Objective To investigate the therapeutic effect of bundle treatments for critically ill patients with pulmonary tuberculosis and respiratory failure (RF).Methods A prospective study was conducted, including 56 patients with pulmonary tuberculosis and RF necessary for invasive mechanical ventilation admitted into Department of Critical Care Medicine of the Fourth People's Hospital of Nanning City from January 2013 to December 2014 as the observation group to be treated by bundle treatments. A series of treatments and cares were given to the critically ill patients, such as invasive mechanical ventilation, application of antibiotics by experience within the first hour, supportive treatment targeted to hemodynamics in early stage, correction of brain dysfunction, effective therapy for tuberculosis, establishment of enteral nutrition in early stage and prevention of ventilator-associated pneumonia (VAP), etc. All the above treatments were completed one by one in 6 hours to 12 hours. Meanwhile, 42 patients who hospitalized from January 2011 to December 2012 and treated with conventional targeted therapy were designed as the control group. The changes of vital signs, blood routine test, respiration, liver, kidney, etc organ functions, the improvement of acute physiology and chronic health evaluation Ⅱ (APACHE Ⅱ) score, expected mortality and sequential organ failure assessment (SOFA) score, the incidence of VAP, cure and improvement rate, mortality, duration of invasive mechanical ventilation, the length of stay in intensive care unit (ICU) were compared between the two groups after treatments.Results There were no statistically significant differences in the comparisons between the two groups before and after treatments in temperature, white blood cell count (WBC), blood glucose, total bilirubin (TBil), alanine transaminase (ALT), albumin (Alb) and cholesterol level (allP > 0.05), except the platelet (PLT) count in observation group was higher than that in control group before treatments. After treatments for 72 hours, in the two groups, the heart rate (HR), respiration rate (RR), APACHE Ⅱ score and expected mortality were lower than those before treatments, while the arterial partial pressure of oxygen (PaO2) and oxygenation index were higher than those before treatments. There were no statistically significant differences in pH value, PLT, arterial partial pressure of carbon dioxide (PaCO2) and SOFA score before and after treatments in the control group (allP > 0.05). In the observation group, after treatments, the pH value was increased compared with that before treatments, while PLT, PaCO2 and SOFA score were decreased compared with those before treatments (allP < 0.05). The degrees of improvement of PaCO2 and oxygenation index in the observation group were superior to those in the control group [PaCO2 (mmHg, 1 mmHg = 0.133 kPa): 43.32±9.10 vs. 56.10±9.39, oxygenation index (mmHg): 330.60±100.98 vs. 245.65±83.20, bothP < 0.05]. After bundle treatments, compared with control group, the incidence of VAP was decreased [16.07% (9/56) vs. 33.33% (14/42),P < 0.05], improvement and cure rate was increased [78.57% (44/56) vs. 59.52% (25/42),P < 0.05] and mortality was decreased significantly in observation group [10.71% (6/56) vs. 28.57% (12/42),P < 0.05]. The duration of invasive mechanical ventilation (days: 9.15±3.59 vs. 16.96±13.44) and the length of stay in ICU (days: 13.30±4.24 vs. 23.00±15.03) in the observation group were shorter than those in the control group, but no statistically significant differences were found (bothP > 0.05).Conclusion The bundle treatments can effectively reduce the incidence of VAP and elevate the improvement and cure rate in patients with pulmonary tuberculosis complicated with RF.

Objective To observe the therapeutic effect of endometrium minimally invasive pretreatment on non -pregnant PCOS patients who are on ovulation induction treatment.Methods According to the digital meter method,divided 66 non -pregnant PCOS patients who were with abnormal endometrial echoes or abnormal thickening by ultrasound in follicular phase in natural periodwith into testing group(33 cases)and control group(33 cases).All patients were treated with drospirenone and ethinylestradiol tablets treatment for 3 to 6 cycles,and then with clomi-phene citrate(CC)for induction of ovulation.In the testing group,endometrium microresecting was given by disposa-ble uterine cavity tissue suction tube device within 3 ~5days after menstrual onset.Patients in the control group were not performed with endometrium microresecting.All patients of the two groups were given estrogen and progesteroneas well as detection of ovarian folicle and endom etrium with B -modeult rasonography.Results Intimal thickness in the testing group was(8.78 ±1.56)mm,the pregnancy rate was 36.36% and the abortion rate was 16.67%,there was no obvious pain and unwell during the operation and the patients were free from infection.Intimal thickness in the testing group was(6.32 ±0.74)mm,the pregnancy rate was 24.24% and the abortion rate was 12.50%.There were significant differences between the two groups of endometrial thickness,pregnancy rate(t =8.184,χ2 =4.60,all P <0.05).Conclusion Endometrium microresecting by endometrial sampling device can increase the endometrium, thickness and the pregnancy rate,and at the same time it doesnot increase the rate of early spontaneous abortion.And it is easy to perate,convenient,less trauma,less pain,easy to acceptand and some other advantages,it has better clini-cal application value,so it deserves to be applied in basic hospital.

Objective To design a stimulating instrument for physiology experiment.Methods A sine wave was produced by a high frequency oscillator,and then the sine wave increased in voltage by a transformer to accord with the maximal range needed.Afterwards,the increscent sine wave became a direct current signal with high voltage by a rectifier and a filter.Finally,the signal became a stimulating impulse to be exported by a switch,which was controlled by a controlling signal with adjustable frequency and width.Results Voltage range adjusted between 1 and 80V;Frequency adjusted between 0.1 and 200Hz;Impulse width adjusted between 0.1 and 5ms.Conclusion The stimulating instrument designed can be used to do electricity stimulating experiment in Physiology.

Objective To summarize the postoperative experience of nursing infants undergoing total anomalous pulmonary venous correction.Method The clinical data of 54 infants undergoing total anomalous pulmonary venous correction were retrospectively reviewed for the summarization of nursing strategies.Result Forty nine patients were clinically cured and discharged, 2 voluntarily left the hospital without further treatment and 3 died of low cardiac output syndrome.Conclusion Early postoperative monitoring,protection of heart function and prevention of pulmonary hypertensive crisis are all critical for successful manipulation of total anomalous pulmonary venous correction.

Objective To investigate the effect of rosiglitazone on non-alcoholic fatty liver (NA and to explore the relationship between insulin resistance and NAFL. Methods Animal model of NAFL was established by feeding Sprague-Dawley rats a high-fat diet for 8 weeks. The model rats were then randomized into rosiglitazone-treated and untreated groups. The animals were sacrificed after being treated with rosiglitazone or vehicle for 4 weeks. The histological changes of liver were examined, and liver function, fasting plasma glucose, fasting serum insulin, serum lipid profile, leptin, and adiponectin were measured. Results As compared with untreated group, hepatic steatosis and liver function were significantly improved in rosiglitazone-treated group. Alanine aminotransferase (ALT) was 54±19 U/L vs 101±24 U/L, aspartic acid aminotransferase (AST) 151±37 U/L vs 198±48 U/L, and alkaline phosphatase (ALP) 87±16 U/L vs 115±39 U/L, respectively (P<0.01). Serum adiponectin level was higher, and serum leptin level and insulin resistance index (HOMA-IR) were lower in rosiglitazone-treated group than in untreated group. HOMA-IR was 6.9±1.8 vs 12.0±1.2 (P<0.01). Serum triglyceride, total cholesterol and low density lipoprotein-cholesterol level were significantly decreased in rosiglitazone-treated group as compared with untreated group (P<0.01). Conclusions Insulin resistance might play important role in the pathogenesis of NAFL. Rosiglitazone effectively reverses NAFL in animal model.

ObjectiveTo investigate the current situation of intensive care unit (ICU) inpatients in Infectious Disease Hospital of Nanning to provide a reference for the prevention and control of infectious diseases and construction and development of ICU in such a hospital.Methods The clinical data of inpatients from January 2011 to December 2015 in the Infectious Disease Hospital Affiliated to Guangxi Medical University (that is the Fourth People's Hospital of Nanning City) were retrospectively analyzed, and the distributions of patients with various diseases, ages, of the characteristics of children severe infectious diseases in ICU, the numbers of patients with infectious diseases in general ward and ICU, the average time and daily cost of hospitalization and mortality were conducted.Results During 2011 to 2015, 855 cases in ICU were treated, including 709 cases of infectious diseases, 146 cases of non-infectious disease. The top 5 infectious diseases were ranked as follows: tuberculosis, human acquired immune deficiency syndrome (AIDS), hand-foot-mouth disease (HFMD), viral hepatitis, tetanus, accounting for 96.47% of the total infectious disease inpatients in ICU; there were 25 cases of other legal infectious diseases, accounting for 3.53%, including dengue fever, measles, malaria, chicken pox, mumps, rabies, typhoid fever, paratyphoid fever, scrub typhus, bacillary dysentery, leptospirosis, human infections with highly pathogenic H7N9 avian influenza, epidemic hemorrhagic fever, A H1N1 influenza, and besides, critically ill patients carrying virus (viral hepatitis B and AIDS) in 7 pregnant women, 22 surgical patients, and 117 patients with internal medicine diseases were also admitted and treated. The top 4 infectious diseases causing deaths in ICU were tuberculosis, AIDS, viral hepatitis and HFMD: The infectious diseases with top 6 high mortalities in ICU were as follows: rabies, viral hepatitis, AIDS, tuberculosis and tetanus. The age range was wide in this study, from 73 days to 97 years, among which there were 167 cases of pediatric infectious diseases from pediatric department, accounting for 23.55% of ICU inpatients, being mainly severe HFMD, tuberculosis and severe varicella. From 2011 to 2015, the number of hospitalized patients showed a rising trend, and the average length of stay of patients in general wards presented a downward tendency, but the average time of hospitalization of inpatients with infectious disease in ICU, mortality and daily cost of hospitalization revealed a gradually increasing trend year by year.Conclusions It is of far-reaching significance to master the spectrum of dangerous severe infectious diseases to deal with the infectious disease epidemic situation and outburst with public health events.

Based on ancient literature of acupuncture in Canon of Chinese Medicine (4th edition), the articles regarding acupuncture for urinary incontinence were retrieved and collected to establish a database. By Weka data mining software, the multi-level association rules analysis method was applied to analyze the acupoints selection characteristics and rules of ancient acupuncture for treatment of urinary incontinence. Totally 356 articles of acupuncture for urinary incontinence were collected, involving 41 acupoints with a total frequency of 364. As a result, (1) the acupoints in the yin-meridian of hand and foot were highly valued, as the frequency of acupoints in yin-meridians was 2.6 times than that in yang-meridians, and the frequency of acupoints selected was the most in the liver meridian of foot-jueyin; (2) the acupoints in bladder meridian of foot-taiyang were also highly valued, and among three yang-meridians of foot, the frequency of acupoints in the bladder meridian of foot-taiyang was 54, accounting for 65.85% (54/82); (3) more acupoints selected were located in the lower limbs and abdomen; (4) specific acupoints in above meridians were mostly selected, presenting 73.2% (30/41) to the ratio of number and 79.4% (289/364) to the frequency, respectively; (5) Zhongji (CV 3), the front-mu point of bladder meridian, was seldom selected in the ancient acupuncture literature, which was different from modern literature reports. The results show that urinary incontinence belongs to external genitalia diseases, which should be treated from yin, indicating more yin-meridians be used and special acupoints be focused on. It is essential to focus inheritance and innovation in TCM clinical treatment, and applying data mining technology to ancient literature of acupuncture could provide classic theory basis for TCM clinical treatment.
Acupuncture Points ; Acupuncture Therapy ; history ; China ; Data Mining ; Databases, Bibliographic ; history ; History, 15th Century ; History, 16th Century ; History, 17th Century ; History, 18th Century ; History, 19th Century ; History, 20th Century ; History, 21st Century ; History, Ancient ; History, Medieval ; Humans ; Medicine in Literature ; Urinary Incontinence ; history ; therapy

Objective To investigate the predictive value of Alberta stroke program early CT score on diffusion-w eighted imaging (DWI-ASPECTS) for predicting new cerebral microbleeds (CMBs) in patients w ith acute middle cerebral artery infarction. Methods The patients w ith acute middle cerebra artery infarction w ere enroled prospectively. MRI examinations w ere completed w ithin 48 h on admission and they w ere examined again at 10 to 14 d after onset. Susceptibility-w eighted imaging (SWI) w as use to detect
CMBs. DWI-ASPECTS w as used to assess the infarction extent. Results A total of 82 patients w ith acute middle cerebra artery infarction w ere enroled, including 27 females and 55 females. Their ages w ere 71.7 ± 8.9 years. Eighteen patients (22.0%) had old CMBs, 25 (30.5%) had new CMBs, 57 (69.5%) did not have new CMBs. Compared w ith the non-new CMB group, DWI-SPECTS (3.20 ±1.73 vs.7.11 ±1.69;t = 9.573, P <0.001) w as low er, NIHSS scores (16.20 ±4.06 vs.12.63 ±5.06; t = 3.111, P = 0.003) w ere higher, there w ere more patients w ith atrial fibrilation ( 40.0% vs.15.8%; χ2 = 5.722, P = 0.017), proportion of intensive antiplatelet therapy ( 0% vs.28.1%; P = 0.002) w as low er, there w ere more large artery atherosclerosis type ( 60.0% vs.29.8%; χ2 = 6.650, P = 0.010 ), more cardiogenic cerebral embolism type (36.0% vs.5.3%; P = 0.001), and less smal artery occlusion type ( 0% vs.57.9%; P <0.001) in the new CMB group, and there w ere no statistical differences in the other indexes. Multivariate logistic regression analysis show ed that after adjusting age, sex, alcohol, histories of hypertension, hyperlipidemia, diabetes, atrial fibrilation and previous stroke or transient ischemic attack history, the higher the DWI-ASPECT scores ( > 5), the risk of new CMBs w ould decrease 86 % (odds ratio 0.14, 95%confidence interval 0.17 -0.48; P < 0.001). Receiver operating characteristic curve analysis show ed that the sensitivity of prediction of DWI-ASPECTS ≤5 for the new CMBs w as 87.7%, specificity w as 88.3%, and the area under the curve w as 0.940. Conclusions DWI-ASPECTS can effectively predict the new CMBs in patients w ith acute middle cerebra artery infarction.

OBJECTIVE:To analyze intervention effect of Drug Rational Usage Guidelines System(DRUGS)on antibacterial agents use in department of obstetrics and gynecology in our hospital. METHODS:The application of antibacterial agents in depart-ment of obstetrics and gynecology in our hospital during Jan.-May(before intervention)and Jun.-Nov. 2012(after intervention)were extracted in respects of drug name,preoperative medication duration,perioperative additional condition,postoperative drug with-drawal time,drug combination,usage and dosage,average hospitalization stay,hospitalization cost. The intervention effects were analyzed. RESULTS:After intervention,the type of antibacterial agents were more in line with national regulations;the proportion of type Ⅰ incision surgery without antibacterial agents increased from 57.8% to 75.2%;the prophylactic application of antibacteri-al agents in type Ⅱ incision surgery within 0.5-2 h increased from 80.2% to 97.0%. The rate of reasonable antibacterial selection, drug combination,usage and dosage increased from 76.9%,64.9%,71.3% to 89.3%,84.6%,90.2%,respectively. The average hospitalization stay and antibacterial cost per capita decreased significantly. There was statistical significance among above indica-tors before and after intervention(P<0.05 or P<0.01). CONCLUSIONS:DRUGS effectively change irrational use of antibacterial agents in department of obstetrics and gynecology,which provide a new method for the management of antibacterial agents.

Objective To evaluate the value of the real-time tissue elasticity imaging quantitative method in differential diagnosis of thyroid nodules.MethodsSeventy-three patients with thyroid nodules，including 95 lesions,were included in the study.A total of thyroid nodules were examined with traditional ultrasonography and elastosonography from which the strain ratios(SR)were derived，with pathologic results as the reference standard.And a receiver-operating charaeterisitc(ROC)curve was used to identify the value of optimal operating point for differential diagnosis of thyroid nodules.Results①The strain ratio of the benign lesions was 2.06 ±1.01，which was significantly different from the value of malignant lesions 5.05±2.23(P＜0.05).②The area under the curve was 0.929，which showed a high statistical significance.③It showed that the optimal operating point of ROC curve was 3.17，with high sensitivity(96.7%)，specificity(90.8%)，postive predictive value (93.3%)and negative predictive value(96.9%).Conclusions The real-time tissue elasticity imaging can provide a quantitative,noninvasive and convenient tool for evaluating the thyroid nodules.