ObjectiveTo analyze the application of β-lactam antibiotics and bacterial drug resistance in our hospital for providing basis of the rational use of antibiotics.MethodsThe DDDs,total consumption sum,DDC and bacterial drug resistance of β-lactam antibiotics during 2008-2009 were analyzed statistically.ResultsCephem Antibiotics was the most extensive application,and the DDC of Benzylpenicillin Sodium was the minimum in the β-lactam antibiotics.There had bacterial drug resistance of most β-lactam antibiotics,but the differences were not significant.ConclusionThere was irrational use of β -lactam antibiotics,and it was important to enhance antibiotics supervisal and drug sensitivity before use for decreasing the abuse of antibiotics.

Objective To carry out hand hygiene(HH) quality control circle(QCC) activity by using WeChat group, improve HH compliance of health care workers(HCWs), and enhance the circle members' ability to solve problems.Methods In June 2015, 11 healthcare-associated infection control professionals in a hospital created HH WeChat group by using cellphones, activity cycle was once every two weeks, professionals analyzed the existing problems, and formulated countermeasures as well as implemented methods by group chat form, circle members introduced and implemented strategies to HCWs in their departments, so as to achieve the implementation effect.Results After the creating of WeChat QCC, HCWs' HH compliance increased from 56.71% before activity to 85.94% after activity, difference was statistically significant (X2=61.928, P<0.05);QCC members' responsibility, self-confidence, enthusiasm, harmony degree, team cohesiveness, quality control technique, communication, coordination, and problem-solving skill were all significantly improved.Conclusion Application of WeChat QCC activity can improve HH compliance of HCWs and the ability of circle members.

Objective To investigate the clinical features and molecular characteristics of bacteremia caused by K. pneumoniae and study on the differences between classical and hypervirulent K. pneumonia( hvKP) . Methods The clinical features of 70 cases of K. pneumoniae bacteremia collected from Beijing Chaoyang Hospital from 2008 to 2012 were retrospectively analyzed. The patients were identified according to the records from the Clinical Microbiology Department. Patients′ data were obtained from medical records. The molecular characteristics of the K. pneumoniae strains were also studied using PCR, multilocus sequence typing and pulsed field gel electrophoresis( PFGE) methods. Data were analyzed using the statistical package SPSS for windows version 17. 0. For categorical data, different groups were compared using the Chi-square test to analyze the quantitative variables. P≤0. 05 was considered to be statistically significant. All susceptibility data were analyzed using Whonet, version 5. 6. Results The hvKP was identified from 31. 4% of the patients with K. pneumoniae bacteremia, which displayed 4 serotypes ( K1, K2, K20, and K57). About 40. 9% (9/22) hypervirulent strains were isolated from patients without underlying diseases, while 95. 8% (46/48) of the classic K. pneumoniae infections were found in patients with the presence of one or more underlying diseases. More hvKP positive patients (95. 5%, 21/22) had community-acquired infections compared with classical K. pneumonia (cKP) infected patients (35. 4%, 17/48). There was a significant difference between these two groups (χ2 =21. 912,P <0. 001). Two ESBLs-producing hvKP strains were found. The 22 hvKP isolates had 14 different PFGE patterns, among which 6 isolates ( patients with primary liver abscess) shared similar PFGE patterns. Conclusions The
emerging hvKP was prevalent in patients with severe community-acquired infections in healthy individuals. Two ESBLs-producing hvKP strains were identified. Drug resistance had a rising trend, which called for more attention in clinical settings.

Objective To investigate the status and influencing factors of cooperation of doctors and nurses in the nutritional support of critically ill patients, and provide the basis for future improve the physician-nurse collaboration in the nutritional support. Methods Doctors and nurses who from ICU in Soochow were investigated by the Nurse-Physician Collaboration Scale (NPCS). Results The doctors′score of physician-nurse collaboration in the nutritional support of critically ill patients was 87.42 ±15.73, which was significantly higher than 80.97 ± 13.80 the nurses′(t=3.279, P= 0.001).In addition, under the item 1, 3, 5 in the dimension one as well as the total items in the dimensions two and three, the doctors′score was similarly higher than the nurses, and the differences are also statistically significant (Z=-3.894--1.964, all P<0.01 or 0.05). Technical titles, educational level and age was significantly related to the cooperative level between doctors and nurses respectively (χ2=11.037, P=0.012;F=3.488, P=0.037; F=3.499, P=0.016). Conclusions Doctors have higher levels of perceived collaboration than nurses in the nutritional support of critically ill patients, while both require further improvement. We should highlight the physician-nurse collaboration in feeding critically ill patients, and should improve the nutrition quality through standardized process management and active team cooperation.

0.05).Conclusion HV-CVVH is effective in the treatment of severe acute pancreatitis.For SAP patients who are suit for the hemofiltration treatment,the treatment of HV-CVVH for 8h and for more than 8h has nearly the same effectiveness.

Aged ; Female ; Humans ; Nasopharyngeal Neoplasms ; diagnosis ; pathology

Objective The objectives of this study were to use Nutrition Risk Screening 2002( NRS2002) to conduct nutri-tional assessment research on patients with advanced cancer in our hospital,and to assess the patients′nutritional deficiencies,nutri-tional risk and nutritional support,and to discuss the nutritional status and clinical indicators of patients with different tumor types in order to provide a scientific evidence for individualized nutritional support. Methods Patients with advanced tumors met the require-ments were enrolled from January 2016 to February 2017. Nutritional questionnaires and anthropometry were conducted and recorded the information of measurements and relevant laboratory tests. NRS2002 was used to screen nutritional risk of patients. Results The nutritional insufficiency rate was 19. 54% in 517 patients with advanced cancer and 49. 52% in nutrition risk. The proportion of nutri-tion-free patients receiving nutritional support was 14. 56% ,and the nutritional support patients with nutritional support were 63. 67%.Theaveragelengthofhospitalstaywas(14.43±11.82)daysforpatientswithnutritionalrisk,and(8.29±6.93)daysforpa-tients without nutritional risk. The incidence of nutritional risk in patients with digestive tract cancer was higher than other tumor types. Conclusion As an effective nutritional screening tool,NRS2002 can help clinicians to screen the potential nutritional risk of patients in oncology and provide the basis for patients to develop rational nutrition support.

Objective To prepare a mouse anti-human B7-2 monoclonal antibody ( McAb) and to study its effect on the induction of death-related molecules on the surface of tumor cells. -ethods Trans-genic cells, L929-B7-2, were used as the immunogen to immunize BALB/c mice. Through cell fusion, mul-tiple screening by immunofluorescence labeling and continuous subcloning, the hybridoma secreting B7-2 McAb was obtained. Biological characteristics of the McAb were analyzed using Ig subclass identification test strip, antigenic site competition inhibition assay and specific cell membrane molecules binding test. McAb was prepared through inducing ascites in vivo and then purified by protein G affinity chromatography. The purified McAb was co-cultured with 8266 cells, naturally expressing B7-2 molecules, to observe the expres-sion of Fas and FasL on cell surface by flow cytometry ( FCM) . Results The prepared B7-2 McAb labeled as 12G4 was successfully obtained with a titer of 0. 1 μg/5×105 cells. Its heavy and light chains were IgG2b and κ, respectively. The concentration of the purified ascites-derived antibody was 1. 61 mg/ml. FCM re-sults showed that the 12G4 McAb recognized cell membrane molecules well with a positive binding rate of 89. 6％ to 8266 cells. The mean value of the Fas molecule on the cell surface increased after incubating with 20 μg/ml of 12G4 McAb for 12 h and reached the peak of 62575. 8 at 48 h, which was significantly higher than the maximum value of 57135. 4 in the IgG control group (P<0. 05). After culturing the cells with 20μg/ml of 12G4 McAb for 12 h, the expression of FasL on the cell surface also increased and reached the maximum of 7. 98％ at 48 h, which was significantly higher than the 1. 10％ in the IgG control group ( P<0. 05). Conclusions B7-2 McAb was successfully prepared. It could be used to induce the expression of some death-related molecules on the surface of tumor cells.

Objective:To summarize and analyze the efficacy, experience and follow-up results of 300 cases of transposition of the great arteries (TGA) intervened by arterial switch operation.Methods:It was a retrospective, single-center study involving 300 TGA patients intervened by arterial switch operation between January 2010 and December 2017 in Guangdong Provincial People′s Hospital.Their clinical data were retrospectively analyzed.There were 236 male patients and 64 females.Among them, 128 cases (42.7%) were TGA with ventricular septal defect (TGA/VSD), and 172 cases (57.3%) were TGA with intact ventricular septal defect (TGA/IVS). The mean age and weight at operation were (23.8±39.2) cases days, and (3.5±0.8) kg, respectively.There were 193 cases (64.3%) with usual coronary artery patterns, and 107 cases (35.7%) with unusual coronary artery patterns.Among the 107 cases with unusual coronary artery patterns, 21 cases (7.0%) were involved with the intramural coronary artery, and 17 (5.7%) presented the single-ostium coronary pattern.Non normal distribution data were used the Mann- Whitney U test.Categorical measures were compared by Chi- square test or Fisher′ s exact test.Survival probability and freedom from events were calculated by the Kaplan-Meier method, and difference in survival probability by the Log Rank test. Results:All patients were successfully intervened by arterial switch operation, 73.3% of patients with TGA/IVS underwent the surgery within 3 weeks after birth, and 85.9% of patients with TGA/VSD underwent surgery within 3 months.The mean cardiopulmonary bypass time and aortic occlusion time were (193±68) min, and (122±39) min, respectively.Twenty-five patients (8.3%) died in hospital.Thirty cases had low cardiac output syndrome, 1 implanted with a permanent pacemaker due to complete atrioventricular block.A total of 254 patients were followed up for 1 month to 10 years.Three patients with single-ostium coronary pattern died at the follow-up period.The 5-year and 10-year survival rates were both 90.7%.During the follow-up, 49 cases (49/254 cases, 19.3%) had pulmonary artery stenosis, 66 cases (66/254 cases, 26.0%) had aortic valve regurgitation, 47 cases (47/254 cases, 18.5%) had pulmonary valve regurgitation, and 4 (4/254 cases, 1.6%) had aortic anastomotic stenosis.Among the 21 patients (21/254 cases, 8.3%) requiring reintervention, 17 patients (17/254 cases, 6.7%) underwent a total of 18 reinterventions, including 12 interventions of pulmonary artery plasty, 4 of percutaneous balloon pulmonary valvuloplasty, 1 of aortic reconstruction at anastomosis and 1 of pacemaker exchange due to battery exhaustion.Conclusions:Arterial switch operation is the optimal treatment for TGA.The long-term follow-up results of arterial switch operation are satisfactory in TGA children, with a low risk of long-term reoperation.

In the past few decades, considerable development was achieved in the cochlear implantation following the emergence of innovative electrode array and advances in minimally invasive surgery. Minimally invasive technique led to a better preservation of residual low-frequency hearing. The loss of residual hearing was caused by complicated factors. According to previous studies, a slower and stable speed of electrode insertion and the use of perioperative steroids were demonstrated to have a positive impact on hearing preservation. The selection of electrode array or its insertion approaches didn't show any distinctive benefits in hearing preservation.