Stenotrophomonas maltophilia.At the same time 136 strains of fungi were isolated.Candida albicans was the most predominant accounted for 60.3%.50.7% Strains of K.pneumoniae and 75.7% strains of E.coli produced ESBLs.The resistance rates of all K.pneumoniae and E.coli to ?lactams were above 50%.All isolates of Enterobacteriaceae were sensitive to imipenem or meropenem.The activity of antibacterial agents against P.aeruginosa was coming down. CONCLUSIONS K.pneumoniae and E.coli are the major pathogens in senile patients with lower respiratory tract infection.Increasing of nonfermenters and fungi as an infection should bring great concern.

OBJECTIVE To study the isolation rate,distribution characteristics and antimicrobial resistance of Acinetobacter baumannii infection.METHODS Surveillance data of A.baumannii infection,distribution and resistance rates to 12 kinds of antibiotics in our hospital for 3 years were analyzed.RESULTS During the 3-year infection surveillance,194 strains of A.baumannii were isolated in our hospital.The isolation rate was 7.8% in 2006,though 2.4% in 2004.Eighty strains(41.2%) of A.baumannii were from intensive care unit;95 strains were from over 60-year-old sufferers;compared with 2004 and 2005,the resistance rates of A.baumannii in 2006 to 12 kinds of antibiotics were increasing at different degree.The antibacterial susceptibility to imipenem/meropenem was the highest.CONCLUSIONS The isolation rate of A.baumannii and antimicrobial resistance rate are increasing year by year.The A.baumannii strains shows obvious multiple antibacterial resistance.We must keep monitoring of A.baumannii infection and drug-resistant changes in order to prevent nosocomial infections.

OBJECTIVE To study the clinical species distribution and drug resistance of Enterococcus.METHODS We had collected 201 isolates of Enterococcus by cultured in normal methods in our hospital from July 2005 to June 2008,and analyzed the characteristics of species distribution,drugsensitive test,drug resistance of high concentration aminoglycoside antibiotics and measured the ?-lactamase.RESULTS There are 106 E.faecalis strains(52.7%),76 E.faecium strains(37.8%) and 19 the other Enterococcus strains(9.5%).There were 102 Enerococcus strains separated from urine and 46 separated from sputamentum.The drug resistance rate of Enterococcus faecalis to erythromycin,tetracycline,rifampin and ciprofloxacin were more than 75.0% and the resistance rate of E.faecium to penicillin,ampicillin,erythromycin,rifampin,ciprofloxacin and nitrofurantoin were more than 93.0%;the total resistance rate of Enterococcus to vancomycin and teicoplanin were 14.4% and 10.4%,respectively.The number of the isolates resistant to high concentration aminoglycoside antibiotics was 151(75.1%);Enterococcus with positive ?-lactamase were 74(36.8%).CONCLUSIONS The infection in urinary system and respiratory system were mainly caused by E.faecalis and E.faeciumwith multidrug resistance.

OBJECTIVE To investigate the correlations on hepatitis B virus(HBV)preS1-antigen(preS1-Ag)and HBV-DNA,HBV markers in patients with hepatitis B.METHODS The markers,preS1-Ag and HBV-DNA were determined by ELISA and PCR in 406 patients with hepatitis B and 80 healthy persons.RESULTS The positive rates of preS1-Ag in 160 patients with HBsAg(+)and HBeAg(+)were 84.4%.The positive rates of preS1-Ag in 246 patients with HBsAg(+)and HBeAg(-)were 42.3%;the difference between them was significant(?2=70.9,P

0.05).(3) The ratio of meticillin-resistant staphylococci was 91.5%.The ratio of resistance of staphylococci to(gentamicin),(erythromycin),ciprofloxacin and tetracycline was all above 50%,but was low to(nitrofurantoin) and rifampin.In 12 strains of Enterococcus faecalis,3 strains were VRE;8 resisted to high-level gentamicin;6 resisted to high-level streptomycin;the resistance rate to tetracycline,ciprofloxacin,rifampin and(erythromycin) ranged from 58.3% to 100.0%.In E.coli,8 of 14 isolates were positive for ESBLs.The resistance was high to usual antibiotics except imipenem,amikacin and Tazocillin.CONCLUSIONS Bacteria are the main pathogens of chronic prostatitis and terribly resist to clinical usual antibiotics.Infection with Uu,Mh and Ct should not be(ignored).It is necessary to diagnose and treat chronic prostatitis according to the results of pathogen(isolation) and drug sensitivity test.

ObjectiveTo discuss the clinical value of serum CA125 and endometrial antibody (EMAb) for the diagnosis of endometriosis.Methods216 patients were determined by the presences of CA125 and EMAb before operation.ResultsAll cases were diagnosed by pathology after operation. CA125 positive rate in the endometriosis group was 58.3% and that in the control group was 12.5%. The difference between two groups was significant (P<0.01).EMAb positive rate in the endometriosis group was 31.3% and that in the control group was 14.3%. The difference between two groups was also significant (P<0.01). When determining CA125 alone to diagnose endometriosis, the sensitivity rate was 58.3% and specificity rate was 87.5%. If determining EMAb alone to diagnose endometriosis, the sensitivity rate was 31.3% and specificity rate was 85.7%. When one of them was used as diagnostic criterion, the sensitivity and specificity were 64.6% and 73.2% respectively. If combining use of both CA125 and EMAb as diagnostic criterion, the sensitivity and specificity were 25.0% and 100% respectively.Conclusions The determination of serum CA125 or EMAb levels is helpful for the qualitative diagnosis of endometriosis, especially using them combined, the diagnostic accuracy may be enhanced.

Objective To summary and analysis the clinical experiences on the three hole method of VATS surgery in treatment of primary spontaneous pneumothorax.Methods The clinical data of 276 cases of primary spontaneous pneumothorax undergoing VATS surgery from July 2005 to July 2011 were analyzed retrospectively.Results The operating times were 25 to 76 minutes,averaging (41.7 ± 2.1) minutes ; all with traces of bleeding; transiting assisted small incision operation in 5 cases;postoperative thoracic closed drainage extubation time of 4-13 days,average (6.7 ± 0.2) days,mild postoperative air leakage in 27 cases,moderate in 9 cases without severe leakage,leakage,postoperative pulmonary atelectasis in 7 cases,pulmonary infection in 2 cases,reexpansion pulmonary edema in 1 cases,postoperative follow-up for 6-17 months,averaging(10.2 ± 1.7) months,recurrence occurred in 7 cases,1 case of operation again.Conclusion Three hole method of VATS technique has short operating time,less trauma,fewer complications,faster recovery,shorter hospitalization time and other advantages,and the recurrence rate is low,which is the ideal mode of operation for the treatment of primary spontaneous pneumothorax.

Bone defects caused by different causes such as trauma, severe bone infection and other factors are common in clinic and difficult to treat. Usually, bone substitutes are required for repair. Current bone grafting materials used clinically include autologous bones, allogeneic bones, xenografts, and synthetic materials, etc. Other than autologous bones, the major hurdles of rest bone grafts have various degrees of poor biological activity and lack of active ingredients to provide osteogenic impetus. Bone marrow contains various components such as stem cells and bioactive factors, which are contributive to osteogenesis. In response, the technique of bone marrow enrichment, based on the efficient utilization of components within bone marrow, has been risen, aiming to extract osteogenic cells and factors from bone marrow of patients and incorporate them into 3D scaffolds for fabricating bone grafts with high osteoinductivity. However, the scientific guidance and application specification are lacked with regard to the clinical scope, approach, safety and effectiveness. In this context, under the organization of Chinese Orthopedic Association, the Expert consensus for the clinical application of autologous bone marrow enrichment technique for bone repair ( version 2023) is formulated based on the evidence-based medicine. The consensus covers the topics of the characteristics, range of application, safety and application notes of the technique of autologous bone marrow enrichment and proposes corresponding recommendations, hoping to provide better guidance for clinical practice of the technique.