OBJECTIVE:To observe clinical efficacy and safety of tigecycline combined with isepamicin in the treatment of multidrug-resistant Acinetobacter baumannii pneumonia. METHODS:70 patients diagnosed as multidrug-resistant A. baumannii pneumonia were selected and randomly divided into control group and observation group,with 35 cases in each group. Both groups received routine treatment oxygen therapy or mechanical ventilation,anti-hypertension,hypoglycemic therapy. Control group was given Cefoperazone sulbactam for injection 3 g added into Sodium chloride injection 100 ml,ivgtt,qid. Observation group re-ceived Tigecycline for injection 100 mg,decreasing to 50 mg added into Sodium chloride injection 250 ml,ivgtt,bid,combined with Isepamicin sulfate injection 400 mg added into Sodium chloride injection 250 ml,ivgtt,qd. The time of body temperature re-turn to normal,pulmonary rale disappearance,chest X-ray shadow disappearance and leucocyte return to normal were observed in 2 groups as well as serum inflammatory factor level before and after treatment;total effective rate,bacterial clearance rate and ADR were compared between 2 groups. RESULTS:The time of body temperature return to normal,pulmonary rale disappearance, chest X-ray shadow disappearance and leucocyte return to normal in observation group were significantly shorter than in control group,with statistical significance(P<0.05). There was no statistical significance in serum inflammatory factor between 2 groups before treatment(P>0.05). The serum inflammatory factor of 2 groups decreased significantly after treatment,and the observation group was significantly lower than the control group,with statistical significance(P<0.05). Total effective rate and effective bacte-rial clearance rate of observation group were 85.7% and 82.9%,which were significantly higher than those of control group (62.9% and 60.0%),with statistical significance(P<0.05). There was no statistical significance in the incidence of ADR between 2 groups(P>0.05). CONCLUSIONS:Tigecycline combined with isepamicin is effective for multidrug-resistant A. baumannii pneu-monia,and can improve clinical symptom,control inflammation reaction,having high sterilization with good safety.

Objective To explore the value of CT quantitative analysis in differentiating lepidicGpredominant adenocarcinoma (LPA)from invasive nonGlepidicGpredominant adenocarcinoma (INV)manifested as subsolid nodules (SSN).Methods A total of patients with lung adenocarcinoma manifested as SSNs on CT images were divided into LPA group and INV group according to their pathological results.Total volume,solid volume,solid volume percentage,total mass,solid mass,solid mass percentage and threeGdimensional mean CT value of the nodules were calculated after segmenting pulmonary nodules by a 3DGCT segmentation software,meanwhile the oneGdimensional mean CT value and maximal diameter were manually measured.SPSS 22.0 software was used for statistical analysis. Results Solid volume (0.1 6 ±0.3 6 cm3 vs 1.2 6 ±2.1 7 cm3 ,P＜0.00 1),solid volume percentage (4.7 9 ±5.40% vs 2 6.3 3 ± 1 5.6 3%, P＜0.001),total mass (1 180.64±1 751.46 mg vs 2 386.59±3 224.54 mg,P＝0.010),solid mass (151.64±337.53 mg vs 1 257.34± 2 220.9 2 mg,P＜0.00 1 ),solid mass percentage (7.9 8 ± 8.5 8% vs 3 7.2 3 ± 1 8.83%,P＜0.00 1 ),threeGdimensional mean CT value (－492.26±71.21 HU vs －350.73±94.52 HU,P＜0.001 )and oneGdimensional mean CT value (－472.29 ± 1 12.46 HU vs －282.02 ± 1 5 9.13 HU,P＜0.001)in LPA group were found significantly lower than those in INV group.There were no significant differences in the maximal diameter and total volume between LPA group and INV group.Solid volume percentage and solid mass percentage were selected according to stepwise discriminant analysis.The accuracy of Bayes modes by using substitution method and cross validation method were 84.2% and 83.3%,respectively.Conclusion Solid volume percentage and solid mass percentage were important parameters for differentiating LPA from INV.Quantitative analysis of SSN was very helpful to preoperatively evaluate the subtypes and prognosis of lung adenocarcinoma by using 3DGCT segmentation technique.

Objective:To investigate whether the nutrition support team (NST) benefits esophageal carcinoma (EC) patients who are concurrently undergoing chemoradiotherapy. Methods: Between June 2012 and December 2013, 40 EC patients undergoing chemoradiotherapy were divided into the NST group and routine treatment (RT) group, with 20 patients in each group. At the end of chemoradiotherapy, the nutritional status, incidence of complications, and completion rates of radiotherapy were evaluated. The length of hospital stay (LOS) and cost were also compared between the two groups. Results:The nutrition and blood parameter values of the NST group were better (P<0.05) than those of the RT group. The incidence of complications was lower in the NST group (P<0.05) than that in the RT group. In addition, all patients in the NST group achieved the treatment plan, whereas five of the patients in the RT group interrupted or delayed the plan (P<0.05). The average LOS decreased by 3.8 d (P<0.05), and the hospitalization costs were reduced to 6300 RMB person-times (P>0.05) for the patients of the NST group. Conclusion: NST could maintain the nutritional status and improve the treatment compliance and tolerance of EC patients undergoing chemoradiotherapy, thereby shortening the LOS time and reducing the costs.

OBJECTIVETo observe the clinical effects of acupuncture combined with auricular point sticking based on the western medication for post stroke depression (PSD).

METHODSSixty patients with PSD were randomly assigned into an acupuncture plus auricular application group (a combination group) and a medication group, 30 cases in each one. 20 mg paroxetine hydrochloride was prescribed orally in the medication group, once a day for continuous 8 weeks. Based on the above treatment, 30-minute acupuncture was used in the combination group for 8 weeks at Baihui (GV 20), Sishencong (EX-HN 1), Shenting (GV 24), Yintang (GV 29), Shenmen (HT 7), Neiguan (PC 6), Taichong (LR 3), Hegu (LI 4), Zusanli (ST 36), Sanyinjiao (SP 6) and Fenglong (ST 40), once the other day and three times a week. Auricular point sticking therapy for 8 weeks was applied at shenmen (TF), pizhixia (AT), xin (CO), and gan (CO), with pressing 3 times a day and once 3-5 days. The total score and each factor scores of Hamilton's depression scale (HAMD) were observed in the two groups before and after treatment, and Asberg's antidepressant side-effect rating scale (SERS) and clinical effect were evaluated.

RESULTSAfter treatment, the total HAMD scores of the two groups decreased compared with those before treatment (both<0.05), with better effect in the combination group (<0.05). The scores of the combination group after treatment were lower than those in the medication group, including the anxiety/somatization factor, sleep disturbance factor, hopelessness factor (all<0.05). The total effective rate of the combination group was 86.7% (26/30), which was better than 66.7% (20/30) of the medication group (<0.05). The SERS score of the combination group was lower than that of the medication group (<0.05).

CONCLUSIONSAcupuncture combined with auricular point sticking can improve the clinical symptoms and are effective and safe for PSD.