Objective To investigate distribution characteristics of blood culture pathogens,and provid a basis for clinical prevention and control in bloodstream infections.Methods The data of the patients with positive blood culture and the nonduplicate strains were retrospectively analyzed with WHONET 5.6 software in the First People's Hospital of Shangqiu from January 2011 to December 2014.Results The total number of positive strains of blood culture was 1 306 from 25 397 blood cultures,and the positive rates were 5.1％,of which gram positive cocci and gram negative organisms accounted for 64.8％ (846/1 306) and 31.2％ (408/1 306),respectively.Candida accounted for 4.0％ (52/1 306).Gram positive bacteria were mainly Coagulase negative Staphylococcus (CNS) of 564 (43.2％) strains,Staphylococcus aureus of 96 (7.4％) strains,Enterococcus faecium of 48 (3.7％) strains and Streptococcus pneumoniae of 31 (2.4％) strains.The isolated rate of Enterococcus faecium was more than Enterococcus faecalis 20 strains (1.5％).The isolated rate of Escherichia coli,Klebsiella pneumoniae,Acinetobacter Bauman and Pseudomonas aeruginosa were 12.5％ (163 strains),6.2％(81 strains),2.0％(26 strains) and 1.8％(23 strains),respectively.Conclusion The isolated rate of Enterococcus faecium more than Enterococcus faecalis in blood culture,the main pathogens are gram positive cocci in children group.Isolates of gram positive bacteria in the proportion of infants,children and adults with blood culture were 85.2％,87.0％,46.5％.There were 264 strains bacteria isolated in infants and young children's intensive care unit,accounting for 67.3％ of all bacteria isolated from infants and young children.There were 122 strains bacteria isolated in pediatric intensive care unit,accounting for 56.7％ of all bacteria isolated from childen.There were 255 strains bacteria isolated in adult intensive care unit,accounting for 36.5％ of all bacteria isolated from adult.Severe basic diseases were the vulnerable groups of bloodstream infections.

Objective To explore the change and the spectra of opportunistic infections in AIDS patients after antiretroviral treatment in He′nan province.Methods Inpatients of post treatment with disease in accordance with the criteria were selected from the Sixth People′s Hospital of Zhengzhou.A retrospective study was carried out, including the content such as gender,age,infection route,treatment time,the date of complication,and CD4+T lympho-cyte counts when the patient with complications.Disease were divided into four group:opportunistic infections,adverse drug reactions,tumor,cardio-cerebrovascular disease and diabetes mellitus.Statistic case number and incidence of every kinds of the disease in the different stages of HAART.Results (1)1 001 cases of patients were involved in the result analysis.People of 41-60 years old,the peasants and peasant workers,accounted for 57.4%and 78.9%.The infection route was mainly through blood transmission and blood collection, accounting for 83.45%.Most of the patients come from Zhumadian, Xuchang, Zhoukou, Nanyang, which were high -incidence area in He′nan.( 2 ) In 1 001 patients of post treatment, the rate of opportunistic infections was 58.4%, while adverse drug reactions was 30.5%.Bacterial pneumonia,extrapulmonary tuberculosis,oral cavity fungal infection and tuberculosis were common in opportunistic infections of patients of post treatment.The main adverse reactions were allergic dermatitis,liver injury and myelosuppression.The liver cancer case was the highest ( 8/29 ) .( 3 ) 1 001 cases were divided into 6 groups according to different count of treatment time,during 3 months of treatment,the incidence rate of opportunistic infec-tions and adverse drug reactions was the highest,accounted for 75.2% and 41.6%.After 5 years of treatment,the incidence rate of cardio-cerebrovascular disease and diabetes mellitus was 6.39%.With the prolonging of HAART time,incidence of opportunistic infections and adverse drug reactions remarkably reduced,but the occurence rate car-dio-cerebrovascular disease and diabetes mellitus increased.Conclusion In AIDS patients after HAART in He′nan at present,opportunistic infections and adverse drug reactions are main diseases and used to occur during three months after HAART.Attention will be focused on tumor, cardio -cerebrovascular disease and diabetes mellitus in AIDS patients of long-term survival.

Objective To analyze strains of Proteus mirabilis (P .mirabilis )and Proteus vulgaris (P .vulgaris ) isolated in a hospital,detect resistance to commonly used antimicrobial agents,and provide reference for rational ap-plication of antimicrobial agents in clinic.Methods 172 P .mirabilis isolates and 68 P .vulgaris isolates isolated between January 1 ,2011 and June 30,2013 were analyzed,antimicrobial resistance susceptibility testing were per-formed by disk diffusion method,data were analyzed with WHONET 5.4 software.Results P .mirabilis strains were mainly isolated from wound secretion(26.74%),sputum(22.68%)and urine(18.61 %),P .vulgaris were mainly from wound secretion(48.53%),urine(17.65%)and sputum(11 .77%).The resistance rates of P .mirabilis to ampicillin and trimethoprim/sulfamethoxazole were both>45.00%;the resistance rates of P .vulgaris to cefazo-lin and trimethoprim/sulfamethoxazole was 86.76% and 41 .18% respectively;the resistance rates of P .mirabilis and P .vulgaris to piperacillin/tazobactam,cefotaxime,ceftazidime,cefepime,carbapenems (ertapenem and mero-penem)and amikacin were all <20.00%.Conclusion The resistance rates of P .mirabilis and P .vulgaris to pip-eracillin/tazobactam,cefotaxime,ceftazidime,cefepime,ertapenem,meropenem and amikacin are all high,and can be used as the empirical medication for the treatment of related infection.

In recent years, Shenyi Capsule has been proven to have certain anti-angiogenic effects, and to be effective to many cancers, but its effects on advanced esophageal cancer are scarcely studied.

OBJECTIVE: To probe into the medication status of the elder patients in community so as to provide reference for pharmacists to promote rational medication for the elderly people in community. METHODS: The medication status of 484 cases in the community was investigated through questionnaire and interview. RESULTS: The principal diseases affecting the health of the elder people included hypertension, diabetes mellitus, coronary heart disease, cerebrovascular disease. The average number of drugs they used totaled 2.92 kinds; the higher the educational background, the higher proportion of the elder people who read drug package instruction but the lower ratio of medication compliance. The elder people commonly had poor knowledge about the drugs and adverse drug reactions(91.74% and 60.74%);21.11% responded that they had ever received medication guidance from pharmacists, only 3.10% responded that they had once consulted pharmacists about medication problems. CONCLUSION: The medication of the elder people in community is characterized by multiple drug varieties, poor ADR knowledge and lower cognition on pharmacists. It is urgent to improve the pharmaceutical care ability of medical institution and enhance the social influence of pharmacists.

Objective To understand the distribution and antimicrobial resistance of pathogenic bacteria isolated from patients in the department of infectious diseases in Xiangya Hospital.Methods The distribution and antimicrobial susceptibility testing results of pathogenic bacteria isolated from patients in this department in 2011 -2015 were analyzed retrospectively.Results A total of 560 strains were isolated during 5 years,of which gram-posi-tive bacteria and gram-negative bacteria accounted for 44.1 % (n =247)and 55.9%(n =313)respectively.69.8%(81/116)of coagulase-negative staphylococcus and 24.3%(9/37)of Staphylococcus aureus were methicillin-resistant (MRCNS,MRSA)respectively.Enterococcus was highly susceptible to vancomycin,linezolid,and phosphonomy-cin (>81 %).Enterobacteriaceae remained highly susceptible to carbapenems (88.9%-100.0%),and was suscep-tible to amikacin,cefoperazone/sulbactam,and piperacillin/tazobactam (>84%).Acinetobacter baumannii was the major isolated multidrug-resistant organism (MDRO),isolation rate of imipenem-resistant Acinetobacter baumannii increased from 50.0% in 2011 to 77.8% in 2015,its resistance rate to imipenem was 64.9%.Conclusion The majority of clinically isolated pathogenic bacteria from this department is gram-negative bacilli,and detection rate of MDROs showed an upward trend;antimicrobial agents should be chosen according to distribution and antimicrobial resistance of pathogenic bacteria.

Objective To investigate the effect of hepatitis C virus (HCV) genotype on antiviral therapy in patients with human immunodeficiency virus (HIV)/HCV coinfection in Henan province.Methods A total of 129 patients were coinfected with HIV and HCV, among whom, 70 were HCV 1b genotype and 57 HCV 2a genotype.And 131 patients were HIV single infection.Immunological failure rate, virological suppression, CD4+ T lymphocyte counts and liver and renal function after antiretroviral therapy (ART) were compared among the three groups.Flow cytometry was used to count CD4+ T lymphocytes and polymerase chain reaction amplification was used to detect HIV RNA.The liver and renal function were tested by automatic biochemical analysis.Statistical analysis was conducted by χ2 test, analysis of variance and LSD-t method.ResultsImmunological failure rate in HCV 1b group, HCV 2a group and HIV single infection group were 7.14% (5/70), 15.79% (9/57) and 9.92% (13/131), respectively.There was no significant statistical difference among the three groups (χ2=2.59, P>0.05).The CD4+ T lymphocyte counts in three groups were (614±258), (529±245), and (518±243) cells/μL, respectively.The difference was statistically significant (F=3.17, P<0.05).The virus inhibition rates of three groups were 87.0% (HCV 1b), 78.2% (HCV 2a), and 82.3% (HIV single infection).The HIV virus failure rates were 8.6% (HCV 1b), 14.5% (HCV 2a), and 13.1% (HIV single infection).There was no significant difference among three groups (χ2=1.967, P>0.05).The levels of aspartate transaminase, alanine aminotransferase and total bilirubin in HCV 1b group and HCV 2a group were all significantly higher than those in HIV single infection group (F=27.38, 15.22 and 7.33, respectively, all P<0.05), while there was no significant difference between HCV 1b and HCV 2a groups (t=1.27, 0.29 and 1.59, respectively, all P>0.05).Conclusions The main HCV genotypes in patients with HIV/HCV coinfection by blood transmission are HCV 1b and HCV 2a in Henan province.HIV/HCV coinfection does not affect the effect of ART, but could aggravate the liver damage in acquired immune deficiency syndrome patients.

Objective To evaluate the efficacy and tolerance of antiretroviral therapy (ART)regimen containing lopinavir/ritonavir (LPV/r) as a second-line regimen.Methods Data of acquired immunodeficiency syndrome (AIDS) patients who have received the first-line therapy for over a year and changed to the second-line antiviral therapy regimen containing LPV/r for more than one year were collected retrospectively from the database of free antiviral therapy in Henan Province from January 1,2009 to December 31,2013.Based on the viral load inhibition status after the alteration of the regimen,the patients were assigned to virology failure with first-line therapy group,and successful viral inhibition but poor immunological reconstruction with first-line therapy group.The variation trend of CD4+ T lymphocyte counts of the two groups in 6,12,24 months after changed to the second-line regimen of LPV/r,the virology inhibition rates between 6 and 12 months,12 and 24 months,and occurrence of adverse events were analyzed.Quantitative data were analyzed by rank sum test,and qualitative data were analyzed by chi-square test.Results A total of 4 113 patients were divided into two groups,including the first-line therapy failure group (n=3 802) and poor immunological reconstruction group (n=311).At 6,12 and 24 months after the alteration of the regimen,the CD4+ T lymphocyte counts increased gradually (all P＜0.01).Between 6 and 12 months after the first-line therapy failure group changed to the secondline regimen,viral inhibition rate was 61.65％(1 408/2 284),while that 12 and 24 months was 68.91％(2 044/2 966).The incidences of adverse reaction of the two groups were 21.88％ (832/3 802) and 22.19％(69/311),respectively,which were not significantly different (x2 =0.015,P=0.901).Condusion The ART regimen containing LPV/r still has good viral inhibition effect and immunological reconstruction effect for AIDS patients who failed the initial therapy with poor immunological reconstruction.

Objective To understand the impact to blood lipid in patients with HIV/AIDS using different HAART regimens . Methods According to HAART regimens ,102 HIV/AIDS patients were divided into two groups :D4T group(D4T+3TC+NVP) and AZT group(AZT+3TC+ NVP) .Blood lipids(TG ,TC ,LDL-C and HDL-C)at baseline ,24 weeks and 48 weeks after HAART were detected .Results Compared with paired t test ,TG ,TC and LDL-C at 24 weeks follow-up of the patients in D4T group were significantly higher than at baseline(P<0 .05) ,and TC at 48 weeks follow-up were still higher than at baseline(P<0 .05) .TG and TC at 24 weeks follow-up of patients in AZT group were significantly higher than at baseline(P<0 .05) .There were no significant difference at blood lipid between the two groups(P>0 .05) .Conclusion There are dyslipidemia of the patients with HIV/AIDS u-sing D4T-based and AZT-based regimens ,and the dyslipidemia are increase of TC and TG ,these increase is border higher .TG and TC at 24 weeks follow-up of the HIV/AIDS patients using D4T-based regimen are increased early ,and TC are still at higher level .

Objective To evaluate the effect of second-line antiretroviral treatment (ART) on human immunodeficiency virus/acquired immune deficiency syndrome (HIV/AIDS) and provide reference for subsequent HIV/AIDS treatment.Methods Two hundred and twenty-eight HIV/AIDS patients received second-line ART during January 2011 and December 2015 in Zhengzhou were included.Two hundred and forty-eight who received first-line ART during this period were randomly enrolled as control group.CD4+ T cell count and HIV RNA load before and after treatment were compared with x2 test and t test when appropriate.Results There were 228 patients (137 male and 91 female) in the second-line ART group and 248 patients (176 male and 72 female) in the control group.In second-line ART group, CD4+ T cells increased from (274±200)/μL to (476±261)/μL after an average treatment of (39.5±18.8) months.The difference was statistically significant (t=12.91, P<0.05).In control group, CD4+T cells increased from (251±199)/μL to (470±233)/μL after an average treatment of (35.7±14.7) months.The difference was statistically significant (t=14.60, P<0.05).CD4+ T cells showed no statistical difference between two groups regardless of treatment (t=1.25 and 0.26, respectively, both P>0.05).During the treatment, the rates of immunological failure were 9.6% (22/228) in second-line ART group and 12.9% (32/248) in the control group.There was no statistical difference between two groups (x2=1.251, P>0.05).Complete viral inhibition rates were 83.3% (190/228) in second-line ART group and 88.7% (220/248) in control group with no statistical difference (x2=2.881, P>0.05).Conclusions Second-line ART regimen has equivalent treatment efficacy with first-line ART.To achieve a better outcome, second-line ART regimen should be selected as an alternative option when first-line regimen fails.Compliance is the key to guarantee the success of antiviral therapy.