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

Polycystic ovary syndrome (PCOS) is a common endocrine metabolic disorder of reproductive age women,often accompanied by obesity,hyperandrogenism,hyperinsulinemia,insulin resistance (IR),and other metabolic syndrome (MS).Oxidative stress (OS) is considered as a potential inducing factor in the pathogenesis of PCOS at present.Glucagon-like peptide-1 (glp-1) receptor agonist and analogues as new therapeutic agents in the treatment of type 2 diabetes mellitus (T2DM),can lose weight,improve IR,resist OS and reduce the expression of inflammatory cytokines,thus they have been widely used in the clinical application of patients with PCOS.The author reviews the latest advances of glucagon-like peptide-1 on polycystic ovary syndrome.

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

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 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.

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.

Microcirculation disturbance and ischemia of the pancreas are important pathophysiological changes in the onset of acute pancrea-titis,and organ hypoperfusion is a risk factor for poor prognosis.During the first 12 to 24 hours after admission,fluid resuscitation is the most important medical treatment for the early stage of acute pancreatitis,and timely and rational fluid infusion helps to improve prognosis. However,there lacks high -quality clinical evidence for type of fluid,infusion speed,and monitoring methods,and more randomized con-trolled trials are needed.