To a greater or lesser extent, the following shortcomings can be found in the administration of various hospitals in China: overlapping institutional functions, aging age structure, low-level specialization, low efficiency, serious lack of reserve force in the contingent of administrators, and lack of competition in the mechanism of personnel employment. To remove these roadblocks to hospital development, the hospital the author works with adopted a series of measures, including readjustment of functions and combination of office work; change of job without change of rank and transfer to other institutions; flow of personnel to service and other profit-making departments; retirement ahead of schedule. The measures resulted in the reduction of administrative personnel by 16.2%, the reduction of administrative expenditure by about 180 thousand yuan per annum, the reduction of the average age of the administrators by 3 years, the rise of the proportion of administrators with a college degree and above from 45.9% to 56.5%, and the enhancement of the administrators awareness of competition, cost, service, profit and efficiency.

Objective To understand the hospital intensive care unit(ICU) pathogenic bacteria distribution and drug resistance for providing the basis for rational drug use and hospital infection control and prevention.Methods The drug resistance of 749 strains of pathogenic bacteria the separated from ICU was analyzed from January 2009 to December 2012.VITEK 2 Compact automatic bacteria identification instrument was used to detect bacteria identification and drug sensitive test using.Results There were Acinetobacter baumannii(208 strains,27.8％),Pseudomonas aeruginosa(108 strains,14.4％),E.coli (96 strains,12.8 ％),Staphylococcus aureus (76 strains,10.1％),Klebsiella pneumoniae(62 strains,8.3％) mainly accupied in 749 strains of pathogenic bacteria.The species was mainly from sputum specimens sources (503 strains,67.2％) ; the separation rate of Methicillin-resistant staphylococcus aureus (MRSA) was 82.9％ (63/76) ; the separation rate of Imine resistance from South pseudomonas aeruginosa(IRPA) was 22.2％ (24/108) ; the separation rate of resistance to carbon penicillium alkene antimicrobial acinetobacter baumannii (CR-AB) was 88.0％ (183/208).The resistant rate of Acinetobacter baumannii to amikacin was from 28.6％ to 31.5％,the other 20 kinds of antimicrobial drug resistant rate was as high as 81.6％-100.0％ ; Pseudomonas aeruginosa to ciprofloxacin,ofloxacin,aztreonam and piperacillin/tazobactam resistant rate of 11.6％-25.0％.Conclusion Detection of pathogens in ICU,multi-drug resistance is serious,the hospital should strengthen the bacterial drug resistance monitoring,rational use of antimicrobial drugs,reduce the nosocomial infection.

Objective To investigate the distribution of the Bauman acinetobacter baumannii (IRAB) resisted to imipenem and character of drug resistance.Methods Retrospective analyzed 517 strains of IRAB and 319 strains of imipenem drug resistance of acinetobacter baumannii from South Africa (not IRAB) by VITEK 2 compact automatic bacterial culture identification.Results IRAB positive rate was 61.8％ (517/836).The main source of IRAB was from sputum(85.5％ (442/517)).The constitute ratio of main areas in IRAB was ICU ward (55.9％) and only 7.8％ in non-IRAB.The resistant rate of IRAB to amikacin was 27.2％.The resistant rate of non-IRAB to Amikacin and piperacillin/tazobactam were 8.0％ (21/262),8.2％ (26/317),suggesting the good antibacterial activity.In terms of rate of resistance drug,apart from Cefazolin,Cefotetan,Cotrimoxazole,Nitrofurantoin,the sort of antibacterial drugs against IRAB was obviously higher than that of non-IRAB,and difference was statistically significant (P ＜ 0.05).Conclusion Drug resistance surveillance should be strengthened because of high detection rate and drug resistance in ICU in terms of IRAB.Combination therapy and related intervention measures might effective control of infection and IRAB.

Objective To understand the distribution and drug resistance change trend of pseudomonas aeruginosa (PA) in hospital clinical infection in order to provide laboratory basis for rational clinical use of medications.Methods Statistical analyses was conducted retrospectively in 818 strains of PA separated in our hospital from January 2007 to December 2011.Results Of all the separation,PA number of the pathogen constituted a ratio of 15.2％ (818/5365) ; The main source of specimens was sputum,accounting for 82.6％ (676/818).There was good antimicrobial activity of Imipenem,Piperacillin/Tazobactam,Aztreonam,Ceftazidime,Levofloxacin and Ciprofloxacin to PA,with resistance rates of 14.9％ (97/653),25.0％ (179/716),26.8％ (179/667),26.9％ (208/773),28.6％ (211/738) and 29.1％ (220/757) respectively; The resistance of Ciprofloxacin and Levofloxacin did not change significantly during 2007-2010 year,but in 2011 year a significant decrease of resistance rates was found (ciprofloxacin:35.1％ (175/498) vs.17.4％ (45/259) ; Levofloxacin:38.0％ (181/476) vs.11.5％ (30/262)) ; During 2009-2011 year,the resistance of Imipenem and Amikacin increased year by year (Imipenem:7.4％ (9/121) vs.7.7％ (66/209) vs.19.5％ (51/262) ; Amikacin:13.0％ (2/23) vs.33.3％ (69/207) vs.36.2％ (94/260)).Conclusion PA detection rate and its resistance is rising from 2007 to 2011 year.We should make rational drug use clinically according to antimicrobial susceptibility test results.Laboratories shall strengthen the bacterial resistance monitoring.

Objective To retrospectively analyze the drug resistance evolution of Staphylococcus aureus and MRSA,to provide the basis for prevention and control measures.Methods 576 strains of clinical isolated Staphylococcus aureus from 2009 to 2012 were analyzed.The bacteria identification and drug sensitivity test were detected by VITEK 2 Compact automatic bacteria identification instrument.Results The separation rate of MRSA from 2009 to 2012 was 59.5％,but the separation rate was gradually decreased per year.The antibacterial activity of MRSA was better to vancomycin,linezolid,quinupristin/Dalfopristin,teicoplanin,nitrofurantoin (resistance rate ＜ 2.4％).The resistance rate and sensitive rate of MRSA to tigecycline was 0.0％,intermediary rate was 100.0％.The resistance of MRSA to gentamicin,ciprofloxacin,moxifloxacin,clindamycin,tetracycline and erythromycin was gradually decreased.From 2010 to 2012,The resistance of MRSA to cotrimoxazole decreased significantly,from 65.3％ in 2010 to 28.2％ in 2011 and 4.7％ in 2012 (P ＜ 0.05).Conclusion Separation of MRSA and drug resistance is reduced year by year,we should continue to strengthen the administration of antimicrobial agents,scientific and reasonable application of antibacterial drugs,reduce the incidence of multiresistant bacteria and drug resistance.

Objective To understand the antibacterial activity of nitrofurantoin from gram negative bacilli,provide the basis for clinical rational use of furan appropriate for drugs.Methods Gram negative bacilli 5 589 strains isolated from clinical were monitored between January 2009 and December 2009.VITEK 2 Compact automatic bacteria identification instrument was used for bacteria identification and drug sensitive test.Whonet 5.6 software was used for data analysis.Results E.coli and klebsiella bacteria produced acid with nitrofurantoin had good antibacterial activity (resistance to ＜ 4.3%),E.coli and klebsiella pneumoniae to with nitrofurantoin for antimicrobial activity was good (the percentages of 25.6% ～ 25.6%),pseudomonas aeruginosa,acinetobacter baumannii,singular deformation bacteria and glue abdulrahman al saleh,bacterium antibacterial activity of furan appropriate for poorer(ni 93.7% ～ 98.9%).Imine resistance from south pseudomonas aeruginosa (IRPA),resistant to carbon penicillium alkene antimicrobial acinetobacter baumannii(CR-AB) and penicillium carbon alkene antimicrobial drug resistant enterobacteriaceae bacteria(CRE) with nitrofurantoin because of the percentages were 100.0% (108/108),100.0% (335/335) and 96.1% (74/77).Conclusion Urine,blood,pus,and secretion of primary separation of E.coli with nitrofurantoin has better antimicrobial activity; Sputum specimens of primary separation of pseudomonas aeruginosa and acinetobacter baumannii with nitrofurantoin has the high prevalence of resistance.

Objective To compare distribution and drug resistance of Acinetobacter baumannii specimen in the intensive care unit(ICU) and the ICU.Methods Retrospective analysis ICU of 1 079 strains isolated and the 8 413 strains of bacteria isolated from ICU , Bacteria identification and drug sensitive test instrument using VITEK 2 Compact automatic bacterial culture identification .Results Most ICU Acinetobacter baumannii separation , form (29.2%) was significantly higher than the ICU (6.2%),the difference was statistically significant (χ2 =625.955, P<0.05).ICU imine resistant Acinetobacter baumannii from south (IRAB)detection rate(91.7%)was significantly higher(43.5%) than the ICU,difference was statistically significant (χ2 =193.541,P<0.05);Specimens of ICU and the ICU isolated bacteria were mainly comes from sputum ,constitute a ratio of 64.0%and 32.9%respectively. ICU and the separation of the ICU Acinetobacter baumannii to amikacin resistant rate was low (20.0%-21.6%),the separation of ICU Acinetobacter baumannii for three or four generation of cephalosporin , composite inhibitor drugs , penicillium carbon alkene ,quinolone antibacterial drugs ,significantly higher percentages of ICU ,difference was statis-tically significant(χ2 =146.124,104.407,253.171,195.646,186.580,all P<0.05).Conclusion Multiple drug resistance of Acinetobacter baumannii in ICU detection rate is high ,the bacteria monitoring should be strengthened , and the rational use of drugs ,reduce the drug resistance of bacteria .

S-adenosylmethionine(SAM) is a physiologically active molecule in all the organizations and the human body fluids, and it is important to participate in a variety of biochemical reactions, the regulation of liver regeneration, liver cells differentiation and various sensitivity of the injury. The SAM affects the liver through a variety of ways. It is confirmed that the SAM and MTA can block the LPS-induced TNF-α of Kupffer cells to protect the liver. In a word, S-adenosylmethionine may be beneficial to LPS-induced liver in-jury in clinical treatment.

Objective To evaluate the curative effect of Keli-Paoxi power for the treatment of acute paronychia. Methods A total of 144 patients with acute paronychia were randomly divided into a Keli-Paoxi power group, a mupirocin ointment group and an ethanol soaking group, 48 in each group. All patients were treated for 3 weeks and followed-up for 2 months. The time to regression of redness and swelling in the nail groove was recorded. The Visual Analogue Scale (VAS) was used to assess tenderness. The curative effects were evaluated, and recurrence of paronychia was recorded. Results The time to regression of redness and swelling in the nail groove in the Keli-Paoxi power group (2.2 ± 0.6 d) was significantly shorter than that in the mupirocin ointment group (8.1 ± 1.7 d) or ethanol soaking group (7.9 ± 1.2 d; F=344.597, P<0.01). The VAS Scores in the Keli-Paoxi power group (1.2 ± 0.2) was significantly lower than that in the mupirocin ointment group (3.2 ± 0.3) or ethanol soaking group (3.1 ± 0.3; F=831.273, P<0.01). The total effective rate in the Keli-Paoxi power group (100.0%, 48/48) was significantly higher than that in the mupirocin ointment group (83.3%, 40/48) or ethanol soaking group (81.3%, 39/48; χ2=9.700, P=0.008). The recurrence rate of paronychia in the Keli-Paoxi power group (2.1%, 1/48) was significantly lower than that in the mupirocin ointment group (16.7%, 8/48) or ethanol soaking group (14.6%, 7/48; χ2=6.000, P=0.049) at 2 months follow-up. Conclusions Keli-Paoxi power can alleviate tenderness, shorten the time to regression of redness and swelling in the nail groove, decraese recurrence in patients with acute paronychia. The curative effect of Keli-Paoxi power is superior to mupirocin ointment and ethanol soaking in the treatment of acute paronychia.