OBJECTIVE To determine the bacterial distribution and resistance status in urinary system infections among old patients with primary susceptibility testing on urine samples. METHODS A total of 990 urine specimens were examined over 3 years to determine the validity of direct antimicrobial agent susceptibility testing.A total of 1149 strains collected from inpatient urine specimens during Oct 2002-Oct 2005 were identified and the drug resistance test was performed. RESULTS Escherichia coli rated the top one(57.9%),followed with Enterococcus,Proteus,Klebsiella pneumoniae,Pseudomonas aeruginosa,Staphylococcus and fungi.Enterobacteriaceae were showed increasing drug resistance trend,but still sensitive to imipenem(100%).G~+-cocci were also showed serious drug resistance trend,but still sensitive to vancomycin(100%)(except Enterococcus faecium). CONCLUSIONS Enterobacteriaceae are the main infectious bacteria in urinary system infection.Rational use of antibiotics should be carried out according to urine culture result.

OBJECTIVE To develop a prospective evaluation strategy to detect the first 3 days of incubation of the clinically significant isolates. METHODS With blood culture positive sample by BacT/Alert~3D and direct identification and antimicrobial susceptibility tests by VITEK32 in clinics to compare with those obtained from cards(GPI,GPS-106,GNI+,GNS-506) incubated with standardized bacterial suspension obtained following subculture to chocolate agar plates and CHRMagarTM microbiology. RESULTS There were 3 strategy reports performed.The sensitivity was 99.18%,specificity was 99.62%,validity was 98.89%,incidence rate was 25.4%,positive predictive value was 99.18%,negative predictive value was 99.62%,positive likelihood ratio was 261,and negative likelihood rate was 0.008. CONCLUSIONS In the first 3 days of incubation,99.36% of the(1 701) clinically significant isolates were detected,suggesting that routine incubation for more than 3 days be not necessary for FA and FN bottles.These findings suggest that VITEK-32 cards inoculated directly from BacT/Alert culture positive bottles provide acceptable bacterial identification or susceptibility testing for Enterobacteriaceae and Staphylococcus,and decrease the time lapse between initial inoculation of blood culture and the reporting of the results.

OBJECTIVE To study the distribution of the nonfermenter(NF) and the change in its resistance between 2002 and 2005 in our hospital ICU,and instruct clinical application of antibiotics reasonably.METHODS The(identification) of bacteria, antibiotic susceptibility and the detection by VITEK-32 of GNI~+、GNS-142 were used.Etest was applied for detection of metallo-?-lactamase.RESULTS The detective rate of the NF was 57.3%,(58.3%),67.5% and 69.8%,(respectively) from 2002 to 2005.Pseudomonas aeruginosa(PAE),Acinetobacter baumannii and (Stenotrophomonas) maltophilia accounted for 34.3%,11.1% and 4.0%,respectively.The highest distribution of the NF was in the sputum.The resistance rate of PAE to imipenem was lower,(however),it had rose from 0.0% to 17.8% in 2005.The resistance rate of S.maltophilia to sulfamethoxazole/(trimethoprim) was lower than the others,and rose from 0.0% in 2002 to 13.8% in 2005.The incidence rates of(metallo)-?-lactamase of PAE was 0.8% and of A.baumannii was 4.8%,respectively;the incidence rates of metallo-?-lactamase of A.baumannii and PAE were 0.8% and 4.8%,respectively.CONCLUSIONS The(detective) rates of PAE, and A.(baumannii) are gradually increased during the last four years.The incidence of(metallo)-?-lactamase of PAE and A.baumannii is also lower,and the other resistance is existed.

OBJECTIVE To study the three-stage reports method using in clinical diagnosis of urinary system infections,and its value in order to fasten the clinical diagnosis and treatment.METHODS A total of 3349 urines specimens used a sequential three-stage reports method to prospectively evaluate and determine the validity of direct antimicrobial agent susceptibility testing by traditional method and VITEK-32.The first report was by Gram stained,the second report by criteria for initiating direct susceptibility testing,and third report was by standardized disk diffusion method and VITEK-32.RESULTS From 3349 samples the Gram negativstained smears were 746(22.3%),Gram negative bacilli were 1365(40.7%) the Gram positive cocci were 1036(31.0%) and the fungi were 202(6.0%).Escherichia coli rated the top one(55.7%),followed with Staphylococcus saprophyticus subsp saprophyticus 437(42.2%),Enterococcus faecalis 389(37.5%),Proteus,Klebsiella pneumoniae,Pseudomones aeroginose,and fungi.Enterobacteriaceae were showed increasing drug resistance trend,but still sensitive to imipenem(100.0%).G+-cocci were also showed serious drug resistance trend,but still sensitive to vancomycin(100.0%)(except E.faesium).CONCLUSIONS Three-stage method using in clinical diepnosis of urinary system infections is very important.Enterobacteriaceae are the main infectious bacteria in urinary system infection.Rational use of antibiotics should be carried out according to urine culture result.

Serum sialic acid (SA) levels were detected by neuraminidase method in 366 patients with malignant tumor, 40 patients with benign diseases and 40 healthy subjects.For 277 malignant tumor patients, serum SA levels were monitored before and after treatment.The serum SA levels in malignant tumor group were significantly higher than those in benign diseases and control groups (P ＜0.01 ), but there were no differences between normal and benign groups (P ＞0.05 ).Serum SA levels were decreased in malignant tumor patients with remission and stable disease after treatment.In remission or stable patients the decrease of serum SA levels occurred in the first three months and no changes were found from the fourth to sixth month; meanwhile SA levels were elevated in patients with instablc condition.

Objective:To explore the effect of Jiudaiqingyuan oral liquid in strengthening immunologic function of children with RRI.Methods:100 children with RRI were randomly divided into two groups:the routine treatment group(RTG) and the group treated with Jiudaiqingyuan oral liquid (JDG).Venous blood was drawn before and after treatment to detect T lymphocyte subsets(SP method),NK cell activity (MTT method),sIL 2R(ELISA method),IgG,IgA,IgM(transmission turbidimetric method).Results:CD3 +,CD4 +,CD4 +/CD8 +,NK cell activity and IgG,IgA of the children with RRI were notably lower and CD8 +、IgM、sIL 6R markly higher before treatment.These indexes recovered to some extent after routine treatment but were still significantly different from those of normal controls(P0 05).Conclusion:Jiudaiqingyuan oral liquid has strong effect on immunologic regulation.It may markly enhance cellular and humoral function of children with RRI.

ObjectiveTo comprehensively elucidate the potential mechanisms of Xiao Xumingtang （XXMT） combined with electroacupuncture （EA） collaboratively in alleviating cerebral ischemia/reperfusion （I/R） injury. MethodThe rat model of cerebral I/R injury was established using the modified suture-occluded method. Seven days after modeling， rats in the XXMT+EA groups were administered XXMT at low （15 g·kg^-1）， medium （30 g·kg^-1）， and high （60 g·kg^-1） doses， alongside daily 20-min EA treatment （stimulating acupoints GV14 and GV20）. Cerebral infarction and neuronal damage were evaluated using the Zea Longa test score， TTC staining， and TUNEL staining. Real-time fluorescence quantitative PCR and Western blot were used to detect the expression of NOD-like receptor hot protein domain related protein 3 （NLRP3）， Gasdermin D （GSDMD）， cysteinyl aspartate specific proteinase-1 （Caspase-1）， interleukin-1β （IL-1β）， and interleukin-18 （IL-18） in the ischemic area of the cerebral cortex. ResultCompared with the sham group， the I/R group showed a significant increase in neurological deficit scores and infarct volume （P<0.01）， along with a higher apoptosis rate of cortical neurons and elevated mRNA and protein expression levels of NLRP3， GSDMD， Caspase-1， IL-1β， and IL-18 （P<0.05）. In contrast， the medium- and high-dose XXMT combined with EA treatment significantly reduced neurological deficit scores and infarct volume （P<0.01）， and decreased the apoptosis rate of cortical neurons as well as the mRNA and protein expression levels of NLRP3， GSDMD， Caspase-1， IL-1β， and IL-18 （P<0.05）. The improvement showed a dose-dependent relationship with XXMT. ConclusionThe combined use of XXMT and EA can exert neuroprotective effects by modulating the NLRP3/GSDMD/Caspase-1 signaling pathway， thereby reducing neurological deficits， minimizing brain infarct size， and improving cortical neuronal damage.