Objective To observe the distribution and drug resistance of pathogenic bacteria causing pulmo-nary infections in cardiology department of general hospital ,and to provide advices for infection control and selection of drugs.Methods 110 sputum specimens of patients with pulmonary infections in cardiology department were col -lected.The distribution and drug resistance of pathogenic bacteria were analyzed .Results In the 110 sputum sam-ples,83 cases(75.5%) were infected by gram-negative bacterias,21 cases(19.1%) were infected by gram-positive bacterias,6 cases(5.4%) of fungal infection .The Escherichia coli and the Pseudomonas aeruginosa after the antibiot-ic resistance analysis were found a trend of multi resistance .Conclusion The major pathogenic bacterias causing pulmonary infections in cardiology department are gram-negative bacterias ,and they show a trend of multi resistance .

Objective To analyze the clinical effect of puerarin and lipoic acid in treatment diabetic peripheral neuropathy.Methods 80 type Ⅱ diabetes patients accompanied with peripheral neuropathy were selected.According to different therapy,they were divided into single drug treatment control group (lipoic acid) and combined treatment group (puerarin + lipoie acid).Total effective rate,MNCV,SNCV,FBG,HbAlc and sorbitol were evaluated after treatment.Results The total effective rate in the treatment group was higher than that in the control group (P ＜ 0.05).Compared with the control group,the recovery rates of MNCV and SNCV were faster in the treatment group(P ＜0.05).And the levels of FBG,HbAlc and sorbitol were significantly lower in the treatment group than in the control group(P ＜ 0.05).Concluslon The clinical effect of puerarin and lipoic acid in treatment diabetic peripheral neuropathy was significant.

Effective chemotherapy is the mainstay of malaria control. However it is undergoing the serious threat by resis?tance of falciparum malaria to antimalarial drugs. In recent years with the development of molecular biology technology molec?ular markers have been widely used to monitor antimalarial drug resistance. This paper reviews the researches on the common molecular markers related to Plasmodium falciparum drug resistance.

Objective To study the effect of BiPAP NIV in treating severe asthma that resists incretion.Method 38 asthma patients that resist incretion were selected with 19 patients given BiPAP NIV and the other 19 patients given oxyen by nasal catheter.We study the changes of blood gas analysis and days of hospitalization.Result After 4 days' treating,two group patients' PO_2 increase obviously and their dyspnea alleviate.In BiPAP NIV group,PO_2 is higher than that of the control group(P

Objective To elucidate the prevalence and risk factors of cardiovascular disease (CVD) in end-stage renal disease (ESRD) patients on peritoneal dialysis (PD), and to investigate the associated problems in treatment. Methods A total of 254 PD patients in our division were enrolled in this study. CVD history, laboratory measurements, examinations of carotid atherosclerosis and left ventricular hypertrophy by ultrasonography were collected and associated factors were analyzed. The median follow-up time was 49 months. Results The overall prevalence of CVD was 37% (93/254). Diabetes, longer dialysis duration, hypertfiglyceridemia, hypoalbuminemia, hypoprealbuminemia were commonly found in the patients with new CVD event. The patients without pre-existing CVD had the higher Ccr, Kt/V, D/Pr, nPCR, serum albumin level. In those with pre-existing CVD, the hypertriglyceridemia and the duration of dialysis were independent predictors of progression of CVD. Differences of LAD, LVST, LVMI and IMT were significant between with and without pre-existing CVD groups. Kaplan-Meier curves showed that the presence of CVD was the independent risk factor of survival. Alb<330 g/L, LAD>39.6 mm and peritonitis were risk factors of CVD. Conclusion The prevalence of CVD in PD patients is quite high. CVD history should be realized, dialysis adequacy should be maintained, and peritonitis should be prevented.

Objective:To investigate the possible role of NKT cells in unexplained recurrent spontaneous abortion by measuring the NKT cell numbers,maturity and cytokine secretion of the placenta of mice with unexplained recurrent spontaneous abortion.Methods:Normal pregnancy model in hybrid by feeding CBA / J and BABL/C in a cage,and the model of unexplained recurrent spontaneous abortion was established by feeding CBA / J and DBA2/J in a cage.The number of NKT and CD3~+T cells was determined by flow-cytometry;Th1/Th2-relative cytokines were assayed by ELISA and T-bet expression was determinded by fluorescence quantitative PCR.Results:There was not significant change of CD3~+ T cells when compared between normal pregnancy and unexplained recurrent spontaneous abortion group (P＞0.05).In the course of normal pregnancy,the IFN-γ secreted by placenta lymphocytes decreased gradually,accompanied by the decline of NKT cell number and the proportion of mature cells;whereas in the course of unexplained recurrent spontaneous abortion,it was on the opposite.There was significant difference of T-bet mRNA expression between the two groups.T-bet mRNA expression was related to the proportion of mature NKT cells or placenta IFN-γ secretion by lymphocytes.Conclusion:Unexplained recurrent spontaneous abortion may be related to NKT cells disorders,NKT cells are of low-mature proportion and inadequate secretion of IFN-γ during early pregnancy,whereas are shown high-mature proportion and excessive secretion of IFN-γ during latter pregnancy;the anomaly of T-bet mRNA expression may be one of the factors leading to NKT cells disorder.

To combine more than 20 years of experience in clinical practice skills teaching of laboratory medicine, with the characteristics of laboratory medicine, the theory system of formative assessment has been constructed, to guide the clinical practice of the students.Based on the construction of network question bank, students make use of the network question bank self testing, to know whether they had got the stage goal, existing problems and future plan through self testing, so as to mobilize their enthusiasm and initiative to enhance their self-confidence.Under the formative assessment teaching system, students establish internship file information, including practice notes, weekly practice, group discussion, self testing results, the teacher and peer assessment information.Teachers set up QQ group, WeChat group with their students, the timely to get the question from students and to take appropriate measures improve teaching.Teachers had established and improved the long-term after graduation feedback mechanism, and formative assessment improved the teaching quality of the whole practice teaching benefits teachers as well as students.

Objective To analyze the pulse-field gel electrophoresis (PFGE) patterns and antibiotic resistance of Salmonella enteritidisstrains isolated in Longyan city in order to provide reference for effective control, clinical diagnosis and treatment of outbreaks of food-borne diseases.Methods Seventy-seven Salmonella enteritidis strains isolated from food poisoning cases, livestock and poultry meat samples collected for food safety risk monitoring and sporadic cases in 2014 and 2016 were analyzed by PFGE.Antibiotic susceptibility testing was carried out to determine the minimum inhibitory concentrations (MIC) of 16 common antibiotics to 57 strains.Results Seventeen PFGE types were identified among the 77 Salmonella strains including three predominant types (P4, P6 and P8) and were grouped into three major pulsotypes (Cluster1-3) at 90% similarity level.The predominant types causing outbreaks of Salmonella enteritidis infection were P8, P6, P4 and P14, which were responsible for five cases of food poisoning.These isolated strains were highly resistant to nalidixic acid (93%), followed by resistance towards ampicillin (74%) and streptomycin (54%).Forty-one strains were resistant to three or more antibiotics (71.93%).Conclusion The PFGE types of Salmonella enteritidis strains isolated in Longyan city exhibit polymorphism and are clustered into three major pulsotypes.PFGE molecular typing can provide early-warning of sporadic outbreaks and help to identify the sources of infections in Salmonella enteritidis-related food poisoning.Attentions should be paid to multidrug resistant Salmonella enteritidis.Surveillance for multidrug resistant strains and usage of antibiotics should be strengthened.

Objective To investigate the resistance mechanism of Carbapenem-Resistant Klebsiella oxytoca.Methods Car-bapenem-Resistant Klebsiellaoxytoca were collected from Fujian Medical University Union Hospital.The modified hodge test (MHT)was used for carbapenemase phenotype screening.The minimum inhibit concentration(MIC)was detected using agar dilution method for 1 7 drugs.PCR and DNA sequencing were used to detect commonβ-Lactamase genes and carbapene-mases genes.Conj ugation experiments demonstrated the transferability of the carbapenem-resistant determinants.Results 5 Carbapenem-Resistant Klebsiella oxytoca of 4 isolates were positive detected by MHT.Minimum inhibit concentration was detected by using agar dilution method for 17 drugs.More than 80% isolates were resistance to nine drugs.2 isolates conju-gated successfully of 5 Carbapenem-Resistant Klebsiella oxytoca Isolates.There were 2 isolates included carbapenemases gene (1 isolates were only IMP producers,1 isolate contained the IMP and KPC),3 isolates produce ESBLs gene.Conclution The due to CRE strains isolated from Fujian Medical University Union Hospital may be metallo-enzyme carbapenemase and KPC gene.And the isolate that produce two Carbapenem-Resistant gene had been found in this hospital.

Objective To evaluate the early diagnostic value of galactomannan ( GM ) test in bronchoalveolar lavage fluid ( BALF ) to invasive pulmonary aspergillosis ( IPA ) in patients with non-neutropenia.Methods A total of 199 patients with suspected IPA were enrolled in the Department of Critical Care Medicine and Respiration of the Union Hospital of Fujian Medical University from January 2016 to October 2017, these patients excluded neutropenia .The patients were divided into IPA group and non-IPA group according to the European Organization for Research and Treatment of Cancer /Infectious Diseases Mycoses Study Group ( EORTC/MSG ) consensus.BALF and serum GM tests were performed in both groups.SPSS 20.0 statistical software was used to analyze the results of both IPA group and non-IPA group.Results The GM index in BALF and serum of IPA group was 2.41 ±2.19 and 0.65 ±1.08 respectively.The former is higher than the latter , the difference was statistically significant ( u=8.27,P<0.0005 ) . The GM index in BALF and serum of non-IPA group was 0.37 ±0.33 and 0.2 ±0.15 respectively, compared with the IPA group, the difference were statistically significant (u=11.18 and 7.07, P<0.0005).When the cut-off of GM was equal or greater than 0.5, the sensitivity, positive predictive value and negative predictive value of GM test in BALF was 86.36％, 74.02％and 92.62％ respectively , were significantly higher than those in serum (31.8％, 67.74％and 73.21％respectively).The specificity of GM test in BALF was 84.96％, which was lower than that in serum (92.48％).When the cut-off of GM was equal or greater than 1.0, the sensitivity, positive predictive value and negative predictive value of GM test in BALF was 66.66％, 84.61％and 85.03％ respectively, significantly higher than those in serum ( 24.24％, 76.19％and 71.9％ respectively ) . The specificity was similar ( 95.98％vs 96.24％) . Conclusions GM test in BALF has a highly sensitivity and specificity in patients with non-neutropenia, better than that in serum.It has high value for early diagnosis of IPA.