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.

Objective To understand the hepatitis B virus(HBV)genotyping and pre-existing antiviral resistance mutation in the patients with clinical chronic HBV infection in Shenzhen area.Methods Serum samples in 244 cases of chronic HBV infection were detected for HBV genotyping and pre-existing antiviral resistance mutation by using PCR combined with reverse dot hybridization. Results In 244 cases of chronic HBV infection,3 kinds of genotype were found,including 143 cases(58.6%)of genotype B,100 ca-ses(41%)of genotype C and 1 case(0.4%)of genotype D;38 cases(15.57%)of pre-existing antiviral resistance mutation were de-tected out.The total detection rate of pre-existing antiviral resistance mutation was 15.57%,in which 22 cases(9.01%)were related with lamivudine resistance and 16 cases(6.56%)were related with adefovir dipivoxil resistance.Conclusion The genotype B and C are the main genotypes in Shenzhen area,and the incidence rate of pre-existing antiviral resistance mutation in the patients with chronic HBV infection is relatively high.The detection of genotyping and pre-existing antiviral resistance mutation of HBV has the important significance to predict the disease progression and guide the individulized treatment.

Objective To compare the surgical outcome of Lichtenstein,open preperitoneal technique and double-laver mesh technique in tension free repair of incarcerated inguinal hernia.Methods Totally 438 cases of indirect inguinal hernia in our hospital were retrospectively analyzed from January 2008 to January 2012,io which 154 patients received Lichtenstein,186 patients received open preperitoneal technique and 98 patients received double-layer mesh technique.Results The recurrence rates of these three groups were low,0.65％,0.54％,0,respectively,and there was no significant difference in the recurrence rate between these 3 groups (P ＞0.05),but significant difference in the foreign body sensation and postoperative pain between the open preperitoneal technique group and the other two groups(P ＜ 0.05),and the cost of the double-layer mesh technique group was ahout 2000 yuan higher than the other two groups.Conclusion The open preperitoneal technique can reduce the postoperative pain and foreign body sensation after surgery with low cost,and it is a good choice for inguinal hernia repair.

Objective To describe the results of the Universal Newborn Hearing Screening (UNHS) in Beijing in 2010; and investigatethe factors related with the results. Methods The result of the UNHS investigated by 106 maternity hospitals were reported. These hospitalswere investigated with the self-made questionnaire. Results In 2010, 159888 infants (91.99%) were screened in 106 maternity hospitals inBeijing as the 1st stage UNHS. 10.32% of them failed OAE tests. 72.30% received the 2nd stage UNHS and 13.27% of them failed testsagain. The referral rate was 0.99% in the end. The screening rate of both the 1st and 2nd stage was more in the newborn with Beijing householdregistration than in those with other household registration, as well as the hospitals in urban than in rural areas. For the rate fail in the1st stage UNHS, it was more in hospitals in urban than in rural areas, with distortion product otoacoustic emission (DPOAE) than with transientevoked otoacoustic emissions (TEOAE), by the bed than in the special room, and screening only once than screening again. ConclusionThe quality of UNHS is as high as in the developed countries in the newborn with Beijing household registration. To further improvethe screening rate, it is important to focus on the newborn with other household registers and the hospitals in rural areas. The instrument, personnelqualifications, environment and operation need to be further standardized.

Objective To study the universal newborn hearing screening (UNHS) results obtained in Beijing from 2007 to 2010 and to evaluate the index of hearing screening in Beijing. Methods The newborn born in Beijing just from October 1, 2007 to September 30, 2010 were selected and their hearing screening and diagnosis data were retrospectively collected. Results From 2007 to 2010, 470537 infants (90.2%) were screened in Beijing as 1st stage UNHS. 43019(9.1%) failed otoacoustic emission (OAE) tests. 31009 infants (72.8%) were screened in 2nd stage UNHS and 4568 failed tests. 1262 infants were referred for more testing and 1087 of them were diagnosed regularly.501infants were normal. 266 infants were finally diagnosed with single hearing loss and 303 infants were diagnosed with binaural hearing loss. 61infants were diagnosed with severe binaural hearing loss. Conclusion Establishment of the perfect newborn hearing screening system and advanced information system, and follow-up for the suspected children actively by doctors of community health care unit facilitate to improve UNHS.

Objective To observe the clinical effect of modified Zhisou powder and Symbicort Turbuhaler simultaneously on patients with Cough Variant Asthma. Methods 120 patients with Cough Variant Asthma were randomly recurited into two groups. 60 patients in the treatment group were treated with modified Zhisou powder and Symbicort Turbuhaler; 60 patients in the control group were treated with Symbicort Turbuhaler. 4 weeks was a therapeutic course in both group. Results The markedly controlled rate (MCR) (clinical control+excenence)of the treatment group was 83.3%, obviously surpassed the control group (70.0%) (P＜0.05); There was obvious improvement of cough, expectoration, breath lessness and throaty pruritus after the therapy in both groups, but it was much better in the treatment group than the control group(P＜0.05). The pulmonary function was significantly improved after treatment in both groups(FEV1, FEV1% and PEF, P＜0.05). The improvement showed significant difference between the two groups(P＜0.05). There was obvious decrease of EOS, IL-5 and ECP in both groups. The decrease of ECP and IL-5 in the treatment group was greater than the control group(P＜0.01). Conclusion The therapy of modified Zhisou powder and Symbicort Turbuhaler has advantage over pure western therapy.

Objective To evaluate the stability and compressive mechanical functions of the lumbar spine following insertion of a new self-made allograft interbody fusion cage.Methods Anti-bending intensity with three points test,anti-rotation intensity and compressive stiffness were measured at L4-L5 lumbar spine on five adult human fresh cadaveric specimens following insertion of a new self-made allograft interbody fusion cage and compared with that of before and after nucleus pulposus removal.Results The anti-bending intensity of flexion and extension of lumbar spine after inserting a new allograft interbody fusion cage was increased significantly(P

Objective To evaluate the clinical efficacy and safety of zinc gluconate nasal spray in the prevention of upper respiratory infection. Methods A random, double-blind and placebo-controlled study was conducted in a total of 901 healthy male recruits, who were randomized into 2 groups, experiment group and control group, by using a random-number table. The experiment group, consisted of 447 recruits, was given zinc gluconate nasal spray, and the control group, consisted of 454 recruits, with placebo for one month. During the course of the experiment, 61 in trial group and 67 in control group were eliminated. The incidence of upper respiratory infection, influenza-like illness, and the incidence of all the symptoms were documented after treatment for one month. Results Seven hundred and seventy-three recruits completed the schedule finally up to standard, among them 386 recruits were in experiment group and 387 in placebo group. The incidence of upper respiratory infection and influenza-like illness were lower in experiment group (26.94% and 0.26%, respectively) than in control group (34.37% and 2.06%, respectively; ?2=5.010 for upper respiratory infection, P

OBJECTIVE:To observe clinical efficacy and safety of torasemide in the treatment of chronic heart failure(CHF). METHODS:94 patients with CHF were selected and randomly divided into control group and observation group,with 47 cases in each group. Control group were treated with routine treatment,such as bed rest,oxygen inhalation,control of total body fluid in-take,routine anti-heart failure therapy and use of diuretic in 24 h. Based on the above treatment,observation group were treated with Torasemide injection with initial dose of 5-10 mg,qd,gradually increasing to 20 mg/d,maximal does of 40 mg/d. Both group re-ceived 7 days of continuous treatment. Clinical efficacies were observed in 2 groups as well as serum potassium and sodium,Scr,24 h urine volume and the rate ofⅠ-Ⅱgrade cardiac function before and after treatment. The occurrence of ADR was compared between 2 groups. RESULTS:The total effective rate of observation group was 61.70%,which was significantly higher than that of control group (46.81%),with statistical significance (P<0.05). There was no statistical significance in serum potassium and sodium and Scr between 2 groups before and after treatment(P>0.05). There was no statistical significance in 24 h urine volume and the rate ofⅠ-Ⅱgrade cardiac function between 2 groups before and after treatment(P>0.05);after treatment,24 h urine volume and the rate ofⅠ-Ⅱgrade cardiac function of 2 groups were increased significantly,the observation group was higher than the control group, with statistical significance (P<0.05). There was no statistical significance in the incidence of ADR between 2 groups (P>0.05). CONCLUSIONS:Torasemide is effective for CHF,and can promote diuresis and the recovery of cardiac function with good safety.

Objective To explore the effectiveness of monitoring for developmental delay (DD) and the feasibility of firsthand data reporting among 0~3 years old children. Methods A study population consisted of a cluster sample of 20907 children aged 0~3 years, from 22 communities in 5 districts in Beijing, was monitored for 1 year using questionnaires and data reports. The results were compared against the non-project communities. Results The screening rate of DD was 62.18%, higher than the non-project groups, and the rate of 0 year old group was significantly higher than the other groups. 268 children were positive screening, referral of 253 children, the referral rate was 94.4%; 97 children were diagnosed as DD with the prevalence rate of 7.46 ‰; 43.28% of the children received intervention and rehabilitation training. Conclusion The surveillance means of DD for 0~3-year-old children are effective and the firsthand data report is feasible