Acupuncture Therapy ; instrumentation ; methods ; Adult ; Aged ; Female ; Hot Temperature ; Humans ; Male ; Middle Aged ; Needles ; Spondylosis ; therapy ; Treatment Outcome ; Young Adult

Anti-Infective Agents ; administration & dosage ; Clinical Competence ; Hematologic Diseases ; Hospitals, Special ; manpower ; Humans ; Medical Staff, Hospital

Objective To investigate distributions and drug resistance of pathogens in cirrhotic ascites comphcated with spontaneous bacterial peritonitis (SBP). Methods Results of bacterial culture and drug sensitivity tests of 117 aacitie specimens from cirrhotic patients with SBP were analyzed retrospectively. Results From the 117 ascitie specimens, 117 bacterial strains were isolated, among which 71 (60.68%)were gram-negative bacteria, 45 (38.46%) were gram-positive bacteria. The isolated strains were highly resistant to antibacterial agents, especially for Escherchia coli and Staphylococcu, the resistances to most antibiotics were above 60%. Conclusions High drug resistances were common for pathogenic bacteria in aacites of liver cirrhosis patients complicated with SBP.

Magnetic Resonance Imaging (MRI) can form a three-dimensional positioning anatomical imaging.By comparing the tumor volume and signal intensity changes,there is great value of MRI in the assessment of the efficacy of cervical cancer.With the development of imaging,magnetic resonance diffusion weighted imaging (DWI),magnetic resonance spectroscopy (MRS) can provide qualitative and quantitative information of the cellular level,which reflects changes in the treatment of tumor cells.Magnetic resonance imaging can predict early locally advanced cervical cancer neoadjuvant chemotherapy,thus providing an important basis for individualized treatment of patients.

Objective To survey the application of diagnosis and implementation of treatment guidelines of cerebrovascular disease( CAD)combined community acquired pneumonia( CAP)in the community of Shenyang. Methods Randomly chose 7 hospitals in different levels in districts and counties of Shenyang,and made a retrospective survey on the treatments of CAD combined CAP from Oct. 2009 to Jun. 2012 to clear the implementation. Meanwhile,the collected cases were divided into in compliance with guidelines group and non compliance with guidelines group. The information including clinical stable time,length of hospital stay,efficient treatment,empiric therapy and prognosis with the help of guidelines were collected. Results Four hundred and eighty-eight cases were qualified from collected 532 cases,in which,38. 5% initial diagnosis and treatment was accord with the guidelines formulated by the Respiratory Branch of Chinese Medical Association. The efficiency of initial empirical treatment was 84. 5%. The clinical stable time in compliance with guidelines group was (5. 00 ± 0. 27)d,better than that in non compliance with guidelines group((8. 00 ± 0. 45)d;P=0. 021). The length of hospital stay was(11. 00 ± 0. 25)d in compliance with guidelines group,significantly less than that in non compliance with guidelines group(( 14. 00 ± 0. 53 ) d;P =0. 015 ). The effective rate of patients with respiratory failure in compliance with guidelines group was 90. 9%,higher than non compliance with guidelines group(58. 6%),and the difference was significant(P=0. 026),while there were no significant differences in terms of gender,heart and lung diseases. Conclusion There is the smaller patient proportion that diagnosed and cured in accordance with the guidelines formulated by the Respiratory Branch of Chinese Medical Association. It is no distinctive difference for the efficient treatment of guidelines. But selected antibiotic application according to the guidelines can improve the clinical stable time and hospital stay of CAD combined CAP,as well as reduce invalid cases and reduce the mortality rate. The guidelines need to be further extended.

Total glucosides of paeony (TGP)is used to treat rheumatoid arthritis(RA)as the first immunoregulatory drug in clinic.The efficacy of TGP in treating RA patients is definite, which is accompanied with mild adverse reaction and slow effects simultaneously.Paeoniflorin (Pae ),the main constituents of TGP,has a bioavailability of 3% ~4%,which may be served as the main reason for its slow effects.Therefore,in this paper,the pharmacokinetics of Pae as well as its influencing factors were re-viewed on basis of pulished papers.In addition,some problems about Pae were also discussed.

Several hot questions such as selection of patients and favorable time of transplantation, design of conditioning regimen, monitoring of chimerism and complication of graft versus host disease (GVHD) in allogeneic hematopoietic stem cell transplantation following reduced intensity regimen (RIC-HSCT) as salvage therapy for refractory leukemia are discussed in this article. More and more investigators began to recognize that it was not a fundamental to undergo transplantation in complete remission for patients with refractory leukemia, since it may expend patients' physical status. RIC-HSCT may be substantially considered as a kind of adoptive immunotherapy, so that immunologic attacking targets and the latency of immunoreactian must be considered when making the decision to use, lacking of attacking targets and rapidly growing diseases seemed to be less susceptible to control. Commonly used reduced intensity regimens differed significantly, but it was clear that dose intensity was very important in refractory leukemia. In fact, many investigators used intermediate dosage between criteria of non-myeloablative and conventional myeloablative regimens. Complete donor chimerism is the hallmark of engraftment but often delayed in RIC-HSCT. Since sustained complete donor chimerism induced persistent graft-versus-leukemia (GVL) effect play an important role in patients' long-term survival, it was recommended that sensitive techniques (eg. STR-PCR) should be used to analysis chimerism and should be measured more frequently (every 2-4 weeks), and lineage-specific chimerism (eg. T cell) analysis was also recommended. As compared with traditional HSCT, the incidences of acute and chronic GVHD are similar and the onset of GVHD is associated with the GVL effect. Decrease or interruption of immunosuppressive drugs early after transplantation and donor lymphocyte infusion may facilitate transformation to complete donor chimerism, so that it may benefit patients with advanced disease at time of transplantation from avoiding disease relapse in one hand, but may induce GVHD in the other hand.

The myelodysplastic syndrome(MDS) comprise a heterogeneous group of clonal disorders.A unique aspect of MDS is the notion that both bone marrow failure and the propensity toward development of acute leukemia coexist. Origin of abnormal clone with MDS occurs at the level of multipotent progenitors or above it. Recently some kinds of MDS were observed the abnormal clone has been potentially originated from normal CD+34 CD-38 Thy-1 + hematopoietic stem cells. The abnormal clones with different chromosomal abnormality have different distribution. With the propotion of abnormal clonality increasing MDS has aggravated. Coherent result will provide new insight into the clinical diagnosis, treatment and prognosis of MDS by strengthening the research of MDS clonality.

Objective To investigate the virologic responses to pegylated-interferon alfa-2a (PegIFNα-2a) plus ribavirin therapy for cryoglobulinemia positive chronic hepatitis C in patients with hepatitis C virus (HCV) genotype 1 b.Methods Clinical data on 60 chronic hepatitis C patients with HCV genotype 1b were collected from Huzhou Central Hospital during January 2008 and December 2012.The patients were divided into cryoglobulinemia positive group (n =22) and cryoglobulinemia negative group (n =38),and both received 48-week PegIFNα-2a (180 μg) plus ribavirin treatments.For those who could not tolerate the treatment,PeglFNα-2a was reduced to 135 μg from 12th week.Rapid virologic response (RVR),end of treatment virologic response (ETVR) and sustained virologic response (SVR) in two groups were observed and compared using Chi-square test.Results RVR,ETVR and SVR in cryoglobulinemia positive group were 59.1％ (13/22),81.8％ (18/22) and 31.8％ (7/22),while those in cryoglobulinemia negative group were 55.3％ (21/38),76.3％ (29/38) and 60.5％ (23/38).There was significant difference in SVRs between two groups (x2 =4.674,P ＜ 0.05).For those completed full course of antiviral therapy with 180 μg PegIFNα-2a,the RVR and SVR in cryoglobulinemia negative group tended to be higher than those in cryoglobulinemia positive group,but the differences were not statistically significant (x2 =1.524 and 1.009,P ＞ 0.05).Serious adverse reactions were observed in 9 (40.9％) patients of cryoglobulinemia positive group,while in 11 (28.9％) patients of cryoglobulinemia negative group (x2 =0.887,P ＞ 0.05).Conclusion Cryoglobulinemia may not have considerable impact on virologic responses to PegIFNα-2a plus ribavirin therapy in patients with chronic genotype 1b hepatitis C.

Objective To evaluate the biomechanical characteristics of the long U-shaped hollow pedicle screw system for percutaneous fixation of thoracolumbar fractures.Methods Models of vertebral compression fracture were created by flexion in 8 fresh cadaveric samples of thoracolumbar spine.The models were divided into 2 equal groups according to the fixation system applied.In group A conventional pedicle screws were used while in group B long U-shaped hollow pedicle screws were used.The yield compressive strength,axial compression stiffness,bending stiffness,torque and torsional stiffness of all the fixated spines in the 2 groups were tested by the bio-mechanical electrical measurement and compared as well.Results The conventional pedicle screws and long U-shaped hollow pedicle screws showed no significant differences regarding yield compressive strength (3450.02 ± 110.03 MPa vs.3430.04 ± 102.12 MPa),axial compressionstiffness (407.52 ± 33.02 N/mm vs.395.04 ± 26.46 N/mm),bending stiffness (305.14 ± 26.53 N · cm/Degvs.295.12±23.80 N · cm/Deg),torque (6.45±0.25 N · m vs.6.25±0.21 N · m) or torsional stiffness (0.54±0.04N·cm/Degvs.0.52±0.03N·cm/Deg) (P＞ 0.05).Conclusion The long U-shaped hollow pedicle screw system can satisfy the biomechanical requirements for fixation of thoracolumbar fractures and can function as well as the conventional pedicle screw system.