As the development of fast-tracking, the patient perception of readiness for hospital discharge is becoming more and more popular in discharge decision making. A lot of research indicates that the patient readiness of discharge can predict the satisfaction, the safety, readmission, death and compliance of the patients. This study is about to review the conception, research significances, measurements, and determinants of the discharge readiness. The primary objective was to analyze the determinants of hospital discharge, according to three aspects of patient factors, hospital factors and social support. This study is expected to offer theoretical support for the improvement of discharge readiness.

Objective To investigate the effects of shiga toxin ( Stx ) phage on the expression of type Ⅲsecretion system (T3SS) in E.coli O157 ∶H7.Methods A standard E.coli O157 ∶H7 strain, EDL933 and a natural Stx phage defective mutant of EDL 933 strain, TUV93-0 were used for this study .The expression of T3SS proteins was compared between EDL 933 and TUV93-0 strains.The expression of five operons ( LEE1-LEE5 ) was evaluated by measuring the green fluorescent protein ( GFP ) in five different plasmids with LEE1-LEE5 promoters, respectively.Results The expression of T3SS proteins in TUV93-0 mutant were significantly increased than those in EDL 933 strain.Moreover, the expression of LEE1, LEE2 and LEE5 were also increased in TUV93-0 mutant.Conclusion The deletion of Stx phage might enhance T3SS expression through the regulation of LEE 1.

Objective To study the clinical application effect of Xuebijing Injection in the treatment of capillary leak syndrome.Methods One hundred patients with capillary leak syndrome in our hospital from January 2013 to April 2016 were selected and randomly divided into the control group and observation group according to the ID number of admission.The two groups were given the Western medicine routine therapy of capillary leak syndrome.The observation group was simultaneously given Xuebijing Injection.The APACHE II score,Mashall score and hemodynamics were compared between the two groups.The disease condition change was dynamically observed.Results The APACHE II score and Mashall score before and after treatment in the observation group were significantly suprior to those in the control group(P<0.05);the peripheral blood circulating endothelial cells (CEC) number at admission in the two groups were higher than the normal level,the CEC content after taking the treatment was gradually decreased (P<0.05),but the CEC content decrease in the observation group was less than that of the control group (P<0.01);were observed before and after the treatment group APACHE II and Mashall score was significantly better than the control group (P<0.05);but the CEC content in the observation group was significnatly superior to the control group(P<0.01);the expressions of vascular endothelial growth factor (VEGF),TNF alpha and interleukin-6 (IL-6) in the observation group were better than those in the control group (P<0.05).Conclusion Using Xuebijing Injection in treating capillary leak syndrome can effectively protect the vascular endothelial cells,improves the living quality of patients and can be popularized and applied in clinical treatment.

Objective: To determine the sinapine in Semen Raphani(Laifuzi) from different places by measns of RP HPLC. Method: The column empolyed was Alltima Phenyl Collumn(250?4.6mm,5?m). The mobile phase was acetonitrile 0.08 mol/LKH 2PO 4(15∶85). The flow rate was 1.0mL/min and detection was effected at 326nm results. Conclusion: The results show the method is accurate, rapid and reproducible. We found it has marked discrepancy in the content of Semen Raphani(Lai Fuzi) from different places.

Bilateral Quchi (LI 11), Zusanli (ST 36), Shenshu (BL 23), Pangguangshu (BL 28),Yinlingquan (SP 9), Dazhui (GV 14) and Ashi points have been selected to treat 60 cases of acute gouty arthritis with the combination of moxa-stick moxibustion, and indomethacin and colchicines have been selected to treat another 60 cases as the control group. Two weeks after the treatment, the therapeutic effect of the two groups had significant difference with the effective rate of 93.3% in the former and 70.0% in the latter respectively (P＜0.01).

Objective To evaluate the clinical efficacy of thyroxine replacement therapy in the treatment of pregnancy patients with subclinical hypothyroidism.Methods 80 cases of patients with subclinical hypothyroidism who were admitted to our hospital from May 2011 to May 2016 were selected, they were divided into thyroxine replacement therapy treatment group ( replacement treatment group ) and conventional treatment group two groups according to the treatment methods, 40 cases in each group.The serum TSH, FT4, TG, CHO levels, childbirth, pregnancy outcomes and complications, neonatal status of the two groups were statistically analyzed.Results The serum TSH, TG, CHO levels of the replacement treatment group were significantly lower, the FT4 level was significantly higher, the difference was statistically significant (P<0.05), the trans vaginal yield rate 70.0%(28/40) was significantly higher than the conventional treatment group 35.0%(14/40), the cesarean section rate 30.0%(12/40) was significantly lower than the conventional treatment group 65.0%( 26/40 ) , the difference was statistically significant ( P<0.05 ) , the incidences of preterm delivery, postpartum hemorrhage, preeclampsia, hypoproteinemia, fetal development restriction 2.5%(1/40), 2.5%(1/40), 5.0%(2/40), 7.5%(2/40), 0 were significantly lower than the conventional treatment group 17.5%(7/40), 15.0%(6/40), 20.0%(8/40), 17.5%(7/40), 15.0%(6/40), the difference was statistically significant (P<0.05), the neonates body weight was significantly higher than the conventional treatment group, the difference was statistically significant (P<0.05), the proportions of low birth weight infants, giant infants, premature infants, asphyxia, death 0, 2.5%(1/40), 5.0%(2/40), 7.5%(2/40), 0 were significantly lower than the conventional treatment group 15.0%(6/40), 20%(8/40), 22.5%(9/40), 27.5%(11/25), 20.0%(8/40), the difference was statistically significant (P<0.05).Conclusion The clinical efficacy of thyroxine replacement therapy in the treatment of pregnancy patients with subclinical hypothyroidism is more significant than conventional treatment .

OBJECTIVE To explore the precaution against nosocomial fungal infections of lower respiratory tract(NFILRT).METHODS A retrospective analysis on eighty-seven cases who catched NFILRT during the years 2002 to 2004 was done.RESULTS 80.46% Cases were over 60 and the average age was 67.95 and the average in-hospital days were 46.95;most of the NFILRT patients had serious underlying diseases.Before the NFILRT,immunosuppressive agents had been injected to 47.13% cases and 42.53% patients had taken anti-acid medicine;94.25% cases had received antimicrobial agents and the average days of using antimicrobial agents were 11.01 days,and among these patients 62.20% had received more than two kinds of antimicrobial agents.About 32.18% of the NFILRT cases were associated with tracheal intubation,incision of trachea and mechanical ventilation;some patients had no clinical symptoms referred to the respiratory tract;the mortality rate was 26.44% and it couldn′t be obviously cut down by using antifungal agents.CONCLUSIONS It is very important to prevent NFILRT by using antimicrobial agents reasonably and enhancing immunity in these patients.

OBJECTIVE To know the basic situation of nosocomial infection control and management in all levels of hospitals in Anhui Province,and provide the theory basis for the future work.METHODS To investigate the students participating in the nosocomial infection management training class by using the questionnaire.RESULTS There were altogether 273 people from 217 hospitals accepting the investigation.From 217 hospitals there were 46 1st grade hospitals and 160 2nd grade hospitals and 11 third graed hospitals.In all the people engaged in the nosocomial infection management,83.88% were the females and 67.03% for nursing staff,the age of 30-50 years old was 79.84%,the middle professional rank accounted for 72.53%,and 79.86% people′s record of formal schooling was the technical college and below.CONCLUSIONS The basic situation of nosocomial infection management in majority hospitals of our Province is good,but in some hospitals,the function of the structure has not certainly obtained the full display.In order to adapt the development of the nosocomial infection supervisory work,promote it to be more perfect,personnel structure,resources arrangement,and administrative offices function should give enough reconstruction and construction.

OBJECTIVE To investigate the surgical site infection(SSI)in clean surgical sites and the perioperative antibiotic usage.METHODS The incidence of SSI and the antibiotics usages in 842 cases during perioperative were analyzed retrospectively in 32 hospitals.RESULTS One case with nosocomial infection was found(0.12%).The use rate of antibiotics was 98.57%.Among 802 cases using prophylactic antibiotics,the antibiotics were given in 181 cases thirty minutes to two hours before operation.136 cases were given 24 h before operation.And 485 cases were given after operation;195 cases stopped using antibiotics after 24 h,472 cases stopped using antibiotics after 4-6 days and 135 cases stopped to use antibiotics after 7 days.CONCLUSIONS The major problem is excessive use of antibiotic in clean surgical site during perioperation,long duration of antibiotics prophylaxis,more expensive antibiotics and unnecessary combination of antibiotics,suggesting that it be important to strengthen the management of antibiotics.

0.05);the main infection site was lower respiratory tract(61.97%),followed by surgical site infection(SSI)(23.94%).CONCLUSIONS In order to reduce postoperation nosocomial infection rate,we should take following measures:Improve pulmonary function,remove tracheal intubation as early as possible,shorten lasting time of surgery and days before operation,keep aseptic technique,strengthen nursing,enhance immunity,and use antimicrobial agents reasonably.