Distribution and drug resistance analysis of carbapenems-resistant Klebsiella pneumoniae / 中华全科医师杂志

Objective To investigate the clinical distribution and drug resistance of carbapenemsresistant Klebsiella pneumoniae (CRKP).Methods A total of 134 clinical strains of CRKP were collected from inpatients in our hospital from January 2014 to December 2016.VITEK-2 compact automatic microbiological analyzer was used to identify the bacteria and the supporting gram-negative bacterial drug susceptibility card was used for susceptibility testing.The sensitivity of other clinical commonly used antimicrobial agents was measured by K-B method.And the clinical distribution of CRKP and its resistance to antimicrobial agents were investigated and analyzed.Results The clinical strains of CRKP were isolated mainly from urine (n=70,52.2％) and sputum (n=38,28.4％).Klebsiella pneumoniae was identified in samples from the department of neurosurgery,including neurosurgery ICU (47.8％,64/134),ICU (23.9％,32/134),department of hepatobiliary surgery (8.2％,11/134) and department of urology (6.0％,8/134).Among all 22 antimicrobial agents tested,the resistant rates of CRKP to 16 antimicrobial agents were ＞90％,especially for ampicillin it was 100％,and those to 19 antibiotics were ＞80％,only for tigecycline it was 23.1％.There were 16 strains of CRKP with positive extended spectrum β-lactamases (ESBLs) (11.9％).All the CRKP strains were resistant to more than three kinds of antimicrobial agents,except one strain that was resistant to two kinds.Conclusion There is a wide range of clinical distribution of CRKP,which is resistant to most of antimicrobial agents,while tigecycline still has a strong antibacterial activity to CRKP.

Clinical application of high-frequency electric snare in treatment of airway neoplasm / 中国内镜杂志

Objective To investigate the clinical efficacy and safety of high-frequency electric snare for the treatment of main airway neoplasm through bronchoscopy. Methods The clinical datas of 18 patients from July 2013 to April 2016, who had main airway neoplasm and were treated with high-frequency electric snare through bronchoscopy, were retrospectively analyzed. Meanwhile, the interventional bronchoscopic techniques partly included argon plasma coagulation and cryoablation. After operarion, the relief of symptoms and complications were observed. Results After operarion, the clinical symptoms, shortness of breath, dyspnea index score and the degree of airway stenosis were improved significantly. No serious complications such as massive hemoptysis occurred in all patients. Conclusion High-frequency electric snare is an effective and safe approach for the treatment of main airway neoplasm.

Effect analysis of setting up full-time visiting nurses in emergency transfusion room / 中国实用护理杂志

Objective To explore the effects analysis of setting up full-time visiting nurses in emergency transfusion room. Methods The transfusion adverse events, patient satisfaction and quality control score of patients before and after setting up full-time visiting nurses were analyzed through setting up the post of full-time visiting nurses in emergency transfusion room. Results Compared with the posts without full-time visiting nurses, the adverse events of infusion decreased from 0.61% (200/32728) to 0.18%(48/26470),χ2=63.762,P<0.05,and the patient satisfaction score increased from 91.33 ± 1.21 to 95.67 ± 1.37, t=10.277, P<0.05, and the quality control score was increased from 91.00 ± 1.55 to 96.50 ± 1.38, t=12.845, P<0.05. Conclusions Setting up full- time visiting nurses can strengthen the management of transfusion and satisfy the needs of patients' life and treatment. It is an important guarantee to reduce the risk of transfusion, ensure the safety of infusion and improve the satisfaction of patients.

Effect analysis of setting up full-time visiting nurses in emergency transfusion room / 中国实用护理杂志

Objective To explore the effects analysis of setting up full-time visiting nurses in emergency transfusion room. Methods The transfusion adverse events, patient satisfaction and quality control score of patients before and after setting up full-time visiting nurses were analyzed through setting up the post of full-time visiting nurses in emergency transfusion room. Results Compared with the posts without full-time visiting nurses, the adverse events of infusion decreased from 0.61% (200/32728) to 0.18%(48/26470),χ2=63.762,P<0.05,and the patient satisfaction score increased from 91.33 ± 1.21 to 95.67 ± 1.37, t=10.277, P<0.05, and the quality control score was increased from 91.00 ± 1.55 to 96.50 ± 1.38, t=12.845, P<0.05. Conclusions Setting up full- time visiting nurses can strengthen the management of transfusion and satisfy the needs of patients' life and treatment. It is an important guarantee to reduce the risk of transfusion, ensure the safety of infusion and improve the satisfaction of patients.

Effect of eletroacupuncture for Z syndrome without organic lesion and serum leptin / 中国针灸

<p><b>OBJECTIVE</b>To explore the effect and mechanism of electroacupuncture (EA) for Z syndrome without organic lesion (metabolic syndrome combined with obstructive sleep apnea hypopnea syndrome).</p><p><b>METHODS</b>Fifty-eight patients with Z syndrome were divided into three groups according to mild,moderate and severe degree. Acupuncture and EA were used at Daimai (GB 26), Zhongwan (CV 12), Xiawan (CV 10), Zusanli ST 36), Qihai (CV 6) and Huaroumen (ST 24), etc., once a day and five times a week. The treatment of ten times was a course, and two courses were acquired continuously. Sleep respiration monitoring (PSG) was done before EA and in one week after treatment respectively. Triacylglycerol (TG) fasting blood glucose (FBG) fasting insulin (INS) and serum leptin (Lep) were tested before and after treatment in the three groups.</p><p><b>RESULTS</b>After treatment apnea hypopnea index (AHI) and the percentage of the time of arterial oxygen saturation (SaO₂) less than 90% taken in the total sleep time (SLT 90%) were improved apparently than those before treatment in the three groups (all P < 0.05). The levels of TG, FPG, INS and Lep were decreased after treatment in all groups (all P < 0.05).</p><p><b>CONCLUSION</b>EA can improve AHI and nocturnal hypoxia of Z syndrome, and the mechanism may be related to decreasing the indices of metabolism syndrome and leptin.</p>

Effect evaluation of different ways of taking magnesium sulfate on bowel preparation prior to performing intravenous pyelography examination / 中国实用护理杂志

Objective To analyze optimal amount of drinking water,ways of drinking water,timelimit of drinking water on the effect of bowel preparation for intravenous pyelography (IVP) examination after oral administration of 50% magnesium sulfate 60 ml. Methods 200 patients who gave their consentfrom June 2009 to February 2010 drank 50% magnesium sulfate 60 ml for IVP check were divided into four groups. Group A: a large amount of graded oral administration of warm water 1200 ml within 1h; Group B: a small amount of oral administration of warm water 1200 ml within 1h;Group C: a large amount of graded oral administration of warm water 2000 ml within 1h; Group D: a medium amount of graded oral administration of warm water 1200 ml within 2 h. And then the bowel preparation effect of the four gro ups were analyzed. Results Through the comparison, group A was much better than the other groups on the aspects of cathartic satisfaction, the effective degree of reading films and flatulence. Conclusions To take a large amount of graded oral administration of warm water 1200 ml within 1h can improve cathartic satisfaction,the effective degree of reading films and flatulence.