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 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 alanyze the imaging features of brain in systemic NHL.Methods CT and MRI of brain in 8 cases of systemicNHL proved pathologically were performed.Imaging findings of brain were analysed and by comparison with that in 73 cases of brainmetastases with marked enhancement after contrast administration.Results 13 lesions in 8 cases were found by CT,the findings on contrast-enhanced CT included:①Ten lesions showed low density with obscure border;②Three nodular lesions showed high density(including 2 homogeneously and 1 ring-like enhanced nodules).All lesions showed neither ventricle enlargement nor occupying effects.Those enhanced showed no edema around the nodules.Of the 4 cases with MRI,low T_1 signal and high T_2 signal with no change after contrast administrationwere seen in 3 cases.One showed ring-like enhancement with no edema around.While 89% of the 73 brain metastatic cases showeddifferent extent of edema.Conclusion The imaging findings in some of the lesions in this study are different from that described before in literatures.In comparison with other metastases,the marked-enhanced nodules with no edema were found to be a specialty of secondary NHL in brain in our cases.

Objective To investigate the possible protective effects of hydrogen sulfide (H2S) on rats with multiple organ dysfunction syndrome (MODS). Methods NaHS was taken as a donor of H2S. Forty Sprague-Dawley rats were divided into 5 groups with 8 rats in each group:sham group,MODS 12 h model group,MODS 24 h model group,NaHS protection 12 h and 24 h groups. The content of superoxidase dismutase (SOD),malondialdehyde (MDA),glutathione peroxidase (GSH-Px),alanime transaminse (ALT),creatine kinase (CK) and creatinine (Cr) in serum were measured,respectively. The histopathological changes in the heart,liver,lung,kidney and small intestine were observed. Results The serum content of SOD and GSH-Px was significantly higher in protected H2S groups (P

Objective To evaluate the early and midterm effect by retrospective analysis of the cone reconstruction in Ebstein′s anomaly. Methods From January 2012 through June 2016,16 patients with Ebstein′s anomaly underwent the cone reconstruction in our hospital. There were 7 males and 9 females at mean age(28.21 ± 11.88)years,including 12 patients of Carpentier B type,4 patients of Carpentier C type. There were 9 patients in New York Heart Association(NYHA)functional class Ⅲ,5 patients in NYHA functional class Ⅳand the others in NYHA functional class Ⅱ. All patients had Tricuspid insufficiency ,including 2 patients with Grade 2 ,10 patients with Grade 3 and 4 patients with Grade 4. All patients were followed up over a period of 6 to 51 months (mean:24.36 ± 10.71). By comparing the details of pre-operation with post-operation and post-operation with current stage,we analyze the outcomes of early and midterm effects. Results All patients are well survived. There were one patient recovering from the low cardiac output syndrome with adding the strength of the positive inotropic drug in the first day after operation ,and one patient recovering from bigeminy of ventricular prematurebeat with the aid of amiodarone and lidocaine the third day after operation. The remaining patients recovered smoothly. Early post-operative echocardiograms showed good right ventricular morphology and reduction in tricuspid regurgitation grade from(3.13 ± 0.62)to(1.75 ± 0.45)(P<0.001)with the functional class improved from(3.19 ± 0.66)to(2.00 ± 0.52)(P<0.001). After mean follow-up of(24.36 ± 10.71)months,the situation is improving furtherly with the tricuspid regurgitation grade reducing to(1.31 ± 0.48)(P=0.016)and the functional class rising to(1.50 ± 0.52) (P = 0.031). Conclusions This surgical technique for Ebstein′s anomaly can improve the function of tricuspid valve and the right ventricular morphology. It showed a satisfactory performance in the early and midterm results by enhancing the Cardiac function and life quality. But indications should be strictly grasped and more experiences need to be accumulated. Long-term effect need to be furtherly explored.