Objective To investigate antibiotic resistance of Pseudomonas aeruginosa isolated from the patients'specimens in the hospital ,the carrying rate of integronⅠ and insertion sequences common area(ISCR)and provide reference for clinical treatment . Methods 106 isolates of Pseudomonas aeruginosa were collected and their bacterial antibiotic resistance and clinical distribution were analyzed by using WHONET5 .6 software .PCR and electrophoresis were used to screen integronⅠ and ISCR carried by the target strains .Results Clinical isolates of Pseudomonas aeruginosa mainly collected from department of pulmonary disease which accounted for 48 .11% ,and sputum specimens were the major source of the 106 isolates ,which accounted for 73 .58% .The sensitiv‐ities of Pseudomonas aeruginosa to tobramycin ,amikacin ,gentamicin were about 85% ,while to imipenem only 65 .09% .The carry‐ing rate of integronⅠ and ISCR in Pseudomonas aeruginosa was 84 .91% and 76 .42% ,respectively .Conclusion Pseudomonas aeruginosa distribution of hospital departments mainly concentrate in pulmonary department and the major type of specimen is spu‐tum .The sensitivity of Pseudomonas aeruginosa to aminoglycoside antibiotic is relatively good .IntegronⅠand ISCR in Pseudomonas aeruginosa could be associated with antibiotic resistance .

Objective To understand the pathogenic distribution and drug resistance in the patients with blood infections in our hospital to provide reference for the empirical medication of blood infections .Methods The cases of blood infections in our hospital during the period 2012-2014 were performed the retrospective investigation .The BD Bactec blood culture system was adopted to conduct the blood culture .The bacterial strain identification and susceptibility test was conducted by using the Microscan Walkaway 40 and the data were analyzed by adopting the WHONET5 .6 software .Results The top four of department distribution in blood infections were the digestive system department ,lung diseases department ,orthopedic department and surgery department ,account‐ing for 25 .20% ,19 .60% ,14 .70% and 10 .50% respectively .The pathogens were mainly Gram negative bacteria ,and the top three were Escherichia coli ,Klebsiella pneumoniae and non fermenting bacteria ,accounting for 44 .10% ,13 .30% and 7 .69% respective‐ly .The top three of Gram positive bacteria were coagulase negative staphylococci ,Staphylococcus aureus and Enterococcus ,account‐ing for 12 .58% ,9 .09% and 7 .69% respectively .The positive rates of ESBL in Escherichia coli and Klebsiella pneumoniae were 45 .5% and 60 .8% respectively .The detection rate of methicillin resistant coagulase negative staphylococci (MRCNS) was 55 .5% , which of methicillin-resistant staphylococcus aureus (MRSA) was 58 .0% .Conclusion The cases of blood infections in our hospi‐tal come from different wards areas ,and the digestive system department is in the majority mostly .The pathogenic bacteria are dom‐inated by Gram negative bacteria ,and the treatment should rationally use the antibacterial drugs according to the bacteria drug re‐sistance situation .

OBJECTIVE:To observe the effects and side effects of recombinant erytropoietin(rEPO)on patients with anemia in chronic renal failure(CRF).METHODS:128 patients with anemia in CRF had been given rEPO by subcutaneous injection for12weeks,the clinical effects were observed by own control method.RESULTS:Excellence cases amounted 91,efficacy cases33,and the overall efficacy rate was96.88%;The side effects included hypertension,coagulation in dialysis machine,pain in injection site and head,no severe adverse drug reactions were found;No degradation in renal function was found in non-dialysis patients during the medication.CONCLUSIONS:rEPO could improve anemia in CRF safely and effectively.

BACKGROUND: Several studies have demonstrated that many American women who are at high risk of developing osteoporosis have higher levels of serum phosphorus. This indicates that some substances which can lower the serum level of phosphorus will supply a new and effective method to prevent and treat osteoporosis.OBJECTIVE: To observe the influences of porcine bone protein on bone mineral density (BMD) and serum levels of calcium and phosphorus in a rat model of osteoporosis.METHODS: Wistar rat models of osteoporosis were established by intramuscular injection of dexamethasone. Rat models were randomly divided into physiological saline, Jiegu Qili tablet, 50, 100, 200 mg/kg porcine bone protein groups. Rats that did not receive any treatments served as normal controls. After 12 weeks of treatment, serum was collected and serum levels of phosphorus and calcium were determined by biochemistry method. At the same time, tibia sections were made to determine tibial DMD by QDR-400 dual energy X-ray absorptiometry and to observe tibia marrow cavity by hematoxylin-eosin staining.RESULTS AND CONCLUSION: There was no significant difference in serum level of calcium among groups (P＞0.05).Compared with the physiological saline group, serum level of phosphorus in the 50, 100, 200 mg/kg porcine bone protein groups was significantly decreased (P ＜ 0.05). BMD was significantly higher in the 50, 100, 200 mg/kg porcine bone protein, Jiegu Qili tablet groups than in the physiological saline group (P ＜ 0.05). The tibia marrow cavity was smallest in the normal control group and largest in the physiological saline group. The tibia marrow cavity was larger in the 50, 100, 200 mg/kg porcine bone protein,Jiegu Qili tablet groups than in the physiological saline group. These results indicate that porcine bone protein cannot change the serum level of calcium, but it lowers serum level of phosphorus, and increases BMD, in a rat model of osteoporosis. However, the dose-dependent effect of porcine bone protein was not observed within the present experimental dosage. In addition, porcine bone protein can also reduce the marrow cavity of the tibia of rats with osteoporosis.

Objective To investigate the changes of major causes of death in patient with dermatomyositis/polymyositis (DM/PM) and the factors affecting the mortality of DM/PM in the past 28 years.Methods Death cases with DM/PM from 1985 to 2013 were retrospectively analyzed.x2 test and Fisher exact test was used for count data analysis;independent samples t-test measurement was used for data analysis;P＜0.05 was consi-dered statistically significant.Results Out of 1 443 patients with DM/PM, 74 died, in whom 48 were female and 26 were male.The mortality rate was 4.7％ among female and 6.3％ among male cases and the total in-hospital mortality of DM/PM was 5.1％.The two most common causes of death in patients with DM/PM were infection and respiratory involvement, accounting for 62.2％ (46/74) and 14.9％ (11/74) respectively.Death occurred most commonly in the first year after disease onset, accounting for 79.7％(59/74).The leading causes of death in the first year were infection and respiratory involvement.The mortality of DM/PM patients was peaked 12.3％(18/146) from 1996 to 2000;infection was the most frequent cause of death.Conclusion Infection and respiratory involvement are the main causes of death in DM/PM.Death occurrs most commonly in the first year after disease onset.

Objective Immune and inflammatory mechanisms could play a significant role in genesis or progression of interstitial lung disease and pulmonary arterial hypertension,especially in patients with connective tissue diseases.Specific antibodies may predict the occurrence of this condition.Methods The plasma of patients with systemic sclerosis(SSc)or mixed connective tissue disease(MCTD)were screened with enzyme linked immunoserbent assay(ELISA)and Western blotting using recombinant mocsin.The clinical data were recorded and pulmonary function tests(PFTs)were performed in 78 consecutive individuals in order to identify the difference in clinical manifestations between anti-mocsin positive group and negative group.Results Our results showed high titers of anti-mocsin antibodies in 21(53%)of 40 patients with SSc,and 15(39%)of 38 patient with MCTD.The presence of anti-moesin antibodies was significantly correlated with pulmonary involvement(ILD and PAH)in SSc and MCTD patiens(P=0.001).Comparing with the antibody negative group,the total lung capacity[(82±10)% vs(90±14)%,P=0.027),forced vital capacity [(76±13)% vs(85±17)%,P=0.040]and diffu-sing capacity of the lung for carbon monoxide[(58±16)% vs (72±23)%,P=0.014]of PFTs in anti-moesin antibodies positive group were noted to be significantly decreased(P＜0.05).Conclusion Specific antibodies to moesin is prevalent in patients with SSc and MCTD,so it may be an early predictor of pulmonary involvement in patients with SSc or MCTD.

Objective The plasma von Willebrand factor(vWF)level in patients with primary microvascular angina(PMVA)were measured to evaluate the vascular endothelial function of the patients.The change of vWF level in patients after the treatment with Shexiangbaoxin Pill were observeg.Methods Totally 69 patients who were definitely diagnosed as PMVA,They were randomly divided into conventional treatment group(33cases)and ShexiangBaoxin Pill group(36cases).The plasma vWF levels of the two groups were measured before and after treatment.Results The level of vWF before treatment in conventional treatment group was(50.93±32.98)μg/L.The level of vWF before treatment in ShexiangBaoxin Pill group was(27.45±25.02)μg/L.The level of vWF in conventional treatment group after treatment was(49.65±35.12)μg/L.The level of vWF after treatment in ShexiangBaoxin Pill group was(17.37±15.68)μg/L.The difference of vWF decrease in Baoxin Pill group after treatment(10.08±16.47)μg/L,was lower than that in conventional treatment group(1.28±12.37)μg/L,the difference is significant(P<0.05).Conclusion Shexiang Baoxin Pill has the function of protecting vascular endothelium,and PMVA patients can benefit from treatment.

BACKGROUND: Perioperative treatment has become an increasingly important aspect of the management of patients with non-small cell lung cancer (NSCLC). Small-scale clinical studies performed in recent years have shown improvements in the major pathological remission rate after neoadjuvant therapy, suggesting that it will soon become an important part of NSCLC treatment. Nevertheless, neoadjuvant immunotherapy may be accompanied by serious adverse reactions that lead to delay or cancelation of surgery, additional illness, and even death, and have therefore attracted much attention. The purpose of the clinical recommendations is to form a diagnosis and treatment plan suitable for the current domestic medical situation for the immune-related adverse event (irAE). METHODS: This recommendation is composed of experts in thoracic surgery, oncologists, thoracic medicine and irAE related departments (gastroenterology, respirology, cardiology, infectious medicine, hematology, endocrinology, rheumatology, neurology, dermatology, emergency section) to jointly complete the formulation. Experts make full reference to the irAE guidelines, large-scale clinical research data published by thoracic surgery, and the clinical experience of domestic doctors and publicly published cases, and repeated discussions in multiple disciplines to form this recommendation for perioperative irAE. RESULTS: This clinical recommendation covers the whole process of prevention, evaluation, examination, treatment and monitoring related to irAE, so as to guide the clinical work comprehensively and effectively. CONCLUSIONS Perioperative irAE management is an important part of immune perioperative treatment of lung cancer. With the continuous development of immune perioperative treatment, more research is needed in the future to optimize the diagnosis and treatment of perioperative irAE.