ObjectiveTo explore the multi-drug resistance condition and independent risk factors ofAcinetobacter baumannii infection in patients after liver transplantation.MethodsClinical data of 257 patients who underwent liver transplantation in Shanghai General Hospital between January 2010 and June 2015 were retrospectively analyzed. The informed consents of all patients were obtained and the local ethical committee approval was received. Twenty-ifve patients were infected with multi-drug resistantAcinetobacter baumannii. Among the patients, 17 were males and 8 were females, 10 were younger than 50 years old and 15 were older or equal to 50 years old. Drug sensitive test was detected using concentration gradient method, metallo-beta-lactamase was detected using composite paper, and bacterial genotype was detected using repetitive sequence polymerase chain reaction (PCR) and gel electrophoresis. Drug resistance, drug-resistant spectrum, genotype distribution, infection time and inlfuence factors of infection for multi-drug resistantAcinetobacter baumannii were observed and analyzed. Single-factor analysis of multi-drug resistantAcinetobacter baumannii was conducted using Chi-squaretest and multiple-factor analysis was conducted using logistic regression analysis.ResultsThe incidence of multi-drug resistantAcinetobacter baumannii infection was 9.7%(25/257).Acinetobacter baumannii strains were highly resistant to aminoglycosides, quinolones, penicillins, cephalosporins and carbapenems, with the drug resistance of 100%. In addition, 96%(24/25) of the strains were metallo-beta-lactamase positive. Three genotypes were observed in the 25 strains ofAcinetobacter baumannii: type B (n=18), type A (n=5) and type C (n=2). Positive postoperative fungal culture (OR=5.470, 95%CI: 1.402-21.333,P<0.05) and re-intubation (OR=11.538, 95%CI: 2.228-59.742,P<0.05) were the independent risk factors for multi-drug resistantAcinetobacter baumannii infection.ConclusionsThe incidence of multidrug-resistant Acinetobacter baumannii infection in patients after liver transplantation is high. Multidrug-resistant Acinetobacter baumannii is highly resistant to multiple antibiotics, and type B is the main genetype. Positive postoperative fungal culture and re-intubation are the independent risk factors for multi-drug resistantAcinetobacter baumannii infection.

目的:比较糖尿病急性心肌梗死病人和非糖尿病急性心肌梗死病人的临床特征和早期死亡率.方法:416例急性心肌梗死病人分为糖尿病急性心肌梗死组59例和非糖尿病急性心肌梗死组357例.结果:糖尿病组女性比例较高,有高血压、高脂血症和心绞痛病史比例高于非糖尿病组.糖尿病组临床心功能较差,超声心动图测得的左室EF、ES较低,心源性休克发生率较高.糖尿病组早期死亡率35.59%,明显高于非糖尿病组(19.33%).结论:糖尿病急性心肌梗死病人心功能较差,早期死亡率较高.

目的比较小范围和大范围急性心肌梗死患者临床特征和早期病死率.方法对416例急性心肌梗死患者按照Wagner的QRS评分法分为小范围心肌梗死组251例和大范围心肌梗死组165例.结果大范围心肌梗死组有高血压病史的比例较高,入院时心率较快,临床和超声心动图测得的心功能较差,心源性休克发生率较高.小范围心肌梗死组早期病死率13.94%,大范围心肌梗死组早期病死率33.33%.结论 QRS评分法对判断急性心肌梗死患者预后具有重要意义.

分析急性心肌梗死时早期死亡(住院期间)的危险因素,对于估计预后,制订正确的治疗措施等具有十分重要的意义.本文对近年来在我院心内科病房住院治疗的急性心肌梗死病人进行分析,以寻找急性心肌梗死时早期死亡的危险因素.

目的:观察非洛地平治疗心绞痛伴高血压病人的临床疗效及对左心室功能的影响.方法:51例病人每日上午口服非洛地平5 mg,连用8周.结果:临床总有效率为84%,左心室功能(每搏量、心排血量、射血分数、左心室小径缩短率、左心室舒张早期流速峰值E峰和心房收缩期流速峰值A峰、E/A比值)比治疗前明显改善(均为P＜0.001).结论:非洛地平有降低血压、改善心肌缺血、改善左心室功能的作用,适合用于心绞痛伴高血压病人的治疗.

目的：比较索他洛尔(Sot)与美西律(Mex)对频发性室性早搏的疗效。方法：60例频发性室性早搏患者，采用双盲随机试验，分为Sot组与Mex组。Sot组初始治疗剂量为80 mg bid po，最大剂量为160 mg bid po。Mex组初始剂量为150 mg tid po,最大剂量为200 mg qid po。结果：Sot组总有效率为83.33%，Mex组总有效率为73.33%，两组间无显著差异。结论：Sot与Mex对室性早搏均有明显疗效。

目的: 比较氨氯地平、非洛地平、缓释硝苯地平的降压疗效.方法:氨氯地平(5 mg, qd)、非洛地平(5 mg, qd)和缓释硝苯地平(30 mg, qd)分别治疗高血压53,50和49例,均连续口服用药2 wk.结果:3药降压有效率分别为81%,76%,76%.3药尚有改善心肌缺血和心功能的作用.结论:3药降压作用均显著,具有服药方便、副作用小等优点.

目的:比较培哚普利与贝那普利治疗心力衰竭的疗效.方法:培哚普利组40例(男性27例,女性13例,年龄67 a±s10 a)应用培哚普利4 mg, po, qd.贝那普利组40例(男性27例,女性13例,年龄71 a±9 a)应用贝那普利10 mg, po, qd.2组疗程均为4 wk.结果:培哚普利组抗心力衰竭有效率为82%,贝那普利组抗心力衰竭有效率为80%,2组间差异无显著意义(P＞0.05).2药均有减轻心肌缺血、改善左室收缩功能作用.2组副作用均轻微.结论:培哚普利和贝那普利抗心力衰竭作用相近.

血管内皮功能异常在动脉粥样硬化和心肌缺血等的病理生理中发挥重要作用.本文旨在观察单硝酸异山梨酯治疗冠心病心绞痛患者的临床疗效和对血管内皮功能的影响.

目的:比较噻氯匹定和阿司匹林对冠心病病人血液粘度、血小板聚集率和血凝系统的作用.方法:噻氯匹定(0.25 g, po, bid)治疗44例病人.阿司匹林(50 mg, po, bid)治疗45例病人.均连续用药4 wk.结果:2组均有降低全血粘度、血浆粘度、血小板聚集率、延长活化的部分凝血活酶和凝血酶原时间等作用.组间比较:P＞0.05.结论:2药均有降低血液粘度、血小板聚集率和抑制凝血功能的作用.