Integrative medicine is the effective combination of dual diagnosis of Chinese medicine and western medicine.The combination can broaden the scope of clinical diagnosis and combine the local pathological changes with the overall response of the human disease.It can add a more comprehensive understanding of diseases for people.Clinically treated with combination of Chinese medicine and western medicine can achieve the complement of advantages.It is significant.Because the theory system of Chinese medicine compared with western medicine is different and the theory system of combination is not practical and standardized.The methods of clinical diagnosis and treatment are also different.So there are still some problems and deficiencies in the integrative medicine.In this study,through extensive literature research,as well as the clinical investigation in some integrative medicine hospitals and the collection of related clinical data,we compared and analyzed the academic ideas and different features of Chinese medicine and western medicine,analysed the status and the insufficience of current clinical integrative medicine.Finally,we put forward a series of effective strategies and methods for how to combine with integrative medicine in a specific,reasonable and effective way.

OBJECTIVE To analyze the risk factors and antimicrobial resistance pattern of Stenotrophomonas maltophilia isolated from 6 hospitals in Beijing,and study the difference in resistance rate of isolates from different hospitals. METHODS In this study,145 cases with S.maltophilia infection were analyzed and their susceptibility was tested.The synergetic screening test was applied to detect metallo-?-lactamases. RESULTS Most of 145 strains were isolated from sputum(86.2%),mainly from ICU(48.3%),and department of respiratory medicine(22.1%).The drug sensitivity tests in vitro showed these strains were resistant to commonly used antibiotics,and drugs whose sensitive rate was over 50% included doxycycline,gatifloxacin,cefoperazone-sulbactam,levofloxacin,compound sulfamethoxazole,ceftazidime-clavulanate and ticarcillin-clavulanate.The antimicrobial resistance of strains isolated from different wards showed some difference.Of all the infected patients,56.7% had underlying diseases;92.2%were treated previously with broad-spectum antibiotics;76.8% underwent invasive examination or treatment. CONCLUSIONS S.maltophilia is resistant to many kinds of antibiotics.The infection caused by S.maltophilia often occurs in patients with severe underlying disease and low immunity.Antibiotics should by chosen by drug sensitivity tests.

Objective To study the sleep quality of the parents whose children with cerebral palsy (CP).Methods The Pittsburgh sleep quality index (PSQI) as an investigative tool was used to investigate 36 cases of parents with CP children and 36 cases of parents with normal children.Results The sleep problem report rate was 34.72％ in parents with CP children,and 19.44％ in parents with normal children,their difference was statistically significant (x2 =4.255,P ＜0.05).Score of PSQI(5.72 ±3.54 vs 3.19±2.76,t =3.380,P ＜0.01),sleep quality(1.33 ±0.83 vs 0.78 ±0.34,t =3.371,P ＜0.01),fall asleep time (1.28 ± 0.88 vs 0.72 ± 0.36,t =3.027,P ＜ 0.01),hours of sleep (1.16 ± 0.72 vs 1.01 ±0.62,t =2.278,P ＜ 0.05),and insomnia(1.23 ± 0.56 vs 0.75 ± 0.28,t =2.949,P ＜ 0.01) of parents with CP children were significantly different from the parents with normal children.Score of PSQI (6.21±0.85 vs4.32 ±0.73,t =3.380,P ＜0.01),sleep quality(1.14 ±0.73 vs 0.89 ±0.66,t =2.986,P＜ 0.01),fall asleep time (1.22 ± 0.81 vs 0.96 ± 0.83,t =2.853,P ＜ 0.01),hours of sleep (1.09 ± 0.66vs 0.85 ± 0.71,t =2.136,P ＜ 0.05),insomnia (1.15 ± 0.63 vs 0.83 ± 0.62,t =2.513,P ＜ 0.01)and daytime function(1.19 ± 0.43 vs 0.88 ± 0.62,t =2.586,P ＜ 0.01) of mothers with CP children were significantly different from fathers with CP children.Conclusions The sleep quality of parents of CP children are worthy of attention.

OBJECTIVE To investigate probationer nurses' knowledge about nosocomial infection (NI) and clean operating-room. METHODS Survey among probationer nurses was performed by self-designed questionnaires. RESULTS 47% probationer nurses thought it very necessary to strength knowledge about NI before probation. The scores of clean operating-room knowledge was lower than that nosocomial infection (NI); The cognition rate among high educated probationer nurses were higher than low educated,P

BACKGROUND: Spine has a variety of morphological structures and complicated adjacent location, so the surgery to treat spinal abnormality is a difficult. Three-dimensional (3D) printing technology can transform 3D digital model into physical model, which has been widely used in the field of medicine, even popularized gradually in spine surgery. OBJECTIVE: To summarize the application and status of 3D printing technology in spine surgery, and to make aprospect. METHODS: The first author retrieved CNKI, Baidu Xueshu, Google Scholar, WanFang and PubMed databases for the articles published from 2010 to 2016 using the keywords of 3D printing technology, spine surgery, navigation template,spine physical model, pedicle screw, individualized implants, clinical teaching in Chinese and English, respectively.Finally 29 eligible literatures were enrolled for further analysis in accordance with the inclusion and exclusion criteria.RESULTS AND CONCLUSION: 3D printing technology has been extensively applied in spine surgery, and shows rapid development in preoperative diagnosis, intraoperative navigation, communication, teaching, graft production, implant customization, bone tissue engineering and other aspects. With the development of society, and medical imaging, 3D printing technology will be more promising in the field of medicine, especially in spine surgery

Teaching is very important for anesthesiology developmemt,so residents should be cultivated the teaching capacity as soon as possible.This article discussed how to cultivate the teaching capacity of residents in anesthesiology department.

Objective: To investigate the efficacy of the green tortoise exploring point technique for treating piriformis syndrome. Methods: Ninety patients were randomly allocated to a green tortoise exploring point treatment group of 30 cases, an acupuncture control group of 30 cases and a hydro-acupuncture control group of 30 cases for clinical observation. Results: The symptoms improved after treatment in all the three groups. The total efficacy rate was 100.0% in the treatment group, 76.7% in the acupuncture group and 83.3% in the hydro-acupuncture group. There were statistically significant differences between the three groups (P<0.01, P<0.05). Conclusion: The technique of green tortoise exploring point is better than conventional acupuncture and hydro-acupuncture in treating piriformis injury syndrome

Objective To investigate the correlation between anatomical structure and recurrence of common bile duct stones.Methods The clinical data of 195 patients with common bile duct stones were studied,including 37 patients with recurrent bile duct stones.The correlation between anatomical structure and the recurrence of common bile duct stones were analyzed by univariate and multivariate analysis.Results Univariate analysis revealed that history of cholecystectomy,choledocholithotomy,periampullar diverticu-lum,papilla hypertrophy or stenosis,intramural duodenal bile duct abnormalities,common bile duct stric-ture,choledochectasia and angulated common bile dust were risk factors of recurrence.Multivariate logistic regression analysis showed that past history of cholecystectomy,periampullary diverticulum,angulated com-mon bile dust,choledochectasia were independent risk factors for the recurrence of common bile duct stones. Conclusion Patients with anatomical structure of past cholecystectom,periampullary diverticulum,choledo-chectasia,angulated common bile dust are prone to recurrence of common bile duct stones.

Objective To summarize the data of newborn screening in Yongchuan district of Chongqing to promote its quali‐ty ,and to provide some measurements to enhance the management of newborn screening in this area .Methods According to the management system and technical standards of newborn screening (2010 Edition) ,newborn screening in Yongchuan district was im‐plemented .Screening rate ,coverage rate of newborn screening in maternity hospital ,recall rate of suspiciously affected newborns and rate of treatment of patients were analyzed from 2013-2014 .Results The screening rate ,coverage rate of newborn screening in maternity hospital ,recall rate of suspiciously affected newborns were increased by 77 .32% ,88 .57% and 17 .44% ,respectively , during these 10 years .All patients were treated appropriately (100% ) .Congenital hypothyroidism and phenylketonuria were screened .Since 2010 ,glucose‐6‐phosphate dehydrogenase deficiency and congenital adrenal hyperplasia were added to the newborn screening test panel .Conclusion Strengthen the management ,establish administrative department ,faculty training ,health education and government financial supports are contributed to improving the quality of newborn screening .

Objective The aim of this study was to explore the effects of volume controlled ventilation (VCV),pressure controlled ventilation(PCV)and pressure controlled ventilation-volume guaranteed (PCV-VG)on respiration and circulation in elderly patients undergoing thoracic surgery. Methods Thirty-six elderly patients who underwent thoracic surgery were enrolled in our study. Patients were divided into VCV,PCV and PCV-VG groups according to randomized design. The hemodynamic and respiratory data and the arterial blood gases had been recorded in the pre-operation,20 min,40 min,60 min after OLV and 20 min after the resumption of two lung ventilation. Results Compared with VCV group,Ppeak value was significantly lower in PCV and PCV-VG groups(P < 0.05),and the difference was not found between the PCV and PCV-VG groups. PaO2 levels in PCV and PCV-VG groups were higher than that in VCV group after the point of OLV+40(P < 0.05). Comparison of PCV group,PaO2 in PCV-VG group was higher,but did not show a significantly improved during OLV(P > 0.05). Conclusion Compared with VCV,the use of PCV and PCV-VG have significant advantages in the operative oxygenation and airway pressure for elderly patients undergoing OLV.