OBJECTIVE To explore the relationship between multidrug resistance of Acinetobacter baumannii(ABA) and its class Ⅰ integron.METHODS In this study,39 multidrug resistant strains and 41 non-multidrug resistant strains of ABA were collected.The improved Kirby-Bauer was employed to check the collected strains′ drug-resistant phenotype;PCR was administrated to detect the distribution of class Ⅰ integron.and their relationship was also analyzed.RESULTS Results showed that ABA′s drug-resistance rate to the most antibiotics was high.imipenem,cefoperazone-sulbactam,ABA was sensitive to ciprofloxacin,amikacin and Piperacillin-tazobactam,however,ABA′s drug resistance rates to other antibiotics were all over 40%.It revealed that ABA′s drug-resistance rate was high.The study indicated that the positive rate of Class Ⅰ integron in multidrug resistant ABA was as hight as 82.1%(32/39).The positive rate of non-multidrug resistant strains was 26.8%(11/41),and the differences were statistically significant(?2=24.6,P

OBJECTIVE To investigate the genotypes of aminoglycoside-modifying enzymes(AMEs)genes of Acinetobacter baumannii.METHODS Clinical isolates of A.baumannii were collected from 2003 to 2006,and their resistance to gentamicin,amikacin and tobramycin were tested by K-B method.Twenty-three isolates were chosen because of their resistance to aminoglycoside antibiotics(at least resistant to one kind of the drugs).Nine types of the AMEs were detected by PCR.RESULTS Drug resistant rates of 23 isolates of A.baumannii to gentamicin,amikacin and tobramycin,were 86.96%,56.5% and 69.56%,respectively.The detection rates of the 9 AMEs,including ant(3')-Ⅰ,aac(3)-Ⅰ、aac(6')-Ⅰ,aph(3')-Ⅵ,aac(3)-Ⅱ,aac(6')-Ⅱ and ant(2″)-Ⅰ were 69.56%,60.87%,56.52%,47.82%,30.4%,26.09% and 21.73%,respectively.CONCLUSIONS The resistance to aminoglycoside antibiotics of A.baumannii is mainly caused by AMEs.

OBJECTIVE To analyze the antimicrobial resistance of Acinetobacter baumannii.METHODS A.baumannii was collected in our hospital from Jan 2003 to Dec 2006.Antimicrobial susceptibility testing was performed by disk-diffusion method.RESULTS A total of 548 A.baumannii were collected during 4 years.Of these isolates,130(23.7%) strains were from intensive care unit(ICU),190 strains(34.7%)from surgical,and others from medical and emergency departments.Most of strains(78.5%) were isolated from sputum,next from wound.The prevalence of A.baumannii was increasing during last 4 years.Results of susceptibility test showed that imipenem was the most active antibiotic against A.baumannii.The resistance rates were high to most antibiotics.Most of the resistant strains was from the ICU and the general ward differentand had significant difference.More than 50% of isolates were resistant to all antimicrobial agents tested except imipenem and ciprofloxacin in ICU.CONCLUSIONS The prevalence of A.baumannii is increasing.A.baumannii isolates show high resistance to multiple antibiotics,especially in ICU.

Objective To determine the prevalence and treatment of chronic obstructive pulmonary diseases (COPD) among citizens in Ningbo. Methods A multi-stage stratified random sampling was applied to select 8 neighborhoods and 3 villages out of 7 districts in Ningbo, people who were older than or equal to 40 years were enrolled as subjects. Information on the prevalence rate and treatment conditions of COPD was collected through respiratory symptoms and treatment questionnaire and lung function screening. Results A total of 5865 people were screened, 5674 of them met inclusion criteria and completed questionnaire and lung function test. Among whom, 3044 people were men (53.6%, the average age is 55.7±11.4), 2630 women (46.4%, the average age was 55.3 ± 10.7);473 of them were diagnosed with COPD, the overall prevalence rate was 8.3%, including 354 cases who had never been diagnosed as COPD, accounted for 74.8% of the total cases diagnosed with COPD, mainly in stage ⅠandⅡof the disease. There were statistically significant differences between diagnosed and undiagnosed patients in the overall COPD group and among different gender groups ( stagesⅠandⅡ) and (stagesⅢandⅣ). Among the 473 COPD cases, 119 (diagnostic yield 25.2%) of whom had been diagnosed with bronchitis, only 48 (41.2%of the diagnosed) received drug treatment, only 13 patients were treated regularly with medication. Conclusion The overall prevalence rate of COPD among those over 40 years of age in Ningbo was quite high and mainly had stagesⅠandⅡof the disease. The number of the diagnostic yield and those who received regular treatment are quite low. The current situation of diagnosis and treatment are far from satisfaction, management of COPD should be strengthened to reduce the burden for family and society.

OBJECTIVE:To observe clinical efficacy and safety of montelukast combined with moxifloxacin in the treatment of cough of acute bacterial bronchitis. METHODS:A total of 139 cases of cough of acute bacterial bronchitis selected from out-patient department of Ningbo Yinzhou District Qianhu Hospital during Jan.-Dec. 2016 were divided into control group(69 cases) and observation group(70 cases)according to random number table. Control group was given Moxifloxacin hydrochloride tab-lets 0.4 g,po,qd;observation group was additionally given Montelukast sodium tablets 10 mg,po,once every night,on the basis of control group. Both groups were treated for 6 d. Cough symptom scores,peripheral blood WBC and CRP contents were compared between 2 groups before and after treatment. Clinical efficacies,the occurrence of ADR and clinical outcome were ob-served in 2 groups. RESULTS:Before treatment,there was no statistical significance in cough symptom scores,peripheral blood WBC or CRP contents between 2 groups(P>0.05). Compared to before treatment,cough symptom scores,peripheral blood WBC and CRP contents of 2 groups were decreased significantly after treatment,and the cough symptom score of observa-tion group after 3 d of treatment was significantly lower than that of control group at the same time,with statistical significance (P<0.05). There was no statistical significance in above indexes between 2 groups after 6 d of treatment(P>0.05). Cure rate of observation group was 64.29%,which was significantly higher than 44.93% of control group,with statistical significance (P<0.05). Response rates of observation group and control group were 97.14% and 97.10%,there was no statistical signifi-cance(P>0.05). No ADR was found in 2 groups during treatment,and good clinical outcome was obtained. CONCLUSIONS:Montlukast combined with moxifloxacin not only relieve cough symptom and inflammation,but also improve cure rate significantly with good safety.

OBJECTIVE:To observe therapeutic efficacy and safety of budesonide and formoterol in the treatment of acute exacerbation of mild to moderate asthma.METHODS:A total of 89 patients with acute exacerbation of mild to moderate asthma were randomized divded into study group (45 cases) and control group (44 cases).Study group was given Budesonide and formoterol dry powder inhalation,one inhalation,q6 h,gargling 5 times after inhalation,6 inhalation per day at most+Montelukast tablet 10 mg orally,once a day.Control group received Prednisone tablet 25 mg orally after breakfast,once a day,d1-5+Theophylline sustained-release capsule 0.2 g,twice a day+Montelukast tablet 10 mg,once a day in the evening.Both groups were treated for 5 d.Acute AQLQ score,FEV1,PEF％pred and SpO2 were observed in 2 groups before and after treatment,and the occurrence of ADR was recorded.RESULTS:Before treatment,there was no statistical significance in acute AQLQ score,FEV1,PEF％pred or SpO2 between 2 groups(P＞0.05).After treatment,acute AQLQ score,FEV1,PEF％pred and SpO2 of 2 groups were significantly higher than before treatment,with statistical significance (P＜0.05),but there was no statistical significance between 2 groups (P＞ 0.05).There was statistical significance in the incidence of ADR between 2 group(P＜0.05).CONCLUSIONS:Budesonide and formoterol can improve pulmonary ventilation function and prognosis in patients with acute exacerbation of mild to moderate asthma with good safety.

Objective To explore influences of bedside sitting nursing on mechanical ventilation duration of patients with chronic obstructive pulmonary disease (COPD). Methods Ninety six patients with COPD admitted in the hospital from January 2013 to January 2014 were selected as research subjects, who were divided into control group and obser-vation group with 48 patients in each group according to different nursing modes. The patients in the control group were subjected to conventional treatment and nursing, while the patients in the observation group were subjected to bedside sitting nursing on the basis of that applied in the control group, mechanical ventilation duration, length of hospital stay, changes in blood and vigor indexes before and after nursing of two groups of patients were compared and analyzed. Re-sults The differences in comparisons of PaO2, PaCO2 and SpO2 levels of patients in two groups had no statistically signif-icant before nursing (P>0.05); and PaO2, PaCO2 and SpO2 levels of patients in the observation group after nursing were better than those indexes of patients in the control group (P<0.05). Mechanical ventilation duration and length of hospital stay of patients in the observation group were lower than those of patients in the control group, the successful removal of respirators used in the observation hit was 85.4%, was higher than 64.6% in the control group, the incidence of ven-tilator associated pneumonia was 4.2%, was lower than 22.9% in the control group, and the difference was significant (P<0.05). Conclusion The bedside sitting position can effectively improve the ventilation function of patients with COPD, reduce the duration of mechanical ventilation, decrease the occurrence of ventilator associated pneumonia, shorten hospitalization time, and improve the quality of survival, delivering high clinical application value.

Objective To investigate the pathogen in adult airway infection of Baise city.Method A total of 391 cases (both outpatient and inpatient)of airway infection were collected.Serum IgM titer of six pathogen(influenza virus,Ⅳ; respiratory syncytial virus,RSV; Coxsackievirus B,CVB; adenovirus,ADV ; mycoplasmal pneumoniae,MP;Chlamydia pneumoniae,CPN) were tested for two times at acute stage and convalescent period respectively.Protein chip technology was used to test the IgM antibody.Results 180 samples were positive,the total positive rate was 46.06％.the positive rate of MP was 18.33％,14.44％ for CPN.Among mixed infection,MP combined with ADV positive rate was 7.78％,5.00％ for MP combined with CPN.The positive rate for cases which MP IgM antibody was positive and had clinical symptoms at acute stage was 89.55％.The positive rate for cases which MP IgM antibody was positive at acute stage and rose 4 times at convalescent period was 86.57％.There was no significant difference between them (P ＞ O.05).We got the same result for The positive rate for CPN IgM antibody.Conclusion The positive rate for IgM antibody of common pathogen among baise adult respiratory tract infection ranked:ADV,MP,CPN.Patients whose MP or CPN IgM antibody was positive and with according clinical symptoms could be diagnosed with MP or CPN infection.

Objective To investigate the clinicopathologic characteristics, differential diagnosis and prognosis of pulmonary epithelioid hemangioendotheliomas (PEHs).Methods The clinical symptoms and imaging findings of 6 cases of PEHs were investigated and pathologic analyses including histomorphologic and immunohistochemical studies were performed.Results Clinical symptoms of the patients were nonspecific and insidious.The typical radiological manifestation was characterized by multiple small pulmonary nodules. The pathological findings were well-demarcated hypocellular hyalinized nodules with more cellularity at the periphery of the nodule. The neoplastic cells showed mild nuclear atypia and prominent eosinophilic cytoplasm with vacuoles, attempting to form primitive vasculature.Immunohistochemically, tumor cells were positive to CD31, CD34 and ERG.Follow-up data from 8 months to 5 years showed no tumor progression, except for the development of bone metastases in one case at 6 months.Conclusions PEHs are uncommon vascular tumors with low-intermediate malignancy. Using H&E and immunohistochemistry, the final pathological diagnosis can be made and misdiagnosed as a benign fibrotic nodule or other malignant tumors can be avoided. The most effective treatment is surgical resection, if necessary, combined with chemotherapy or radiotherapy.