A retrospective analysis of antibiotic treatment of pneumonia caused by Acinetobacter baumannii

目的:本文回顾性分析我院鲍曼不动杆菌肺炎患者抗菌药物的使用情况及治疗结果,以期为我院鲍曼不动杆菌感染患者的抗菌治疗提供依据。方法:对我院2011年1月-2012年12月收治的鲍曼不动杆菌(ACInETObACTEr bAuMAnnII,A.b)所致肺炎患者的临床基本资料、药敏情况、抗菌药物使用情况及治疗结果进行统计和分析。结果:48例鲍曼不动杆菌肺炎患者都存在严重原发病或免疫功能低下。在48株A.b中检出多重耐药鲍曼不动杆菌(Mdr A.b)12株,A.b对亚胺培南耐药率最低(19.05%),其次依次为美罗培南(21.43%)、阿米卡星(27.90%)。使用频次列前5位的抗菌药物依次为美罗培南、阿米卡星、莫西沙星、头孢吡肟和左氧氟沙星。单一用药24例,二联用药21例,三联用药3例。治疗有效率37.5%(18/48)。结论:该院肺部感染A.b存在多重耐药现象,抗菌治疗以单一及二联用药为主,治疗有效率低,应参照药敏结果联合用药,以提高治疗有效率。Objective:To retrospectively analyze the current antibiotic therapy of Acinetobacter baumanniicaused pneumonia in patients in our hospital and to provide the basis for clinically rational use of antibiotics in pneumonic patients infected by Acinetobacter baumannii.Methods:The basic information of patients,antibiotic susceptibility,the application of antibiotics and their therapeutic effects in pneumonic patients infected by Acinetobacter baumannii in our hospital from January 2011 to December 2012 were analyzed retrospectively.Results:In 48 patients with Acinetobacter baumannii-caused pneumonia,most patients suffered from severe basic diseases or suppressed immunity.A tatol of 12 strains of multidrug-resistant Acinetobacter baumannii were detected in 48 patients.Acinetobacter baumannii had the lowest resistance rate to imipenem(19.05%),followed by meropenem(21.43%) and amikacin(27.90%).Top 5 frequently used antibiotics for treating Acinetobacter baumannii infections were meropenem,amikacin,moxifloxacin,cefepime and levofloxacin.In 48 patients with Acinetobacter baumannii-caused pneumonia,single-drug therapy was used in 24,two-drug therapy in 21,and three-drug therapy in 3.Total effective rate was 37.5 %(18/48).Conclusion:Acinetobacter baumanii has multiple drug resistance to antibiotics.Single-drug therapy and two-drug therapy have been the main therapeutic regimens,but the effective rate is low.Thus,the therapeutic effects should be improved depending on antibiotic sensitivity test and combination drug therapy

Determination of nitrofuran residues in feed and water samples by monolith-based stir bar sorptive extraction and high performance liquid chromatography

利用自制的以聚(乙烯基咪唑-二乙烯基苯)(VIdb)整体材料为涂层的固相萃取搅拌棒(VIdb-SbSE)萃取3种硝基呋喃类药物,然后与高效液相色谱-二极管阵列检测器联用建立了测定饲料和水样品中硝基呋喃类药物残留的方法。详细考察了萃取过程中萃取和解吸时间、样品基质的PH值以及离子强度等实验条件对萃取效率的影响。在最佳条件下,呋喃唑酮的线性范围为0.5~200μg/l,呋喃妥因和呋喃西林的线性范围为0.25~200μg/l,3种目标物的检出限(lO d)(S/n=3)在0.068~0.11μg/l之间,所建方法具有理想的日内和日间重现性(r Sd值均小于6%)。在对饲料和实际水样的测定中,不同加标浓度呋喃唑酮、呋喃妥因和呋喃西林的回收率在80.6%~108%之间。研究表明,所建立的方法具有简便、灵敏、环境友好等特点。A simple,efficient and sensitive method for the simultaneous determination of nitrofurantoin( NFT),furazolidone( FZD) and nitrofurazone( NFZ) in feed and water samples was developed by stir bar sorptive extraction( SBSE) coupled to high performance liquid chromatography w ith diode array detection.T he SBSE based on poly( vinylimidazole-divinylbenzene)( VIDB) monolithic material as coating w as used to concentrate the three target analytes.T o obtain the optimum extraction performance, several VIDB-SBSE parameters w ere investigated and studied,including pH value,ionic strength of sample matrix,extraction and desorption time.U nder the optimized experimental conditions,the linear ranges w ere 0.5- 200 μg / L for FZ D,0.25- 200 μg / L for N FT and N FZ.T he limits of detection( S / N = 3) w ere in the range of 0.068- 0.11 μg / L for the three analytes.T he precision of the proposed method w as evaluated in terms of intra- and inter-day repeatability calculated as R SD,and it w as found that the R SDs w ere all below 6%.T he developed method w as successfully applied to the determination of nitrofuran residues in animal feed and w ater samples.T he satisfactory recoveries of the spiked target compounds w ere in the range of 80.6%- 108%.国家自然科学基金项目(21377105;21077085); 福建省新世纪优秀人才项

レキシガク ダイ5ショウ レキシ ノ ジュウソウセイ ト チイキ カラ ノ シセン ゲンゴキョウイク ニ ミル チイキ ト コッカ

2017年度大阪大学歴史教育研究会院生グループ報告（1）福井憲彦 『歴史学入門』 岩波書店, 2006.研究者・教員・市民のための新しい歴史学入門（平成26・29年度科学研究費補助金・基盤研究（A）・課題番号26244034） 研究代表者 桃木至朗（大阪大学大学院文学研究科教授

EFFECT of CLIPPING ON CARBOHYDRATE RESERVE IN UNDERGROUND PARTS of GRASSES

贮藏养分对牧草生长、越冬和再生极为重要，通过对几种牧草在年内多次刈割条件下的贮藏碳水化合物含量变化的研究，结果表明：随着刈割次数增加，贮藏碳水化合物含量下降，刈割次数越多，糖含量下降越多。不同的牧草下降幅度不同。Carbohydrate reserve is important for plant grow ,survive winter and regrowth.In this paper carbohydrare reserve of several grass in relation to herbage removal was studide.The results showed that as clipping times increase,carbohydrate content decreases.Different species of herbage have different decrease trends.国家自然科学基

主体的に問題を見いだす単元導入教材の開発 : 小学校理科第3学年「音の性質」の授業デザイン

平成29年に告示された小学校学習指導要領では、小学校理科第3学年の内容に「音の伝わり方と大小」が追加された。本研究では、小学校学習指導要領に示されている小学校理科の改訂の要点及び具体的な改善事項を踏まえ、単元の導入で児童が主体的に問題を見いだすことを目指した教材を作成した。そして作成した教材を実際に用いた授業を構想し、授業実践を通してその効果を検証した。授業では児童一人一人が作成した教材を用いて主体的に学習に取り組む姿が見られた。本実践における児童の姿から作成した教材が主体的に問題を見いだすことに有効であることが示唆された。In the Course of Study for elementary schools announced in 2016, “Propagation of Sound and Its Magnitude” was added to the content of Grade 3 elementary school science. In this study, teaching materials aimed at nurturing independent identification of problems by children through the introduction of units were created based on the key points of revision of elementary school science and the specific improvements indicated in the Course of Study for elementary schools. Further, a class was conceptualized in which the teaching materials created were actually used, and the effects based on the classroom practices were verified. In the class, children were seen engaging independently in learning through the use of the teaching materials created. The image of the children in these practices indicated that the teaching materials created were effective in independent identification of problems

Correlation between length of stay in acute stroke wards and the functional prognosis after comprehensive rehabilitation

　脳卒中発症後の機能予後改善には回復期リハビリテーションが有効である．急性期病棟から回復期リハビリテーション病棟に早期に移ることが，機能予後改善につながる可能性がある．本研究では，急性期病棟の在院期間と長期予後改善効果の関連性を検討することを目的とした．2018年１月1日から2018年12月31日までに川崎医科大学附属病院脳卒中科に入院した急性期脳卒中症例のうち，回復期リハビリテーション病棟に転棟・転院した症例を対象とした．脳卒中科退院時に比し，一年後に modified Rankin scale が１以上改善した症例を改善有と定義した．改善有と関連する患者背景因子，入院中の診療データについて検討を行った．関連性はカイ二乗検定を用いて評価し，有意な関連性を示した因子についてはロジスティック回帰分析を用いて解析した．対象期間に入院した急性期脳卒中408例中，回復期リハビリテーション病棟に転棟・転院したのは142例であった（男性90人，中央値76.0歳）．改善有は57例であり，在院期間の第一四分位である17日未満で回復期病棟に移った群で改善有が有意に多かった（P < 0.01）．ロジスティック回帰分析でも急性期病棟の在院期間が短い（17日未満）ことが改善有と独立して関連した．急性期脳卒中患者の急性期病棟在院期間を短縮することが機能予後改善につながることが示唆された．　Neurological symptoms and functional disability of stroke survivors can be improved through comprehensive rehabilitation in the post-acute phase. Early transfer from the stroke unit to the rehabilitation ward possibly leads to an improvement of functional prognosis. The purpose of this study was to investigate the relationship between the length of stay in the stroke unit and the long-term prognosis improvement. The study involved acute stroke patients admitted to the Department of Stroke, Kawasaki Medical School Hospital between January 1, 2018 and December 31, 2018. Specifically, those selected and included in the study were patients eventually transferred to a rehabilitation department or hospital. Improvement of functional prognosis was defined as a 1-point decrease on the modified Rankin scale at 1 year compared with that at the time of discharge from the stroke department. Factors associated with the improvement group were evaluated using the chi-square test and then logistic regression analysis. Of the 408 patients with acute stroke admitted during the study period, 142 were transferred to rehabilitation centers (90 men, median age: 76.0 years). Fifty-seven patients had improvement. The rate of improvement was significantly higher in the group transferred to the rehabilitation ward by day 17, the first quartile of time in the stroke unit (p < 0.01). Logistic regression analysis also showed that a shorter length of stay (< 17 days) in the stroke unit was independently associated with improvement. The results suggest that early initiation of comprehensive rehabilitation in the post-acute phase leads to improved functional outcomes of patients with acute stroke