Objective To investigate the distribution and drug resistance of pathogens isolated from blood culture samples from January 2012 to October 2013 to provide the basis for clinical lection of antibacterial drugs.Methods The blood samples were col-lected from the patients with suspected blood infection and cultured by the BD BACTEC 9120 automatic blood culture instrument. The samples with positive results were performed the bacterial identification and the drug sensitivity test by using the VITEK-2 COMPACT automatic bacterial identification instrument.Results A total of 969 strains of pathogens were isolated from blood cul-ture samples,including 540 strains(55.7%)of Gram-positive bacteria,413 strains(42.6%)of Gram-negative bacteria and 16 strains (1.7%)of fungi.The top 3 isolated pathogenic bacteria were Staphylococcus epidermidis,Escherichia coli and Staphylococcus au-reus.Staphylococcus epidermidis and Staphylococcus aureus were highly resistant to penicillin,sensitive to vancomycin and linezol-id;Escherichia coli and Klebsiella pneumoniae were highly sensitive to imipenem and Piperacillin/tazobactam.Conclusion It is nec-essary to understand the blood culture results timely so as to provide the basis for clinical antibacterial therapy and the improvement of the cure rate.

Objective: To explore the relationship between the ratio of neutrophil/lymphocyte (NLR) and in-hospital major adverse cardiac events (MACE) in patients with acute ST-elevation myocardial infarction (STEMI) at early admission.
Methods: A total of 420 acute STEMI patients admitted and received primary PCI in our hospital from 2010-01 to 2014-12 were retrospectively studied. The patients were divided into 2 groups:In-hospital MACE group, n=47 and Normal discharged group, n=373. Uni-and multivariate analyses were conducted to assess whether high NLR is the independent predictor for in-hospital MACE occurrence.
Results: Univariate regression analysis indicated that the occurrence rate of in-hospital MACE in high NLR patients were higher than those in low NLR patients (OR=3.19, 95%CI 1.55-2.65, P=0.012). Multivariate regression analysis showed that high NLR was the independent risk factor for in-hospital MACE occurrence in STEMI patients (OR=3.05, 95%CI 1.59-10.54, P=0.015).
Conclusion: High NLR is the independent risk factor for in-hospital MACE occurrence in STEMI patients at the early admission.

Objective To analyze a population of cells on the right lower lateral of monocyte population in forward scatter/side scatter(FSC/SSC)(X-axis/Y-axis)scatterplot of peripheral blood leucocyte by flow cytometry(FCM)and its influencing factors.Methods The type of cells were identified based on cluster of differentiation antigen(CD)by FCM.The impact of temperature,hemolysin concentration,and incubation time was evaluated.Blood lipid tests were performed to observe the relation between them by statistical methods.Results (1) Phenotypo of this population of cells on the right lower lateral of monocytes in FSc/SSC scatterplot is CD+45 CD+13 CD+14 CD3- CD-19 ,which was the same as monocyte cells:(2)The monocytes in FSC/SSC scatterplot shifted to left side after using haemolysin;(3)The monocytes showed less resistance to antihemolysin in 37℃ than that in 220C:There were more monocytes shifting to left side with the increase of haemolysis time:(4)The swarming ratio of monocytes in patients (31.5%,40/126) Was higher than it in normal controls (5.1%,5/98)(x2=22.74,P<0.01);(5)The levels of total serum cholesterol(TC),triglyeride(TG),low density lipoprotein cholesterol(LDL-C), apoprotein B100(Apo B100) in patients with swarming monocytes were lower than that in the patients without swarming monocytes,(P<0.05).There was no statistical significance between the two groups with respect to levels of total bilirubin(TBIL),albumin(Alb),hish density lipoprotein cholesterol(HDL-C),apoprotein A I(Apo A I),lipoprotein(Lpa).Conclusions Peripheral blood monocytes can be divided in two groups in FSC/SSC scatterplot when analyzed with FCM.The presence of this population of cell Was related to resistance to hemolysin.It can be influenced by haemolysis time and incubation temperature.Therefore,the effect of swarming monocytes and abnormal cell membrane should be taken into consideration when the markers and function of monocytes are detected by FCM.

Objective:To observe the therapeutic effect of recombinant human brain natriuretic peptide (rhBNP)on patients with cardiorenal syndrome.Methods:The data of 75 patients,who were diagnosed as cardiorenal syndrome and hospitalized in our hospital,were retrospectively analyzed.They were randomly divided into routine treatment group (n=40,received routine treatment)and rhBNP group (n=35,received rhBNP based on routine treatment) according to number table method.The rhBNP was pumped with 0.0075μg·kg-1 ·min-1 using micropump intrave-nously,once/day,about 10h/time and 7d was regarded as a course of treatment.Changes of 24h urine volume,N terminal pro brain natriuretic peptide (NT-proBNP),glomerular filtration rate (GFR)and echocardiograph were recorded in all patients before and 7d after treatment.Results:Compared with routine treatment group after treat-ment,there were significant increase in total effective rate (62.5% vs.94.3%),24h urine volume [(785.2 ± 143.4)ml vs.(965.34±171.8)ml],GFR [(34.1±2.6)ml/min vs.(45.2±5.6)ml/min]and left ventricular e-jection fraction [(35.6±5.5)% vs.(45.9±6.8)%],and significant reduction in NT-proBNP level [(3451.1± 1314.2)pg/ml vs.(1516.43 ± 431.52)pg/ml]in rhBNP group,P<0.01 all.Conclusion:Recombinant human brain natriuretic peptide is safe,effective and can improve renal function in treating patients with cardiorenal syn-drome.

The relevant policies of national essential medicine system were reviewed, major concerns and actions in the implementation of essential medicine system in Shanghai were introduced, and the suggestions to improve the implementation of essential medicine system of Shanghai were made. These provided the information for policy making and provided a useful experience for facilitating the establishment of essential medicine system and the improvement of its implementation in Shanghai as well as China.

Adult ; Female ; Humans ; Hyperlipoproteinemia Type II ; complications ; Ventricular Fibrillation ; complications

Objectives:To report the clinical experience of combined interventional procedures in the treatment of elderly patients with coexisting two or more cardiovascular diseases in our medical center, and to assess the feasibility, safety and therapeutic efficacy of this management strategy. Methods : Patients were selected to the study if: 1) age ＞65 years; 2) with coexistence of two or more cardiovascular diseases which are indications for interventional therapy; 3) patients' general condition and organ functions allow the performance of combined multiple procedures; 4) the predicted procedure time is within 150 min; 5) the predicted contrast medium dosage is within 300 ml. The criteria we analyzed included procedural type, rocedural time, fluoroscopy time, dosage of contrast medium, success rates of the procedures, complications and in-hospital mortality. All patients were followed up for 30.4 ± 9.3 months,to determine the all-cause mortality, recurrence rates and adverse cardiac events. Results : From January 2000 to December 2004,combined interventional procedures were performed on 136 patients, with 2 procedures on 134 patients and 3 procedures on 2 patients.The mean procedure time was 115.4±11.6 min, the mean fluoroscopy time was 35.7±9.3 min, and the mean dosage of contrast medium used was 183.6±19.4 ml. Procedural success rate was 100%, no procedure related death or major complications occurred.Conclusion: Performed by a competent team, combined interventional procedures in elderly patients with multiple cardiovascular diseases were feasible and relatively safe.

To evaluate the feasibility, safety and efficacy of percutaneous stent implantation for treating left main coronary artery (LMCA) stenosis. Methods Consecutive patients with unprotected left main coronary artery disease treated by stent-based percutaneous intervention (PCI) at 6 medical centers in China were enrolled. Procedural data and clinical outcomes were obtained from all patients. Results From January 2001 to December 2004, 138 patients (79 males and 59 females; mean age: 69.7±5.8 years)underwent PCI for LMCA stenosis. Bare metal stents (BMS) were implanted in 51 patients with non-bifurcational lesions and in 5 patients with bifurcational lesions from January of 2001 to June of 2003 (BMS group);. Drug eluting stents (DES) were used unselectively to cover both bifurcational and non-bifurcational lesions in 86 patients from July of 2003 to December of 2004 (DES group). Procedural success rate of the 138 cases was 98% (135/138). One patient (0.7%) with bifurcation lesion who was treated with DES died from severe heart failure 2 weeks after the procedure. During a mean follow up period of 21.3 ± 5.6 months, one patient died from renal failure, one from sudden cardiac death, 4 underwent target lesion revascularization (TLR) in the BMS group, which all occurred in patients with bifurcational lesions; whereas in the DES group no deaths occurred and only one patient with bifurcational lesion had TLR. Conclusions (1) PCI is feasible and relatively safe to treat unprotected left main coronary artery disease in elderly patients at medical centers with experienced professionals. (2) BMS and DES have similar immediate and long-term efficacy in the treatment of ostium and shaft lesions of the LMCA. (3) DES are strongly suggested in the therapy of distal bifurcation lesion of unprotected LMCA.