Objective:To explore and optimize the preparation method of specimen about mouse liver tissue for scanning electron microscopy.Methods: The specimens of mouse liver using for scanning electron microscope were prepared through improving the fixed location of perfusion, optimizing material and procedure of perfusion, adopting fixation of perfusion via portal vein and changing the process of fixation and so on. And the results of morphological observation of histocyte were compared between the improved method and traditional method.Results: The improved preparation method could save the liver tissue and the living state of the cells in preferably situation. By using this method, the ultra-micro morphological structure of liver tissue and cell could be clearly observed and the ideal effect of observation could be achieved. Besides, its operation was simple and its success rate was high. Therefore, it was superior to traditional method.Conclusion: The preparation of specimen about the fixation of mouse liver tissue via perfusion of portal vein for scanning electron microscope is a superior method, which has certain applied value.

OBJECTIVE To study the distribution and drug resistance conditions of inpatients in our hospital and make us antibiotics use reasonable.METHODS Retrospective analysis was conducted from all the pathogens of the clinical specimens from 2007-2008 and the data were analysed.RESULTS A total of 5508 pathogens were isolated from 2007-2008.Among 2441 pathogens(44.32%),there were Gram-negative bacilli(Enterobacteriaceae 1715 pathogens,Nonfermenters 707 pathogens,Vibrionaceae 19 pathogens),1154 pathogens(20.95%) were Gram-positive bacilli,1906 pathogens(34.60%) were Fungi.There were 331 pathogens which extended spectrum ?-lactamases(ESBLs) of Enterobacteriaceae(19.30%).The resistance of Escherichia coli to amikacin,ceftazidime,gentamicin,ciprofloxacin,piperacillin resistance rates were 10.94%,60.53%,62.08%,82.01%,86.46%,resistance of Enterobacter cloacae to amikacin,ciprofloxacin,gentamicin,piperacillin,ceftazidime resistance rates were 30.61%,46.29%,52.96%,55.20%,53.05%,resistance of Klebsiella pneumoniae to ciprofloxacin,amikacin,gentamicin,ceftazidime,piperacillin resistance rates were 13.04%,15.90%,16.90%,20.17%,30.07%,The resistance of E.coli,E.coli to ceftazidime,gentamicin,ciprofloxacin,piperacillin were not found were than 60.00%,E.cloacae to gentamicin,piperacillin,ceftazidime not more than 50.00%,K.pneumoniae to ciprofloxacin,amikacin,gentamicin,ceftazidime resistance rates more than 30.00%,not found E.coli,E.cloacae,K.pneumoniae PEI-pei South-resistant strains.The resistance of Pseudomonas aeruginosa to imipenem,amikacin,ciprofloxacin were less than 20.00%,the resistance rate of Acinetobacter baumannii more than 40.00%;of 199 methicillin resistant staphylococcus were not found out vancomycin-resistant S.aureus strains.CONCLUSIONS More of the pathogens show multiple drug resistance.It is urgent for surveillance of bacterial resistance and rational use of anti-microbial agents during the clinical therapy.

OBJECTIVE To know the status of management knowledge and disposal process of medical waste in village.METHODS Questionnaire was conducted among crowds randomly selected from Huishi,taipin,Gangou and Hepan town in Huining country of GanSu province.RESULTS The understanding rate of management regulation of medical waste among crowd in these four town was 12.31%;The touching opportunity to medical waste was very high;When medical waste was manipulated,people of chooseing to bury accounted for 12.15%,choosing to throw 43.35%,choosing localized manipulate accounted for 4.43%;The phenomenon of throwing medical waste was very serious(85.77%).CONCLUSIONS The understanding rate of management regulation of medical waste are not high,wehereas the touching opportunity was very high in the village.At the same time,the phenomenon of throwing medical waste was very serious and correct manipulating rate are not high.So we should strengthen the education of correlated policy,formulate eligible manipulating method,improve and consummate scientific management system of the medical waste in village.

Objective To investigate the changes and significance of serum C reactive protein (CRP) and calcitonin (PCT) levels in the elderly patients with acute exacerbation of chronic obstructive pulmonary disease (AECOPD).Methods One hundred and twenty elderly patients with AECOPD in the respiration deplartment of our hospital from January 2013 to study One hundred and twenty elderly patients with AECOPD in our hospital from January 2013 to June 2015 were selected to conduct the study and performed the subgroup analysis according to the BODE index (body weight,dyspnea,airflow,motor function index),times of acute exacerbation within 1 year after treatment and recurrence time,and other 40 healthy subjects in the outpatient department were selected as the control group.The serum PCT and CRP levels were compared among various groups.Results Serum CRP and PCT levels in AECOPD patients with grade 1-4 of BODE index were significantly higher than those in the control group (P＜0.05),moreover in the intra-group comparison of serum CRP and PCT,the grade l＜grade 2＜grade 3＜grade 4,the differences were statistically significant (P＜0.05).Serum CRP and PCT had the significantly positive correlation with the grades of BODE index in AECOPD patients (r=0.482,0.317,P＜0.05).After treatment,serum CRP and PCT levels in AECOPD patients with recurrence occurred more than 3 months were significantly lower than those in the patients with recurrence occurred within 3 months,the difference was statistically significant (P＜0.05);serum CRP and PCT levels in the patients with more than once recurrence at 1 year after discharge from hospital were significantly higher than those in the patients with recurrence ≤once,the difference were statistically significant (P＜0.05).Conclusion The serum levels of CRP and PCT in the patients with AECOPD can reflect dyspnea,airflow limitation and motor function ability,and conducts the preliminary assessment on the patient's prognosis.

Objective To investigate the influences of psychological rehabilitation nursing on immune function in post stroke depression patients.Methods A total of 80 elderly patients with post stroke depression were recruited from the inpatients in geriatric neurology department at Tianjin Medical University General Hospital.All patients were divided into two groups:the control group received only conventional and auxiliary exercise therapy for 3 months; rehabilitation group received psychological rehabilitation nursing added to the above therapy for 3 months.Barthel indexes,Hamilton Depression Scale (HAMD) scores and immune function were detected at recruit and three months after treatment.Results There were no statistically significant differences in clinical data between the rehabilitation group and control group (all P＞0.05).There were no statistically significant differences in Barthel indexes,Hamilton Depression Scale (HAMD) scores and immune function between rehabilitation group and control group before treatment (all P＞ 0.05).Compared with control group,the rehabilitation group showed that the Barthel Indexes were increased (P=0.000),Hamilton Depression Sale (HAMD) scores were decreased (P=0.000),the levels of T lymphocyte subpopulation (P＜ 0.05) and immunoglobulin (P＜ 0.01) were increased after three months treatment.Conclusions The combination treatment of psychological rehabilitation nursing,auxiliary exercise and drug are helpful to recover immune function and improve the quality of life in patients with post stroke depression.

Objective To explore the effect of diabetic liaison nurses on controlling blood sugar levels in patients with hyperglycemia in department other than endocrinology. Methods Four hundred diabetic patients with high blood sugar were selected from January to December, 2014 in department other than endocrinology. They were divided randomly into 2 groups equally:the control group and the observation group. The control group received traditional nursing care, while blood sugar management was carried out by diabetic liaison nurse in the observation group. Result Pre-discharge sugar metabolism in the observation group was significantly better than that in the control group (P<0.05). Conclusion The diabetic liaison nurses in other departments than the endocrinology department can help control blood sugar levels in patients with hyperglycemiain.

Objective To compare the efficacy of oxycodone versus sufentanil for intravenous analgesia after radical resection of pulmonary carcinoma performed via video-assisted thoracoscope.Methods One hundred fifty-four patients of both sexes, aged 18-64 yr, with body mass index of 18-25 kg/m2, of American Society of Anesthesiologists physical status Ⅰ or Ⅱ , scheduled for elective radical resection of pulmonary carcinoma performed via video-assisted thoracoscope, were randomly divided into either sufentanil group (group S, n=76) or oxycodone group (group O, n =78) using a random number table.The 2 groups received combined intravenous-inhalational anesthesia.When postoperative visual analogue scale (VAS) score ≥ 4, sufentanil 5 μg or oxycodone 2 mg was injected intravenously, and the administration was repeated when necessary until VAS score ≤ 3.Patient-controlled intravenous analgesia (PCIA) was then used for postoperative analgesia (lasting for 48 h).PCIA solution contained tropisetron 20 mg and sufentanil 200 μg in 100 ml of normal saline in group S.PCIA solution contained tropisetron 20 mg and oxycodone 50 mg in 100 ml of normal saline in group O.The PCIA pump was set up to deliver a 2 ml bolus dose with a 10 min lockout interval and background infusion at a rate of 1 ml/h.VAS score was maintained ≤3.When VAS scores ≥4, morphine 10 mg injected intramuscularly was used as rescue analgesic.The requirement for rescue analgesic, level of patient's satisfaction with analgesia,and analgesia-related adverse events were recorded.Results The incidence of nausea and vomiting was significantly lower in group O than in group S (P＜0.05).There was no significant difference in the requirement for rescue analgesic, level of patient's satisfaction, and incidence of dizziness and over-sedation between the two groups (P＞0.05).No patients developed respiratory depression and pruritus in the two groups.Conclusion Compared with sufentanil, oxycodone can produce similar analgesic efficacy when used for PCIA after radical resection of pulmonary carcinoma performed via video-assisted thoracoscope, with lower incidence of nausea and vomiting.

Objective To investigate perioperative antimicrobial prophylaxis in thyroid operation at all levels of hospitals in a province.Methods From January 1 ,2011 to December 31 ,2013,all kinds of thyroid operation in a province were conducted targeted monitor,investigated results were analyzed.Results A total of 1 304 cases of thy-roid operation were investigated,1 294 (99.23%)were elective operation;duration of operation of 1 051 cases (80.60%)were ≤2 hours;antimicrobial use rate was 96.70%;196 patients (15.45%)were administered 30 mi-nutes before operation,887 patients (70.34%)used antimicrobial agents for >48 hours;19.53% of patients used the first generation cephalosporins and clindamycin.Conclusion There are some problems in antimicrobial use in thyroid operation in this province,such as inappropriate choice of antimicrobial agents,improper administration time,long time use of antimicrobial agents,and use antimicrobial agents without indications.Management of anti-microbial agents should be strengthened,so as to promote the rational use of antimicrobial agents.

Objective To analyze the epidemiological characteristics of a healthcare-associated infection(HAI) outbreak due to multidrug-resistant Acinetobacter baumannii (AB) in an intensive care unit(ICU), and provide basis for the prevention and control of HAI.Methods Epidemiological investigation and environmental hygiene monitoring methods were adopted to investigate patients who had pulmonary infection after they were admitted to the ICU of a hospital in April 1-26, 2015, risk factors were analyzed and corresponding preventive control measures were taken.Results A total of 15 cases of extensively drug-resistant AB(XDR-AB) healthcare-associated lower respiratory tract infection occurred.15 strains of AB were isolated from 15 patients.No.1, 3, 4, 5, No.6, 7, 8, 9, and No.10, 11 patients were detected AB with the same antimicrobial susceptibility testing results respectively;occurrence time of infection was relatively centralized.A total of 43 specimens from environmental surface and hands of health care workers(HCWs) were collected, detection rates of AB from bedside cabinet, monitor button, and hands of HCWs were 100.00%(1/1), 75.00%(6/8), and 66.67%(4/6)respectively.AB were not detected from specimens of treatment table, infusion pump button, and doctors' nasal swabs.By late May 2015, there were no new such cases in ICU.Conclusion This AB HAI may be spread through environmental surface and hands of HCWs in ICU, AB isolated from patients is extensively antimicrobial resistant, active treatment of patients and strict disinfection and isolation measures can effectively control further prevalence.

Objective To evaluate the application value of time-intensity curve analysis of contrastenhanced ultrasonography (CEUS) in differential diagnosis of malignant and benign breast masses.Methods From January 2015 to September 2015,30 patients with one lesion confirmed by surgical pathology were examined by CEUS.Then time-intensity curve analysis was performed.Results 16 lesions were found in the benign group and 14 lesions were in the malignant group.Five parameters of benign and malignant group were statistically analyzed,including Perfusion slope rate (C),intensity of peak (A),Subsidence slope rate (K),time of peak value (T) and area under the curve (Area).The perfusion slope rate (C) of benign and malignant group is [(0.24 ± 0.41) vs (0.67 ± 0.39)].There was no statistical difference between the two groups in intensity of peak (A),Subsidence slope rate (K),time of peak value (T) and area under the curve (Area),except perfusion slope rate (P＜0.05).Conclusion Time-intensity curve analysis of CEUS has certain effect on differential diagnosis of malignant and benign breast masses.