OBJECTIVE To study the distribution and drug resistance of nosocomial infection pathogens isolated from of lower respiratory tract in senile patients and preventive control measures.METHODS The sputum and lower respiratory tract secretion of 594 senile patients were cultured to detect pathogens which were confirmed by routine methods.Disk diffusion test was used to analyze drug resistance.RESULTS Pseudomonas aeruginosa was the top one(21.2%).The drug resistance of Gram-negative organisms were the highest.Extensive-spectrum beta-lactamase(ESBLs) were tested out with 38.2% occurrence.CONCLUSIONS Strictly control in every step of procedures could reduce nosocomial infection.

OBJECTIVE Through detecting to drug susceptibility results of 12 commonly used antibiotics in Pseudomonas aeruginosa (PAE),we provide the scientific basis for the prevention of infection and reasonable choice of antibiotics. METHODS Twelve antibiotics′ susceptibility tests in vitro were carried out in PAE isolated from lower respiratory tract in Renming Hospital,Wuhan University from Jan 2007 to Dec 2008. RESULTS In the anti-infective drugs,the resistance rate to ceftazidime was the lowest (36.8%),followed by amikacin (39.6%),piperacillin/tazobactam (43.8%),cefepime (47.8%) and cefoperazone/sulbactam (48.5%).The resistant status of PAE was serious and multi-drug resistance existed. CONCLUSIONS The lower respiratory tract infection caused by PAE which possesses single and multiple drug-resistance. We should more think of it and strengthen preventive measures to reduce the rate of infection. Reasonably prudent use of antibiotics is still the best way of delaying its rapid increase of drug-resistance strains.

Purpose　The aim is to purify the peptide with antifu ngal activity from Aspergillus fumigatus culture fluid.Methods　 The pept ide was separated by ion exchange column chromatography and further purified by r everse phase HPLC,and the molecular weight was determined by tricine gel electro phoresis.Results　A kind of peptide(FIP) with antifungal activit y wa s separated. The molecular weight was about 8 000. The detection result by MTT method showed significant antifungal activity of the peptide to 5 kinds of fung i.Conclusion　 The study provided a reliable basis for developin g drug and antiseptic.

Objective To study the effects of use of cyclamic acid on monitoring D-Dimer and predicting deep venous thrombosis on lower limbs during total hip arthroplasty.Methods Ninety-three cases patients who received total hip arthroplasty operations at Joint Surgery Department of the Central Hospital of Zhuzhou city and Zhuzhou Hospital Affiliated to Xiangya Medical College of Central South University from December 2015 to May 2016 were selected as subjects and randomly assigned into study group with 50 cases and control group with 43 cases.During the operations,cyclamic acid was used intravenously and locally as a routine in the study group while saline was utilized instead in the control group.The D-Dimer was dynamically monitored before operation and 1,3,5,7,9 d after the operation,and venous color ultrasonography of both lower limbs were taken 3,6,9 d after the operation to check the conformation of thrombosis.Results The total blood loss after treatment in the study group was (350.5 ± 65.2) ml,intraoperative blood loss of (129.3 ± 43.1) ml,postoperative drainage volume of (80.9± 12.6) ml,occult blood loss of (141.9± 20.6) ml,corresponding to the control group were (560.8±60.6) ml,(208.9± 57.8) ml,(150.8 ± 18.9) ml,(202.9±23.9) ml.The above indicators were lower in the study group than in the control group,the differences between the two groups were statistically significant(t =16.02,7.59,21.24,13.22,P＜0.05).There were significant differences in terms of D2-dimer level of 1,3,5 d after the operation between the study group and the control group (P＜0.05),but at 7,9 d after the operation,the difference between the two groups were not statistically significant(P＞0.05).The study group and the control group at 9 d after operation with color Doppler ultrasound examination showed that there were 1 cases of patients with calf vein thrombosis both in two groups,there was no significant difference between the two groups(2.00％ vs.2.32％,x2 =0.012,P＞ 0.05).Conclusion The proper use of cyclamic acid can reduce blood loss and will not increase the risk of thrombosis.Monitoring dynamically on D-Dimer and deep venous color ultrasonography on lower limbs is helpful for early detection of thrombosis after total hip arthroplasty.However,the use of cyclamic acid during total hip arthroplasty will affect the monitoring on D-Dimer and therefore needs to be taken seriously.

Objective:To investigate the detection rate of motoric cognitive risk(MCR)syndrome and explore the possible risk factors at different age groups.Methods:A total of 561 patients from geriatric outpatient clinic of Hubei Provincial Hospital of Traditional Chinese Medicine from November 2018 to December 2019 were divided into two age groups under 70 years old(n=241)and 70 years old and above(n=320). The general information, Pittsburgh Sleep Quality Index, Geriatric Depression Scale-15(GDS-15), 4-meter walking test, Mini-Mental State Examination and Morse Fall Scale were collected.Patients with MCR were screened out according to the MCR diagnostic criteria.Logistic multiple regression analysis was used to analyze the associated risk factors.Results:7 cases(7/241, 2.9%)met the MCR diagnostic criteria in age<70 years group, and 34 cases(34/320, 10.7%)in age ≥ 70 years group.The proportion of hearing impairment complaints and GDS-15 scores of MCR patients were higher than those of the non-MCR group in age<70 years group, and the Morse Fall Scale of MCR patients was higher than that of the non-MCR group in age ≥70 years old group( P<0.05). After adjusting for associated confounding factors, multiple logistic regression analysis showed that hearing impairment complaints( OR=26.394, P<0.05)and GDS-15( OR=1.385, P<0.05)were independent risk factors for MCR in age<70 years group.And female( OR=0.445, P<0.05)was a protective factor for MCR in age ≥70 years old group. Conclusions:Motoric cognitive risk syndrome has different risk factors in different age groups, which may indicate that the causes and predictive significance of MCR in these two different age groups are different.

BACKGROUNDLipoprotein glomerulopathy (LPG) is a renal disease characterized by thrombus-like lipoproteins in the glomerular capillaries and its abnormal lipoprotein profiles with marked elevation of apolipoprotein E (apoE). In this study, 15 Chinese patients with LPG were involed in exploring the association of the genetic variation and its plasma level in the pathogenesis of LPG.

METHODSA retrospective analysis of the clinical and pathological features was made in 15 patients with LPG. Plasma concentrations of apoE were measured with radial immunodiffusion assay. Genetic variations of apoE gene were detected using polymerase chain reaction and restriction fragment length polymorphism. Glomerular deposition of apoA, apoB and apoE in these patients were detected by immunofluorescence staining using monoclonal antibodies.

RESULTSBiochemical profiles of lipids and lipoproteins revealed markedly elevated levels of triglyceride, apoB and apoE, but approximately normal levels of total cholesterol, apoA1 and lipoprotein(a) [Lp(a)], which resembled familial hypertriglyceridemia. Genetic analysis demonstrated that the genotype distribution of apoE were 7 cases with epsilon3/epsilon4, 4 cases with epsilon3/epsilon3 and 2 cases with epsilon2/epsilon3. The other 2 cases (a mother and her son) showed a same distinct band. The band pattern of later 2 cases was quite similar to the apoE variant of Tokyo type. The calculated allele frequency of epsilon 4 was relatively high in cases with LPG in comparison with that in the normal controls. We further divided the 13 patients into three groups according to their genotypes of apoE. Patients with the genotype of apoE epsilon2/epsilon3 showed a lower level of plasma apoE as compared to those with apoE epsilon3/epsilon4 (P < 0.05). The serum level of high-density lipoprotein (HDL) was the lowest in patients with the genotype of apoE epsilon3/epsilon4. No difference was found among the patients with different apoE genotype in the other clinical and pathological characteristics.

CONCLUSIONSThe genotype of apoE epsilon3/epsilon4 is the predominant one in Chinese patients with LPG. Patients with this genotype tend to have a higher plasma level of apoE and more severe lipid dysmetabolism. No correlation was found between the genotype of apoE and the clinical features in patients with LPG.

Adolescent ; Adult ; Apolipoprotein E2 ; Apolipoprotein E3 ; Apolipoproteins E ; blood ; genetics ; Child ; Female ; Genetic Variation ; Genotype ; Humans ; Kidney Diseases ; blood ; genetics ; pathology ; Kidney Glomerulus ; blood supply ; pathology ; Lipoproteins ; metabolism ; Male ; Middle Aged

Objective Erythroderma is a very serious disease that affects nearly the entire cutaneous surface and are highly subjected to secondary hypoalbuminemia, infection, cardiovascular diseases, complex causes and high death rates. The article aimed to explore the etiology, comorbidities and complicated infection of erythroderma.Methods Retrospective analysis was conducted on clinical data of 95 cases of erythroderma in our department from January 2009 to August 2016. Observations were made on the patients' clinical characteristics, etiology and inducement, lab examination, complications and complicated infection.Results There were 73 first-episode and 22 recurrent patients, among which 14 cases are psoriasis as the basic disease. As to etiological factors, there were 57 cases secondary to other skin diseases (60%) and 25 cases by drug reactions (26%). As to inducing factors, there were 6 cases by upper respiratory tract infection, 38 cases by irrational application of glucocorticoids, and 7 cases by external stimulants (traditional Chinese medicine scrubbing and external medicinal liquor). The main complications were 38 cases of cardiovascular diseases (40%). The complicated infection rates of plasma albumin in patients <35g/L and ≥35g/L were 65.78% and 12.28%(P<0.01). The complicated infection rates of the patients with hypoalbuminemia and electrolyte disturbance were 44.2% and 25% respectively (P<0.05).Conclusion The erythroderma is mainly secondary to previous skin diseases, mostly psoriasis, with cardiovascular diseases as the main comorbidities. In clinical practice, importance should be attached to monitoring decreased plasma albumin level and electrolyte disturbances in order to reduce the risk of infection.

Objective To investigate the developmental characteristics of static visual acuity (SVA) and kinetic visual acuity (KVA) and the correlation between the for children. Methods From April to June, 2018, SVA and KVA of 715 children aged 6 to 10 years in Suzhou were tested with logarithmic visual chart and KVA meter. Results KVA and SVA increased with age within 6 to 9 years old, and decreased then. KVA was higher in boys than in girls (t = 4.604, P < 0.001), but not significantly different for SVA (t = 1.822, P > 0.05). There was a moderate positive correlation between KVA and SVA (r = 0.552, P < 0.01). KVA can predicted SVA (B = 0.617, P < 0.001). Conclusion KVA and SVA develop for children aged 6 to 9, and moderately positive correlate with each other. It means SVA may be improved via training of KVA.