Objective To investigate the therapeutic effect of Saccharomyces boulardii on antibiotics associated diarrhea (AAD)in infant pneumonia.Methods 302 hospitalized infant patients (1 month-3 years) with pneumonia but without gastroenteric disease were selected , and antibiotics were administrated intravenously at least 5 continuous days for each patient .Patients were all giv-en antibiotics and randomly divided into three groups:control group with no Saccharomyces boulardii administration ( group A, 60 ca-ses);Saccharomyces boulardii were applied as addition on the occurrence of diarrhea (group B, 92 cases), and Saccharomyces boular-dii and antibiotics were co-administrated (group C, 150 cases).Incidences of AAD in all groups were carefully examined and differ-ences of therapeutic effect between groups were compared and analyzed .Results The incidence of AAD in Group C was significantly lower than that in other groups .In term of diarrhea severity, no significant difference was observed in all groups (P>0.05).Howev-er, duration of diarrhea showed significant different between groups (P<0.001):group A with the longest duration and group C with the shortest .The results indicated that the total efficiency of anti-diarrhea in group C was significantly higher than that in control group (P<0.05).However, group B presented no significant difference compared with neither control group nor group C in term of therapeu -tic effect on diarrhea .Conclusion Administration of Saccharomyces boulardii Sachets could shorten the duration of diarrhea on the oc-currence of AAD in infant pneumonia .According to our results , Saccharomyces boulardii was effective in both preventing the develop-ment of AAD and shortening duration of diarrhea , and therefore improved therapeutic effect on ADD .

Objective To explore the effect of cognitive behavior intervention nursing on the prognosis of elderly patients with chronic obstructive pulmonary disease (COPD).Methods A total of 80 elderly patients with COPD were randomly divided into observation group with 40 cases and control group with 40 cases in our hospital.Control group was given conventional nursing and observation group was given cognitive behavioral intervention nursing based on conventional nursing.The Chinese version of WHO (WHO) quality of life questionnaire (WHOQOL-BREF) were selected to evaluate and compare quality of life,detection and second forced expiratory volume (FEV1) and forced vital capacity (FVX) were compared on admission (T0),after 14 d of nursing intervention (T1) and 3 months after discharge (T2).Self rating Anxiety Scale (SAS) and the self rating Depression Scale (SDS) were used to evaluate the psychological status of the two groups at T0 and T1.Results The values of FEV1 and FVX in the two groups were dependently increased (P ＜0.05).At T1,FEV1 and FVX in the observation group were significantly higher than that in the control group (P ＜ 0.05).WHOQOL-BREF scores and total scores of the two groups showed a rise of time dependence (P ＜0.05).At T1,the score and total score of WHOQOL-BREF in the observation group were significantly higher than that of the control group (P ＜ 0.01).Conclusion Cognitive behavioral intervention nursing can significantly improve the quality of life and psychological status of patients with COPD,and promote the prognosis of patients with benign prognosis.

Objective To explore the effect of cognitive behavior intervention nursing on the prognosis of elderly patients with chronic obstructive pulmonary disease (COPD).Methods A total of 80 elderly patients with COPD were randomly divided into observation group with 40 cases and control group with 40 cases in our hospital.Control group was given conventional nursing and observation group was given cognitive behavioral intervention nursing based on conventional nursing.The Chinese version of WHO (WHO) quality of life questionnaire (WHOQOL-BREF) were selected to evaluate and compare quality of life,detection and second forced expiratory volume (FEV1) and forced vital capacity (FVX) were compared on admission (T0),after 14 d of nursing intervention (T1) and 3 months after discharge (T2).Self rating Anxiety Scale (SAS) and the self rating Depression Scale (SDS) were used to evaluate the psychological status of the two groups at T0 and T1.Results The values of FEV1 and FVX in the two groups were dependently increased (P ＜0.05).At T1,FEV1 and FVX in the observation group were significantly higher than that in the control group (P ＜ 0.05).WHOQOL-BREF scores and total scores of the two groups showed a rise of time dependence (P ＜0.05).At T1,the score and total score of WHOQOL-BREF in the observation group were significantly higher than that of the control group (P ＜ 0.01).Conclusion Cognitive behavioral intervention nursing can significantly improve the quality of life and psychological status of patients with COPD,and promote the prognosis of patients with benign prognosis.

Objective To investigate antimicrobial resistance among Streptococcus pneumoniae clinically isolated from 14 teaching hospitals located at different areas in China in 2005-2008 and to give logical guidance for clinical empirical therapy.Methods A total of 1 317 non-repetitive S.pneumoniae isolates in 14 teaching hospitals from 2005-2008 were collected and sent to the central lab for reidentification and susceptibility testing, including 271 isolates collected in 2005, 391 isolates collected in 2006, 363 isolates collected in 2007 and 292 isolates collected in 2008. Most of the isolates were from community-acquired respiratory tract infections, which were isolated from outpatient or emergency department patients with respiratory tract infections or those patients with respiratory tract infections within ≤48 hours hospitalization.The districts where the organisms were isolated include North China, Northeast China, South China, Central and Northwest China and East China.The patients included adults, teenagers and children.The minimum inhibitory concentrations (MICs) or inhibitory zone diameter of 17 antimicrobial agents were determined by Etest method, agar dilution method or disk diffusion method.WHONET5.5 software was used to analyze susceptibility rate, intermediate rate, resistance rate, MIC50 and MIC90.Results Linezolid (100%) and fluoroquinolones (95.2%-99.7%) showed excellent activities against S.pneumoniae.Among β-lactams, amoxicillin-clavulanic acid remained high activities (73.8%-92.1%),followed by penicillin, ceftriaxone and cefepime with year-over-year decrease in activities.The activities of three second-generation cephalosporins were low (36.3%-38.4% in 2008).The activities of erythromycin, azithromycin, clindamycin, trimethoprim/sulfamethoxazole and tetracycline against S.pneumoniae were poor and decreased year over year.The incidence of penicillin non-susceptible S.pneumoniae (PNSP) was increasing especially for PISP (from 4.4% in 2005 to 20.2% in 2008).The incidence of PNSP in North China was low (6.0%), while this value were high in central China and East China (30.1% and 38.7%, separately).The incidence of PNSP in adults (15.7%) was obviously lower than that in children(≤5 years:33.0%) and teenagers (6-17 years:38.2%).Conclusions linezolid and fluoroquinolones showed excellent in vitro activity against S.pneumoniae, followed by penicillin and cephalosporins with year-over-year decrease of activity. Clinicians should pay more attention when using those antimicrobial agents with poor activity against S.pneumoniae, which include macrolides, clindamycin, trimethoprim/sulfamethoxazole and tetracycline.

OBJECTIVE To investigate the antimicrobial resistance of hospital-and community-acquired pathogens collected from 10 teaching hospitals located at different areas in China in 2006.METHODS According to the study protocol,the strains of Streptococcus pneumoniae,meticillin-susceptible Staphylococcus aureus(MSSA),Escherichia coli and Klebsiella pneumoniae were collected and sent to the central lab for reidentification and susceptibility testing.The minimal inhibitory concentrations(MICs) of antimicrobial agents against Str.pneumoniae were determined by Etest method and MICs of antimicrobial agents against S.aureus,E.coli and K.pneumoniae strains were determined by agar dilution method.WHONET5.4 software was used to analyze the data.RESULTS Among 353 Str.pneumoniae strains,74.2% were penicillin-susceptible(PSSP),9.6% were penicillin-intermediate(PISP) and 16.2% were penicillin-resistant(PRSP).Strains from different hospitals showed different sensitivity to penicillin.Among ?-lactam antibiotics,cefuroxime showed the lowest susceptibility rate of 0%(for PRSP) to 76.7%(for PSSP).The susceptibility rate to ceftriaxone and amoxicillin-clavulanic acid was 98.1% and 98.9% in PSSP group,61.8% and 64.7% in PISP group,and 15.8% and 10.5% in PRSP group.The ESBLs rate was 56.2% among 267 Escherichia strains and 42.7% among 206 K.pneumoniae strains.For ESBLs-producing strains,the susceptibility rates to cefotaxime and ceftriaxone were low and the rate to ceftazidime was relatively high among ?-lactam antibiotics.73.4% MSSA strains produced ?-lactamase.?-Lactam antibiotics tested showed high susceptibility against MSSA strains.The susceptibility rate was 98.9-100%.The susceptibility rate to ciprofloxacin and levofloxacin was 80.8% and 88.1%,separately.CONCLUSIONS Fluoroquinolones show high susceptibility against Str.pneumoniae.Ceftriaxone and amoxicillin-clavulanic acid have relatively high susceptibility among ?-lactams.For MSSA and non-ESBLs-producing E.coli and K.pneumoniae strains,?-lactams show high susceptibility.For ESBLs-producing E.coli and K.pneumoniae strains,the susceptibility rates to cefotaxime and ceftriaxone are low and that to ceftazidime,cefepime and cefoperazone-sulbactam are relatively high.