Objective To evaluate clinical efficacy and safety of single puncture and irrigation with Mammotome system in treatment of lactational breast abscess without drainage. Methods 32 patients with lacta-tional breast abscess were treated with ultrasound-guided puncture and irrigation by Mammotome system. Pus was cleared and necrotic material was removed. The residual cavity was irrigated with 3% hydrogen peroxide solution and Kangfuxin solution and no drainage was placed. Breast-feeding on time was encouraged. Results All pa-tients were successfully treated with single puncture and irrigation. The average length of hospital stay was 4 days. Except for 3 cases actively requesting to stop lactating, the other 29 patients continued to breast-feed. There was one case with postoperative hematoma, one with wound granuloma, and no other complications occurred. There was no relapse during the follow-up of 3 to 36 months. All patients were satisfied with the appearance of the breasts. Conclusions Single puncture and irrigation with Mammotome system without drain placement is a safe procedure in treatment of lactational breast abscess with the advantage of minimal invasion, low complication and does not affect breastfeeding.

Objective To observe the effect of Naoxintong capsule on blood lipid and hemorheology in the treatment of type 2 diabetes mellitus patients complicated with cerebral infarction with Qi deficiency and blood stasis type.Methods From February 2015 to February 2017,96 type 2 diabetes mellitus patients complicated with cerebral infarction with Qi deficiency and blood stasis type who treated in the Traditional Chinese Medicine Hospital of Tongxiang were selected in the research.The patients were randomly divided into two groups according to the digital table,with 48 cases in each group.The control group was treated with routine treatment scheme,while the observation group was added Naoxintong capsule.The blood lipids and hemorheology data before and after treatment were compared between the two groups.Results After treatment,the levels of LDL-C,TG,TC and HDL-C in the observation group were (1.8 ± 0.3) mmol/L,(0.9 ± 0.4) mmol/L,(2.1 ± 0.4) mmol/L,(1.6 ± 0.7) mmol/L,respectively,which were lower than those in the control group [(2.2 ± 0.4) mmol/L,(1.2 ± 0.6) mmol/L,(2.3 ± 0.3)mmol/L,(1.3 ±0.4) mmol/L] (t =5.54,2.88,3.18,2.58,all P ＜0.05).The HCT,ESR,EEP,Fig in the observation group were (41.5 ± 1.3) ％,(16.5 ± 2.1) mm/h,(292.1 ± 18.3) s,(7.6 ± 0.4) g/L,respectively,which were lower than those in the control group[(45.6 ± 1.4)％,(21.1 ± 3.2)mm/h,(332.3 ± 19.2)s,(8.2 ± 0.3) g/L] (t =14.87,8.33,10.50,8.31,all P ＜ 0.05).Conclusion Naoxintong capsule is effective in the treatment of type 2 diabetes mellitus patients complicated with cerebral infarction with Qi deficiency and blood stasis type,and can effectively improve the related indicators of blood lipids and hemorhelogy and stabilize the carotid artery plaque,it is worthy of clinical application.

Objective To investigate the multi-drug resistance of Klebsiella strains and its mechanism.Methods Twenty strains of Klebsiella were isolated from the Affiliated Hospital of Medical College,Ningbo University from October 2009 to March 2011,in which 18 isolates were Klebsiella pneumonia and 2 were Klebsiella planticola. Drug sensitivity was determined by K-B tests. Drug resistant genes gyrA,parC (chromosome mediated) and aac( 6′)-I b-Cr,qnrA,qnrB,qnrS,qepA (plasmid mediated) were amplified by PCR and verified by direct automated fluorogenic sequencing. Results Resistance to β-1actams,aminoglycosides and quinolones was observed in 20 strains,and resistant rates were all above 80％.Klebsiella planticola strains were sensitive to imipenem and meropenem.Mutations of gyrA and parC genes existed in 18 strains (90％),and the positive rates of aac (6') -I b-C r,qnrB and qnrS were 60％ (12/20),20％ (4/20) and 20％ (4/20),respectively.Conclusion The mutations ofgyrA and parC genes may be the main cause of the resistance to quinolones in these strains.

OBJECTIVE: To establish a method for the determination of aesculin and aesculetin in Jiuxiang zhixie tablets.METHODS: HPLC method was developed to quantitative determination.Thermo C18(250 mm?4.60 mm,5?m) column was adopted.The mobile phase consisted of acetonitrile-0.1%H3PO4(12 ∶ 88)with flow rate of 1.0 mL?min-1 and the detection wavelength of 334 nm.The column tempreture was set at 30℃.RESULTS: The linear range of aesculin was 80～800 ng(r=0.999 8).The average recovery was 100.1%(RSD=1.89%,n=9).The linear range of aesculetin was 32.96～329.6 ng(r=0.999 5).The average recovery of aesculetin was 101.5%(RSD=2.42%,n=9).CONCLUSION: The method is simple,accurate for the content determination of Jiuxiang zhixie tablet.

OBJECTIVE: To establish a HPLC method for the determination of Paeonol in Yuxianling granules. METHODS: The determination was performed on Phenomenex C18-ODS with mobile phase consisted of methanol-water (60∶40) at a flow rate of 1.0mL?min-1. The detection wavelength was set at 274nm. RESULTS: The linear range of Paeonol was 8.24～41.20?g?mL-1(r=0.999 7). The recovery was 99.50% (RSD=1.12%). CONCLUSION: The established method is simple, rapid, sensitive, accurate, stable and reproducible, and suitable for the determination of the content of paeonol in Yuxianling granules.

Objective To standardize the management of narrative pharmaceutical documents,and to promote the standardization of narrative pharmaceutical services.Methods With the help of PaaS cloud computing technology design and development,and with the help of OpenAI technology,narrative material writing and narrative communication activities were assisted.Results The functions of narrative prescription,management of narrative activities,narrative writing and parallel medical records were realized and the resource database of narrative materials was established.Conclusion PaaS cloud computing technology has the advantages of rapid deployment and development of narrative pharmaceutical management forms,and it is combined with OpenAI technology.It can help clinical pharmacists quickly complete the search and writing of clinical cases and narrative materials,and greatly improve the efficiency of narrative pharmaceutical services.

Objective:To explore the mechanism of Xijiao Dihuang Ddecoction (XJDHT) against sepsis-induced liver injury based on transcriptomics.Methods:Sixty C57BL/6 mice were randomly (random number) divided into the sepsis group, sepsis treatment with XJDHT and control group, with 20 mice in each group. The sepsis mouse model was established by intraperitoneal (i.p.) injection of lipopolysaccharide (LPS). The control group was intraperitoneally injected with the same amount of normal saline. The sepsis treatment with XJDHT group was injected with XJDHT (crude drug 187.5 mg) twice a day 2 days before modeling. After modeling, gastric feeding was continued twice a day, while the control group and sepsis group were gavaged with the same amount of normal saline. At 72 h after LPS intervention, 9 mice in each group were randomly selected. After anesthesia, part of the liver were taken for small RNA and RNA sequencing and analysis, and part of the liver were taken for pathological examination.Results:XJDHT could improve the histopathological changes of liver in septic mice, and alleviate some abnormally expressed microRNAs (mmu-mir-292a-5p, mmu-mir-871-3p, mmu-mir-653-5p, mmu-mir-293-5p, mmu-mir-155-3p, mmu-mir-346-5p, mmu-mir-187-5p, mmu-mir-3090-3p) and their target genes.Conclusions:XJDHT can reduce the liver histopathological changes in septic mice, and its mechanism may be related to XJDHT regulating the expression of important key genes of liver of sepsis like mmu-mir-187-5p and its target genes such as ADAM8, irak3 and PFKFB3

Objective To explore the applicable conditions of the Cox-TEL(Cox PH-Taylor expansion adjustment for long-term survival data)method for analysis of survival data that contain cured patients.Methods The simulated survival data method based on Weibull distribution was used to simulate and generate the survival data with different cure rates,censored rates,and cure rate differences.The Cox-TEL method was used for analysis of the generated simulation data,and its performance was evaluated by calculating its type I error and power.Results Almost all the type I error of the hazard ratios(HRs)obtained by the Cox-TEL method under different conditions were slightly greater than 0.05,and this method showed a good test power for estimating the HRs for data with a large sample size and a large difference in proportions(DPs).For the data of cured patients,the type I error of the DPs obtained by the Cox-TEL method was well around 0.05,and its test power was robust in most of the scenarios.Conclusion The Cox-TEL method is effective for analyzing data of uncured patients and obtaining reliable HRs for most of the survival data with a sample size,a low censored rates,and a large difference in cure rates.The method is capable of accurately estimating the DPs regardless of the sample size,censored rates,or the cure rates.

Objective To investigate the effect of modified controllable lateral prone position in thoracoscope resection of esophageal carcinoma. Methods From December 2011 to December 2013, 200 cases of esophageal cancer patients treated by thoracoscope resection were randomly divided into observation group and control group, with 100 cases each. Observation group adopted the modified controllable lateral prone position, and the control group was given the traditional lateral position. The different postures of the skin pressure situation, operation field exposure, anesthesia cost and doctors′ satisfaction and so on were compared between two groups. Results The incidence of skin complications, operation time, anesthesia cost in the observation group were 4. 0%, (78 ± 20) min and (1 812 ± 490) RMB, respectively, which were significantly lower than those in the control group (χ2/t=4. 348,-13. 929,-3. 683, respectively;P<0. 05). The doctor satisfaction of the observation group was 99% which was significantly higher than 93% of the control group (χ2 =4. 688, P<0. 05). Conclusions The modified controllable lateral prone position can fully expose the operation field during thoracoscope resection of esophageal carcinoma, reduce the operation time, make sure patients safety and comfort, reduce the skin complications, decrease the cost of anesthesia, so it is worthy of clinical popularization and application.

Objective To study the effect of age-related white matter changes (ARWMC) on first symptomatic ischemic stroke events in the oldsters. Methods For the prospective study, a total of 368 eligible oldsters were enrolled in the study from January 2010 to August 2012. The degrees of ARWMC were assessed by ARWMC scale;according to the scores, they were divided into non ARWMC group, mild-moderate ARWMC group and severe ARWMC group. The patients were followed up once every 3 months. The clinical endpoint events and time (first symptomatic ischemic stroke, myocardial infarction and all-cause death) were recorded. Analyses of variance and Chi-square test were used to compare the differences of clinical data among the 3 groups. COX regression was used to assess the risk differences of first symptomatic ischemic stroke in the oldsters of three groups. Results After an average of follow-up for 48.7 months, 50 participants (13.6％) had first symptomatic ischemic stroke;25 (25.8％) were categorized as the severe ARWMC group, 22 (10.9％) were as the mild-medium group, and 3 (4.4％) were as the non ARWMC group. Among the three groups, the differences in age, history of hypertension, systolic blood pressure, incidence of clinical endpoint events and first symptomatic ischemic stroke, and follow-up time of endpoint events were statistically significant (P<0.05); patients from the severe ARWMC group were the oldest, and had the longest history of hypertension, the highest systolic blood pressure, the highest incidence of clinical end events and first symptomatic ischemic stroke, and the shortest follow-up period for clinical end events. COX regression analysis showed that the risk of first symptomatic ischemic stroke in the severe ARWMC group was about 8 times higher than that in the non ARWMC group (hazard ratio=9.012, 95％CI: 2.310-35.154, P=0.002). Conclusion In oldsters, severe ARWMC often accompany hypertension history and poor blood pressure controll, and it is an independent and serious risk factor for long-term first symptomatic ischemic stroke.