OBJECTIVE To investigate the epidemic situation of nonfermentative bacteria in lower respiratory tract infection and guide rational use of antimicrobials.METHODS API system was applied for bacterial identification.K-B disk diffuse method was used in susceptibility testing.WHONET 5.3 software was used for data analysis.Pseudomonas aeruginosa,Acinetobacter baumannii and Stenotrophomonas maltophilia isolates were included in this study.RESULTS Less than 20% of P.aeruginosa isolates were resistant to amikacin,imipenem or cefoperazone/sulbactam.For A.baumannii,the most active compounds tested were imipenem and cefoperazone/sulbactam with resistance rates of 4.8% and 7.3%,respectively.26.6% And 27.4% of A.baumannii isolates were resistant to piperacillin/tazobactam and ticarcillin/clavulanic acid.The resistance rate of S.maltophilia to cefoperazone/sulbactam,ticarcillin/clavulanic acid and piperacillin/tazobactam was 0,2.7% and 10.8%,respectively.CONCLUSIONS The isolation rate of nonfermenters is increasing in the lower respiratory tract infection,and the ways to improve the cure rate are to avert nosocomial infection and choose antimicrobials properly.

Two rare cases of calcitoninoma (C cell AP0Doma)were diagnosed by electronmi-croscopic and immunohistochemical evidence though the histopathological findings had failed to sstablish.Bath cases rac^ivad operative tr^atinsnt and recovery was uneventful.The diagnosis is consistent with the follow-up observation so far.Patient A had retroperitoneal and hepatic multiple calcitoninoma and patient B suffered from ectopic thyroid medullar carcinoma.Well differentiated calcitoninoma cells contained special APUD granules which were spherical, membrane bound and measured 300-700nm in diameter.The characteristic APUDamyloid was found in neoplastic cells of palient A, but not in all cells.Patient B had three types of endocrine cells, though the tumor was mainly made up of C cells.Calcitonin-producing C cells were present clearly in two cases with double PAP method.Diagnosis, clinical treatment and the origin of calcitoninoma are discussed.The authors emphasize that electron microscopic and immunohistochemical examinations are important in the diagnosis of APUDoma, and good results might be obtained by early operative treatment.

Objective To improve our knowledge by analyze the image findings of stromal tumor at small intestine.Methods The image findings in 23 cases with pathological-proved small intestinal stromal tumor were retrospectively analyzed as follow:image examine with GI(11 cases),DSA(2 cases),B-us(13 cases) and CT(all cases).Results The tumors originated from the duodenum(n=5),jejunum(n=11) or ileum(n=8).Found by GI(n=2),DSA(n=2),B-us(n=12) and CT(n=21).The lesions were mainly round or oval in shape.On plain CT scans,the tumors showed low-density centrally with isodensity peripherally(n=17),or homogeneous isodensity(n=4),or cystical low-density(n=2).On enhanced CT scans,moderate or marked enhancement was seen in most cases.Conclusion It has some spacial findings by image examination about small intestinal stromal tumor,include:well-defined margins,markedly enhancement,no metastases to local lymph nodes and the common clinical symptoms.CT and B-us are the mainly examination,therefore,a confirmed diagnosis relies on the pathological examination.

Objective To study the relative factors of concomitant depression after stroke.Methods Using Geriatric depression Scale(GDS) and SSS,we scored 121 storke cases who were treated from January 2001 to December 2001, in which 54 cases were concomitant with depression, assessed defect and promotion degree of nervous function, and observed relationship between number of lesion and onset of depression.Result Incidence of depression of cerebral hemarrhage patients was apparently higher than that of cerebral infarction patients (P< 0.05), there was no apparent difference in lesion location and concomitant depression (P >0.05), incidence of concomitant depression of stroke patients with multiple lesions was apparently higher than that of stroke patients with single lesion.Conclusion Concomitant depression of stroke patients is related to location, number of lesions and severity of stroke.

Objective To observe the relationship between visual-spatial perception impairment and the characteristics of asymptomatic cerebral infarction (ACI). Methods After evaluating the cognitive impairment of 112 patients with ACI using the Revised Visual Retention Test (VRT), we compared the result of VRT test among different groups grouped by number, size and location of the cerebral infarction. Results The total score of the patients with ACI with correct answers in VRT was significantly lower than that of the controls (14.5?3.2 vs 22.8?3.3, P

After signs of risk have been happened in risk management of medical equipment at present, reports are taken step by step. So there is a report not timely, incomplete information, it is difficult to monitor, and many other problems. With the improvement of risk management requirements; the development of the information technology s apply, and increasing sources of information used for risk early warning analysis. This paper analyzes the requirement of risk management, and proposes a total solution of enterprise risk early warning based on EAI. It will make managers accurately and fully grasp the risks, find risk signs timely, speed up the response to risk.
Materials Management, Hospital ; Risk Management

Based on the analysis of the present status of medical devices management, this paper optimized management process, developed a medical devices management system with Web technologies. With information technology to dynamic master the use of state of the entire life-cycle of medical devices. Through the closed-loop management with pre-event budget, mid-event control and after-event analysis, improved the delicacy management level of medical devices, optimized asset allocation, promoted positive operation of devices.
Equipment and Supplies ; Management Information Systems ; Materials Management, Hospital

ObjectiveTo investigate the relationship between life meaning and life satisfaction among university students.MethodsTotally 473 university students were investigated with The Purpose In Life Test and Life Satisfaction Scale.Results ( 1 ) The scores of life satisfaction and positive affection in highcr levels of life meaning were significantly higher than those in the lower levels of life meaning( (4.53 ± 1.04)vs(3.38 ± 0.98 ),(2.89 ±0.88)vs(2.04 ± 1.07) ) among the university students(F=27.806,P＜0.01 ; F=13.635,P＜ 0.01 ),however the higher levels of life meaning were significantly lower than the lower levels of life meaning ( ( 1.09 ± 1.12 ) vs ( 2.45 ± 1.41 ) ) in negative affection (F =21.513,P ＜ 0.01 ).( 2 ) The students' life satisfaction was negatively correlated with escape( r=-0.336,P＜0.01 ).The others factors of life meaning were positively correlated with life satisfaction ( r =0.285 ～ 0.380,P ＜ 0.01 ).The negative affection was negatively correlated with life meaning( r =-0.121 ～ -0.335,P ＜ 0.05 ).(3)The escape had significantly negative prediction on life satisfaction and positive affection ( β =-0.133 ～ -0.179,P ＜ 0.05 ).The life of goals and the life of passion had significantly positive prediction on life satisfaction and positive affection ( β =0.170 ～ 0.206,P ＜ 0.05 ).Conclusion Life meaning of the university students is closely related to life satisfaction,the higher levels of life meaning can upgrade individual life satisfaction.

OBJECTIVE To investigate the existance of class Ⅰ gene integron and transposon(merA and tnpA) gene marker in Escherichia coli isolated from the elderly patients.METHODS Antibiotic sensitivity was performed by microdilution test.Integron gene IntⅠ1 and transposon marker genes were detected by polymerase chain reaction(PCR).The PCR products were purified and sequenced.RESULTS E.coli resistant to amikacin accounted for 60%,to sulfamethoxazole 95%,and to third-generation cephalosporin 100%(all ESBLs-producing strains).The resistance was related closely to the class Ⅰ integron.The positive rate of integron intⅠ1 was 80%(16/20),whereas the positive rate of gene merA was only 10%(2/20).Gene tnpA was not tested out.CONCLUSIONS The drug resistance of E.coli has close relation with transmission of integron and transposon.The transposons of Tn21/Tn501 are all firstly reported in China.

Objective To evaluate the feasibility and indications of endoscopic submucosal dissection (ESD) by analyzing the early gastric cancer cases.Methods All the pathological materials of radical gastric resections in Huashan hospital from 2007 to 2011 were retrieved and the EGC cases were selected.All the cases in EGC group which met the extended ESD criteria were reviewed.Extended ESD criteria were cited from Treatment guidelines for gastric cancer in Japan edited by JGCA in 2001.The risk factors relevant with regional metastasis,such as invasive depth and differentiation degrees,were also analysed.Results In the recent five years,there were 1159 cases of gastric cancer undergoing radical gastrectomy in Huashan hospital including 210 EGC.According to the extended criteria of JGCA,151 cases could be candidates for ESD while 126 cases could be candidates for ESD according to the typical criteria for ESD.The local metastases of lymphatic or vascular involvement for mucosa cancer,muscularis mucosae cancer,sm1 and sm2 cancer were 6.75％,15.00％,23.25％,and 39.62％ respectively (P ＜0.05).Twenty-five cases had local metastases that met the extended criteria for ESD.Within the 210 EGC cases,the local metastases of differentiated type and undifferentiated type were 13.95％ and 47.37％ respectively (P ＜ 0.05).Conclusion Most EGC cases undergoing radical gastrectomy can be cured by ESD.Its metastases are highly correlated with invasion depth and differentiation,so indications of ESD should be assessed.