Objective To analyze the distribution and drug resistance situation of pathogens in the respiratory department during the recent 9 years to provide the basis for rational use of antibacterial drugs in clinic .Methods All pathogens isolated from the respiratory depeartment from January 2003 to December 2011 and the drug susceptibility test results were retrospectively and statistically analyzed .Results A total of 5 714 strains of pathogenic bacteria were isolated ,which mainly distributed in the sputum (90 .1% ) ,excrement (4 .2% ) and urine (3 .6% );among them ,2 943 strains (51 .5% ) were Gram‐negative bacteria ,596 strains (10 .4% ) were Gram‐positive bacteria and 2 175 strains (38 .1% ) were fungi .The top six of isolated bacteria were Candida albi‐cans ,Pseudomonas aeruginosa ,Acinetobacter baumannii ,Klebsiella pneumoniae ,Candida tropicalis and Escherichia coli .The isola‐tion rates of A .baumannii and C .albicans were increased year by year ,while the isolation rate of E .coli was decreased .A .baumannii and P .aeruginosa had a high resistant to all antibacterial drugs ,whereas the resistant rate of A .baumannii was increased year by year and that of P .aeruginosa showed some fluctuation .K .pneumoniae had a high susceptibility to imipenem and meropenem ,and the sensitivity to other antimicrobial agents had a gradually increasing tendency .The sensitive rate of C .albicans to amphotericin B was almost 100% ,and they had a high susceptible to other antifungal agents .Conclusion Drug resistance of the pathogens is com‐mon in the respiratory department .It is of importance to emphasize the pathologic examination ,carry out the surveillance of drug re‐sistance of pathogenic bacteria ,and use the antibacterial drugs rationally in clinical anti‐infective therapy .

OBJECTIVESTo improve the diagnosis of patients with neurogenic lower urinary tract dysfunction and to provide a basis for proper selection of rehabilitation methods.

METHODSThe urodynamics was tested with Assend Urodynamic Instrument in 220 patients with spinal cord injury. Of these patients, 100 received regular cystometrograrhy (CMG) and urethal pressure profile (UPP) test, and the remaining patients were measured by bladder/ external sphincter pressure profile. The detrusor pressure, maximum detrusor voiding pressure, and maximum urethral pressure were recorded. The date from the tests were processed with SPSS 8.0 (independent samples T test).

RESULTSThe maximum urethal pressure (83 +/- 39) cm H(2)O (1 cm H(2)O = 0.098 kPa) and maximum voiding detrusor pressure (12 +/- 10) cm H(2)O were lower in coda-equina group than in other groups (t = 2.096,P < 0.05). The group with different spinal cord injury had almost an equal ratio of low bladder compliance (51.2%, 52.4% and 50% separately). Statistical differences were found between complete injury and incomplete injury in each group(t = 1.023, P > 0.05). In bladder/external sphincter cystometry, urethral pressure profile could be classified into four types.

CONCLUSIONSThe maximum urethral pressure and maximum pressure of detrusor contractile were lower in the cauda-equina injury group than in other groups. The cauda-equina injury group showed a lower incidence of detrusor sphincter because most of these patients were incompletely injured. The features of urethral pressure profile in bladder/external sphincter cystometry resulted from the abnormal contraction of external sphincter and periurethral striated muscles.

Adolescent ; Adult ; Aged ; Child ; Child, Preschool ; Female ; Humans ; Male ; Middle Aged ; Spinal Cord Injuries ; complications ; physiopathology ; Urinary Bladder ; physiopathology ; Urodynamics ; Urologic Diseases ; physiopathology

OBJECTIVE To analyze the influencing factors for the metabolism of voriconazole in adult patients， and to provide reference for the rational use of voriconazole in clinic. METHODS The clinical data of adult patients admitted in our hospital receiving voriconazole and therapeutic drug monitoring from April 2021 to March 2022 were collected. The trough concentration of voriconazole （c0） and plasma concentration of voriconazole-N-oxide concentration （cN） were determined， and voriconazole-to-voriconazole N-oxide concentration ratio （c0/cN） was calculated. Pearson’s correlation analysis was used to analyze the influencing factors for c0 and c0/cN of voriconazole. Multiple linear regression models were used to analyze the independent influencing factors for c0 and c0/cN of voriconazole. RESULTS The underlying diseases of the patients were mainly pneumonia， kidney disease and leukemia. The detected fungi were mainly Aspergillus， Candida and yeast-like fungi. Voriconazole was mainly administered by intravenous drip， especially in patients who used proton pump inhibitor in combination. The levels of C-reactive protein （CRP）， total bilirubin （TBIL）， direct bilirubin （DBIL） and indirect bilirubin （IBIL） were positively correlated with c0 of voriconazole， while platelet count and albumin levels were negatively correlated with voriconazole c0. The levels of CRP， TBIL and DBIL were positively correlated with c0/cN， while albumin levels were negatively correlated with c0/cN. Multiple linear regression analysis showed that the independent influencing factors of voriconazole c0 included the levels of CRP and IBIL， route of administration and dose of voriconazole， and the independent influencing factors of voriconazole c0/cN were the levels of CRP and DBIL and age. CONCLUSIONS The levels of CRP and IBIL， route of administration and dose of voriconazole are independent influencing factors of voriconazole c0； the levels of CRP and DBIL and age are independent influencing factors of voriconazole c0/cN. The influence of above indexes on the metabolism of voriconazole should be considered when using voriconazole clinically； and the route of administration and dose of voriconazole should be adjusted reasonably.