Objective To explore the clinical effect of Chinese medicine enema combined with massage of Hui medicine for treatment of patients with ulcerative colitis (UC).Methods A prospective randomized controlled trial (RCT) was conducted, 390 patients with UC admitted to Department of Traditional Chinese Medicine (TCM) of Ningxia Hui Autonomous Region People's Hospital from January 2013 to December 2014 were enrolled, and they were divided by using random envelope method into the western medicine control group (88 cases), simple TCM enema group (102 cases), simple massage of Hui medicine group (94 cases) and enema combined with massage group (106 cases). The patients in western medicine control group took sulfasalazine orally, once 0.75 g, thrice a day. The simple TCM enema group adopted the self prepared Shexue Fuyang decoction (ingredients: carbonized sanguisorba root 15-20 g, bletilla striata 15 g, patrinia 15-30 g, sculellaria barbata 15-30 g, Chinese goldthread 15 g, radix glycyrrhizae preparata 15 g, Fry terminaliachebuia 10 g, yam 15-30 g, india madder root 15 g) retention enema once a day. The following principles should be followed: firstly, the dose of drug should be large enough (250 mL), secondly the speed of enema should be relatively slow and it finished in 15-20 minutes, thirdly the temperature of decoction should be kept at moderate degree about 39-41 ℃ (a warm bag being around the enema tube), and lastly, the patient's posture should be changed (lying left-side for 20 minutes, lying at chest-abdomen position for 20 minutes, lying right-side for 20 minutes). In massage of Hui medicine group, based on the location and size, depth and seriousness of the lesion, the doctor would selectively use palm or index finger to carry out massage manipulations of pressing, fractioning, rubbing or grasping for different disease situations of patients, once 30 minutes pre day. The patients in enema combined massage group were treated with the same methods as above, and the therapeutic course of the four groups was 15 days; at the end of experiment,the therapeutic effects and the improvement of main symptoms in four groups were observed.Results The clinical total effective rates of Chinese medicine enema group, massage of Hui medicine group, enema combined massage group were obviously higher than the rate of western medicine control group [78.4% (80/102), 85.1% (80/94), 93.4% (99/106) vs. 62.5% (55/88), allP < 0.05]; the symptom integrals, such as abdominal pain, diarrhea, tenesmus, purulent blood stool, fever, etc. were significantly decreased after treatment in the TCM enema, massage and combined treatment groups, and the integrals of the three treatment groups were obviously lower than those in the western medicine control group (abdominal pain: 0.45±0.75, 0.56±0.57, 0.35±0.96 vs. 1.13±0.86, diarrhea: 0.76±0.91, 0.78±0.69, 0.55±0.81 vs. 1.43±0.34, tenesmus: 0.52±0.37, 0.44±0.23, 0.21±0.13 vs. 0.72±0.98, purulent blood stool: 0.43±0.34, 0.50±0.24, 0.52±0.76 vs. 0.68±0.44, fever: 0.32±0.56, 0.35±0.65, 0.26±0.45 vs. 0.49±0.77, allP < 0.05).Conclusion The therapeutic effects of Shexue Fuyang decoction enema combined with massage of Hui medicine for treatment of patients with UC are better than those of each of the following treatment alone: western medicine, Chinese medicine enema or medical massage treatment.

Objective To evaluate quantitative examination of urinary sediment bacteria as a basic feasibility of screening indicators for urinary tract infection .Methods 191 outpatients and inpatient specimens were gathered firstly to implement a urine culture ,and then the rest of the urine were used for sediment bacteria quantitative testing .Meanwhile ,bacterial culture was conducted as the standard .According to the results of bacterial culture ,receiver operating characteristic(ROC) was drawn ,the threshold values of leukocyte and bacteria counts for diagnosis of urinary tract infection were found out and its sensitivity ,specificity ,positive / negative predictive value ,false positive/false negative rate and accuracy were calculated .Results The positive rate of urine culture was 39 .7% ,and the most common pathogen was Escherichia coli .The threshold value of bacteria and leukocyte counts for diagnosis of urinary tract infection was 1 024 .5/μL and 135 .8/μL respectively .When combined leukocyte and bacteria counts for urinary tract infection ,the optimum sensitivity was 62 .5% ,specificity was 98 .1% ,positive predictive value was 95 .7% ,negative predictive value was 79 .6% ,false positive rate was 1 .9% ,false negative rate was 37 .5% ,and accuracy was 83 .8% .Conclusion With UF‐1000i urinary sediment analyzer ,the combined determination of leukocyte and bacteria counts can remove the great mass of negative results ,Especially the results of bacterial culture positive predictability is higher ,but still can not replace of quantitative bacterial culture .

Objective To study the distribution ,specimen types and characteristics of antibiotic resistance of Escherichia coli producing extended‐spectrum βlactamases(ESBLs) of the hospital in 2013 and to guide clinical drug use .Methods Analyzed the distribution and antibiotic resistance for the 375 strains of ESBLs‐producing E .coli ,and ESBLs was detected by disk diffusion phe‐notypic confirmatory test .Results The major distribution department was gynecology department which accounted for 42 .67% , followed by uropoiesis surgical department which accounted for 14 .67% ;the major specimen type was urine(55 .2% ) ,followed by puncture fluid(15 .47% )and excretion(14 .67% ) .For the 375 isolates of ESBLs‐producing E .coli ,the resistance rates to cefazolin , cefuroxime ,cefoperazone and cefotaxime were 100 .00% ,to SMZco was 78 .10% ,while the resistance rate to imipenem was 0 .00% , and to amikacin and fosfomycin were 4 .30% and 10 .10% respectvely ,the resistance rates to piperacillin/tazobactam and aztreonam were 17 .10% and 66 .70% respectvely .Conclusion ESBLs producing Escherichia coli have severe multidrug resistance .Antibiotics should be chosen and used rationally in accordance with results of drug susceptibility testing ,meanwhile the monitoring of ESBLs′infection rate and drug resistance should be strengthened .

AIM The proofs of evidence-based medicine of Qingkailing Injection's effect on viral hepatitis are lack in spite of the wide use of Qingkailing Injection in medical practice.This study aims to use Meta-analysis to evaluate its clinical effect and safety.METHODS Such databases as CNKI,VIP and Wanfang were searched for randomized controlled trials related to Qingkailing Injection in treatment of viral hepatitis,which were published officially between 1996--2016.Revman 5.3 software was used to conduct Meta-analysis for the effective rate,rate of adverse reaction,the decrease rate of ALT,AST and TBIL of Qingkailing Injection.Meanwhile,subgroup analysis was conducted to the clinical effect of doses [＜ 0.5 mL/(kg · d),0.5-0.67 mL/(kg · d),＞0.67 mL/(kg · d)],treatment courses (≤ 14 d,＞ 14 d),manufacturers (Beijing University of Chinese Medicine Pharmaceutical Factory,Shenwei Pharmaceutical Company,Shanxi Taihang Pharmaceutical Company),year (1996 to 2002,2003 to 2009,2010 to 2016).RESULTS Fourteen studies were included according to the criterion.The results of Meta-analysis showed that the total effective rate,the decrease rate of ALT,AST and TBIL in Qingkailing Injection group were significantly higher than those in the control group (P ＜ 0.05).Whereas,no significiant differences were found between Qingkailing Injection group and the control group of its rate of adverse reaction (P ＞ 0.05).Subgroup-analysis showed that the effective rate of Qingkailing in doses subgroup,treatment courses subgroup,manufacturers subgroup and year subgroup were significantly higher than those of the control group.CONCLUSION Qingkailing Injection has obvious benefit in the treatment of viral hepatitis,which can reduce the activity of ALT and AST,also can reduce the content of TBIL.But we should pay attention to the prevention of allergic reaction in the clinical use.

BACKGROUND: Permanent or transient implantation of biomaterials can result in biomaterials-centered infections (BCI) in lung cancer patients.OBJECTIVE: To investigate the relationship between BCI and peripheral blood transforming growth factor β1 (TGF-β1) in patients with lung cancer.METHODS: A total of 248 lung cancer patients undergoing in vivo intravascular catheter indwelling > 7 days were included.Quantitative method was used for intubation, bacteriological culture and paired blood culture, and API Staph strips were adopted for positive patients. While enzyme-linked immunosorbent assay was used to detect TGF-β1 levels in the peripheral blood of patients with lung cancer and 75 healthy volunteers as normal controls.RESULTS AND CONCLUSION: Among the 248 patients, there were 82 BCI-positive cases, and 166 BCI-negative cases.Thirteen patients were confirmed to have catheter-related bloodstream infection. There were 48 Gram-positive bacteria, 24Gram-negative bacilli, and 10 fungal. The levels of TGF-β1 were higher in BCI-positive patients than BCI-negative patients (P < 0.05); the levels of TGF-β1 in the BCI-negative group were higher than those in the normal control group (P < 0.05). For lung cancer patients with nosocomial infection induced BCI, there are various species of pathogenic bacteria, and Gram-positive bacteria are more common. To detect TGF-β1 levels in patients with lung cancer is of significance for early prevention of BCI.

(P < 0.05 ).Scanning electron microscopy showed that the three-dimensional structure of mix-biofilm in control group was more complex.As real-time PCR showed,after 6-hour culture,the expressions of icaA,fbe,aap,hwp1, als3 and efg1 genes in Farnesol group were down-regulated compared to those in control group and after 24-hour culture the expressions of aap,hwp1,als3 and efg1 genes in Farnesol group were down-regulated compared to those in control group.Conclusion With the intervention by fungal quorum sensing molecules Farnesol,the structure in control group became denser and more complex than that in Farnesol group.This change may have a closer correlation with the down-regulated expressions of als3,hwp1 and efg1 genes,which are related to the formation of Candida albicans biofilms.

Objective To evaluate 1-week and 1-year outcomes of carotid artery stenting (CAS)using cerebral perfusion CT(PCT). Methods The clinical database of 20 patients with unilateral carotid artery stenosis( ≥60% ) who underwent CAS were retrospectively reviewed. Relative cerebral blood volume (rCBV), relative cerebral blood flow(rCBF) and relative mean transit time( rMTT) were measured by using cerebral PCT within one week before CAS and at one week and at one year after CAS. Cerebral MRI was performed within one week before CAS. The noncontrast CT was performed within one week before CAS and immediately after CAS. The arteriography was performed at one year after CAS. The variance analysis was performed to determine whether there were significant differences of rCBV, rCBF, rMTT in anterior cerebral artery area( ACA area), middle cerebral artery area( MCA area), posterior cerebral artery area( PCA area),basal ganglia area, front and back cortical watershed area( CWS area) and internal watershed area( IWS area) among the different time points. Results In the three measures, there was no significant difference of rCBV in all areas among the three time points( P ＞ 0. 05 ) , and there was no significant difference of rCBF and rMTT in PCA area( P ＞ 0. 05 ), but there were significant differences of rCBF and rMTT in all other areas among the three time ponits(P ＜0. 01). In one week before CAS, at one week and at one year after CAS, rCBF of 20 patients is 0. 86 ±0. 06, 0. 95 ±0. 04, 0. 98 ±0. 07 in ACA area, 0. 81 ±0. 04, 1.06 ±0. 04, 1.03 ±0.07 in MCA area, 0. 84 ±0. 06, 0. 97 ±0. 04, 0. 96 ±0. 04 in basal ganglia, 0. 78 ±0. 03,0. 97 ±0. 03, 0. 96 ±0. 02 in front CWS area, 0. 77 ±0. 03, 1.00 ±0. 02, 0. 98 ±0. 03 in back CWS area,and 0. 80 ± 0. 04, 0. 94 ± 0. 03, 0. 93 ± 0. 04 in IWS area ( F = 18. 95, 146. 41,63.03,540. 85,415.97,164.19, P＜0. 01). rMTT is 1.17 ±0.05, 1.04±0.04, 1.01 ±0.06 in ACA area, 1.41±0.06, 1.08±0.04, 1.07±0.04 in MCA area, 1.20±0.06, 1.06±0.04, 1.05±0.04 in basal ganglia, 1.41 ±0.05,1.10 ±0. 05, 1.09 ±0. 04 in front CWS area, 1.43 ±0. 10, 1.07 ±0. 06, 1.08 ±0. 06 in back CWS area,1.29±0.10, 1.09 ±0.05, 1.11 ±0.07 in IWS area (F=51.74, 248. 89, 70.08, 381.68, 288.94,41.53, P ＜0. 01 ). There were significant differences of rCBF and rMTT between those measured one week before CAS and one week or one year after CAS ( P ＜ 0. 01 ), but there were no significant differences of rCBF or rMTT in any area measured between those at 1 week after CAS and those measured at 1 year after CAS(P＞0.05). Conclusions Hemodynamic outcome at one year after CAS is good in the absence of contralateral carotid artery steno-occlusive disease. In addition, the coherence of results between 1-week and 1-year indicates that the outcome of one week after CAS could predict long-term hemodynamic outcome.

Objective To investigate the value of multi-slice computed tomography angiography (MSCTA)in the detection of intracranial micro-aneurysms(aneurysm≤3 mm in maximal diameter, IMA).Methods The clinical history and images of 826 patients with suspected intracranial aneurysms were retrospectively analyzed.All patients underwent MSCTA on 16-slice row CT before hospitalization(from 2 h to 4 d after symtom onset).All intracranial aneurysms were confirmed by digital subtraction angiography (DSA), three-dimensional rotational angiography (3DRA) or surgery.Two independent radiologists assessed all the images.The MSCTA findings were compared with the DSA/3DRA results.The sensitivity, specificity, and accuracy of MSCTA for diagnosis of IMA was calculated.The diagnostic consistency between DSA/3 DRA and MSCTA was determined by Kappa statistics.The prevalence of multiple aneurysms between the group of patients with IMA and the group of patients without IMA was evaluated by Chi-square test Results A total of 889 aneurysms in 788 of the 826 patients were detected.Among them, 706 patients had single aneurysm and 82 patients had multiple aneurysms.No aneurysms were detected in 38 patients.Among the 212 patients who underwent DSA/3 DRA, 271 aneurysms were found and 232 were IMA.MSCTAdetected 229 IMA.There was 1 false-positive finding and 4 false-negative findings by MSCTA.The sensitivity, specificity and accuracy of MSCTA for IMA was 98.3% (228/232), 97.4% (38/39), 98.2% (266/271).There was excellent agreement between two techniques (Kappa=0.927, P<0.05).The prevalence of multiple aneurysms was 21.2% (45/212) in the patient group with IMA and 6.4% (37/576) in the group without IMA.There was statistically significant difference between the two groups (X~2=36.421, P<0.01).Conclusions The detection value of IMA by MSCTA was high.The cutoff level of diameter of intracranial IMA should be adjusted from 4-5 mm to ≤3 mm.

BACKGROUND: It is confirmed that pathogenicity of biomaterials-centered infection is positive correlated to bacterial biofilm formation of Staphylococcus epidermidis on the surface of catheter-related materials. OBJECTIVE: To analyze the relations between expressions of central venous catheter-related Staphylococcus epidermidis icaA, icaD, transforming growth factor β1 (TGF-β1) and formation of bacterial biofilm. METHODS: The type of Staphylococcus epidermidis in lung cancer cases with catheter-related bloodstream infections (CRBSI) was indentified, followed by bacterial genomic DNA extraction. The expression of biofilm formation-related genes icaA, icaD mRNA and phenotype of biofilm were detected by PCR. The serum TGF-β1 levels in cases with or without CRBSI were measured by enzyme-linked immunosorbent assay.RESULTS AND CONCLUSION: The expression of Staphylococcus epidermidis operon icaA and icaD gene was positive correlated to biofilm formation in lung cancer cases with CRBSI (P < 0.01); particularly, the TGF-β1 levels in CRBSI cases were greater than that of non-CRBSI cases (P < 0.05). The results demonstrated that, central venous catheter infection causes positive Staphylococcus epidermidis icaA and icaD gene expressions in lung cancer cases and is prone to form biofilm, high level of peripheral TGF-β1 may play a positive role in bacterial biofilm formation.

Objective To investigate the relationships among free triiodothyronine( FT3 ), free thyroxine (FT4 ), and thyroid-stimulating hormone( TSH) in both plasma and breast milk of patients with thyroid diseases. Methods A total of 102 female subjects with hyperthyroidism(GD), normal thyroid function(NC), and Hashimoto′s hypothyroidism(HT or hypothyroidism)were enrolled. Their plasma and breast milk were collected for measurement of FT3 and FT4 , and TSH. Meanwhile, 11 infants of patients with hyperthyroidism and another 11 infants of patients with hypothyroidism were selected, blood FT3 , FT4 , and TSH content were determined during lactating period and 2 months after lactation. Results (1) FT3 and FT4 contents in breast milk among 3 groups were different[(1. 48 ± 0. 81), (7. 79 ± 3. 56), and (0. 77 ± 0. 42)pg/ ml; (2. 94 ± 1. 43), (14. 78 ± 7. 40), and (1. 51 ± 0. 40)pg/ ml, P<0. 05], TSH in breast milk was similar between hyperthyroidism and normal groups(P>0. 05). (2) FT3 ratio of breast milk to plasma of the hyperthyroidism group was different to other 2 groups(0. 42 ± 0. 04 vs 0. 35 ± 0. 03, 0. 36 ± 0. 03, P<0. 05), but no difference existed in FT4 and TSH among 3 groups(both P>0. 05). (3)Blood FT3 , FT4 , and TSH contents from infants of patients with hyperthyroidism and hypothyroidism were different, both during lactating period and 2 months after lactation[(5. 06 ± 1. 76)vs (6. 51 ± 2. 23)pg/ ml, (17. 39 ± 2. 78)vs (19. 87 ± 3. 26)pg/ ml, (1. 34 ± 1. 33)vs (0. 74 ± 0. 78)mIU/ L; (1. 43 ± 0. 74)vs (1. 83 ± 0. 91)pg/ ml, (4. 28 ± 1. 55)vs (5. 00 ± 1. 75)pg/ ml, (6. 48 ± 2. 70) vs (5. 49 ± 2. 39) mIU/ L; all P<0. 05]. (4) FT3 and FT4 contents were positively correlated in plasma and breast milk(all P<0. 05), while TSH contents were positively correlated only in hypothyroidism group(P<0. 05). Conclusion FT3 , FT4 , and TSH in blood and breast milk are correlated.