Objective To investigate current management of external auditory canal irrigation among the nurses in otolaryngology in Guangdong Province,and to provide a reference for development and promotion of a standardised procedure.Methods From January to February in 2022,a total of 48 head nurses or nursing backbone in otolaryngology department of 48 hospitals from 21 major cities in Guangdong Province were selected by convenience sampling.A questionnaire proposed by Otolaryngology Nursing Committee of Guangdong Nursing Association was used to investigate the knowledge,operation procedure and training management in external auditory canal irrigation.Results A total of 48 head nurses or nursing backbone responded to the survey.The survey revealed that 34(70.8%)of the participants had mastered the knowledge of external auditory canal irrigation and 38(79.2%)of them had mastered the knowledge on the irrigation indications.In terms of operation procedure,syringe was applied as irrigator in 43(89.6%)hospitals,disposable irrigation needle was applied as flushing connector in 24(50.0%)hospitals,body surface temperature test of operator or patient was carried out in 24(50.0%)hospitals and adjusted flushing pressure was applied according to patients'feedback in 37(77.1%)hospitals.Regarding the training of external auditory canal irritation,35(72.9%)hospitals did not ask patients to sign an informed consent before,29(60.4%)hospitals required qualifications for operator and 45(93.7%)hospitals had the training programs.Conclusions The knowledge of external auditory canal irrigation of otolaryngology nurses in Guangdong province needs to be improved.The management of procedure and training of external auditory canal irrigation shall be standardised.It is suggested that the profession should draw up the external auditory canal irrigation standard,and all hospitals strengthen the management and training in order to promote the standardisation of specialised nursing together.

Objective To investigate the detection and distribution of hospitalized specimens from a tertiary hospital over 5 years. Methods Specimens of sputum, urine, blood, secretions and puncture fluid were collected from patients admitted to the Harrison International Peace Hospital from November 2013 to November 2018. The origin of specimens, the distribution of departments and the distribution of pathogenic bacteria isolated were analyzed retrospectively. Results A total of 61 286 specimens were sent for examination during the 5 years. The top 5 specimens were sputum culture (n = 18 302, 29.9%), sputum smear (n = 11 253, 18.4%), blood culture (n = 9 713, 15.8%), urine culture (n = 6 448, 10.5%) and secretion culture (n = 6 133, 10.0%), accounting for 84.6% (51 849/61 286). Sputum specimens accounted for 48.2% (29 555/61 286) with the largest proportion. The number of specimens from medical wards was much higher than that from surgical wards (specimens: 25 468 vs. 10 521), respiratory medicine, department of critical care medicine and emergency intensive care unit (EICU) were important sources of pathogenic specimens in the hospital, accounting for 29.8% (18 243/61 286) in total. The average positive rate of all specimens was 23.5% (14 424/61 286). The positive rates of sputum culture and urine culture were 29.7% (5 428/18 302) and 35.4% (2 281/6 448), respectively, while the positive rate of blood culture was only 6.6% (643/9 713). Escherichia coli was the most common pathogen in all specimens except for sputum culture and fecal culture. Escherichia coli [40.6% (926/2 281)], Klebsiella pneumoniae [9.2% (210/2 281)], Pseudomonas aeruginosa [8.2% (188/2 281)], Enterococcus faecalis (group D) [6.6% (151/2 281)] and Candida albicans [3.2% (73/2 281)] were the most common pathogens in urine culture. Klebsiella pneumoniae [24.1% (1 309/5 428)], Acinetobacter baumannii [21.3% (1 154/5 428)], Pseudomonas aeruginosa [15.1% (818/5 428)], Escherichia coli [6.5% (351/5 428)] and Maltose oligotrophomonas maltose [5.8% (316/5 428)] were the most common pathogens in sputum culture. Escherichia coli [36.5% (235/643)], Klebsiella pneumoniae [10.9% (70/643)], Pseudomonas aeruginosa [4.8% (31/643)], Staphylococcus epidermidis [3.4% (22/643)] and Staphylococcus humanis [3.3% (21/643)] were the most common pathogens in blood culture. Conclusion Specimens sent for examination by inpatients are mainly from internal medicine wards, mainly from sputum, blood and urine, and the detected pathogens are mainly Gram-negative bacteria.

OBJECTIVE： To study the chemical constituents from the petroleum ether part from whole herbs of Pteris vittata. METHODS： The petroleum ether part from whole herbs of P. vittata was separated and isolated by silica gel column， gel column， recrystallization and TLC. The structures of the compounds were identified according to physicochemical properties and spectrum data （1H-NMR and 13C-NMR）. RESULTS： A total of 11 compounds were isolated and identified from the petroleum ether part from whole herbs of P. vittata， as （2R）-acetyl pterosin B （Ⅰ）， palmitic acid （Ⅱ）， hop-22（29）-ene （Ⅲ）， epifriedelanol （Ⅳ）， lupenone （Ⅴ）， olean-18-en-3-one （Ⅵ）， stigmasterol （Ⅶ）， β-sitosterol （Ⅷ）， 22-hydroxyhopane （Ⅸ）， ergosterol （Ⅹ）， β-sitosterol acetate （Ⅺ）. CONCLUSIONS： Compounds Ⅰ-Ⅶ and Ⅸ-Ⅺ are isolated from this plant for the first time， and can provide theoretic reference for further studying bioactive pharmacodynamic substances in P. vittata and enriching chemical component data.

Objective To explore the influence of anti-syphilis treatment to pregnant women with lower titer seroresistance on infantile serum,so as to provide the guidance for clinical diagnosis and treatment.Methods Totally 134 cases of pregnant women with lower titer syphilis serofast reaction were divided into treatment group (75 cases) and untreated group(59 cases) according to whether received anti-syphilis treatment during their pregnancy.The change of syphilis serology toluidine red unheated serum test (TRUST) and Treponema pallidum particle assay (TPPA) for the two groups mothers and babies were compared.Results (1) The first detection of TRUST titers between the two groups of pregnant women did not show statistically significant difference (x2 =0.520,P ＞ 0.05).(2) Among the 134 neonates,20 cases(14.9％) were negetive for both TRUST and TPPA,23 cases (17.2％) were Treponema pallidum particle assay(TPPA) positive only,91 cases (67.9％) were positive for both TRUST and TPPA and showed lower or equivalent TRUST titers compared to their mothers,without significant differences between the two groups(x2 =0.892,P ＞ 0.05).(3)In the two groups of babies with the same TRUST titers,the seroreversion time of TRUST showed no significant differences(P =0.229,0.309,1.000).The negative time of TRUST in infants with neonatal higher titer was later than those with neonatal lower titer in the two groups (all P ＜ 0.05).The infant with TRUST + showed longer duration than those with neonatal TRUST-in TPPA seroreversion(all P ＜ 0.05).The seroreversion time of TPPA in infants with neonatal TRUST titer of 1:4 in untreated group was later than that in treatment group[(14.1 ±1.4)months vs.(12.5 ±1.1)months,t =2.900,P =0.010].Conclusion The treatment for mothers with lower titer seroresistance in pregnant period had no influence in the positive rate of TRUST and TPPA in the neonates and seroreversion time of TRUST in infant.It may have certain effect to shorten the seroreversion time of TPPA in infant with high TRUST titer by the treatment.

Objective To investigate the mortality risk factors of nosocomial infection patients in intensive care unit (ICU), and to guide clinicians to take effective control measures. Methods A retrospectively cohort study was conducted. The relevant information of patients with nosocomial infection treated in ICU of Hengshui Harrison International Peace Hospital Affiliated to Hebei Medical University from June 2009 to December 2015 was analyzed. The patients who admitted to ICU again, with length of ICU stay less than 48 hours, without first etiology of screening within 48 hours of ICU admission, or without complete pathogenic information were excluded. The gender, age, diagnosis, length of ICU stay, invasive operation, nutritional status, acute physiology and chronic health evaluation Ⅱ (APACHEⅡ) score, sequential organ failure assessment (SOFA) score, distribution and drug resistance of the pathogens, and procalcitonin (PCT) levels at 7 days after nosocomial infection were recorded. The risk factors leading to death in patients with nosocomial infection were analyzed by logistic regression, and the receiver operating characteristic curve (ROC) was drawn to evaluate the predictive value of all risk factors on the outcome of patients with nosocomial infection. Results In 864 enrolled patients with male of 54.75% and mean age of (63.50±15.80) years, 732 (84.72%) patients survived and 132 (15.28%) died. Compared with survivors, the non-survivors had higher age (years: 65.47±15.32 vs. 58.15±13.27), incidence of urgent trachea intubation (32.58% vs. 22.81%), deep venous catheterization (83.33% vs. 63.25%), and multiple drug-resistant infection (65.91% vs. 33.20%), longer length of ICU stay (days: 13.56±4.29 vs. 10.29±4.32) and duration of coma (days: 7.36±2.46 vs. 5.48±2.14), lower albumin (g/L: 23.64±8.47 vs. 26.36±12.84), higher APACHEⅡ score (19.28±5.16 vs. 17.56±5.62), SOFA score (8.55±1.34 vs. 6.43±2.65), and PCT (μg/L: 3.06±1.36 vs. 2.53±0.87, all P < 0.05). There was no significant difference in gender and urinary tract catheterization between survivors and non-survivors (both P > 0.05). The low respiratory tract was the most common site of infection followed by urinary tract and bloodstream in both groups. It was shown by logistic regression analysis that prolonged ICU stay [odds ratio (OR) = 2.039, 95% confidence interval (95%CI) = 1.231-3.473, P = 0.002], APACHEⅡ score (OR = 1.683, 95%CI= 1.002-9.376, P = 0.000), SOFA score (OR = 2.060, 95%CI = 1.208 -14.309, P = 0.041), PCT (OR = 2.090, 95%CI = 1.706-13.098, P = 0.004), and multi-drug resistant pathogens infection (OR = 5.245, 95%CI = 2.213-35.098, P = 0.027) were independent risk factors for ICU mortality in patients with nosocomial infection. The area under ROC curve (AUC) of length of ICU stay, APACHEⅡ score, SOFA score, and PCT level for predicting death of nosocomial infection patients was 0.854, 0.738, 0.786, and 0.849, respectively, the best cut-off value was 16.50 days, 22.45, 6.37 and 3.38 μg/L, respectively, the sensitivity was 83.6%, 90.0%, 81.1%, and 89.6%, and the specificity was 70.3%, 75.6%, 71.3%, and 85.4%, respectively. Conclusions Prol onged ICU stay, nosocomial infection with secondary sepsis and multiple organ dysfunction syndrome were the leading causes of death for nosocomial infection patients in ICU. Prolonged ICU stay, APACHE Ⅱ score, SOFA score, and PCT level could effectively predict death risks for nosocomial infection patients.

Objective To analyze the isolation rates and antimicrobial resistance of Acinetobacter baumannii (AB) from intensive care unit (ICU)between 2010 and 2013,and provide evidence for clinical anti-infective therapy. Methods The isolation and antimicrobial resistance of AB from ICU between 2010 and 2013 were analyzed retro-spectively.Results A total of 1 413 pathogenic strains were isolated,556(39.35%)of which were AB,isolation rates in each year were 39.45%,41 .35%,29.44%,and 40.53% respectively.AB were mainly isolated from lower respiratory tract (75.72%).Antimicrobial susceptibility testing results showed that AB had low resistance rates to cefoperazone/sulbactam(5.85%)and amikacin (17.45%);detection rates of multidrug-resistant and extensively drug-resistant AB increased from 9.63% and 3.70% to 42.50% and 31 .88%,respectively (both P < 0.001 ). Conclusion AB is the common pathogen in ICU,antimicrobial resistance is serious,isolation of multidrug-resistant and extensively drug-resistant AB increased year by year;intensifying the monitoring of drug resistance is helpful for the treat-ment and prevention of AB infection.

Objective To develop a nursing network teaching platform gathered teaching, learning, interaction, inspectors, feedback and other advantages. Methods We designed and developed a network teaching platform to support the course learning of ‘Fundamental Nursing’, and questionnaire 72 Grade 2012 bachelor of nursing students to assess the effects of the network teaching platform. Results The network teaching platform acquired a high score of educational, scientific and usable aspects (3. 59 ± 0. 58), (3. 61 ± 0. 57) and (3. 58 ± 0. 60) among 72 students, as well as a high score at second-level indictor of assessment items. Conclusions The network teaching platform can broaden student′s knowledge reserve, and enhance autonomous initiative learning and quality of nursing education, so it achieves the predictive target.

Objective To study the feasibility, safety and clinical application value of LRH, comparing with abdominal radical hysterectomy (ARH) . Methods A total of 80 patients' clinical data were collected to analyze the development of LRH in Yunnan Tumor Hospital while compared with another 40 patients between June 2012 to June 2013 of ARH for some associative indexes. Results The patients were divided into group A and B equally.Compared with Grope A, the time of operation decreased 26.9%, 37.2% has been augment for lymph gland sweeping, the amount of bleeding and intraoperative complication reduced 37.3% and 7.5% in Grope D, respectively, with distinctive difference ( >0.05) .Hospitalization expenses had a small degree reduced but no distinctive difference.The learning curve of LRH was 40 approximately.Comparison between LRH and ARH in the same period showed that LRH was more splendid than ARH in several index.1 case relapsed in 2-48 months follow-up in ARH while no relapse in the other group. Conclusion LRH is safe and feasible and has good prospects in clinical application and deserves clinical generalization because of its advantages such as less trauma,less pains, quick recovery,less scars and aesthetical appearance.

ObjectiveTo observe the effects of chemotherapy on mitochondria ultrarnicrostructure and stereological characteristic of mucinous cystadenocarcinoma (MC) and serous cystadenocarcinoma (SC) and to investigate clinical significance and possible mechanism of chemotherapy on two cystadenocarcinoma.MethodsThe ultramicrostructure changes of mitochondrion were observed with electronic microscope and the stereological changes and its interrelation of volume density (Vv), surface density (Sv) and ratio of surface density(Rsv,μm-1)of mitochondria of the cells in ovarian carcinoma were studied and compared with the normal control. ResultsElectron microscope reveals that the mitochondria swelling and cristae disorganizing were seen in ovarian carcinoma.The Vv(0.072±0.059)and Sv(0.057±0.040)of MC mitochondria were decreased markedly(P =0.004 and P =0.029, respectively), while its Rsv (0.891 ±0.400) μm-1 increased obviously (P =0.015); but the Vv and Sv of mitochondria of the SC cells were increased markedly (0.267±0.12,P =0.001 and 0.122±0.057,P =0.003,respectively).After chemotherapy,cancer cells mitochondrion Sv elevated significantly (0.060±0.037, P = 0.053), showing a similar MC mitochondria of variability. Conclusion Therearedifferentcharacteristicsintheultramicrostructureandstereologicalcharacteristicinthe mitochondria of two types ovarian carcinoma. Effects of chemotherapy may be associated with the ameliorate of construction and function of ovary cells.

Objective To investigate the expression of c-jun in precancerous lesion and squamous cell carcinoma tissues of hamster buckle pouch mucosa.Methods The models of premalignant and malignant lesions were established in hamster buckle pouch mucosa induced with DMBA.The expressions of c-jun in 23 oral normal mucosa, 22 abnormal epithelial hyperplasia and 29 oral squamous cell carcinoma (OSCC) were measured with immunohistochemical SABC method.Results c-jun mainly expressed in basal cells and prickle cells in normal mucosa,simple and abnormal epithelial hyperplasia,its positive expression was in nucleus.c-jun expressed mainly in various layer cells of OSCC,its positive expression was in nucleus and cytoplasm.There were significant differences of positive expression rate between various groups(?2=13.71,P