肺结核并下呼吸道感染489株病原菌的分布及耐药性分析

目的:调查我院肺结核并下呼吸道感染病人痰液标本中临床分离病原菌的分布及耐药状况,以指导合理用药。方法:对我院近两年来肺结核并下呼吸道感染病人1 321份痰液标本分离的病原菌进行回顾性分析。结果:共检出489株致病菌,其中革兰阳性菌184株,占37.6%,主要有表皮葡萄球菌、粪肠球菌、链球菌属、金黄色葡萄球菌;革兰阴性菌169株,占34.6%,主要有大肠埃希氏菌、醋酸钙不动杆菌、假单胞菌属、克雷伯菌属;真菌136株,占27.8%,多为为白色念珠菌。药敏结果(除真菌)显示:大多数革兰氏阳性菌及阴性菌对多种抗生素耐药,耐药率较高的抗生素依次为苯唑西林、克林霉素、磺胺甲恶唑、红霉素、万古霉素、青霉素钠、环丙沙星、左氧氟沙星;仍具有较高敏感率的依次为亚胺培南、头孢吡肟、阿米卡星、妥布霉素、头孢噻肟钠、头孢曲松钠、头孢哌酮钠。结论:肺结核病并下呼吸道感染的细菌多为条件致病菌,且具有多重耐药性,临床上应加强监测,根据药敏结果合理使用抗生素。     

糖尿病合并下呼吸道感染病原学及临床特点分析

目的:探讨糖尿病患者合并下呼吸道感染时病原菌的菌群分布、药物敏感性试验结果及临床危险因素.方法:回顾性分析108例糖尿病患者并发下呼吸道感染的病原学及其耐药性的特点;住院天数、病程、血糖水平、有无接受侵入性医疗操作等危险因素与糖尿病发生下呼吸道感染的关系.结果:108例糖尿病并发下呼吸道感染患者中共分离出微生物116株,以革兰阴性杆菌为主,占60.34％,主要菌株为铜绿假单胞菌、肺炎克雷伯菌、大肠埃希菌;革兰阳性菌属占34.48％,以葡萄球菌属为主;真菌占5.18％;两种细菌混合感染占6.48％,细菌与真菌并存占0.93％.药物敏感试验提示:革兰阴性杆菌对美罗培南、哌拉西林他唑巴坦、头孢他啶敏感性较高,但对氨苄西林的敏感率很低.革兰阳性球菌对万古霉素有较高的敏感性.血糖控制不好、住院天数长、接受侵入性医疗操作的糖尿病患者合并下呼吸道感染增多,且预后不良.结论:控制血糖,缩短住院时间,重视病原学监测,合理使用抗生素是治疗糖尿病合并下呼吸道感染的关键.     

某二甲医院感染常见病原菌分布及耐药性分析

目的:了解感染常见病原菌分布变迁和耐药趋势。方法:对2012年8月至2013年7月从医院感染患者标本中分离出的主要致病菌,采用法国梅里埃VITEK-2 Compact全自动微生物鉴定仪鉴定,并进行药敏试验。结果:2012年8月至2013年7月共分离出病原菌659株,其中革兰阴性菌为393株,占59.64%,革兰阳性菌为128株,占19.42%,真菌为138株,占20.94%,大肠埃希菌对氨苄西林、庆大霉素、头孢吡肟、头孢曲松、氨曲南、复方新诺明、四环素,肺炎克雷伯菌对氨苄西林、哌拉西林、呋喃妥因,铜绿假单胞菌对氨苄西林、四环素、头孢曲松、头孢唑啉,金黄色葡萄球菌对青霉素,表皮葡萄球菌对复方新诺明、青霉素等呈耐药率逐渐增高趋势。结论:革兰阴性菌以大肠埃希菌为主、革兰阳性菌以表皮葡萄球菌为主,掌握细菌变迁动态,从而不断进行耐药性监测,才能有效的指导临床合理应用抗菌药物。     

110例下呼吸道感染致病菌及药敏分析

本组110例下呼吸道感染患者经痰菌培养分离出的122株致病菌中革兰氏阴性菌106株,占86.9％,显著多于革兰氏阳性菌。其中铜绿假单胞菌检出率最高(40/106),依次为肺炎克雷白氏菌(25/106)、大肠埃希氏菌(12/106)等。药敏试验结果显示不同致病菌对不同抗生素的敏感性不一。但有近半数抗生素的总敏感率在50％以下,表明耐药严重,应高度重视合理选用抗生素。     

支气管肺炎患儿与菌群失调关系分析

支气管肺炎为小儿最常见的肺炎，多见于婴幼儿。我们对４１例支气管肺炎任院患儿的病原学研究表明，需氧性病原菌中革兰氏阳性菌约占２６．５％，主要为葡萄球菌、肺炎链球菌等，革兰氏阴性菌约占７３．５％，其中以大肠杆菌、克雷伯氏菌等为主，阳性细菌减少，阴性菌种类多，含量大。厌氧菌检出１８株，提示厌氧菌感染不可忽视。药敏试验表明，这些细菌对抗生素的敏感性亦有所降低，因此对小儿肺炎的研究和防治尤为重要。     

社区获得性肺炎患者肿瘤坏死因子α-308位点基因多态性与多药耐药菌感染的相关性

目的 探讨肿瘤坏死因子α(TNF-α)基因启动子区域308位点G/A多态性与社区获得性肺炎(CAP)患者多药耐药菌感染的相关性.方法 选取140例社区CAP感染患者(120例多重耐药菌感染者(CAP多重耐药组),20例单纯性CAP患者(CAP组))及97例健康体检中心的受试者为研究对象(对照组),采用Taqman探针荧光定量PCR法对TNF-α基因多态性位点-308A/G进行基因分型,利用SPSS统计软件分析TNF-α基因-308A/G位点多态性与CAP患者多药耐药菌感染的相关性.结果 与对照组比较,CAP组患者TNF-α-308位点GG、GA、AA基因型频率和A、G等位基因频率无显著性差异(P>0.05).与CAP组比较,CAP多药耐药菌组TNF-α-308位点GG、GA、AA基因型频率和A、G等位基因频率差异具有统计学意义(均P<0.01).与对照组比较,CAP多药耐药菌感染组患者血清TNF-α水平显著升高(P<0.01).与CAP-GG和CAP-GA基因型患者比较,CAP-AA基因型患者血清TNF-α表达水平显著升高.结论 TNF-α-308位点基因多态性可能通过影响TNF-α水平进而影响CAP患者多药耐药菌感染的生存状况.     

楚雄州中医院2011年细菌耐药性监测结果分析

目的:了解2011年临床分离菌株对常用抗生素的耐药性。方法:采用API鉴定和ATB药敏板条及纸片扩散法对2011年临床分离1 127株细菌进行药敏试验。结果:1 127株细菌中革兰阴性菌占76.8%,革兰阳性菌占23.2%。革兰阴性菌中前3位为大肠埃希菌45.7%(395/865)、肺炎克雷伯菌10.6%(92/865)和铜绿假单胞菌9.0%(78/865);革兰阳性菌中前3位为屎肠球菌27.1%(71/262)、金黄色葡萄球菌24.8%(65/262)和表皮葡萄球菌16.0%(42/262)。药敏试验结果显示泛耐药铜绿假单胞菌和不动杆菌检出率分别为19.2%(15/78)和32.8%(23/70);MRSA和MRCNS分别占金黄色葡萄球菌和CNS的32.3%(21/65)和83.3%(40/48)。结论:定期进行耐药性监测有助于了解细菌耐药性的变迁,为临床用药提供依据。     

儿科重症监护病房细菌感染特点及耐药性发展趋势探究

探究儿科重症监护病房(PICU)细菌感染特点及其耐药性发展趋势,为临床科学选用抗菌药物提供参考。从甘肃医学院附属医院PICU收集60例患儿的感染标本145份,对其做细菌培养及药敏试验,分析现今病原菌感染特点及耐药性;比对近年来PICU抗菌药物使用情况。送检的145份标本有128份结果显阳性,其中革兰阴性菌52株(40.6%),革兰阳性菌70株(54.7%),真菌6株(4.6%)。不同细菌对常用抗菌药物的耐药性并不一致,常见的革兰阴性菌和革兰阳性菌对某些药物很敏感,对某些药物却100%耐药。但抗菌药物使用越来越规范,合理用药率逐年提升。PICU主要病原菌种类虽变化不大,但耐药性却在增强。因此,准确把握各病原菌的特点,合理选择抗菌药物,能最大限度降低耐药性,力免过度医疗。     

某医院感染性病原菌分布及耐药性分析

对2012~2014年间某综合医院心脏中心感染性病原菌的构成及细菌耐药性变迁进行回顾性分析,为抗菌药物的合理使用提供依据.以痰液和尿液为主要标本来源,分离出177株病原菌,其中140株革兰氏阴性菌(79.1%),37株革兰氏阳性菌(20.9%).主要革兰氏阴性菌为大肠埃希菌(16.9%)、铜绿假单胞菌(15.3%)、肺炎克雷伯菌(14.1%)和鲍曼不动杆菌(12.4%).主要革兰氏阳性菌为金黄色葡萄球菌(12.4%).MRSA检出率为72.7%.大肠埃希菌和肺炎克雷伯菌对阿米卡星、亚胺培南和美洛培南的敏感性高;铜绿假单胞菌对阿米卡星和美洛培南的敏感性高;不动杆菌属对包括亚胺培南、美罗培南在内的14种抗生素的耐药率均超过30%,金黄色葡萄球菌对青霉素、喹诺酮类、大环内酯类等大多数抗生素耐药,对万古霉素和替考拉宁敏感.2012~2014年我院心脏中心住院患者感染病原菌中革兰氏阴性菌占优势,病原菌主要来自呼吸道细菌耐药性仍然形势严峻,应加强对细菌耐药性监测.     

SICU病房感染病原菌流行情况调查及耐药性分析

目的:分析2009年至2012年楚雄州医院SICU病房引起感染的病原菌及其耐药情况,为临床合理使用抗菌药物提供帮助。方法:采用法国梅里埃VITEK-2全自动细菌鉴定仪,对4年间楚雄州医院SICU病房培养的病原菌进行鉴定及药敏试验,并利用WHONET5.6软件进行统计分析。结果:4年间SICU病房共检出临床感染病原菌893株,其中革兰阳性菌141株,占15.7%,革兰阴性菌752株,占84.2%。这些菌株分别来自痰、尿、血液、胆汁等,以痰标本多见。在检出细菌中,多重耐药菌株分离率2009年22.1%,2010年30.9%,2011年47.5%,2012年54.3%。从药敏结果看,SICU病房中分离病原菌对常用抗菌药物的耐药率较高,但未发现对碳青霉烯酶类抗生素耐药的肠杆菌科细菌及耐万古霉素肠球菌。结论:医院SICU病房中的感染病原菌多以革兰阴性杆菌为主,多重耐药菌株比例较高,且多重耐药菌株分离率呈逐年上升趋势,应加强区域性细菌耐药监测,以指导临床用药。     

Markedness and its Interpretation in Language Use

Language markedness is a common phenomenon in languages, and is reflected from hearing, vision and sense, i.e. the variation in the three aspects such as phonology, morphology and semantics. This paper focuses on the interpretation of markedness in language use following the three perspectives, i.e. pragmatic interpretation, psychological interpretation and cognitive interpretation, with an aim to define the function of markedness.     

Lower Paleozoic oil relationships within Williston Basin, Canada

The Williston Basin is a significant petroleum province, containing oil production zones that include the Middle Cambrian to Lower Ordovician, Upper Ordovician, Middle Devonian, Upper Devonian and Mississippian and within the Jurassic and Cretaceous. The oils of the Williston Basin exhibit a wide range of geochemical characteristics defined as "oil families", although the geochemical signature of the Cambrian Deadwood Formation and Lower Ordovician Winnipeg reservoired oils does not match any "oil family". Despite their close stratigraphic proximity, it is evident that the oils of the Lower Palaeozoic within the Williston Basin are distinct. This suggests the presence of a new "oil family" within the Williston Basin. Diagnostic geochemical signatures occur in the gasoline range chromatograms, within saturate fraction gas chromatograms and biomarker fingerprints. However, some of the established criteria and cross-plots that are currently used to segregate oils into distinct genetic families within the basin do not always meet with success, particularly when applied to the Lower Palaeozoic oils of the Deadwood and Winnipeg Formation.     

An Analysis of Catherine＇s Character——Wuthering Heights

Wuthering Heights, Emily Bronte＇s only novel, was published in December of 1847 under the pseudonym Ellis Bell. The book did not gain immediate success, but it is now thought one of the finest novels in the English language. Catherine is the key character of this masterpiece, because everybody and everything center on her though she had a short life. We can understand this masterpiece better if we know Catherine well.     

Characterization of Ordovician carbonate reservoirs, southeastern Saskatchewan, Canada

The discovery of the prolific Ordovician Red River reservoirs in 1995 in southeastern Saskatchewan was the catalyst for extensive exploration activity which resulted in the discovery of more than 15 new Red River pools. The best yields of Red River production to date have been from dolomite reservoirs. Understanding the processes of dolomitization is, therefore, crucial for the prediction of the connectivity, spatial distribution and heterogeneity of dolomite reservoirs.The Red River reservoirs in the Midale area consist of 3～4 thin dolomitized zones, with a total thickness of about 20 m, which occur at the top of the Yeoman Formation. Two types of replacement dolomite were recognized in the Red River reservoir: dolomitized burrow infills and dolomitized host matrix. The spatial distribution of dolomite suggests that burrowing organisms played an important role in facilitating the fluid flow in the backfilled sediments. This resulted in penecontemporaneous dolomitization of burrow infills by normal seawater. The dolomite in the host matrix is interpreted as having occurred at shallow burial by evaporitic seawater during precipitation of Lake Almar anhydrite that immediately overlies the Yeoman Formation. However, the low δ18O values of dolomited burrow infills (-5.9‰～ -7.8‰, PDB) and matrix dolomites (-6.6‰～ -8.1‰, avg. -7.4‰ PDB) compared to the estimated values for the late Ordovician marine dolomite could be attributed to modification and alteration of dolomite at higher temperatures during deeper burial, which could also be responsible for its 87Sr/86Sr ratios (0.7084～0.7088) that are higher than suggested for the late Ordovician seawaters (0.7078～0.7080). The trace amounts of saddle dolomite cement in the Red River carbonates are probably related to "cannibalization" of earlier replacement dolomite during the chemical compaction.     

Features of Women's language

Language is a means of verbal communication. People use language to communicate with each other. In the society, no two speakers are exactly alike in the way of speaking. Some differences are due to age, gender, statue and personality. Above all, gender is one of the obvious reasons. The writer of this paper tries to describe the features of women＇s language from these perspectives： pronunciation, intonation, diction, subjects, grammar and discourse. From the discussion of the features of women＇s language, more attention should be paid to language use in social context. What＇s more, the linguistic phenomena in a speaking community can be understood more thoroughly.     

Design and analysis of generic LBS application developing platform

Location based services is promising due to its novel working style and contents.A software platform is proposed to provide application programs of typical location based services and support new applications developing efficiently. The analysis shows that this scheme is easy implemented, low cost and adapt to all kinds of mobile nework system.     

A computer generator for randomly layered structures

AcomputergeneratorforrandomlylayeredstructuresYUJia shun1,2,HEZhen hua2(1.TheInstituteofGeologicalandNuclearSciences,NewZealand;2.StateKeyLaboratoryofOilandGasReservoirGeologyandExploitation,ChengduUniversityofTechnology,China)Abstract:Analgorithmisintrod…     

橡胶颗粒沥青混合料低温抗裂性试验研究

以AC-13级配为基础,将橡胶颗粒代替部分集料掺入混合料中,以低温弯曲试验为评价方法对不同橡胶颗粒掺量下沥青混合料的低温抗裂性进行研究,并引入应变能密度值对混合料的低温抗裂性进行综合评价.试验结果表明:橡胶颗粒沥青混合料试件的破坏微应变均超过2 300,满足冬寒区的技术指标;无论是否掺加橡胶颗粒,随着温度的下降,沥青混合料破坏时的最大弯拉强度增大,弯拉应变降低,劲度模量增大;弯曲应变能密度在胶粒掺量为1%左右时具有较大的弯曲应变能密度值,此时橡胶颗粒沥青混合料具有较好的低温抗裂性.     

低渗透非均质砂岩油藏启动压力梯度研究

理论推导与室内实验相结合,建立了低渗透非均质砂岩油藏启动压力梯度确定方法。首先借助油藏流场与电场相似的原理,推导了非均质砂岩油藏启动压力梯度计算公式。其次基于稳定流实验方法,建立了非均质砂岩油藏启动压力梯度测试方法。结果表明:低渗透非均质砂岩油藏的启动压力梯度确定遵循两个等效原则。平面非均质油藏的启动压力梯度等于各级渗透率段的启动压力梯度关于长度的加权平均;纵向非均质油藏的启动压力梯度等于各渗透率层的启动压力梯度关于渗透率与渗流面积乘积的加权平均。研究成果可用于有效指导低渗透非均质砂岩油藏的合理井距确定,促进该类油藏的高效开发。     

On Tragic Consciousness In The Works By Ernest Hemingway

As an American modern novelist who were famous in the literary world, Hemingway was not a person who always followed the trend but a sharp observer. At the same time, he was a tragedy maestro, he paid great attention on existence, fate and end-result. The dramatis personae's tragedy of his works was an extreme limit by all means tragedy on the meaning of fearless challenge that failed. The beauty of tragedy was not produced on the destruction of life, but now this kind of value was in the impact activity. They performed for the reader about the tragedy on challenging for the limit and the death.