To explore clinical characteristics of patients with infectious caused by carbapenem-resistant Klebsiella pneumonia (CRKP) in an intensive care unit (ICU).

The clinical features, laboratory manifestations, the diagnosis and treatment of patients with CRKP infection from October 2015 to December 2015 in ICU of Xinqiao Hospital, Third Military Medical University were analyzed retrospectively.

The incidence of CRKP in ICU is 27.42%, and most of the CRKP patients were old male (average age was 64.14±14.45, male accounted for 78.57%). Fever ( 85.71% in CRKP group versus 51.35% in non-CRKP group, 9.09% in non-infection group, χ²=14.484, P=0.001), white blood cell count (15.70±6.92 versus 10.09±4.33, 9.41±4.48×10⁹/L, χ²=9.980, P=0.007), C reactive protein (142.00(50.50, 240.00) versus 71.10(27.00, 107.50), 14.10(5.00, 53.30) mg/L, χ²=9.387, P=0.009) and procalcitonin (3.50(1.07, 27.05) versus 0.71(0.20, 3.14), 0.20(0.20, 0.30)μg/L, χ²=16.236, P<0.001) increased were the main performance. The CRKP mortality rate (35.71% versus 45.95%, 36.36%, χ²=0.607, P=0.738) didn′t increase due to the tigecycline combined with carbapenem treatment, but the hospitalization time (33.00(18.75, 44.50) versus 7.00(4.00, 11.50), 9.00(4.00, 13.00) days, χ²=15.398, P<0.001) and hospitalization costs (23.92(10.14, 36.08) versus 4.41(2.64, 11.22), 2.80(1.94, 3.19) million yuan, χ²=21.370, P<0.001) extended.

CRKP epidemic is prone in ICU. Reduction in the non-standard use of broad-spectrum antibiotics and unnecessary invasive operation, timely adjustment of anti infection scheme, is an important measure to control the epidemic of CRPK and reduce the clinical burden.

To explore the differences of efficacy of the chemotherapy and epidermal growth factor receptor-tyrosine kinase inhibitor treatment in advanced lung adenocarcinoma patients harboring exon 21 mutation.

The clinical characteristic of advanced lung adenocarcinoma harboring EGFR 21 L858R mutation receiving first-line chemotherapy and EGFR-TKI treatment in Xinqiao hospital from Jan 2010 to Dec 2015 were studied. The differences between the clinical indicators of the two groups, such as objective response rates (ORR), disease control rates(DCR), progression free survival(PFS), overall survival(OS) were analyzed.

①The data of 68 patients were collected including 40 chemotherapy and 28 EGFR-TKI. Baselines of sex, age, smoking status, ECOG PS between the two groups were consistent (P>0.05) . ②The ORR of the two groups were 45% and 17.9%(P=0.020), the DCR of the two groups were 95% and 71.4%(P=0.012). The PFS of the two groups were 9.901 and 6.746 months (P=0.045), the OS of the two groups were 21.738 and 23.611 months (P=0.378).

Compared with EGFR-TKI, the patients of advanced lung adenocarcinoma treated with chemotherapy had significant advantage of ORR, DCR and PFS, no difference on OS.

To study the correlation between chronic obstructive pulmonary disease assessment test score (CAT) and prognostic factors of chronic obstructive pulmonary disease (COPD), and explore the clinical application value of CAT in assessing the prognosis of patients with COPD.

Au 106 patients with diagnosed COPD in the department of resiratory of our hospital from January 2013 to January 2015 were enrolled in the study. The CAT score, 6-min walking distance (6MWD), modified medical British research council (mMRC), BODE index, St George′s respiratory questionnaire (SGRQ) and pulmonary function indices were collected before and after treatment. The correlation between the CAT scores and clinical characteristics were analyzed by univariate linear correlation.

With the CAT scores increased, the 6MWD, forced vital capacity (FVC) measured values, FVC observed/predicted value, forced expiratory volume in one second (FEV₁) measured values, FEV₁ observed/predicted values, FEV₁/FVC, peak expiratory flow (PEF) measured values, PEF observed/predicted values were significantly lower (P<0.05), while mMRC score, BODE index and SGRQ total score were significantly higher (P<0.05); After the short-term treatment for patients, the CAT scores, BODE index and SGRQ total scores were significantly lower than that before treatment (P<0.05), while 6MWD, FEV₁ measured values, FEV₁ observed/predicted values, FEV₁/FVC were significantly higher than that before treatment (P<0.05); The univariate analysis found that the CAT score in pre-treatment was positive correlated with mMRC scale (r=0.254, P=0.018), BODE index (r=0.426, P=0.009) and SGRQ total scores (r=0.563, P=0.007), which was negative correlated with 6MWD (r=-0.387, P=0.000), FVC measured values (r=-0.181, P=0.023), FVC observed/predicted value (r=-0.192, P=0.021), FEV₁ measured values (r=-0.201, P=0.016), FEV₁ observed/predicted values (r=-0.214, P=0.013) and FEV₁/FVC (r=-0.223, P=0.012); the CAT score in post-treatment was positive correlated with mMRC scale (r=0.304, P=0.011), BODE index (r=0.382, P=0.010) and SGRQ total scores (r=0.621, P=0.004), which was negative correlated with 6MWD (r=-0.407, P=0.000), FEV₁ measured values (r=-0.211, P=0.014), FEV₁ observed/predicted values (r=-0.228, P=0.012) and FEV₁/FVC (r=-0.231, P=0.011).

The CAT score has a good correlation with mMRC scale, BODE index, SGRQ, 6MWD and pulmonary function in COPD patients, suggesting which has a potential to predict the prognosis of COPD.

To explore the effects of mindfulness-based intervention model on the quality of life and psychological status of lung cancer patients during chemotherapy.

A total of 76 patients with lung cancer during chemotherapy were randomly divided into control group and observation group, the control group were given routine nursing. In addition, patients in observation group received mindfulness-based intervention. The EORTC QLQ-30 and SAS scales, SDS scales were used to evaluate the quality of life of the patients before and after the 8-week intervention.

Before intervention, there was no significant difference in quality of life (QOL)between the two groups. After 8 weeks of intervention, the overall health score of observation group was 59.6±5.0, the control group was 59.6±5.0. In fatigue, pain, nausea and vomiting, the score of observation was 43.2±2.7, 26.2±4.3, 30.5±5.6, and the control group was 57.8±4.2, 47.8±3.9, 51.4±5.6, the difference was statistically significant, the QOL of the observation group was better than control group, P<0.05. Two groups of patients with anxiety, depression scores were reduced. The SAS score of observation group was 38.64±5.02, the control group was 44.06±5.24. And the SDS score of observation group was 41.26±5.2, the control group was 46.89±5.34, the psychologic status of observation group was better than the control group, P<0.05.

Mindfulness-based intervention can effectively improve the psychological status and quality of life of lung cancer patients during chemotherapy.