OBJECTIVE To investigate the distribution and resistance of pathogens in lower-respiratory tract infection in our area,and help doctors to use antibiotic reasonably.METHODS According to National Guide to Clinical Laboratory Procedures,API identification system or K-B method,the pathogens of 1326 cases sputum specimens were isolated,identified and tested in drug sensitive test.RESULTS A total of 982 strains of pathogens that included 540(20.0%) G-bacilli,196(20.0%) G+ cocci and 246(25.1%) fungi were isolated from 1326 sputum specimens and the detection rate was 74.1%.From them 176 cases which occupied 13.3% were with mixed infection.The drug resistance of G-bacilli to imipenem was the lowest,then was to cefoperazone and amikacin,but the resistance of ampicillin was the highest.From 234 strains of Klebsiella had 89 strains of ESBLs-positive;in 50 strains of Escherichia coli,the strains of ESBLs-positive were 20(40.0%).The resistance rate of Staphylococcus aureus and S.epidermidis to penicillin was 97.5% and 97.2%,respectively,both of them were sensitive to vancomycin,and less sensitive to ciprofloxacin.Fifty seven strains of MRSA were detected from 90 strains of S.aureus(63.3%);and 42 strains of MRSE were detected(56.0%).CONCLUSIONS G-bacilli are the main pathogens in lower respiratory tract infection and the infection caused by fungi is more than that caused by G+ cocci,so we must pay attention also to mixed infection which occupies certain ratio.

BACKGROUND:How to promote homing of scarce limbal stem cel s is the key to improving transplantation efficiency. And stromal cel-derived factor-1 plays an important role in the repair of retinal pigment epithelial cel s injury. OBJECTIVE:To observe changes of stromal cel-derived factor-1 levels in rat and mouse limbal stem cel deficiency models in order to confirm whether these changes wil induce peripheral blood stem cel s homing into the cornea. METHODS:Eye models of limbal stem cel deficiency were prepared in rats and mice by cutting method, then peripheral blood samples were continuously drawn to detect the mass concentration of stromal cel-derived factor-1 by enzyme-linked immunosorbent assay within 1 month after modeling. RESULTS AND CONCLUSION:In the rat peripheral blood, the mass concentration of stromal cel-derived factor-1 started to increase at 24 hours after modeling and firstly peaked at the 3rd day;then it tended to decrease and reached a second peak lower than the first one at the 25th day;subsequently, it returned to the normal level. In the meanwhile, the mass concentration of stromal cel-derived factor-1 in the mouse peripheral blood, increased at 12 hours after modeling, peaked at the 3rd day, subsequently decreased until another peak lower than the former one presented at the 20th day, and final y it returned to the normal level. In conclusion, the level of stromal cel-derived factor-1 in the peripheral blood is significantly associated with limbal stem cel s deficiency, which may play an important role in corneal injury repair.

BACKGROUND:Stromal cel-derived factor-1 (SDF-1) and chemokine receptor-4 (CXCR4) play an important role in stem cel homing during bone marrow, organ and tissue transplantation. But there are few reports on limbal stem cel transplantation and homing as wel as the distribution and content of SDF-1/CXCR4 on the cornea. OBJECTIVE:To detect the expression levels of SDF-1/CXCR4 mRNA in rat corneal tissue by fluorescence quantitative PCR. METHODS: The normal rat cornea was taken completely, and subdivided into central cornea, peripheral corneal and limbal area. Fluorescence quantitative PCR method was employed to detect SDF-1/CXCR4 mRNA levels at corresponding positions. RESULTS AND CONCLUSION: The expression levels of SDF-1 and CXCR4 mRNA were 0.213±0.015 and 0.189±0.02 in the central cornea, 0.529±0.077 and 0.285±0.015 in the peripheral cornea, 0.666±0.069 and 0.258±0.067 in the limbal area, respectively. These data show that there are significant differences in the expression levels of SDF-1 and CXCR4 mRNA in the central cornea, peripheral corneal and limbal area, and these differences exert an important role in cel homing and migration during limbal stem cel transplantation for treatment of limbal stem cel deficiency.

Objective To find out exposure level and distributional characteristics of risk factors for stroke in sampling population among communities. Methods Target population aged≥40 years were selected from Beijing,Shanghai,Fuzhou and Tangshan by cluster sampling and grouped by area,age and gender. They were investigated face to face with a questionnaire which included general information and common risk factors of stroke. Body height,weight and levels of blood pressures were measured. Exposure rate of risk factors and its distributional characteristics of area and population were described. Results 23 471 individuals were enlisted into data analysis. Exposure rate of hypertension,heart disease,diabetes,family history of stroke,obesity,cigarette smoking and alcohol drinking were 27.73%,14.14%,5.19%,15.95%,11.28%,28.7% and 16.6%,respectively. There were significant differences between areas for all factors (P

Objective To investigate the maternal attitude and demands for Institute of Postpartum Care in order to provide targeted services.Methods 285 women were a investigated about maternal attitude and demands towards Institute of Postpartum Care with self-designed questionnaire.Results 97.9％ (279/285) women thought sitting the month (puerperal period) was very important,50.2％ (143/285)women were interested in Institute of Postpartum Care.They thought the main three advantages were energy saving,medical expertise and technology and avoidance of family conflicts;The three major issues were high price,lack of monitoring mechanism and unfamiliar environment and less family company;33 items of services demands over four points accounted for 78.6％,the three modules with highest scores were cleaning services scored 4.64±0.47,newborn services scored 4.45±0.41,consultation service scored 4.41:±0.53.Conclusions Professional postnatal care services have been a trend and social need,and a large proportion of women have great interest and demand on Institute of Postpartum Care which should make full use of its concentrate resources,and provide specific services according to maternal demands for services.It is urgent to build unified service standards and evaluation indicators to improve service quality.

Objective To investigate the effect of preoperative chlorhexidine bath for reducing the incidence of sur-gical site infection(SSI)in patients undergoing spinal surgery.Methods All patients who undergoing spinal surgery (with no implants)in the department of neurosurgery of a hospital between January 2013 and December 2014 were monitored,the selected patients were divided into control group (January-December of 2013,no intervention meas-ures were taken)and trial group(January-December of 2014,1 .8%-2.2% chlorhexidine bath for two nights before operation),incidence of SSI between two groups of patients before and after intervention was compared,interven-tions effect was evaluated.Results A total of 1 043 patients undergoing spinal surgery were enrolled,41 (3.93%) had SSI,incidence of SSI rates in control group and trial group were 6.47% and 2.34% respectively,the difference was statistically significant (P=0.001).According to the incidence of SSI in control group,actual infected patients in trial group were 27 less than the anticipated patients with infection.The average hospitalization expense in SSI group and non-SSI group were ￥33 641 .00 and ￥23 072.50 respectively,each patient could save ￥10 568.50 on average.Therefore,through the intervention measures,￥285 349.50 of hospitalization expense could be saved. Except ￥2 100 of trial material cost and ￥12 820 of manual labour cost,￥270 429.50 of social cost was ultimately saved.The mean length of hospital stay in control group and trial group were 10 (8-12)days and 9 (8-12)days respectively,rank test showed that the difference was not statistically significant (Z = - 0.68,P = 0.50 ). Conclusion Chlorhexidine bath intervention can not only reduce SSI rate,but also save the expense of hospitaliza-tion,whether it can shorten the length of hospital stay needs to be further studied.

OBJECTIVE To raise the level of laboratory diagnosis of diarrheal pathogens.METHODS The stool samples were inoculated on the of SS agar,SMAC agar,TCBS agar,blood agar.RESULTS Over the past three years in our hospital pathogen detection rate of diarrhea was 48.2%.The scope of the baeteria isolated were not limited to Salmonella and Shigella,but also Escherichia coli-induced diarrhea,Vibrio,Staphylococcus arreus,Candida albicans.The Klebsiella,Proteus,Citrobacter,Pseudornonas aeruginosa and the like were also detected out.CONCLUSIONS It′s important to choose right medium and detect intestinal pathogens in clinical.

Objective To understand the impact of methicillin-resistant Staphylococcus aureus (MRSA)blood-stream infection on the length of hospital stay,hospital mortality,and poor prognosis of patients.Methods 357 patients with Staphylococcus aureus (S .aureus)bacteremia in a hospital between January 1 ,2009 and December 31 , 2013 were surveyed and analyzed retrospectively.Results Of 357 patients,91 were infected with MRSA and 266 with methicillin-susceptible S .aureus (MSSA).The length of hospital stay was statistically different between MR-SA and MSSA group(29 d vs 23 d,P <0.01);before infection,length of hospital stay of MRSA group was longer than MSSA group(P <0.01 );after infection,length of hospital stay was not statistically different between two groups(17 d vs 16.5 d,P = 0.92 ).Mortality of MRSA group and MSSA group was not statistically different (13.19% vs 9.02%,χ2 =1 .28,P =0.26).The incidence of poor prognosis of MRSA group was higher than MSSA group(29.67% vs 16.92%,χ2 =6.85,P =0.01 ).Multivariate analysis results showed that MRSA infection was independent risk factor for poor prognosis (P <0.01).Conclusion MRSA infection doesn’t contribute to the pro-longation of hospital stay,but MRSA bloodstream infection is a risk factor for poor prognosis of patients.

Objective To explore the effect of folic acid on neural stem cells(NSCs) proliferation from fetal rats in vitro.Method NSCs were isolated and cultured by microdissection,mechanical blowing and serum-free suspension culture,and identified by immunofluorescent staining using antibody against nestin.BrdU(5’bromo-2’deoxyuridine) was used to mark dividing neural stem cells.Cultured NSCs were divided into four groups:control group,low,high dose group(liquid media with added 4,40 mg/L folic acid),and deficiency group(liquid media with added 0.4 mg/L methotrexate,MTX).Monotetrazolium(MTT) and double-label immunofluorescence technique detected NSCs proliferation under the condition of folic acid.Results In the serum-free suspension medium,neurospheres that consisted of a great number of nestin-positive cells could be obtained.The proliferative ability of NSCs were observed by BrdU labeling methods.MTT assay and double-label immunofluorescence for nestin+BrdU showed that the growth tendency was increased with folate concentration in the medium.Compared with control group,NSCs growth rate of folate group was significantly increased in vitro.Conclusion The culture of NSCs isolated from fetal rats possesses the abilities of proliferation and self-regeneration.Folic acid may stimulate proliferation of NSCs efficiently.

Objective To explore the risk factors and prognosis of hospitalized patients with bloodstream infection due to carbapenem-resistant Acinetobacter baumannii (CRAB).Methods 163 patients with CRAB bloodstream in-fection from 2010 to 2013 were conducted retrospective case-control study,68 patients with bloodstream infection due to carbapenem-susceptible Acinetobacter baumannii (CSAB)during the same period were as control group. Results The independent risk factors for CRAB bloodstream infection were stay in intensive care unit(ICU)(OR, 1 .27[95%CI ,5.55-22.89])and emergency department(OR,3.57 [95%CI ,1 .67 -7.62])before infection.Pa-tients with CRAB bloodstream infection had lower 28-day survival rate than those with CSAB bloodstream infection (66.17% vs 96.95%,χ2 =15.71 ,P <0.001 ).The independent risk factors for influencing prognosis of Acineto-bacter baumannii bloodstream infection were infection of CRAB (HR 95% CI ,3.01 -67.28),blood disease(HR 95%CI ,3.77-25.97),cardiac insufficiency(HR 95%CI ,2.10-20.41),stay in ICU(HR 95%CI ,1 .01 -5.28), and age(HR 95%CI ,1 .01 -1 .04).Conclusion The independent risk factors for CRAB bloodstream infection are stay in ICU and emergency department before infection,CRAB bloodstream infection is risk factor for influencing prognosis of patients.