Objective The changing patterns of pathogenic isolates and antibiotic susceptibility in Chongqing's neonates between 2010 and 2015 were investigated for the purpose to provide evidence for rational use of antibiotics and control of nosocomial infections.Methods The distribution of pathogenic bacteria and antibiotic susceptibility were analyzed.Identification and antibiotic susceptibility testing were carried out using BD Phoenix 100 automated system and the conventional Kirby-Bauer method.The results were interpreted in accordance with the breakpoints of the Clinical and Laboratory Standards Institute.Results A total of 10 569 pathogenic bacterial strains were isolated during the period,most of which were gram-negative bacteria (80.8 ％,8 540/10 569),primarily Klebsiella pneumoniae (29.3 ％),followed by Escherichia coli (16.7 ％),Acinetobacter baumanmii (9.9 ％),Enterobacter cloacae (8.6 ％) and Pseudornonas aeruginosa (3.3 ％).Gram-positive strains accounted for 14.1％ (1 490/10 569),mainly Staphylococcus aureus (7.8％),Staphylococcus epidermidis (2.2 ％),and Staphylococcus haemolyticus (1.8 ％).Imipenem and meropenem showed high activity against Enterobacteriaceae (＜ 10％ resistant),followed by P.aeruginosa (＞ 10 ％ resistant),and A.baumannii (＞20％ resistant).The prevalence of carbapenem-resistant strains was 8,4 ％ in K.pneumoniae and 2.9 ％ in E.coli isolates,No gram-positive isolates were resistant to vancomycin,teicoplanin or linezolid.Conclusions K.pneumoniae was the most frequently isolated pathogen in the neonates treated in Children's Hospital of Chongqing Medical University.The prevalence of A.baumannii isolates is increasing.Carbapenem-resistant Enterobacteriaceae strains are emerging.

Objective To study the influencing factors which will lead to depression in patients undergoing orthopedic operation and put forward reasonable nursing countermeasures. Methods 198 patients with orthopaedic operation were investigated using the self-rating depression scale (SDS),social support rating scale (SSRS) and self-designed questionnaire.The influencing factors underwent Logistic regression analysis. Results 105 cases of patients with depression were found among 185 cases,accounting for 56.8％,and 70 cases(66.6％) with mild depression,30 cases(28.6％) with moderate depression,5 cases (4.8％) with severe depressive disorders.SDS score before operation was (37.59 ± 8.74),higher than (33.46 ± 8.55 ) of the national norm.Single factor and multiple factors Logistic regression analysis revealed that paying out-of-pocket for healthcare,worrying about poor prognosis,worrying about the diagnosis and treatment level,considering bad attitude of medical staff were main influencing factors for depression,while social support is a good way to protect patients against depression. Conclusions To cope with the serious depression of orthopedic patients,medical staff should take certain measures to improve patients' psychological quality,so as to achieve the purpose of improving their physical quality.

Objective To evaluate the effects of recombinant human hematopoietic synergistic factor (rhHSF) on rapid mobilization of the peripheral blood stem cells. Methods 8 monkeys were divided into rhG-CSF 10?g/(kg?day) and rhG-CSF 10?g/(kg?day) + rhHSF 500?g/(kg?day) group, with 4 monkeys in each group. All of them received rhG-CSF subcutaneously once daily for 4 days, and in the latter group, the animals received rhHSF subcutaneously in single dose on the fifth day. Results The highest counts of CD34~+ cell, CFU-GM and neutrophils in animals receiving rhHSF only were 23, 1.8 and 3.3 times of baseline value at 180, 45 and 60 min, while those in animals receiving rhG-CSF and rhHSF were 41.3, 8.3 and 4.9 times of base line value. Conclusion rhHSF can rapidly mobilize hematopoietic stem cells and neutrophils into peripheral blood, and it is found to synergize with G-CSF to augment stem cell mobilization, suggesting a potent clinical utility of rhHSF in peripheral blood stem cells transplantation.

Objective To explore the value of MSCT enhanced scanner in diagnosis and differential diagnosis of spleen tumor. Methods The MSCT enhanced feautures of 23 cases of spleen tumor proved by imaging examination,follow-up and pathologically were anlayzed retrospectively,the features of MSCT enhanced scanner in spleen tumor were analyzed.Results All cases included 12 benign tumor (5 cysts,6 hemangiomas,1 lymphangioma).1 1 malignant tumor(2 primary lymphomas,3 secondary lymphomas,6 metastatic tumors).Conclusion MSCT enhanced scanning for the qualitative diagnosis of spleen tumors with high value.

Objective To investigate the association between the systolic/diastolic orthostatic hypotension (OH-S/OH-D) and myoeardial infarction (MI) in the elderly.Methods Health screening physical examination were carried in 1081 subjects without MI aged over 65 years in Guangzhou Military region.The orthostatic blood pressure and heart rate were measured in supine position after resting for more than 5 minutes and at 0 and 2 minutes after standing.All the cases were divided into systolic or diastolic group on the basis of definition of orthostatic hypotension and followed up by telephone or inpatient medical records with mean period of 315.8 days.The primary endpoint was MI occurrence.Results The prevalence of OH in this cohort was 24.5％ ( OH-S/OH-D:19.3％/17.2％ ).Significant differences in the occurrence of OH and OH-S were found in the elderly and the very elderly subjects( ≥80 years) (26.1％ vs 20.1％,P=0.045; 21.0％ vs 14.6％,P =0.018),while no difference was found in OH-D.The prevalence of MI in the OH positive subjects was significantly higher than that in the OH negative subjects,as well as in OH-S or OH-D group.After adjustment of age,supine blood pressure,creatinine and cerebrovascular history by logistic regression,the association was observed between MI and OH ( HR 15.635,95 ％ CI 3.299-74.091,P=0.001),OH-S(HR 8.760,95％CI2.487-30.851,P=0.001)and OH-D(HR 3.889,95％ CI 1.097-13.790,P =0.035 ).Conclusion OH-S and OH-D hypotension are robust predictors for MI in the elderly.

OBJECTIVE: To investigate the incidence rate of the ampC gene and AmpC enzyme of gram-negative(G-) bacterium in children,to analyze drug resistance of produced AmpC enzyme and un-produced AmpC enzyme strain.METHO_DS: 4 022 clinical G-isolates collected from 2002 to 2004 were identified and tested using K-B method.Selection 108 ESBLs bacterium,the ampC genes were amplified by PCR using common primers to AmpC and the AmpC enzymes were tested using the enzymatic rough extraction cefoxitin three-dimensional test.The drug resistance of bacterium produced AmpC enzymes were compared with the ones without AmpC enzymes.RESULTS: In 108 G-bacterium,the ampC genes positive bacterium were 70 strain(accounting for 64.8%),and 7 bacterium produced AmpC enzymes(accounting for 6.5%) were detected.The drug resistance of bacterium produced AmpC enzymes to ceftazidime(CAZ),ceftriaxone(CRO),piperacillin(PIP),ampicillin(AMP),aztreonam(ATM) were 85.7%,85.7%,71.4%,79.4%,79.4% respectively.The drug resistance of bacterium non-produced AmpC enzymes to CRO,PIP,gentamicin,AMP,ATM were 50.8%,55.6%,55.6%,70.3%,54.0% respectively,the drug resistance of bacterium to imipenem were the lowest,lower to ciprofloxacin.CONCLUSIONS: Detection rate of ampC gene were higher than AmpC-producing enzymes strains obviously,whereas the drug resistance to antibiotic of AmpC-producing enzymes strains were higher than non-producing enzymes strains.

OBJECTIVE:To discuss ward drug control to ensure safe.METHODS:We analyzed retrospectively the application of 5S theory in ward drug control.RESULTS & CONCLUSION:By this drug control mode,drugs were classified according to varieties,usage,frequency of use etc,drug control quality and work efficiency were enhanced,patients' needs could be satisfies and staff' s professional quality was enhanced.

2h.The shape of bacterium was changed by amikacin from sphero-rhabditiform to dolicho-rhabditiform,while by ceftriaxone changed from rhabditiform to long-chain-form or filament-form.Conclusion The capability of ceftriaxone-induced release of endotoxin from Escherichia coli is significantly stronger than that of amikacin,and the morphologic changes of bacteria caused by ceftriaxone were more significant.For clinical treatmentg of infectious diseases the first dosage of medication should increase to reach the effective bactericidal concentration but not the bacteriostasis concentration in order to receive better therapeutic effects.

Objective To investigate the effect of Shenmai injection in treating elderly with orthostatic hypotension. Methods The total of 97 cases of patients with orthostatic hypotension were randomly divided into 2 groups, which was injected intravenously with 100 mL Shenmai injection once daily as the treatment group, with 100 mL glucose as the control.The treatment lasted 14 days. The clinical symptom score, the difference of blood pressure, the P￣selectin, and the platelet maximum aggregation were measured. Results Compared with the control, Shenmai injection significantly reduced the clinical symptom scores of patients (P<0.05), lowered the difference of blood pressure for upright and supine significantly (P<0.05), decreased the platelet maximum aggregation and P￣selectin remarkably (P<0.05). Conclusion Shenmai injection significantly reduces the difference of blood pressure for upright and supine of the elderly with orthostatic hypotension, and inhibits the activities of platelets, thus improves the clinical symptoms.

Objective To describe the profile of patients with infective endocarditis (IE) and assess prognostic factors of IE.Methods Clinical and etiology data of 218 patients with IE were collected retrospectively from January 2011 to January 2013.The distribution and antimicrobial susceptibilities of pathogens causing IE were evaluated.Prognostic factors associated with IE were determined by univariate and multivariate regression analysis.Results There were 148 men and 70 women with age of (46.0 ± 14.6)years.Ninety-five (43.6％) of them had heart diseases,including 72 cases (33.0％) of congenital heart disease and 23 cases (10.6％) of chronic rheumatic heart disease.Vegetations were detected by echocardiography in 171 (78.4％) patients.Microorganisms causing IE were identified in 84 cases (38.5％) cases.Streptococcus viridans was the dominant pathogen,accoumed for 63.1％ of all the pathogens,followed by Staphylococcus (13.1％) and Enterococcus (4.8％).Totally 7/11 Streptococcus viridans was susceptible to penicillin,while 100％ susceptible to the third and fourth generation cephalosporins,vancomycin and linezolid.One hundred and eighty cases underwent operations.The in-hospital mortality rate of IE was 3.2％.In univariate regression,health care-associated infection,prosthetic valve,anemia and chest symptoms (distress or pain) were related to the increased risk of mortality in patients with IE,while surgery appeared to be a protective factor.In the logistic regression model,the variables significantly associated with IE prognosis were health care-associated infection (OR =17.03,95％ CI 1.76-164.75,P =0.014) and anemia (Hb ＜ 90 g/L) (OR =13.47,95％ CI 2.46-73.60,P =0.003) and surgery treatment (OR =0.17,95％ CI 0.03-0.97,P =0.047).Conclusions Although Streptococcus viridans is the most common pathogen causing IE,the pathogens of IE become versatile.The antibacterial activity of penicillin against Streptococcus viridans is low.Health care-associated infection and anemia are risk factors of IE prognosis,while surgery treatment is a protective factor of severe IE.