Objective To investigate the treatment effect of gonadotropin releasing hormone agonist and oral contraceptive on endometriosis diseases.Methods One hundred and eighty-six cases with endometriosis who were hospitalized in Traditional Chinese Medicine Hospital of Fangshan District of Beijing from Jan.2012 to Dec.2012,were randomly divided into control group (93 cases) and observation group (93 cases).Patients in control group were given Marvelon by oral from the first day of menstruation after operation to 6 months,1 tablet/day,and patients in observation group were given Marvelon combined with Zoladex after laparoscopic conservative treatment (3.6 ml subcutaneous injected Zoladex from the first week after operation,4 weeks/time,3 times).The total subjective symptom scores,efficacy rate,Pregnancy rate and adverse reaction were calculated and recorded.Results Subjective symptom score of observation group was (0.91 ± 0.32),significantly lower than that of the control group (1.64 ± 0.74 ; t =8.73,P ＜ 0.01).The efficiency rate in observation group were 95.70％ (89/93) was significantly higher than that in control group(82.80％ (77/93) ;t =4.328,P ＜0.05).Adverse reactions rate and reoccurrence in observation group were 4.30％ (4/93) and 3.23％ (3/93),lower than that of the control group(16.13％ (15/93) and 10.75％ (10/93) ; x2 =4.854,5.168 ; P ＜ 0.05).After treatment,the pregnancy rate in infertile patients of observation group the was 85.71％ (12/14),significantly higher than that of the control group (61.54％ (8/13),x2 =3.987,P ＜ 0.05).Conclusion Gonadotropinreleasing hormone agonist combined contraceptive is worthy of recommendation due to alleviating clinical symptoms,reducing adverse reactions occur,the relapse rate and improving the chances of conceiving infertility patients.

Objective To understand multidrug-resistant organism (MDRO) healthcare-associated infection(HAI) in patients with malignant tumor, so as to provide basis for making HAI prevention and control measures.Methods Targeted surveillance method was used to survey MDRO HAI in patients with malignant tumor in a hospital from January 1 to December 31, 2014, WHONET 5.3 software was used to analyze the data.Results A total of 54 056 patients with malignant tumor were surveyed, HAI occurred in 3 542 (6.55%) patients, 847(23.91%)of which were MDRO HAI.Most patients(54.55%) with MDRO HAI were >60 years old.A total of 2 606 bacterial strains were isolated from patients with HAI, 847 (32.50%) of which were MDROs, and most were extended-spectrum beta-lactamases (ESBLs)-producing Escherichia coli (n=459, 54.19%).The major site of MDRO HAI was lower respiratory tract (47.34%).The top 3 departments of detection of MDROs were departments of thoracic surgery(17.12%), colorectal and anal surgery(9.92%), and general surgery (8.26%).Conclusion Incidence of MDRO HAI is higher in patients with malignant tumor, surveillance of high risk population and monitoring of antimicrobial resistance of pathogens should be strengthened, so as to reduce the occurrence of HAI.

OBJECTIVE:To improve the quality and efficiency of ADR monitoring in hospital for the convenience of reporters and ADR monitoring personnel.METHODS:Combined with the characteristics of hospital information system,computer technology such as network,ASP.NET programming language,SQL server 2005 database and data transformation were used to develop and apply ADR monitoring system based on hospital local area network.RESULTS:The ADR reporting quality has been improved and the quantity of ADR reports increased markedly and was kept stable.CONCLUSION:The system contributed to a informationalized and networking administration of ADR reporting,and it improved ADR reporting level thus deserving to be recommended.

OBJECTIVE To analyze the values of drug-resistant Pseudomonas aeruginosa pneumonia in the older patients using thymosin ?1 combined with Sulperazone.METHODS The thirty five older patients with drug-resistant P.aeruginosa pneumonia were divided into two groups,one group was treated with thymosin ?1 combined with Sulperazone,the other group was treated with Sulperazone alone.We observed the changes in clinical symptom of the patients,results in culture of sputum,routine blood test,C-reactive protein(C-RP),albumin,pre-albumin,and T cell subset before and after drug use.RESULTS The clinical symptoms of the patients were improved,days of disappeared drug resistance of P.aeruginosa,reconverted normally days of routine blood test,decreased concentration of CRP,albumin,and pre-albumin reconverted to normalize,increased percent of CD4+,decreased percent of CD8+,CD4+ /CD8+ were more prominently reconverted to normalize in thymosin ?1 combined with Sulperazone treated group than in Sulperazone alone group.CONCLUSIONS Thymosin ?1 can improve immunological function,inflammation condition and protein metabolism.Its application with Sulperazone has a coordinated effect on drug-resistant P.aeruginosa pneumonia in the older patients.

Objective To investigate the effect of necrostatin-1 (Nec-1) on the expression of liver monocyte chemotactic protein-1 (MCP-1) in septic rats and its mechanism. Methods Forty-eight male Sprague-Dawley (SD) rats were randomly divided into sham group, model group, and Nec-1 group by randomized digital number method, with 16 rats in each group. The model of sepsis was reproduced by cecal ligation and puncture (CLP). Rats in sham group received anesthesia, and flipping the cecum followed by closure of the abdomen without ligation of the cecum. Rats in Nec-1 group were given 1 mg/kg Nec-1 [25 mg Nec-1 solution dissolved in 2.5 mL of dimethyl sulfoxide (DMSO)] through caudal vein 30 minutes before operation, while the rats in model group were given 0.1 mL/kg of DMSO only. Blood from abdominal aorta and liver tissue in each group were collected at 0 hour and 8 hours after operation. Serum alanine aminotransferase (ALT) and aspartate aminotransferase (AST) were determined with automatic biochemistry analyzer. The pathological changes in liver were observed under light microscope using hematoxylin-eosin (HE) staining. The serum levels of tumor necrosis factor-α (TNF-α) and interleukin-6 (IL-6) were determined by enzyme linked immunosorbent assay (ELISA). The MCP-1 mRNA expression in the liver was determined by reverse transcription-polymerase chain reaction (RT-PCR). Results There was no significant differences in the levels of serum ALT, AST, TNF-α, IL-6 and expressions of liver MCP-1 mRNA at 0 hour among three groups, and the liver cellular structure was normal. At 8 hours, compared with sham group, the expressions of serum ALT, AST, TNF-α, IL-6 and liver MCP-1 mRNA were significantly increased in model group and Nec-1 group [ALT (U/L): 172.35±21.88, 129.67±18.20 vs. 60.04±11.74, AST (U/L): 511.03±34.92, 363.51±25.25 vs. 254.83±31.04, TNF-α(ng/L): 603.96±24.18, 483.87±26.60 vs. 265.74±15.14, IL-6 (ng/L): 975.62±65.37, 712.09±45.47 vs. 310.42±13.88, MCP-1 mRNA (2-ΔΔCt): 7.09±0.18, 5.51±0.45 vs. 0.99±0.06, all P < 0.05]. Levels of the above parameters in Nec-1 group at 8 hours were significantly decreased compared with those of model group (all P < 0.05). Under light microscopy, it was noted that the structure of hepatic lobules was destroyed, with exacerbation of immunocyte infiltration at 8 hours in model group. At 8 hours, it was found that Nec-1 alleviated the pathological damage in Nec-1 group. Conclusion Nec-1 can protect the liver of rats with sepsis, lower the expression of serum TNF-α and serum IL-6 and liver MCP-1 mRNA, and obviously reduce the damage of inflammation.

Objective To investigate the clinical characters of death in AIDS patients with Penicilliosis marneffei (PSM), improving the diagnosis and treatment of PSM. Methods Retrospectively analyze the data of 27 AIDS patients died of PSM from January 2009 to December 2011 and review the relevant literatures in the past several years. Results The etiology diagnosis time ranged from 4 to 7 (4.9 ± 1.4) days from admission. There were 22 (81.5%) cases complicated with septic shock and 25 (92.6%) cases complicated with metabolic acidosis. There were 12 (44.4%) cases co-infected with pneumocyst pneumonia , 7 (25.9%) cases with TB. The main reasons accounting for the death were as follow:15(55.6%) cases died of septic shock, 5(18.5%) cases died of respiratory failure. Conclusion The death cases of AIDS patients with PSM showed the characters of relatively late etiology diagnosis and pathogenic therapy , mostly complicated with other opportunistic infections and often died of septic shock. Therefore, timely etiology diagnosis and earlier pathogenic therapy are the keys to treat the disease. Effectively controlling of the complications and co-infections may decrease the mortality.

ObjectiveTo investigate the pathogens and prognostic factors of AIDS-associated severe pneumonia. MethodsClinical data were collected from 95 patients with AIDS-associated severe pneumonia admitted to Guangzhou No. 8 People' s Hospital from January 2005 to December 2008. The pathogens of pulmonary infections were investigated. Univariate analysis and multivariate logistic regression analysis were performed to study the relationships between the outcome and influencing factors. Results The most prevalent pathogen was Pneumocystis jirovecii (64/95, 67.4％ ), followed by bacteria (61/95, 64.2％ ),fungi ( 50/95, 52. 6％ ), mycobacterium tuberculosis ( 27/95, 28. 4％ ) and cytomegalovirus ( CMV ) (25/95, 26.3％ ). Among 95 cases, monocontamination was detected in 15 cases ( 15.8％ ), while mixed infection in 80 cases (84. 2％ ). Logistic regression analysis showed that mechanical ventilation, higher serum lactic dehydrogenase (LDH) level and severe underlying diseases were risk factors for the death of AIDS-associated severe pneumonia, and higher serum albumin level was the protective factor. Conclusion Pneumocystis jirovecii, bacteria and fungi are the main pathogens for AIDS-associated severe pneumonia, and mixed infection is popular.

Objective:To analyze the clinical features of acquired immunodeficiency syndrome (AIDS) patients complicated with peripulmonary occupational lesions.Methods:Fifty-five AIDS patients with peripulmonary occupational lesions treated in Guangzhou Eighth People′s Hospital from January 2012 to January 2019 were included, and the clinical data of patients were retrospectively analyzed. According to the results of lung biopsy, the patients were divided into Mycobacterium infection group, fungal infection group and tumor group. The clinical characteristics, the proportion of different CD4 + T lymphocyte counts and chest computed tomography (CT) features of the three groups were compared. Chi square test was used for comparison among the three groups, and Bonferroni method was used to correct the test level for pairwise comparison. The significance level was 0.016 7 because of three pairwise comparisons. Results:Among 55 AIDS patients complicated with peripulmonary occupational lesions, pulmonary biopsy showed 14 cases with Mycobacterium infection, 12 cases with fungal infection and 15 cases with tumor lesions. Mixed diseases were found in 11 patients, including seven cases with Mycobacterium and fungus coinfection, four with tumor complicated with fungus and (or) Mycobacterium. Three with chronic interstitial pneumonia. The main clinical manifestations of 55 patients were fever, expectoration, fatigue, weight loss and superficial lymph node enlargement. There were no significant differences in symptoms/signs, white blood cell counts, hemoglobin levels, alanine transaminase and creatinine among Mycobacterium infection group, fungal infection group and tumor group (all P>0.05). There was significant difference in anti-retroviral therapy (ART) acceptance among the three groups ( χ2=15.165, P<0.01). However, the results of pairwise comparison between groups showed that there was significant difference between fungal infection group and tumor group ( χ2=7.514, P<0.016 7), while there was no significant difference between Mycobacterium infection group and tumor group, Mycobacterium infection group and fungal infection group ( χ2=0.255 and 5.306, respectively, both P>0.016 7). There were significant differences in clinical outcomes among the three groups ( χ2=15.119, P<0.01), and the pairwise comparison between the Mycobacterium infection group and the tumor group, and the fungal infection group and the tumor group showed significant differences ( χ2 =10.311 and 9.095, respectively, both P<0.016 7). The cases with CD4 + T lymphocyte count ≤50/μL, 51-<200/μL and ≥200/μL in Mycobacterium infection group were three cases, one case and 10 cases, respectively; those in fungal infection group were 10 cases, two cases and 0 case, respectively, and those in tumor group were one case, two cases and 12 cases, respectively. The difference was statistically significant ( χ2=21.284, P<0.01). Chest CT showed that there was significant difference in the types of space occupying lesions among the three groups ( χ2=13.308, P=0.003), and pairwise comparison between the two groups showed that there was significant difference between the Mycobacterium infection group and the tumor group ( χ2=11.312, P<0.016 7), while there were no significant differences between the Mycobacterium infection group and fungal infection group ( χ2=0.931, P>0.016 7), and the fungal infection group and the tumor group ( χ2=7.053, P>0.016 7). There was significant difference among the three groups in calcification focus ( χ2=8.524, P=0.004), while there was no difference between the Mycobacterium infection group and fungal infection+ tumor group ( χ2=10.982, P<0.016 7). Conclusions:Mycobacterium infection, fungal infection and tumor are the main types of peripulmonary occupational lesions in AIDS patients. The differential diagnosis could be made by combining with chest CT features, ART acceptance and CD4 + T lymphocyte level.

Objective To analyze the characteristics of opportunistic infection (OI) in patients with HIV/AIDS in Guangdong and the relationship between OI and the change in blood CD4+ T lymphocyte count (CD4+ ).Methods Seven hundred and sixty two patients with HIV/AIDS admitted were analyzed. Results Among all the 762 patients, 704 (92.39% ) had more than one kind of OI, with 1428 episodes totally.Etiologically, fungus infection (38.38% ) was most common, followed by bacteria (36.20% ), and virus (7.77% ) infection. Most OI occurred in the lungs (33.05% ), mouth (26.89% ), skin (10.29% ) and gastro-intestine (8.96% ).Septicemia and other systemic disseminated diseases accounted for 6.58% and 9.94% respectively.The incidence of OI in patients with CD4+= 200/μ1 (103/136, 75.74%) was significantly lower than that in patients with CD4+ <200/μ1 (601/626, 96.01%), P<0.01.All the AIDS defining OI were found in patients with CD4+ <200/μ1 Among them, 81.97% of patients with pneumonia carinii pneumonia (PCP), 71.43% of patients with cytomegalovirus retinitis and all the patients with cryptococcal meningitis, disseminated cryptococosis, disseminated histoplasmosis, mycobacterium avium intracellular complex (MAC), disseminated penicilliosis mameffei and toxoplasma cerebritis had the CD4+ less than 50/ μ1.Conclusions The most common OI in patients with AIDS in Guangdong area are fungi, bacterial and viral infections.Lung, mouth, skin, gastro-intestine and systemic disseminated infections are the most prevalent infections.As the CD4+ decreased, the incidence of OI especially AIDS defining OI increased. Dynamic detection of CD4+ will be of great help for the prediction, prevention, early diagnosis and treatment of OI in patients with AIDS.

Objective To study the pathogens and drug resistance profiles of pulmonary infection in patients with AIDS. Methods The pathogens and their drug susceptibility of pulmonary infection diagnosed by fibrobronchescopy-induced brunchoalveolar lavage fluid (BAI.F) culture and/or transbronchial biopsy in 116 AIDS cases were analyzed. Results Monopathogenic infection in lungs were detected in 18 cases(15.5%) and mixed infection in 98 cases ( 84.5%). Of the 116 cases, bacteria were present in 91 patients, fungi in 62, tubercle bacillus in 49, pneumocystis jiroveci in 29, and cytomegalovirus in 11.Ninety-five bacterial strains were isolated from BALF, mainly including Streptococci (34), coagulase negative Staphylococcus (20), Klebsiella pneumoniae (10) and Escherichia (7). The isolated bacteria were resistant to β-lactam, macrolides, quinolones and aminoglycosides, of which were 14 methicillin-resistant Streptococci (MRS) strains and 12 extended spectrum β-lactamases (ESBL) strains. Sixty-eight fungal strains were isolated, including 36 Candida mycodermas, 19 Penicilliums, 6 Aspergilli and 5 Mold fungi;they were sensitive to amphotericin B but resistant to fluconazol (5.6% -50. 0% ) and itraconazole( 10. 5%-60. 0% ). Conclusion Pneumonia in AIDS patients are usually caused by multiple pathogens,predominantly consisting of multiresistant bacteria and fungi. Therefore, antibiotics should be rationally chosen according to drug susceptibility test.