鲍曼不动杆菌468株的临床分布及耐药性研究

目的 了解鲍曼不动杆菌的临床分布及耐药性,为临床合理用药提供实验室依据.方法 回顾性分析山西省太原市某医院2009年1月至12月临床分离的非重复鲍曼不动杆菌的临床分布及耐药性.结果 2009年共分离鲍曼不动杆菌468株,主要分布在呼吸科及重症监护病房(ICU),来自痰标本76.3%,其他标本23.7%.米诺环素的耐药率最低(13.4%),其次是头孢哌酮/舒巴坦29.0%、亚胺培南31.2%、美罗培南31.8%、左氧氟沙星46.6%、阿米卡星49.0%,对其他的10种抗生素耐药率达50%以上.结论 鲍曼不动杆菌多重耐药及泛耐药现象严重.通过对鲍曼不动杆菌的耐药率监测有助于临床合理选择抗菌药物,降低多重耐药株及泛耐药株的产生,并有效控制院内感染.     

鲍曼不动杆菌感染分布及耐药性变迁分析

目的 了解本院临床分离的鲍曼不动杆菌的感染分布及耐药性变迁情况.方法 回顾性调查分析2003年1月～2006年12月临床标本中分离的628株鲍曼不动杆菌的临床感染特点及其耐药性变化情况.结果 鲍曼不动杆菌临床分布以ICU及呼吸科最多.临床标本中以呼吸道标本分离率最高,占78.5%,其次为伤口分泌物,占11.0% .体外药敏试验结果 显示:鲍曼不动杆菌对16种临床常用抗菌药物的耐药率总体呈上升趋势.结论 鲍曼不动杆菌的分离率及耐药性逐年增加,需引起临床的高度重视.     

2008～2009年鲍曼不动杆菌临床分布特征及耐药性分析

目的了解江苏省姜堰市人民医院鲍曼不动杆菌的临床分布及其耐药性,为临床治疗提供参考。方法采用回顾性调查方法,对2008年1月～2009年12月临床分离的鲍曼不动杆菌分布特征及耐药率进行统计分析。结果共检出78株鲍曼不动杆菌,其中60株来自痰液占76.9%,创口分泌物9株占11.5%。科室分布以ICU（51株）、呼吸内科（13株）、神经外科（8株）为主,对头孢菌素耐药性率47.7%～87.6%,对氨苄西林耐药率96.7%～98.8%,对亚胺培南、头孢哌酮/舒巴坦、哌拉西林/他唑巴坦耐药率小于30%。2009年与2008年相比,耐药率未呈现上升趋势。结论鲍曼不动杆菌最常见于痰标本,主要分布于ICU、呼吸内科、神经外科,对除碳青霉烯类外的常用单一抗菌药物呈高度耐药及多重耐药,鲍曼不动杆菌耐药性监测,可分为临床合理用药提供依据。     

我院ICU病房2008年鲍曼不动杆菌耐药性分析

目的 了解2008年我院重症监护病房(ICU)患者鲍曼不动杆菌感染的临床特点及耐药趋势,分析引起ICU鲍曼不动杆菌感染的原因,指导临床正确面对鲍曼不动杆菌感染,合理使用抗生素.方法 做细菌培养及鉴定,并以纸片法(K-B法)测定一年来150株鲍曼不动杆菌对16种抗菌药的耐药率.结果 共分离鉴定鲍曼不动杆菌150株,其中源于呼吸道的105株,占68 %,居首位;鲍曼不动杆菌多重耐药,耐药率最低的是亚胺培南2.2 %,其次是头孢哌酮/舒巴坦3.7%.结论 鲍曼不动杆菌已成为医院感染尤其是ICU感染的主要致病菌,在抗生素治疗过程中极易变异而形成多重耐药;对多重耐药的鲍曼不动杆菌感染的患者应以亚胺培南和β-内酰胺酶抗菌抑制剂作为第一线抗菌药物;病情严重尤其是全耐药时,可联合用药,提高疗效.耐碳青霉烯类药物菌株的出现,提示临床用抗菌药物时应严格掌握用药指标.ICU病房应加强消毒隔离措施,阻隔各种可能的传播媒介,避免鲍曼不动杆菌的交叉感染.     

某院2011年重症监护病房鲍曼不动杆菌感染的耐药性分析

目的了解某院2011年重症监护病房(ICU)内鲍曼不动杆菌的耐药情况,为预防与治疗鲍曼不动杆菌感染提供依据。方法回顾性调查某院2011年ICU35例鲍曼不动杆菌感染病例的标本分布、耐药性、危险因素和抗菌药物使用情况。结果 ICU鲍曼不动杆菌主要来源于痰标本(35株,占85.37%),其次为创面分泌物(3株,占7.31%)。有基础疾病、侵入性操作、前期使用抗菌药物和激素、入住ICU、住院时间大于60d等是感染鲍曼不动杆菌的高危因素。鲍曼不动杆菌对头孢哌酮舒巴坦(100.0%)及亚胺培南西司他汀(92.5%)的敏感率较高,对其他16种抗菌药物的耐药率均在50.0%以上。临床治疗鲍曼不动杆菌感染多经验性选择第三代头孢菌素、喹诺酮及广谱青霉素类抗菌药物。结论 ICU内鲍曼不动杆菌耐药情况严重,控制感染的关键在于注意高危因素的防范,加强对该菌的耐药监测,合理使用抗菌药物。     

638株鲍曼不动杆菌的临床分布及耐药性分析

目的:了解本院鲍曼不动杆菌的临床分布情况及耐药特点,为临床合理使用抗菌药物和有效控制感染提供参考依据。方法:收集2015年1月-2016年9月本院各科室的各类临床送检标本,分离鲍曼不动杆菌,进行细菌鉴定和药敏试验,分析其感染分布和耐药情况。结果:共检出鲍曼不动杆菌638株,其中以痰液检出最多,共560株(87.8%),其次为伤口分泌液35株(5.5%);鲍曼不动杆菌在ICU、急诊内科、呼吸内科检出率较高,分别占比30.9%、30.4%和11.1%。鲍曼不动杆菌对阿米卡星的耐药率最低(45.0%),其次为复方新诺明(69.2%),其余16种抗菌药物的耐药率均超过70%,多重耐药较为严重。结论:鲍曼不动杆菌主要引起呼吸道感染,对多种抗菌药物的耐药严重,临床医生要重视该菌,加强对该菌的监测,合理使用抗菌药物,以减少耐药菌株的产生。     

1476株鲍曼不动杆菌的临床分布及耐药性特点

目的了解鲍曼不动杆菌的临床分布及耐药性特点。方法 1 476株鲍曼不动杆菌经Vitek2 Compact鉴定,使用AST-GN16药敏卡进行MIC药敏试验,结合医院病案系统,对菌株及耐药菌株检出患者的临床特征进行分析。结果 98.10%菌株来自住院病人,男性病人占69.11%。儿科、烧伤科、神经外科、ICU、呼吸科、神经内科等科室是检出鲍曼不动杆菌较多的科室。ICU是检出耐药菌株数比例最高科室,其对泰能耐药率上升最快;儿科耐药菌检出数很少,耐药率持续在低水平。年龄≤50岁检出的多重耐药鲍曼不动杆菌主要分布在烧伤科、神经外科和ICU,年龄50岁检出的多重耐药鲍曼不动杆菌主要分布在呼吸科和ICU,不同年龄组检出多重耐药鲍曼不动杆菌的病区分布差异有统计学意义(Z=5.652,P0.05)。结论年龄和疾病对医院内病人感染鲍曼不动杆菌有影响,环境中耐药鲍曼不动杆菌的污染导致耐药率增加的情况不容忽视。     

儿童鲍曼不动杆菌感染情况及其耐药率分析

目的了解儿童鲍曼不动杆菌感染的情况及其对15种抗菌药物的耐药情况。方法对20株鲍曼不动杆菌的临床分布、药敏检测结果进行分析。结果源自气管分泌物、痰、咽拭子标本的鲍曼不动杆菌共16株,占80%;耐药率≥40%的抗菌药物有头孢唑林、氨苄西林、呋喃妥因、氨曲南、头孢曲松、头孢他啶、头孢吡肟,耐药率≤30%的抗菌药物有庆大霉素、环丙沙星、复方磺胺甲口恶唑、妥布霉素、左氧氟沙星、哌拉西林/他唑巴坦、氨苄西林/舒巴坦、亚胺培南;20株鲍曼不动杆菌中多重耐药株共16株,占80%。结论呼吸道是鲍曼不动杆菌的主要来源;鲍曼不动杆菌对抗菌药物已产生多重耐药,应重视该菌感染及耐药性检测情况,预防院内感染发生。     

某院近三年鲍曼不动杆菌临床分布及耐药性分析

目的:了解近3年鲍曼不动杆菌的临床分布及耐药性变迁,指导临床合理使用抗菌药物。方法:回顾性分析2012~2014年该院住院患者鲍曼不动杆菌感染的相关数据,用Kirby-Bauer法进行药敏试验,采用WHONET 5.4软件对药敏试验结果进行统计分析。结果:3年共分离鲍曼不动杆菌182株,主要分离自痰液(50株)、血液(45株)、尿液(42株)、伤口分泌物(31株)及其他标本(14株);主要分布于重症监护室(ICU)53株(29.1%),呼吸内科47株(25.8%),外科36株(19.8%)及骨伤科30株(16.5%)等。鲍曼不动杆菌对多种抗菌药物的耐药率均>70%,且均出现多重耐药;对亚胺培南的耐药率高达60.5%;耐药率相对较低的有美罗培南、粘菌素和米诺环素(均≤50%)。结论:3年间鲍曼不动杆菌检出率逐年增多且总体耐药性呈上升趋势,对多种药物耐药率高,多重耐药情况严重。连续监测鲍曼不动杆菌临床分布及耐药性变迁有助于指导临床合理使用抗菌药物。     

西宁地区鲍曼不动杆菌的临床分布及耐药性分析

目的：了解西宁地区临床分离的鲍曼不动杆菌的感染分布及耐药性情况。方法：分析2005年1月—2007年12月临床标本中分离的189株鲍曼不动杆菌的临床感染特点及其耐药性情况。结果：鲍曼不动杆菌临床分布以ICU及呼吸科最多。临床标本中以呼吸道标本分离率最高,占60.8%,其次为烧伤伤口分泌物,占11.6%。体外药敏试验结果显示：鲍曼不动杆菌对19种临床常用抗菌药物的耐药率总体呈上升趋势。结论：西宁地处高原,海拔2 200m,气温寒冷缺氧,呼吸道疾病患者较多,且呼吸科大部分是老年患者,他们往往有高原性基础疾病,抵抗力低下,成为鲍曼不动杆菌易感染人群,鲍曼不动杆菌的分离率及耐药性逐年增加,需引起临床的高度重视。     

Value of D-Dimers in patients with acute aortic dissection

Objective: To evaluatel the value of D-dimers in patients with acute aortic dissection (AAD). Methods: This study consisted of 16 patients with AAD and 27 non-AAD patients. Serum D-dimets were measured by Sta-Liatest D-DI immunoturbidimetric assay. Results: D-dimer level was higher (P ＜ 0.001) in patients with AAD(7.91 ± 5.52 μg/ml) than that in non- AAD group(1.57±1.24 μg/ml). D-dimer was positive (＞0.4 μg/ml) in all patients with AAD and in 10 control group patients (37%). Among patients with acute AAD, D-dimers tended to be higher in Stanford A than in Stanford B (8.67 ± 4.31 μg/ml vs. 3.24±1.27 μg/ml, P ＜0.01). D-dimer values tended to be higher in more extended disease(3.84 ± 1.65 μg/ml, 8.57 ± 3.58 μg/ml and 11.87 ± 5.69 μg/ml in thoracic aorta, thoracic and abdominal aorta, thoracic and abdominal aorta and iliacal arteries, respectively, P ＜ 0.05 for both 8.57 ± 3.58 and 11.87 ± 5.69 vs. 3.84 ± 1.65 ). Including the control group into the analysis, we found a sensitivity of 100%, a negative predictive value of 100%, and a specificity of 66% and a positive predictive value of 64% for D-dimer in diagnosis of AAD in our patients with suspected AAD. Conclusion: D-dimer was elevated in patients with AAD. A negative D-dimer test result could be useful in excluding AAD.     

Research of combined liver-kidney transplantation model in rats

Objective： To set up a simple and reliable rat model of combined liver-kidney transplantation. Methods： SD rats served as both donors and recipients. 4℃ sodium lactate Ringer＇s was infused from portal veins to donated livers,and from abdominal aorta to donated kidneys, respectively. Anastomosis of the portal vein and the inferior vena cava （IVC） inferior to the right kidney between the graft and the recipient was performed by a double cuff method, then the superior hepatic vena cava with suture. A patch of donated renal artery was anastomosed to the recipient abdominal aorta. The urethra and bile duct were reconstructed with a simple inside bracket. Results： Among 65 cases of combined liver-kidney transplantation, the success rate in the late 40 cases was 77.5%. The function of the grafted liver and kidney remained normal. Conclusion： This rat model of combined liver-kidney transplantation can be established in common laboratory conditions with high success rate and meet the needs of renal transplantation experiment.     

APPLICATION OF LORNOXICAM TO PATIENT-CONTROLLED ANALGESIA IN PATIENTS UNDERGOING ABDOMINAL SURGERIES

FOR anesthesiologis s ,treatingpostoperativepainhas alwaysbeen a problem.Althoughopioidshave been provedtobe effective,theirsideeffectscouldnotbeignored.With thedevelopmentofscienceand pharmacology,many drugs with aspectsof satisfactoryanalgesicefficacyand couldbe welltoleratedby patientshave been developed.And lornoxicamisone of them, which isa non-steroidalanti-inflammatorydrug (NSAID ), with analgesic, anti-infl-ammatory,andantipyreticproperties.Itseliminationhalf-time(3 to 5 hours) isle…     

BLOOD PRESSURE CHANGE WITH AGE IN SALT-SENSITIVE TEENAGERS

Objective To observe blood pressure change with age in salt-sensitive teenagers whose salt sensitivity were determined by repeated testing.Methods Salt sensitivity was determined through intravenous infusion of normal saline combined with volume-depletion by oral diuretic furosemide in 55 teenagers. After five years, salt sensitivity was re-examined and subject blood pressure was followed up. Blood pressure changes in salt-sensitive teenagers were compared to that of non-salt sensitive teenagers over five years.Results After 5 years, the repetition rate of salt sensitivity determined by intravenous saline loading is 92.7%. In teenagers with salt sensitivity on the baseline, both the systolic blood pressure increments and increment rates were much higher than non-salt sensitive teenagers (12.7±12.1 mmHg vs. 2.8±5.2 mmHg, P＜ 0.01; 12.2%± 12.0% vs. 2.5% ±4.4%, P＜ 0.001,respectively). There was a similar trend for diastolic blood pressure (8.4 ± 6.4 mmHg vs. 3.7 ± 6.4 mmHg, P = 0.052; 13.2% ±10.6 % vs. 6.8%± 10.1%, P = 0.053, respectively).Conclusions Salt sensitivity determined by intravenous saline loading showed good reproducibility. Blood pressure increments with age were much higher in salt-sensitive teenagers than non-salt sensitive teenagers, especially in terms of systolic blood pressure.     

Development on Adjustable Calibration Marker for Shock Wave Focus

Shock wave lithotripsy （SWL） is a treatment of choice for upper urinary stones. However, this procedure is inappropriate for obese patients because the focus is often unable to reach the target owing to the limited focal distance in shock wave source. Although treating such patients in a blast path may increase the application length of shock wave source, it＇s difficult to find this path on the lithotripter monitor. For this reason, we invented an adjustable calibration marker in order to set an effective focus in the shock wave hath.     

Study on the TCM Pathogenesis of Angiopathic Complications of Type II Diabetes

Excess production of reactive oxygen species(ROS)of mitochondrion mediated by hyperglycemia is the common pathogenesis of angiopathic complications of diabetes.TCM holds that the damp from the dysfunction of spleen.kidney and liver is the causative factor of complications of diabetes.This is similar to the mechanism of Ros resulting in angiopathic complications of diabetes.When the angiopathic complications of type II diabetes mellitus(T2DM)are difierentiated as caused by turbid damp in TCM can be explained as ROS.Since the obstruction of pathogenic damp in channels and collaterals is said to be the main pathogenesis,the treating principle should be dissolving the damp to remove the obstruction.     

Leptin, Ghrelin and TNF-α before and after Hypo-caloric Traditional Chinese Diet and Auricular Acupuncture

INTRODUCTION Obesity is a complex emergent problem, which can be possibly solved not only by the diet but also by the life style and promotion of a constant physical exercise. 1, 2 No doubt careful attentions must be given to the nutritional condition of obese people, the dietary habits, the somatic build (i.e. distribution of fat mass) and the organic functions linked to formation of the fat mass. All the parameters should be constantly monitored before, during and after a diet treatment. 3, 4, 5     

Relationship between Dysglycemia and Carotid Atherosclerosis in Tibetan Population

People with dysglycemia are at high risk for atherosclerotic diseases. This study aims at investigating the atherosclerotic vascular damage in dysglycemia and its metabolic origin in Tibetan population.     

Acupuncture Combined with Spinal Tui Na for Treatment of Primary Dysmenorrhea in 30 Cases

Objective: To observe the therapeutic effects in acupunture treatment of primary dysmenorrhea combined with spinal Tui Na, and study its mechanism. Methods: Thirty cases of the treatment group were treated by acupuncture combined with spinal Tui Na, and thirty cases in the control group were treated by routine acupuncture. Results: The total effective rate was 93.3% in the treatment group, and 73.3% in the control group, with a significant difference between the two groups (P<0.05). Conclusions: Acupuncture combined with spinal Tui Na has good prospects for treatment of primary dysmenorrhea.     

Luo Lingjie's Experience in Treating Chronic Nephropathy

In treating chronic nephropathy,Luo Lingjie,a chief physician,pays attention to regulating the balance between yin and yang,treating infection if present,and removing pathogenic factors.He prescribes gentle drugs and uses carefully strongly warming-tonifying ones,emphasizes the importance of persuading the patient to persist in treatment with medication and nurse one's health for recuperation,and is good at combined use of TCM and western medicine therapy and brings the merits of various therapies into full play,with obvious theraoeutic effects.