OBJECTIVE:To investigate the pathogen distribution and drug resistance situation in bronchoalveolar lavage fluid (BALF) from patients with refractory pulmonary infection,and provide reference for clinical rational drug use. METHODS:The sputum and BALF specimen of 136 inpatients with refractory pulmonary infection from the First People’s Hospital of Zhenjiang City from Jan. 2012 to Dec. 2015 were cultured and identified,pathogen detection was compared,and results of drug sensitivity test for pathogen in BALF specimen was analyzed. RESULTS:The positive rates of sputum and BALF specimen of 136 inpatients were 22.06%and 47.79%,with statistical significance(P<0.01);a total of 32 and 72 strains were isolated,they mainly were Ste-notrophomonas maltophilia,Pseudomonas aeruginosa,Acinetobacter baumannii and Staphylococcus aureus. S. maltophilia in BALF was sensitive to minocycline and levofloxacin;resistance rate of P. aeruginosa to common antibiotics was lower than 50%;A. baumannii was sensitive to imipenem,ampicillin sodium and sulbactam sodium,amikacin and minocycline;S. aureus was sen-sitive to linezolid,chloramphenicol and vancomycin. CONCLUSIONS:The positive rate of BALF specimen is higher than spu-tum,the pathogens are mainly Gram-negative bacteria. Clinic should rationally select antibiotics based on the drug sensitivity test and clinical symptoms.

Objective Discuss the integrate attendance′s effect on maintenance hemodiafiltration patient. Methods Our hospital implemented integrate attendance on 105 cases of maintenance hemodiafiltration patients during January 2004 to December 2005, to observe the patient′s blood pressure abnormal change occurence rate, puncture success rate,internal leakage obstruction rate, hospitalization rate, satisfaction rate; examined the Blood albumin(ALB) , blood serum albumin (PA) ,hemoglobin(Hb) and so on.There were 96 hemodiafiltration patients without integrate attendance in our hospital during January 2002 to December 2003.Then make a comparison between them with related data. Results Blood albumin , blood serum albumin ,hemoglobin and so on figures have a obvious rise after the implementation of integrate attendance(P

Objective Observe the influence of using PCEA on the recovery of postoperative patient with cesearn section.Methods Observe the analgesic effect in advance of PCEA analgesia with 110 cases,and analgesic effect of non-PCEA analgesia for selective cesarean section 67 patients.Results PCEA analgesic effectiveness for cesarean section postoperative 6 hours and 24 hours respectively are 98% and 94%,the difference is remarkable(P0.05).Conclusion PCEA uses for cesarean section postoperative analgesia,has a good analgesic effects and highly safety.

Objective To investigate the nursing cooperation in clinical application of RetCamⅢ wide-field digital pediatric retinal imaging system.Methods 119 patients were given pointed nursing guidance while they underwent RetCamⅢ wide-field digital pediatric retinal imaging system examination.Results All patients accomplished the examination.29 cases had adverse reactions after using mydriatic.27 cases felt discomfort during the examination.22 cases appeared adverse reactions after examination,but relieved after nursing cooperation and guidance.Conclusions RetCamⅢ wide-field digital pediatric retinal imaging system is a rapid,safe and effective method for pediatric fundus examination.Favorable nursing cooperation and guidance is the guarantee of accurate and effective examination and harmonious relationship between doctor-nurse-patient.

Objective To observe the ultrasonic features of cystic renal cell carcinoma. Methods Ultrasonic features of 18 patients of cystic renal cell carcinoma confirmed with operation and pathology were analyzed retrospectively.Results Among 18 patients, 7 were clear-cell carcinoma of cystis degeneration, 5 were cystic renal cell carcinoma (clear cell type), 3 were multilocular renal cell carcinoma, 1 was corpora mammillaria renal cell carcinoma, and one clear-cell carcinoma was on capsule wall of cyst and 1 was nephroblastoma. Ultrasound diagnosed 15 patients and misdiagnosed 3 with a diagnostic rate of 83.33%.Conclusion Cystic renal cell carcinoma has specific ultrasonic characteristics, and having an intimate knowledge of these characteristics may be helpful to diagnosis.

Objective To explore the ultrasonographic appearance of dermatofibrosarcoma protuberans. Methods Clinical data, sonographic features and color Doppler flow imaging characteristics of 12 patients surgically and pathologically confirmed dermatofibrosarcoma protuberans were retrospectively analyzed.Results Single mass was detected in 11 patients (11/12, 91.67%) with the diameter ranged 0.9-8.0 cm. The tumors distributed in the trunk (8/12, 66.67%), proximal limbs (2/12, 16.67%) or face and neck (2/12, 16.67%). Most of the tumors (10/12, 83.33%) developed from skin and subcutaneous fat layer of the trunk and limbs and were hypoechoic and heterogeneous (11/12, 91.67%), some (8/12,66.67%) with distinct boundary and regular shape without liquification, calcification nor regional lymph node metastasis. Affluent color Doppler flow signals of tumor were found in 11 patients (91.67%).Conclusion Ultrasonographic characteristics of dermatofibrosarcoma protuberans include distinct boundary, regular shape, heterogeneous hypoechogenicity and rich color Doppler flow signals without regional lymph node metastasis.

Objective To study the value of ultrasonographic diagnosis of galactostasis in lactation.MethodsPatients in lactation and post-lactation were examined by color Doppler ultrasonography.Combined puncture,operation and pathology,the imaging features of different stage were summarized.Results The type of galactostasis included ductal ectasia,galactocele,infection and consolidation.The ultrasonographic examination with imaging features can determine the diagnosis and judge the type and the course of disease.Conclusions Ultrasonography is a first choice in diagnosing galactostasis in lactation.

Objective To explore the clinical significance of serum vascular endothelial growth factor (VEGF) level in nasopharyngeal carcinoma patients. Methods Serum VEGF level of 55 nasopharyngeal carcinoma patients were measured by sandwich enzyme?- linked immunosorbent assay (ELISA). 40 normal healthy volunteers served as control. Results Serum VEGF level of nasopharyngeal carcinoma patients was significantly higher than that of control group (P =0.000); Serum VEGF level was significantly higher in advanced nasopharyngeal carcinoma stage (stage Ⅲ ~Ⅳ) than that in early stage(stageⅠ ~Ⅱ) (P =0.003); Serum VEGF level with nasopharyngeal carcinoma patients with lymphnode metastasis was significantly higher than that of patients without lymphnode metastasis. There was no significant relationship compared serum VEGF level in nasopharyngeal carcinoma patient's gender, age and pathological types. Conclusions Serum VEGF can be used as a marker of nasopharyngeal carcinoma for diagnosis and monitoring the progress and the prognosis of the disease.

Objecfive To analyze the relationship between aortic root dimension(ARD)and anterior circulation infarction(ACI)by measuring ARD of ACI patients.Methods The ARD of 110 ACI patients(56 men and 54 women)were measured with 2-dimensional uhrasonography during ventricular systole.66 control subjects(32 men and 34 women)without the clinical signs of cerebral infarction or organic heart disease and cardiac insufficiency were selected after carrying out detailed cage history inquiring.physical examination,CT or MRI and ultrasonic examination.ResultsARD in men and women Was respectively(29.80±2.35)mm and(28.88±3.06)mm in the ACI group.While it was(27.64±1.70)mm and(26.98±1.60)mm respectively in the control subjects.ARD in men and women was significantly higher in the ACI group as compared with the control subjects(P＜0.01).Logistic regression analysis indicated that the odds ratio(confidence interval)associated with ARD Was 1.630(1.205-2.204)in men and 1.494(1.098-2.033)in women for ACI.Conclusions There is a close relationship between ARD and ACI.ARD is an important risk factor of ACI.

Objective To explore the influence of humanistic care on psychological stress in diag-nostic process for patients with lung cancer. Methods 40 suspicious lung cancer patients were divided into the experimental group and the control group according to admission sequence. The control group ac-cepted routine care, the experimental group received humanistic care based upon routine care. Zung's self-rating anxiety scale(SAS) and self- rating depression scale(SDS) were applied in two groups at admission day and 2 days post- diagnosis, the results underwent comparison with norm using t test. Results On ad-mission day 2 groups showed no significant difference in SAS and SDS, 2 days post- diagnosis the SAS and SDS score were evidently lower than those of the control group. Conclusions Lung cancer patients were in anxiety and depression condition during diagnostic process, and humanistic care could effectively relieve their psychological stress.