Objective To investigate the efficacy and safety of Wenxin Granule Combined with metoprolol in the treatment of arrhythmia in elderly patients with coronary heart disease.Methods84 cases of elderly patients with coronary heart disease arrhythmia treated in our hospital from April 2014 to May 2016, were randomly divided into observation group and control group, 42 cases in each group.The observation group was given the Wenxin Granule Combined with metoprolol treatment, the control group were treated with metoprolol,The changes of systolic status, the ischemic condition, hemodynamic changes and plasma viscosity were compared before and after treatment between the two groups, and the clinical effect after treatment were compared.ResultsAfter treatment, two groups of patients with atrial premature contraction, ventricular premature contractions and junctional premature contractions were decreased, the observation group was lower than the control group, the difference between the two groups was statistically significant (P<0.05);After treatment, two groups of patients with ischemic frequency were reduced, the observation group (5.45±1.12)times was lower than the control group (8.12±2.70)times, the difference between the two groups was statistically significant (P<0.05);After treatment, the two groups of patients with total ischemic time is shortened, the observation group (16.45±3.87)min shorter than the control group (22.45±4.89)min, the difference between the two groups was statistically significant (P<0.05);The total effective rate of the observation group was 92.85% higher than the control group (69.20%), the difference was statistically significant(P<0.05).ConclusionElderly patients with coronary heart disease arrhythmia patients with Wenxin granule combined with metoprolol treatment, can effectively improve the clinical symptoms of patients with significant effect.

OBJECTIVE To investigate the antibiotics resistance and the presence of resistant gene of Staphylococcus aureus isolated from nosocomial infection patients in our hospital.METHODS Antibiotic susceptibility tests were conducted by Microscan WalkAway-40,the antibiotics resistant genes of aac(6')/aph(2″),aph(3')-Ⅲ,ant(4',4″),TEM,tetM,macA,erm and qacA/B of 16 MRSA and 24 MSSA strains were detected by PCR.RESULTS The percentage of MRSA in this investigation was 59.4%,the positive rate of ?-lactamases of 192 S.aureus strains was 98.9%,resistant rate of S.aureus to ?-lactam antibiotics was 52.1-99.0%,and to erythromycin,clindamycin,clarithromycin,ciprofloxacin,norfloxacin,gentamicin and tetracycline was 52.1%,78.1%,85.5%,56.3%,61.1%,55.2%,and 69.8%,respectively,but to nitrofurantoin and sulfamethoxazole/trimethoprim were relatively lower(1.1% and 10.5%) than the others.VISA,h-VISA and VRSA were not measured.To the most of antibiotics,the resistant rate of MRSA was higher than MSSA.The presence of resistant gene of MRSA and MSSA was different.There was more positive percentage of gene in MRSA than in MSSA.CONCLUSIONS Antibiotics resistance of S.aureus isolated from nosocomial infection patients in our hospital is severe.Compared to MSSA,MRSA has higher antibiotic resistant rate and more complicated drug-resistant mechanism.Some measures should be done to reduce the antibiotic resistance of S.aureus.

OBJECTIVE To investigate the staphylococcal cassette chromosome mec(SCCmec) genotype characteristics and antibiotic-resistant genes in meticillin-resistant Staphylococcus aureus(MRSA) isolated from Lianyungang.METHODS The SCCmec of clinically isolated MRSA strains were genotyped with a novel multiplex PCR strategy reported by Zhangetal.Antibiotic-resistant genes of aac(6′)/aph(2″),aph(3′)Ⅲ,tetM,erm,TEM,and ant(4′,4″) were analyzed by traditional PCR.RESULTS The isolates were almost SCCmec Ⅲ positve,only one isolate couldn′t be typed.The positive rates of aac(6′)/aph(2″),aph(3′)Ⅲ,tetM,and erm were 98%,46%,72% and 86%,respectively.TEM and ant(4′,4″) tested were all negative.CONCLUSIONS Almost all genotypes of MRSA prevailing in Lianyungang carry the SCCmec Ⅲ gene.There are high positive percentages of antibiotic-resistant genes of aac(6′)/aph(2″),aph(3′)Ⅲ,tetM and erm in the isolates.The novel multiplex PCR strategy recommended by Zhang et al can be applied into genotyping study of MRSA SCCmec effectively.

Objective To explore the clinical curative effect and safety of intra -abdominal beacizumab bead sheet resistance combined with hyperthermic intraperitoneal chemotherapy in treatment of ovarian cancer perito-neal effusion.Methods 60 patients with ovarian cancer peritoneal effusion in Binzhou Central Hospital from June 2012 to July 2015 were randomly divided into two groups.30 cases in the control group were treated with intraperito-neal hyperthermic perfusion chemotherapy, while 30 patients in the observation group were given intra-abdominal beacizumab bead sheet resistance combined with hyperthermic intraperitoneal chemotherapy.The short-term effica-cy,toxicity and quality of life were compared.Results The effective rate of the observation group was 73.33%, which was significantly higher than 53.33% in the control group,the difference was significant (χ2 =8.55,P<0.05).In the two groups, there were no significant differences on thrombocytopenia, reduced white blood cells and hemoglobin,nausea,vomiting and abdominal pain (χ2 =1.07,1.87,0.90,1.51,2.88 , all P >0 .0 5 ) .The improvement rate of life quality of the observation group was 76.67%,which was significantly higher than 50.00%of the control group,the difference was significant (χ2 =8.06,9.31,all P<0.05).Conclusion Intra-abdominal beacizumab bead sheet resistance combined with hyperthermic intraperitoneal chemotherapy has remarkable curative effect in treatment of ovarian cancer peritoneal effusion,with high safety,and can significantly improve the quality of life of patients,that is suitable for clinical application.

This study was aimed to investigate effects of Er-Xian (EX) decoction in follicular granulosa cell apoptosis in chemotherapy-induced premature ovarian failure (POF) of rats. SD rats were randomly divided into the normal group, model group, positive group and EX decoction group. Intraperitoneal injection of cisplatin was used in the establishment of chemotherapy-induced POF rat model. Intragastric administration of corresponding medication was give to each group for four weeks. The general conditions of rats were observed. The serum contents of E2, FSH, LH and Pro were determined. The ovarian tissue morphology was observed. Granulosa cell apoptosis was analyzed by TUNEL. The expressions of BAX, Bcl-2 and VEGF protein were detected by immunohistochemistry. The results showed that in the model group, the body weight decreased with disordered estrous cycle. After treatment, the weight gained, and the estrous cycle recovered. Compared with the normal group, in the model group, E2 decreased, FSH and LH levels increased. There was no significant difference in the content of progesterone among different groups. Detection of TUNEL showed that the positive expression in the model group was increased compared with the normal group (P < 0.05). The positive expression of EX decoction group was reduced compared to the positive group (P < 0.05). Compared with the normal group, the expression of BAX was obviously increased and Bcl-2 was decreased in the model group. After EX decoction treatment, the expression of BAX was decreased and the Bcl-2 was increased compared to the model group. The expression of VEGF protein in the model group was obviously less than that in the normal group. It was concluded that cisplatin can induce follicular granulosa cell apoptosis, and cause premature ovarian function recession. EX decoction can adjust the content of different hormones in serum, alter expression of apoptosis related protein to reduce the damage of cisplatin on ovarian follicular development, in order to promote follicular development, improve and enhance the ovarian function.

Objective: To observe the efficacy of mild moxibustion combined with arthroscopic meniscal repair in the treatment of meniscal injury and to explore its action mechanism. Methods: Ninety-eight patients with meniscal injury were divided into a surgery group and a moxibustion plus surgery group by the random number table method, with 49 cases in each group. Both groups received arthroscopic meniscal repair, and the moxibustion plus surgery group was treated with add-on mild moxibustion. The Lysholm score, visual analog scale (VAS) score, and mobility of the affected knee were measured before and after treatment, and transforming growth factor (TGF)-β1 and platelet-derived growth factor (PDGF) levels were measured in the fluid of the affected knee joint. The healing of the meniscus was recorded at a follow-up visit 3 months after the surgery. Results: After treatment, the Lysholm score increased, the VAS score decreased in both groups, and the intra-group differences in both groups were statistically significant (P<0.05). The Lysholm score was higher in the moxibustion plus surgery group than in the surgery group, and the VAS score was lower in the moxibustion plus surgery group than in the surgery group. The differences between groups in both scores were statistically significant (P<0.05). The mobility of the affected knee joint increased in both groups (P<0.05), and it was greater in the moxibustion plus surgery group than in the surgery group (P<0.05). When compared with pretreatment, the levels of TGF-β1 and PDGF in the fluid of the knee joint increased in both groups (P<0.05), and the levels of TGF-β1 and PDGF in the fluid of the affected knee joint were higher in the moxibustion plus surgery group than in the surgery group (P<0.05). The healing of the meniscus in the moxibustion plus surgery group was significantly better than that in the surgery group at the follow-up visit 3 months after the surgery (P<0.05). Conclusion: The effect of mild moxibustion combined with arthroscopic meniscal repair is better than the surgery alone in improving knee function, relieving pain, increasing mobility of the affected knee, and promoting meniscal healing, which may be related to the up-regulation of TGF-β1 and PDGF levels in the fluid of knee joint.

Objective To investigate the usefulness of acoustic radiation force impulse (ARFI) elastography for noninvasive evaluation of liver fibrosis in rats.Methods A total of 70 male Wistar rats were included in the group for dimethylnitrosamine (DMN)-induced liver injury,and 10 saline-injected rats were used as normal control.Hepatic injury was induced by a single intraperitoneal injection of DMN at a dose of 50 mg/kg of body weight.Several rats in the group with DNM injected and the normal control group were randomly selected and sacrificed at each of the following post-injection time:day 5,7,10,14,21,24,and 28.And their livers were taken for pathology analysis.All the rats underwent ARFI elastography before sacrificed in order to acquire a shear wave velocity (Vs) to represent liver stiffness.Correlation between Vs and the histological finding was analysed.ResultsAmong 58 successfully modeled rats,9,13,14 and 12 rats were found to be with S1,S2,S3 and S4 of liver fibrosis pathologically,respectively.And 10 rats were found to be with severe inflammatory activity without any fibrosis.Values of Vs increased with the stage of liver fibrosis ( P ＜0.05).There was a significant correlation between Vs and stage of liver fibrosis ( r =0.947,P =0.000).The areas under ROC curve for the diagnosis of fibrosis S≥S1,S≥S2,S≥S3 and S=S4 were 0.983,0.995,0.999 and 0.964,respectively;for the cutoff values of Vs were 1.59 m/s,2.13 m/s,2.33 m/s and 2.51 m/s,respectively,the sensitivity was 95.8％,92.3％,100％ and 84.6％,and specificity was 100％,100％,96.9％ and 95.6％,respectively.The values of Vs in the group with severe inflammatory activity were significantly higher than those in the control group ( P =0.000).ConclusionsARFI has a relatively high value in the evaluation of liver fibrfosis in rats,while severe inflammatory activity may affect its accuracy.

Objective To investigate the features of quantitative analysis and parametric imaging of contrast-enhanced ultrasound (CEUS) in renal clear cell carcinoma (ccRCC).Methods Ninety-seven pathologically confirmed ccRCCs underwent conventional ultrasound and CEUS.Both quantitative parameters and dynamic vascular pattern (DVP) reconstructure were analyzed with Sonoliver software.Four types of DVP curves were described with type Ⅰ (Unipolar +),type Ⅱ (Bipolar + /-),type Ⅲ (Bipolar -/+) and type Ⅳ (Unipolar-),while the DVP parametric images,similarly,were divided into four types,with type Ⅰ,Ⅱ,Ⅲ and Ⅳ,respectively.Results As for the parameter of CEUS,there were statistical differences in maximum intensity (IMAX),area under the curve (AUC) and mean transit time (mTT) (P ＜0.05) and no statistic differences in rise time (RT) and time to peak (TTP) between ccRccs and peripheral renal parenchyma.Concerning of DVP of ccRCCs,type Ⅰ,Ⅱ,Ⅲ and Ⅳ accounted for 58.8％ (57/97),11.3％ (11/97),10.3％ (10/97) and 19.6％ (19/97) respectively.As for each type in DVP parametric images,the percentages were 58.8％ (57/97),11.3％ (11/97),8.2％ (8/97),21.7％ (21/97),respectively.Conclusions Quantitative analysis and parametric imaging can depict different features of vascularity in ccRCCs and improve the diagnosis of the tumors.

ObjectiveTo investigate the capacity and diagnostic value of various MRI seguences in patients with trigeminal neuralgia.Methods MR images of 60 patients with trigeminal neuralgia were analyzed retrospectively.The sensitivity,specificity and diagnostic value of various MRI sequences were evaluated comparing with clinical data and operation results.All patients were scanned with conventional sequences including SE-T1WI,T2WI,FLAIR of head.Among them,9 cases were injected with contrast agent,49 cases were scanned with 3D-TOF and 3D-TSE sequences on cerebellopontine angle additinally.The sensitivity,specificity and accuracy of the 3D-TOF and 3D-TSE sequences were analyzed by using the x2 test.Results Six cases with tumor,3 cases with radiculitis and meningitis,1 case with multiple sclerosis and 1 case with pons infarction were diagnosed by conventional MR sequences.MRI of 49 cases with 3D-TOF and 3D-TSE showed neurovascular compress proved by operation.The sensitivity,specificity and accuracy of 3D-TOF and 3D-TSE were 95.3％ (41/43)vs.95.6％ (43/45),66.7％ (4/6)vs.50.0％(2/4) and 91.8％ (45/49)vs.91.8％ (45/49),and no significantly difference was found between the two sequences (x2 =0.13,0.19 and 0.17,P ＞0.5).ConclusionsMRI plays an important role in displaying the causes and diagnosis of trigeminal neuralgia.The conventional head MR sequences should be recommended for diagnosis of secondary TN caused by tumor and inflammation et al,and further 3D-TOF and 3D-TSE with high sensitivity and accuracy should be applied in patients with primary TN to display the neurovascular relationship.

OBJECTIVE:To provide reference for promoting rational use of essential medicines. METHODS:Combined with the actual situation of our hospital,a set of risk prevention and control system on essential medicine was constructed on the basis of relevant laws and regulations and support of information,and then implemented. RESULTS:The implementation of the system greatly promoted cognition of all medical staffs on reasonable,economical and safe use of essential drugs,standardized medication behavior and improved essential medicine use more reasonable. After the implementation of risk prevention and control system on essential medicines,medicine ratio of whole hospital decreased from 34.62% to 32.64%,inpatient medicine ratio decreased from 33.02% to 27.89%;essential medicine ratio of whole hospital rose from 31.22% to 43.34%,inpatient essential medicine ratio in-creased from 23.46%to 39.17%;the proportion of outpatient antibiotics prescriptions decreased from 15.04%to 13.46%,the utili-zation of inpatient antibiotics decreased from 62.11% to 48.47%. Various early warning were sent out 104 times in total,and 23 medical staff were punished due to irrational drug use. The prescription form and rationality of drug use were improved gradually. CONCLUSIONS:The construction of risk prevention and control system on essential medicine is one of the keys to the success of health care reform. It is suggested to make full use of thesystem+technologymeans,establish long-term mechanism for risk pre-vention and control,and constantly improve the system.