and revised tension band to internal fix for comminuted patella fractures,the operations are facile and the results are satisfactory.

Objective To study the transcription and expression of excision repair cross complementing 1(ERCC1) in the peripheral blood and the skin tissue in coal-burning borne endemic arsenism, and to explore the role of arsenism in its pathogenic or carcinogenesis mechanism. Methods According to "Endemic arsenism diagnostic criteria" (WS/T 211-2001), 110 arsenism patients were chosen as case group in Xingren county,Guizhou province and they were divided into 3 groups according to their hnir arsenic: ＜ 2(31 cases),2 ～＜ 4(31 cases),≥4 mg/kg(48 cases), respectively. Another 36 healthy residents about 13 km away from the endemic area were chosen as healthy control group. Under the principle of informed consent, hair samples were collected for arsenic analysis by Ag-DDC and blood samples were collected to determine mRNA expression levels of ERCCI by real-time fluorescence quantitative PCR. At the same time, skin tissue samples were collected from the voluntary surgical treatment of 62 patients with endemic arsenism as case group which were divided into 3 groups according to their hair arsenic: ＜ 2(16 cases), 2 ～＜ 4(20 cases) and ≥4 mg/kg(26 cases), respectively, and these patients were also divided into general pathological changes (32 cases), precancerous (19 cases) and cancerous groups( 11cases), respectively, according to their skin pathologic diagnosis of skin lesions. Another 13 cases pathologically normal without skin cancer surgery from a certain hospital were chosen as control group. Skin samples were collected to detect the ERCC1 protein by immunohistochemical method. Results The mRNA levels of ERCC1 were 0.7156(0.2158 ～ 1.2405),0.5772(0.0843 ～ 1.1234) and 0.5490(0.1895 ～ 0.8431 ), respectively, among ＜ 2, 2 ～＜ 4and ≥4 mg/kg groups, which were lower than the mRNA levels of ERCC1 in the control group[1.5128(1.0000 ～2.1295)], and the difference was statistically significant(all P ＜ 0.05). The expression rate of ERCC1 protein were 87.5%, 80.0% and 77.0%, respectively, among ＜ 2, 2 ～＜ 4 and ≥4 mg/kg groups. The expression rate of ERCC1 protein in 2 ～＜ 4 and ≥4 mg/kg groups were lower than the rate in the control group(100.0%), and the difference was statistically significant (all P ＜ 0.05). The expression rate of ERCC1 protein were 84.4%, 79.0%and 72.8%, respectively, among general pathological changes, precancerous and cancerous groups compared with the control group( 100.0% ), and the difference was statistically significant(all P ＜ 0.05). Conclusions Arsenic from coal-burning can lead to abnormal ERCC1 gene transcription and protein expression, which may inhibit DNA repair through influencing the removal of damaged DNA and promoting the incidence of arsenism development and even skin carcinogenesis.

Objective To investigate the transcription and expression of DNA methyltransferase 1 (DNMT1) mRNA in endemic arsenism patients by burning coal usage,to probe its effects on the development and carcinogenesis of arsenism. Methods In 2008,68 arsenism patients(including 24 mild cases,28 moderate cases and 16 severe cases) were selected in the areas with endemic arsenism according to Standarding of Diagnosis for Endemic Arsenism from Xingren county,Guizhou province. Among the subjects,40 cases were diagnosed by pathological methods,and they were divided into general pathological changes(20),precancerous(14) and cancerous group(6). Tweleve kilometer away from the endemic arsenism area,23 controls were selected in Daguoduo village (non-arsenism exposure). Under the principle of informed consent,blood samples were collected from individuals. The mRNA expression of DNMTI was detected by real-time quantitative reverse transcription polymerase chain reaction(FQ-PCR). At the same time,skin tissue samples were collected from the voluntary surgical treatment patients with endemic arsenism (total 61 cases,including 34 general pathological changes cases,21 precancerous cases and 6 cancerous cases) and from the control(15 cases). DNMT1 protein was detected by immunohistochemical method.Results Average level of DNMT1 mRNA were 0.221 83±0.595 09,0.246 11±0.509 79 and 0.389 27±0.411 33 respectively among mild,moderate and severe arsenism group. DNMT1 mRNA level of mild and moderate group were obviously lower than the control group(0.695 95±0.463 98,all P < 0.01). The mRNA average level of DNMT1 were 0.320 64±0.547 46,0.313 09±0.529 13 and 0.159 07±0.342 56 individually among general pathological changes,precancerous and cancerous group,which were obviously lower than the control group(0.695 95±0.463 98,all P < 0.05). The expression rates of DNMT1 protein in skin were 88.24%(30/34),100%(21/21) and 100% (6/6) among general pathological changes,precancerous and cancerous group were higher than the control group [0(0/15),all P < 0.01],and the extent of expression gradually increased with the aggravation of skin damage(r,= 0.740,P < 0.01). Conclusions DNMT1 participated in the development of the arsenism. High expression of its protein was an early event during the process of the arsenism. DNMT1 may be the new target markers for early diagnosis and treatment of arsenism.