OBJECTIVE To investigate the pathogens of hospital acquired pneumonia(HAP) in the general ward of our hospital to provide the basis for clinical experiential medication.METHODS The bacteria of the 62 patients with HAP whithout organ dysfunction in the general ward of our hospital between Jan 2005 and Apr 2008 was analyzed.RESULTS The main pathogens followed by Klebsiella pneumoniae(29.03%),Escherichia coli(22.58%),Staphylococcus haemolyticus(16.13%),S.epidermidis(12.90%),Pseudomonas aeruginosa(8.06%) and S.aureus(4.84%).Gram-negative bacilli showed better sensitivity to imipenem,piperacillin/tazobactam and cefepime(91.89-81.08%);Gram-positive cocci had lower resistance to vancomycin and rifampin(100.00-92.00%).CONCLUSIONS Hospital-acquired pneumonia in the general ward can be cured by appropriate commonly used antibiotics.

Objective To explore the magnetic resonance spectroscopy characteristics of prefrontal white matter in bipolar Ⅱ disorder and its relation with executive function.Methods Thirty bipolar Ⅱ disorder patients and twenty healthy controls were evaluated with Multi-Voxel proton magnetic resonance spectroscopy (1H-MRS)scans on prefrontal white matter to assess the N-acetyl-aspartate (NAA),Choline (Cho),Creatine (Cr) and myoinositol (MI),and then the ratios of NAA/Cr,Cho/Cr,MI/Cr,NAA/Cho and NAA/Cho + Cr were calculated.All subjects were assessed for executive function using the Wisconsin Card Sorting Test (WCST).Results NAA/Cr in right prefrontal white matter(1.43 ± 0.26) and NAA/Cr,NAA/Cho,NAA/Cho + Cr in left prefrontal white matter (separatelyl.40 ± 0.29,1.13 (1.53,0.24),0.62 ± 0.12) were lower than healthy controls (separately 1.58 ±0.18,1.59,0.23,1.30 (0.53 ± 0.29),0.71 ± 0.08) (P ＜ 0.05).The correct trials and the number of categories of WCST in Bipolar Ⅱ disorder (separately 26.97 ± 8.97,3(6,3)) were less than in healthy controls(separately 36.35±4.85,5 (3,2)),and perseverative errors and random errors were more in patients (separately 12.77 ±5.73,7 (21,5)) than healthy controls (separately 7.35 ± 3.01,4 (13,2)).NAA/Cho and NAA/Cho + Cr in left prefrontal white matter were positively correlated with correct trials,number of categories,and negatively related with perseverative errors (P＜0.05).Conclusions Bilateral prefrontal white matter fiber damage occurs to bipolar Ⅱ disorder.And left prefrontal white matter fiber damage in bipolar Ⅱ disorder may lead to executive impairment.

Objective To investigate the relationship between the severity of insomnia and the curative effect in acute stage in patients with major depressive disorder (MDD). Methods The Insomnia Severity Index (ISI) was used to evaluate and group the severity of insomnia in the 57 patients with MDD. The Pittsburgh Sleep Quality Index (PSQI) was used to assess sleep quality. The 24－item Hamilton Depression Scale (HAMD24) was used to evaluate depressive symptoms, and the effect of acute stage (4～6 weeks) was evaluated with its reduction rate. The difference of curative effect was compared among patients with different insomnia levels. Results There was a significantly different recovery rate in acute stage in 3 groups of patients with mild, moderate and severe insomnia ( X2=22.34,P＜0.01). The severity of insomnia in patients with MDD (PSQI) was negatively correlated with the curative effect of acute stage (r=－0.44,P＜0.01). The total score, anxiety/somatization factor score, retardant factor score and despair factor score were significantly higher in severe insomnia group than in the moderate and mild insomnia groups after acute treatment (P＜0.01). Conclusion The severity of insomnia in patients with MDD can predict the curative effect in acute stage. The depressive patients with severe insomnia have residual anxiety/somatization, retardant, feelings of despair and other symptoms more obvious than mild and moderate insomnia patients after acute treatment.