OBJECTIVE:To observe clinical efficacy and safety of tigecycline combined with isepamicin in the treatment of multidrug-resistant Acinetobacter baumannii pneumonia. METHODS:70 patients diagnosed as multidrug-resistant A. baumannii pneumonia were selected and randomly divided into control group and observation group,with 35 cases in each group. Both groups received routine treatment oxygen therapy or mechanical ventilation,anti-hypertension,hypoglycemic therapy. Control group was given Cefoperazone sulbactam for injection 3 g added into Sodium chloride injection 100 ml,ivgtt,qid. Observation group re-ceived Tigecycline for injection 100 mg,decreasing to 50 mg added into Sodium chloride injection 250 ml,ivgtt,bid,combined with Isepamicin sulfate injection 400 mg added into Sodium chloride injection 250 ml,ivgtt,qd. The time of body temperature re-turn to normal,pulmonary rale disappearance,chest X-ray shadow disappearance and leucocyte return to normal were observed in 2 groups as well as serum inflammatory factor level before and after treatment;total effective rate,bacterial clearance rate and ADR were compared between 2 groups. RESULTS:The time of body temperature return to normal,pulmonary rale disappearance, chest X-ray shadow disappearance and leucocyte return to normal in observation group were significantly shorter than in control group,with statistical significance(P<0.05). There was no statistical significance in serum inflammatory factor between 2 groups before treatment(P>0.05). The serum inflammatory factor of 2 groups decreased significantly after treatment,and the observation group was significantly lower than the control group,with statistical significance(P<0.05). Total effective rate and effective bacte-rial clearance rate of observation group were 85.7% and 82.9%,which were significantly higher than those of control group (62.9% and 60.0%),with statistical significance(P<0.05). There was no statistical significance in the incidence of ADR between 2 groups(P>0.05). CONCLUSIONS:Tigecycline combined with isepamicin is effective for multidrug-resistant A. baumannii pneu-monia,and can improve clinical symptom,control inflammation reaction,having high sterilization with good safety.

Background and purpose:The quality of life and psychological status of the advanced cancer patients has been widely valued. This study aimed to analyze the psychological status of the advanced cancer patients and its influence factors.Methods:The patients who were hospitalized in the palliative care department of Fudan University Cancer Center from Sep. 2011 to Mar. 2013 were included in this study. Self-rating anxiety scale(SAS), self-rating depression scale (SDS), EORTC QLQ-C30, social support revalued scale and symptom checklist 90 (SCL-90) were recorded and analyzed.Results:Fifty-six patients were included in this study, 18 were depression and 24 were anxiety while 16 of them were depression together with anxiety. The patients were divided into 2 groups according to their psychological status. There’s no signiifcant difference between the age and the social support between the two groups, while the mental disorders group have lower scores on body function, role function, emotional function and social function. The mental disorders were positive correlated with the symptoms score while negative correlated with the quality of life.Conclusion:There’s a high ratio of mental disorders in advanced cancer patients, the symptom scores and quality of life are related to mental disorders. We should pay more attention to the patients who were suffered more from the illness or had lower QOL scores.

Objective To investigate the value of roentgen stereophotogrammetric analysis (RSA) in assessing early migration of femoral implant after total hip arthroplasty (THA) with modular prostheses.Methods From May 2009 to April 2010,37 patients underwent THA with modular prostheses inour hospital,including 25 males and 12 females,aged from 58 to 72 years (average,60.23±5.64 years).There were 32 cases of degenerative osteoarthritis,3 cases of femoral neck fracture and 2 cases of developmental dysplasia of the hip.The Harris hip score and RSA were used to assess the clinical results and the migration of femoral implant at 3,6,12,24 months postoperatively,respectively.Results The average Harris hip score improved from preoperative 26.36 ±10.56 to 78.24±12.72,84.51±16.05,86.72±9.34,and 87.55±8.97 at 3,6,12,and 24 months after operation,respectively,and the differences between pre-and post-operative Harris score were significant.There was no prosthetic revision,and slight thigh pain occurred in 3 patients.According to RSA,the degree of initial migration of femoral implant had large individual differences,and the initial migration was higher from 3 to 6 months after operation.Clinical and biological stabilization was achieved in 36 patients,while progressive migration was found in 1 patient.There was a positive correlation between the distal migration and posterior migration within 24 months after operation (r=0.3,P=0.01).The distal migration and posterior migration/rotation mainly occurred within 3 months after operation.There was no correlation between prosthetic size/offset and degree of migration of implant.Conclusion RSA provides an objective reference for assessing the migration of femoral implant after THA with modular prostheses,which is a reliable method to evaluate early implant stability.

Objective Background and objective Bioinformatics technology found the TCF21 gene has difference expression in non-small cell lung cancer (NSCLC) and benign lung tissue.To explore TCF21 mRNA and protein expression in nonsmall cell lung cancer and its methylation of the promoter region is the aim of this study.Methods Use RT-PCR,Western blot and Pyrosequencing detected TCF21 gene mRNA,protein and the methylation of the promoter region respectively in 97 cases of non-small cell lung cancer and 21 cases of benign lung tissue.Results TCF21 gene mRNA-positive expression were detected 23 cases (23.71％) and 14 cases (66.67％) in 97 cases of NSCLC cancer tissue and 21 cases of benign lung tissue,the average gray value of TCF21 protein expression levels in NSCLC cancer tissue is 0.49 ± 1.78,while it is 1.48 ± 1.58 in benign lung tissue,the TCF21 gene promoter region have varying degrees methylation in NSCLC cancer tissue and benign lung tissue,and the significant of methylation frequency was found statistically significant between NSCLC cancer tissue and benign lung tissue,also it has higher frequency of 49.04％ and 51.37％ respectively at point 1 and 5 in NSCLC cancer organizations.Conclusion TCF21 gene mRNA and protein expression were statistically significant in NSCLC cancer tissue and benign lung tissue,the TCF21 gene promoter region average methylation frequency was significantly higher than that in benign lung tissue cells.

Objective To explore the characteristics of P300 of subjects with attention deficit/hyperactive disorder(ADHD).Methods 34 children with ADHD were selected as ADHD group and 32 healthy subjects were selected as the health control group.They were matched in age,gender,degree of education.The auditory Oddball paradigm was applied,the event-related long latency components (N2 and P3) from Cz and Pz were measured in each test.Results Compared with the health control group,at the Cz electrode,children with ADHD showed a significandy prolonged latency of target N2 [(277.2 ± 20.3) ms vs (259.0 ± 14.9) ms,t =3.70,P ＜ 0.01] and decreased amplitude of target P3[(4.1 ± 1.6) μμV vs (5.7 ±2.0) μμV,t =3.57,P＜ 0.01].At the Pz electrode,the patient showed a significantly prolonged latency [(342.4 ± 26.3) ms vs (324.6 ± 15.5) ms,t =3.33,P ＜ 0.01] and decreased amplitude of target P3 [(4.1 ± 1.9) μV vs (7.4 ± 2.2) μV,t =6.54,P ＜ 0.01],decreased amplitude of non-target P2 [(3.0±1.l)μμV vs (3.7 ±1.3) μV,t =2.30,P＜0.05].Conclusion This study provides direct evidence that ADHD subjects have abnormal indices of endogenous P300,which is suggested that P300 might be potentially objective indicator applied in evaluation of cognitive dysfunction in ADHD children.

BACKGROUND: At present, there are many drugs and therapeutic methods for dementia at home and abroad. Both xingding and piracetam are the kind of improver for circulatory obstruction and protector for nerve cells and can slow down the functional decline of brain tissue and provide improvement for cognitive deficit.OBJECTIVE: To observe the improvement of allied application of xingding and piracetam on cognitive function in treatment of vascular dementia.DESIGNS: Case-controlled study based on patients.SETTING: Neurological Department in Affiliated Hospital of Henan University. PARTICIPANTS: Totally 91 cases of vascular dementia hospitalized in Neurological Department of First Affiliated Hospital of Henan University from October 2000 to March 2002, which were randomized into treatment group of 48 cases and the control of 43 cases.INTERVENTIONS: In treatment group, xingding injection of 20 mL and piracetam of 8 g were administrated and 50 g/L glucose injection 250 mL was added respectively for intravenous injection, once daily and 14 days made one session. In the control, piracetam of 8 g was prescribed with 50 g/L glucose injection 250 mL added for intravenous injection, once daily and 14 days made one session. There was no any difference in other medication treatment. One month later after treatment of two groups, he patients were re-examined with mini-mental state examination(MMSE) and Hasegawa dementia scale(HDS) was used to assess the cogitative improvement and neurological defect scale(NDF) was used to analysis the improvement of neurological functional symptoms.MAIN OUTCOME MEASURES: ① Scores of MMSE, HDS and NDF in two groups. ② Analysis on therapeutic effects.RESULTS: Totally 91 cases entered the analysis on the results. There was no significant difference in MMSE and HDS before treatment in two groups. In treatment group, after treatment, MMSE and HDS scores were (23.26±5.12) and(2.78±3.46) respectively, indicating significant difference(t=4.79, 15.44, P＜0.01) compared with the control(19.14 ±3.21)and(15.21±2.29) . NDF score was 13.68±7.83 after treatment and the significant difference was presented compared with the control(17.33 ±8.81) . The total effective rate(total remarkable rate + progression) was 92% in the treatment group and was 56% in the control. By the comparison between two groups, the difference was significant(χ2= 15.48, P＜0.01).CONCLUSION: After treatment, MMSE score in treatment group was higher than that in the control and HDS score was lower than that in the control, explaining that xingding allied piracetam significantly improves cogitative function in the treatment of vascular dementia.

Objective To discuss the effect of group social skills training on improving psychiatric symptoms and disability and the family relationship in patients with schizophrenia.Methods 101 followup patients of rehabilitation with schizophrenia in mental health center of a top three hospital and in a community were chosen from June 2011 to August 2012.Based on the principle of voluntary,45 and 56 patients were grouped into the control group and the intervention group,respectively.The scores of psychiatric symptoms,mental disability and family relationship were compared between two groups by independent sample test.Results At the end of six months,the score of positive and negative symptoms and mental disability were lower in the intervention group,and there was significant difference in different measuring time,the interaction existed between the intervention and the measuring time.Meanwhile,the total score of family concern in the intervention group was higher than that in the control group,and there was significant difference in different measuring time,no interaction existed between the intervention and the measuring time.Conclusions Group training of social skills could improve psychiatric symptoms and the family relationship of patients with schizophrenia,reduce mental disability and promote recovery of patients.

Objective To compare the procotol of EGDT +Pt (cv-a ) CO2 with EGDT in fluid resuscitation and management after evaluate fluid responsiveness in shock patients by Vigileo and passive leg raising test.Metheds Prospectively collect patients who meet the criteria between 2013.5.1-2013.1 1.30 in our ICU.Randomly (random number)divided into Vigileo group (first evaluate the fluid responsiveness then give EGDT +Pt (cv-a) CO2 ) and CVP group (give EGDT).Compare the hospital mortality and morbility of MODS,the volume given in the first 6 hours and the first 7 days,consume of blood products , the ICU and hospital stay.Results Collected 46 patients,Vigileo group (21 )and CVP group (25 ). There’s no significant difference between groups at baseline.In the first 6 hours the CVP group had received more fluids (3656.281678.57 vs. 2639.141326.59 ) mL, P =0.03;and more blood products (573.00172.57 vs. 190.4770.82)mL,P=0.04,respictivily.Vigileo group significantly short the ICU stay ,(6.384.34 vs. 12.165.77)d,P=0.04.But there’s no significant difference in hospital motality and the morbility of MODS.The ROC of Age ,the accumulative volume of balance in 7 days,APACHEⅡscore in the first day to predict death is 0.84 (0.68-0.99)、0.82 (0.69-0.95)、0.80 (0.66-0.94),all P>0.05,respectively.By 7 days the accumulative volume of balance 3454.51mL as cutoff to predict death with the sensitivity of 0.67,specificity of 0.84.Conclusions 1.Given EGDT +Pt (cv-a) CO2 after evaluate the fluid responsiveness can reduce fluid and blood products given in the first 6 hours,significantly short the ICU stay,without worsen the tissue flow or increase the morbility of MODS;2.Consecutive positive fluid balance is a risk factor about poor prognosis,and also a sensitive indicator to predict death.

ObjectiveTo observe the clinical efficacy of external application of sihuang-honey for aseptic inflammation after total knee arthroplasty.Methods 30 cases of total knee arthroplasty patients were recruited into two groups,of 15 cases in each group.The treatment group was treated with sihuang-honey (made of rhubarb,scutellaria,phellodendron,coptis according to the same proportion of powder with honey ),which was placed on a sterile plastic sheet,0.5 cm thickness.The sheet was applied on the knee of the highest skin temperature for 6 hours,removed it for 2 hours interval,and reapplied on it,for altogether 24 hours before changing another sheet.The control group were treated by continued covering ice on the knee every day,with the ice completely surrounded the knee.Both groups were treated for 2 weeks.Clinical efficacy was observed before the treatment,and 3 d,7 d,14 d after the treatment.ResultsAfter the treatment,compared with the control group,the treatment group was effective in terms of VAS score (4.12± 1.08) points in 3d,(3.34±0.61)points in the first 7 days; skin temperature (37.56±0.40) ℃,activity (98.56±3.24) ° in 3d,and the difference was statistically significant (P＜0.05).The degree of swelling in 3 d (5.80±2.00) ％,7 d (9.33±2.55)％,14 d (12.13 ± 2.70)％ in the treatment group were better than the control group (P＜0.05); The rate of pain relief of treatment group was 93.33％ and satisfaction was 66.67％,although better than 86.67％ and 46.67％ of the control group,the difference was not statistically significant (x2 were 1.33,3.04,P＞0.05).Conclusion Sihuang-honey was effective for the treatment of aseptic inflammation after the surgery of total knee arthroplasty.

Objective To investigate meclical ethits level of first-year mecdical stuclents in Guangzhou medical college,which contributes to provide guidance of medical ethics education for interns. Methods To investigate 183 cases of first-year medical students. They were asked to deal with a case of 'a vagrant needed emergency treatment'. The statistics datum were classified according to 'norms of medical ethics and ways of implementation made by the Ministry of Health for medical staff'.Results 99.45% of them thought they should immediately save patients' live;but less than 28.96%thought of using cheap and fine medicines;only 38.80% mentioned the patients' mood. And there was no significant difference between boys and girls(P>0.05). Conclusion Medical students have already established a 'life-saving' awareness when they are freshman, but they also need to learn how to put ethics into practice.