Non-responding pneumonia describes the situation, in which an inadequate clinical response is present de-spite antibiotic treatment. The incidence of treatment failure in community acquired pneumonia (CAP) can range up to 31%. At present, the diagnosis and treatment of this kind of disease remain a great challenge to CAP. For this reason, several stud-ies have attempted to establish risk factors and new strategies for the treatment of non-responding pneumonia. This article re-views the progress of the pathogeny and treatment of non-responding CAP.

Objective To evaluate the effect of comprehensive intervention measures on reducing the bacterial colonization of the intensive care unit (ICU)bedside notebook computer keyboards and mice.Methods According to bacterial contamination of ICU bedside notebook computer keyboards and mice,comprehensive intervention meas-ures were taken (including wiping computer keyboards and mice with alcohol twice a day,intensifying hand hy-giene,and monitoring hand-washing compliance),specimens of keyboards and mice were taken,bacterial detection results were analyzed.Results Before intervention,bacterial counts of keyboards and mice of 8 specimens were all>5 CFU/cm2 ,detection rate of Bacillus subtilis was 64.71 %,Micrococcus ,coagulase negative staphylococcus, Acinetobacter baumannii ,and Klebsiella pneumoniae were 17.65%-58.82%,Escherichia coli and Acinetobacter calcoaceticus were both 5.88%.After comprehensive intervention measures were taken,bacterial counts of only two specimens of keyboards and mice were >5 CFU/cm2 ,the qualified rate of monitoring result after intervention was significantly higher than before intervention (88.24% vs 52.94%;χ2 =5.10,P <0.05).Conclusion Compre-hensive intervention measures can significantly reduce bacterial count on ICU bedside notebook computer keyboards and mice,and decrease the occurrence of healthcare-associated infection.

Pseudomyxoma peritonei is a rare kind of clinical disease,mainly characterized by mucus exocrine cells grown in the peritoneum or omentum sticky which caused lots of jelly-like ascites.There is no obvious clinical specificity performance for pseudomyxoma peritonei,which is always misdiagnosed.By enhancing the awareness of pseudomyxoma peritonei,improving the relevant checks and reasonably extracting specimens for pathological examination can improve diagnosing rate of pseudomyxoma peritonei.Using complete cytoreductive surgery or major debulking surgery combined with intraperitoneal hyperthermic perfusion chemotherapy help to improve the survival of patients with pseudomyxoma peritonei.

Objective To evaluate the efficacy and safety of Tanreqing injection in the treatment of elder chronic senile obstructive pulmonary disease.Methods 78 cases of chronic senile obstructive pulmonary disease patients from August 2014 to May 2015 in our hospitol were selected and divided into control group and experiment group,with 39 cases in each group.The patients in the both groups were give regular treatment,patients in the control group were given theophylline sustained release tablets 0.2 g oral,two times a day;The experiment group were treated on base of the control group were given Tanreqing injection 20mL+5％intravenous glucose injection 500mL.The clinical efficacy,type B brain natriuretic peptide(BNP),calcitonin(PCT),forced vital capacity(FVC),forced expiratory volume in one second(FEV1),forced vital capacity(FVC)/expected value,and adverse reactions were compared between the two groups.Results The clinical efficacy in experiment group was 94.87％,which significant higher than that in control group(82.05％,P<0.05).The level of BNP serum PCT in two groups after treatment were significantly decreased,and the experiment group was significantly lower than the control group(P< 0.05);FEV1/expected,value FEV1/FVC levels were significantly increased and the experiment group was significantly higher than that of the control group(P< 0.05).The adverse drug reactions was not statistically different between the two groups.Conclusion Tanreqing injection in the treatment of elder chronic senile obstructive pulmonary disease with significant clinical efficacy,and with high safety.

The incidence of locally recurrent rectal cancer is about 10%. Most patients have serious symptoms after tumor recurrence, which seriously affects the quality of life and prognosis of patients. Although it is more difficult to perform reoperation, it is still the main method to treat local recurrence of rectal cancer. At present, the main methods of reoperation include transabdominal anterior resection, combined pelvic organ resection, combined pelvic organ resection, and sacral resection. Open surgery is the main method. In recent years, with the extensive development of laparoscopic technology, laparoscopic techniques have been tried at home and abroad to perform reoperations for locally recurrent rectal cancer, showing good short-term results. The authors systematically introduce the application of laparoscopic technology in the reoperation of locally recurrent rectal cancer based on relevant research advances at home and abroad, in order to explore its clinical application prospects and promotion value.

“Acupoint characteristics” has a significant influence on the study of acupoints. The description pattern of “property of Chinese medicine - function - indication” of analogy TCM put forward the description pattern of “acupoint characteristics-function-indication axis”. The study was carried out from the following three aspects:sorting, forming and improving the theories on acupoint characteristics; determining the functions according to present theories and indications of acupoints, methodizing the indications of acupoints; through functions, gradually simplifying and supplementing. Therefore, the above would make great sense to further research and systematic study and memorizing of acupoints and promoting clinical thinking about acupuncture, with a purpose to better guide clinical application.

Objective To evaluate the parameters of inner diameter different rate (D%), mean wave intensity(MWl) and diameter-adjusted mean wave intension(DAMWI) in assessing the function of common carotid artery(CCA) by quality intima-media thickness(QIMT) technique. Methods Twenty-four healthy subjects were performed 2D and CDFI examination under the normal quiescent and cold pressor test(CPT) condition respectively. The diastolic and systolic diameters of left-CCA were measured by QIMT respectively. Corresponding the inner diameter different range,rate,MWI and DAMWI were calculated respectively. The curves of their ROC were drawn. Results The different range and rate of diameters were decreased when subjects suffered CPT (P< 0.05) ,but the MWI and DAMWI were increased (P<0. 05). The areas under the ROC curves were 0. 827,0. 821 and 0.728 corresponding DAMWI, MWl and different rate of diameter. There was no significant difference among them(P>0. 05). Conclusions Conclusions The changed rate of diameter can be measured exactly by QIMT. The function of CCA can Be evaluated by MW1 and DAMWI which were calculated by conventional parameters.

Objective To evaluate the effects of Rebamipide,Omeprazol and their combination in treatment of gastric ulcer.Methods Forty gastric ulcer models were induced by acetic acid and randomly divided into 4 groups with 10 in each.The rats in control,Rebamipide,Omeprazol and combination groups were received saline (3 ml/d),Rebamipide (60 mg/kg),Omeprazol (10 mg/kg) as well as Rebamipide combined with Omeprazol for 7 days,respectively.After sacrifice,size of the ulcer and focal layer structures were measured in vitro by using miniature probe ultrasonography(MPS),mucosal sections were stained with H-E for histological examination,levels of interleukin-8/ prostaglandin E2 (PGE2) and methylenedioxyamphet amine (MDA) were evaluated by ELISA and TBA,respectively. Results ① Miniprobe ultrasonography revealed that comparing to control group[(22.3 ± 1.8)mm2], the maximal length of ulcer in Rebamipide [(9.2 ± 1.0) mm2 ],Omeprazol [(9.8 ± 1.3) mm2] and combination [(4.8 ± 1.2 )mm2 ] groups were significantly reduced ( P＜0.05 ).② In vitro,MPS examination revealed that layer echo structure of gastric wall was partially rebuilt in three medication groups,③ Histopathologically,comparing to control group,ulcer range and inflammatory infiltration in all medication groups were less important.④ The mucosal level of IL-8 in control group [(1387.8 ± 132.6)pg/ml] was higher than that in Rebamipide group[(970.0 ± 91.6) pg/ml],Omeprazol group [(1102.2±76.9)pg/ml] and combination group[(934.4 ± 110.2) pg/ml] (P＜0.05).⑤ The mucosal level of MDA was (9.4±1.4)nmol/ml and (8.5 ± 4.8)nmol/ml in Omeprazol and Rebamipide groups, respectively,which was higher than that in combination group[(4.6±1.4)nmol/ml-] and lower than that in control group[(13.0±2.6)nmol/ml].⑥ The PGE2 level was significantly increased in Omeprazol, Rebamipide and combination groups [(96.9 ± 7.0) pg/ml,( 103.5 ± 12.5 ) pg/ml,and(235.5 ± 26.0) pg/ m,respeetively] compared to control group[(55.0±22.5)pg/ml,P＜0.05)].Conclusions Rebamipide, Omeprazol and combination regimen may improve quality of ulcerative healing by increasing level of PGE2 and decreasing levels of IL-8 and MDA in gastric mucosa,and this will result in potentially reducing the rate of ulcer recurrence.Combination regimen shows more anti-ulcer effect comparing to monotherapy.

Objective To evaluate the effect of try psin on the proliferation,migration and adhesion of a skin squamous cell carcinoma cell line A431.Methods Cultured A431 cells were divided into several experimental groups treated with trypsin at concentrations of 0.1,1,10 and 100 nmol/L for 24,48 and 72 hours respectively,and a control group treated with DMEM complete medium only.Cell counting kit-8 (CCK8) assay was conducted to evaluate cellular proliferative activity to select the optimal concentration of trypsin.Then,some A431 cells treated with trypsin at the selected concentration for 24,48 and 72 hours respectively (or 48 hours only) served as the experimental groups (or group),and other A431 cells treated with DMEM complete medium served as the control group.Flow cytometry was performed to assess cell cycle distribution and proliferation index,fibronectin-based adhesion assay to estimate cell adhesive capacity,and wound healing assay and Transwell assay were conducted to evaluate the migratory capacity of cells in two-and three-dimensional space.Statistical analysis was carried out by using analysis of variance,paired samples t test and chi-square test.Results The proliferative activity of A431 cells increased along with the increase of trypsin concentrations,with the strongest increasing effect observed at 100 nmol/L.After treatment with 100 nmol/L trypsin,the experimental group showed a decrease in the percentage of G1-phase cells,but an increase in the percentage of S-phase cells,proliferation index,migratory and adhesive capacity compared with the control group (all P ＜ 0.05).Conclusion Trypsin can promote the proliferation,migration and adhesion of A431 cells.

Objective To investigate the relationship between the echinoderm microtubule associated protein like 4-anaplastic lymphoma kinase (EML4-ALK) and epithelial growth factor receptor (EGFR) mutation status and overall survival (OS) in Uygur patients with stageⅣnon-small cell lung cancer (NSCLC) who did not accept tyrosine kinase inhibitor treat-ment. Methods Totally 97 tissue samples were collected from Uygur patients with stageⅣNSCLC who did not accept tyro-sine kinase inhibitor treatment. EML4-ALK fusion gene and EGFR mutation status were detected by using FISH and ARMS methods. The survival rates were analysed. Results In 97 tissue samples, EML4-ALK fusion genes were found in 6 (6.2%) samples, EGFR mutations were found in 26 (26.8%) samples. The survival analysis showed that there was no significant dif-ference in OS between EML4-ALK fusion gene group and no EML4-ALK fusion gene group (P=0.941). There was no signifi-cant difference in OS between EGFR mutation group and wild-type EGFR group (P=0.607). The values of median OS were 17.7 months, 17.3 months and 16.2 months for EGFR mutant group, EML4-ALK positive group and EML4-ALK negative+EGFR wild-type group, and thre was no significant difference between them (P=0.915). Conclusion Excluding the thera-peutic influence in TKIs, EML4-ALK fusion gene and EGFR mutation status of tumor tissue can not be used as an indepen-dent factor in assessing the prognosis in Uygur patients with stageⅣNSCLC.