Objective To evaluate the predictive value of pathological tumor cell proportion size(PTS)and invasive lesion classification for recurrence of stage Ⅰ lung adenocarcinoma(LUAD).Methods A total of 160 patients who underwent stage Ⅰ LUAD resection in the hospital from February 2019 to February 2022 were retrospectively enrolled.According to PTS,the patients were divided into a high proliferation group(n=76)and a low proliferation group(n=84).According to the invasive lesion classification,the patients were divided into adenocarcinoma in situ(AIS)group(n=58),minimally invasive adenocarcinoma(MIA)group(n=52)and invasive adenocarcinoma(IAC)group(n=50).Cox proportional hazards regression was used to analyze the influencing factors of recurrence of stage Ⅰ LUAD.Kaplan-Meier was used to analyze the disease-free sur-vival(DFS)of each group,and the statistical power of variable factors was analyzed by receiver operating characteristic(ROC)curve.Results There were significant differences in mean tumor diameter,nodule type,margin condition,spread through air spaces(STAS),TNM stage,maximum tumor diameter,degree of differ-entiation,lymph node metastasis and proliferation cell nuclear antigen(Ki-67)proliferation index among pa-tients with different PTS(P＜0.05).STAS was a risk factor for DFS in patients with different PTS(P＜0.05),and the difference in DFS among patients with different PTS was statistically significant(P＜0.05).DFS in the low proliferation group was higher than DFS in the high proliferation group.PTS combined with STAS had a better efficacy in predicting stage Ⅰ LUAD recurrence[area under the curve(AUC)was 0.748].There were significant differences in mean tumor diameter,nodule type,margin condition,STAS,TNM stage,maximum tumor diameter,degree of differentiation,lymph node metastasis and Ki-67 proliferation index a-mong patients with different invasive lesions(P＜0.05).Margin condition and STAS were risk factors for DFS in patients with different invasive lesion types(P＜0.05).There was a significant difference in DFS be-tween patients with different invasive lesion types(P＜0.05),DFS in AIS group＞DFS in MIA group＞DFS in IAC group.The type of invasive lesions and margin condition combined with STAS had a good predictive value for stage Ⅰ LUAD recurrence(AUC was 0.784).Conclusion Different PTS combined with STAS can predict the recurrence of stage Ⅰ LUAD.Different invasive lesions combined with margin condition and STAS also have important predictive value for the recurrence of stage Ⅰ LUAD.

Objective To understand antimicrobial resistance and homology of carbapenem-resistant Klebsiella pneumoniae (CRKP)from an intensive care unit (ICU).Methods 11 CRKP isolates from patients and environment of an ICU in a hospital were performed antimicrobial susceptibility testing,the homology of CRKP was analyzed by randomly amplified polymorphic DNA (RAPD)method.Results Of 11 CRKP isolates,8 were from patients,and 3 from environment,the main specimen was sputum(n =6,54.55%).Antimicrobial susceptibility testing results re-vealed that 10 (90.91%)CRKP isolates were resistant to ciprofloxacin;11 isolates were susceptible to compound sulfame-thoxazole,intermediate to imipenem,and resistant to other antimicrobial agents(100%).All 11 CRKP isolates had 3 bands,and were divided into two types:(typeⅠ,n=10;type Ⅱ,n=1).Conclusion Antimicrobial resistance of Kleb-siella pneumoniae in ICU is serious,CRKP isolated from ICU patients and environment are of the same clone. Cleaning,disinfection,and monitoring of ICU environment should be strengthened,which is helpful for reducing, timely warning of multidrug-resistant organisms,and reducing healthcare-associated infection.

Objective To realize the characteristics of clinical distribution of multidrug-resistant organisms (MDRO)in a hospital,and take specific measures for the prevention and control of infection.Methods Surveillance data of 891 MDR isolates detected in a hospital between January 1 and December 31,2012 were analyzed retrospec-tively.Results Of 891 MDR isolates,extended-spectrumβ-lactamase (ESBL)-producing Escherichiacoli ranked first(342,38.39% ),followed by ESBL-producing Klebsiellapneumoniae(195,21.89% ),MDRAcinetobacterbau-mannii(185,20.76% ),methicillin-resistantStaphylococcusaureus(138,15.49% ),MDRPseudomonasaeruginosa (27,3.03% ),ESBL-producingProteusmirabilis(2,0.22% ),and ESBL-producing Klebsiellaoxytoca(2,0.22% );Bacteria mainly concentrated on general intensive care unit(ICU)(163,18.29% ),department of neurology(136, 15.26% ),general surgery(103,11.56% ),neurosurgery(85,9.54% ),and respiratory diseases department(71, 7.97% ).The most common bacteria isolated from sputum was MDR Acinetobacterbaumannii(242,50.63% ),and mainly concentrated on general ICU;the most common bacteria isolated from urine was ESBL-producing Escherich-iacoli(141 ,80.57% ),mainly concentrated on the departments of neurology and urology. Conclusion MDRO infec-tion in this hospital mainly concentrate on lower respiratory tract and urinary system. Monitor on high-risk depart-ments and vulnerable patients should be intensified,targeted preventive measures should be stressed to curb MDRO infection and spread.