Objective To investigate the distribution and antibiotic susceptibilities of quantitatively cultivated bacteria from bronchoalveolar lavage fluid (BALF) samples. Methods Totally 312 BALF samples were streak inoculated to chocolate,blood and MAC plates with 10 μL annulus,and the bacterial colony ＞ 104 CFU/mL was considered pathogenic bacteria. The identification of pathogenic bacteria was carried out with Vitek 2-Compact,and Kirby-Bauer disc agar diffusion method,Etest and dilution method were used for antibiotics sensitivity test.Results Totally 216 (69.2％) strains of pathogenic bacteria were isolated.The major gram-negative strains were Pseudomonas aeruginosa,Acinetobacter baumannii,Klebsiella pneumoniae and Escherichia coli, and the major gram-positive strains were Staphylococcus aureus,Streptococcus pneumoniae and Staphylococcus epidermidis.The resistance rate of Pseudomonas aeruginosa to aztreonam was high,but lower than 30％ to piperacillin/tazobactam,imipenem,cefepime,ofloxacin,ceftazidime and amikacin.Staphylococcus aureus was highly resistant to erythromycin,benzylpenicillin and clindamycin,but it was sensitive to furadantin,vancomycin,quinupristin/dalfoprisdn,tigecycline and linezolid.Conclusion The positive rate of BALF cultivation is high,and the main pathogenic bacteria Pseudomonas aeruginosa, Acinetobacter baumannii, Klebsiella pneumoniae, Staphylococcus aureus and Escherichia coli are resistant to several commonly used antibiotics.

Objective To explore the elinical characteristics and the effects of thrombolytic and anti-coagulation therapy on pulmonary embolism(PE)in over 60-year-old patients. Methods The clinical findings,diagnostic techniques,effects of thrombolytic and anti coagulation therapy in 72 patients with PE aged over 60-year were analyzed retrospectively. Results Each one of 72 patients in this study suffered from two or more chronic diseases.Hypertension(56.9%)and deep venous thrombosis(DVT)in lower limbs(53.6%)were the most common thrombosis risk factors in the study.The clinical findings were atypical in elderly patients with PE.Different degree of dyspnea was the main characteristics(91.7%).Other findings were cough(30.6%),chest pain(27.8%),cyanosis (18.1%),faint(13.9%)and emptysis(12.5%).The objective signs showed edema of lower extremity (44.4%),moist rales(31.9%),P2 accentuation(18.1%),vascular murmur(5.6%).Blood gas analysis in 61 cases showed that 53 patients suffered from hypoxemia(86.9%)along with 37 cases of hypocapnia(60.7%).The alveolar-arterial oxygen gradient was increased in 27/31 cases(87.1%)and blood D-dipolymer was positive in 50/61 cases(82.0%).Spiral CT pulmonary angiogram(CTPA)in 62 cases and radioactive nuclear ventilation perfusion scan in 16 cases demonstrated PE in 58(93.5%) and 16(100%)patients respectively.The cure rate of thrombolytic therapy combined with anti-coagulation versus anti-coagulation therapy alone was 86.2%versus 30.2%(P=0.000).There was no haemorrhagia phenomenon during thrombolytic and anti-coagulation therapy. Conclusions The most common risk factors of PE in the elderly are hypertension and DVT in Iower limbs.The clinical symptoms are atypical and variable.Dyspnea is the main characteristics.Thrombolytic with anti-coagulation therapy is safe and effective,but anti-coagulation therapy alone has no benefit.

ObjectiveTo investigate anatomical characteristics of the medial foot vessels and effects of different vascular pedicle skin flaps in repair of foot and ankle trauma.MethodsThirty adult cadaveric lower limbs were injected with red latex through the popliteal artery and posterior tibial artery to anatomically observe the cutaneous arterial origin,branches,distribution and anastomosis of the medial foot.Then,anterior medial malleolar artery perforator flaps and distally-based medial foot flaps were harvested and used for repairing foot and ankle trauma of 16 patients.Results The origin of cutaneous blood vessels of the medial foot was diversified and mainly included the anterior medial malleolar artery,medial tarsal artery,and arterial arcades anastomosing with anterior posterior branches of the two former arteries and the superficial branches of plantar digital artery and the medial plantar artery.According to distribution area of the anterior medial malleolar artery and the medial tarsal artery,the vascular anatomy of the medial foot skin was classified into three types.Clinically,all the flaps survived.Follow-up ranged from 2 weeks to 20 months,which showed normal color,good shape and good pain and warm sensation of the flaps.ConclusionThe anterior medial malleolar artery perforator flaps present good reconstruction of soft tissue defects around the ankle,whereas the distally-based medial foot flaps present good reconstruction of soft tissue defects of the mid-forefoot.

Objective To discuss the distributional characteristics and drug-resistance of Enterococcus species isolated from urine specimens.Methods 3096 middle-segment urine specimens were collected since January to December in 2011 for culture.The identification of pathogenic bacteria and antibiotics sensitivity tests were carried out with VITEK2-compact combined with GN,AST-GN13,GP,AST-GP67,and antibiotics sensitivity tested performed by K-B and E-test at the same time.The results were determined by CLSI 2011.Results 1248 of 3096 pathogenic bacteria were isolated (40.31％).549 strains of Escherichia coli were detected (43.99％) which was the most common and 159 strains of Enterococcus were detected (12.74％) which was the second most common.The Enterococcus detection rate in woman (15.02％)was higher than that in man (10.35％),in out-patients (15.54％) than the that in hospitalized patients (12.49％),and in the patients of non-surgical departments (13.65％) than those of surgical departments (11.38％).The Enterococcus was absolutely sensitive to tigecycline,and the sensitive rate to vancomycin and linezolid were over 90％.The antibiotics sensitivity was higher for Enterococcus faecalis than that for Enterococcus faecium,and in surgical departments than non-surgical departments.Conclusions The detection rate of Enterococcus in urinary tract infection patients is quite high and varied between sexes and departments.The difference of drug resistance between species is obvious,and the bacteria species should be identified in order to use the antibiotics reasonably to postpone the development of drug resistant strains.

Objective To compare the drug resistance of mucoid Pseudomonas aeFagillosa with that of non-mucoid.Methods All specimens isolated and cultured from patients were identified and the antibiotic sensitivity was tested by automatic microorganism analyzer VITEK-32,GNI+,GNS-448,E-teat and K-B.Results Drug resistant rates of mucoid Pseudomonas aeruginosa to imipenem.levofloxacin.meropenem,cefepime,cefoperazone/sulbactam,amikacin,gentamicin,piperacillin.tazobactam,ceftazidime and cefotaxime were 5.3%, 16.1%, 5.6%, 20.6%, 1.1%, 10.5%,26.9%,5.3%.31.5% and 60.2%,respectively.The drug resistant rates of mucoid Pseudomonas aeruginosa were lower than those of non-mucoid except to ceftazidime.Conclusion Compared with non-mucoid Pseudomonas aeruginosa,antibiotic resistance of mucoid Pseudomonas aeruginosa is weaker in vitro.

Objective To look for suitable short-term weight loss and long-term maintenance method for army cadres. Method A total of 142 patients with simple overweight and obesity were randomly selected as the research subjects, and were followed up for 2 years, 130 of them were valid for analysis, 97 were male, and 33 female, age 27-59 years, average(47.41±7.55)years. SPSS 16.0 was used for analysis. Repeated measurements analysis of variance was used for data analysis, K-related samples nonparametric test was used for enumeration data. Result The army cadres population weight intervention management model was divided into three stages. They were respectively intensified weight loss stage for 6 months, the consolidation of weight loss for 6 months, and self-management stage maintained for 12 months, totally 24 months. Variance analysis results showed that after two years of focused intervention and health management, the body mass index(BMI)fell from(27.42 ± 2.81)kg/m2 to(24.69 ± 2.63)kg/m2 (F=2 649.945, P<0.05), waist circumference decreased from(91.09±8.24)cm to(85.26±7.76)cm(F=1 207.248, P<0.05). Nonparametric test results showed that after two years intervention management the behavior patterns concerning physical exercise became better. Exercisers increased from 33.8%to 73.3%(H=68.448, P<0.05); proportion of smoking decreased from 38.5% to 20.0%(H=33.692, P<0.05); drinking alcohol decreased from 50.8%to 20.8%(H=59.128, P<0.05);high salt diet decreased from 39.2%to 23.1%(H=31.722, P<0.05);high-fat diet decreased from 46.2%to 27.7%(H=41.571, P<0.05). Conclusion The practice showed that the short-term intensified weight loss, long-term maintenance, exercise and psychological intervention, changed the cadres population from passive to active on the weight control and self-management with remarkable effects, therefore such intervention is worthy of promoting.

Objective To analyze the antibiotic resistance of Branhemella catarrhalis strains isolated from sputum specimens of patients with lower respiratory tract infections from Linyi, Shandong Province, and to explore the relationship between bro genotypes of the strains and their resistance to antibiotic agents.Methods Sputum specimens were colleted from the patients with lower respiratory tract infections in Linyi People ’ s Hospital from the January 2010 to December 2014.The specimens were inoculated into 4 different disks for bacterial isolation and cultivation.β-lactamase detection and drug sensitivity tests were performed, and PCR coupled with restriction endonuclease analysis was employed for bro genotyping.χ2 test was used to compare drug resistance of strains with different bro genotypes.Results A total of 497 Branhemella catarrhalis strains were isolated in five years, among which 221 strains were isolated in winter.All strains were sensitive to ertapenem and chloramphenicol, and the resistance rates to amoxicillin/clavulanate and cefaclor were low (≤2.8%).The strains were highly resistant to compound sulfamethoxazole, erythromycin and ampicillin (47.6%-89.8%), and there was a trend of increasing resistance rates with the year, but no statistically significant difference was observed ( P >0.05 ) .β-lactamases was positive in 412 strains (82.9%), and all of these strains were positive for bro gene, and the resistances to erythromycin, compound sulfamethoxazole, levofloxacin and ampicillin were higher in bro positive strains than those in bro negative strains (χ2 =12.16, 16.18, 8.41 and 200.00,P<0.05).Among bro positive strains, 391 (94.9%) were of genotype bro-1, 21 (5.1%) were of genotype bro-2, and their resistance to antibiotic agents was not of statistical difference ( P >0.05 ).Conclusions Most of Branhemella catarrhalis clinical isolates are β-lactamase producing strains, and bro-1 is the most common genotype.Strains are highly sensitive to carbapenems, cephalosporins andβ-Lactamaseinhibitors, which can be recommended for the treatment of Branhemella catarrhalis-related respiratory tract infections.

Objective To explore the characteristics of narcissism in a sample of violent criminal and analyze the relationship between narcissism and impulsive-premeditated violent aggression.Methods A total of 88 violent criminal were administered by means of cluster random sampling with the Chinese version of the Impulsivepremeditated Aggression Scale and the Narcissistic Personality Questionnaire.Results (1) Comparing with the impulsive violent criminal,premeditated violent criminal had higher level of Overt narcissism,and the difference was statistically significant(59.77±10.89,54.67±10.15; P＜0.05).(2) Overt narcissism had significantly positive correlation with premeditated aggression(r=0.560; P＜0.01) ;and covert narcissism had significantly positive correlation with impulsive aggression(r=0.440; P＜0.01).(3)The authority and self-admiration traits of overt narcissism had significantly positive prediction to premeditated aggression(β=0.442,P＜0.01;β=0.297,P＜0.05);The vulnerability trait of covert narcissism has significantly positive prediction to impulsive aggression(β=0.526,P＜0.01).Conclusion Overt narcissism can result in premeditated aggression;Covert narcissism can result in impulsive aggression.

Objective To investigate the drug sensitivity of mucoid Pseudomonas aeruginosa to common antibiotics and the expression of β-lactamase-resistant phenotype.Methods The specimens were inoculated onto different disks to isolate and cultivate bacteria.The antibiotic susceptibility of mucoid Pseudomonas aeruginosa isolates was detected and judged by CLSI 2013.The detection of drug resistance was done by Kirby-Bauer (K-B) method and β lactamase-resistant phenotype was detected by E-test.SPSS19.0 was used to statistic data and x2 test was used to compare the antibiotic susceptibility between different groups.For all statistical test,a P values less than 0.05 was defined as statistically significant.Results The susceptibilities of mucoid Pseudomonas aeruginosa to the regular antibiotics were above 70％,of which the sensitivities to amikacin,to bramycin,gentamicin,imipenem and meropenem were higher than 90％.The positive rate of ampler class C β-lactamase (AmpC) was 28.3％ (56/198).The drug sensitivity of positive strains was lower than that of the negative strains,and the differentiation was significant to piperacillin-tazobactam,amikacin,ceftazidime,levofloxacin,ciprofloxacin and aztreonam (x2 =3.89-14.45,all P ＜0.05).The positive rate of extended spectrum β-lactamase(ESBLs) was 10.6％ (21/198).The drug sensitivity to ceftazidime and aztreonam of positive strains[42.9％ (9/21) and 57.1％ (12/21),respectively].It was lower than that of the negative strains [73.5％ (130/177) and 72.3％ (128/177)],x2 =5.06 and 19.24,both P ＜ 0.05.The difference of the other antibiotics was not significant(x2 =0.01-3.47,all P ＞0.05).The positive rate of metallo-β-lactamase (MBL) was 19.7％ (39/198),and the drug susceptibility of positive strains was lower than that of negative strains except gentamicin and aztreonam(x2 =4.07-15.99,all P ＜ 0.05).All the detected strains were Klebsiella pneumonia carbapenemase (KPC) negative.Conclusions The antibiotic susceptible rate of mucoid Pseudomonas aeruginosa was high,but some enzyme-produced strains were lower.The clinician should adjust medicine program by the results of laboratory.

OBJECTIVE To study the prevalence,fungal species,therapy and prevention of invasive fungal infections in our Affiliated Hospital.METHODS From Jan 2004 to Dec 2005,all patients with positive results for fungal culture of blood and sterile fluid were reviewed retrospectively.The in vitro activity of antifungal agents against fungal isolates was determined.RESULTS Eighty-eight positive patients were collected in this analysis based on the diagnosis of invasive fungal infection in our hospital for two years,from them the majority were diagnosed as candidal infections(n=72,81.8%),the others were Cryptococcus neoformans(n=8,9.1%),Aspergillus(n=5,5.7%) and other different fungal infections.The most common was C.albicans(n=48,66.7%),C.glabrata(n=12,16.7%),and C.tropicalis(n=8,11.1%),C.parapsilosis and C.krusei were both the same results(n=2,2.8%).CONCLUSIONS Infections caused by Candida are the most common invasive fungal ones in our hospital,and C.albicans is the most common one.Fluconazole remains effective for treament of candidal infections,especially those caused by C.albicans.