Inadequate empirical antibiotic therapy and delayed target therapy have been demonstrated to be significantly associated with higher mortality.Because microbiological results based on the traditional culture and identification require quite a long time,empirical broad-spectrum antimicrobial therapy is often initiated according to the clinical presentation,which may resulting in the development of antimicrobial resistance.One of the strategies to alter the dilemma situation is that the initial empirical therapy is adjusted to definitive therapy as early as possible,which can only be done on the basis of rapid microbiological reports.Clinical microbiology laboratories should integrate a variety of rapid detection methods,improve working process,present reports as soon as possible,and bear fast-responsibility.

OBJECTIVE To investigate the distribution of commonly encountered pathogenic microbes during the last five years.METHODS A total of 9318 strains of NI pathogens during from Jan 2004 to Dec 2008 were surveyed and analyzed.RESULTS From them the percentage of Gram-positive cocci was 13.6%,the main pathogen was coagulase negative Staphylococcus,Gram-negative bacilli(28.8%).The predominant pathogens were Escherichia coli,Klebsiella pneumoniae and Pseudomonas aeruginosa.The drug resistance of NI pathogens was markedly increased.Especially,the rate of drug resistance of P.aeruginosa to imipenem was from 0 to 31.8% in 2005,and that of Enterococcus to vancomycin was 4.0% in 2007.The percentage of fungi was 26.4% and increased sharply year by year.CONCLUSIONS The Gram-negative bacteria play a dominant role in clinics and drug resistance of isolated pathogenic bacteria is a serious problem.Monitoring the trends of pathogenic bacteria′s distribution and drug resistance is very important in guiding the clinical administration of drugs and we should pay attention to fungal infection.

Objective To explore the Gram-positive bacterial drug resistance in blood culture in 2013 to 2015 from the members of Antimicrobial Resistant Investigation Net of Shaanxi province,and guide the clinicians touse antimicrobial drugs rationally.Methods All the objective bacterial isolates were collected and identified susceptibility date by software WHONET 5.6.Results 8 824 Gran positive bacterial isolates and their antibacterial susceptibilitydata were collected.The top five populations of Gram-positive bacterial isolates were Staphylococcus epidermidis,Staphylococcus hominis,Staphylococcus haemolyticus,Staphylococcus aureus and Enterococcus feacium.The isolating rates of methicillin-resistant Staphylococcus aureus (MRSA) and methicillin-resistant coagulase negative Staphylococcus(MRCNS) were 33.9 ～ 54.9％ and 72.1 ～88.6 ％ respectively.No vancomycin,Linezolid and teicoplanin resistant Staphylococcus isolates were found.There were 0.9 ～2％ E.faecium vancomycin-resistant isolates.Conclusion The composition of blood culture from 2013 to 2015 was not changed,The rate of MRSA and MRSE showed downward trend.But it was severe that the situation of bacterial drug resistance in blood culture in Shaanxi province.Should fully use bacterial drug resistance surveillance results for supervision and administration,and take effective measures for controlling the spread of resistant isolates.

Objective To explore the antibacterial active components of Flos Caryophylii. Methods The components were distilled by extraction and big - hole colophony. The minimum antibacterial concentration of components was detected. Results and conclusion The and - staphylococcus aureus active components of of Flos Caryophylii. include fat - soluble ingredients and water - soluble ingredients.

Objective To explore the bacterial drug resistance in blood culture in 2015 from the members of Antimicrobial Re-sistant Investigation Net of Shaanxi province,and to guide the clinicians touse antimicrobial drugs rationally.Methods All the objective bacterial isolates were collected and identifiedsusceptibility date by software WHONET 5.6.Results 6 871 bacterial isolates and their antibacterial susceptibilitydata were collected which included 3 199 (46.56%)Gram-negative bac-terial isolates and 3 672 (53.44%)Gram-positivebacterial isolates.The top five populationsof Gram-positive bacterial iso-lates were Staphylococcus epidermidis (30.94%),Staphylococcus hominis (17.84%),Staphylococcus haemolyticus (11.74%),Staphylococcusaureus (9.69%)and Enterococcus feacium (6.29%).The top five populationsof Gram-negative bacterial isolates were E.coli (43.67%),Stenotrophomonas maltophilia (14.63%),K.pneumoniae (13.47%), P.aeruginosa (4.13%)and Acinetobacter baumannii (3.63%).Theisolating rates of methicillin-resistant Staphylococcus aureus (MRSA)and methicillin-resistant coagulase negative Staphylococcus (MRCNS)were 31.2% and 76.1%,respec-tively.No vancomycin resistant Staphylococcusisolates were found.There were 0.9% E.faecium vancomycin-resistant iso-lates.The isolates of Enterobacteriaceae were still highly susceptible to carbapenem,whosetotal resistance rate was below 4.0%.The resistance rates of A.baumannii to most surveillance drugs in cludingimipenem were above 50.0% and the iso-lates of P.aeruginosa were still highly susceptible to most surveillancedrugs.Conclusion It is severe that the situation of bacterial drug resistance in blood culture in Shaanxi province.Should fullyuse bacterial drug resistance surveillance results for supervision and administration,and take effective measures forcontrolling the spread of resistant isolates.

Objective To evaluate the advantages of TB-IGRA and protein chip to detect the Mycobacterium tuberculosis. Methods From October 2013 to March 2014,collected 78 cases of clinical diagnosis of tuberculosis and normal control’s pe-ripheral blood specimens,used TB-IGRA kits and Mycobacteriumtuberculosis IgG kit(protein chip)to detected respectively. The results were analyzed and compared.Results The sensitivity of protein chip and TB-IGRA in the detection of Mycobac-teriumtuberculosis were 34.5% and 89.7% respectively,which was statistically significant (χ2=26.95,P<0.05).The spe-cificity of protein chip and TB-IGRA were 90.0%,95.0% respectively,which were not statistically significant (χ2=1.64,P> 0.05).The positive rate of TB-IGRA and Protein chip in tuberculosis were 90.5% and 42.9%.The positive rate of TB-IGRA and Protein chipin extrapulmonary tuberculosis were 89.20% and 29.7% respectively.Conclusion Compared TB-IGRA and protein chip,either diagnose tuberculosis or extrapulmonary tuberculosis has highly positive rate and sensitivity, TB-IGRA can be widely used in the early screening of tuberculosis.

Objective To investigate the reasons of higher result of CK-MB than the total CK with the immune suppression method for deteting serum CK-MB and solution methods.Methods Selected 68 cases of inpatients with myocardial infarc-tion from Department of Cardiology,32 cases of malignant tumor from Internal Medicine-Oncology,including 8 cases of liver cancer,6 cases of lung cancer,6 cases of gastric cancer,5 cases of neuroblastoma,4 cases of breast cancer and 3 cases of o-varian cancer and 16 cases of cirrhosis from Department of Gastroenterology,and at the same time,selected 100 cases of healthy persons as control group from Out-patient Health Examination Center of Shaanxi Provincial People’s Hospital.Used Roche MODUALR automatic biochemical analyzer to detected the activity of serum CK-MB with the immune suppression method and the activity of total CK with the enzyme coupling rate method.Results In 68 cases of inpatients with myocardial infarction,the activity of serum CK-MB of 2 1 cases were individually increased,the activity of total CK of 3 9 cases were in-creased,and the two indexes of 30 cases were increased in the same period.In 32 cases of inpatients with malignant tumor, the activity of serum CK-MB of 1 1 cases were individually increased,the activity of total CK of 3 cases were increased and the two indexes of 3 cases were also increased.The activity of serum CK-MB of 6 cases were individually increased in 1 6 ca-ses of cirrhosis.Conclusion The immune inhibition assay for the detection of CK-MB as the diagnosis index of myocardial infarction had certain defects,and the higher activity of CK-MB could be highly associated with some severe inflammation, malignant tumor.

Objective To investigate the changes of the morphology,structure and biological characters of mutated Candida and through its genetic characteristics,research and reveal the mechanism of the variation at the molecular level.Methods Used different nutritional conditions,different growth conditions and different azole antifungal agents to induce mutation of the standard strains of Candida albicans.In clinical study,Candida mutant strains was isolated from vaginal secretions,pleu-ral effusion and gastric juice samples in patients of poor effect with Antifungal therapy,and studied on the morphological characteristics,and the nuclear structure,the biochemical reaction,the drug resistance,the bacterial composition and the ge-netic characteristics of above variants,etc.Results Mycelial?morphology:Candida were prone to mutation like bacteria, mutant bacteria could show G+ Aureus shape,G+ Bacillus,G+ long filamentous,G- Aureus shape,G- Bacillus and G- long filamentous;Nuclear structure:Candida mutant strains changed like prokaryotes under the electron microscope because it lost the original structure of eukaryotic cells.Biochemical reaction:there were 5 different items in 20 biochemical test ob-served.Drug sensitivity test:Candida mutated to antifungal drugs being originally sensitive was completely resistant,sensi-tive and resistant originally was completely sensitive,and the same as ordinary bacteria resistant.The cell component chan-ges:there was significantly different in Candida variant strain and the atavism of variant strain identified by mass spectrome-try.The most conservative fungalgene expression:Candida mutated had conservative gene expression of eukaryotes.It could be demonstrated that oidiomycetes mutant strains like bacterial morphology with prokaryotic cell biological characteristics was derived from Candida with eukaryotic cells.Conclusion Candida was prone to variation like bacterial morphology.The biological characteristics of mutant resembled prokaryote.There was a qualitative change among the standard strains of Can-dida albicans,mutant strains of oidiomycetes like bacterial morphology and the atavism of variant strain with clear genetic re-lationship under the electron microscope in the form of nuclear matter.The study on biological evolution,especially contact in prokaryotic cells and eukaryotic evolution has very important significance.

Objective To determine the prevalence of diabetes mellitus and related risk factors among residents in the urban and rural area of Chengdu.Methods A cluster sampling was used to establish a study population of inhabitants aged 30 to 70.Totally,1 847 participants were enrolled in this study.Questionnaire including general information and dietary information in the past year was used to collect related data.Height,body weight and oral glucose tolerance test (OGTT) were measured.Factor analysis was used to analyze the dietary pattern while multivariate unconditional logistic regression used for risk factors in total population,urban and rural residents,respectively.Results The population standardized prevalence rates of diabetes in the overall,urban and rural residents were 20.2％,28.7％,11.1％,respectively.Among total population,middle-aged (OR=2.337,95％CI:1.305-4.185) and the elderly (OR=5.990,95％ CI:3.389-10.586) residents had higher diabetes risk than the younger ones.Administrators (OR=1.434,95％ CI:1.000-2.057) and ordinary clerks (OR=2.870,95％ CI:1.653-4.980) were more vulnerable to diabetes than peasants.Similarly,middle-aged (OR=2.973,95％ CI:1.101-8.031) and elderly (OR=5.972,95％ CI:2.267-15.730) turned out to be more predisposed than young people in the urban area.Compared with peasants,ordinary clerks (OR=2.196,95％CI:1.213-3.975) seemed to be more liable to diabetes.In the mral areas,dietary pattern with higher energy and protein (OR=1.404,95％ CI:1.113-1.772) could be subject to diabetes.Conclusion The prevalence of diabetes in Chengdu was relatively high.Age,career and dietary pattern are mainly risk factors.The factors in different districts are vaious.Intervention on nutrition should be different,area-wise.

Objective:To investigate the value of CD64 index and C-reactive protein (CRP)/albumin (Alb) ratio (CRP/Alb) in predicting infection after modified radical mastectomy for breast cancer.Methods:The clinical data of 203 breast cancer patients who underwent modified radical mastectomy from January 2018 to August 2021 in Anhui No.2 Provincial People's Hospital were retrospectively analyzed. All cases were divided into infection group (40 cases) and non-infection group (163 cases) according to whether they were infected at the 1st month after operation. On the 1st day after operation, the serum CD64 index was measured by using flow cytometry, the serum CRP and Alb levels were measured by using immunoturbidimetry, and the CRP/Alb was calculated. The values of CD64 index and CRP/Alb in the diagnosis of infection after modified radical mastectomy for breast cancer were evaluated by using receiver operating characteristic (ROC) curve. The factors influencing infection after modified radical mastectomy for breast cancer were explored by using multivariate logistic regression.Results:The levels of CD64 index, CRP, CRP/Alb in the infection group were higher than those in the non-infection group [5.7±1.1 vs. 1.5±0.3, t = 32.05, P < 0.001; (78±13) mg/L vs. (11±3) mg/L, t = 39.26, P <0.001; 3.09±0.42 vs. 0.36±0.02, t = 57.48, P < 0.001], and the level of Alb in the infection group was lower than that in the non-infection group [(25±3) g/L vs. (32±4) g/L, t = 8.37, P < 0.001]. There were statistically significant differences in the catheterization time, CD64 index and CRP/Alb between the infection group and non-infection group (all P < 0.05); multivariate logistic regression showed that catheterization time >9 d, CD64 index >42.65 and CRP/Alb >1.25 were risk influencing factors of infection after modified radical mastectomy for breast cancer (all P < 0.001). The ROC curve results showed that the area under the curve, sensitivity, and specificity of CD64 index in the diagnosis of infection after modified radical mastectomy for breast cancer were 0.804, 89.5% and 85.4%, the CRP were 0.712, 70.6% and 76.5%, the Alb were 0.766, 72.4% and 75.4%, and the CRP/Alb ratio were 0.856, 88.0% and 90.5%. Conclusions:The CD64 index and CRP/Alb have certain values in the prediction of infection after modified radical mastectomy for breast cancer.