OBJECTIVE:To prepare tongmai oral liquid and study its quality control method.METHODS:The danshen root in tongmai oral liquid was identified by TLC.The content of ferulic acid in the oral liquid was determined by HPLC.RESULTS:Danshen root showed a good specificity in qualitation identification.The linear range of ferulic acid was5.12～71.68?g/ml(r=0.9998).The mean recovery was99.96%(RSD=1.3%).CONCLUSIONS:The preparation technology is practicable and quality control method is reliable.

With the ventilator associated lung injury (VALI) atracting more and more attention,lung protective ventilation strategy (LPVS) has gradually been applied to clinical practice.Obese patients are at higher risk in VALI for laparoscopic surgery,mechanical ventilation induced atelectasis is an important reason for low oxygen in intraoperative and postoperativen procedure.In laparoscopic surgery,high abdominal pressure causes the elevation of diaphragm,and increases airway pressure.The excessive pressure increases the amount of alveolar dead space and airway pressure,reduces lung compliance,and increases the possibility of barotrauma and colotrauma.In addition,carbon dioxide pnenmoperitoneum indces hypercapnia.Both of them influence the recovery of postoperative lung function.To optimize intraoperative management and improve the prognosis of patients with general anesthesia,the application of LPVS attracts more attention,including small tidal volume,positive end-expiratory pressure,and recruitment maneuvers,etc.However,LVPS may also cause lung injury.This article is a review on the application of LPVS in laparoscopic surgery of obese patients.

A total of 256 medical professionals at the hospitals of different levels were interviewed and requested to complete the relevant questionnaires.The findings revealed that the top five unsatisfied items were growth & development,working conditions,doctor-patient relationship,income and social status.The levels of job satisfaction varied with their specific occupations and technical titles.Around two thirds of them once had the thought of leaving their pre-hospital care posts.

Objective To discuss the clinical feature of chronic pain of aged people and strategies and effect of its self-management as well as their relationship.Methods Investigation with questionnaires wag carried out in 243 aged people who were above 65 years old to understand the clinical feature of chronic pain and strategies of its self-management.The results underwent analysis.Results Non-narcotic analgesics,physical exercise,cold and heat therapy and spiritual activity were used most frequently in selfmanagement of pain.No statistical difference existed in the use of self-management strategies between people in different age groups.Effect of self-management strategies was negatively correlated with degree of pain,interrupting with daily life and anxiety,but Wag positively correlated with self-efficacy score.Conclusions Aged people ale willing to attemp various strategies to cope with chronic pain.We should pain attention to the standardization of physical exercise,confrontation of anxiety and improvement of self-efficacy to improve the effect of self-management.

Objective To investigate the distribution and antibiotic resistance of isolated pathogens in neonatal sepsis. Methods The results of blood culture and drug susceptibility test in neonates sepsis from January 2012 to June 2013 were retro-spectively analyzed. Results One hundred and thirty-two strains were detected in the blood samples, with 100(75.76%)Gram-positive bacteria, 30 (22.73%) Gram-negative bacteria and 2 (1.52%) fungus. Staphylococcus epidermidis, Escherichia coli and Staphylococcus aureus were the three most common pathogens. Gram-positive cocci was strongly resistant to penicillin (100.00%), erythromycin, selectrin and ampicillin/sulbactam (62.50%-100.00%), but still sensitive to vancomycin and teico-planin. The resistance rate of Gram-negative bacilli to ampicillin was 100.00%, and the resistance rate to cefatriaxone, selectrin and cefuroxime was 61.54%-100.00%. The resistance rate to imipenem and piperacillin/tazobactam was lower. Conclusions The selection of sensitive antibiotics should be based on the pathogens and drug resistance testing for the treatment of neonatal sepsis.

Objective To study mechanisms of lipopolysaccharide (LPS) release from Acinetobacter baumannii (A. baumannii) induced by biapenem (BIPM), meropenem (MEM) and levofloxacin (LVFX). Methods A. baumannii was ex-posed to different concentrations of BIPM, MEM, LVFX, and ceftazidime (CAZ) at different time points. The LPS release was measured by tachypleus amebocyte lysate (TAL) test. Quantities of bacteria exposing to 0.5 MIC antibiotics were measured. The morphology of bacteria treated with different antibiotics for 7-hour was evaluated by light microscope. Results The LPS releases of A. baumannii treated with four kinds of antibiotics were significantly less than those of control group. In the later period, LPS releases of A. baumannii exposed to the high concentration of antibiotics tended to smooth. The cell quanti-ties of bacteria were significantly lower in treatment group than that of control group. The cells of A. baumannii treated with CAZ and LVFX showed long filamentous shape. The bacteria exposed to MEM and BIPM showed obviously globular. At the same time, some bacterial cells were induced to lysis rapidly by BIPM. Conclusion The level of LPS release is influenced by kinds of antibiotics, concentration and incubation period. All kinds of antibiotics could induce morphological changes of A. baumannii, which may be related to the different mechanisms that bacteria induce the different levels of LPS release.

Objective To investigate the occurrence and risk factors of surgical site infection(SSI)in patients with colon or rectal cancer.Methods Patients who were diagnosed with colon or rectal cancer and underwent emergency or elective surgery in a hospital between January 1,2008 and December 31,2013 were monitored prospectively.General data,operation condition,and antimicrobial use of patients were analyzed,occurrence of SSI was observed every day and followed up after operation,risk factors of SSI were analyzed by univariate and multivariate analysis.Results A total of 694 patients with colon cancer(n=380)or rectal cancer(n=314)were monitored,SSI occurred in 125 patients,including 15 incisional infection and 110 organ/space infection,incidence of SSI was 18.01%;incidence of SSI in colon cancer patients and rectal cancer patients were 17.11%(65/380)and 19.11%(60/314)respectively.Univariate analysis showed that among colon cancer patients,incidence of SSI was higher in those with co-infection of other sites during perioperative period,underlying diseases,phase Ⅰcancer,and relaxation suture(all P<0.05);among rectal cancer patients,incidence of SSI was higher in those with co-infection of other sites during perioperative period,underlying diseases,obstruction,operation time>2 hours,stoma,drainage,relaxation suture,rinsing during operation,and use of antimicrobial agents>72 hours(all P<0.05);logistic regression analysis showed that the independent risk factors for SSI in colon cancer patients were underlying disease,co-infection of other sites during perioperative period,and relaxation suture(all P<0.05);independent risk factors for SSI in rectal cancer patients were underlying disease,co-infection of other sites during perioperative period,and stoma(all P<0.05).Conclusion Prevention and control measures should be taken according to risk factors of SSI in patients undergoing colon cancer and rectal cancer surgery,especially those who with chronic underlying diseases and other site infection during perioperative period;in addition,patients with colon or rectal cancer should also pay attention to relaxation suture and stoma respectively.

Objective To investigate the efficacy of entecavir (ETV) sequential therapy in the treatment of hepatitis B e antigen(HBeAg) positive chronic hepatitis B(CHB) patients with suboptimal early response to Peginterferon-α(Peg-IFN-α).Methods The cases of HBeAg-positive CHB who were treated with Peg-IFN-α for 12 to 24 weeks and serum HBsAg ＞ 20 000 IU/mL were enrolled into observation group.Treatment naive HBeAg positive CHB with serum HBsAg ＞ 20 000IU/mL were enrolled into control group.Both two groups received ETV for 96 weeks.Hepatitis B virus (HBV) virological and serological data were collected every 12 weeks.Results At the end of 48-week and 96-week,the rates of HBeAg seroconversion in the observation group were 23.3％ (10/43),30.2％ (13/43),respectively,which in the control group were 23.1％ (12/52),28.8％ (15/52),respectively.The HBsAg decline at 24-week was observed in both two groups.Conclusion Sequential strategy for patients with suboptimal early response to IFN is preferable.

目的探讨启蒙教育对提高脑瘫患儿智力和注意力集中能力的作用。方法组织启蒙教育班,对25名脑瘫患儿通过游戏、手工、学儿歌、音乐、辨色、认识方位等多种形式开发智力 ,培养注意力集中能力。结果经启蒙教育后,患儿智商比教育前明显增高(χ2=4.13,P<0.05),注意力集中能力明显增高。结论启蒙教育可提高脑瘫患儿的智力和注意力集中能力,促进患儿的全面康复。