Objective To investigate the therapy and influencing factors for prognosis of ventilator-associated pneumonia(VAP) caused by multidrug-resistant organisms(MDROs).Methods 169 patients with VAP who were admitted to a hospital between January 2012 and December 2013 were included in analysis, 125 were in MDRO infection group and 44 in non-MDRO infection group.MDRO infection group was subdivided into MDR-A group(n=78, resistant to selected antimicrobial agents) and MDR-B group (n=47, sensitive to at least one kind of selected antimicrobial agent).Antimicrobial choice and prognosis between each group were analyzed and compared.Results 242 strains of pathogenic bacteria were isolated from airway secretion of VAP patients, 173(71.49％) were MDROs.The major pathogens causing VAP were Klebsiella spp.(n=66), Pseudomonas aeruginosa(n=64), Acinetobacter spp.(n=60), Staphylococcus aureus(n=27), and Escherichia coli (n=17), the percentages of MDROs of above pathogens were 68.18％, 50.00％, 91.67％, 88.89％, and 76.47％ respectively.The prognosis of MDRO infection group was poorer than that of non-MDRO infection group, MDR-A group had the worst prognosis(P<0.001).Persistent fever, leukocytosis, and progress of pulmonary inflammation in VAP patients suggested poor prognosis(all P<0.001);antimicrobial use in patients with effective therapy was higher than those in a worsened condition before onset, at the beginning of onset, and after culture of specimens(all P<0.001), while coma, early-onset VAP and multiple bacterial infection had no prognostic significance in patients with VAP(all P>0.05).Conclusion There is high incidence of MDRO infection in patients with VAP, effective antimicrobial therapy can improve the prognosis.

Objective To evaluate the application effect of clinical pharmacy services in the secondary prevention ot stroke.Methods Hospitalized stroke patients were selected in Taihe Hospital from June 2013 to August 2014.The patients meeting the inclusion criteria were paired and sequentially numbered,and randomly divided into observation group (n =100) and control group (n =102).The patients were treated routinely during thc hospitalization.The clinical pharmacists conducted the drug education.The control group implemented the telephone follow-up for guiding compliance behavior one month after discharge.The observation group continued to perform clinical pharmacist-leading service projects.The medication compliance (Morisky scale),systolic blood pressure (SBP),diastolic blood pressure (DBP),glycated hemoglobin (HbA1 C),serum total cholesterol (TC),low density lipoprotein-C (LDL-C) and relapse rate were compared three months,six months and twelve months after the two groups discharged.Results The medication compliance,SBP,DBP,HbA1C,TC,LDL-C and recurrence rate after hospital discharge were no statistically significant (P ＞ 0.05) three months after the two groups discharged,but statistically significant between the two groups (P ＜ 0.05 or P ＜ 0.01) six months and twelvc months after the two groups discharged.Levels of SBP,DBP,HbA1 C,TC and LDL-C in the two groups were both significantly lower than before (P ＜ 0.05 or P ＜ 0.01).The relapse rate of the observation group three months,six months and twelve months after they discharged was 2.00％,5.00％ and 15.00％,respectively,and that of the control group was 2.94％,13.72％ and 28.43％,respectively.Conclusion The pharmacy services in the secondary prevention of stroke can improve the patient medication compliance and better control the blood pressure,blood glucose and blood lipid lcvcls,and reduce the relapse rate.It should be recommended in the clinical practice work.

Objective To investigate the relationship between Kashin-Beck Disease(KBD) and Human Parvovirus B19(HPVB19).Methods HPVB19DNA was detected in 55 sera of KBD patients and 52 healthy in adjacent non-endemic area and 35 healthy sera in normal area using PCR and then linked the HPVB19DNA to pGEM-T vector.The nucleotide sequence was analyzed and compared with HPVB19 nucleotide sequence published by Genebank and another in Journal of virology.Results HPVB19DNA was found in 16 of 55 sera in KBD patients,and the HPVB19DNA position rate(29.09%) is significantly higher than that of the two healthy control groups(11.54%、11.42% respectively)(P＜0.05).The nucleotide sequence homologies compared with the two published nucleotide sequence were 97.75%、97%,respectively.The putative amino acid homologies compared with the tow published were 93.5%.The amino acid variation was greater than the nucleotide sequence variation because of a base insertion.Conclusion There was a close relationship between HPVB19 infection and Kashin-Beck Disease.

Objective: To investigate the clinical effect of acupuncture-moxibustion therapy on simple obesity due to spleen deficiency. Method: Sixty-eight cases of simple obesity due to spleen deficiency syndrome, including internal dampness due to spleen deficiency, qi deficiency of lung-spleen, yang deficiency of spleen-kidney, were randomly allocated into two groups, treatment group (36 cases) and control group (32 cases). The former group was treated with warm needling moxibustion method, and the latter was treated with electroacupuncture. The therapeutic effect and body weight (BW) were observed, respectively. Result: There was a significant difference between the two groups in the total effective rate (P<0.05); there was a significant difference between the two groups in the decrease of BW (P<0.01), furthermore, the long-term effect in warm needling moxibusiton group was better than that in the electroacupuncture group. Conclusion: The effect of needle wanning moxibustion therapy on simple obesity due to spleen deficiency is accurate, and it is worth to spread.

OBJECTIVETo observe the effect of Ganoderma lucidum decoction in treating Russula subnigricans poisoning (RSP) patients.

METHODSThe 14 patients of RSP in the treated group were treated with GLD (GLD, one dose was prepared by 100 g of Ganoderma lucidum decocted with water to 600 ml), on the base of conventional treatment, and 11 patients received conventional therapy in the previous year were taken as control. The clinical efficacy and parameters in them were compared, including the urine N-acetyl-D-glucosaminidase (NAG, which reflects the injury of kidney), the red blood cell and protein in urine, the alanine transaminase (ALT, which reflects the injury of liver), and the aspartate aminotransferase (AST, which reflects the injury of heart).

RESULTSA better clinical cure-markedly improving rate was showed in the treated group as compared with the control group, P < 0.01. In the treated group, red blood cell in urine disappeared after 24 hrs treatment in the majority of patients, urinary protein reduced obviously and the other three parameters reached the peak at the 3rd day then lowered gradually. In the control group, all the parameters increased continuously. Comparison between the parameters at corresponding time in the two groups showed significant difference (P < 0.01), those in the treated group were markedly lower than those in the control group respectively.

CONCLUSIONGLD has good effect in treating RSP, could obviously lower the fatat rate of RSP.

Acetylglucosaminidase ; urine ; Adolescent ; Adult ; Aged ; Alanine Transaminase ; blood ; Aspartate Aminotransferases ; blood ; Drugs, Chinese Herbal ; therapeutic use ; Female ; Humans ; Male ; Middle Aged ; Mushroom Poisoning ; drug therapy ; Phytotherapy ; Reishi ; chemistry

Objective: To analyze the clinical characteristics of hypophosphatemic osteomalacia induced by adefovir dipivoxil (ADV) in order to improve the understanding of the disease.Methods: A retrospective analysis was performed according to the medical records of 11 cases of ADV-induced hypophosphatemic osteomalacia.The medical history, laboratory indicators (ALT, AST, ALB, SCr, UA, blood glucose, blood pH, BE), bone metabolic markers (25OHD3, PTH, tP1NP, β-CTX, OC), urine indicators (urine pH, 24h urine Ca, 24h urine P, 24h urine Pro, urine Scr), DXA and skeleton ECT signs of the patients with hypophosphatemic osteomalacia induced by ADV were analyzed, and the symptoms, blood P, AKP level and urine routines were followed up after 1-month withdrawal and in July, 2016, respectively.Results: The mean ADV administration time of the 11 patients was (5.7±1.2) years, and the bone pain time was (2.2±0.6) years.The serum P was (0.45±0.99)mmol·L-1, 24h urine P was (17.9±4.8)mmol, AKP was (248±107)IU·L-1,the concentration threshold of renal phosphate was(0.31±0.10)mmol·L-1.After the one-month withdrawal of ADV, the bone pain in the patients were all relieved, and with the phosphorus supplement, the level of serum phosphorus was increased.In July of 2016, the average withdrawal time of ADV was (18.3±10.7) months, the serum phosphorus significantly increased and AKP significantly decreased when compared with that on the admission and 1 month after the ADV withdrawal (P<0.05), and the serum phosphorus of 2 patients returned to normal with the recovery rate of 20% (2/10).The regression analysis showed that the influencing factors on serum phosphorus on the admission were renal concentration threshold of phosphate and tP1NP (P<0.05);the influencing factor on serum phosphorus on the last follow-up was bone mineral density at the admission (P<0.05).Conclusion: Hypophosphatemic osteomalacia is a potential side effect of ADV, and ADV-induced renal injury is not completely reversible, which should be paid more attention in clinical work.

0.05).And the increasing of weight in high protein+plus prolein jelly group was significantly higher than those of other two groups(Pa

Objective To investigate the incidence and risk factors of chronic post-surgical pain (CPSP) and its effects on the quality of life in a large sample prospective study.Methods A total of 1098 patients of either sex,aged 18-70 yr,of American Society of Anesthesiologists physical status Ⅰ or Ⅱ,undergoing elective surgery,were enrolled in the study.Data regarding patient age,gender,body mass index,educational level,marital status,living situations,occupation,pre-surgical pain in the site of surgery,complications,type of surgery,surgery time and anesthesia method were recorded.The highest numeric rating scale scores within 3 days after surgery were also recorded.The patients were followed up at 3,6 and 12 months after surgery to record the development of CPSP.The patients were divided into CPSP group and non-CPSP group according to whether or not CPSP developed.Multivariable logistic regression analysis was performed to identify the risk factors for CPSP,and the quality of life was scored.Results A total of 981 patients completed the 1 year follow-up after surgery,the incidence of CPSP was 35.7％,and the constituent ratio of the distribution of the course was as follows:3 months ≤ postsurgical course ＜ 6 months was 33.1％;6 months ≤ postsurgical course ＜ 12 months was 16.8％;postsurgical course ≥ 12 months was 50.1％.Female,no diabetes mellitus and pre-surgical pain in the site of surgery were the independent risk factors for CPSP (P＜ 0.05).Compared with non-CPSP group,the physiological function score,professional function score,body pain score,vitality score,social function score,mental health score and general health score were significantly decreased (P＜0.01),and no significant change was found in the emotional function score in CPSP group (P＞0.05).Conclusion The probability of development of CPSP is high and the course is long,and the quality of life score is decreased;female,no diabetes mellitus and pre-surgical pain in the site of surgery are the independent risk factors for CPSP.

OBJECTIVETo evaluate the expression of CD4+, CD8+ T cells and cell apoptosis in oral lichen planus (OLP) and investigate the role and the relationship of immunological reaction and cell apoptosis in the pathogenesis of OLP2.

METHODSImmunohistochemical technique was used to study the expression of CD4+, CD8+ T cells in 27 OLP cases. TUNEL was used for detecting the cell apoptotic index (AI) in 17 OLP2 cases.

RESULTSThe expression of CD4+, CD8+ T cells were obviously elevated in lamina propria of OLP group compared with control group (P<0.05). There was a strong significance when compared the ration of CD4/CD8 in both group. AI was remarkably increased in epithelia cells and significantly decreased in lymphocytes in lamina propria in OLP cases compared with its expression in the control group respectively.

CONCLUSIONThe increased amount of CD4+, CD8+ T cells in lamina propria of OLP and the change ration of CD4/CD8 suggest that immune response is involved in the pathogenesis of OLP. The abnormal cell apoptosis plays an important role in the pathogenesis of OLP.

Apoptosis ; Epithelial Cells ; Humans ; Lichen Planus, Oral

Objective To analyze the condition and characteristics of hand-foot-mouth disease ( HFMD) from 2010 to 2012 in Renqiu city.Methods Surveillance and detecetion of HFMD was collected according to Renqiu city system for diseases control and prevention .The pathogen of HFMD severe case was deteceted .Results 12 293 cases including 735 severe cases were recorded in Renqiu city from 2010 to 2012,The highest of the resident population was in 2012 and the lowest one was in 2010(r=0.47,P<0.05).The total morbidity presented the obvious seasonal char-acteristic,which reached the summit in June ,July,August.The population morbidity was the clustered children .The average incidence rate of severe cases was 5.98%.The incidence rate in 2012 and 2011 was higher than that in 2010 (r=0.43,0.39,all P<0.05).There was significant difference of the pathogens types in severe cases among three years with the pathogen of CoxA 16 in 2010,2011 and humantero virus 71 viruses in 2012.Conclusion The inci-dence of HFMD presents the increasing and seasonal characteristics with the prevalence in the scattered children and the pathogens of CoxA16 in 2010,2011,humantero virus 71 in 2012.