OBJECTIVE:To investigate the distribution and drug resistance of Acinetobacter baumannii in our hospital,and provide reference for rational use of antibiotics. METHODS:Clinical specimen of inpatients in our hospital from Jan. 2012 to Dec. 2015 was collected,the identification of strains and drug sensitivity test were performed by the VITEK-2 microorganism analyzer;use rate of antibiotics and detection of multidrug-resistant and pandrug-resistant A. baumannii for inpatients in our hospital were an-alyzed,and their correlation was detected by Pearson correlation analysis. RESULTS:Totally 2 468 strains of A. baumannii were isolated in our hospital during 2012-2015,mainly derived from sputum samples (88.2%),distributed in respiratory medicine de-partment(47.0%)and ICU(13.1%);A. baumannii showed totally high drug resistance to common antibiotics,and only sensitive to tigecycline. Totally 386(79.3%),434(61.6%),358(53.4%)and 291(48.0%)strains multidrug-resistant A. baumannii were detected every year in our hospital;and pandrug-resistant A. baumannii were 336(69.0%),385(54.7%),331(49.3%)and 256 (42.2%) strains,respectively. There was a positive correlation between the percentage of multidrug-resistant and pandrug-resistant A. baumannii in total strains and use rate of antibiotics (r=0.987、0.981,P<0.05). CONCLUSIONS:A. baumannii has emerged as an important pathogen in hospital acquired infections,which mainly caused respiratory system infection;the drug resistance situ-ation is not optimistic,tigecycline can be used as one of the best choice for treatment of A. baumannii infections;our hospital should continue to control the use of antibiotics to decrease the emerging of drug resistance strains.

Objective To analyze the composing experience of Menghe physician Ma Peizhi for cough by TCM inheritance support system. Methods The prescriptions for cough of Ma Peizhi were collected, frequency and association of drugs were analyzed by using data mining methods such as revised mutual information, complex system entropy cluster and unsupervised hierarchical cluster. Results Based on the analysis of 57 prescriptions, the frequency of each herb and association rules among the herbs were computed, 18 core combinations and 9 new prescriptions were mined from the database. Conclusion Menghe physicians Ma Peizhi is well experienced in expelling wind and opening the inhibited lung, dissolving phlegm and relieving cough. TCM inheritance support system can be used to analyze clinical experience of old TCM doctor.

Objective To evaluate the diagnostic value of the early rheumatoid arthritis (RA) classification criteria for early RA and to assess the clinical efficacy of knee arthroscopic synovectomy for RA.Methods A total of 62 patients who had arthritic complaints with disease duration less than one year were treated with knee arthroscopic synovectomy.Patients were diagnosed as RA confirmed by changes of synoviomorphous under arthroscopy,synovial biopsy,immunological biochemical laboratory and MRI,and compared with the preoperative ERA diagnosis.The efficacy was assessed at the third months and more than 12 months after operation,including Health Assessment Questionnaire (HAQ),Lysholm score,laboratory parameters of erythrocyte sedi-mentation rate (ESR) and C-reactive protein (CRP).Results The sensitivity and specificity in the early RA classification criteria for RA diagnosis were 81.58％ and 91.67％.38 patients diagnosed as RA and the remaining 24 patients were significantly improved of HAQ,Lysholm score,ESR,CRP compared with preoperation,showed statistical difference (P ＜ 0.01).There were still statistical differences between the follow-up results of the group of patients with RA in different period after operation (P ＜ 0.01).Conclusion The early RA classification criteria is worthy of clinical application,because it has the advantages of simple,practical,and is beneficial to early diagnosis of RA.The early RA patients should be treated with knee arthroscopic synovectomy as far as possible.It can improve not only the knee function,but also the general symptoms,and it can interrupt the RA pathological process,effective maintain curative effect after operation.

Objective To investigate the correlation between liver-type fatty acid binding protein (L-FABP) and nonalcoholic fatty liver disease (NAFLD) extent and other clinical parameters.Methods Ninety-six patients of NAFLD (NAFLD group) and 100 cases of healthy controls (control group) were selected.The levels of serum L-FABP and blood biochemical parameters were measured by enzyme-linked immunosorbent assay.The lesion degree was assessed by ultrasound.The body mass index (BMI),waist to hip ratio (WHR) and homeostasis model assessment insulin resistance index (HOMA-IR) were calculated.Results The WHR,BMI,fasting plasma glucose (FBG),triglycerides (TG),alanine aminotransferase (ALT),HOMA-IR and L-FABP in NAFLD group were higher than those in control group,there were statistical differences (P ＜ 0.05).The result of correlation analysis showed L-FABP level was positively related with ALT,TG,FBG,WHR,BMI,HOMA-IR (r =0.735,0.728,0.681,0.713,0.699,0.673 ;P ＜0.05),and negative correlation with HDL-C (r =-0.607,P ＜ 0.05).The L-FABP level in control group was (15.42 ± 2.51) g/L,mild NAFLD was (15.96 ± 2.92) g/L,moderate NAFLD was (17.48 ± 3.91) g/L,serious NAFLD was (25.14 ± 5.37) g/L.There was statistical difference in L-FABP level between serious NAFLD and control group,mild NAFLD,moderate NAFLD (P ＜ 0.05).Conclusion Serum L-FABP level of serious NAFLD patient significantly increases,and L-FABP level is related with biochemical parameters of liver function.

Skillful in the treatment of gouty arthritis (GA) by integrated therapies of Chinese and Western medicine,chief physician Zhang Tang-fa proposes to ‘deal with the exterior with the needles,and attack the interior with the drugs,by integrated application of acupuncture and herbal medicine',in combination with comprehensive intervention of dietetic therapy and health education.In the treatment of GA,he adopts the syndrome differentiation based upon the pathogenic factors,in combination of syndrome differentiation based upon the six meridians,to reinforce and benefit the spleen and kidney,clear away heat and remove dampness as the therapeutic principle.By acupuncture mainly at the acupoints of the Spleen and Liver Meridians,he also proposes to select the acupoints by the theory of Na Zi Fa (earthly branch method) of Zi Wu Liu Zhu (midnight-noon ebb-flow),and to puncture the surrounding area of the involved joints shallowly by multiple needles as the major needling method,simultaneously with the reinforcing and reducing manipulations based upon the respiration.In the treatment,acupuncture and acupoint-injection are often used.In diet,low purine diet is often suggested.In health education,the patients are often instructed to understand the disease correctly,eliminate fears and cooperate with doctor's treatment positively.

Objective To analyze the principle of the drug use ofMenghe PhysiciansMa-Peizhi by using the Traditional Chinese Medicine(TCM)inheritance support system.Methods The prescriptions for the commonly encountered diseases that used byMa-Peizhi were collected to build a database, and analyze by the unsupervised data mining methods, such as apriori algorithm, entropy clustering complex systems, from which we could get the frequency of the drugs, the association rules between drugs, the core drug combinations, and so on.Results Based on the analysis of 745 prescriptions, the most frequently used drugs were tuckahoe, chiretta, paenoiae alba, dried orangepeel and dioscoreae. The core drug combinations were “radix rehmanniae recen- salivia chinensis-ophiopogon root”, “teasel root-viscum album-achyranthes”, “menispermaceae-heracleum hemsleyanum michaux-gentiana macrophylla”, and “mulberry leaf-periostracum cicadae-the root of balloon flower”. The new prescriptions were “mulberry leaf-viter rotundifolia-batryticated silkworm-periostracum cicadae-the root of balloon flower”, “teasel root-viscum album- achyranthes- ramulus mori- periplocae”, and so on.ConclusionMenghe PhysiciansMa-Peizhi was well experienced in treating the commonly encountered diseases by agile diagnosis and treatment, and addition or subtraction of changes based on the classical prescriptions.

OBJECTIVETo discuss the clinical effects and superiority of applying external fixation and bone transport to treat osteomyelitis and bone defect of femoral bone.

METHODSFrom August 2008 to December 2013,16 patients with osteomyelitis and bone defect of femoral bone were treated including 11 males and 5 females with an average age of 42 years old ranging from 13 to 62 years old. The average course of disease was 18 months ranging from 2 months to 4.5 years, and the average length of bone defect was 7.8 cm ranging from 4.5 to 15 cm. The bone defect of all cases were treated by external fixation and bone transport, the bone transport began at 1 week after operation, 1 mm per day and 4 times per day.

RESULTSAll patients were followed up for 10 to 36 months (means 22.5 months). One patient did not cooperate with treatment leads to the failure, then took the amputation. The remaining 15 cases of osteomyelitis were under control, including 12 cases of bone transport achieved one stage bone union, 3 cases achieved bone union via bone graft from iliac bone. The bone union time was 5 to 13 months(means 7.9 months). Thirteen patients almost obtained the same length of two lower extremities,2 patients had shortening of 1.5 to 2 cm. The time of moving the external fixation was from 6 to 16 months (means 9.3 months).

CONCLUSIONApplication of external fixation and bone transport is an effective method in treating the osteomyelitis and bone defect that can control the infection, eradicate wounds, and be the equalization of limb length.

Adolescent ; Adult ; Bone Transplantation ; External Fixators ; Female ; Femur ; surgery ; Humans ; Male ; Middle Aged ; Osteomyelitis ; surgery

Objective To observe the effects of endoplasmic reticulum stress (ERS) on the activation of monocytes induced by high glucose and explore the underlying mechanism.Methods The monocyte cell line THP-1 was stimulated with high glucose,and then treated with molecular chaperone betaine.The levels of glucose regulation protein 78 (GRP78) and p-JNK,which were associated with ERS were detected by real-time PCR and Western blotting.The proliferation of the cell line was detected by MTT method.Transwell and immunofluorescence were applied to observe the chemotaxis and phenotype of cells respectively.Results The levels of GRP78 and p-JNK of THP-1 cells stimulated by high glucose were significantly increased compared with the normal control group (all P ＜ 0.05).The proliferation and chemotactic were also enhanced (all P ＜ 0.05).The number of cells in M1 phenotype was increased remarkably (P ＜ 0.05).All the indexes above could be rescued by betaine.Conclusion The activation of THP-1 cells can be induced by high glucose through ERS,while molecular chaperone betaine can reverse the activation.

Analyzed the prescriptions for phlegm retention syndrome that built by Ma Peizhi by the association rules and clustering algorithm, the frequency of drug usage and the relationship between drugs could be get. And from that we could conclude the experiences for phlegm retention syndrome of Ma Peizhi of menghe medical genre. The results of the analysis were that 18 core combinations were dig out, such as Citri Exocarpium Rubrum-Eriobotryae Folium-Citri Reticulatae Pericarpium. And there were 9 new prescriptions were found out such as Aurantii Fructus-Citri Exocarpium Rubium-Eriobotryae Folium-Citri Reticulatae Pericarpium. The results of the analysis were proved that Ma Peizhi of Menghe Medical Genre was good at curing phlegm retention syndrome by using the traditional Chinese medicine of mild and light, such as the medicines of mild tonification, and clearing damp and promoting diuresis.
Algorithms ; Data Mining ; Databases, Factual ; Drug Prescriptions ; standards ; Drugs, Chinese Herbal ; therapeutic use ; Humans ; Mucus ; chemistry ; Practice Patterns, Physicians' ; Respiratory Tract Diseases ; drug therapy

The clinical prescriptions of hemoptysis that built by Menghe physician Ma Peizhi were collected, and were analyzed by the method of unsupervised data mining, such as association rules and clustering algorithm. From the prescriptions, we got the frequency of drugs, the association rules among drugs, 10 core drug combinations and 5 new prescriptions. Accordingly, after the analysis, Menghe physician Ma Peizhi had rich experience in the treatment of hemoptysis. His therapy for hemoptysis was clearing heat and moistening lung, dispel heat from blood to stop bleeding, and enriching yin and blood. And we can also make a conclusion that the TCM inheritance support system is of great practical value for minning the old doctors' clinical experiences.
Data Mining ; Databases, Factual ; Drug Prescriptions ; standards ; Drugs, Chinese Herbal ; chemistry ; therapeutic use ; Hemoptysis ; drug therapy ; Humans ; Practice Patterns, Physicians'