Objective To understand the clinical distribution and drug resistance situation of112 strains of Acinetobacter Bau-mannii isolated from the patients′sputum samples in cerebral surgery ICU in order to provide the basis for the rational use of anti-bacterial drugs in clinical therapy.Methods 112 strains of Acinetobacter Baumannii were performed the retrospective analysis.The VITEK2-Compact automatic microbiological analyzer was adopted to conduct the bacterial identification and the drug susceptibility test and the K-B method was combined as the supplement control.The Whonet 5.6 software was used for conducting the statistical analysis.Results Among 112 strains of Acinetobacter baumannii,75 strains(67.0%)were multi-drug resistant,8 strains(7.1%) were pan-resistant.The antimicrobial susceptibility tests showed that the resistant rates of Acinetobacter baumannii to mezlocillin, piperacillin and nitrofurantoin reached up to 100%.Acinetobacter Baumannii had the lower resistant rate to polymyxin B (2.7%), the resistant rates to minomycin and ceperazone/sulbactam were 4.5% and 10.7% respectively.Conclusion The drug resistance phenomena of Acinetobacter Baumannii in the cerebral surgery department ICU is serious.Minomycin,polymyxin B and ceperazone/sulbactam have the better antibacterial activities to clinically isolated Acinetobacter Baumannii and may be the alternative drugs for therapy.Clinic should strengthen the monitoring and rationally use the antibacterial drugs.

Objective To investigate the impacts of Xuebijing injection on systemic inflammatory response and immune function of patients with acute exacerbation of severe chronic obstructive pulmonary disease (AECOPD). Methods A prospective randomized controlled trial (RCT) was conducted. Forty patients with severe AECOPD were divided into control group and Xuebijing group in accordance with the random number table, each group 20 cases. Both groups were treated by routine conventional basic therapy of severe AECOPD including anti-infection, phlegm-expelling formula, bronchodilators and mechanical ventilation, etc, while in Xuebijing group, intravenous drip of Xuebijing (100 mg, twice a day for 5 days) was additionally used. The changes of data of arterial blood gas analysis, blood routine examination, C-reactive protein (CRP), procalcitonin (PCT), immune function, and acute physiology and chronic health evaluation system Ⅱ (APACHE Ⅱ) score before and after therapy were observed and compared between the two groups. The length of stay in hospital, duration of mechanical ventilation, and prognosis were also compared between the two groups. Besides, according to the difference in APACHE Ⅱ score, all the patients were divided into APACHEⅡscore≥15 score group (18 cases) and APACHEⅡscore<15 score group (22 cases), and the immune function were compared between the two groups. Results ①The immune function was descended and disordered in patients with severe AECOPD. Compared with the < 15 score group, the expressions of CD45+, CD3+, CD4+, CD4+/CD8+ ratio, B-lymphocyte, natural killer cell (NK cell) in ≥ 15 score group were significantly lowered [CD45+(×106/L):663.92±100.61 vs. 1 289.92±169.38, CD3+(×106/L):342.05±108.93 vs. 882.37±172.56, CD4+(×106/L):205.96±63.97 vs. 486.24±108.64, CD4+/CD8+ratio:0.76±0.49 vs. 1.32±0.57, B-lymphocyte (×106/L):124.77±32.72 vs. 166.06±48.02, NK cells (×106/L): 186.47±39.57 vs. 243.51±44.72, all P < 0.05]. There was no statistically significant difference in the expression of CD8+ between the ≥ 15 score group and < 15 score group (P > 0.05). ② Compared with those before therapy, the pH value, oxygenation index, arterial partial pressure of carbon dioxide (PaCO2), white blood cell count (WBC), CRP, PCT were significantly improved after therapy in both control and Xuebijing groups. Compared with those in the control group, WBC, CRP, PCT were significantly lowered in Xuebijing group [WBC (×109/L): 10.29±3.83 vs. 12.69±3.42, CRP (mg/L): 9.06±4.19 vs. 15.26±4.22, PCT (ng/L): 0.18±0.21 vs. 0.42±0.24, all P < 0.05]. There were no statistically significant differences in pH value, oxygenation index and PaCO2 between two groups (all P>0.05). The degrees of improvement of CD45+, CD3+, CD4+, CD8+ and CD4+/CD8+ ratio were more remarkable in Xuebijing group after treatment than those in control group [CD45+ (×106/L): 1 079.38±153.86 vs. 1 015.63±157.11, CD3+ (×106/L): 652.05±100.05 vs. 596.81±106.85, CD4+ (×106/L): 358.92±67.53 vs. 329.99±72.61, CD8+ (×106/L): 205.73±35.19 vs. 230.41±39.74, CD4+/CD8+ratio: 2.16±0.63 vs. 1.52±0.54, all P < 0.05]. The B-lymphocyte and NK cell before treatment and after treatment showed no statistical significant differences between the two groups (all P > 0.05). Compared with the control group, the duration of mechanical ventilation (hours: 56.25±22.87 vs. 69.45±26.59) and the length of stay in hospital (days: 11.00±0.74 vs. 14.00±2.06) were shortened, and APACHE Ⅱ score was significantly lowered in Xuebijing group (8.21±2.97 vs. 12.08±3.12, P < 0.05). The numbers of multiple organ failure and dead patients in Xuebijing group were less than those of control group, but no statistical significant differences were found (both P > 0.05). Conclusion Xuebijing injection for treatment of patients with severe AECOPD can ameliorate inflammatory response, improve immune function, shorten the duration of mechanical ventilation and the length of stay in hospital, and decrease the risk of death.

Arrhythmias, Cardiac ; therapy ; Biomedical Research ; methods ; standards ; Catheter Ablation ; Child ; China ; Drug Therapy ; Humans

Cardiac Catheterization ; trends ; Forecasting ; Heart Defects, Congenital ; therapy ; Humans

Autistic disorder is a severe neuropsychiatric disease and abnormal development in early childhood.The main clinical manifestations of autistic disorder are social interaction,language and behavior barriers.Currently,the incidence trend has showed increased year by year,the pathogenesis of autism has also been considerable development.This paper reviews the latest developments in autism,make excitatory/inhibitory neurotransmitter imbalances,nicotinamide metabolism and HPA axis dysfunction is the main pathogenesis of autism.

In addition to conventional palpation method, examination on vertebral range of motion (ROM) and mobility can help to determine a pathological displacement and thus provide solid basis for spinal tuina manipulation.

Objective To investigate the effect of community nursing intervention on the dementia caregivers'quality of life at home.Methods General situation questionnaire,simple intelligent state scale and patients daily life ability scale were used to evaluate patients' medical condition.Health questionnaire (SF-36) was used to assess the caregiver's quality of life at baseline and 3,6,9,12,18 and 24 months after the intervention.Results Compared with the control group,three dimension scores of the caregivers,including physical function(PF),restriction of physical heahh(RP) and mental health(MH),were significantly increased at 9,12,18 and 24 months after intervention,and the difference was significant(PF:t values were 2.084,2.118,2.051 and 2.591,respectively; RP:t values were 2.204,2.377,3.032 and 3.785,respectively; MH:t values were 2.112,2.369,3.204 and 2.913,respectively; all P＜0.05).Moreover,there was significantly difference between the two groups in two dimension scores of restricted role caused by emotional problems(RE) and general health(GH) at 12,18 and 24 months after intervention(RE:t values were 2.211,2.471 and 2.779,respectively; GH:t values were 2.158,2.485 and 2.887,respectively; all P＜ 0.05).For the intervention group,RP,RE,PF,MH and GH at 24 months showed statistically significant difference with baseline(t values were 3.131,3.293,2.457,3.618 and 3.433,respectively; all P＜0.05).However,there was no difference between the two groups in body pain(BP),vitality(VT) and social function (SF),and there was no statistically significant difference before and after the intervention(all P＞0.05).There was no statistically significant difference before and after the intervention in each dimension scores of SF-36 of the control group(P＞0.05).Conclusion Community nursing intervention can improve senile dementia caregivers'quality of life.

Objective To observe the effect and toxicity of oxaliplatin combined with calcium folinate and tegafur in the treatment of rectal cancer patients,in order to provide a safe and effective clinical program for rectal cancer treatment.Methods 117 rectal cancer patients conforming to the selection criteria were randomly divided into treatment group 59 cases and control group 58 cases by using random number method,treatment group were received chemotherapy of Oxaliplatin,calcium folinate and tegafur;control group were received FOLFOX4 program.After imple-mentation of two treatment plans,solid tumor curative effect evaluation standard from WHO was referenced to evaluate the curative effect.And toxicity classification was reached according to the WHO cancer drug toxicity assessment standard.Results Total effective rate of treatment group was 27.1%,total effective rate of control group was 29.3%,the comparative difference of two rates was not statistically significant (χ2 =0.069,P >0.05).The main symptoms of adverse reactions of two treatment plans were decreased of leukopenia,hemoglobin and thrombocytopenia of the blood system;nausea,vomiting,weak and abnormal liver function of the digestive system;,and limb numbness or pain of the nervous system.Adverse reactions difference in two groups was not significant (χ2 =0.106,0.158, 0.000,0.563,0.001,0.284,0.068,0.000,all P >0.05).After treatment,the median surial time was 15.5 months in treatment group and 16.5 months in control group,the difference of the median surial time in two groups was not statistically significant (P =0.781,P >0.05).Conclusion Combination of Oxaliplatin,calcium fluoride and tegafur is another safe and effective plan after the FOLFOX4 program in the treatment of rectal cancer drug application.

Evidence-Based Medicine ; Humans ; Practice Patterns, Dentists'

Evidence-Based Dentistry ; Humans