OBJECTIVE To investigate the distribution,epidemic trend and transition of drugs′ sensitivity about the pathogenic bacteria of children′s urinary tract infection(UTI) in the past 8 years in the local area.METHODS The medical records of 391 UTI cases which were hospitalized in our hospital and confirmed as UTI through urine culture from 2000 to 2007,were reviewed and the clinical features were analyzed.RESULTS A total of 402 pathogenic bacteria were determined.Gram-negative bacilli were predominant,accounted for 72.9%,and Escherichia were the most commonly found(34.4%).Gram-positive cocci accounted for 27.1%,including 12.9% of Staphylococcus and 10.4% of Enterococcus.The proportion of Escherichia,Klebsiella and Enterococcus was increased year by year.Gram-negative bacilli had a high resistance rate to ampicillin and 1st to 4th generation cefalosporins and a low resistance rate to piperacillin/tazobactam.Gram-positive cocci had a high resistance rate to ampicillin and erythromycin and a low resistance rate to nitrofurantoin and vancomycin.In the past 8 years,the resistance rate to most of the antibacterial agents has been increased,especially ampicillin and cephalosporins.Only piperacillin/tazobactam and vancomycin maintained high antibacterial activities.CONCLUSIONS Gram-negative bacilli are the major pathogens in pediatric UTI,and Gram-positive cocci appear to be increasing.Ampicillin should not to be chosen commonly.The observation of variation of pathogenic bacteria and drug resistance is of great importance.

Enzyme-linked immunosorbent assay ( ELISA) was applied to detect the antibody against CoxA16 and EV71 among 0~14 age groups. In 1 000 cases of children, the total positive rate of anti-EV71 IgM was 19. 9%, the total positive rate of anti-EV71 IgG was 47. 7%, the total positive rate of anti-CoxA16 IgM was 22. 8%, the to-tal positive rate of anti-CoxA16 IgG was 51. 3%. There was a negative correlation between positivity for EV71 IgM and positivity for CoxA16 IgM(χ2 =2. 794,P>0. 05). There was also a negative correlation between positivity for EV71 IgG and positivity for CoxA16 IgG(χ2 =2. 793,P>0. 05). The positive rate of IgG antibody against CoxA16 and EV71 was higher in neonatal group in which anti-EV71 IgG was 41 . 5% and anti-CoxA16 IgG was 49 . 5%. The lowest positive rate of IgG antibody against CoxA16 and EV71 was in infant group in which anti-EV71 IgG was 38. 0% and anti-CoxA16 IgG was 43. 5%. Except for neonatal group,the positive rate of IgG antibody against Cox-A16 and EV71 increased gradually with the age growth, there were statistical differences among the age groups (χ2=27. 04 and 19. 98,P<0. 01). With the age growth,the positive rate of IgM antibody against EV71 and CoxA16 increased,there were statistical differences among the age groups(χ2 =41. 12 and 37. 13,P<0. 01). There were not statistical differences between gender groups (χ2 =0. 51,1. 77,0. 36 and 2. 12,P>0. 05).

OBJECTIVE To analyze the occurring characteristic and curing measures of hospital infection for inpatients in the departments of neurology.METHODS The data of hospital infection for the medical records of 22 936 inpatients with disease in the departments of neurology of 40 hospitals in Anhui from Jan 2005 to Mar 2006 were analyzed.RESULTS Among all inpatients 1 011 were infected.The rate of infection was 4.41%.The infection distribution is described as follows:640 patients were infected in respiratory tract(63.30%);181 patients in urinary tract(17.90%),84 patients in gastrointestinal tract(8.31%);and 16 patients were in cutis tissue(1.58%).CONCLUSIONS Through performing aseptic manipulation strictly,curing underlying diseases,paying attention to aseptic manipulation and making the rational use of antimicrobial agents,the infection rate could be lowered.

OBJECTIVE:To investigate the effects of atorvastatin with different doses on related indicators and major adverse cardiovascular events(MACE)in patients with acute myocardial infarction(AMI)after percutaneous coronary intervention(PCI). METHODS:120 patients with AMI after PCI were randomly divided into conventional dose group(60 cases)and high dose group (60 cases). All patients were immediately given low molecular weight heparin,Aspirin enteric-coated tablet,Clopidogrel bisulfate tablet,Angiotensin-converting enzyme inhibitor,β-blockers,nitrates and other conventional treatment;based on it,conventional dose group was given 20 mg Atorvastatin calcium tablet,once every day before bedtime;high dose group was given 40 mg Atorv-astatin calcium tablet,once every day before bedtime. The treatment course for both groups was 1 month. Total cholesterol(TC), triglyceride(TG),low density lipoprotein cholesterol(LDL-C),high density lipoprotein cholesterol(HDL-C),C-reactive protein (CRP),OX40L,interleukin (IL)-6 levels in 2 groups before and after treatment were observed,the correlation among OX40L with CRP and IL-6 were analyzed,and the incidence of MACE in 2 groups was recorded after 1 month follow-up. RESULTS:Be-fore treatment,there were no significant differences in the TG,TC,LDL-C,HDL-C,OX40L,CRP and IL-6 between 2 groups (P>0.05). After treatment, TG, TC, LDL-C, OX40L, CRP and IL-6 were aignificantly lower than before, TC, LDL-C, OX40L,CRP and IL-6 in high dose group were lower than conventional dose group,HDL-C was significantly higher than before, the differences were statistically significant(P<0.01 or P<0.05);but there was no significant difference in the HDL-C between 2 groups(P>0.05). Before treatment,OX40L showed positive correlation with CRP(r=0.746,P<0.01)and IL-6(r=0.763,P<0.01);after treatment,OX40L also showed positive correlation with CRP (r=0.755,P<0.01) and IL-6 (r=0.760,P<0.01). The incidence of MACE in high dose group were significantly lower than conventional dose group,the difference was statistically significant(P<0.05). CONCLUSIONS:Based on the conventional treatment,atorvastatin can significantly reduce lipid,inflamma-tion levels and incidence of MACE,but the effect is more significant in high dose.

Objective To study on transcatheter closure of membranous ventricular septal defect (VSD) with pseudoaneurysm by patent ductus arteriosus(PDA) occlusion devices in children and summarize the skill and clinical experience. Methods The study included 20 membranous VSD cases in children.According to the finding of the left ventricular angiography, various kinds of the PDA occlusion devices was implanted. The mean diameter of the waist of the occluder was ( 10.4 ± 2.6) mm. Examination by transthoracic echocardiography (TTE) immediately and left ventricular angiography after the occluder was implanted 15minutes later to evaluate the efficacy. Results In the 20 patients, one of the Ⅳ type VSD patient was quitted because of the significant residual shunts(≥2 mm). Slightly residual shunts ( ＜ 2 mm) was found in one Ⅲ type VSD patient with multi-outlet. And disappeared in 1 month after the procedure, which VSD patient was confirmed by TTE. Thirteen cases were normal by EKG examination (or the same before procedure).Incomplete right bundle branch block was found in 4 cases. First degree atrioventricular block was found in 1 case and paroxysmal junctional tachycardia was found in 1 case. All of them were recovered in 1 week.Conclusions Transcatheter interventional therapy with PDA occlusion devices for membranous VSD with pseudoaneurysm is safe and effective. The key of the procedure is to select suitable occluder and suitable position to plant them according to the membranous morphologic characteristics,size and position of the pseudoaneurysm. It is a facultative method for transcatheter therapy this kind of congenital heart disease.

Objective To investigate the clinical features,diagnosis and treatment of appendix tumor.Methods The clinical data of 58 cases with primary appendiceal tumor were analyzed retrospectively.Results In the 58 cases clinical presentation mimicked acute appendicitis in 22 cases,chronic appendicitis in 15 cases,appendiceal abscess in 12 cases,intra-abdominal mass in 7 cases,and gastrointestinal perforation in 2 cases.Primary appendiceal tumor was diagnosed intraoperatively by intraoperative frozen histopathological examination in 10 cases,and the diagnosis was made by postoperative histopathological examination in the other 48 cases.There was appendiceal carcinoid in 40 cases,adenocarcinoma in 6 cases,mucocele in 2 cases,mucous adenocystoadenoma in 5 cases,pseudomyxoma peritonei in 2 cases,malignant neurilemmoma in 1 case,and malignant lymphoma in 2 cases.Surgical procedures included appendectomy in 6 cases,ileocecal resection in 8 cases,and right hemicolectomy in 44 cases (including right hemicolectomy and intraperitoneal chemotherapy with 5-FU 1 000 mg for pseudomyxoma peritonei in 2 cases).Radical resection was achieved in 55 cases and palliative resection in 3 cases.The 2 cases with pseudomyxoma peritonei died of tumor recurrence at 36 months and 54 months after operation respectively.All the 5 cases of adenocystoadenoma and 2 cases of appendix cyst survived without an evidence of recurrence.7 of 49 cases of malignant appendiceal tumor suffered recurrence postoperatively,the recurrence rate was 14％,which included liver metastasis in 4 cases and intraperitoneal recurrence in 3 cases.The 1,3,5-year survival rates of malignant appendiceal tumors were 100％ (49/49),92％ (35/49) and 80％ (39/49),respectively,which were 100％,98％ and 92％ for carcinoid,and 100％,67％ and 33％ for adenocarcinoma,respectively.Conclusions The preoperative diagnosis of primary appendiceal tumor is very difficult,the intraoperative frozen histopathological examination is helpful for diagnosis,the prognosis of appendiceal carcinoid is fair after resection.

Objective To observe the influence of large dose of mecobalamin combining with breviscapin injection on the levels of serum tumor necrosis factor-α(TNF-α)and C-reactive protein (CRP)and the antithrombin Ⅲ(AT-Ⅲ)activity in the patients with diabetic foot(DF).Methods 240 cases of DF were divided into 4 groups according to the random number table method,60 cases in each group:the large dose of mecobalamin plus breviscapin injection group (group Ⅳ);the routine dose of mecobalamin plus brevis-capin injection group (group Ⅲ);the simple breviscapin injection group (group Ⅱ)and the routine dose of mecobalamin group (groupⅠ).4 weeks were taken as a course of treatment.The TNF-α,CRP levels and the AT-Ⅲ activity before and after the treat-ment were detected and performed the comparative analysis.Results The levels of TNF-α,CRP and AT-Ⅲ before treatment had no statistically significant differences among in the four groups (P >0.05).Compared with the results before treatment,the levels of TNF-αand CRP after treatment in 4 groups were obviously decreased and the AT-Ⅲ level was significantly increased,the differ-ences had statistical significance (P <0.05);compared with the group Ⅰ,Ⅱ and Ⅲ,the difference in the group Ⅳ had statistical significance(P <0.05).Conclusion Mecobalamin combined with breviscapin injection is able to decrease the serum inflammatory factors such as TNF-αand CRP,and increase the AT-Ⅲ activity in the patients with DF,which is more significant when increasing the mecobalamin concentration.Therefore,adopting the therapeutical scheme of increasing the mecobalamin concentration combined with breviscapin injection could obviously decrease the inflammatory reaction of DF with good safety,which is one of effective meas-ures for increasing the curative effect of DF.

OBJECTIVE To know the basic situation of nosocomial infection control and management in all levels of hospitals in Anhui Province,and provide the theory basis for the future work.METHODS To investigate the students participating in the nosocomial infection management training class by using the questionnaire.RESULTS There were altogether 273 people from 217 hospitals accepting the investigation.From 217 hospitals there were 46 1st grade hospitals and 160 2nd grade hospitals and 11 third graed hospitals.In all the people engaged in the nosocomial infection management,83.88% were the females and 67.03% for nursing staff,the age of 30-50 years old was 79.84%,the middle professional rank accounted for 72.53%,and 79.86% people′s record of formal schooling was the technical college and below.CONCLUSIONS The basic situation of nosocomial infection management in majority hospitals of our Province is good,but in some hospitals,the function of the structure has not certainly obtained the full display.In order to adapt the development of the nosocomial infection supervisory work,promote it to be more perfect,personnel structure,resources arrangement,and administrative offices function should give enough reconstruction and construction.

OBJECTIVE To investigate the surgical site infection(SSI)in clean surgical sites and the perioperative antibiotic usage.METHODS The incidence of SSI and the antibiotics usages in 842 cases during perioperative were analyzed retrospectively in 32 hospitals.RESULTS One case with nosocomial infection was found(0.12%).The use rate of antibiotics was 98.57%.Among 802 cases using prophylactic antibiotics,the antibiotics were given in 181 cases thirty minutes to two hours before operation.136 cases were given 24 h before operation.And 485 cases were given after operation;195 cases stopped using antibiotics after 24 h,472 cases stopped using antibiotics after 4-6 days and 135 cases stopped to use antibiotics after 7 days.CONCLUSIONS The major problem is excessive use of antibiotic in clean surgical site during perioperation,long duration of antibiotics prophylaxis,more expensive antibiotics and unnecessary combination of antibiotics,suggesting that it be important to strengthen the management of antibiotics.

OBJECTIVE To investigate the status of the management of nosocomial infection in Anhui Province so as to help to improve it.METHODS Twenty-four hospitals were on-the-spot investigated in a way of questioning and sampling using uniform questionnaire by trained investigators.RESULTS 95.83% Of all involved hospitals have built independent department of nosocomial infection management.These departments from 70.83% hospitals play an important role in infection management and 45.83% of them have suitable structure of staff.There are some problems in the key regions of nosocomial infection control such as operating room,blood dialyzing center and sterilization supply department: small work area,old equipment,irrational arrangement,sterilizing inadequately and so on.CONCLUSIONS The work of administration of nosocomial infections needs to be strengthened.