Objective To understand the distribution and change in drug resistance of common pathogens before and after the implementation of special rectification activity on antimicrobial use in 2011-2015,and provide guidance for clinical application of antimicrobial agents.Methods Antimicrobial use in hospitalized patients and pathogens isolated from patients in a hospital from 2011 to 2015 were collected,changing trend of resistance rates of major pathogens to commonly used antimicrobial agents was analyzed.Results From 2011 to 2015,antimicrobial utilization rate in hospitalized patients dropped from 75.84%to 37.35%,antimicrobial use density decreased from 59.53 per 100 patient days to 33.63 per 100 patient days,both showed a downward trend(both P<0.05).A total of 10 091 strains of pathogens were isolated,2 338(23.17%)of which were gram-positive bacteria,7 110(70.46%)were gram-negative bacteria,and 643(6.37%)were fungi.The top five pathogens were Escherichia coli(20.85%),Klebsiella pneumoniae(15.90%),Pseudomonas aeruginosa(11.70%),Staphylococcus aureus(7.35%),and Acinetobacter baumannii(6.82%).Resistance rates of major pathogens to commonly used antimicrobial agents decreased year by year(P<0.05),resistance rates of Escherichia coli and Klebsiella pneumoniae to piperacillin/tazobactam,cefoxitin,and amikacin declined most obviously(all<4%in 2015);compared with Acinetobacter baumannii,Pseudomonas aeruginosa had higher sensitivity to commonly used antimicrobial agents,resistance rates to piperacillin/tazobactam,cefoperazone/sulbactam,ceftazidime,cefepime,amikacin,and ciprofloxacin decreased obviously,resistance rate to above antimicrobial agents was <20%,to carbapenems was higher than other commonly used antimicrobial agents.Resistance rates of Acinetobacter baumannii to amikacin,levofloxacin decreased most obviously,to meropenem and imipenem increased obviously,in 2015 were both above 50%.Resistance rate of Staphylococcus aureus to fluoroquinolones declined most obviously(<2%),vancomycin-resistant strains were not found.Conclusion After the implementation of special rectification activity,resistance rates of common pathogens decreased with the decline of antimicrobial use,rational use of antimicrobial agents may be related to delaying bacterial resistance.

Objective To observe the effects of dietary nursing based on macroscopic and microscopic syndrome differentiation on the compliance, clinical efficacy and quality of life (QOL) of ulcerative colitis patients with damp-heat in large intestine. Methods One hundred and ten cases meeting the diagnostic criteria of ulcerative colitis patients with damp-heat in large intestine were divided into routine group and observation group, 55 cases in each group. Both groups were given oral use of Sulfasalazine Tablets, and routine health education and dietary nursing for ulcerative colitis patients with damp-heat in large intestine. Additionally, the observation group was given dietary nursing based on macroscopic syndrome differentiation and colonoscopic microscopic syndrome differentiation. One month constituted a treatment course. After 6 courses of treatment, the compliance, clinical efficacy and QOL of the two groups were compared. Results (1) The incidence of medication missing or suspension in the routine group was 14.55%, while the incidence of diet missing or suspension in the observation group was 1.82%, the difference between the two groups being statistically significant (P < 0.01). (2) In the routine group, the cure rate was 5.5% and the total effective rate was 81.8%; in the observation group, the cure rate was 12.7% and the total effective rate was 92.7%. The differences between the two groups were statistically significant(P<0.05).(3) The scores of each dimension of QOL scale in the observation group were higher than those of the routine group (P < 0.05) , indicating that the improvement of QOL in the observation group was superior to that of the routine group. Conclusion The compliance, clinical efficacy and QOL of ulcerative colitis patients with damp-heat in large intestine are enhanced after treatment with dietary nursing based onmacroscopic and microscopic syndrome differentiation.

Objective To investigate the effect of choledochoscopic gallbladder-preserving cholecystolithotomy combined with traditional Chinese medicine treatment.Methods A randomized controlled clinical study was conducted to analyze the 91 patients who were treated with choledochoscopic gallbladder-preserving cholecystolithotomy and 92 patients who underwent the same operation combined with subsequent treatment of traditional Chinese medicine.Intraoperative,postoperative and follow-up data were compared between the 2 groups (including operation time,blood loss,the rate of biliary fistula and common bile duct injury during the operation,gallbladder contraction function,the recurrence rate of gallstone,etc).Results In the simple choledochoscopic gallbladder-preserving cholecystolithotomy group,rate of gallstone recurrence was 7.7％ (7/91),the gallbladder wall was (3.5 ±0.6) mm,the gallbladder contraction function was (34.0 ± 3.6)％.However,the comprehensive treatment group,the rate of gallstone recurrence was 1.1％ (1/92),the gallbladder wall was(2.5 ±0.5) mm,the gallbladder contraction function was(48.0 ±4.5)％.There were significant differences between the two groups respectively (P ＜ 0.01,respectively).Conclusion Choledochoscopic gallbladder-preserving cholecystolithotomy combined with traditional Chinese medicine treatment is a safe,feasible,and minimal invasive approach for gallstone,and it can be considered as a alternative treatment of gallstone.

Objective To find out the general features ,drug type ,route of administration DID clinical mani-festation,outcome and so on in DID patients .Methods The statements of drug-induced diseases caused by traditional Chinese medicine and its preparation were collected ( the data provided by Adverse Drug Reaction Monitoring Center of Dongying City ) from 2004 to 2012 in Dongying area ,which would be reviewed and analyzed .Results 3 446 drug-induced disease cases of traditional Chinese medicine preparations were screened out .From 3 446 DID reports in which 603 kinds were involved ,599 kinds of traditional Chinese medicine and 4 kinds of Chinese herbal medicine .The rates of the new and serious DID were high .Conclusion The defense system of the drug-induced diseases caused by traditional Chinese medicine need to be established urgently which is used for collecting ,monitoring and analyzing the data of Chinese medicine drugs to the clinicians ,providing the information of rational use and advisory services by ef-fective ways and management measures ,and providing the basis to modify the specification for pharmaceutical manage-ment and administrative departments .As a result,it can minimize the incidence of drug-induced diseases and maintain the safety of the public takeing medicine .