A strain of extensively drug resistant and KPC-2 carbapenemase-producing Kleb-siella pneumoniae is identified in Dongguan,Guangdong province / 中国感染与化疗杂志

Objective To explore the extensively drug resistant mechanism and clinical treatment strategy of Klebsiella pneu-moniae .Methods The isolate was identified by Vitek2 Compact System.Antimicrobial susceptibility testing was conducted by Kirby-Bauer method.KPC-2 carbapenemase was detected by modified Hodge test.The gene encoding KPC-2 carbapenemase was amplified by polymerase chain reaction (PCR)and then sequenced.Results The strain was resistant to all antibiotics used in routine antimicrobial susceptibility testing except amikacin.Modified Hodge test showed positive result.KPC-2 gene was detected by PCR.The sequence was consistent with that of 11844849 in GenBank.After treatment for one month,no exten-sively drug resistant K.pneumoniae strain was detected from the patient.Conclusions It is necessary to strengthen the monito-ring and improve the awareness of extensively drug resistant K.pneumoniae for better control of such infections.

Hospital quality of care appraisal based on the 2012 medical record front page / 中华医院管理杂志

Objective To explore an evaluation method of quality of care using the 2012 medical record front page.Methods The admission pathway and discharge method information of inpatients discharge recorded in the medical record front pages of the hospital were chosen and evaluated with contingency tables.Results The outcomes indicated that the differences between discharge methods of those admitted through different pathways are significant statistically (x2 =856.55,P ＜ 0.05).The correlation analysis showed that the coefficient of Spearman correlation between the inpatients admitted through different pathways and their discharge methods was -0.11 (P＜0.05).Calculated as such,the score of quality of care was 4.95 for the hospital as a whole.Conclusion The establishment of this evaluation system showed that the indicators set for quality of care using the 2012 medical record front page are scientific,and the results are more objective.

Prospective study of radical resection of breast cancer with preservation of intercostobrachial nerve / 中国医师进修杂志

Objective To explore the clinical significance of preserving the intercostobrachial nerve (ICBN) in the radical resection of breast cancer. Method All of 140 cases of breast cancer with Ⅰ - Ⅲ a stage operable eligible,were randomly divided into the experimental group with 79 cases (7 cases were rejected, 1 case was lost) that patients received radical resection of breast cancer with preservation of ICBN,and the control group with 61 cases (2 cases were lost) that patients received routine radical resection of breast cancer based on the time of admission. Analyzed postoperative local recurrence and compared to sensory dysfunction of the two groups. Results There was no significant difference between the two groups of patients in the rate of postoperative local recurrence [0-4.2% ( 3/71 ) vs. 0-3.4% (2/59)] ( P ＞ 0.05 ). The local sensory disturbance of the experimental group [2.8% (2/71 )-11.3% (8/71)] was significantly lower than the control group [54.2%(32/59)-71.2%(42/59)], there was significant difference between the two groups (P ＜ 0.01 ). Conclusion Radical resection of breast cancer with preservation of ICBN is an ideal operation in breast cancer.