Objective To describe the experience of nurses in combined care program of traditional Chinese medicine (TCM) and provide references for nursing managers. Methods The phenomenology research method was adopted in this study. Fourteen nurses who had achieved the combined care program of TCM participated in an in-depth interview. Data were analyzed by using phenomenological analysis. Results All nurses approved nursing program of TCM: finding sense of belonging in nursing work;demonstration of self-value;standardization of nursing tednnique;harmonious environmont of nursing work. But some defect still existed: too subjective evaluation item of nursing program of TCM;inappropriate evaluation table;lact of hospital characteristics of TCM nursing;deficiency of TCM knowledge. Conclusion Nursing managers should pay more attention to nurses' emotional experience, grasp the implementation of the problems during the program and improve the program, optimize the skills, provide trainings.

OBJECTIVE To investigate the epidemiology of fungemia and provide evidence for clinical therapy.METHODS A retrospective survey was done with the 69 cases of fungemia in our hospital from Jan 2004 to Dec 2008.RESULTS More than 65% of the patients suffered from two and more underlying diseases.Over a half of infections were developed following placement of catheters.And all of the patients had a history of antimicrobial agents use before blood culture.53(76.8%) cases were associated with Candida spp.Only 18 strains were C.albicans.The mortality rate of fungemia was 44.9%.Different Candida species had different resistance rates to antifungal agents.CONCLUSIONS Fungemia patients often have serious underlying diseases.Most fungemia cases are candidemia caused by non-C.albicans.Some fungal pathogens are resistant to fluconazole and itraconazole.

OBJECTIVE To monitor the characteristics of distribution and drug resistance of Acinetobacter baumannii in our hospital. METHODS A. baumannii isolates were collected in our hospital from Jan 2004 to Dec 2005. Antimicrobial susceptibility testing was performed by disk-diffusion method,according to the standards of NCCLS 2004. RESULTS Totally 177 strains of A. baumannii were distributed clinically in the respiratory unit as the most ones (47 strains, 26.6%), and in ICU as the next (38 strains, 21.5%); the older the age, the higher the appearing rate; the highest appearing rate was from the sputum, up to 78.1%; more than 60% of isolates were resistant to all antimicrobial agents tested except imipenem, meropenem and cefoperazone/sulbactam. However,10 pan-resistant strains were found. CONCLUSIONS With the increasing isolation rate of A. baumannii, its drug resistance increases simultaneously.

BACKGROUND:During joint replacement, different materials of prosthesis can be used. Different prosthesis can produce different effects and the stress distribution of bone interface. OBJECTIVE:To explore the effects of different materials on the stress distribution and biomechanics of the bone interface of artificial hip joint. METHODS:The CT scan of the hip was carried out. The image data were saved in DICOM format and processed by MIMICS software. The 3D finite element model of the femur was obtained by ANSYS. A three dimensional finite element model of the femur was made with the material properties of the femur. Three kinds of different replacement prosthesis materials (Co Cr Mo aloy, titanium aloy and composite materials) were selected, and the specific requirements of the actual joint replacement were selected, and different types of prosthesis were designed in CAE software. In the STL format, the prosthesis model was imported into MIMICS, and the femur and prosthesis were assembled. The stress status of different prosthesis was analyzed, and the stress shielding rates of exterior and interior sides of middle and lower parts of the femur, right to and 30 mm below lesser trochanter and right to lesser trochanter of the proximal femur were calculated. RESULTS AND CONCLUSION:Through three-dimensional finite element analysis, a direct and accurate model of the femur and the three-dimensional model of the prosthesis were established. According to the actual situation, material assignment of the femoral three-dimensional finite element model was conducted to obtain the corresponding model. Thus, the properties of different materials of the femur were shown visualy. The femoral stress of cobalt chromium molybdenum aloy, titanium aloy, and composite material was simulated after replacement. Results found that the stress shielding rate can decrease in the middle and lower parts of the femur. After replacement, the femoral stress is higher than that of the intact femur. The experimental results show that the stress shielding of the joint was performed after joint replacement with Co Cr Mo aloy, titanium aloy and composite materials. Among them, the composite material is more close to the actual physiological environment of the human body, and it can better reduce the stress shielding effect, and is beneficial to the stress from the prosthesis to the femur.

Objective To detect the inhibiting effects of ionizing radiation combined with inhibitors or inducer of autophagy and apoptosis on MCF7 cell line,and to provide the evidence for human breast cancer therapy radiation.Methods MCF7 cells were exposed to X-rays and randomly divided into 4 groups,including 0 Gy,4 Gy,4 Gy+rapamycin,4 Gy+3-MA,and 4 Gy+z-VAD-fmk groups,including 0 Gy,4 Gy,4 Gy+rapamycin,4 Gy+3-MA,and 4 Gy+z-VAD-fmk groups,respectively.The growth doubling time was calculated by MTT method.The specific protein expressions of LC3 autophagy and beclinl were detected by using Western blot and the difference of Drotein contents wasLC3 autophagy and beclinl were detected by using Western blot and the difference of Drotein contents was compared.The percentage of apoptosis of MCF7 cells was measured by flow cytometry (FCM).Resuits The growth doubling time of MCF7 cells in 4 Gy group wag longer than that in O Gy group(t=4.41,P

Objective To observe the role of short-term use of megestrol acetate in reducing the toxicity of chemotherapy in breast cancer and in improving the quality of life of patients, as well as its impact on neo-adjuvant chemotherapy effects. Methods The effection of adjuvant chemotherapy, toxicity, and the quality of life of 158 patients with breast cancer were investigated by a retrospective control study. The data were statistically analysized by X~2 test. Results There was no significant difference of neo-adjuvant chemotherapy effects between Megestrol acetate + CEF chemotherapy group and vitamin C + CEF chemotherapy group (Megestrol acetate + CEF chemotherapy group was 74. 84%, vitamin C + CEF chemotherapy group was 76.15) ; Megestrol acetate + CEF chemotherapy group had more modest bone marrow suppression and gas-trointestinal reactions and better food intake, weight, KPS score than vitamin C + CEF Chemotherapy group, all the differences being statistically significant (P < 0.05). Conclusion Short-term use of megestrol ace-tate can reduce the adverse effects derived from chemotherapy of breast cancer and improve the quality of life of patients with breast cancer and had no effects on the efficacy of the neo-adjuvant chemotherapy.

Objective To compare the uniformity between spine MRI and 18F-FDG PET/CT in detection of spinal metastatic tumor, and to analyze the reasons for the discrepancy between them.Methods Data of 42 malignant tumor patients underwent spine MRI and 18F-FDG PET/CT were analyzed retrospectively.And the two tests were underwent within 30 days.The author censused and analyzed the number of centrums with metastatic tumor detected by spine MRI and 18F-FDG PET/CT,and supposed that 18F-FDG PET/CT was gold standard,to evaluate the sensitivity and specificity of spine MRI.The inconsistent between two tests was analysed.Results The study included 509 centrums of 42 patients.123 positive centrums (24.2%) were detected on spine MRI,and 114 positive centrums (22.4%) on 18F-FDG PET/CT(P=0.22>0.05).The uniformity between two tests was good (Kappa=0.76).Supposing that 18F-FDG PET/CT was gold standard,the sensitivity,specificity,positive predictive value, negative predictive value,false negative rate and false positive rate of spine MRI was 85.1%(97/114),93.4%(369/395),85.1%(97/114),93.4% (369/395),14.9%(17/114) and 6.6%(26/395) respectively.43 centrums of 14 patients were diagnosed inconsistently by spine MRI and 18F-FDG PET/CT.The main reasons for the inconformity were as following: types of primary tumors, insensitivity of spine MRI for diffuse scattered spinal metastatic tumors, the existence of misdiagnosis on spine MRI, misdiagnosis of spine MRI for metastatic lesions located in the vertebral appendix and paramedian vertebral body,misdiagnosis of 18F-FDG PET/CT for metastatic lesions located in the sacral centrum, existence of false positive on 18F-FDG PET/CT and so on.Conclusion The uniformity between spine MRI and 18F-FDG PET/CT is good.The inconformity still existes in some cases.Carefully comparative analysis of them contributes to find metastatic lesions.

OBJECTIVE To determine the clinical distribution and drug resistance characteristics of pathogens from nosocomial infection cases to provide the gist for clinical therapy. METHODS Pathogens isolation, and identification and drug resistance tests were conducted for samples, which were gathered from inpatients in our hospital between Jan 2006 to Dec 2006. Then, MRSA tests were performed for Staphylococcus and ESBLs-producing G-bacilli were also detected. RESULTS Among 4 262 strains pathogens from 10 573 samples, 2 475 strains were G-bacilli (58.1%), 695 strains were G+ bacteria (16.3%) and 1 092 strains were fungi (25.6%).The most common species among 3 170 pathogen strains were Pseudomonas aeruginosa (24.3%), Acinetobacter baumannii (10.9%), Klebsiella pneumoniae (10.4%), Escherichia coli (8.9%) and Staphylococcus aureus (10.7%).The clinical departments with higher infective rate were Department of Neurosurgery, Department of Respiratory Disease, ICU, Department of Hepatobiliary Surgery, and Department of Geriatrics in order. Drug resistance results showed that the resistance rates of S. aureus to clindamycin, quinolones, and tetracyclines were more than 50%, but no S. aureus was resistant to vancomycin and minocycline. The resistance rates of G-bacilli to imipenem, meropenem, and piperacillin/tazobactam were lower, but with 30-60% of resistance rates to other commonly used antibiotic drug. CONCLUSIONS The pathogens in nosocomial infection are mainly the opportunistic pathogenic bacteria and mostly G-bacilli. The infection due to fungi shows an increasing trend. It should pay attention to the pathogenic detection and rational use of antimicrobial agent.

OBJECTIVE To investigate the clinical distribution and resistance of Acinetobacter baumannii in our hospital in order to provide evidence to proper use of antibiotic drugs in clinics. METHODS A. baumannii isolates were collected in our hospital from Jan 2004 to Dec 2006. Antimicrobial susceptibility testing was performed by disk-diffusion method,according to the standards of CLSI/NCCLS, the data were analyzed by WHONET5.4 software. RESULTS The isolating rate of A. baumannii from 2004 to 2006 was 2.5%,3.8%, and 10.9%, respectively.It was distributed mainly from ICU (29.2%), respiratory ward (19.3%) and emergency ward (10.9%). The highest appearing rate was the sputum, up to 78.0%. More than 60% of isolates were resistant to antimicrobial agents tested such as PIP, CTX, CRO and ATM. A. baumannii showed the highest susceptibility to carbopenems with about 80%. CONCLUSIONS The infection of A. baumannii is one of the most complex problems. Therefore, monitoring A. baumannii constantly and regularly, finding out resistant strains timely, and adjusting the treatment regimen are very important to the prevention of nosocomial infection. The disinfection should be strengthened for hospital environment and medical staff in order to control existence and spread of A. baumannii.

OBJECTIVE To investigate the drug susceptibility of clinical isolates in local region for using antibiotic reasonably. METHODS Totally 3 170 strains of clinical isolates were identified by API and Microscan and tested for drug resistance against antimicrobial agents by K-B method. WHONET5.4 was applied for analysis. RESULTS The commonly encountered bacteria were Pseudomonas aeruginosa (24.3%), Acinetobacter baumannii (10.9%), Klebsiella pneumoniae (10.4%), Escherichia coli (8.9%), and Staphylococcus aureus (SA,8.0%). In Gram-negative isolates, the resistance rate to meropenem was 19.7%, and to piperacillin-tazobactam was 26.5%. The incidences of E.coli and K. pneumoniae isolates producing extended spectrum beta-lactamases (ESBLs) were 49.1% and 33.5%, respectively. In Gram-positive isolates, the susceptibility rate to vancomycin and teicoplanin both was 100.0%. The oxacillin resistant rates of SA and coagulase negative Staphylococcus (CNS) were 54.2.0% and 82.3%. CONCLUSIONS The production ratio of ESBLs and oxacillin resistance of bacteria in local region are high. It is important to promote the rational use of antimicrobial agents and take effective contaminant methods to reduce resistant rates of bacteria and dissemination of multi-resistant bacteria.