Objective To investigate the extended-spectrum beta-lactamases ( ESBLs) producing clinical isolates of gram negative bacilli and their antibiotic resistance in Shantou and to provide suggestions on empirical treatment against the bacteria.Methods A total of 1 445 strains of gram negative bacilli (895 strains of Escherichia coli and 550 strains of Klebsiella pneumonia) were collected and examined for the production of ESBLs and antibacterial susceptibility test by Vitek-2.Results There were 69.4% of escherichia coli and 33.6% of klebsiella pneumonia producing ESBLs.The resistance rate of the ESBLs-producing strains to penicillins,cephalosporins and monocyclic beta-lactam antibiotics were very high.The ESBLs-producing strains were multidrug resistant and the resistance rates were higher than that of the non-ESBLs-producing strains.Both ESBLs-producing and non-ESBLs-producing strains were susceptible to Imipenem.Conclusion The incidence of ESBLs-producing strains was high in gram negative bacilli in Shantou.The resistance rates of the ESBLs-producing strains were higher than that of the non-ESBLs-producing strains and they expressed multiple drug resistance phenotypes.Imipenem was the best drug in the treatment of infections caused by ESBLs-producing strains.

Objective To investigate the clinical value of the gated blood pool imaging phase analysis method in the evaluation of left ventricular mechanical synchronization in patients with chronic heart failure. Methods A total of 169 patients with chronic heart failure were enrolled in our study , using gated blood pool imaging phase analysis method to obtain left ventricular phase angle width ( PHB) and left ventricular phase angle standard deviation ( PSD) as evaluating left ventricular mechanical synchrony index; using tissue Doppler imaging (TDI) measurement of the standard deviation of systolic peak time(Ts-SD) of each segment by using the current prevailing 12 non-apical segments analysis method as evaluating left ventricular mechanical synchrony index, and parameters derived from both methods were compared. Results LVPHB was highly correlated with Ts-SD (r = 0. 83 ,P = 0. 000 ) . LVPSD was modestly correlated with Ts-SD ( r - 0. 69, P = 0. 000) . The ejection fraction measured by echocardiography was (42.93 ± 14. 89) % ,which was significantly higher than that measured by ERNA (39. 76 ± 17. 89)% (P <0. 01). Conclusions The evaluation of left ventricular mechanical synchrony in patients with chronic heart failure by the gated blood pool imaging can provide similar information with TDI, which can simultaneously measure two ventricular functions and get more accurate measurement of ejection fraction. Cardiac resynchronization therapy patients can be identified by combining two kinds of approaches, and cardiac resynchronization therapy responders could be improved as well. More patients with heart failure can benefit from cardiac resynchronization therapy therapy.

Objective To explore the characteristics of diffusion weighted imaging (DWI) of lumbar sacral nerve roots (LSNR)in normal and degenerative lumbosacral vertebrae. Methods The research recruited 20 normal volunteers and 31 patients with spinal stenosis on conventional MRI and DWI scans in lumbosacral spine. We measured the areas from lumbar 3 to sacral 1 at the intervertebral spaces and reconstructed the 3D maximum intensity projection (MIP) and counted the apparent diffusion coefficient (ADC)of LSNR and ganglions. Results In the control group, 196 (98%) LSNR ran symmetrically and lateroinferiorly and 200 ganglions were well defined on MIP of DWI. In the patients group, 74 LSNR showed changes of compression on both T1WI and T2WI, in which DWI appeared thin and distorted in 59 (80%). The ADC value of LSNR were(1.70 ± 0.40)× 10-3 mm2/s and(1.98 ± 0.57) × 10-3 mm2/s separately in normal volunteers and patients (P=0.000), while the ADC values of ganglions were(1.42 ± 0.21)× 10-3 mm2/s and (1.54 ± 0.53)× 10-3 mm2/s respectively in normal volunteers and patients (P=0.000). Conclusion DWI can display the pattern and course of LSNR and ganglions, which indicate that ADC values of compressed LSNR and ganglions are higher than normal ones.

Objective:To investigate the relationship between life events, cognitive emotional regulation strategies, neuroticism and depression in pregnant women and the internal mechanism of action.Methods:Short-term longitudinal follow-up design were used in this study.A total of 327 pregnant women in the third trimester of pregnancy were investigated with pregnant women's life events scale, cognitive emotion regulation strategy questionnaire, neuroticism subscale of Chinese big five personality questionaire-short form at T1 time point, and patient health questionnaire 9 were measured after 6 weeks(T2).SPSS 20.0 macro program PROCESS was used to examine the mediating effect of cognitive emotion and the moderating effect of neuroticism.Results:(1) The incidence of depression in the third trimester pregnant women was 12.23%.(2)There was significant positive correlation between the total score of life events in pregnant women(T1) and the total score of non-adaptive cognitive emotional regulation strategies(T1) ( r=0.25, P<0.01).Total neurotic personality(T1) and total depressive mood(T2) were significantly positively correlated ( r=0.46, P<0.01).The total scores of life events(T1) of pregnant women were significantly positively correlated with the total scores of depression(T2) ( r=0.36, P<0.01).(3) The non-adaptive cognitive emotion regulation strategy (T1) played a partial mediating role between life events (T1) and depression (T2).The direct effect (effect size=0.29) and the mediating effect (effect size=0.07) accounted for 80.55% and 19.44% of the total effect (effect size=0.36).(4) Neuroticism regulates the second part of the mediating effect of the mediating model.Specifically, the higher the level of individual neuroticism, the stronger the positive predictive effect of non-adaptive cognitive emotion regulation strategies on maternal depression. Conclusion:Pregnant life events play a role in maternal depression through the mediating role of non-adaptive cognitive emotional regulation strategies and the moderating role of neuroticism.

This article describes the design and development of an ultrasonic power meter which is consist of an electronic balance, a practice target, an acoustic enclosures and a blocking. The electronic balance mounted on the blocking is linked with the practice target by connecting rod. By adjusting the blocking makes the practice target suspended above ultrasound probe, and then the ultrasonic power can be measured. After initial tests, the ultrasonic power meter performanced with good stability and high precision.
Equipment Design ; Ultrasonics

Objective To investigate the status of subjective well-being and its influencing factors among undergraduate nursing students. Methods By using stratified cluster sampling method,557 undergraduate nursing students were investigated by questionnaires including general information questionnaire, Interpersonal Reactivity Index-C( IRI-C) and Index of Well-being Scale. Results The total average score of subjective well-being was (10. 43 ± 2. 86),and the total average score of empathy was (52. 31 ± 9. 15). There were significant differences in gender, grade, the student cadres and single-parent families ( t= -3. 79, 172. 97, 2. 52, -2. 56, 4. 07, respectively;P<0. 05). The global empathy, dimension of perspective taking, imagine, sympathy and care were positively related to subjective well-being (r =0. 10, 0. 14, 0. 10, 0. 20,respectively;P <0.05),and the dimension of personal distress was negatively related to subjective well-being (r= -0. 17,P<0. 05). Stepwise regression analysis revealed that the impact factors of subjective well-being were gender, grade, the dimension of sympathy and care, personal distress. Conclusions In order to improve the subjective well-being of the undergraduate nursing students, the educator should help them with targeted guidance in their different stages.

Objective To explore the impactof Lysosome-Associated Membrane Protein 3(LAMP3)on theproliferation,migration and angiogenesis of PC-3 cells.Methods LAMP3 expression in normal prostate epithelial cells and prostate cancer bone metastasis cells was detected using western blot and RT-PCR.Stable LAMP3-silenced PC-3 cells were constructed,and the effects of LAMP3 on proliferation,invasion,and migration of PC-3 cells were assessed using CCK8,scratch assay,and transwell assay,respectively.ELISA and angiogenesis assays were employed to examine the expression of VEGF and MMP9,as well as angiogenesis of HUVEC cells induced by PC-3 cells.Finally,WB and RT-PCR were used to detect the expression of VEGF,AKT/p-AKT.Results Our findings showed that the expression level of LAMP3 was significantly higherin prostate cellsthan in normal prostate epithelial cells,especially in PC-3 cells(P<0.05).We also found that silencing LAMP3 could inhibit the proliferation,migration and invasion of PC-3 cells,along with the expression of VEGF and MMP9 and the PC-3 cells-induced angiogenesis,and these results were statistically significant(P<0.05).Furthermore,LAMP3 downregulated the expression of VEGF and AKT/p-AKT in PC-3 cells.Conclusion LAMP3 can affect the proliferation,migrationand angiogenesis of PC-3 cells through the regulation of VEGF/AKT pathway.Thus,LAMP3 might be a potential thera-peutic target for prostate cancer bone metastasis.

Moral injury is a kind of trauma symptom caused by the impact of external immoral events on the internal moral value system of individuals or groups. Its origin lies in the deviation between individual’s internal moral schema and external moral situation. As a collection of moral consciousness units with value orientation in the regular activities of individuals in the moral environment, moral schema is composed of periphery and core. Moral schema realizes the domination of moral ego by supervising individual’s speech and behavior, exercising moderate control over individuals based on moral practice, and examining individual behavior with self-guilt as the tool of judgment. Moral schema is selective about what happened and acts as a filter for trauma events. Based on this, individuals can interpret or be subverted by moral events, thus playing a preventive role in moral injury.

Objective:To investigate the diagnosis and treatment of gastrointestinal fistula after radical gastrectomy .Methods:The clinical data of 15 patients ,who underwent radical gastrectomy and suffered post‐surgery gastrointestinal fistula at Depart‐ment of Gastric Cancer and Soft Tissue Sarcoma ,Shanghai Cancer Center ,Fudan University from Jan 2013 to Dec 2014 ,were retrospectively analyzed .Results:Four of the fifteen patients received reoperative procedures for peritoneal drainage .And the other 11 patients were cured after B ultrasound or CT imaging guided percutaneous catheter drainage and treatments such as fasting ,gastrointestinal decompression ,and enteral nutrition via needle catheter jejunostomy .No patient died .There was no statistically significant difference regarding length of hospital stay ,leukocytes abnormal days in peripheral blood and fever days after the diagnosis of gastrointestinal fistula between the reoperation group and the non‐reoperation group(P>0 .05) .Conclu‐sions:Early diagnosis ,as well as adequate and effective drainage is the key to cure for gastrointestinal fistula after radical gas‐trectomy .If operation indication is properly managed and nonsurgical treatment such as percutaneous catheter drainage is effec‐tive ,then reoperation can be avoided .

This article describes the design and development of an ultrasonic power meter which is consist of an electronic balance, a practice target, an acoustic enclosures and a blocking. The electronic balance mounted on the blocking is linked with the practice target by connecting rod. By adjusting the blocking makes the practice target suspended above ultrasound probe, and then the ultrasonic power can be measured. After initial tests, the ultrasonic power meter performanced with good stability and high precision.