Objective:To monitor the rug resistance and epidemiology state of pseudomonas aeruginosa(PA)isolated clinical pa- tient.Methods:antimicrobial sensitivity tests were performed by K-B method and metallo-?-lactamases-producing PA was genotyped by the randomly amplified polymorphic(PAPD)assay.Results:Among24 strains resistant to imipenem.19(8%)strains produced metal enzyme which could be distingurished into 10 kinds of PAPD type.the type ability was 100%.There was same gene type strain.Isolated from three patient and there were two kinds of gene types. Among 2 strains isolated from the same patient at the different time.Conclusions:the K-B method could be used to determine metal enzyme,rapidly and eonviently. And PAPD could to be used in the molecular epidemiological study of PA.

Objective:To study bacterial distribution and antimicrobial resistance of 489 strains of bacteria isolated from clinical urinary specimens of inpatients in department of kidney diseases of our hospital from 2001 to 2002,and propose rational use of antibiotics.Methods:Bacteria was isolated and identified by routine methods.Antimicrobial susceptibility was tested by K-B method.Results:in the 489 strains,there were307 strains of gram-regtive bacilli which account for 62.5%,mean while,there were 182 strains of gran-positive cocci which acconnt for 37.5%.The gram-negative bacilli mainly included K.pneumonice P.mirabilis and E.aerogenes.And the gram-positive cocci mainly included enterococcus and serum coagulase negative staphylococcus.The gram-negative bacilli were sensitive to imipenem and piperacillin/tazobactam,while the gram-positive cocci were sensitive to vancomycin and Teicoplamin.Conclusion:The urinary system infection is always induced by E.coli and Enterococcus.The periodical detection for bacterial resistance has an important significance for clinical treatment.

Adolescent ; Adult ; Chronic Disease ; Female ; Humans ; Laryngeal Diseases ; etiology ; therapy ; Male ; Middle Aged ; Occupational Diseases ; therapy ; Singing ; Young Adult

Objective To understand the pathogenic bacteria distribution and drug resistance in patients with acute exacerbation of chronic obstructive pulmonary disease(AECOPD). Methods The retrospective analysis was per-formed in the sputum culturs and drug resistance results of 740 patients with AECOPD. Results The positive rate of bacterial infection was 39. 1%. Among them, gram-negative bacteria were 196 strains (62. 4%), gram-positive bacteria 21 strains (6. 7%), and fungi 97 strains(30. 9%). The main kinds of gram-negative bacteria were Pseud-omonas aeruginasa, Acinetobacter baumannii,Klebsiella pneumoniae,Stenotrophomonas maltophilia and Escherichia-coli. Staphylococcus haemolyticus, Streptococcus pneumoniae and Staphylococcus aureus were the most frequent gram-positive bacteria. The major fungi was Candida albicans. Gram-negative bacteria showed high resistance to the third-generation cephalosporins,penicillins, moderate resistance to aminoglycosides,low resistance to imipenem. Gram-positive bacteria were resistant to many kinds of antibiotics, but they were responsive to linezolid and vancomycin. Fungi showed high sensitivity to antifungal agents. Conclusion The pathogens of AECOPD mainly are gram-nega-tive bacteria with a high drug resistance rate. To monitor pathogenic bacteria is conducive to master the pathogens distribution, drug resistance and provide the basis of rational use of antibiotics,which can slow down the emergence and spread of resistant bacteria.

Objective To investigate the effects of compound danshen dripping pill (CDDP) on carotid intima￣media thickness (CIMT) and cardiac function in patients newly diagnosed as hypothyroidism. Methods The total of 40 subclinical hypothyroidism patients and 40 hypothyroidism cases was enrolled.The clinical hypothyroidism patients were treated with L￣T4 as the conventional treatment, and comprehensive CDDP plus levothyroxine (L￣T4 ) as treated groups (CDDP group) for 6 months. The therapeutic effect was evaluated by combining with data of thyroid function, blood lipid profile and ultrasound.The 40 healthy subjects were chosen as normal control group. Results Compared with normal control group, the levels of TC and LDL￣C were higher (P<0.05) in subclinical hypothyroidism group, which were more obvious in the clinical hypothyroidism group (P<0.01), CIMT increased markedly (P<0.05), the left ventricular systolic functions (ejection fraction) and diastolic functions (mitral flow velocity E and A wave ratio) were markedly decreased (P<0.05) in the clinical hypothyroidism group.Upon treatment, the blood￣lipids were improved (P<0.05), CIMT were reduced (P<0.05), the left ventricular functions were restored to near normal with the attainment of euthyroidism in both groups of clinical hypothyroidism;the reduction of CIMT and the improvement of the left ventricular functions were faster in CDDP group than that in the conventional treatment group (P<0.05). Conclusion Disturbance of blood lipid in hypothyroidism patients, CIMT growth and impaired left ventricular function objectively indicate the existence of cardiac and cerebral vascular risk, while CDDP helps improving lipid metabolism, reversing CIMT and cardiac function, reducing cardiovascular risk, blocking or delaying cardiovascular event chains.

Early recognition of severe sepsis and septic shock,early initiation of effective interventions,implementation of early goal-directed therapy may be key approaches for reducing the mortality and improving the prognosis.This article focused on the staging diagnosis systems for sepsis (PIRO sepsis classification system) and the systematic early warning or rapid response system.We also discussed the diagnostic value of biomarkers,proteomics and metabolomics in sepsis and severe sepsis.No single marker as golden standard has emerged that can provide clinicians with all the information they need for early recognition of sepsis.Therefore,we suggested that clinicians should have even more reason to combine the sepsis symptoms,signs and biomarkers for a comprehensive evaluation,and that they needed to dynamically monitor the changes in these parameters,in order to make reasonable clinical decisions and strategies.

By improving the existing pattern that different medical institutions with competition fragmentary health care mode,the bundled payment could improve the coordination and cooperation between medical institutions,improve the overall medical service quality and reduce medical service cost.It provided a helpful thought for the supply-side reform in health field in China.Foreign experience indicated that in order to implement bundled payment mode,China should build a complete medical service supply chain to promote integration of medical institutions;shift economic stimulus to economic constraints,build orderly competition environment;strengthen the construction of informatization and promote the applications of healthy big data.

Objective Health promotion aims to empower people to enjoy good health by providing conditions at the micro-,meso-and macro-levels.So the organizational culture on which the target population rely in their daily lives should be considered as specific context for promoting their healthy behavior at the micro-level.The study of BANBANCHA,a specific form of sex industry in LZ city of southwest China,has revealed that it is characterized with culture of quasi-family and commercial sense.Accordingly,a relevant HIV prevention strategy has been developed,such as motivating the boss to participate in peer education,involving marketing discourse in health promotion,encouraging the target population to care for their own health,and integrating public and private topics into the health education activities.

As a mode of pay for performance,hospital value-based purchasing has been become widespread the US.Medicare managed to encourage the service providers to provide medical services with more value and quality.The implementation background,financing,payment mode and performance evaluation of hospital value-based purchasing were briefly introduced.In the payment reform of China,it also needed to focus on the medical service quality,learn from the performance evaluation system,incentive mechanism and multiple measurement,reasonably design the implementation scheme.

Objective:To explore the influence of counseling methods of different groups on college students mental health.Methods:Two counseling groups were formed,each group having six people.Two counseling methods were adopted:long intensive training marathon group and brief group.The effect was assessed with SCL-90.Result:Group members had a rather high satisfaction;SCL90 test scores after testing had significant differences,P=0.001