Objective To investigate the effect of informational support on disease uncertainty in liver cancer patients undergoing interventional therapy. Methods Sixty patients of liver cancer patients undergoing interventional therapy were randomly divided into the intervention group and the control group with 30 in each.The control group was treated with general treatment and care. The patients in the intervention group were given general treatment and care with a series of informational support interventions. Patients in the two groups were measured by uncertainty in illness scale (MUIS) at the day of admission,before operations and discharged from hospital. The measurement results were statistically analyzed. Results There was significant decrease about disease uncertainty scores both on the day before operation and the day before discharge in the intervention group compared to the day of admission. The decreasing score of uncertainty in illness in the intervention group was significantly greater than the control group on the day before operation and the day before discharge. Conclusions A series of informational support interventions could significantly reduce the diseases uncertainty in liver cancer patients undergoing interventional therapy.

OBJECTIVE To investigate the resistance and molecular epidemiology of Pseudomonas aeruginosa isolated from ICU. METHODS Susceptibility of P. aeruginosa isolates to 14 antimicrobial agents were tested by microScan WalkAway-40 system,and Molecular typing was analyzed by enterobacterial repetitive intergenic consensus(ERIC-PCR). RESULTS The lowest resistance rate of P. aeruginosa to the antimicrobial agents was to ceftazidime (27.3%),then to cefepime (45.5%). The highest resistance rate was to cefotaxime (100.0%) and the resistance rate to other antimicrobial agents was more than 60.0%. Patterns of ERIC-PCR were same in 5 strains of P. aeruginosa. CONCLUSIONS P. aeruginosa isolated from ICU is resistant to most of antimicrobial agents and clone spread is found in them. We should enhance detection and surveying of these isolates.

OBJECTIVE To investigate the resistance of Pseudomonas aeruginosa strains to 5 ?-lactams.METHODS Susceptibility of 218 P.aeruginosa strains isolated from Anhui Province in 2005 to ceftriaxone,cefotaxime,ceftazidime,aztreonam,and piperacillin were tested by agar dilution method.RESULTS The resistance rate to ceftriaxone,cefotaxime,aztreonam,piperacillin,and ceftazidime were 59.2%,57.3%, 56.0%,51.8%,and 39.0%,respectively.There was statistically significant difference between ceftazidime and other 4 ?-lactams(P0.05).CONCLUSIONS Ceftazidime is the most susceptible antibiotic to P.aeruginosa strains among 5 ?-lactams tested.

OBJECTIVE To analyze the drug resistance of 141 clinical strains of Acinetobacter baumannii to 15 kinds of antimicrobial agents for the rational application of antimicrobial agents.METHODS All 141 strains of A.baumannii isolates were tested for minimal inhibitory concentration(MIC) to 15 kinds of antimicrobial agents included meropenem,imipenem,piperacillin,and so on using agar dilution method.RESULTS The lowest resistance rate of A.baumannii to the antimicrobial agents was to imipenem(22.7%),then was to meropenem and cefoperazone/sulbactam.The highest resistance rate was tetracycline(81.5%).The resistance rate to other antimicrobial agents was to about or more than 50%.CONCLUSIONS Most of A.baumannii isolates are susceptible to meropenem,imipenem,and cefoperazone/sulbactam and resistant to other antimicrobial agents,therefore,we should enhance to this kind of isolates detection.

Objective To investigate the adhesion levels in uropathogenic Escherichia coli with various degree of drug resistance.Methods One hundred strains of Escherichia coli isolated from urine specimen were collected from patients admitted to 4 Grade A tertiary hospitals in Tianjin during March 2012 to October 2015.Escherichia coli were divided into drug sensitive group and drug resistant group by drug sensitivity tests with 50 strains in each group.The expressions of fimH,fimA,fimB genes of type I fimbriae and papA,papB,papC,papGII genes of P fimbriae were detected by polymerase chain reaction(PCR)and real-time fluorescence quantitative RCR (RT-PCR),respectively.Adhesion ability of type I fimbriae and P fimbriae were tested by yeast cell adhesion test and erythrocyte agglutination test.Chi square test and t(Z) test were used to analyze the data.Results The positive rate of papGII in drug resistant group (42.0%) was significantly higher than that in the drug sensitive group (16.0%)(χ2 =8.208,P <0.05),while there were no significant differences in the positive rates of fimH,fimA,fimB,papA,papB and papC genes between two groups(all P >0.05).The expression levels of fimH,fimB and papC genes in the sensitive group were higher than those in the resistant group(Z =3.427,t =5.182 and 8.120,all P <0.05).The adhesion ability of strains carrying type I fimbriae in sensitive group was stronger than that of resistant group (χ2 =5.769,P <0.05).Conclusions The decline in adhesion ability of type I fimbriae in drug resistant E.coli strains is possibly associated with the adaptive cost of bacteria,the transcription and deficiency of other genes encoded by fim and pap gene cluster will also affect the adhesion function of type I pili and type P pili.

Objective To investigate the effect of Doula delivery ball apparatus combined with correct occipitoposterior.Methods Four hundred primiparas whose dilatation of cervix of 3 cm and position of foetus was occipitopostenor position, were randomly divided into observation group and control group according their wishes, and each group of 200 cases.Doula delivery ball was used for the observation group,while the free body position, the traditional delivery mode was the control group.The vaginal delivery rate, degree of pain, postpartum 2 h bleeding volume and neonatal asphyxia rate were compared between the two groups.Results The degree of pain Ⅲ degree was 4.0％ (8/200) ,lower than the control group(50.0％ (100/200), x2 =11.55,P＜0.01).The vaginal delivery rate in observation group was 84.5％ (169/200), higher than that in control group (60.5％ (121/200);x2 =28.905,P=0.001).Postpartum 2H bleeding was (156.3±53.2) ml, lower than the control group((268.1±54.6) ml, t =20.70, P＜0.01).The Postpartum bleeding rate was 0.5％ (1/200), lower than that in control group (4.0％ (8/200) ,P =0.018).Conclusion Doula delivery ball is applied to the first active stage of labor can effectively relieve pain, promote the safety of natural childbirth.

Objective To study the relationship between neurodevelopment and early nutritional status of very low birth weight(VLBW)infants in NICU.Methods VLBW infants admitted to NICU of our hospital from January 2013 to December 2014 and received regular follow-up management at our high-risk infant outpatient clinic were retrospectively studied. All infantsˊdevelopmental quotient ( DQ) were evaluated at 3 months of corrected gestational age ( cGA) . DQ ≥130 was defined as excellent, 115-129 above medium, 85-114 medium, 70 -84 below medium and ≤69 abnormal. According to their DQ scores, infants were assigned into two groups, normal neurodevelopment group ( DQ≥85 ) and abnormal neurodevelopment group ( DQ<85 ) . Nutritional status during hospitalization between the two groups were compared.Results A total of 125 VLBW infants were recruited.At three months of cGA, 2 cases ( 1. 6℅) had excellent DQ score; 3 ( 2. 4℅) above medium; 63 ( 50. 4℅) medium;57 (45. 6℅) below medium. 68 cases (54. 4℅) in the normal development group and 57 (45. 6℅) in the abnormal group. The total energy intake, the proportion of enteral energy supply on 4 d, 7 d, 14 d after birth and amino acid supply on 4 d, 7 d were significantly higher in the normal neurodevelopment group than the abnormal group (P<0. 05). Comparing with the abnormal group, weight loss of VLBW infants in the normal neurodevelopment group was less; the time needed to reach birth weight and exclusive enteral nutrition in the normal neurodevelopment group was shorter. The differences were statistically significant between the two groups(P<0.05).Conclusions VLBW infantsˊearly nutritional status may influence their neurodevelopmental outcome.

Objective To investigate the clinical significance of the antenatal detection of four indices of coagulation(PT,APTT, TT,FIB),D-dimer(DD)and platelet(PLT)in the judgment of parturient coagulation function and bleeding risk.Methods 795 pregnant women and childbearing age non-pregnant women with physical examination in this hospital from June 2012 to September 2013 were collected and divided into the normal pregnancy group(early pregnancy,middle pregnancy,late pregnancy,parturient pe-riod),obstetric accident group,pregnancy complicating other disease group and healthy control group.At the same time,PT, APTT,TT,FIB,DD and PLT were detected and the related statistical analysis was conducted.Results DD and FIB in the normal pregnancy group were significantly higher than those in the healthy control group(P<0.05),PT and APTT were significantly low-er than those in the healthy control group(P <0.05),TT had no statistically significant difference between these two groups(P >0.05 );DD and FIB in the obstetric accident group and the pregnancy complicating other disease group were significantly higher than those in the normal pregnancy group(P <0.05),while PT was significantly lower than that in the normal pregnancy group(P <0.05).PLT in the obstetric accident group and the pregnancy complicating other disease group was significantly lower than that in the normal pregnancy group(P <0.05).The sensitivity and specificity of the combined detection of 3 indices in diagnosing the ob-stetrical accidents were greatly superior to those of the single index detection or the combined detection of two indices.Conclusion The prenatal combination detection of four coagulation indices,DD and PLT can preliminarily judge the coagulation status of preg-nancy period in pregnant women,help to treat abnormal bleeding of pregnant women an possess the important guidance significance in formulating the labor scheme and preventing the occurrence of obstetric accidents.

Objective To investigate antiproliferative activity of endostatin(ES), the combining effect of Endostar and radiation on VEGF and apoptosis of the A549 human lung adenoearcinoma cell line.Methods The cell of exponential phase of growth were divided into the control, radiation alone, ES alone,radiation after ES(ES→RT), ES after radiation(RT→ES), radiation and ES at equal paee (RT+ES), γ-ray radiation at a dose of 2 Gy, single fracination irradiation, YH-16 10 μg/ml in the cell culture bottle. The combining effect was quantified by the survival curve. ELISA was used to observe the VEGF of radiation with ES on A549 cell lines. Apoptosis was observed by Hoeehst staining. Results There showed that both of ES and combining treatment had the function of antiproliferative. But the union treatment's function was more obvious (P＜0.05). The expression of VEGF in ES and the combining treatment group was more lower than others (P＜0.05). On apoptosis, the rate of apoptosis in ES, RT, combining treatment group was higher than others (P＜0.05). Conclusion On antiproliferative activity and rate of apoptosis, the combining of ES and radiation is better than to use them alone. To reduce VEGF of the A549 human lung adenocareinoraa cell line by ES could enhance radioresponse. There is no evidences to show that the expression of VEGF is concerned with the different choronological order of radiation and ES.

This paper summarizes the nursing care of patients with extracorporeal membrane oxygenation (ECMO) for postoperative support in heart transplantation. Ten patients suffered from acute graft failure after heart transplantation and applied the extracorporeal membrane oxygenation for postoperative support. All the patients were monitored on electrocardiogram, hemodynamics, body temperature, urine volume, drainage volume, activated coagulation time, liver and renal function, free hemoglobin and colloid osmotic pressure. Nine survivals were discharged with recovery and one patient died. The duration of ECMO support ranged from 40 to 824 hours. When the heart function showed recovered based on bedside UCG. the ECMO could be weaned off uneventfully after 100 hours and the long-term clinical outcomes were good. It is suggested that close monitoring of heart & lung function during ECMO support, proper adjustment of ventilator index, intensive lung & respiratory tract care, prevention of arrhythmia, bleeding, embolism, infections, bedsores and other complications may decrease the mortality of severe patients with heart transplantation.