Rhizome anemarrhena,sweet and bitter to taste,cold,in the lung,stomach and kidney meridian,has the function clearing away heat and purging pathogenic fire,nourishing Yin and moistening dryness.Zhang Zhong Jin in "Essential Prescriptions of the Golden Chamber "with a different combination of herbs and Rhizome anemarrhenae,reflects the multiple efficacies of TCM and compatibility.

OBJECTIVE To detect the genes of plasmid-mediated AmpC and ESBL ?-lactamases and classⅠ integron in clinical isolate of Escherichia coli.METHODS The bacterial susceptibility to antimicrobial agents for strain E50 was determined by agar dilution method.The genes of AmpC,ESBLs,and intⅠ1 were analyzed using PCR and verified DNA sequencing.Conjugation experiment was used to study the transfer of drug resistance.RESULTS The strain was only susceptible to imipenem.CTX-M-15,SHV-1,TEM-1,DHA-1 and intⅠ 1 genes were positive.CONCLUSIONS It has complicated mechanism of drug resistance.Some of clinical strains producing plasmid-mediated AmpC ?-lactamase are accompanied by extensively producing ESBLs.Carbapenems are the best choice for treatment infection caused by strains producing ESACs.More attention should be paid to integron which plays an important role in multi-resistance.

[Objective]To investigate the characteristics and clinical results of open reduction and internal fixation for fractures of the calcaneus for earthquake patients.[Method]The fractures were classified according to Sanders classification.Fifteen cases(24 fractures) were treated by open reduction and internal fixation.Thirteen cases(21 fractures) were followed up from four,four and half months(average of 4.2 months).[Result]All fractures had been healed.Functional results were evaluated using Marryland Foot Score and excellent results occured in 9(42.9%),good in 10(47.6%),fair in 2(9.5%) and the satisfactory rate was 90.5%.Two cases of incision infection were cured by skin flap transplantation.[Conclusion]Open reduction and internal fixation is an effective method for treatment of displaced intra-articular fractures of the calcaneus.Earthquake patients are not fit for early operation.They should be treated with operation after normal functional index and stable psychological situation.

Objective To study the changes and significance of HBV DNA and it's antigen and antibody in patients with liver transplanting.Methods 35 cases with liver transplanting in 302th hospital from Oct.2006 to Mac.2007 has been studied.The HBV antigen and antibody has been studied by ELISA in 188 samples including one from before transplanting and 4 to 7 from after transplanting.The quantitative of HBV DNA has been detected by real time PCR technology.45 cases of hepatitis B,whose sera HBV DNA is positive no more than 10 000U/ml,treated with lamifudine in 2 weeks about has been used in controls.Results 95(34/35)percent of liver-transplanting patients acquired serum-transfer in HbsAg to it's antibody,and 6 patients with HBeAg positive acquired from HbeAg to it's antibody in 2 days after transplanting.The HBV DNA in sera is distinguished of 34 cases from 35s in 6 months after liver-translpanting.Only one patient is insisting with HBsAg and HBV DNA positive.In lamifudine treatment controls,none of patients acquired sera-transferred from HBsAg to antibody in 45 cases.The HBV DNA is decreased from positive to negative under cove in 11 controls.29 cases of HBV DNA are decreased in 2 to 3 Log E after treatment with lamifudine.The HBV DNA is insisting in high levels in 5 patients.The HBeAg is negative in 29 cases after lamifudine treatment,but it's antibody is not acquired serum transferring.Conclusion The HBV DNA,HbsAg and HbeAg in patients with HBV infection may be transferred into negative forever transplanting with healthy liver underlined in HBIG and lamfudine treatment.

The paper briefly discusses the theories of human capital and related concepts, analyzes the interaction between human resources and human capital, and gives an account of the formation and forms of investment of human capital. The paper lays special emphasis on expounding the five basic features of human capital, viz. private ownership, dependence, changeability of added value, stratification and risk of investment. It stresses full understanding and scientific utilization of these features in hospital administration so as to properly manage human capital.

Management of salaries is one of the key integrants of the reform of the human resources management system and the running of the modern hospital. By giving an account of the concept, composition, connotation and chief functions of salaries in the hospital, the paper underlines a number of issues that ought to be stressed in the management of salaries, viz. external competitiveness or impartiality with regard to salaries, internal impartiality or u-niformity with regard to salaries, impartiality of increased salaries by performance, and salaries of special groups of people. The paper also offers a brief account of the relationships between salaries in the hospital and such functions as the design of human resources management posts, the recruitment of talented personnel, training and development, and management by performance.

Objective To explore the clinical pathologic characteristics of gallbladder cancer and prognostic factors for patients with gallbladder cancer.Methods We retrospectively reviewed 108 patients diagnosed pathologically with gallbladder cancer and treated in HuBei Three Gorges Polytechnic Medical College,Yichang Central People's Hospital and Yichang First People's Hospital from January 2003 to December 2012.Kaplan-Meier method was used to estimate survival.The association between the clinicopathologic characteristic and the prognosis in gallbladder cancer patients was assessed using Log-rank test.Cox proportional hazards model was used to determine independent risk factors.Results All patients were followed up from 3 to 102 months,the median follow-up time was 46 months.There were 77 deaths (71.3％),31 patients are alive.Survival time after operation was from 4-98 months.The mean and the median survival time were 28.4 months and 17 months respectively.The 1,2,3 and 5-year overall survival rates were 54.2％,37.5％,31.3％ and 21.6％.Multivariate analysis indicated independent risk factors were such as incidental gallbladder cancer,lymph node metastasis,poor differentiation.Conclusions Gallbladder cancer is a malignancy with poor prognosis.Incidental gallbladder cancer,lymph node metastasis,tumor poor differentiation are independent risk factors.

Objective To study the changes of serum high-sensitivity C-reactive protein (ha-CRP) and depression in patients with obstructive sleep apnea-hypopnea syndrome (OSAHS),and investigate the relationship between them.Methods Thirty healthy volunteers (control group) and 54 OSAHS patients (OSAHS group) were recruited for the study.The level of serum hs-CRP was determined by scatter rate nephelometry,and the state of depression was assessed by self-rating depression scale (SDS).Results The level of serum hs-CRP and SDS score were higher in OSAHS group than those in control group [(48.8 ± 12.7) scores vs.(36.3 ± 6.3) scores,(3.3 ±0.7) mg/L vs.(1.4 ± 0.4) mg/L](P＜0.01).SDS score and the level of serum hs-CRPwere positively correlated to apnea-hypopnea index(AHI) (r = 0.636,0.628 ;P<0.01) and negatively related to the MSaO2 (r =-0.509,-0.614;P <0.01) and LSaO2 (r =-0.607,-0.512;P <0.01).The level of serum hs-CRP was positive correlation to SDS score (r = 0.536,P<0.01).SDS score was related to the AHI,the level of serum hs-CRP and LSaO2 in multiple linear regression(F= 33.31,P = 0.002).Conclusion Depression is correlated to AHI and the level of serum hs-CRP in patients with OSAHS.

Objective To evaluate the effect and safety of tiotropium plus sustained-release theophylline in treating stable moderate chronic obstructive pulmonary diseases (COPD) . Methods A randomized clinical trail was conducted in 80 patients with stable moderate COPD, who were admitted to our hospital from March 2008 to December 2009. All patients were divided into two groups randomly and accepted tiotropium (groupⅠ ,n =40) or tiotropium plus sustained-release theophylline (group Ⅱ ,n =40) treatment for 12 weeks. Results Seventy patients completed the study,in which 36 cases had tiotropium alone and 34 cases had combination therapy. At the end of treatment, no statistically significant difference was found between the two groups in the comparisons of FEV1, FEV1%, FVC, FEV1/FVC, activity score and impacts score of the St George's Respiratory Questionnaire (SGRQ) (Ps > 0. 05). While the symptoms score (53.08 ± 12.25 vs.59.39±9.74,t=2.39,P<0.05) and total score (23. 91 ±2. 57 vs. 25. 27 ±2.14, t =2.40, P <0.05) of SGRQ were significantly lower in group Ⅱ compared to group Ⅰ. Six adverse events,including dry mouth (n =4), palpitation (re = 1) , constipation (n = 1), were observed in tiotropium alone group during the treatment period. Eleven adverse events were observed in combination treatment group, including dry mouth (re = 3) ,stomach discomfort or nausea (n = 3), diarrhea (re = 2) , palpitation (n = 2), constipation (n = 1) . The incidences of adverse reactions of two groups had no significant difference (P > 0. 05). Conclusion Compared with the single application of tiotropium, tiotropium plus sustained-release theophylline therapy can alleviate symptoms and improve life quality in patients with stable moderate COPD,without significantly increasing adverse reactions.

Objective To discuss method,operative characters and curative effect of total hip arthroplasty(THA)in treatment of acetabular fractures combined with ipsilateral femoral head or neck fractures.Methods One stage THA was done in seven patients with acetabular fractures combined with ipsilateral femoral head fracture(one patient)or femoral neck fractures(six patients)7-21 days after fractures.There were five males and two females,at age range of 41-65 years(average 50 years).According to AO classification,there were one patient with type A fracture,three with type B and three with type C.Of all,five patients received biological acetabular replacement after reduction and internal fixation of acetabular fracture and two received PMMA acetabular replacement with metal enforcement ring.All patients received biological femoral stem.Results Of all,six patients were followed up for from 2 years and 3 months to 6 years and 5 months(mean 3 years and 9 months),which showed heterotopic ossitlcation in one patient and dislocation in one who recovered after manipulative reduction.The Harris score was increased from mean prooperative 48 points to mean postoperative 91 points.X-ray found no loosening of prosthesis during follow-up.Conclusions THA can improve function of hip joint significantly,avoid further operation and lessen the burden of patients mentally and economically and hence is effective in treatment of acetabular fracture combined with ipsilateral femoral head or neck fractures.