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ObjectiveTo prepare  inorganic   lanthanumdoped titanium （LaTiO2 ） compounds, and observe the antibacterial activity on Staphylococcus aureus (ATCC 6538). MethodsThe six level samples of TiO2 were prepared by solgel method. The energy spectrometer technology was used to characterize these products. Antibacterial activity of 6  samples on Staphylococcus aureus were evaluated. Flask Shaking test was used to evaluate the best antibacterial activity among 6 samples; tube test method was used to determine the minimal inhibitory concentration (MIC) and minimal bactericidal concentration (MBC) of sample (code designation was FH1) with the best antibacterial activity in dark condition. Change in  bacterial ultrastructure was observed by electronmicroscope before and after the action of FH1 for 30 minutes. ResultsThe serials compounds without any foreign materials could be gotten with solgel technique,sample 1（FH1） had the best antibacterial activity. The MIC and MBC of FH1 for Staphylococcus aureus was 12.5mg/mL and 25mg/mL respectively. The  ultrastructure of  Staphylococcus aureus changed after exposed to FH1. ConclusionLaTiO2  compounds has good disinfection efficacy on Staphylococcus aureus.

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ObjectiveTo explore the ability of  vpr gene in human immunodeficiency virus type 1 (HIV1 vpr) to induce cell G2 arrest and apoptosis, and the influence when it mutated, the relationship between vprinduced G2 arrest and apoptosis. MethodsFourteen mutated vpr fragments were selected from  patients with HIV. Both eukaryotic expression vector pcDNA3.1(+) and PCR products were purified, doublecut by HindⅢ and BamH Ⅰ, and the cut products were legated and  transformed into competent cells JM109. The 14 reconstructed plasmids were transfected into Hela cells.  Cells with pcDNA vprwt, pcDNA vprFs and pcDNA3.1  blank cells, and without pcDNA3.1 cell were established.  vpr mRNA expression was detected by RTPCR. The DNA content and percentage of apoptosis were monitored by flow cytometry. ResultsTransfected with 14 mutated HIV1 vpr fragments, cells displayed different G2 percentage and apoptosis ratio. HIV1 vpr induced cell cycle G2 arrest and apoptosis, whereas Vpr Fs with a Cterminal truncation, vector pcDNA3.1(+) and the blank cells can not. The  G2 percentage and apoptosis ratio reduced when transfected with Vpr expressing mutation of 70V, 85P, 86G, 94G compared with the Vpr wild type. The higher G2 percentage, the higher ratio of apoptosis was induced. ConclusionHIV1 vpr  can induce cell cycle G2 arrest and apoptosis, whereas Vpr Fs with a Cterminal truncation can not. The mutated sites of 70V, 85P, 86G, 94G may reduce the ability of Vpr to induce cell cycle G2 arrest and apoptosis. The extent of Vprinduced G2 arrest correlated with the levels of apoptosis, This study can  make a good foundation for further research on gene therapy.

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ObjectiveTo evaluate the clinical efficacy of a combination therapy with capreomycin, levofloxacin and sodium aminosalicylate in the treatment of multidrug resistant pulmonary tuberculosis ( MDRPTB). MethodsOne hundred and twenty patients with MDRPTB were divided  into treatment group（60 cases） and control group（60 cases）. In the treatment group, patients mainly received treatment of capreomycin, levofloxacin and sodium aminosalicylate, and combined with rifapentine, isoniazid  and  pyrazinamide; in control group, patients mainly received treatment of amikacin, ethambutol, combined treatment was the same with that of treatment group, the course of treatment were both 16 months. ResultsAll patients received 16 months treatment, the sputum negative conversion rate of the treatment group was 83.33%, which was significantly higher than 65.00% of control group (χ2=5.26, P=0.02); The focal absorption rate and cavity closure rate in treatment group was 90.00% and 71.43% respectively, which was obviously higher than 66.67% and 31.25% of control group respectively (χ2=9.62, P=0.00; χ2=10.82, P=0.00); Adverse effects  in treatment group and control group was 35.00% and 33.33% respectively, there was no significant difference between two groups  (χ2=0.04, P=0.85). ConclusionThe combination treatment  of  capreomycin, levofloxacin  and sodium aminosalicylate is effective and safe for patients with MDRPTB.

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ObjectiveTo evaluate the epidemic characteristics of Pseudomonas aeruginosa (PA)infection in patients in ICU through typing of PA by random amplification  polymorphism DNA (RAPD). MethodsThirteen  strains of PA from lower respiratory tract in patients with nosocomialacquired pneumonia were typied by RAPD method, and were compared with antimicrobial  drugresistance spectrum typing. ResultsThirteen strains of PA were divided into two drugresistance phenotypes, type A (12 strains, 92.31%) and type B (1 strain, 7.69%), the dominant strain was type A; these strains were divided into two genotypes with RAPD typing, type Ⅰ(6 strains, 46.15%) and typeⅡ(7 strains, 53.85%).The dominant strains were  7 strains with both drugresistance type A and molecular type Ⅱ as well as 5 strains with both drugresistance type A and molecular type Ⅰ, these dominant strains were the pathogens causing PA nosocomial infection in ICU. ConclusionPA can cause  outbreak and epidemic of infection  in ICU, the epidemic strains were drugresistance type A/molecular type Ⅱ as well as drugresistance type A /molecular type Ⅰ.PA can cause multidrug resistance,RAPD typing is the ideal molecular epidemiological method for tracing source of infection.

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ObjectiveTo investigate drugresistance and multiple drugresistant genes  of Enterobacter cloacae (E.cloacae) in nosocomial infection(NI), so as to  provide evidence for the  treatment of IN.MethodsForty trains of  E.cloacae isolated from clinic were performed antimicrobial susceptibility test by disc agar diffusion and agar dilution method, twelve kinds of antimicrobialresistant genes were detected by polymerase chain reaction(PCR) and DNA sequencing. ResultsForty strains of E. cloacae were only highly sensitive to imipenem and meropenem, sensitive rate were all 100.00%;the resistant rate to cefepime was low(15.00%); and resistant rates to the other 15 kinds of antimicrobial agents were high (42.00%~92.50%). Eight kinds of drugresistant genes were detected, which was TEM1,SHV2a,CTXM3, CTXM9, AmpC,aac(3′)Ⅰ,IntⅠ1 and sul1,sul1+ IntⅠ1 was the main pattern; drugresistant pattern was divided into A~I 9, the main pattern were C and D.ConclusionE. cloacae shows a multiple  and high drugresistance, resistant mechanisms are complicated and varied.

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ObjectiveTo explore the genetic marks of continuously isolated Escherichia coli (E.coli) and Pseudomonas aeruginosa (P. aeruginosa) and the correlation with nosocomial infection (NI). MethodsPolymerase chain reaction (PCR)  was used to detect plasmid AmpC genes (ACT1 and DHA), class Ⅰ integrase gene (IntⅠ1) and disinfectantresistant gene (qacE△1sul1) of E.coli; Four kinds of genetic marks of  integron and transposon (qacE△1sul1, merA, tnpA, tnpU) in P. aeruginosa were also  detected by PCR.  ResultsAmong E.coli, the positive rate of plasmid AmpC genes of ACT1 and DHA was 57.50% and 40.00% respectively, the positive rate of IntⅠ1 and qacE△1 sul1 was 47.50% and 57.50% respectively. Among P. aeruginosa, the positive rate of qacE△1sul1 and merA  was 48.57%  and 11.43% respectively. There were neither gene tnpA nor gene tnpU  in P. aeruginosa strains. ConclusionE.coli isolated from the clinic carries plasmid  AmpC genes, IntⅠ1 genes and qacE△1sul1; P.aeruginosa carries qacE△1sul1 and merA. Resistant genes among different bacteria strains can be transmitted, which is significant in epidemiology.

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ObjectiveTo evaluate the economic loss caused by upper respiratory tract infection, lower respiratory tract infection, urinary tract infection and  surgical wound infection from the point of health economy. MethodsBased on 1∶1 matching method, health resource expense of 100 patients ［patients with nosocomial infection (NI, infection group) and patients without NI (control group)］ were compared, and economic evaluation were carried out.  ResultsThe median of total hospitalization expenses of each case were 22 379.01 and 7 611.52 yuan in  infection and control group respectively, infection group was significantly higher than control group (Z=-6.72, P=0.00).The economic loss varied from infection sites, the highest loss was caused by  lower respiratory tract infection, which were 21 701.03 yuan,the following were urinary tract infection, surgical wound infection and upper respiratory tract infection, which were 6 374.52, 5 849.04 and 3 598.00 yuan  respectively; The main increased expenses of hospitalization were medicine cost, laboratory test cost, material cost, therapy costs and disposable fee; The median of hospitalization days of each patient in infection group and control group were 24.51 and 11.00 days respectively, there was significant difference between the two(Z=-7.84, P=0.00). ConclusionThe economic loss are large caused by NI, the loss varied from infection sites, hospitalization days were prolonged by NI.

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ObjectiveTo promote the nosocomial infection(NI) control  in China by using the experience of foreign countries for reference. MethodsThe international and domestic literature in the field of NI control and management was reviewed to clarify the achievement and problems of NI control in China. ResultsAt present, the laws and regulations for NI control are gradually getting perfected in China, nationwide infection control surveillance system was established and a large amount of data and experience were accumulated. The NI rate decreased from 9.36% in 1989 to around 6% at present; with the setup of professional society for NI control, the scientific research level has strikingly been improved. However, there are several problems: the position of NI control as a discipline is still obscure, the financial support is quite insufficient, and the research is weak.ConclusionThe discipline position of NI control should be clarified as early as possible, it is a branch of preventive medicine and important part of disease control and prevention. This reform for a reasonable position in preventive medicine will bring the stronger financial support, scientific exchange among different disciplines will significantly promote the NI control in China.

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ObjectiveTo evaluate the epidemiological characteristics, clinical features and prognosis of handfootmouth disease(HFMD) in children. MethodsClinical data of 120 HFMD children  who were admitted  in hospital  from May  to September, 2008 were analyzed retrospectively. ResultsThe majority of sick children were under the age of five, boys were more than girls; the incidence focused on May to July, most children had a history of  close contact with HFMD; the incidence of fever was 60.83%, all children  showed skin rash which distributed on hand, foot, mouth, buttock, trunk and perianal, rash subsided time were (4.59 ± 1.36) days. Patients were susceptible to complications,such as respiratory tract infection and gastroenteritis; 4 cases(3.33%) were severe HFMD, after antiviral and expectant treatment, only 1 case complicated with severe viral encephalitis and was transferred to the other hospital, the others were cured, length of hospital stay were (6.36 ±2.53) days. Pathogenic detection of 48 cases showed the positive rate of enterovirus 71 was 12.50%, the coxsackievirus type A16  was 66.67%, 20.83% of 48 patients were not detected pathogen. ConclusionHFMD has  strong infectious and epidemic, the majority occur in children under the age of five. Early diagnosis and treatment for patients and  isolation and disinfection measures can control the transmission of HFMD. The main treatment is antivirus, the prognosis of patients are generally good if no serious complications occur.

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ObjectiveTo carry out targeted surveillance on surgical wound infection(SWI) in patients in a general surgery department of a hospital, so as to take effective measures to reduce the  SWI rate. MethodsProspective survey was performed to evaluate  risk factor indexes of each patient, and a targeted surveillance of surgeonspecific infection  rate were  given statistical analysis. ResultsAmong 193 patients with surgical operations,  SWI rate was 6.74%(13/193)，the first three operations were cholecystectomy(20.00%), radical operation of gastrointestinal tumors (16.67%) and intestinal tract neoplasty/excision(16.00%). There was significant difference  between the types of the surgical wound, age of patients, the duration of operations and the degrees of risk indexes respectively (P<0.05 or P<0.01). ConclusionSWI rate in patients in department of general surgery in this hospital is high， the infection rate is related with the types of operation，age of patients and the duration of operation. 

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ObjectiveTo study effective ways of management of antimicrobial agents, so as to  promote rational use  of antimicrobial agents.MethodsAntimicrobial application policy was made, a group of supervisors for rational use of antimicrobial  agents in clinic was set up, regular quality control and check was undertaken. Antimicrobial application before (2005) and after (2007) performing management was compared. ResultsThrough  performing management of antimicrobial agents, antimicrobial application rate dropped from 83.34% to 52.69%(χ2=608.81, P<0.001), prophylactic  application rate dropped from 49.23% to 28.86%(χ2=252.31, P<0.001); perioperative antimicrobial application rate(0.5~2 hours before operation) dropped from 83.14% to 76.12%(χ2=94.51,P<0.001), nonuse rate of antimicrobial agents before operation increased from 58.43% to 73.00% (χ2=301.21, P<0.001); surgical wound infection rate decreased from 3.08% to 2.34%(χ2=6.56, P<0.05). ConclusionThrough  strict management of antimicrobial agents, antimicrobial application rate and prophylactic  application rate decreased markedly, and surgical wound infection rate also decreased obviously.

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ObjectiveTo study the changes and mechanisms of  blood coagulation in children with Kawasaki disease ( KD) in acute stage.MethodsFortyeight KD children were as case group, according to the examination result of coronary artery  ultrosonography ,12 of 48 patients were in coronary artery lesion group(CAL) and 36 patients were in noncoronary artery lesion group(NCAL), another 30 persons were as health control group. Function of blood coagulation including prothrombin time(PT), thrombin time(TT), activated partial thromboplastin time (APTT) and fibrinogen (FIB) were determined and compared among these groups.  ResultsCompared with patients  in control group, the PT,TT and APTT was shorter in CAL group, and the FIB was higher than those in control group, the difference was  significant (P≤0.01)； the PT and APTT were both shorter in NCAL group（P＜0.01）, and FIB was higher (P=0.01); compared with NCAL group, the PT,TT and APTT was shorter in CAL group（P≤0.01）, and the FIB was higher (P=0.02). ConclusionHypercoagulability exists in KD children in acute stage, and is susceptible to coronary artery disease, which may be related to blood vascular inflammation.

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ObjectiveTo investigate the nasal and hand carriage state of Staphylococcus aureus (SA) in tumor patients with chemotherapy, so as to strengthen nosocomial infection prevention and control. MethodsOne hundred and ninetynine patients in chemotherapy department from May to November 2008 were investigated, samples of patients’ anterior nares and hands within 48 hours of admission and before discharge were taken, SA  were isolated and identified, methicillinresistant Staphylococcus aureus (MRSA) were detected with cefoxitin disk diffusion method. ResultsTwentytwo (11.06%) of 199 patients’ anterior nares carried SA at admission, 2 (1.01%)of which  were MRSA;  34 (17.09%) patients' hands carried SA at admission, 9 (4.52%)of which were MRSA; Before discharge, 29 (14.57%) patients’ anterior nares carried SA, 8(4.02%) of which were MRSA; 26 (13.07%) patients’ hands   carried  SA, 7 (3.52%)of which  were MRSA; The increased nasal carriage of SA before discharge were 17 (8.54%) cases, 7 (3.52%) of which were MRSA; The increased hand carriage of SA was 19 cases (9.55%), 7(3.52%) of which were MRSA, the nasal carriage rate  of MRSA before discharge was 27.59%(8/29), which was higher than the nasal carriage rate of 9.09% (2/22) at admission, there was significant difference between the two (u=1.65, P<0.05). Among patients who carried SA at admission, the continued carriage of SA in anterior nares was 54.55%, in hands was 20.59%, the former was obviously higher than the latter (u=2.63, P<0.01). ConclusionPatients can acquire SA and MRSA during hospitalization, and nasal carriage can be continuous, and last  for long time. The awareness of hand hygiene of health care workers and cleaning and disinfection of ward environment should be strengthened.

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目的方法结果结论回顾性调查某院产科2003年1月—2006年5月间医院感染病例资料。6 187例产妇发生医院感染91例，医院感染率1.47%。感染部位包括剖宫产切口感染20例（21.98%），会阴侧切切口感染4例（4.40%），宫腔感染13例（14.29%），上呼吸道感染40例（43.96%），下呼吸道感染9例（9.89%），泌尿系感染5例（5.49%）。引起感染的相关因素为肥胖（＞70 kg）、贫血、总产程延长（＞16 h）、妊娠合并症与并发症、阴道检查或肛查次数多（＞6次）、剖宫产、手术时间长（＞1.5 h）、围术期未预防性应用抗菌药物等。提示应针对上述因素积极采取措施，有效预防控制产妇医院感染的发生。

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目的方法结果结论探讨不同年龄尖锐湿疣（condyloma acuminatum, CA）患者治疗前后血清白细胞介素（IL）2和IL10的水平及其临床意义。应用酶联免疫吸附试验（ELISA）法检测23例青年（18~35岁，青年组）、20例中老年（50~72岁，中老年组）CA患者的血清IL2和IL10水平，并与25例健康体检者（正常对照组）进行比较。结果显示，CA患者治疗前后血清IL2水平均低于正常对照组（与正常对照组比较，青年组与中老年组均P＜0.001），IL10水平高于正常对照组（青年组治疗前与正常对照组比较，P＜0.001，治疗后与正常对照组比较，P＜0.05；中老年组治疗前后与正常对照组比较，均P＜0.001），差异均有显著性。青年组CA患者治疗后血清IL2水平高于治疗前，IL10水平低于治疗前（分别P＜0.05，P＜0.01），差异均有显著性；中老年组CA患者治疗前后血清IL2及IL10水平差异均无显著性（P＞0.05）。提示CA患者细胞免疫功能存在明显障碍，中老年患者细胞免疫恢复能力不及青年患者明显，其愈后复发可能性高于青年患者。

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目的方法结果结论为了解鲍曼不动杆菌临床分布及其耐药情况，对某院2005—2007年间分离的鲍曼不动杆菌的耐药性进行监测分析。共分离鉴定鲍曼不动杆菌682株，其中674株分离自住院患者：重症监护室（ICU）248株，内科221株，外科205株；8株分离自门诊患者。标本来源以痰为主，共分离443株，占64.95%；其次为分泌物、脓液标本，分离91株，占13.34%。药敏结果显示，鲍曼不动杆菌对头孢他啶和头孢吡肟的耐药率较高，分别为69.17%和58.58%；对头孢哌酮/舒巴坦、哌拉西林/他唑巴坦、亚胺培南和美罗培南的耐药率分别为25.85%、66.46%、3.80%和7.10%。提示鲍曼不动杆菌在ICU的分离率高，对常用抗菌药物的耐药率高，必须加强抗菌药物合理使用的管理。

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回顾性调查某院2005年6月—2008年6月323例出院的腹外疝患者抗菌药物使用情况。323例腹外疝手术患者均使用抗菌药物，抗菌药物使用率100.00%，无正规围手术期预防用药病例。抗菌药物平均使用时间为（4.46±2.98） d；单一用药占93.81%，二联用药占5.57%，三联用药占0.62%；使用抗菌药物八大类13个品种，以头孢菌素类最多（主要为第三代）。调查结果显示，该院腹外疝患者围手术期抗菌药物应用不规范，应加强监管。

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目的方法结果结论在某院消毒供应中心的各个工作环节中采用色系管理(指将物品的外表采用不同颜色作为标识记号，通过肉眼识别直观地将不同的物品进行分类的一种工作方法)，发现此种管理方法有如下优点。（1）简单、直接：通过肉眼可以直接进行辨别，减少了工作量和工作时间；（2）方便管理工作：通过颜色的区别，可以直观地判断工作方式的正确与否；（3）提高了无菌物品的质量：通过色系管理，可以减少对无菌物品触摸的次数，减少了其污染的机会；（4）美化工作环境,调动了工作人员的积极性。

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目的方法结果结论对某院消毒供应中心脉动真空压力蒸汽灭菌中出现湿包的原因进行分析。2006年10月，共灭菌64锅次，2 245个灭菌包，其中出现湿包56个，湿包率达2.49%。53个湿包发生在第1锅次，占湿包总数的94.64%。蒸汽质量差是造成湿包的主要原因（占64.29%），且主要发生在第1锅次；其次为灭菌器相关问题（16.07%），拟灭菌物品准备不当（12.50%），物品装载不合理（7.14%）。针对各相关因素采取措施后，每个月湿包数下降为3个左右，湿包率降至0.13%，湿包现象得到明显改善。

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无色藻菌（Leuconostoc）属乳酸菌群（Lactobacillus flora），最初报道的感染病例多为菌血症［1］。在1985年前认为其是非致病菌，就现而言临床仍不多见。现将本院2009年1月收治的1例无色藻菌皮肤感染病例报告如下。

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研究人员证实，香港海鸥型菌自被发现以来，即与社区获得性胃肠炎、旅行者腹泻有关，甚至可能是近20年来发现的首种可致严重胃肠炎的新病菌。淡水鱼可能是香港海鸥型菌的主要储存宿主，进食鱼类为其主要的感染途径。同时,亚洲、欧洲、非洲及中美国家相继发现感染个案，提示病菌可能在全球范围广泛分布。本文描述了香港海鸥型菌的生物学及生化特性，并阐述其病原学、流行病学、实验室诊断等方面的主要进展，展望其研究前景。

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抗逆转录病毒治疗（antiretroviral therapy, ART）在人免疫缺陷病毒/获得性免疫缺陷综合征（HIV/AIDS）患者中的应用极大地降低了HIV病毒载量，随之使CD4+细胞上升，免疫功能恢复。这些免疫学的改变对患者是有利的，减少了机会性感染的发生，可延长生命。但经ART后不久，部分患者却由于对病原特异性免疫反应的失控而引起病情加重［1-2］，这被称为免疫重建炎性综合征（immune reconstitution inflammatory syndrone, IRIS）、免疫重建综合征或免疫重建疾病（immune reconstitution disease, IRD）。IRIS绝大多数在ART后3个月内发生。IRIS在一些非HIV相关的快速恢复免疫功能的病例中亦有描述，如免疫抑制治疗撤退或癌症患者停止化疗后可发生。

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关于万古霉素目标血药浓度达标及如何进行调整已讨论多年。根据有效血药浓度监测出万古霉素血药谷浓度和调整的初始浓度，两者均高于其最低抑菌浓度（MIC）和避免可能的耳毒性或肾毒性等副作用的浓度。前期很多研究由于缺乏设计良好的随机临床评估或缺乏某血药浓度与患者预后间的确切关系的明确资料，由此导致了监测力度不够或不监测以及如何进行剂量调整的争论。