Based on a correct understanding of the related concepts and system of the evaluation of human resources for military medical sciences ( EHRMMS), this thesis established a three-dimension model of EHRMMS that is composed of the evaluation goal, evaluation subject and evaluation object, and analyzed the factors that affect the crucial parameters in the model.We also analyzed the features and regularity of the evaluation model, and tentatively explored the application of the model.

Objective To establish a military disease prevention and control website to achieve dissemination of disease control information , resource sharing , business communication in the whole army , and popularize relevant knowledge of disease prevention and control promotion among the troops .Methods Based on the content management system and meta-data repository platform,B/S system architecture, JSP,MySQL and other programming techniques and tools were used to complete the system development .Results The military disease prevention and control website we designed has been for-mally launched ,which was able to implement a set of functions such as content distribution , full-text retrieval ,classification and aggregation of knowledge , online consultation .Conclusion This website plays a positive role in enhancing military prevention and control ,popularizing relevant laws and regulations ,meeting the health needs of the army soldiers and impro-ving the ability of disease prevention in grass-roots units.

OBJECTIVE To investigate the resistance rates of Gram negative bacilli and the distribution of ?-lactamases in hospital infections(HI) or community acquired infections(CAI) in Tongling.METHODS Antimicrobial(susceptibility)(test) was done on 356 strains of Gram negative bacilli isolated in Tongling from Oct 2003 to Sep 2004 by Kirby-Bauer method.The detection of ESBLs and AmpC ?-lactamases was performed by three-dimensional test,MBL by the double-disk synergy test.RESULTS Among total 356 strains of Gram negative bacilli,267 were with HI(53.9%) isolated from sputum of patients,89(34.8%) were(isolated) from CAI patients and urine.The antimicrobial susceptibility rates of Gram negative bacilli from CAI patients was significantly higher than that from HI patients,for Acinetobacter baumannii they were 1.5 to 3.0,for(Pseudomonas aeruginosa) were 1.2 to 1.6.No strains of Escherichia coli and Klebsiella pneumoniae were found resistant to imipenem.Among 356 Gram negative bacilli,77 strains hyperproducing ESBLs and AmpC ?-lactamases,the detection rate was 21.6%, 69 strains were isolated from HI patients,and 8 strains were from CAI patients.From strains resistant to imipenem had 13 strains detected MBL,the detection rate was 52.0%.All of them were isolated from HI patients.CONCLUSIONS The resistance of Gram negative(bacilli) is a serious problem in Tongling.The antimicrobial(susceptibility) rates of Gram negative bacilli from CAI patients are significantly higher than those from HI patients.Gram negative bacilli produce all kinds of(?-lactamases,) such as ESBLs,AmpC(?-lactamases) and MBL.

OBJECTIVE To study the resistance of Acinetobacter baumannii in our hospital and the relation with ADC ?-lactmases.METHODS Antibiotic susceptibility testing was determined by K-B methods to 115 A.baumannii strains,and three dimensional extract testing was performed to detect the ADC ?-lactmases-producing strains,blaADC gene was detected by PCR methods,and the MIC of ceftazidime,et al were determined in the presence of cloxacillin(500 mg/L) in 30 A.baumannii strains detected.RESULTS The resistance to imipenem and cefoperazone/sulbactam was below 10.4%,to other antibiotic resistance was over 54%;the multiresistance strains were 59%.ADC ?-lactmases and blaADC genes were all positive and the MIC of ceftazidime,et al except cefepime was decreased over eight-fold in the presence of cloxacillin for multiresistant A.baumannii,but not for non-multiresistant A.baumannii.CONCLUSIONS The resistance of A.baumannii is very serious in our hospital,ADC ?-lactmases-producing strains are related markedly with the multiresistance of A.baumannii.

OBJECTIVE To investigate the drug-resistant rates of clinical Acinetobacter baumannii strains isolated from our hospital and to understand the integrons distribution carried by A.baumannii.To identify the type of the integrons and analyze the correlation between integron and drug resistance in A.baumannii clinical isolates. METHODS Collected clinical isolates and the drug-sensitivity tests were completed by the method of KB.Amplified integrase were tested by PCR and identified the integron category.Correlation between integron in A.baumannii and drug resistance was analyzed.The open reading frame(ORF) of integron were amplified and observed the polymorphism of integron,Part of amplified products were sequenced. RESULTS Apart from imipenem and cefoperazone /sulbactam,the drug-resistant rate of 85 A.baumannii clinical isolates to else 15 kinds of antibacterials surpassed 30.0%.67.1% A.baumannii clinical isolates carried the integrons,and confirmed all of them belonged to integron Ⅰ after identification,but integrons Ⅱ and Ⅲ were not found.The drug-resistant rates of A.baumannii with integron to 14 kinds of antibacterials were higher than those of A.baumannii without integron.The length of amplified products in variable region of ORF of integron varied from 0.15 to 2.5 kb.The sequencing results confirmed the integron carried multidrug-resistant gene code. CONCLUSIONS Drug-resistant rate of A.baumannii clinical isolates in our hospital is higher and the majority of them are multidrug-resistant strains.The drug-resistant rates of A.baumannii with integron to 14 kinds of antibacterial are higher.The multidrug-resistant A.baumannii is associated with integrons.

Objective To evaluate clinic efficacy and safety of tigecycline combined with cefoperazone/sulbactam for treatment of intracranial infection with drug-resistant Acinetobacter baumannii (DRAB).Methods 12 patients with DRAB intracranial infection admitted in a department of neurosurgery between January 2014 and April 2015 were analyzed retrospectively,clinic efficacy and safety of tigecycline combined with cefoperazone/sulbactam for treatment of DRAB intracranial infection were evaluated.Results After patients received tigecycline combined with cefoperazone/sulbactam for 12-62 days (39.5 days on average), clinical symptoms and signs (including body temperature,signs of meningeal irritation)of most patients were significantly improved compared with before treat-ment,3 cases were cured,5 were markedly effective,4 abandoned or ineffective(death).The overall effective rate was 66.67%(8/12),mortality was 33.33% (4/12);bacterial clearance rate of cerebrospinal fluid (CSF)was 83.33%(10/12).Causes of death:2 were with failure of brain stem following craniocerebral trauma,1was extensive parenchymal infection,1was recurrence of intracranial infection and formation of brain abscess after withdrawing an-timicrobial agents.No significant adverse reaction occurred during the treatment period.Conclusion On the basis of keeping CSF drainage unobstructed,long course treatment of tigecycline combined with cefoperazone/sulbactam can effectively eliminate DRAB from CSF,and has a good safety.

Objective To investigate the effects of artesunate (AS) on septic lung injury in mice and to study the modulation of heme oxygenase-1 (HO-1) in lung in order to clarify the mechanism of AS action.Methods Sixty male Kunming mice were randomly (random number) divided into four groups: Sham group (n =15), CLP group (n =15), AS + CLP group (n =15) and AS + ZnPP + CLP group (n =15).Cecal ligation and puncture (CLP) method was employed to induce septic lung injury.AS (15 mg/ kg) was injected into the abdomen of mice 2 hours before the CLP procedures, and ZnPP Ⅸ, an inhibitor of HO-1, was intraperitoneally injected in dose of 40 μmol/kg 1 hour after the AS injection.The equivalent volume of normal saline was intraperitoneally injected instead in mice of Sham group and CLP group.The mice were sacrificed 24 hours after the CLP procedures.The TNF-α, IL-6 in serum were assayed by ELISA method.The lung injury score and wet/dry ratio were measured.The western blotting and immunohistochemistry methods were used to determine HO-1 protein expression in lung tissue.The protein level of nuclear factor-E2-related factor-2 (Nrf-2), an important transcriptional factor of HO-1 in lung tissue was also analyzed by western blotting.One-way analysis of variance (ANOVA) was used for comparisons among the groups, and SNK-q (Student-Newman-Keuls) test was performed for further comparison, and difference was statistically significant at P ＜ 0.05.Results The TNF-α (pg/mL) (54.37 ± 15.59 vs.627.45 ± 117.03, P ＜ 0.05), IL-6 (pg/mL) (81.53 ± 26.89 vs.898.52 ± 222.78, P ＜ 0.05) in serum was increased, and the lung protein exudation, pulmonary edema (wet/dry weight ratio: 4.27 ± 0.22 vs.6.78 ±0.73, P ＜ 0.05), pulmonary pathology injury (lung injury score: 2.20 ± 0.2 vs.13.25 ± 2.67, P ＜ 0.05) were aggravated by CLP.The HO-1 and Nrf-2 were up-regulated in lung tissue in CLP group compared with the sham group (P ＜ 0.05).After the intervention of AS, the HO-1 and Nrf-2 were further increased (P＜0.05), theTNF-α (pg/mL) (627.45 ±117.03 vs.307.88 ±72.33, P＜0.05), IL-6 (pg/mL) (898.52 ± 222.78 vs.413.47 ± 115.14, P ＜ 0.05) in serum, lung protein exudation, pulmonary edema (wet/dry weight ratio: 6.78 ± 0.73 vs.5.05 ± 0.61, P ＜ 0.05), pulmonary pathology injury (lung injury score: 13.25 ± 2.67 vs.4.95 ± 1.46, P ＜ 0.05) were attenuated compared with the CLP group.However, the protective role of AS in the septic lung injury in mice was partly reversed by ZnPP, and no significant difference was detected between the AS + CLP + ZnPP and CLP group (lung injury score: 12.15 ± 2.95 vs.13.25 ± 2.67, P ＞ 0.05;wet/dry weight ratio: 6.78 ± 0.73 vs.6.29 ± 0.82, P ＞ 0.05).Conclusions AS plays protective roles in septic lung injury, and it is attributed to limiting lung inflammation via up-regulation of HO-1.

Objective To investigate the bacterial resistance profile of clinical isolates collected in Tongling area . Methods Antimicrobial susceptibility test was conducted by Kirby‐Bauer method . All the data were analyzed with WHONET 5 .6 software .Results A total of 3 419 clinical isolates were collected during 2013 ,of which gram negative organisms and gram positive organisms accounted for 75 .9% and 24 .1% .MRSA accounted for 41 .3% of S .aureus and MRCNS accounted for 73 .5% of coagulase negative Staphylococcus ,respectively .MRSA showed higher resistance to gentamicin ,ciprofloxacin , erythromycin and rifampicin . No vancomycin‐ or teicoplanin‐resistant strains of Staphylococcus spp . were found . No vancomycin‐or teicoplanin‐resistant strains of E . f aecalis and E . f aecium were found .About 51 .6% of E .coli isolates and 42 .8% of K . pneumoniae isolates produced extended‐spectrum β‐lactamases (ESBLs ) . The prevalence of imipenem‐ or meropenem‐resistant strains of K . pneumoniae increased significantly .The percentage of P . aeruginosa strains resistant to amikacin ,piperacillin‐tazobactam ,ciprofloxacin ,cefepime and cefoperazone‐sulbactam was lower than 20 .0% .The percentage of A .baumannii strains resistant to cefoperazone‐sulbactam , minocycline and amikacin w as 34 .7% ,57 .0% and 58 .3% , respectively . More than 68 .0 % of A . baumannii strains were resistant to any of the other antibiotics tested . Conclusions The antibiotic resistance is growing in clinical bacterial isolates .The spread of carbapenem‐resistant strains of K . pneumoniae in some departments poses a serious threat to clinical practice .We should pay more attention to resistance surveillance and rational use of antibiotics .

Objective To investigate the bacterial resistance of clinical isolates collected in Tongling area during 2011.Methods Antimicrobial susceptibility testing was conducted by Kirby-Bauer method.All the data were analyzed by WHONET 5.5 soft-ware.Results A total of 2 690 clinical isolates were collected during 2011,of which gram negative organisms and gram positive organisms accounted for 74.2% and 25.8%,respectively.MRSA and MRCNS accounted for 45.1% of S.aureus and 71.6%of coagulase negative Staphylococcus,respectively.MRSA and MRCNS showed higher resistance to gentamicin,ciprofloxacin and erythromycin than the corresponding methicillin-susceptible strains.No vancomycin- or teicoplanin-resistant strain of Staphylococcus spp.was identified.The resistance rate to penicillin,nitrofurantoin and fosfomycin was low in E.faecalis.No ampicillin-,vancomycin-or teicoplanin-resistant strains were found.For E.faecium,some strains were resistant to vancomy-cin and teicoplanin.About 46.6% of E.coli isolates and 27.7% of Klebsiella isolates produced extended-spectrumβ-lactamas-es (ESBLs).No imipenem-or meropenem-resistant isolate was found.The percentage of P .aeruginosa strains resistant to imipenem,meropenem and amikacin were 29.5%,36.9%and 2.3%, respectively. More than 60.0% of the Acinetobacter strains were resistant to all the antibiotics test-ed except minocycline and cefoperazone-sulbactam,to which 26.4% and 12.5% of the strains were resistant.Conclusions No glycopeptides-resistant isolate was found in gram positive organisms except E.faecium.The resistance rate of Enter-obacteriaceae isolates was lower to imipenem,meropenem, cefoperazone-sulbactam,piperacillin-tazobactam and amika-cin.The prevalence of resistant strains is still increasing,es-pecially carbapenem-resistant P .aeruginosa and carbapenem-resistant A.baumannii.It is mandatory to take effective antibiot-ic policy and infection control measures.