Objective To explore the application value of control chart in the management of nosocomial infection in intensive care unit (ICU) by using quality control chart to monitor the infectionsin ICU.Methods From October 2011 to June 2016, ventilator-associated pneumonia (VAP), central line-associated bloodstream infection (CLABSI) and catheter-associated urinary tract infection (CAUTI), namely the three catheters, occurred in ICU of the Affiliated Hospital of Guizhou Medical University were monitored and recorded monthly, then the data was imput into the Excel, and the data was analyzed using SPSS. According to the properties of the data, control chart was derived for monitoring nosocomial infections, finding out problems and for taking actions on time.Results From October 2011 to June 2016, the numbers of new patients in ICU were 23-103 cases per month and the median was 45.00 (39.00, 55.50) cases per month. The numbers of new VAP patients were 0-7 cases per month which median was 3.00 (1.00, 4.00) cases per month and the VAP rates were 0-22.58 cases per 1000 ventilation-days which median was 8.62 (3.28, 12.10) cases per 1000 ventilation-days. The numbers of new CLABSI patients were 0-3 cases per month which median was 0.00 (0.00, 1.00) cases per month and the CLABSI rates were 0-14.82 cases per 1000 catheter-days which median was 0.00 (0.00, 5.38) cases per 1000 catheter-days. The numbers of new CAUTI patients were 0-8 cases per month which median was 1.00 (0.00, 2.00) cases per month and the CAUTI rates were 0-14.06 cases per 1000 catheter-days which median was 3.02 (0.00, 5.86) cases per 1000 catheter-days. 57 points of the three catheter-associated infections incidences were continuously monitored monthly, in which some data points overstepped the warning limit, only 1 CAUTI infection incidence overstepped the control limit, the other monthly three catheter-associated infections incidences were in the control range and had no abnormal arrangement occurred, so all of them were in a controlled state. By using the control chart, the situation of nosocomial infections were analyzed scientifically and intuitively, the existing problems were discussed in time, the improvement programs were made, and the three catheter-associated infections were in a controlled state.Conclusion Control chart has the characteristics of simple operation, intuitive results, and finding problems on time, so it can be used in daily monitoring of nosocomial infection and is worthy of generalization.

Objective To assess the prevalence and related factors of postpartum depression in mothers of preterm infants in neonatal intensive care unit (NICU).Methods A total of 83 mothers who met the inclusion and exclusion criteria were investigated by using Edinburgh Postnatal Depression Scale (EPDS) and the comprehensive questionnaire for mothers of preterm infants in NICU,and the analysis was performed on SPSS 13.0 using the Spearman correlation analysis and Logistic regression analysis.Results Among the 83 mothers,38 got the EPDS score of 10 and above,which accounted for 45.78％ (38/83).The disease severity (OR =3.318,P ＜ 0.01),the worry about disease prognosis (OR =4.348,P ＜0.01),the worry about mental development of the newborn (OR =5.420,P ＜ 0.01) were the risk factors for postpartum depression in mothers of preterm infants in NICU.Conclusions It's different from the correlation to postpartum depression in mothers of full-term newborns,the correlation to postpartum depression in mothers of preterm infants in NICU are closely related to premature and admission in NICU.The mothers of preterm infants in NICU are the high-risk population for postpartum depression.Routine screening mechanism for mothers of preterm infants should be established for early detection and treatment of postpartum depression,and to promote maternal and infant health.

Practical teaching of medical ethics is the key point in judging the effectiveness of the course.After 27 years of teaching efforts and exploration,the teaching of medical ethics in our college has gradually formed the basic form of practical teaching,such as case teaching,group discussion,scientific research activities,case assessment,the combination of medical ethics teachers and clinical teachers in the teaching process.But more attention and efforts are still needed in the following issues,including building a scientific evaluation system for the course of medical ethics,focusing on the continuity of practical and systematic teaching,dedicated practice of medical ethics course,and handling new arising problems in modern medical and healthcare practice.

Through the analysis of medical ethics teaching questionnaire investigation,to understand the recognition states of medical ethics from the medical students ,then find out the problems in teaching processes,and provide scientific basis for carrying out medical ethics education purposedly

Nowadays,in instruction of clinical practice,inaprepriate practice resulting from inappropriate instructional concept is one reason responsible for medical entanglement.In order to make instruction of clinical practice to be more standard,in the meantime coodinate the relation between everu aspect,and let it play the important role in cultivating medical talents, it must adopt the most fundamental intructional conecpt, In other words,the instructional concept of human-basis,quality,law-abiding,creation and wholiness.

Medical personnel conducted a spirit of resisting SARS,such as face danger fearlessly,step forward bravely,treat and cure with all his strength,scrupulously abide by a professional responsibility,patient above all,scientical treatment and et.al. This spirit should be propagated,learned and modeled.

OBJECTIVE:To observe the clinical efficacy of oral traditional Chinese medicine concomitant with artificial liver in the treatment of severe type hepatitis.METHODS:A total of176patients were randomly divided into the treatment group and control group:the control group was treated with conventional internal medicine therapy together with artificial liver,while the treatment group was treated with additional traditional Chinese medicine besides the therapy for the control group.And the course of treatment was2weeks.RESULTS:The cure rates for the treatment group and the control group were45.5%and20.5%,respectively(P

Objective To investigate the relationships of nuclear factor кB (NF-кB) activation with protein kinase B (Akt) and glycogen synthase kinase 3β (GSK-3β) during amyloid-β (Aβ) (25-35) -induced apoptosis in pheochromocytoma cells (PC12 cells) of rats. Methods Apoptosis in PC12 cells was induced by A(25-35). The activities of Akt, GSK-3β and NF-кB were analyzed in this process. The Akt and GSK-3β pathways were blocked by their specific inhibitors, respectively, and the relationships of Akt and, GSK-3β with NF-кB during Aβ(25-35)-induced apoptosis in PC12 cells were determined. Results Aβ(25-35) induced apoptosis was in a dose-dependent manner. With 0, 5, 10, 20 μmol/L and 40 μmol/L Aβ(25-35) treaing for 48 h, the apoptosis rates of PC12 cells were (3. 01 ± 0.03)%, (3.08 ±0.03)%, (25.32 ± 0.76)%, ( 42.88 ± 0.60 )% and ( 60.85 ± 2.39 )% , respectively. Compared to control, both Akt and GSK-3β were suppressed during apoptosis, at meantime NF-кB was activated. The inhibited Akt activity by wortmannin leaded to decreased NF-кB activatity and increased GSK-3β activatity. Suppression of GSK-3β with its specific inhibitor LiCl caused the decreased activation of NF-кB too, but it had no significant influence on Akt activity. Conclusions These results suggest that both Akt and GSK-3β are upstream regulators of NF-кB. They co-regulate the activation of NF-кB during Aβ(25-35)-induced apoptosis in PC12 cells. This study contributes to the theoretical base for the pathogenesis of Alzheimer disease (AD) , and provides a new idea to AD prevention and therapy.

Objective To observe and explore the therapeutic effect of acupuncture combined rehabilitation training in treating with spasm cerebral palsy patients.Methods 128 spasm cerebral palsy patients in our hospital from February 2012 to May 2014 were selected and randomly divided into the observation group (68 cases) and the control group (60 cases).The patients of the control group were given massage,ganglioside intravenous treatment,the patients of the observation group were given acupuncture combined rehabilitation training on the basis of the control group.The total treatment was 3 months,after the treatment,the Ashworth score and the total effective effective rate of the two groups were compared.Results After treatment,the observation group of patients with Ashworth spasm rating scale significantly better than that of control group (P ＜ 0.05),the observation group of patients and the control group after treatment in patients with Ashworth spasm of rating scale were significantly better than that of before treatment (P ＜ 0.05),the treatment of patients with observation group total effective rate is significantly higher than control group (P＜ 0.05).Conclusions On the basis of the comprehensive treatment of acupuncture combined rehabilitation training therapy in patients with spastic type cerebral palsy treatment effect significantly,can significantly improve the patient' s level of limb muscle tension,worthy of clinical popularization and application.

Objective To investigate the genotypes of extended spectrum β-lactamases (ESBLs) and their carrying modes in Escherichia coli (E.coli) isolates,and to analyze the mechanism of protein phosphorylation and ESBLs gene expression induced by β-lactam antibiotics or inhibited by histidine kinase inhibitors.Methods The predominant genotypes of ESBLs (KPC,TEM,SHV and CTX-M) and their carrying modes were identified by PCR and sequencing analysis.E-test and micro-tube dilution method were applied to measure minimal inhibitory concentrations (MICs) and minimum bactericidal concentrations (MBCs).Immobilized metal ion affinity chromatography,bacterial protein phosphorylation detection kit and real-time fluorescent quantitation RT-PCR were performed to analyze the enhancing effects of 1/4 MIC penicillin or cefotaxime or the inhibitory effects of histidine kinase inhibitors (closantel,bromized or iodized methylimidazol) on protein phosphorylation and the expression of ESBLs at mRNA level in E.coli isolates.Results In 183 β-lactam antibiotics-resistant E.coli isolates,TEM and CTX-M genes (83.1％ and 77.1％) were highly expressed than other two ESBLs genes with a prevalent carrying mode of coexisting (65.0％) (P＜0.05).Penicillin or cefotaxime at 1/4 MIC induced the protein phosphorylation and promoted the expression of TEM,SHV and CTX-M at mRNA level (P＜0.05).Closantel (200 μmol),bromized methylimidazol (2 or 10 μmol) or iodized methylimidazol (20 or 50 μmol) could neither kill E.coli isolates nor inhibit their growth,but could inhibit the protein phosphorylation induced by above mentioned antibiotics and enhance the expression of ESBLs at mRNA level (P＜0.05).Moreover,the susceptibility of antibioticresistant E.coli strains to penicillin and cefotaxime were increased (P＜0.05).Conclusion TEM and CTX-M were the predominant genotypes of ESBLs carried by β-lactam antibiotics-resistant E.coli strains isolated from Zhejiang province,which were mostly found in a TEM plus CTX-M carrying mode.Sublethal dose of β-lactam antibiotics could up-regulate the expression of ESBLs genes in E.coli isolates via TCSS,but it could be inhibited by histidine kinase inhibitors.