Objective To profile the types of bacteria in bile culture and study their antibiotic sensitivity pattern in patients with varying de-grees of acute cholangitis and to provide data guidance for the prevention and treatment of bacterial infection.Methods The clinical data of 230 patients with acute cholangitis who were admitted to our hospital from April 2010 to April 2014 were retrospectively analyzed.Classifica-tion of pathogenic bacteria and the antibiotic sensitivity test in bile cultures were performed using VITEK 2 Compact Biomerieux microbiologi-cal system.Results Within the 230 patients,172 tested positive for biliary bacteria,and the positive rate was 74.78%(172/230).There were 237 strains of pathogenic bacteria,including 135 strains of Gram-positive bacteria (56.96%),comprised mainly of Enterococcus and Staphylococcus aureus,96 strains of Gram-negative bacteria (40.5 1%),comprised mainly of Pseudomonas aeruginosa,Escherichia coli, and Klebsiella pneumonia,and 6 strains of fungi (2.53%),comprised mainly of yeast.Significant difference in the positive rate of bacteria was detected between patients with mild and severe cholangitis (χ2 =4.58,P =0.028).Gram-negative bacteria were the predominant i-solates in patients with mild and moderate acute cholangitis,while multiple bacterial infection was more common in patients with severe cholangitis.Biliary bacteria had a higher rate of susceptibility to vancomycin,imipenem,and amikacin compared with other antibiotics. Conclusion Gram-positive bacteria are the predominant pathogens in acute cholangitis.Early detection,immediate intervention,and ac-curate drug susceptibility test should be implemented at regular intervals to direct effective clinical therapy.

Objective To observe the effect of the compound Qinbudan recipe in treating multi-drug resistant pulmonary tuberculosis (MDR-PTB) of deficiency of both qi and yin. Methods A randomized controlled trial was carried out in 72 MDR-PTB cases, and the patients were divided into treatment group and control group, 36 cases in each group. The treatment group was treated with the compound Qinbudan recipe while the control group was treated with Feitai capsules. After treatment for 3 months, the therapeutic effect, scores of traditional Chinese medical syndromes, and adverse reactions were compared in the two groups. Results ( 1) After treatment for 3 months, the total effective rate of the treatment group was 82.86%, and that of the control group was 25.81%, the difference being significant (P <0.01) . (2) After treatment for 3 months, the total scores of traditional Chinese medical syndromes of the treatment group were lower than those of the control group, and the difference was significant ( P <0.05) . ( 3) At the end of the treatment course, the treatment group showed better effect on relieving shortness of breath, night sweating, spontaneous perspiration, cough with sputum than the control group ( P<0.05 or P <0.01) . The two groups had similar effect on relieving cough, dry throat, tidal fever, and emaciation ( P >0.05) . ( 4) Blood routine examination and hepatorenal function showed no disorders during the treatment. Gastrointestinal disturbance was not found either. Conclusion The compound Qinbudan recipe is effective in treating multi-drug resistant pulmonary tuberculosis of deficiency of both qi and yin, and has better effect on relieving shortness of breath, night sweating, spontaneous perspiration and cough with phlegm than Feitai capsules .

Objective Early identification of deep vein thrombosis(DVT) risk in patients with joint arthroplasty helps to reduce the incidence of DVT.The study aimed to investigate the effectiveness of Autar risk assessment model in assessing DVT risk in patients with joint arthroplasty.Methods 72 patients with DVT from 10 hospitals from November 2014 to February 2016 were selected as the case group, and 144 non-DVP patients who hospitalized during the same period served as the control group.The medical history, laboratory tests and other related clinical data of the patients were collected, and Autar risk assessment scale was used to evaluate the patients.Multiple logistic regression was applied to analyze the relationship between the risk scale of DVT and the risk of DVT formation.Results 216 patients were included in the research.The Autar score of DVT patients (17.09±2.83) in case group was higher than that of control group (14.25±2.46) and the difference is of statistical significance(P<0.05).The area under the ROC curve of Autar scale in case group was 0.789 (95％CI: 0.719, 0.858,P<0.05).When the ROC curve cutoff point was 15, the sensitivity and the specificity of Autar scale were 88.57％ and 57.90％ respectively.In Autar scale, the main risk factors of DVT incidence were age≥70 years old, BMI≥30, strict bed rest, varicose veins, lower limb injuries and orthopedic surgery.The result of logistic regression analysis showed the difference of Autar risk rating between these two groups was of statistical significance(P<0.05).In comparison with low risk group, the DVT risk of patients with joint arthroplasty at medium risk was of no significant difference (OR=1.178, 95％ CI: 0.733-1.490, P=0.053) while that of patients with joint arthroplasty at high risk was of significant difference (OR=5.536, 95％ CI:3.577-7.132, P<0.001).Conclusion Autar DVT risk assessment scale assessed patients with joint arthroplasty at high risk are high risk group of DVT.The risk of DVT increases with the risk rating in patients with joint arthroplasty.Therefore, Autar risk assessment scale can be applied in the assessment of DVT risk in patients with joint arthroplasty.

Objectives: To research the effects of recombinant human growth hormone on hypoproteinemia after severe head injury. Methods: Thirty six patients with hypoproteinemia after severe head injury were randomized into study group and control group. In study group, the rhGH was administered subcutaneously in the dose of 8 U every day for 7～10 days. Serum albumin, prealbumin and transferin were determined in 5 days and 10 days after giving rhGH. Results: The serum albumin, prealbumin and transferin were increased obviously in study group. Conclusions: rhGH can effectively correct hypoproteinemia after severe head injury.

Objective To investigate the clinical effect of different nutritional therapies on the immune function of patients with malignant obstructive jaundice after percutaneous transhepatic cholangiodrainage (PTCD).Methods A total of 50 patients with malignant obstructive jaundice who were admitted to our hospital from January 2009 to March 2013 were randomly divided into two groups according to the admis-sion order.The patients in group A (n=25 )received enteral nutritional support after PTCD,and those in group B (n=25 )received total parenteral nutritional support after PTCD.Intra-group and inter-group comparisons were made in terms of jaundice clearance,nutritional indices,and body’s immune function on preoperative day 1 and postoperative day 7;comparison between the two groups was made by t test. Results Among the 50 patients who underwent PTCD,39 (78%)had good drainage,while 1 1 (22%)did not reach the expectation,of which,5 (10%)were in group A and 6 (12%)in group B.In both groups,the nutritional indices on postoperative day 7 were significantly higher than those on preoperative day 1(P<0.05),but no significant difference in these indices was observed between group A and group B on postoperative day 7 (P>0.05).The immune function of patients in both groups was significantly improved following PTCD and nutrition-al support (P<0.05),but there was no significant difference between the two groups (P>0.05).Although the same scheme of nutritional support was used,there were 1 1 patients who did not achieve the expected jaundice clearance after PTCD and had limited improvement in immune function compared with those who had complete jaundice clearance (all P<0.05).Conclusion Jaundice clearance is closely re-lated to PTCD in patients with malignant obstructive jaundice,but not markedly associated with the ways of nutritional support.

Objective To investigate the effects of splenectomy on peripheral immune cells including Th17 cells in patients with portal hy-pertension and to analyze the influence of splenectomy on their immune function.Methods Twenty-five portal hypertension patients trea-ted with splenectomy in No.180 Hospital of PLA from June 2012 to June 2014 were selected as observation group,and 25 healthy controls who underwent physical examination in the same period as control group.Flow cytometry was used to determine the percentages of CD3 , CD4,and CD8 T lymphocytes,CD4/CD8 ratio,and percentage of Th17 cells in the peripheral blood of portal hypertension patients (1 day before operation and at 7 days,1 month,and 3 months after operation)and healthy controls.ELISA was used to evaluate the changes in ser-um interleukin-6 (IL-6),interleukin-17 (IL-17),and interleukin-23 (IL-23).Comparison between groups was made by one-way ANOVA and LSD-t test.Results Before splenectomy,the portal hypertension patients had significantly lower percentages of CD3, CD4,and CD8 T lymphocytes and CD4/CD8 ratio (P<0.01 for all)and significantly higher percentage of Th17 cells and levels of their as-sociated inflammatory cytokines (IL-6,IL-17,and IL-23)(P<0.01 for all),as compared with the control group.At 7 days,1 month,and 3 months after operation,the percentages of CD3,CD4,and CD8 T cells and CD4/CD8 ratio in portal hypertension patients first decreased and then increased,and these values were significantly lower at 7 days after operation than before operation (P<0.01 for all);at 3 months after operation,the patients showed no significant differences in the percentages of CD3,CD4,and CD8 T cells and CD4/CD8 ra-tio compared with the control group (P>0.05 for all).At 7 days,1 month,and 3 months after operation,the percentage of Th17 cells and levels of their associated inflammatory cytokines (IL-6,IL-17,and IL-23)in portal hypertension patients decreased gradually (P<0.05 for all).Conclusion Th17 cells and their associated inflammatory cytokines (IL-6,IL-17,and IL-23)are reduced in portal hy-pertension patients treated with splenectomy,so their immune function can be improved.

Objective To observe the analgesic effects of ethanol injection on advanced cancer patients by epidural two locus puncture. Methods Epidural two locus puncture was performed on 46 cases of advanced cancer patients. One locus was T 4 T 5, the other T 9 T 10 . Ethanol injection was used at the dose of 4 ml 95% ethanol on each locus. Results Satisfactory analgesic effect was found in all 46 patients. Conclusion Epidural two locus puncture is of wide diffusing range, low dose of injection and effective analgesia, which can overcome the disadvantage of partial analgesia by one locus puncture.

Aim To study the effect of montelukast on eosinophilic airway inflammation of asthmatic guinea pigs,and explore possible mechanism of montelukast. Methods Experimental asthma model of guinea pigs was induced by ovalbumin in vivo. The eosinophils in BALF were separated by density gradient centrifugation. The apoptosis of eosinophils was labeled by TdT-mediated dUTP nick end labeling (TUNEL)technique. The content of IL-5 in BALF was detected by enzyme-linked immunosorbent assay (ELISA). The level of ECP in BALF was detected through fluorescence enzyme-labeled assay. Results In BALF of asthmatic guinea pigs model, the number of eosinophils and content of IL-5 and ECP increased obviously, while the apoptosis index of eosinophils was lowered. After treatment with montelukast, the number of eosinophils and content of IL-5 and ECP in BALF of asthmatic guinea pigs decreased significantly, while the apoptosis index of eosinophils was elevated significantly. Conclusion Montelukast can inhibit the eosinophilic airway inflammation of asthmatic guinea pigs. Lowering the levels of IL-5 and ECP in BALF, promoting apoptosis of eosinophils and relieving airway infiltration of eosinophils may be important mechanisms for montelukast to antagonize airway inflammation of asthma.

Objective To investigate the clinical significance of intra-abdominal pressure measure in patients with liver transplantation by summarizing the data of 143 cases.Methods Intra-abdominal pressure was indirectly measured by urinary bladder pressure.Intra-abdominal pressure over 10 cm H2O (1 cm H2O=0.098 kPa) was regarded as intra-abdominal hypertension (IAH),and 10

To investigate the relation between AR and the survival period in patients with colorectal cancer.Multiple variance Cox regression analysis was performed between AR, DNA and CEA in tumor tissues and normal mucosa, and other host and tumor characteristics, such as gender, age, location of tumor (colon, rectum), degree of differentiation (high, middle, low), Dukes stage (A,B,C,D) and the survival period, in 30 colorectal patients. There were no significant differences with regard to gender, age, histological differentiation, AR, DNA and CEA levels in tumor tissues. Rectal carcinoma had poorer prognosis than colon carcinoma ( P