In the last few years,the morbidity of pulmonary fungal infection is keeping increasing.However,misdiagnosis is very common in clinical practice since it has no specific clinical characteristics.Subsequently,delayed treatment happened.Laboratory test is the key method to diagnose pulmonary fungal infection.In fact,only pathology and positive cultural results obtained from germfree specimens could make the final diagnosis.Recently,some new methods put into effect such as G-test and GM-test.These methods greatly improve the early diagnosis of invasive fungal infection.Among them,PCR is a very prospective way.Nevertheless,the most basic and common used way is to detect and analysis sputum,blood and the specimen obtained through bronchoscopy.The specimen collecting process need to be standardized and the results need to be evaluated along with the clinical data. Abstract:Summ ary: In the last few years,the morb id ity of pu lmo-nary fungal infection is keep ing increasing.However,m isd iag-nosis is very common in c lin ical practice since it has no spec if-ic c lin ical characteristics.Subsequently,delayed treatm ent hap-pened.Laboratory test is the key m ethod to d iagnose pu lmonary fungal infection.In fact,on ly pathology and positive cu ltural re-su lts obtained from germ free spec im ens cou ld m ake the final d i-agnosis.Recently,som e new m ethods put into effect such as G-test and GM-test.These m ethods greatly improve the early d iag-nosis of invasive fungal infection.Among them,PCR is a very prospective way.Nevertheless,the most basic and common used way is to detect and analysis sputum,b lood and the spec im en obtained through bronchoscopy.The spec im en collecting process need to be standard ized and the resu lts need to be eval-uated along w ith the c lin ical data.

Atypical pathogens are very common in community-acquired pneumonia(CAP) with the morbidity of about 22%(20%～28%).Therefore,CAP guidelines around the world usually emphasize the importance of atypical pathogens.The diagnosis tests are also listed in the guidelines,but only applied among inpatients.Japanese Respiratory Society recommended the diagnosis criteria of atypical pneumonia based on the clinical characteristics for the first time in the world.All guidelines recommended that empirical antibiotic therapy should cover those atypical pathogens when Mycoplasma pneumoniae,Chlamydia pneumonia or legionella pneumophilia infection are possibly exist.Antibiotic therapy against Mycoplasma pneumoniaen and Chlamydia pneumonia should be considered among outpatients and inpatients as well as anti-legionella pneumophilia therapy in severe patients in ICU.The recommended regimen is beta-lactam antibiotics combined with macrolides or fluoroquinolones alone.

The incidence of gram-positive coccus infection was keeping rising in recent years,with increase in hospital-and community-acquired pneumonia,as well as the incidence of infection caused by drug-resistant bacteria.Staphylococcus sp.,Streptococcus sp.and Enterococcus sp.were the most common pathogens inducing infection of the respiratory system,among which Streptococcus ranked the first.Streptococcus pneumoniae is still the most common pathogen causing respiratory infection.Recently,infection produced by penicillin-resistant strains of Streptococcus pneumoniae became more and more prevalent,leading to frequent failure in treatment.Regarding to Staphylococcus aureus,the methicillin-resistant strains (MRSA) account for approximately 60% of the pathogens inducing hospital-acquired infections,and what is worse,such a tendency is spreading to community,while the features of community-acquired MRSA infections (CA-MRSA) are very different from that of hospital-acquired MRSA infections (HA-MRSA).The purpose of present article is mainly to summarize the advances in diagnosis and treatment of pneumonia caused by Streptococcus pneumoniae and Staphylococcus aureus.

Objective To reveal the literature resources in traditional Chinese medicine from the end of the Qing Dynasty to 1949 .Methods The papers published in journals of traditional Chinese medicine from the end of the Qing Dynasty to 1949 were statistically analyzed .Results The largest number of journals was published in Shang-hai, the largest number of papers was published in Guanghua Medical Journal, 95%of the papers were published by a single author, the contents were focused on classical prescriptions and proved recipes, food therapy, disease treatment, baby care knowledge, and the most commonly studied were infectious diseases, such as exogenous febrile disease, cholera, and malaria.Conclusion The papers published in journals of traditional Chinese medicine from the end of the Qing Dynasty to 1949 are focused much more on the application of the knowledge about traditional Chinese medicine , but less on the theories of traditional Chinese medicine .

Pseudomonas aeruginosa,a ubiquitous organism,shows a remarkable resistance to antibiotics because of its low permeability of the outer-membrane,over-expression of efflux pumps,inactivation of antibotics,or mutations in targets.These mechanisms are often present simultaneously,and increase the burden on clinical therapy.

Objective To compare the effects of invert sugar versus 10% glucose on the blood glucose concentrations of patients in neurosurgical intensive care unit .Methods This is a prospective ,randomized ,double blind and compared study .A total of 40 in-sulin-requiring neurosurgical critical patients were randomized to receive intravenous ,1 000 mL ,either 10% invert sugar (experi-mental group) or 10% glucose(control group) on their first day when they were admitted to the intensive care unit (ICU ) .Blood glucose concentrations were measured every four hours and liver and kidney function indicators were recorded respectively .We’ve also compared the difference of the blood glucose concentrations changes between the two groups .Results There were significant differences in the glucose concentration between the two treatment groups (P<0 .05) ,whereas no significant differences in the inci-dences of hypoglycemia ,renal failure and hepatic damage were observed .No allergic reactions were found in both groups .Conclusion 10% invert sugar is a better choice for neurosurgical critical patients who need regular insulin infusion to control blood glucose .

The numbers of eosinophils and mast cells expressing 5-lipoxygenase of airway in aspirin-induced asthma (AIA) increased. LTC 4 synthase, the terminal enzyme for cys-LT production, is overexpressed markedly in bronchial biopsy specimens of most patients with AIA. These characterized the unique airway inflammation of AIA which may illuminat the pathogenesis of AIA to some extent.

Chlamydia pneumoniae(Cpn) is one of the most common pathogens causing human respiratory tract infection.They cause acute respiratory tract infection,atherosclerosis and many other diseases. Cpn infection often recur or remain persistent,which may induce Th1-type response.At the same time,antibody-mediated immune and Toll like receptor play an auxiliary role.In this review,the author summarized advances in the immune response to Chlamydia pneumoniae infection.

Chlamydia pneumoniae is one of the most common pathogens causing community acquired pneumonia.It may activate immune cells,release mediators of inflammation and cytokine and cause immune response.Researches on its signal transduction after infection through Toll-like receptors may help prevent and cure chlamydia penumoniae infection disease.

Objective To investigate the clinical distribution characteristics and trend in antibacterial resistance of Acinetobacter baumannii in Pudong Hospital Affiliated to Fudan University,so as to provide the guidance for clinical rational use of antibacterial agents and infection control.Methods SPSS 1 9.0 statistical software was adopted to retrospectively analyze the specimen source, department distribution and antibacterial resistance change of the 1 678 strains of Acinetobacter baumannii in this hospital from Jan-uary 2010 to October 2014.Results Clinical isolates of Acinetobacter baumannii mainly came from respiratory tract specimens(ac-counted for 79.1%).The intensive care unit(21.1%),department of neurosurgery(1 7.7%)and department of cardiology(1 7.6%) were the top three departments from which the strains were isolated.The isolates of Acinetobacter baumannii were highly resistant to the first and second generation of cephalosporins,cephamycin,ampicillin and nitrofurantoin,and the resistance rates reached a-bove 90%.The resistance rates of these isolates against carbapenems,aztreonam,cefperazone-sulbactam and ampicillin-salbactam showed obviously uptrends,but the resistance rates of these isolates against amikacin and cotrimoxazole showed downtrends.And the resistance rates of these isolates against other antibacterial agents stayed between 30% and 50%.During the five years,the de-tection rates of multi-drug resistant strains steadied around 35.0%.Though the detection rates of pan-drug resistant strains de-clined year by year,the strains were isolated each year.Conclusion The antibacterial resistance of Acinetobacter baumannii is seri-ous in this hospital,with multi-drug and pan-drug resistance persisting.It is necessary to enhance monitoring antibacterial resist-ance,ensure rational use of antibacterial agents,and promote implementation of disinfection and isolation,so as to prevent the spread and popularity of Acinetobacter baumannii resistance in hospital.