To a greater or lesser extent, the following shortcomings can be found in the administration of various hospitals in China: overlapping institutional functions, aging age structure, low-level specialization, low efficiency, serious lack of reserve force in the contingent of administrators, and lack of competition in the mechanism of personnel employment. To remove these roadblocks to hospital development, the hospital the author works with adopted a series of measures, including readjustment of functions and combination of office work; change of job without change of rank and transfer to other institutions; flow of personnel to service and other profit-making departments; retirement ahead of schedule. The measures resulted in the reduction of administrative personnel by 16.2%, the reduction of administrative expenditure by about 180 thousand yuan per annum, the reduction of the average age of the administrators by 3 years, the rise of the proportion of administrators with a college degree and above from 45.9% to 56.5%, and the enhancement of the administrators awareness of competition, cost, service, profit and efficiency.

Objective To evaluate the curative effect of Keli-Paoxi power for the treatment of acute paronychia. Methods A total of 144 patients with acute paronychia were randomly divided into a Keli-Paoxi power group, a mupirocin ointment group and an ethanol soaking group, 48 in each group. All patients were treated for 3 weeks and followed-up for 2 months. The time to regression of redness and swelling in the nail groove was recorded. The Visual Analogue Scale (VAS) was used to assess tenderness. The curative effects were evaluated, and recurrence of paronychia was recorded. Results The time to regression of redness and swelling in the nail groove in the Keli-Paoxi power group (2.2 ± 0.6 d) was significantly shorter than that in the mupirocin ointment group (8.1 ± 1.7 d) or ethanol soaking group (7.9 ± 1.2 d; F=344.597, P<0.01). The VAS Scores in the Keli-Paoxi power group (1.2 ± 0.2) was significantly lower than that in the mupirocin ointment group (3.2 ± 0.3) or ethanol soaking group (3.1 ± 0.3; F=831.273, P<0.01). The total effective rate in the Keli-Paoxi power group (100.0%, 48/48) was significantly higher than that in the mupirocin ointment group (83.3%, 40/48) or ethanol soaking group (81.3%, 39/48; χ2=9.700, P=0.008). The recurrence rate of paronychia in the Keli-Paoxi power group (2.1%, 1/48) was significantly lower than that in the mupirocin ointment group (16.7%, 8/48) or ethanol soaking group (14.6%, 7/48; χ2=6.000, P=0.049) at 2 months follow-up. Conclusions Keli-Paoxi power can alleviate tenderness, shorten the time to regression of redness and swelling in the nail groove, decraese recurrence in patients with acute paronychia. The curative effect of Keli-Paoxi power is superior to mupirocin ointment and ethanol soaking in the treatment of acute paronychia.

Objective:To observe the efficacy of acupuncture plus tuina therapy for insomnia.
Methods:Totally 100 eligible patients were randomized into a treatment group (n=51) and a control group (n=49) by using the random number table. The treatment group was intervened by acupuncture at Baihui (GV 20), Fengchi (GB 20), Wangu (GB 12), Shenting (GV 24), Anmian [Extra, locates at the midpoint between Yiming (EX-HN 14) and Fengchi (GB 20)], and Neiguan (PC 6) plus tuina treatment; the control group was intervened by acupuncture alone. For both groups, the treatment was given once a day, 10 sessions as a treatment course, and the efficacies were evaluated and compared after 3 treatment courses.
Results:Of the 51 subjects in the treatment group, 46 cases completed 3 treatment courses, and 17 cases were cured, 18 cases showed marked efficacy, 7 cases were improved, 4 cases had invalid result, and the total effective rate was 91.3%. Of the 49 subjects in the control group, 46 cases completed 3 treatment courses, and 8 cases were cured, 12 cases showed marked efficacy, 14 cases were improved, 12 cases had invalid result, and the total effective rate was 73.9%. The total effective rate of the treatment group was significantly higher than that of the control group (P<0.05).
Conclusion:Acupuncture plus tuina can calm the mind and activate meridian qi in treating insomnia, and it can produce a more significant efficacy than pure acupuncture treatment.

Objective To analyze clinical distribution and change in drug resistance of Acinetobacter baumannii (A.baumannii)in 2009-2013,guide clinical rational antimicrobial use,and reduce healthcare-associated infection rate.Methods 919 A.baumannii isolates were isolated from inpatients and outpatients in a hospital between Janu-ary 2009 and December 2013,specimen and department sources,as well as change in drug resistance of A.bauman-nii were analyzed.Results A total of 10 273 pathogens were isolated from 2009 to 2013,the constituent ratio of A.baumannii in each year was 7.98%(n=93),11.31%(n=155),10.22%(n=185),7.73%(n=217),and 8.62%(n=269)respectively;the constituent ratio of imipenem-resistant A.baumannii was 24.73%,38.06%,71.89%, 64.52%,and 86.99% respectively;the main specimen source was sputum (83.68%);the major department sources were intensive care unit(ICU,39.28%),department of neurology (20.78%),and department of respiratory medi-cine(8.60%).The resistant rate of A.baumannii to most antimicrobial agents increased,the resistant rates to imi-penem and piperacillin/tazobactam increased from 24.73% and 4.44% in 2009 to 86.99% and 86.25% in 2013 re-spectively;resistant rate to sulphamethoxazole/trimethoprim decreased from 91.30% in 2009 to 27.14% in 2013;in 2013,except resistant rates to amikacin and sulphamethoxazole/trimethoprim were low (20.82% and 27.14%respectively),resistant rates to the other 11 kinds of antimicrobial agents were all >83.64%.Conclusion The iso-lation rate of A.baumannii is high in this hospital,the main specimen source is sputum,the main department source is ICU;antimicrobial resistant rate of A.baumannii is high,prevention and control of infection and trans-mission of A.baumannii should be strengthened.

Objective To compare distribution and drug resistance of Acinetobacter baumannii specimen in the intensive care unit(ICU) and the ICU.Methods Retrospective analysis ICU of 1 079 strains isolated and the 8 413 strains of bacteria isolated from ICU , Bacteria identification and drug sensitive test instrument using VITEK 2 Compact automatic bacterial culture identification .Results Most ICU Acinetobacter baumannii separation , form (29.2%) was significantly higher than the ICU (6.2%),the difference was statistically significant (χ2 =625.955, P<0.05).ICU imine resistant Acinetobacter baumannii from south (IRAB)detection rate(91.7%)was significantly higher(43.5%) than the ICU,difference was statistically significant (χ2 =193.541,P<0.05);Specimens of ICU and the ICU isolated bacteria were mainly comes from sputum ,constitute a ratio of 64.0%and 32.9%respectively. ICU and the separation of the ICU Acinetobacter baumannii to amikacin resistant rate was low (20.0%-21.6%),the separation of ICU Acinetobacter baumannii for three or four generation of cephalosporin , composite inhibitor drugs , penicillium carbon alkene ,quinolone antibacterial drugs ,significantly higher percentages of ICU ,difference was statis-tically significant(χ2 =146.124,104.407,253.171,195.646,186.580,all P<0.05).Conclusion Multiple drug resistance of Acinetobacter baumannii in ICU detection rate is high ,the bacteria monitoring should be strengthened , and the rational use of drugs ,reduce the drug resistance of bacteria .

Objective To understand the distribution and drug resistance change trend of pseudomonas aeruginosa (PA) in hospital clinical infection in order to provide laboratory basis for rational clinical use of medications.Methods Statistical analyses was conducted retrospectively in 818 strains of PA separated in our hospital from January 2007 to December 2011.Results Of all the separation,PA number of the pathogen constituted a ratio of 15.2％ (818/5365) ; The main source of specimens was sputum,accounting for 82.6％ (676/818).There was good antimicrobial activity of Imipenem,Piperacillin/Tazobactam,Aztreonam,Ceftazidime,Levofloxacin and Ciprofloxacin to PA,with resistance rates of 14.9％ (97/653),25.0％ (179/716),26.8％ (179/667),26.9％ (208/773),28.6％ (211/738) and 29.1％ (220/757) respectively; The resistance of Ciprofloxacin and Levofloxacin did not change significantly during 2007-2010 year,but in 2011 year a significant decrease of resistance rates was found (ciprofloxacin:35.1％ (175/498) vs.17.4％ (45/259) ; Levofloxacin:38.0％ (181/476) vs.11.5％ (30/262)) ; During 2009-2011 year,the resistance of Imipenem and Amikacin increased year by year (Imipenem:7.4％ (9/121) vs.7.7％ (66/209) vs.19.5％ (51/262) ; Amikacin:13.0％ (2/23) vs.33.3％ (69/207) vs.36.2％ (94/260)).Conclusion PA detection rate and its resistance is rising from 2007 to 2011 year.We should make rational drug use clinically according to antimicrobial susceptibility test results.Laboratories shall strengthen the bacterial resistance monitoring.

Objective To understand the hospital intensive care unit(ICU) pathogenic bacteria distribution and drug resistance for providing the basis for rational drug use and hospital infection control and prevention.Methods The drug resistance of 749 strains of pathogenic bacteria the separated from ICU was analyzed from January 2009 to December 2012.VITEK 2 Compact automatic bacteria identification instrument was used to detect bacteria identification and drug sensitive test using.Results There were Acinetobacter baumannii(208 strains,27.8％),Pseudomonas aeruginosa(108 strains,14.4％),E.coli (96 strains,12.8 ％),Staphylococcus aureus (76 strains,10.1％),Klebsiella pneumoniae(62 strains,8.3％) mainly accupied in 749 strains of pathogenic bacteria.The species was mainly from sputum specimens sources (503 strains,67.2％) ; the separation rate of Methicillin-resistant staphylococcus aureus (MRSA) was 82.9％ (63/76) ; the separation rate of Imine resistance from South pseudomonas aeruginosa(IRPA) was 22.2％ (24/108) ; the separation rate of resistance to carbon penicillium alkene antimicrobial acinetobacter baumannii (CR-AB) was 88.0％ (183/208).The resistant rate of Acinetobacter baumannii to amikacin was from 28.6％ to 31.5％,the other 20 kinds of antimicrobial drug resistant rate was as high as 81.6％-100.0％ ; Pseudomonas aeruginosa to ciprofloxacin,ofloxacin,aztreonam and piperacillin/tazobactam resistant rate of 11.6％-25.0％.Conclusion Detection of pathogens in ICU,multi-drug resistance is serious,the hospital should strengthen the bacterial drug resistance monitoring,rational use of antimicrobial drugs,reduce the nosocomial infection.

Objective To retrospectively analyze the drug resistance evolution of Staphylococcus aureus and MRSA,to provide the basis for prevention and control measures.Methods 576 strains of clinical isolated Staphylococcus aureus from 2009 to 2012 were analyzed.The bacteria identification and drug sensitivity test were detected by VITEK 2 Compact automatic bacteria identification instrument.Results The separation rate of MRSA from 2009 to 2012 was 59.5％,but the separation rate was gradually decreased per year.The antibacterial activity of MRSA was better to vancomycin,linezolid,quinupristin/Dalfopristin,teicoplanin,nitrofurantoin (resistance rate ＜ 2.4％).The resistance rate and sensitive rate of MRSA to tigecycline was 0.0％,intermediary rate was 100.0％.The resistance of MRSA to gentamicin,ciprofloxacin,moxifloxacin,clindamycin,tetracycline and erythromycin was gradually decreased.From 2010 to 2012,The resistance of MRSA to cotrimoxazole decreased significantly,from 65.3％ in 2010 to 28.2％ in 2011 and 4.7％ in 2012 (P ＜ 0.05).Conclusion Separation of MRSA and drug resistance is reduced year by year,we should continue to strengthen the administration of antimicrobial agents,scientific and reasonable application of antibacterial drugs,reduce the incidence of multiresistant bacteria and drug resistance.

S-adenosylmethionine(SAM) is a physiologically active molecule in all the organizations and the human body fluids, and it is important to participate in a variety of biochemical reactions, the regulation of liver regeneration, liver cells differentiation and various sensitivity of the injury. The SAM affects the liver through a variety of ways. It is confirmed that the SAM and MTA can block the LPS-induced TNF-α of Kupffer cells to protect the liver. In a word, S-adenosylmethionine may be beneficial to LPS-induced liver in-jury in clinical treatment.