OBJECTIVE To investigate the bacterial distribution and antibiotic resistance situation with urinary tract infection(UTI) for the guidance of rational use of antibiotics.METHODS The antibiotic resistance of clinical isolates from urinary tract infection from Mar 2005 to Jul 2006 was analyzed. RESULTS The most common pathogens in urinary tract infection were Escherichia coli(50.2%),Enterococcus(14.4%),Staphyloccus aureus(8.7%),Klebsiella pneumoniae(7.3%),and Proteus mirabilis(3.9%).E.coli,K.pneumoniae,and P.mirabilis were found to be highly resistant to ampicillin,quinolones and SMZ(70.6-100.0%).Enterococcus were highly resistant to penicillin and quinolones(81.0-96.8%).41.4% of E.coli and 31.3% of K.pneumoniae isolates produced ESBLs.HLGR-Enterococcus were 79.4%.78.9% S.aureus isolates were resistant to oxacillin.CONCLUSIONS The high antibiotic resistance of commonly encountered pathogens is a serious problem and much attention should be paid to detect pathogens and their antibiotic resistance.

Objective:To observe the effect of tuina manipulations on blood pressure and its variability in hypertension patients. Methods:Forty hypertension patients were randomized into an observation group and a medication group, 20 cases in each group. The observation group was intervened by tuina manipulations of kidney-tonifying blood-circulating and collaterals- unblocking in addition to regular medication, while the medication group was by the same medication. The 24-hour blood pressure monitoring was performed before intervention and after 3-month intervention. The blood pressure and its variability were observed and compared. Results:There were no significant differences in comparing the blood pressure and blood pressure variability between the two groups before intervention (P>0.05); after 3-month intervention, the blood pressure and its variability were significantly improved in both groups (P<0.05); the improvements in the observation group were more significant than those in the control group (P<0.05). Conclusion:Tuina manipulations of kidney-tonifying blood-circulating and collaterals-unblocking plus medication can produce a better effect than regular medication in promoting blood pressure and its variability, and this method is worth applying in clinic as it’s easy-to-operate and has no adverse effect.

Objective To analyze the distribution and drug resistance characteristics of pathogenic bacteria isolated from blood cultures in the infected patients in our hospital during 2009-2013 to provide the newest evidence for the clinical anti-infection ther-apy.Methods The bacterial identification and drug susceptibility test were performed by applying the VITEK-32 System.The dis-tribution situation and the drug susceptibility test results of pathogens isolated from blood culture specimens in our hospital during this period were analyzed.Results 2 301 strains of positive bacteria were isolated from 14 006 cases of blood culture during these five consecutive years.The positive rate was 16.4%.Among them,1 303 strains were Gram positive bacteria(56.6%),954 strains of Gram negative bacilli(41.5%)and 44 strains of fungi(1.9%).Gram-positive bacteria were mainly Staphylococcus aureus,coagu-lase negative staphylococci(CNS),etc.Gram-negative bacteria were mainly E.coli,Klebsiella pneumoniae,etc.E.coli and Klebsiella pneumoniae were highly sensitive to carbapenem,amikacin,cefoxitin and antibacterial drugs containing enzyme inhibitor.The detec-tion rates of extended-spectrumβ-lactamase(ESBL)-producing Escherichia coli and Klebsiella pneumoniae were 55.8% and 18.4%respectively.Acinetobacter baumannii in blood culture had serious resistance to most of antibacterial drugs.Conclusion The kinds of pathogens isolated from blood culture are complex with different sensitivity to antibacterial drugs.Timely understanding the re-sults of blood culture has the important significance to adjust the treatment scheme in clinic and timely discover drug-resistant strains for serve clinic better.

Objective　To investigate the association betwee n the β3-adrenergic receptor gene (β3-AR) and obesity. Methods　147 patients with obesity and 106 controls were selected. Genotype of the β 3-AR was determined by polymerase chain reaction (PCR) and restriction fragme nt length polymorphism methods (RFLP). Body mass index (BMI) was detected. Results　The frequency of Arg64 allele of β3-AR gene in the obesit y g roup (20.3%) was significantly higher than those in the control group (10.2%) ( P=0.001) . The distribution of Trp64Arg and Arg64Arg genotype in the patient group (38.7% and 0.9%) were both higher than that in the control group (19.0% and 0.7%). In the female subj ects, the Trp64Arg mutation and frequency of Arg64 allele of the β3-AR gene in the obesity group(40.6% and 20.3%) were also higher than those in control (16 . 7% and 9.5%)(P<0.01). Conclusions　These results suggest th at the Trp64Arg mutation of the β3-adrenergic-receptor gene may be associat ed with increased body fat.

Objective This work was to study the distribution of Acinetobacter baumannii and analyze the change in the trend of its resistance,so as to provide experimental basis for clinical rational drug usage.Methods The identification of isolates were car-ried out by using VITEK-2 compact automatic identification system,and drug susceptibility testing was performed by disc diffusion method,the results were carried out according to the Standard of CLSI 2014 version for interpretation,and data analysis was per-formed with WHONET5.6.Results A total of 981 strains of Acinetobacter baumannii had been isolated from the samples in 2013 to 2015,most of them were isolated from respiratory samples accounted for 80.4%,followed by the urines and other body secre-tion.The distribution of this kind of bacteria mostly was 30.1% in ICU,departments of Emergency observation(16.0%),respirato-ry diseases(15.7%)and senior cadres(10.8%).The drug resistance of this kind of bacteria to polymyxin B and cefoperazone/sul-bactam was to a minimum of lower than 5.0%,and has relatively high sensitivity to amikacin and minocycline(<30.0%).And the resistance to other antimicrobials were higher than 30.0%,and the resistance to Nitrofurantoin and cefotaxime were higher than 94.0%.The most drug resistance of Acinetobacter baumannii in 2014 were lower than those in 2013,but the most drug resistance of Acinetobacter baumannii in 2015 were increased significantly as well as strains had been isolated from the samples.Conclusion The main source for isolation of Acinetobacter baumannii in this hospital mainly comes from sputum specimens of patients in ICU, departments of emergency observation,respiratory diseases and senior cadres.The high prevalence of antimicrobial resistance of this kind of bacteria should be prevented and controlled in nosocomial infection,and rational application of antimicrobial agents in order to reduce the spread of drug-resistant strains.

Objective To investigate the clinical application significance of flow cytofluroometric(FCM ) antibiotic susceptibility test for A .baumannii in vitro .Methods The sensitivity to Ampicillin/Sulbactam ,Levofloxacin ,Meropenem ,Cefotaxime of an Esch‐erichia coli standard strain and 66 isolates of A .baumannii were tested with FCM by using propidium iodide as a fluorescent probe . The survival rates of the bacteria in the culture after treatment with different dosages of the antibiotics were determined according to the fluorescence strength .The MIC value of the antibiotics against the 66 strains were judged with FCM ,compared with microdi‐lution and VITEK methods .Results The antibiotic resistant strains number of sultamicillin ,levofloxacin ,meropenem and cefo‐taxime sodium were 35 ,30 ,13 and 38 respectively in flow cytofluorometric antibiotic sensitivity test(FCST) of 66 strains of A .bau‐mannii .There was no significant difference(P>0 .05) compared with the antibiotic susceptibility results by the methods of VITEK instrument and microdilution by measuring with χ2 test respectively .Conclusion The established method of FCST for A .baumannii is suitable for dectecting bacterial drug‐sensitivity ,which is more rapid ,accurate and objective .

Objective To investigate the antibiotic resistance of clinical isolates from hospital for the guidance of rational use of antibiotics .Methods Automatic VITEK‐2 system was used to identify bacterial strains and analyze the antimicrobial resistance . WHONET 5 .6 was applied for data analysis according to the breakpoints of Clinical and Laboratory Standards Institute 2013 . Results A total of 3 880 nonduplicate strains were collected in 2013 ,35 .2% (1 366/3 880) of which were gram positive organisms ,64 .8% (2 514/3 880) were gram negative bacteria .The top 6 most frequently isolated microorganisms were E . coli (20 .2% ) , K . pneumoniae (12 .0% ) , P . aeruginosa (11 .1% ) , coagulase negative Staphylococcus (9 .8% ) , A . baumannii (9 .8% ) ,E .f aecalis (8 .1% ) .The bacteria were mainly isolated from respiratory tract (51 .0% ) ,urine (26 .2% ) , and blood (9 .4% ) .The prevalence of both meticillin‐resistant Staphylococcus was higher than 72 .0% .No staphylococcal strainwasfoundresistanttolinezolid,vancomycinortigecycline.Amongthe509Enterococcusisolates,E.faecalisandE. f aecium accounted for 61 .5% and 32 .8% ,respectively .No enterococcal strain was resistant to vancomycin or tigecycline . Enterococcal isolates also showed low resistance (<2 .0% ) to teicoplanin and linezolid .About 67 .4% of the E .coli strains and 32 .0% of the K lebsiella isolates produced extended spectrumbeta‐lactamases.Thestrainsof E.coli,Klebsiella spp.,Enterobacterspp.,and Proteusspp.wererelatively susceptible to beta‐lactam/beta‐lactamase inhibitor combinations such as cefoperazone‐sulbactam and piperacillin‐tazobactam , carbapenems such as meropenem ,imipenem and ertapenem ,and amikacin (< 15 .0% of the strains were resistant) . K . pneumoniae isolates were more resistant than other gram‐negative bacilli .P .aeruginosa was relatively susceptible to amikacin , tobramycin ,cefepime ,gentamicin ,piperacillin‐tazobactam ,but more than 20% of these strains were resistant to meropenem and imipenem .More than 35 .0% of the A . baumannii isolates were resistant to any of the antimicrobial agents tested . Conclusions Antimicrobial resistance is still a serious threat in clinical antimicrobial therapy .It is important to promote the rational use of antimicrobial agents so that resistance is minimized . It is necessary to conduct epidemiological survey and proactively implement effective interventions in the clinical setting with relatively heavy burden of antimicrobial resistance .

Objective To determine the risk factors for emergence agitation (EA) during the recovery period after general anesthesia.Methods One thousand and thirty-four patients of both sexes aged 18-89 yr undergoing general anesthesia were divided into EA group and non-EA group.EA occurring during recovery from general anesthesia was assessed by using Riker sedation-agitation scale.Age,sex,complication,education,medical history,ASA physical status,type and duration of anesthesia and operation,volume of blood loss,fluid replacement,urine volume,duration of stay in PACU,number of drainage tubes and so forth were recorded.Multivariate logistic regression was used to analyze the risk factors for the occurrence of EA.Results Thirty-six patients developed EA during recovery from anesthesia.The incidence of EA was 3.5 ％.Logistic regression indicated that high risk operation,premedication with diazepam,induction of anesthesia without midazolom and fluid replacement during operation were the risk factors for EA (P ＜ 0.05).Conclusion High-risk operation,premedication with diazepam,induction of anesthesia without midazolom and fluid replacement during operation are the risk factors for EA during recovery from general anesthesia.

Coronary Occlusion ; therapy ; Coronary Vessels ; Humans ; Percutaneous Coronary Intervention

OBJECTIVETo study the relationship between the inheritable factor and environmental factors of type 2 diabetes mellitus in humans.

METHODSA case-control study based on 154 type 2 diabetes mellitus and 130 healthy controls was carried out in Jiangsu Province in 1997.

RESULTSThe age, family history of diabetes mellitus, hypertension history, high waist/hip ratio (WHR), high systolic blood pressure, huge fetus history, and the genotype of beta(3)-adrenergic receptor (beta(3)-AR) were the risk factors of type 2 diabetes mellitus; while occupational physical activity was protective factor of type 2 diabetes mellitus. The risk for diabetes mellitus distinctly increased while genetic factor and obesity, beta(3)-AR mutation were coexisting.

CONCLUSIONType 2 diabetes mellitus is caused by the effect of both genetic and environmental factors.

Aged ; Case-Control Studies ; China ; Diabetes Mellitus, Type 2 ; epidemiology ; etiology ; genetics ; Environment ; Female ; Humans ; Logistic Models ; Male ; Middle Aged ; Multivariate Analysis ; Obesity ; Risk Factors