BACKGROUND: Frustration tolerance, affected by many factors, is a kind of ability that an individual can endure and overcome the adversity. This research would adopt group therapy, especially the experienced therapy. On the basis of helping clients rebuilt cognition, this research would make clients experience frustration by themselves, increase frustration experience and enhance the threshold value of frustration.OBJECTIVE: To observe the enhancing effect of group therapy on frustration tolerance of postgraduates. DESIGN : Self-control observation. SETTING: Department of Preventive Medicine, Medical College of Jiangsu University. PARTICIPANTS; This experiment was conducted in Jiangsu University. A total of 1200 fresh postgraduates enrolled in 2005 from business administration, computer science and communication engineering, mechanical engineering, medical technology, automobile and traffic and chemistry and chemical engineering colleges were screened with "frustration tolerant questionnaires" from "perfect personality testing handbook". There were 19 questions in this questionnaire. All of these questions were negative, for example, you did not want to compete with others when you were behind others. There were A, B, C, D, E five scales for every question. The different answers will have different scores. A represented extremely coincidence, B represented slight coincidence, C represented unknown, D represented discrepancy, and E represented very discrepancy. Different answers corresponded to different scores. The total scores were given at last. The higher the scores were, the more severe the anxiety scale was. There were 70 postgraduates whose scores of frustration tolerant were below 50, the scores of the other 1 130 postgraduates were equal to or more than 50. Twenty-three students were sampled randomly, whose scores of frustration tolerance were below 50 as an experimental group. At the same time, 44 ones with scores of frustration tolerance over or equal to 50 were sampled as a control group. There were 67 postgraduates in the two groups.METHODS: Sixty-seven postgraduates were divided into 7 groups with 10 in each group according to gender, scores of frustration tolerant and different colleges. We adopted group therapy. Firstly, we chose language induction based on background music for hypnotherapy, and placed the clients at ease and into therapeutic state. After hypnosis, we developed a game "breaking ice" which would help clients understand each other and make a comfortable atmosphere. Next, we carried on the cognitive rebuilt to change the bad cognition of the students, and help them foster the right thought of frustration. Besides, we had an activity "blind looking for road" and a psychodrama and "beastly boss". During the treat ment of "blind looking for road", the students' eyes were blindfolded, and they walked through the campus to experience the hard life in blind. During the play of "beastly boss", one of them acted a boss, and other one acted an employee, then by turns. The story was that a boss scolded an employee in a rough manner, an employee explained, pled, but the boss went on inveighing. In order to avoid being fired, the employee had to chokes down. In the act, the students would taste the frustrated feeling when rebuked innocently, and thus the students would get experience of frustration and enhance their patience. After every activity, we divided them into small and big groups, then let them talk and share, to give utual study and promotion. In the process, we integrated all the approaches and organized them naturally to heighten the effect of the treatment.MAIN OUTCOME MEASURES: ① Comparison of mean scores of frustration tolerance before and after treatment. ② Comparison of mean scores of frustration tolerance before and after treatment among clients with different frustration toler ances.RESULTS: Sixty-seven questionnaires were handed out, and 57 effective questionnaires were collected in total by the end of treatment, and the other 10 questionnaires were invalid due to incomplete filling. Nineteen of effective questionnaires were from experimental group and 38 from control group. The total retrieved rate of questionnaires was 87.7％. The mean scores of frustration tolerance of involved 57 postgraduates before treatment were significantly higher than those after treatment [(54.4±8.90) points vs. (58.70±10.94) points, t =0.38, P ＜ 0.05). The mean scores of frustration tolerance of postgraduates with mean scores of frustration tolerance ＜ 50 points were significantly higher after treatment than before treatment (t =3.49, P ＜ 0.05).CONCLUSION: Group therapy, especially psychodrama and other frustration experience therapies can effectively enhance the frustration tolerance of clients.

BACKGROUND: More and more psychiatric problems require liaison consultation in specific clinical departments of general hospital.OBJECTIVE: To enhance the recognition of physicians in non-psychiatric departments on psychiatric illness by carrying on psychiatric liaison consultation in general hospital.DESIGN: Case analysis.SETTING: Department of Psychology in the affiliated hospital to Guangdong Medical College.PARTICIPANTS: Totally 154 inpatients for the consultation in Department of Psychology were selected in the Affiliated Hospital of Guangdong Medical College from April 2003 to April 2004, of either sex and different age and educational backgrounds.METHODS: It was to investigate the distributions of departments and diseases with consultation-liaison psychiatry (CLP) in general hospital in 154 cases based on statistics.RESULTS: Totally 154 cases were employed and were all in result analydepartments applying for consultation, the department of internal nedicine occupies the top, 57 cases (37.0%) involved, followed by department of emergency, with 26 cases (16.8%), department of infection, with 17 cases illness: The most common diseases in consultation were neurotic disorders due to brain disease (31.1%), psychiatric disorder (25.3%) and psychiatric disorder due to body disease (13.6%).CONCLUSION: Psychiatric problem happens in every clinical department of general hospital. It is necessary to enhance liaison psychiatric consultation in general hospital.

Objective To develop and evaluate an aptamer based biosensor (aptasensor) for rapid colorimetric detection of enteropathogenic Escherichia coli (EPEC). Method The aptasensor was fabricated by modifying the truncated LPS-binding aptamer on the surface of nanoscale polydiacetylene vesicles using peptide bonding between the carboxyl group of the vesicle and the amine group of the aptamer. Molecular recognition between EPEC and aptamer at the interface of the vesicle led to blue-red transition of polydiacetylene which was readily visible to the naked eyes and could be quantified by colorimetric responses (CR). Transmission electron microscopy (TEM) was used to confirm the specific interactions between EPEC and polydiacetylene vesicles. Result Truncated aptamer showed the similar LPS-binding activity. The aptasensor could detect the target bacteria in a range of 105-108 colony-forming units (CFU)/ml within less than 30 minutes and its specificity was 100% for detection of EPEC O111. The sensor reproducibiliry obtained at 106 CFU/ml was 6. 08% R. S. D. The results of TEM confirmed that the specific interactions between EPEC and polydiacetylene vesicles. Conclusion A new aptasensor was developed successfully for rapid colorimetric detection of EPEC.

Objective To discuss the clinical effects of hemiarthroplasty for the treatment of intertrochanteric comminuted fracture in aged patients.Methods From June 2006 to June 2010,91 cases with intertrochanteric comminuted fractures were treated by hemiarthroplasty using Zweymtüller long-stem cementless implant.There were 35 males and 56 females,with an average age of 81.2 years (range,75-94 years).There were fresh fractures in 75 cases and old fractures in 16 cases.According to classification of Evans-Jensen,there were 36 cases with type Ⅲ fracture and 55 with type Ⅳ.Osteoporosis was graded by Singh index,and there were 51 cases with level Ⅲ and 40 with level Ⅱ.The interval between injury and operation was 2-10 d (average,3.5 d).Results The surgery lasted 30-50 min (average,39 min).The blood loss was 320-610 ml (average,405 ml).The hospital stay was 14-21 d (average,16.5 d).Two cases who experienced with the infection of the respiratory system after operation,recovered through routine treatment.Thirty-seven cases were followed up for 15 to 38 months (average,24.5 months).According to the Harris score,the overall rate of excellent or good result was 83.8％ (31/37).Conclusion Hemiarthroplasty using Zweymüller long-stem cementless prosthesis is reliable option for intertrochanteric comminuted fracture in the aged patients.

Objective To explore the value of computer-aided measurement of the mass-based consolidation-to-tumor ratio(CTRmass)in predicting preoperative clinical stage IA lung adenocarcinoma invasion.Methods A total of 56 patients with stage IA lung adenocarcinoma were retrospectively selected from Linfen Central Hospital and the National Lung Screening Trial(NLST)database(project number NLST-1053),and all of them were confirmed by pathology.Computer-aided software was used to automatically cal-culate parameters such as the volume-based consolidation-to-tumor ratio(CTRvol),CTRmass,average CT value,and maximum axial diameter,and its correlation with pathological results was analyzed.Results When the CTRmass≥30.95％,it indicated that lung nodules were more likely to be invasive adenocarcinoma(IAC).Conclusion CTRmass,based on computer-aided software measure-ment,can be used as one of the important indicators to evaluate the preoperative invasion of clinical stage IA lung adenocarcinoma,guiding the selection of surgical methods,and obtaining better curative effects.

Objective To investigate the distribution and antimicrobial resistance profiles of the common pathogens isolated from urine from 2015 to 2021 in the CHINET Antimicrobial Resistance Surveillance Program.Methods The bacterial strains were isolated from urine and identified routinely in 51 hospitals across China in the CHINET Antimicrobial Resistance Surveillance Program from 2015 to 2021.Antimicrobial susceptibility was determined by Kirby-Bauer method,automatic microbiological analysis system and E-test according to the unified protocol.Results A total of 261 893 nonduplicate strains were isolated from urine specimen from 2015 to 2021,of which gram-positive bacteria accounted for 23.8％(62 219/261 893),and gram-negative bacteria 76.2％(199 674/261 893).The most common species were E.coli(46.7％),E.faecium(10.4％),K.pneumoniae(9.8％),E.faecalis(8.7％),P.mirabilis(3.5％),P.aeruginosa(3.4％),SS.agalactiae(2.6％),and E.cloacae(2.1％).The strains were more frequently isolated from inpatients versus outpatients and emergency patients,from females versus males,and from adults versus children.The prevalence of ESBLs-producing strains in E.coli,K.pneumoniae and P.mirabilis was 53.2％,52.8％and 37.0％,respectively.The prevalence of carbapenem-resistant strains in E.coli,K.pneumoniae,P.aeruginosa and A.baumannii was 1.7％,18.5％,16.4％,and 40.3％,respectively.Lower than 10％of the E.faecalis isolates were resistant to ampicillin,nitrofurantoin,linezolid,vancomycin,teicoplanin and fosfomycin.More than 90％of the E.faecium isolates were ressitant to ampicillin,levofloxacin and erythromycin.The percentage of strains resistant to vancomycin,linezolid or teicoplanin was＜2％.The E.coli,K.pneumoniae,P.aeruginosa and A.baumannii strains isolated from ICU inpatients showed significantly higher resistance rates than the corresponding strains isolated from outpatients and non-ICU inpatients.Conclusions E.coli,Enterococcus and K.pneumoniae are the most common pathogens in urinary tract infection.The bacterial species and antimicrobial resistance of urinary isolates vary with different populations.More attention should be paid to antimicrobial resistance surveillance and reduce the irrational use of antimicrobial agents.

Objective To understand the distribution and changing resistance profiles of clinical isolates of Enterococcus in hospitals across China from 2015 to 2021.Methods Antimicrobial susceptibility testing was conducted for the clinical isolates of Enterococcus according to the unified protocol of CHINET program by automated systems,Kirby-Bauer method,or E-test strip.The results were interpreted according to the Clinical & Laboratory Standards Institute(CLSI)breakpoints in 2021.WHONET 5.6 software was used for statistical analysis.Results A total of 124 565 strains of Enterococcus were isolated during the 7-year period,mainly including Enterococcus faecalis(50.7％)and Enterococcus faecalis(41.5％).The strains were mainly isolated from urinary tract specimens(46.9％±2.6％),and primarily from the patients in the department of internal medicine,surgery and ICU.E.faecium and E.faecalis strains showed low level resistance rate to vancomycin,teicoplanin and linezolid(≤3.6％).The prevalence of vancomycin-resistant E.faecalis and E.faecium was 0.1％and 1.3％,respectively.The prevalence of linezolid-resistant E.faecalis increased from 0.7％in 2015 to 3.4％in 2021,while the prevalence of linezolid-resistant E.faecium was 0.3％.Conclusions The clinical isolates of Enterococcus were still highly susceptible to vancomycin,teicoplanin,and linezolid,evidenced by a low resistance rate.However,the prevalence of linezolid-resistant E.faecalis was increasing during the 7-year period.It is necessary to strengthen antimicrobial resistance surveillance to effectively identify the emergence of antibiotic-resistant bacteria and curb the spread of resistant pathogens.

Objective To examine the changing antimicrobial resistance profile of Enterobacter spp.isolates in 53 hospitals across China from 2015 t0 2021.Methods The clinical isolates of Enterobacter spp.were collected from 53 hospitals across China during 2015-2021 and tested for antimicrobial susceptibility using Kirby-Bauer method or automated testing systems according to the CHINET unified protocol.The results were interpreted according to the breakpoints issued by the Clinical & Laboratory Standards Institute(CLSI)in 2021(M100 31st edition)and analyzed with WHONET 5.6 software.Results A total of 37 966 Enterobacter strains were isolated from 2015 to 2021.The proportion of Enterobacter isolates among all clinical isolates showed a fluctuating trend over the 7-year period,overall 2.5％in all clinical isolates amd 5.7％in Enterobacterale strains.The most frequently isolated Enterobacter species was Enterobacter cloacae,accounting for 93.7％(35 571/37 966).The strains were mainly isolated from respiratory specimens(44.4±4.6)％,followed by secretions/pus(16.4±2.3)％and urine(16.0±0.9)％.The strains from respiratory samples decreased slightly,while those from sterile body fluids increased over the 7-year period.The Enterobacter strains were mainly isolated from inpatients(92.9％),and only(7.1±0.8)％of the strains were isolated from outpatients and emergency patients.The patients in surgical wards contributed the highest number of isolates(24.4±2.9)％compared to the inpatients in any other departement.Overall,≤ 7.9％of the E.cloacae strains were resistant to amikacin,tigecycline,polymyxin B,imipenem or meropenem,while ≤5.6％of the Enterobacter asburiae strains were resistant to these antimicrobial agents.E.asburiae showed higher resistance rate to polymyxin B than E.cloacae(19.7％vs 3.9％).Overall,≤8.1％of the Enterobacter gergoviae strains were resistant to tigecycline,amikacin,meropenem,or imipenem,while 10.5％of these strains were resistant to polycolistin B.The overall prevalence of carbapenem-resistant Enterobacter was 10.0％over the 7-year period,but showing an upward trend.The resistance profiles of Enterobacter isolates varied with the department from which they were isolated and whether the patient is an adult or a child.The prevalence of carbapenem-resistant E.cloacae was the highest in the E.cloacae isolates from ICU patients.Conclusions The results of the CHINET Antimicrobial Resistance Surveillance Program indicate that the proportion of Enterobacter strains in all clinical isolates fluctuates slightly over the 7-year period from 2015 to 2021.The Enterobacter strains showed increasing resistance to multiple antimicrobial drugs,especially carbapenems over the 7-year period.

Objective To understand the changing distribution and antimicrobial resistance profiles of Klebsiella strains in 52 hospitals across China in the CHINET Antimicrobial Resistance Surveillance Program from 2015 to 2021.Methods Antimicrobial susceptibility testing was carried out according to the unified CHINET protocol.The susceptibility results were interpreted according to the breakpoints in the Clinical & Laboratory Standards Institute(CLSI)M100 document.Results A total of 241,549 nonduplicate Klebsiella strains were isolated from 2015 to 2021,including Klebsiella pneumoniae(88.0％),Klebsiella aerogenes(5.8％),Klebsiella oxytoca(5.7％),and other Klebsiella species(0.6％).Klebsiella strains were mainly isolated from respiratory tract(48.49±5.32)％.Internal medicine(22.79±3.28)％,surgery(17.98±3.10)％,and ICU(14.03±1.39)％were the top 3 departments where Klebsiella strains were most frequently isolated.K.pneumoniae isolates showed higher resistance rate to most antimicrobial agents compared to other Klebsiella species.Klebsiella isolates maintained low resistance rates to tigecycline and polymyxin B.ESBLs-producing K.pneumoniae and K.oxytoca strains showed higher resistance rates to all the antimicrobial agents tested compared to the corresponding ESBLs-nonproducing strains.The K.pneumoniae and carbapenem-resistant K.pneumoniae(CRKP)strains isolated from ICU patients demonstrated higher resistance rates to majority of the antimicrobial agents tested than the strains isolated from non-ICU patients.The CRKP strains isolated from adult patients had higher resistance rates to most of the antimicrobial agents tested than the corresponding CRKP strains isolated from paediatric patients.Conclusions The prevalence of carbapenem-resistant strains in Klebsiella isolates increased greatly from 2015 to 2021.However,the Klebsiella isolates remained highly susceptible to tigecycline and polymyxin B.Antimicrobial resistance surveillance should still be strengthened for Klebsiella strains.

Objective To investigate the changing distribution and antibiotic resistance profiles of clinical isolates of Staphylococcus in hospitals across China from 2015 to 2021.Methods Antimicrobial susceptibility testing was conducted for the clinical isolates of Staphylococcus according to the unified protocol of CHINET(China Antimicrobial Surveillance Network)using disk diffusion method and commercial automated systems.The CHINET antimicrobial resistance surveillance data from 2015 to 2021 were interpreted according to the 2021 CLSI breakpoints and analyzed using WHONET 5.6.Results During the period from 2015 to 2021,a total of 204,771 nonduplicate strains of Staphylococcus were isolated,including 136,731(66.8％)strains of Staphylococcus aureus and 68,040(33.2％)strains of coagulase-negative Staphylococcus(CNS).The proportions of S.aureus isolates and CNS isolates did not show significant change.S.aureus strains were mainly isolated from respiratory specimens(38.9±5.1)％,wound,pus and secretions(33.6±4.2)％,and blood(11.9±1.5)％.The CNS strains were predominantly isolated from blood(73.6±4.2)％,cerebrospinal fluid(12.1±2.5)％,and pleural effusion and ascites(8.4±2.1)％.S.aureus strains were mainly isolated from the patients in ICU(17.0±7.3)％,outpatient and emergency(11.6±1.7)％,and department of surgery(11.2±0.9)％,whereas CNS strains were primarily isolated from the patients in ICU(32.2±9.7)％,outpatient and emergency(12.8±4.7)％,and department of internal medicine(11.2±1.9)％.The prevalence of methicillin-resistant strains was 32.9％in S.aureus(MRSA)and 74.1％in CNS(MRCNS).Over the 7-year period,the prevalence of MRSA decreased from 42.1％to 29.2％,and the prevalence of MRCNS decreased from 82.1％to 68.2％.MRSA showed higher resistance rates to all the antimicrobial agents tested except trimethoprim-sulfamethoxazole than methicillin-susceptible S.aureus(MSSA).Over the 7-year period,MRSA strains showed decreasing resistance rates to gentamicin,rifampicin,and levofloxacin,MRCNS showed decreasing resistance rates to gentamicin,erythromycin,rifampicin,and trimethoprim-sulfamethoxazole,but increasing resistance rate to levofloxacin.No vancomycin-resistant strains were detected.The prevalence of linezolid-resistant MRCNS increased from 0.2％to 2.3％over the 7-year period.Conclusions Staphylococcus remains the major pathogen among gram-positive bacteria.MRSA and MRCNS were still the principal antibiotic-resistant gram-positive bacteria.No S.aureus isolates were found resistant to vancomycin or linezolid,but linezolid-resistant strains have been detected in MRCNS isolates,which is an issue of concern.