Objective To retrospectively analyze the drug resistance evolution of Staphylococcus aureus and MRSA,to provide the basis for prevention and control measures.Methods 576 strains of clinical isolated Staphylococcus aureus from 2009 to 2012 were analyzed.The bacteria identification and drug sensitivity test were detected by VITEK 2 Compact automatic bacteria identification instrument.Results The separation rate of MRSA from 2009 to 2012 was 59.5％,but the separation rate was gradually decreased per year.The antibacterial activity of MRSA was better to vancomycin,linezolid,quinupristin/Dalfopristin,teicoplanin,nitrofurantoin (resistance rate ＜ 2.4％).The resistance rate and sensitive rate of MRSA to tigecycline was 0.0％,intermediary rate was 100.0％.The resistance of MRSA to gentamicin,ciprofloxacin,moxifloxacin,clindamycin,tetracycline and erythromycin was gradually decreased.From 2010 to 2012,The resistance of MRSA to cotrimoxazole decreased significantly,from 65.3％ in 2010 to 28.2％ in 2011 and 4.7％ in 2012 (P ＜ 0.05).Conclusion Separation of MRSA and drug resistance is reduced year by year,we should continue to strengthen the administration of antimicrobial agents,scientific and reasonable application of antibacterial drugs,reduce the incidence of multiresistant bacteria and drug resistance.

Objective To understand the distribution and drug resistance change trend of pseudomonas aeruginosa (PA) in hospital clinical infection in order to provide laboratory basis for rational clinical use of medications.Methods Statistical analyses was conducted retrospectively in 818 strains of PA separated in our hospital from January 2007 to December 2011.Results Of all the separation,PA number of the pathogen constituted a ratio of 15.2％ (818/5365) ; The main source of specimens was sputum,accounting for 82.6％ (676/818).There was good antimicrobial activity of Imipenem,Piperacillin/Tazobactam,Aztreonam,Ceftazidime,Levofloxacin and Ciprofloxacin to PA,with resistance rates of 14.9％ (97/653),25.0％ (179/716),26.8％ (179/667),26.9％ (208/773),28.6％ (211/738) and 29.1％ (220/757) respectively; The resistance of Ciprofloxacin and Levofloxacin did not change significantly during 2007-2010 year,but in 2011 year a significant decrease of resistance rates was found (ciprofloxacin:35.1％ (175/498) vs.17.4％ (45/259) ; Levofloxacin:38.0％ (181/476) vs.11.5％ (30/262)) ; During 2009-2011 year,the resistance of Imipenem and Amikacin increased year by year (Imipenem:7.4％ (9/121) vs.7.7％ (66/209) vs.19.5％ (51/262) ; Amikacin:13.0％ (2/23) vs.33.3％ (69/207) vs.36.2％ (94/260)).Conclusion PA detection rate and its resistance is rising from 2007 to 2011 year.We should make rational drug use clinically according to antimicrobial susceptibility test results.Laboratories shall strengthen the bacterial resistance monitoring.

Objective To investigate the correlation between the NADPH oxidase p22phox-A930G polymorphism and hypertensive intracerebral hemorrhage in Chinese Han population in Shanghai area.Methods The patients with hypertensive intracerebral hemorrhage and normal controls were enrolled.The polymerase chain reaction and the polymerase chain reaction-restriction fragment length polymorphism (PCR-RFLP) were used to detect the genotypes and alleles of NADPH oxidase p22phox-A930G.Results A total of 128 patients with hypertensive intracerebral hemorrhage and 151 healthy controls were enrolled.The levels of systolic blood pressure,diastolic blood pressure,glucose,and triacylglycerol,as well as the proportions of smoking and alcohol consumption in patients of the hypertensive intracerebral hemorrhage group were significantly higher than those of the control group (all P＜ 0.05).There were significant differences in AA,AG,and GG genotypes (42.2％,44.5％,and 13.3％ vs.63.6％,27.8％,and 8.6％,x2 =12.757,P =0.002) and in A and G allele (64.5％ and 35.5％ vs.77.5％ and 22.5％ ;x2 =8.734,P=0.001) frequencies between the hypertensive intracerebral hemorrhage group and the control group.Multivariatelogistic regression analysis showed that systolic blood pressure ≥ 140 mm Hg (1 mm Hg =0.133 kPa) (odds ratio [OR] 13.952,95％ confidence interval [CI] 7.242-26.879; P ＜ 0.001),apolipoprotein A ≥ 0.99 mmol/L (OR 3.139,95％ CI 1.012-9.733; P =0.048),and AG +GG genotype (OR 2.333,95％ CI 1.253-4.342; P=0.008) were the independent risk factors for hypertensive intracerebral hemorrhage.Conclusions Among the Chinese Han population in Shanghai area,the NADPH oxidase p22phox-A930G polymorphism is an independent risk factor for hypertensive intracerebral hemorrhage.

Objective To analyze clinical distribution and change in drug resistance of Acinetobacter baumannii (A.baumannii)in 2009-2013,guide clinical rational antimicrobial use,and reduce healthcare-associated infection rate.Methods 919 A.baumannii isolates were isolated from inpatients and outpatients in a hospital between Janu-ary 2009 and December 2013,specimen and department sources,as well as change in drug resistance of A.bauman-nii were analyzed.Results A total of 10 273 pathogens were isolated from 2009 to 2013,the constituent ratio of A.baumannii in each year was 7.98%(n=93),11.31%(n=155),10.22%(n=185),7.73%(n=217),and 8.62%(n=269)respectively;the constituent ratio of imipenem-resistant A.baumannii was 24.73%,38.06%,71.89%, 64.52%,and 86.99% respectively;the main specimen source was sputum (83.68%);the major department sources were intensive care unit(ICU,39.28%),department of neurology (20.78%),and department of respiratory medi-cine(8.60%).The resistant rate of A.baumannii to most antimicrobial agents increased,the resistant rates to imi-penem and piperacillin/tazobactam increased from 24.73% and 4.44% in 2009 to 86.99% and 86.25% in 2013 re-spectively;resistant rate to sulphamethoxazole/trimethoprim decreased from 91.30% in 2009 to 27.14% in 2013;in 2013,except resistant rates to amikacin and sulphamethoxazole/trimethoprim were low (20.82% and 27.14%respectively),resistant rates to the other 11 kinds of antimicrobial agents were all >83.64%.Conclusion The iso-lation rate of A.baumannii is high in this hospital,the main specimen source is sputum,the main department source is ICU;antimicrobial resistant rate of A.baumannii is high,prevention and control of infection and trans-mission of A.baumannii should be strengthened.

Objective To understand the antibacterial activity of nitrofurantoin from gram negative bacilli,provide the basis for clinical rational use of furan appropriate for drugs.Methods Gram negative bacilli 5 589 strains isolated from clinical were monitored between January 2009 and December 2009.VITEK 2 Compact automatic bacteria identification instrument was used for bacteria identification and drug sensitive test.Whonet 5.6 software was used for data analysis.Results E.coli and klebsiella bacteria produced acid with nitrofurantoin had good antibacterial activity (resistance to ＜ 4.3%),E.coli and klebsiella pneumoniae to with nitrofurantoin for antimicrobial activity was good (the percentages of 25.6% ～ 25.6%),pseudomonas aeruginosa,acinetobacter baumannii,singular deformation bacteria and glue abdulrahman al saleh,bacterium antibacterial activity of furan appropriate for poorer(ni 93.7% ～ 98.9%).Imine resistance from south pseudomonas aeruginosa (IRPA),resistant to carbon penicillium alkene antimicrobial acinetobacter baumannii(CR-AB) and penicillium carbon alkene antimicrobial drug resistant enterobacteriaceae bacteria(CRE) with nitrofurantoin because of the percentages were 100.0% (108/108),100.0% (335/335) and 96.1% (74/77).Conclusion Urine,blood,pus,and secretion of primary separation of E.coli with nitrofurantoin has better antimicrobial activity; Sputum specimens of primary separation of pseudomonas aeruginosa and acinetobacter baumannii with nitrofurantoin has the high prevalence of resistance.

Objective To understand the hospital intensive care unit(ICU) pathogenic bacteria distribution and drug resistance for providing the basis for rational drug use and hospital infection control and prevention.Methods The drug resistance of 749 strains of pathogenic bacteria the separated from ICU was analyzed from January 2009 to December 2012.VITEK 2 Compact automatic bacteria identification instrument was used to detect bacteria identification and drug sensitive test using.Results There were Acinetobacter baumannii(208 strains,27.8％),Pseudomonas aeruginosa(108 strains,14.4％),E.coli (96 strains,12.8 ％),Staphylococcus aureus (76 strains,10.1％),Klebsiella pneumoniae(62 strains,8.3％) mainly accupied in 749 strains of pathogenic bacteria.The species was mainly from sputum specimens sources (503 strains,67.2％) ; the separation rate of Methicillin-resistant staphylococcus aureus (MRSA) was 82.9％ (63/76) ; the separation rate of Imine resistance from South pseudomonas aeruginosa(IRPA) was 22.2％ (24/108) ; the separation rate of resistance to carbon penicillium alkene antimicrobial acinetobacter baumannii (CR-AB) was 88.0％ (183/208).The resistant rate of Acinetobacter baumannii to amikacin was from 28.6％ to 31.5％,the other 20 kinds of antimicrobial drug resistant rate was as high as 81.6％-100.0％ ; Pseudomonas aeruginosa to ciprofloxacin,ofloxacin,aztreonam and piperacillin/tazobactam resistant rate of 11.6％-25.0％.Conclusion Detection of pathogens in ICU,multi-drug resistance is serious,the hospital should strengthen the bacterial drug resistance monitoring,rational use of antimicrobial drugs,reduce the nosocomial infection.

Objective To investigate the distribution of the Bauman acinetobacter baumannii (IRAB) resisted to imipenem and character of drug resistance.Methods Retrospective analyzed 517 strains of IRAB and 319 strains of imipenem drug resistance of acinetobacter baumannii from South Africa (not IRAB) by VITEK 2 compact automatic bacterial culture identification.Results IRAB positive rate was 61.8％ (517/836).The main source of IRAB was from sputum(85.5％ (442/517)).The constitute ratio of main areas in IRAB was ICU ward (55.9％) and only 7.8％ in non-IRAB.The resistant rate of IRAB to amikacin was 27.2％.The resistant rate of non-IRAB to Amikacin and piperacillin/tazobactam were 8.0％ (21/262),8.2％ (26/317),suggesting the good antibacterial activity.In terms of rate of resistance drug,apart from Cefazolin,Cefotetan,Cotrimoxazole,Nitrofurantoin,the sort of antibacterial drugs against IRAB was obviously higher than that of non-IRAB,and difference was statistically significant (P ＜ 0.05).Conclusion Drug resistance surveillance should be strengthened because of high detection rate and drug resistance in ICU in terms of IRAB.Combination therapy and related intervention measures might effective control of infection and IRAB.

Objective To evaluate the intervention efficacy of hand hygiene of health care workers(HCWs)in a hospital before and after the comprehensive interventions were taken. Methods The baseline investigation stage was in April-June,2013 ,intervention was performed from July,2013,post-intervention efficacy evaluation stage was in October-December ,2013. Hand hygiene compliance was observed by investigators ,and questionnaires were filled out. Results After multiple interventions were taken,hand hygiene compliance rate of HCWs increased from 38.02% to 53.86% (χ2= 181.82,P<0.05),post-intervention compliance rates of hand hygiene improved significantly in departments of internal medicine,surgery and intensive care unit (all P<0.05).After intervention,the overall hand hy-giene compliance rate at different work opportunities rose from 41.87% (1 740/4 156)to 53.45% (2 044/3 824)(χ2=107.2,P<0.05);except sterile manipulation,the other 4 manipulation opportunities were all higher than pre-intervention (all P<0.05);HCWs of different professions were all higher than pre-intervention(all P<0.05).Conclusion Active hand hygiene intervention can effectively improve hand hygiene compliance of HCWs.

Vascular eognitive impairment (VCI) is a large class of syndromes from mild cognitive impairment to dementia, which are caused by the cerebrovascular risk factors (eg, hypertension, diabetes and hyperlipemia), obvious (eg, cerebral infarction and intracerebral hemorrhage) or unobvious cerebrovascular diseases (leukoaraiosis and chronic cerebral ischemia). Accurate early diagnosis provides the best treatment opportunity and slows down the progress of the disease. In recent years, the research on VCI has made a great progress. This article reviews VCI from the aspects of the etiology, clinical manifestation, neuropsychology, imaging, neuroelectrophysiology, biomarkers, and diagnostic criteria.

The lipoprotein-associated phospholipase A2 (Lp-PLA2), a subtype of the phospholipase A2 superfamily, is produced primarily by macrophages and lymphocytes. Lp-PLA2specifically hydrolyzes oxidized phospholipids on oxidized low-density lipoprotein particles,resulting in production of lysophosphatidylcholine and oxidized fatty acids. Lp-PLA2 is expressed in atherosclerotic plaques and in macrophages within a fibrous cap of unstable plaque.Studies haw shown that the plasma Lp-PLA2 activity increases significantly in patients with ischemic stroke, and Lp-PLA2 may become an independent risk factor for predicting ischemic cerebrovascular events. The selective Lp-PLA2 inhibitor can reduce the inflammatory response,enhance the stability of plaques, and inhibit the formation of atherosclerotic plaques, and may become a new class of drugs for preventing the formation of atherosclerotic plaques.