Epistaxis ; diagnosis ; etiology ; Hemophilia B ; complications ; diagnosis ; Humans ; Male ; Young Adult

Antitussive Agents ; poisoning ; Child, Preschool ; Dextromethorphan ; poisoning ; Humans ; Male

Objective To understand the risk of heterotopic pregnancy when intrauterine pregnancy and abdominal pain co-exist. Methods and results We report a patient with heterotopic pregnancy in a naturally occurring pregnancy; she also had high risks for secondary infertility. At gestational week 13 she had hemorrhagic shock due to intrauterine pregnancy complicated with rupture of tubal pregnancy; salpingectomy was performed via open operation. The intrauterine pregnancy was uneventful after operation, and a healthy baby was delivered through cesarean section at 37+2 weeks due to placental previa. Conclusion Heterotopic pregnancy usually occurs in women receiving assisted reproductive technology, but it can also happen in natural conception when there are high risk factors. Satisfactory outcome can be obtained in patients with heterotopic pregnancy, rupture of tubal pregnancy, and hemorrhagic shock, if prompt measures and supporting treatment can be given.

Abscess ; complications ; Adult ; Brain Abscess ; complications ; Female ; Humans ; Meningocele ; complications ; Nasal Cavity ; pathology ; Nose Diseases ; complications

Objective To investigate the distribution of acquired carbapenemases in carbapenemresistant strains of Klebsiella pneumoniae, and explore its role in epidemiology of nosocomial infection. Methods From November 2008 to March 2009, twenty clinical isolates of carbapenem-resistant Klebsiella pneumoniae were collected from children hospitalized in Wuhan children's hospital. MICs of antibiotics were tested by DNA of Klebsiella pneumoniae. Modified Hodge test was used to screen strains producing carbapenemases,combined imipenem(IPM)-EDTA , meropenem(MEM)- EDTA and ceftazidime(CAZ) - EDTA double-disk synergy test (DDST) were used to detect metallo-β-lactamase-producing. PCR amplification of the carbapenemase and integrase genes, and sequencing were performed. Plasmid conjugation transfer experiments and Southern hybridization were applied to study the mode of drug resistance transmission. Results Four types of Klebsiella pneumoniae were detected by PFGE, type A consisted of 5 strains, including 3 strains of type Al and 2 strains of type A2), type B (2 strains), type C (12strains) and type D (1 strain). Type A and C were the main drug resistant clones. Eight strains of Klebsiella pneumoniae carried both KPC-2 and IMP-4 genes, 10 strains carried IMP-4 gene, 2 strains carried KPC-2 gene. None of NDM-1 ,GIM, SPM, SIM, OXA-23, and VIM carbapenemase genes was detected in 20 isolates. All of 20 isolates carried lntl which were found to be located on bacterial chromosome by Southern blot. Conclusions KPC-2and IMP-4 genes are the major carbapenemase genes in Klebsiella pneumoniae isolated in Wuhan.Transmission of drug resistance is mainly through vertical transmission of type C resistant clone and horizontal transmission of Intl on bacteria chromosome.

Objective To investigate the molecular epidemiology of CRAB isolated from children in wuhan. Methods Forty non-repetitive strains of CRAB were collected from hospitalized children of emergency department, neonatal medicine, cardiothoracic surgery, bone surgery, respiratory medicine and renal medicine in Wuhan children's hospital during December 2008 and May 2009. MIC values were PFGE; KPC, IMP, GIM, SPM, SIM, OXA-23, VIM genes and integrase gene were amplified by PCR and then sequenced to confirm the genotypes.; Plasmid conjugation experiment was used to study the transfer method of bacterial resistance and southern blot hybridization was used to target the resistance genes. Results Susceptible rates of 40 strains to gentamicin, tobramycin, amikacin, ciprofloxacin, levofloxacin, trimoxazole were 20%, 5%, 93%, 93%, 95%, and 23% respectively. Eleven types of clone were detected by PFGE,including 29 strains of type A clone, 2 strains of type B clone, and 1 strain for each type of C to K clone. Eleven isolates produced both IMP-4 and OXA-23 carbapemase. Twenty-six isolates only possessed OXA-23 carbapemase. Thirty-six strains carried class Ⅰ integron. The results of southern blot hybridization showed that Intl, IMP-4 and OXA-23 type were located on chromosome. Conclusions Type A clone of CRAB is the most common. OXA-23 and IMP-4 type are the major acquired carbapemases, especially the OXA-23 is the most common type. The horizontal transmission of OXA-23 and IMP-4 gene mediated by Int1 and the spread of type A resistant clone is the major way of the spread of carbapenem-resistant Acinetobacter baumannii in the region.

Objective To observe the clinical efficacy of Jianpi Huatan Decoction plus Zhongwan (RN12) moxibustion on patients of mild to moderate stable chronic obstructive pulmonary disease (COPD) with syndrome of qi deficiency of lung and spleen, and analyze the related influencing factors. Methods With prospective randomized clinical trial, 140 cases of mild to moderate stable COPD were randomized into two groups (70 cases for each group). Treatment group was treated by Jianpi Huatan Decoction plus Zhongwan moxibustion based on western medicine, and control group was only treated by western medicine. Both groups were treated for 12 weeks and followed up for 12 weeks. Scores of clinical symptoms and quality of life questionnaire were examined, and multiple logistic regression analysis was used to find possible impacting factors on the effect. Results Symptoms were significantly alleviated after treatment (P<0.01) in both groups. The clinical effects and quality of life in treatment group were significantly improved than the control group (P<0.01). There were no significant changes in life quality of control group ( P>0.05). Multiple logistic regression analysis showed that different therapies and severity of COPD were the major influencing factors of clinical effect (P<0.05, P<0.01). Conclusion Jianpi Huatan Decoction plus Zhongwan moxibustion had significant therapeutic effect on mild to moderate stable COPD patients with syndrome of qi deficiency of lung and spleen by alleviating symptoms and improving quality of life. Treatment style and severity of COPD are the main influencing factors.

Objective To observe the effect of acupoint thread-embedding at Neiguan (PC6) and Zusanli (ST36) on anxiety and sleep disorders after heroin withdrawal. Method Sixty-seven patients with heroin addiction were randomized into a Neiguan group (25 cases), a Zusanli group (22 cases) and a Neiguan plus Zusanli group (20 cases), to receive corresponding treatments once every 20 d, for 4 sessions in total. The Self-rating Anxiety Scale (SAS) and Pittsburgh Sleep Quality Index (PSQI) were adopted to observe the anxiety and sleep condition before and after the treatment. Result After 60 d thread-embedding treatment, the total and standard SAS scores, sleep initiation time and total PSQI score were significantly decreased in the 3 groups (P<0.05), and the sleep durations were significantly extended (P<0.05); in comparing the improvement of anxiety, Neiguan plus Zusanli group > Neiguan group >Zusanli group (P<0.05); in comparing the improvement of sleep, Neiguan plus Zusanli group was superior to both Zusanli group and Neiguan group (P<0.05), while there was no significant difference between Zusanli group and Neiguan group (P>0.05). Conclusion It's effective to use thread-embedding at Neiguan and Zusanli independently or together for anxiety and sleep disorders after heroin withdrawal, but the efficacy is more significant when the two points are used in combination, indicating the synergy of acupoints.

In theory teaching,we let students know the knowledge of some important discovery and invention in the history of physiology and while in experiment teaching,we added the experiments designed by students in addition to traditional experiments,so as to enhance the students,ability of innovation.

OBJECTIVE To intensify the management of the acupuncture department and prevent and control nosocomial infection.METHODS During the course of the management of the acupuncture department,the causes of nosocomial infection were found through analyzing the possible reasons of nosocomial infection and a series of relevant measures were taken to improve the control of nosocomial infection.RESULTS In order to control nosocomial infection in acupuncture department we needed to strength the disinfection management in the following aspects:air in the room,medical procedures and implement,medical staff hands and medical disposals.CONCLUSIONS Strict management is the important measures to reduce the nosocomial infection.