OBJECTIVE To investigate the distribution and resistance characteristic of Escherichia coli in order to provide reference for the clinical application of drugs.METHODS The strains of E.coli were detected and their sensitivity to antibiotics was determined by VITEK automatic bacterium identifying and drug sensitivity analyzing systems,then the specimens in which E.coli was detected and the result of sensitivity to antibiotics were analyzed.RESULTS Among 210 specimens in which E.coli was detected,the urine was the most frequent.There were 46 strains which produced extended-spectrum ?-lactamases(ESBLs),the ESBLs-producing rate of E.coli was 21.9%,the drug resistance of ESBLs producers was more serious than that of nonproducers.The resistant rate of ESBLs producers against penicillins was 100%,but the susceptibility rate was 19.6-84.8% while combined with the ?-lactamases inhibitors.The susceptibility rates of ESBLs producers to the antibiotics from the first generation cephalosporins to the third generation ones were 0.0-45.6%.The susceptibility rates of ESBLs producers to cefepime,cefoxitin,ciprofloxacin and Cotrimoxazole were 60.9%,34.8%,10.9% and 13.0%,respectively,whereas amikacin,imipenem,and meropenem were more effective against the bacteria,the susceptibility rates of ESBLs producers were 89.1%,97.8% and 97.8%,respectively.while all the nonproducers were susceptible to them.The ESBLs producers had high sensitivity to imipenem,meropenem,amikacin and piperacillin/tazobactam,and had high resistance to the other antimicrobial drugs,they showed multi-drug resistance.CONCLUSIONS It is rather serious the resistance of E.coli to usual antibiotics,and that of ESBLs producers is more serious.It should be cautious to use cephalosporins to treat infections caused by E.coli,carbapenem,amikacin and some of complex antibiotics containing ?-lactamases inhibitor are very effective to treat infections caused by ESBLs producers.It is very important to select rational drugs correctly for clinical treatment of the infections according to the results of antibiotics susceptibility tests.

Babesia parasites are obligate intracellular apicomplexan protozoa and important pathogens causing babesiosis of humans and animals. They have conserved subcellular structures and invasion mechanism. Rhoptry⁃associated proteins，which are released into the host cell，are considered to be the key molecules of invasion and replication of parasites in the host cell and are immunosuppressive factors of the host cell mediated immunity in the stage of parasitophorous vacuole（PV）formation. The knowledge about rhoptry⁃associated proteins has made a great progress with the development of genomics and proteomics，so we review the research progress in rhoptry⁃associated proteins of different Babesia including Babesia bovis，B. ovine，B. gibsoni，B. bigemina and B. orientalis，etc.

Objective To investigate the relationship of glycosylated hemoglobin A1C(HBA1c) and 2 hour postprandial blood glucose(2hPBG) with 12-hour urinary albumin excretion rate(UAE).Methods One hundred and thirteen patients with type 2 diabetes mellitus(T2DM),whose fast blood glucose(FBG) levels after treatment were less than 7.0 mmol/L,and 54 healthy subjects were the control group in this study.The level of HBA1c was detected by high performance liquid chromatography(HPLC).The level of 2hPBG was measured by glucose oxidase assay and the level of UAE was detected by radioimmunoassay.According to the level of HBA1c and 2hPBG,the patients were divided into 4 groups: group A(HBA1c7% and PBG

The PBL teaching and the case teaching have begun to be applied to the course of health economics, which has strong adaptability to the two teaching methods. Two teaching methods not only have the same characteristics, such as diversified teaching, outstanding students as the main body, paying atten-tion to the theory and practice, emphasizing on the comprehensive use of knowledge, but also have different characteristics, such as teaching idea, applied range and points of focus. These similar characteristics and differences are reflected in the development of health economics course. Based on the differences and simi-larities of the two teaching methods and further integration of the characteristics of health economics, this paper puts forward the countermeasures to optimize the application of the two teaching methods in health economics course.

Objective To explore the direct effect of attachment and the indirect effect through coping style and social support on mental health in technical school students. Methods 372 technical school students were assessed by Experiences in Close Relationship' s Inventory ( ECR), Symptom Check Scale List-90 ( SCL90) ,Coping Style Scale For Secondary School Students( CSS)and Perceived Social Support Scale(PSSS). Results ( 1 ) Total score of SCL-90 had significant correlations with all index of attachment anxiety, parents attachment avoidance( r=0. 165 ～0.370, P＜0.01 ) ,with coping style focus on problem ( r=0.291 ～0.552, P＜0. 01 ) and perceived social support( r = -0. 245, P ＜ 0.01 ). (2)Coping style focus on emotion had significant correlations with attachment anxiety( r=0.237 ～0.383, P＜0.01 ) and coping style focus on problem had significant correlations with attachment avoidance( r= -0. 267 ～ -0. 403, P＜0. 01 ). (3) Perceived social support had significant negative correlations with attachment avoidance ( r= - 0. 425 ～ - 0. 459, P ＜ 0.01 ). (4) The coping style focus on emotion had 65.2% mediation effect between attachment anxiety and mental health and perceived social support was moderated by attachment avoidance. Conclusions ( 1 ) Attachment anxiety and attachment avoidance have direct effect on mental health. ( 2 ) The indirect effect of attachment anxiety on mental health is a lot mediating effect performed by the coping style focus on emotion. Attachment avoidance also indirectly influences on mental health by moderating perceived social support.

OBJECTIVE To investigate the pathogens of hospital acquired pneumonia(HAP) in the general ward of our hospital to provide the basis for clinical experiential medication.METHODS The bacteria of the 62 patients with HAP whithout organ dysfunction in the general ward of our hospital between Jan 2005 and Apr 2008 was analyzed.RESULTS The main pathogens followed by Klebsiella pneumoniae(29.03%),Escherichia coli(22.58%),Staphylococcus haemolyticus(16.13%),S.epidermidis(12.90%),Pseudomonas aeruginosa(8.06%) and S.aureus(4.84%).Gram-negative bacilli showed better sensitivity to imipenem,piperacillin/tazobactam and cefepime(91.89-81.08%);Gram-positive cocci had lower resistance to vancomycin and rifampin(100.00-92.00%).CONCLUSIONS Hospital-acquired pneumonia in the general ward can be cured by appropriate commonly used antibiotics.

BACKGROUND:Epidermal stem cells as special stem cells of the skin not only plays an important role in maintaining the metabolism of skin, but also is closely related to wound repair, which are the basis for the occurrence and repair of skin and its appendages. Now, epidermal stem cells have been paid great attention on the research of gene therapy and celltherapy with its specific biological advantages. OBJECTIVE:To summarize the research status on features and clinical application of epidermal stem cells. METHODS:A computer-based online retrieval of CNKI, PubMed database and Google scholar was performed for searching papers about clinical application of epidermal stem cells using the keywords of“epidermal stem cells, stem cells division, stem cells culture, clinical application”in Chinese and English. Older theoretical perspectives and repetitive research were excluded. Finally, only 41 articles were included in result analysis. RESULTS AND CONCLUSION:Epidermal stem cells have the great potential of proliferation and multi-directional differentiation, and have important significances for large-area skin defects (burn and trauma), skin tissue engineering, and gene therapy. There are stil many problems that need to be solved, such as how to screen surface markers special for epidermal stem cells and how to induce skin differentiation of epidermal stem cells.

Objective To determine the relationship between the aggravation of CAAS and coronary atherosclerosis (CAS) ;and to summarize the pathologic character of CAAS of the patients with various coronary artery disease. Methods Review the result of coronary angiography and carotid artery ultrasonography and the related risk factors of the patients who were diagnosed as CAD through coronary angiography ( CAG). The patients were divided into the scleratheroma group and the non scleratheroma group. The patients were divided into stable angina pectoris( AP) group, unstable angina pectoris(UAP) group and acute myocardial infarction (AMI) group according to the criterion of coronary artery disease of WHO. The patients were divided into group A (coronary artery of single vessel lession) ,group B( coronary artery of double vessel lession ) , group C( coronary artery of triple vessel lession )and group D(left main vessel lession ).The aggravation of CAAS was graded. Results There were 198 patients with various CAAS among 228 patients with coronary artery disease ( 86. 8%). CAAS was much related with hypertension and non-related with age, sex, BMI, smoking, drinking, hyperlipoidemia, hyperuricosuria and diabetes mellitus. The aggravation of CAAS much graver with much graver CAS. But only the plaque number of Group A was more than Group D( P ＜0. 05). The grading integral and Crouse integral of CAAS of AP group was not remarkable less than UAP group. The grading integral of CAAS of AP group was less than AMI group and the Crouse integral of AP group was more. But there was no remarkable difference. The number of all plaque,plaque and plaque of AP group was not remarkable less than UAP group and AMI group. There was the plaque among the three group. Conclusion Carotid artery atherosclerosis (CAAS) is relative to coronary artery disease ( CAD).

OBJECTIVE To investigate the characteristic of clinical distribution and drug resistance of pathogenic bacteria in lower respiratory tract infection. METHODS Bacterial culture of the lower respiratory tract samples collected from patients who were admitted from Jan to May 2008 was done.The bacteria identification and drug sensitivity tests were done by VITEK bacterium identifying and drug sensitivity analyzing system. RESULTS A total of 502 pathogens were isolated,in which 340 strains of Gram-negative bacteria(67.7%),32 strains of Gram-positive cocci(6.4%)and 130 strains of fungi(25.9%).Of all the 372 strains of bacteria,the most common pathogens in turn were Acinetobacter baumannii,Pseudomonas aeruginosa,Klebsiella pneumoniae and Escherichia coli,respectively.Non-fermenters were the dominant pathogens in intensive care unit(ICU)and the surgery wards,Enterobacteriaceae and fungi were the dominant pathogens in the non-operation wards.Of A.baumannii strains,the antibiotic resistant rates to imipenem and meropenem were 7.5% and 8.8%,respectively,the resistant rates to the other antibiotics were high(53.8%-100.0%,respectively).Of P.aeruginosa strains,the antibiotic resistant rates to imipenem,meropenem,polymyxicn E,ciprofloxacin,amikacin,tobramycin and gentamicin were 11.1%-27.0%,respectively,The resistant rates to the other antibiotics such as penicillins,cephalosporins and the complex antibiotics containing ?-lactamases inhibitor were 38.1%-100.0%.The ESBLs-producing rate of K.pneumoniae strains(71.7%)was higher than that of E.coli strains(29.1%).K.pneumoniae strains and E.coli strains were all sensitive to imipenem and meropenem,and both of their resistant rates against amikacin were the same(10.9%),but against the other antibiotics the resistance of E.coli strains were more serious than that of K.pneumoniae strains. CONCLUSIONS In our area,non-fermenters are mainly isolated from ICU and the surgery wards.Enterobacteriaceae and fungi are mainly isolated from the non-operation wards.The major pathogens show multi-drug resistance except imipenem,meropenem and amikacin.It′s important to prevent hospital acquired lower respiratory tract infection during the clinical therapy,and it is urgent for rational use of antimicrobial agents according to the results of antibiotics susceptibility tests.

Objective To discuss the application effect of task-driven basic nursing probation based on the action research. Methods Using the frame of Lewin's action research, with random sampling, we selected a class for the study, for the first time in the traditional training model, and the second time in the task-driven model based on the action research. and information was collected according to the interviews and diary records, narrative description was used for records of the results. Results Action research promoted changes in basic nursing probation model, constructed knowledge, ability and improved various kinds of ability of nursing students. Conclusions The task-driven probation model improved the quality of clinic practice, which proved to be effective.