OBJECTIVE To investigate the distribution of Stenotrophomonas maltophilia and drug sensitivity.METHODS A total of 194 strains of S.maltophilia were isolated from patients,during the period of Jan 2007 to Sep 2008,the antibiotic susceptibility was tested to 20 kinds of antibiotics.RESULTS The antibiotic resistance of S.maltophilia to Imipenem,tetracycline,cefotaxime and aztreonam were up to 90.00%,to gentamicin,meropenem and tobramycin were up to 80.00%,to cefoperazonel sulbactam(Sulperazone)was 10.3% and to minocycline was 1.55%.CONCLUSIONS S.maltophilia isolated from our hospital shows high resistance to several kinds of antibiotics.The drugs should be choosed reasonably according to their antibiotic suscepitibity results,such as cefoperazonel sulbactam and minocycline.

OBJECTIVE Based on hospital information system operation platform,the antibacterial drugs utilization and control information system was designed to share prescriptions for antibacterial drugs and results for bacteria culture and drug sensitivity,to analyze pathogen composition and drug resistance trend,and supervise physicians to utilize antibacterial drugs properly. METHODS Adopting C/S framework,the backstage supporter adopted the large-scale database of SQL SERVER 2000 enterprises edition,the front application program used PowerBuilder7 programming.Antibacterial drugs utilization software was integrated into resident physician's working stations.Antibacterial drugs utilization control software was installed into working stations for department of nosocomial infection. RESULTS The application of the information system strengthened control of antibacterial drugs utilization and could guide physicians to utilize antibacterial drugs properly. CONCLUSIONS Antibacterial drugs utilization and control information system could reinforce management of antibacterial drugs utilization,and facilitate to utilize antibacterial drugs properly and safely.

OBJECTIVE Based on hospital information system operating platform,the Nosocomial Infection Early Warning Information System is designed to study nosocomial infection concerning its risk factors,occurrence pattern,and control measures so that the epidemic of nosocomial infection could be early found and controlled effectively,the capability of nosocomial infection supervision could be steadily increased.METHODS Adopting C/S framework,the backstage supporter adopted the large-scale database of SQL SERVER 2000 enterprises edition,the front application program used PowerBuilder7 programming.To structure a reporting,early warning,and supervising network,nosocomial infection reporting card software was integrated into resident physician′s working stations,and early warning control software was installed into working stations for department of nosocomial infection.RESULTS The application of the information system could early warn and supervise occurring nosocomial infection cases,help to find the epidemic of nosocomial infection in time and take effectively control measures as soon as possible.CONCLUSIONS Nosocomial Infection Early Warning Information System could early warn and control nosocomial infection on-the-spot,increase efficiency of nosocomial infection management and improve quality of care.

OBJECTIVE To understand the situation of pathogenic organism of surgical cut infection and germiculture result from incisal margin swab,analyze the characteristic of pathogenic organism,and provide the measures to control.METHODS To investigate the patients from Jun 2004 to Sep 2005,and analyze the data of pathogenic organism of surgical cut infection and germiculture result from incisal margin swab.RESULTS From 10278 surgical cases 124 cases(1.29%) were with surgical cut infection,From 94 samples of incisal margin swabs 58(61.70%) were positive with 59 bacterial strains,including 32(54.24%) Escherichia coli isolates,10(16.95%) of coagulase negative Staphylococcus(CNS),3(5.08%) Klebsiella pneumoniae isolates and 3(5.08%) Streptococcus intermedius isolates.From 118 samples of surgical cut infection cases 102(86.44%) were positive with 120 strains,including 49(40.38%) E.coli isolates,25(20.83%) of CNS,and 7(5.83%) K.pneumoniae isolates.CONCLUSIONS The main bacteria of type Ⅰ surgical cut infection are Staphylococcus and that of types Ⅱ and Ⅲ surgical cut infection are E.coli.The rusults from incisal margin swabs have the important value to the treatment of surgical cut infection to guide the antibiotic use reasonably.

Objective To observe the clinical efficacy of acupuncture, chiropractic plus functional exercise of lumbar and gluteal muscles in treating postpartum sacroiliac malposition.Method Forty patients with postpartum sacroiliac malposition were randomized into group A, group B, group C and group D, 10 cases in each group. Group A was intervened by acupuncture, chiropractic plus functional exercise of lumbar and gluteal muscles, group B by acupuncture plus chiropractic, group C by acupuncture plus functional exercise of lumbar and gluteal muscles, and group D by chiropractic plus functional exercise of lumbar and gluteal muscles. The four groups were intervened once every other day. The modified Oswestry Disability Index (ODI) score was observed before and after 5 treatment sessions, and the clinical efficacies in the four groups were compared.Result The total effective rates were 100.0% in the four groups, and the inter-group differences were statistically insignificant (P>0.05). The ODI scores in the four groups were significantly changed after treatment and in the 3-month follow-up study compared with those before the treatment (P<0.05). After the treatment, the ODI score in group B was significantly different from that in the other groups (P<0.05). The ODI scores in group A and B in the 3-month follow-up study were significantly different from those after the treatment in the same group (P<0.05). The ODI score in group A was significantly different from that in the other groups in the 3-month follow-up study (P<0.05). The ODI score in group B in the 3-month follow-up study was significantly different from that in group C and D (P<0.05).Conclusion Acupuncture, chiropractic plus functional exercise of lumbar and gluteal muscles is definitely effective in treating postpartum sacroiliac malposition, acupuncture plus chiropractic can produce a significant short-term efficacy and alleviate the symptoms, and functional exercise of lumbar and gluteal muscle can produce an obvious long-term efficacy.

ObjectiveTo evaluate the intraoperative combined application of fibercholedochoscopy and B-type ultrasound for the treatment of intrahepatic biliary duct stones. Methods In our department 65 cases of intrahepatic biliary duct stones treated by fibercholedochoscopy and followed up for ten years were used as control. Results were compared with that of 78 cases undergoing combined management.ResultsFollow-up at first 5 years showed that patients treated with fiberbiliascopy had a much lower stone recurrent rate than that without, though difference became less significant within second 5 years. Intraoperative combined application of fibercholedochoscopy and B-ultrasound futher decreases the stone recurrence rate. ConclusionsCombining fibercholedochoscopy with B-type ultrasound intraoperatively enables the operator to locate intrahepatic biliary duct stones, reduces retained stone rate and stone recurrence.

OBJECTIVE To understand the distribution and antibiotic resistance of E.coli isolated from our hospital and offer suggestions for clinic.METHODS The antibiotic susceptibility to 21 kinds of antibiotics were tested by K-B method and analyzed by Whonet software.RESULTS The antibiotic resistance of 301 E.coli strains to ampicillin,quinolones,piperacillin,gentamicin,cefazolin,cefuroxime,ceftriaxone,ceftazidime,aztreonam,cefepime, ampicillin/sulbactam were 83.39%,69.44%,62.79%,44.19%,42.86%,36.88%,35.22%,31.23%,29.90%,29.57% and 26.91%,respectively.CONCLUSIONS E.coli isolated from our hospital show high resistance to several kinds of antibiotics.The drugs should be choosed reasonably according to their antibiotic suscepitibity results.

Objective To investigate the effect of edaravone plus beating-heart-preservation as well as beating-heart-transplantation technique on myocardial protection in donation after cardiac death (DCD) heart transplantation.Methods Twenty-four swine (body weight 28 ± 3 kg) were divided into two groups (n =12 each),and another twelve swine were used for blood donor.( 1 ) Experimental group:cardiac arrest was induced by asphyxiation (turning off the ventilation),and then the swine were subjected to 25-min warm ischemia,and cold oxygenated blood was perfused before the harvest of donor heart.Cardiac resuscitation was initiated by the ex vivo perfusion equipment and warm oxygenated blood was reperfused.Edaravone was given before harvesting of donor heart and in the early period of reperfusion.Donor hearts were kept beating throughout preservation and transplantation period.(2) Control group:all animals were treated in the same way except for without the application of edaravone.Hemodynamic,myocardial enzymes,and water content of myocardium were observed,and uhrastructural damage of cardiomyocytes was examined.Results All recipient animals could wean from cardiopulmonary bypass successfully.Left ventricular compliance and left ventricular contractility were significantly better preserved in experiment group than in control group.Though there was no significant difference in myocardial creatase level,the myocardial edema in experimental group was milder than in control group,and myocardial ultrastructure was better preserved in experimental group.Conclusion Heart from DCD,even though experienced 25-min warm ischemia after cardiac arrest by asphyxiation,still could be resuscitated via isolated heart perfusion equipment ( i.e.,beating-heart-preservation ) successfully.Furthermore,beating-hearttransplantation is feasible technically.Edaravone,a free-radical scavenger,could alleviate asphyxiation-induced myocardial injury,and further improve post-transplantation heart function.

Objective To evaluate the effects of fasudil on DCD hearts .Methods Sixteen domestic ,mixed‐breed male porcine [mean body weight (28 ± 3)kg] were randomly divide into experiment group and control group (n= 8 in each) .Experiment group :animals were sedated ,anesthetized and paralyzed .Mechanical ventilation with room air was provided .After thoroctomy ,cardiac arrest was established by bloodletting ,and then keeps at room temperature for additional 25 minutes (warm ischemia) .Hearts were perfused via the aortic root with fasudil (0 .1 mg/kg) enriched cold Stanford solution for coronary artery flushing ,rapidly excised and the aorta was cannulated .Hearts were subjected to isolated Langendorff perfusion (retrograde perfused with warm oxygenated autologous blood) afterwards ,and then underwent 20 minutes of equilibrium ,immersed in fasudil (0 .5 mg/kg) enriched cold Stan‐ford solution for 2 hours in situ cold preservation .Finally ,all the hearts were resuscitated with the warm oxygenated autologous blood perfusion .Control group :hearts from the animals experienced the same except for fasudil supplement .Left ventricular per‐formances were evaluated .Coronary blood flow ,myocardial infarction volume ,myocardial water content ,and myocardial enzyme were measured .Myocardial electron microscopic examinations were carried out as well .Results All the hearts from both groups were successfully resuscitated ,fasudil significantly decreased water content ,enzyme leakage (P< 0 .01 each versus control group) , and increased coronary blood flow (P< 0 .01 versus control group) .Left ventricular function were better preserved (P< 0 .01 each versus control group) .All hearts lacked severe necrosis as determined by tetrazolium staining ,myocardial infarction volume were decresed in experiment group (P< 0 .01 each versus control group) .Intracellular components retained various types of organelle in both group ,but still ultrastructural alterations in control group were more distinctive than in experiment group .Conclusion (1) Donor heart arrested by exsanguinations and plus 25 minutes warm ischemia ,could still be resuscitated with satisfactory result ;(2) The addition of fasudil to Stanford solution (before excise of graft ,during the cold preservation) ,might alleviate DCD heart I‐R in‐jury ,improving the effect of DCD heart preservation ,and hopefully ,might be a novel arsenal in clinical DCD heart transplantation in the future .

Objective To summarize our experience on the treatment for severe vascular injuries in the operation of great saphenous varicose vein. Methods The clinical data of 4 cases (5 lower limbs) from December 2004 to April 2009 of severe vascular injuries were retrospectively analyzed. For the lower limbs in which from the end of femoral artery to the upper part of posterior tibial artery were stripped, reconstruction operation using blood vessel prothesis was performed, above knee amputation was performed because of limb gangrene. For three limbs in which 10 cm to 15 cm superficial femoral artery were stripped, reconstruction operation using autologous saphenous vein were performed, above knee amputation was performed for one limb 5 days after the operation. For the limb in which 2 cm superficial femoral vein were cut, reconstruction operation using autologous saphenous vein were performed. Results No cases died perioperatively,for four limbs of injuried artery, ampution were performed for two limbs(50% ) ;two limbs (50%) were saved. The patient of injuried superficial femoral vein recovered. Conclusions Severe vascular injuries can be prevented and its incidence reduced by improving the awareness for iatrogenic vascular injuries,accurate operation; once the vascular injury occurred, prompt and rational measures must be adopted.