Humans ; Liver Neoplasms ; Carcinoma

Objective To investigate the infection distribution of the hospital-acquired pneumonia (HAP) in patients with Staphylococcus aureus (S.aureus) and its drug resistance to those commonly-used antimicrobial agents, so as to provide evidence for rational use of antibacterial drugs clinically .Methods Retrospective analysis of the infection status and drug resistance of Staphylococ-cus aureus in 336 cases of HAP treated in the hospital from January 2011 to December 2015 was made in the study .Results (1) Nine-ty-three strains of Staphylococcus aureus were isolated from the 336 cases of HAP (27.7%), including 78 strains of methicillin-resist-ant Staphylococcus aureus (MRSA), accounting for 83.9%.(2) The infection rates of Staphylococcus aureus for the HAP patients in the five years were respectively 29.6%, 26.7%, 26.9%, 25.3%and 30.1%.There were no statistical differences in infection rates , when comparisons were made between the years (P>0.05).(3) Bacterial resistance analysis indicated that the patients with HAP-MRSA infection were completely sensitive to vancomycin and linezolid ( by 100%) , fairly sensitive to compound sulfamethoxazole and rifampicin ( by about 70%) and other antibiotics , such as beta lactams , macrolides and fluoroquinolones , was poorly sensitive ( by as low as less than 30%).Conclusion In HAP patients, Staphylococcus aureus was the main Gram positive pathogen , with MRSA infec-tion being the main case .Vancomycin and linezolid should be the first choice of drugs in clinical application of antibiotics for the treat -ment of HAP-MRSA infection.

To investigate the chemical constituents from Barringtonia racemosa, twelve compounds were isolated by chromatography methods and identified as 3β-p-E-coumaroymaslinic acid (1), cis-careaborin (2), careaborin (3), maslinic acid (4), 2α, 3β, 19α-trihydroxyolean-12-ene-24, 28-dioic acid (5), 3β-p-Z-coumaroylcorosolic acid (6), corosolic acid (7), 1α, 2α, 3β, 19α-tetrahydroxyurs-12-en-28-oic acid (8), 19α-hydroxyl ursolic acid (9), 3α, 19α-dihydroxyurs-12-en-24, 28-dioic acid (10), tormentic acid (11), 3-hydroxy-7, 22-dien-ergosterol（12） by the NMR and MS data analysis. Among them, compounds 1-4,7-12 were obtained from the genus Barringtonia for the first time. All the compounds didn't show nocytotoxic activity against MCF-7 and A549 cell lines (IC₅₀>50 mg•L⁻¹).

Objective To observe the clinical effects and adverse reactions of gamma knife combined with pemetrexed plus carboplatin in concurrent or sequential chemoradiotherapy of locally advanced non-small cell lung cancer( LANSCLC) .Methods A to-tal of 125 cases of LANSCLC were randomly divided into 3 groups, in accordance with different therapeutic methods.The concurrent group ( or group A, 30 cases) received body gamma knife combined with pemetrexed plus carboplatin.The sequential group ( or group B, 31 cases) was given 2 weeks of chemotherapy with pemetrexed and carboplatin, then sequential body gamma knife radiotherapy and finally underwent two cycles of chemotherapy with the same regimen.The radiotherapy group ( or group C, 64 cases) was given just body gamma knife radiotherapy.Clinical therapeutic effects and adverse reactions were evaluated.Results The short-term effects for group A, group B and group C were respectively 83.33%, 77.42%and 73.44%, and no statistical significance could be seen when comparisons were made between them(P<0.05).The 1-2-year survival rate and the median survival time for group A were respectively 73.33%, 43.33%and 17.5 months, those for group B were respectively 64.52%, 35.48%and 15.4 months, and those for group C were respectively 46.88%, 23.44%and 10.6 months.Analyses indicated that group A was superior to group B, and group B was su-perior to group C, with the former having a better survival rate, and no statistical significance could be noticed when comparisons were made between them(P>0.05).However, there was statistical significance when comparisons were made between group A and group C (P<0.05).With regard to toxic reactions, all the adverse reactions were from gradeⅠ-Ⅲ, with bone marrow suppression and gastro-intestinal reactions as the main manifestations.GradeⅣadverse reaction never occurred.There was no statistical significance in the in-cidence rates of radiation-induced esophagiti and pneumonitis, when comparisons were made between the 3 groups(P>0.05).With re-gard to the incidence rates of bone marrow suppression and adverse reactions of the digest system, there was no statistical significance, when comparisons were made between group A and group B(P>0.05).However, statistical significance could be noted, when compari-sons were made between group A/B and group C(P>0.05).Conclusion Body gamma knife combined with pemetrexed and carboplatin in concurrent chemoradiotherapy was more superior to body gamma knife alone, furthermore it displayed better safety and higher tolerance.

Objective To observe the clinical effects of bi-level positive airway pressure ( BiPAP) combined with tiotropium bromide in the treatment of chronic obstructive pulmonary disease ( AECOPD) with acute exacerbation .Methods Sixty cases of AECO-PD with acute exacerbation were randomly divided into group A and group B , each consisting of 30 cases, and clinical analyses were made on them .The patients in both groups were given routine treatment , including oxygen breathing , spasmolysis , expectoration , anti-infection and BiPAP.At the same time, the patients in group B were administered with the above treatment couple with BiPAP inhala-tion agent, with a dosage of 18μg, once a day.Symptoms, pulmonary functions and blood-gas analysis were performed to see the effects and adverse reactions , and hospitalization days were also recorded accordingly .Results Total effective rate for group A was 73.33%, while the rate for group B was 93.33%, and statistical differences could be seen , when comparisons were made between them ( P<0.05 ) .Following treatment , symptom scores , pulmonary functions and results of blood gas analysis in the patients of both groups signif -icantly improved, as compared before treatment (P<0.05).The conditions of the patients in group B were obviously superior to those of the patients in group A, with statistical significance (P<0.05).For the average length of stay at the hospital , the patients in group B were obviously superior to those of the patients in group A (P<0.05).The incidence of adverse reactions for the patients in group B was low, with minor symptoms.Conclusion The effects of BiPAP combined with tiotropium bromide in the treatment of chronic ob-structive pulmonary disease with acute exacerbation were obviously superior to that by simple BiPAP therapy .Furthermore, the former was safer and more effective , which was worth further clinical extension .

ObjectiveTo evaluate the influence of ginkgo dipyridolum injection on blood-rheological and coagulation function in pationts with AECOPD.Methods78 cases of patients with AECOPD were divided into group A (38 cases)and group B (40 cases)by mean of digital random table method.The routine treatment including oxygen inhalation,spasmolytics and anti-infection was given to patients in both groups while ginkgo dipyridolum injection (30 ml/d)was additionally added to patients in group B for two weeks.The blood-rheological and coagulation function were evaluated.ResultsAs for blood-rheological after the treatment,whole blood high shearing viscosity(5.25 ± 1.24)mPa · S,low shearing viscosity (11.12 ±2.43) mPa · S,plasma viscosity (2.06± 0.14 ) mPa · S and hematocrit (45.52 ± 2.78) ％ in the group A indicated significant differences compared to those in group B [ (4.83 ± 1.42)mPa· S,(8.78± 3.02) mPa · S,(1.73 ±0.21) mPa · S,(39.05 ± 3.41) ％],(P＜0.05); as for coagulation function after the treatment,PT (13.14± 1.31 ) S,APTT (30.85±5.24)S,FIB (4.99±1.04)S,D-D (1.42±0.23)mg/L in the group A indicated significant differences compared to those in group B [ (14.78 ± 3.13) S,(36.67 ± 8.12)S,(3.81 ± 0.42) S,(0.84 ±0.39) mg/L],(P＜0.05).ConclusionFor the patients with AECOPD,the ginkgo dipyridolum injection can decrease hood-viscosity,and obviously improve hypercoagulabale state.

Objective To evaluate the clinical effects and immune function of shenqi 11 flavor capsule as an adjuvant treatment in advanced NSCLC patients during chemotherapy.Methods 58 cases of advanced NSCLC were divided into two groups by mean of digital random table method,with 29 patients in each group.GP scheme chemotherapy was applied to patients in group B,using gemcitabine (1000 mg/m2) on the 1st and 8th day intravenously (procedure should be finished within 30 minutes) and cisplatin (75 mg/m2) on the 1st day intravenously.Each cycle was 3 weeks,two cycles in total.Same scheme was applied to patients in group A and with an addition of shenqi 11 flavor capsule(1.65 g/time,3 times/d) throughout the whole procedure of chemothrapy.Recent curative effect,life quality,toxic reactions and changes in immune indexes of both groups were observed.Results Short-term response rate in group A was 48.27％ and 41.38％ in the group B (x2=0.279,P＞0.05),which showed no significant differences between the two groups.Toxic reactions such as leukopenia,hematochrome decrease and gastrointestinal reactions in the group B were significantly severe compared to group A after chemotherapy(x2 were 4.678,4.549 and 4.687 respectively,P＜0.05).As for immune indexes after chemotherapy,CD3+ (55.21 ± 3.28) ％,CD4+ (38.84±5.13) ％,CD8+ (29.86±4.83) ％,CD4+/CD8+( 1.29± 0.17) and NK cells (20.12± 2.11 ) ％in the group B indicated significant differences compared to those in group A[(62.96±4.12)％、(45.21±3.43)％、(25.23±2.79)％、(1.82±0.21)、(25.78±3.36)％],(P＜0.05).The life quality was 58.62％ in group A and 31.03％ in the group B,which showed significant difference (x2=4.462,P＜0.05).Conclusion Shenqi 11 flavor capsule as an adjuvant treatment in advanced NSCLC patients during chemotherapy can not only improve life quality of patients,alleviate the symptoms,but also enhance their immune function.