OBJECTIVE To investigate the risk factors of fungal ventilator associated pneumonia(FVAP) and the characteristic of pathogenic fungi.METHODS Thirty seven VAP patients were divided into FVAP group and nonfungal ventilator associated pneumonia(NFVAP) group.Risk factors were compared between the two groups and the characteristic of pathogenic fungi was analyzed.RESULTS Compared to the NFVAP group,the FVAP group showed a significant higher rate in systemic usage of glucocorticosteriod and combined application of antibiotics.The cases of FVAP appeared frequently over the period since 7th to 14th days after intubation.Twelve strains of fungi were isolated from the sputum of patients in FVAP group.Ten strains(83.3%) of the isolates belonged to Candida species included(C.albicans 6 strains(50.0%),C.tropicalis 2 strains(16.7%),C.krusei 1 strain(8.3%),and C.parapsilosis 1 strain(8.3%),and 2 strains(16.7%) of the isolates belonged to Aspergillus.CONCLUSIONS The rate of tracheal intubation should be decreased and the time of mechanical ventilation should be shortened to avoid FVAP.Identifying the strains of fungi and their sensitivity are useful to direct the treatment.

OBJECTIVE To approach to the point of clinical diagnosis and treatment in patients with Chryseobacterium meningosepticum(CM) infection,and test the high sensitivey antibiotic in order to provide evidence for clinical rational drug utilization.METHODS We had retrospectively analyzed the 36 clinical infections with CM during 2003.A microdilution broth method was used to detect the C.meningosepticum MIC and metallo-?-(lactamases-)production.RESULTS C.meningosepticum infections related to the critical underlying diseases,old age,stay in hospital,nosocomial infections and broad spectrum antibiotics use.Metallo-?-lactamases-producing accounted for 100% in all CM isolates.CM were susceptible or partly susceptible to VAN,CTX/CA,PIP/SU,CFP/SU,PIP,CIA,PIP which were 100%,100%,91.7%,88.9%,86.1%,72.2%,and 44.4%,respectively.The(susceptibility) to other 21 kinds of antimicrobials were in 8.3%.CONCLUSIONS CM is multi-drug resistant.The main risk factors of CM infection are old age,long-term in hospital,critical underlying disease,and decreased immunological function.VAN,CTX/CA,PIP/SU, CFP/SU,PIP,CIA,and PIP are the effective antibiotics(against) CM.

Objective:To assess the effectiveness of peer-supported diabetes self-management group intervention and explore a community-based diabetes health management model.Methods:From September to December in 2016, patients with type 2 diabetes were recruited from 6 streets (townships) in Binhu and Xishan district of Wuxi, Jiangsu Province. According to a structured diabetes self-management course, guidance was provided by community health workers and peer volunteers. Self-management group intervention was led by type 2 diabetes patients. A self-control design was used to collect information on self-management behavior, fasting blood glucose, and health care utilization at baseline and after 4-month intervention, and compare the difference of these indicators before and after the intervention.Results:Compared with the baseline, 147 participants aged from 30 to 80 years old had more increases in proportions of salt control (78.2% vs 60.5%, P<0.001) and oil control (79.6% vs 58.5%, P<0.001) in daily diet. The P50 ( P25, P75) of scores of symptom management and consultation list increased from 6 (0, 11) and 0 (0, 2) to 9 (4, 13) and 1 (0, 2) ( P<0.05) after 4-month intervention. Fasting blood glucose significantly decreased from (8.8±2.9) mmol/L at baseline to (7.6±1.9) mmol/L and the control rate of blood glucose significantly increased from 29.3% to 44.2% ( P<0.05) after 4-month intervention. The proportion of outpatient visited decreased from 42.2% to 12.9% and the proportion of hospitalized decreased from 10.2% to 4.1% ( P<0.05) after 4-month intervention. Conclusion:Peer-supported diabetes self-management group intervention could effectively improve behavior and blood glucose control of patients with type 2 diabetes.

Objective:To assess the effectiveness of peer-supported diabetes self-management group intervention and explore a community-based diabetes health management model.Methods:From September to December in 2016, patients with type 2 diabetes were recruited from 6 streets (townships) in Binhu and Xishan district of Wuxi, Jiangsu Province. According to a structured diabetes self-management course, guidance was provided by community health workers and peer volunteers. Self-management group intervention was led by type 2 diabetes patients. A self-control design was used to collect information on self-management behavior, fasting blood glucose, and health care utilization at baseline and after 4-month intervention, and compare the difference of these indicators before and after the intervention.Results:Compared with the baseline, 147 participants aged from 30 to 80 years old had more increases in proportions of salt control (78.2% vs 60.5%, P<0.001) and oil control (79.6% vs 58.5%, P<0.001) in daily diet. The P50 ( P25, P75) of scores of symptom management and consultation list increased from 6 (0, 11) and 0 (0, 2) to 9 (4, 13) and 1 (0, 2) ( P<0.05) after 4-month intervention. Fasting blood glucose significantly decreased from (8.8±2.9) mmol/L at baseline to (7.6±1.9) mmol/L and the control rate of blood glucose significantly increased from 29.3% to 44.2% ( P<0.05) after 4-month intervention. The proportion of outpatient visited decreased from 42.2% to 12.9% and the proportion of hospitalized decreased from 10.2% to 4.1% ( P<0.05) after 4-month intervention. Conclusion:Peer-supported diabetes self-management group intervention could effectively improve behavior and blood glucose control of patients with type 2 diabetes.

Objective:To analyze the trend of premature death of non-communicable diseases (NCDs) in Wuxi from 2008 to 2018 and evaluate the influence of premature mortality probability caused by four main NCDs on life expectancy.Methods:Based on the mortality data collected by Wuxi Mortality Registration System and the population data collected by Wuxi Public Security Bureau during 2008-2018, this study analyzes the trend of the probability of premature death on malignant tumors, cardiovascular and cerebrovascular diseases, chronic respiratory diseases, and diabetes. The impact on life expectancy was analyzed by using the methods of abridged life table, Joinpoint regression, and life expectancy contribution decomposition.Results:From 2008 to 2018, the total probability of premature death of four main NCDs in Wuxi were declined consistently from 11.25% to 9.25% (AAPC = -2.0%, 95% CI: -2.6--1.5), higher in female (from 7.74% to 5.91%) than that in male (from 14.49% to 12.51%). The Wuxi resident's life expectancy increased by 1.86 years (from 78.66 to 80.52 years), in males and 1.26 years (from 83.85 to 85.11 years) in females, respectively. The decline of premature death of malignant tumors, cardiovascular and cerebrovascular diseases and chronic respiratory system diseases had a positive contribution to life expectancy, which contributed 0.34 years (23.90%), 0.15 years (10.50%), and 0.03 years (2.36%) to the life expectancy growth, respectively. Among which, premature death of cardiovascular and cerebrovascular diseases in men aged 40-55y had a negative contribution to life expectancy (-0.04 years). The probability of premature death of males with diabetes was on the rise (AAPC = 7.1%, 95% CI: 2.8-11.6), which negatively contributed to life expectancy for both males and females, reducing life expectancy by 0.03 years (-2.14%) in Wuxi. Conclusion:The premature death probability of four main NCDs in Wuxi declined consistently from 2008 to 2018, which played a positive role in the growth of life expectancy. Compared with females, males had a higher premature death probability and a slower rate of decline. More intervention and health management of premature male death on cardiovascular and cerebrovascular diseases and diabetes should be conducted to improve life expectancy further.