妇女生殖道支原体感染现状及药敏分析

目的了解妇女生殖道支原体感染现状及支原体对10种常用的抗生素敏感性。方法对有生殖道感染症状或／和体征的3128例妇女按年龄不同分为4组，组I（17～30岁）、组Ⅱ（31-40岁）、组Ⅲ（41-50岁）、组Ⅳ（〉50岁）。取宫颈分泌物进行支原体培养＋药敏试验。结果3128例患者宫颈分泌物支原体阳性者共1992例，感染率63．88％，其中解脲支原体阳性1958例，感染率62．60％，人型支原体阳性436例，感染率13．92％o＇1992例中有402例同时感染解脲支原体和人型支原体。4组解脲支原体感染率分别为62．36％、63．25％、66．67％、40．00％，组I～Ⅲ3组间感染率差异无显著性，而组Ⅳ感染率明显低于前三个组（P〈0．05）。选取资料保存完整的732株解脲支原体药敏结果分析，显示解脲支原体对交沙霉素最敏感（敏感率97．27％），最低的是壮观霉素（敏感率8.20％）。结论生育年龄妇女生殖道支原体感染率较高，以解脲支原体为主，支原体对抗生素的药敏性已发生变化，过去常用的红霉素耐药株明显增加，交沙霉素敏感性最高。     

ICU气管切开患者医院感染分析

①目的 了解引起ICU气管切开患下呼吸道医院感染的主要病原菌种类及药敏性。②方法 无菌条件下取1998年1月－2000年12月ICU气管切开患的深部痰做培养及药敏试验,进行细菌学分析。③结果 143例气管切开患中,133例诊断为下呼吸道医院感染（93．0％）。送痰培养767次,培养出1153株病原菌,G^-杆菌821株（72．2％）,其中绿脓杆菌196株（17％）,G^ 球菌167株（14．5％）,其中金黄色葡萄球菌103株（8．9％）,真菌165株（14．3％）;混合感染340次,气管切开保留时间越长,混合感染率越高（P＜0．01）。氟康唑是首选的抗真菌药物,G^-杆菌对头孢类及青霉素类抗生素普遍产生耐药,G^ 球菌对万古霉素敏感（目前尚未发现耐药菌株）,各类细菌对喹诺酮类及氨基糖甙类抗生素亦有一定程度的耐药性。④结论 气管切开后呼吸道防御病原菌免疫力下降,反复医源性交叉感染,大量广谱抗生素的广泛不合理应用是引起气管切开患易发下呼吸道医院感染的主要原因。     

两种不同浓度氯化钠用于气管切开患者气道湿化的效果比较

目的：观察两种不同浓度氯化钠在气管切开患者气道湿化中的作用。方法：选取68例重型颅脑外伤气管切开的病人，随机分成两组，实验组给0．45％氯化钠，对照组给0．9％氯化钠，观察两组患者肺部感染率。结果：实验组肺部感染率明显低于对照组（P〈0．05）。结论：0．45％氯化钠用于气管切开病人气道湿化，效果明显优于0．9％氯化钠。     

重症监护室患者院内感染危险因素分析及细菌耐药研究

目的分析重症监护室（ICU）院内感染的危险因素及院内感染细菌耐药现状。方法回顾性分析浙江省长兴县中医院ICU487例患者资料,对院内感染的危险因素、感染部位及种类进行分析;同时对病原菌进行药敏分析,判断细菌对常用抗生素的耐药情况。结果ICU院内感染率为23．2％,感染组高龄患者、发生低蛋白血症的患者比率明显高于未感染组（P〈0．05）,感染组采取中心静脉置管和呼吸机患者的比率明显高于未感染组（P〈0．05）,口腔黏膜和呼吸道系统是感染的常见部位。细菌耐药性检测发现,ICU细菌耐药情况十分严重．有的甚至已经完全耐药。结论ICU应加强规范性操作,尤其是对老龄患者、发生低蛋白血症患者及采取中心静脉置管和呼吸机患者应给予高度重视,减少患者病原菌暴露机会。此外,需要注意抗生素的合理使用,避免耐药的发生。     

铜绿假单胞菌的耐药性监测分析

目的研究铜绿假单胞菌（PA）的感染现状及对目前常用12种抗菌药物的耐药性变化，以利临床合理选用抗菌药物。方法对该院2001年1月1日-2006年12月31日分离出1425株PA的药敏试验结果进行回顾分析。结果PA感染主要发生在重症监护病房34．1％和呼吸病房28．2％；感染部位主要是呼吸道82．1％；1425株PA对常用12种抗菌药物的耐药性均较高，总耐药率较低的抗生素是：美罗培南（22．8％），亚胺培南（25．7％），头孢他啶（26．8％）。阿米卡星（28．3％），哌拉西林／他唑巴坦（30．9％），头孢吡肟（31．4％）。结论重症监护病房较其他病房易发生PA感染，PA对常用抗菌药物的耐药率均高。合理应用抗菌药物和耐药性监测是当务之急。     

重症监护病房铜绿假单胞菌耐药性的研究及其临床意义

目的了解重症监护病房（ICU）病人铜绿假单胞菌（Pseudomonasaeruginosa,PA）的耐药谱及其变化,为临床预防控制ICU感染及合理选择使用抗菌药物提供依据。方法采用回顾性方法对ICU三年送检的痰标本中分离的298株铜绿假单胞菌耐药性进行调查分析。结果ICU病房铜绿假单胞菌感染率为67．9％。药敏实验中以头孢吡肟和头孢他啶等抗生素的抗菌作用较强,而氨苄西林／舒巴坦钠、氧氟沙星、氨曲南、阿莫西林／克拉维酸、复方磺胺等抗生素的抗菌作用较差,耐药率均达到50％以上,显示PA单一耐药和多重耐药现象非常严重。结论ICU病房病人PA感染情况十分严重,对抗生素的耐药率有上升趋势,应及时进行PA耐药监测,指导临床合理选择抗菌药物。     

吸入性损伤患者血浆中ANP、BNP的临床意义

目的探讨烧伤吸入性损伤患者伤后早期血浆中心房肽（ANP）、脑钠肽（BNP）浓度变化的临床意义。方法55例烧伤患者根据临床诊断，分成吸入性损伤组和非吸入性损伤组，吸入性损伤组中再根据损伤轻重程度分非气管切开与气管切开2组。用酶联免疫吸附法（ELSA）检测患者血浆中ANP、BNP浓度，同时查动脉血氧分压（PO2）。比较吸入性损伤与非吸入性损伤患者ANP、BNP、PO2差异，比较气管切开组与非气管切开组血浆ANP、BNP、PO2差异，比较气管切开组术前、术后ANP、BNP、PO2差异。健康成人作为对照组。结果55例烧伤患者血浆中ANP、BNP浓度均高于对照组（P〈0．001）；吸入性损伤组ANP、BNP浓度高于非吸入性损伤组（P〈0．001），PO2差异无统计意义（P〉0．05）；气管切开组ANP、BNP高于非气管切开组（P〈0．01），PO2差异无统计学意义（P〉0．05）；气管切开组术前、术后ANP浓度变化不大，差异无统计意义（P〉0．05），BNP浓度下降、PO2升高，差异有显著性意义（P〈0．05）。结论烧伤后血浆中ANP、BNP浓度明显上升；合并吸入性损伤的患者早期ANP、BNP浓度明显高于非吸入性损伤，ANP、BNP浓度的变化比PO2早且敏感，能较好的反映吸入性损伤程度，指导临床诊断治疗。     

重型颅脑损伤患者早期气管切开的临床研究

目的：探讨早期气管切开（建立人工气道4～5天）和晚期气管切开（建立人工气道9—10天）对重型颅脑损伤病人呼吸机相关肺炎发生率、呼吸机治疗时间、住ICU时间和28天病死率的影响。方法：选取67例在ICU行经口气管插管并行机械通气的重型颅脑损伤患者,所有患者呼吸机治疗时间〉48小时,且插管前无肺部感染,均预期行气管切开,入ICU即行APACHEⅡ评分、GCS评分,将这些病人随机分成2组：观察组予早期气管切开,对照组予晚期气管切开,观察2组病人：建立人工气道3天、7天、14天呼吸机相关肺炎发生率的差异;呼吸机治疗时间、住ICU时间和28天病死率的差异。结果：2组病人建立人工气道3天呼吸机相关肺炎发生率无统计学差异（P〉0．05）,建立人工气道7天、14天观察组病人呼吸机相关肺炎发生率明显低于对照组（P〈0．05）;观察组病人呼吸机治疗时间、住ICU时间明显低于对照组（P〈0．05）;观察组28天病死率稍低于对照组,但无统计学意义（P〉0．05）。结论：重型颅脑损伤病人予早期气管切开可明显降低呼吸机相关肺炎发生率;缩短呼吸机治疗时间及住ICU时间,从而缩短住院时间,降低医疗费用,但不能降低病死率,对远期预后无明显改善。     

不孕不育患者生殖道支原体感染状况及耐药性分析

目的：分析不孕不育夫妇生殖道支原体感染状况及耐药情况,为生殖保健提供参考。方法：对288对不孕不育夫妇（观察组）和51对已生育的健康夫妇（对照组）进行生殖道支原体培养及药敏试验,观察支原体感染率、感染支原体种类及耐药情况差异。结果：观察组支原体阳性率为73.3%,对照组支原体阳性率为36.3%,观察组高于对照组,差异有高度统计学意义（P〈0.01）。药敏结果显示,克拉霉素、强力霉素敏感率高（89.3%、88.2%）,红霉素、洛美沙星的耐药率高（81.5%、91.1%）。结论：生殖道支原体感染与不孕不育有着密切的相关性,且支原体对常用抗生素的耐药性较高。     

早期气管切开对老年重型颅脑损伤术后防止肺部感染的影响

目的研究老年重型颅脑损伤术后早期气管切开对防止肺部感染的影响。方法选择急诊开颅手术后老年重型颅脑损伤患者120例随机分为两组，A组为早期气管切开（即切开时间在术后24h以内）60例。B组为未行早期气管切开（即切开时间在术后24h以后）60例；所有患者术后均用头孢三代、半合成青霉素静滴预防感染，出现肺部感染者均行痰培养药敏试验，选择敏感药物进行治疗。结果75例患者出现肺部感染。其中A组21例，有16例感染控制，感染控制时间4～10d，平均6．5d；B组54例，有16例感染控制，感染控制时间为10～20d，平均17．2d；A组肺部感染率和控制感染平均时间均显著低于B组（P〈0．01），同时A组感染控制率亦显著高于B组（P〈0．05）。结论早期气管切开能有效防止老年重型颅脑损伤术后并发的肺部感染。     

Acupuncture Treatment of Vomiting

CASE HISTORY A female patient, 46 years old, head of the foreign affairs department of a certain university in Beijing, paid her first visit on October 9, 2006, with the chief complaint of vomiting for one month. She got vomiting after meals in early September. Before that, she had discomfortable sensation in the stomach due to angry with others, but she didn't pay much attention. Later, it developed into vomiting after eating. After the vomiting, the discomfort would be relieved, but with slight hypodynamia. She was once diagnosed as having 'neurogenic vomiting'. Having taken some western and Chinese drugs, the above symptoms were a little bit improved, but she would have nausea upon eating and with regurgitation. Because of the fear for vomiting, she did not dare to have food intake, with body weight reduction of 6 kilos in one month.     

Qiu Baoguo''''s Experience in Treating Consumptive Syndromes after Radio-Chemotherapies

Radiotherapy and chemotherapy are the important modern medical therapies for malignant tumors,yet they can also bring about serious local and systemic toxic side reactions so to decrease the patient;'s life quality,manifested by a series of consumptive symptoms.Having engaged in the combined work of Chinese and western medicine for nearly 50 years,the research fellow Qiu Baoguo in Henan Provincial Academy of TCM has developed his unique views on the TCM study of consumptive syndromes.The author of this essay had once the fortune tO follow Dr.Qiu in clinic,and specially would like to introduce in the following Dr.Qiu's experience in treating consumptive syndromes after radio-chemotherapies for patients with malignant tumor.     

Insomnia Due to Deficiency of Both the Heart and Spleen Treated by Acupuncture-Moxibustion and Chinese Tuina

OBJECTIVE: To observe therapeutic effects of the comprehensive therapy of acupuncture-moxibustion and Chinese Tuina for treatment of insomnia due to deficiency of both the heart and spleen. METHODS: 92 cases were divided randomly into the treatment group (treated by acupuncture-moxibustion and Chinese Tuina) and the control group (treated by acupuncture-moxibustion). RESULTS: The therapeutic effect of the treatment group was obviously superior to that of the control group (the CHI2 test showed P < 0.01). CONCLUSIONS: The comprehensive therapy of acupuncture-moxibustion and Chinese Tuina can give marked therapeutic effects for treatment of insomnia due to deficiency of both the heart and spleen.     

Analysis of CK-19,PDX-1,Nestin,Ngn3 in different donor islet purity in rats

Objective: To investigate if there are the CK-19, PDX-1, Nestin, Ngn3 positive cells in the donor islets of different purity in rats. Methods: Thirty male adult SD rats were randomly divided into 3 groups. Islets were isolated using digestion by ductal injection of collagenase. Group Ⅰ (n=10): Separating cell preparations were not purified, Group Ⅱ(n=10): Islet sediment was purified with 25% Ficoll400 ,Group Ⅲ (n=10): Islet sediment was purified with 25% and 11% Ficoll-400. The levels of protein of CK-19, PDX-1, Nestin and Ngn3 were detected by immunohistochemistry and the mRNA of CK-19, PDX-1, Nestin, Ngn3 was amplified by RT-PCR. Results: After two different purification methods applied, three islet preparations of different purities were obtained. The difference of islet purity was significant among various groups (P＜0.05). Compared with group Ⅱ and group Ⅲ,the protein and mRNA of CK-19, PDX-1, Nestin,Ngn3 were both higher in group Ⅰ; group Ⅲ was poorly expressed. Conclusions: The three different islet purity donor islet have different CK-19, PDX-1, Nestin, Ngn3 positive cells within them, indicating that there are some islet stem cells in the purified donor islet.     

A preliminary screening study on the associated proteins in human psoriasis vulgaris by serum proteomics technologies

Objective：To investigate the optimum screening conditions of associated proteins in human psoriasis vulgaris by serum proteomics technique, and to screen the different expression proteins related with psoriasis vulgaris. Methods：Serum samples of peripheral blood were collected from newly diagnosed psoriasis vulgaris patients in the clinic, and 20 matched healthy persons. Serum albumin IgG was removed by filtering with ProteoExtract Albumin/IgG. After comparative proteomics analysis the different protein spots were identified using 2-DE and MS. Results ：Electrophoresis figures with high resolution and reproducibility were obtained. Three different expression proteins were found only in the serum from psoriasis vulgaris patients, while nine other different proteins expressing from healthy volunteers. Conclusion：The protein expression was different in the serum between the psoriasis vulgaris patients and healthy volunteers. It was hoped that we could find the biomarkers related to psoriasis vulgaris by using proteomics.     

A CASE OF HUGE GASTRIC DISOPYROBEZOAR

PYTOBEZOARS are common bezoars in gastrontestinal tract, commonly seen in stomach and mall intestine,1but huge disopyrobezoars are     

Acupuncture Treatment of Chest Bi Syndrome

CASE HISTORY A male,a retired officer of 61 years old,paid his first visit on May 12,2006.The patient stated that 2 weeks before he suddenly got paroxysmal precordial choking pain,with irregular attacks.Each attack would last several seconds to several minutes.The attack was accompanied with heavy oppressed sensation in the precordial region,palpitation,lassitude,and in severe cases,sweating,which was once diagnosed by a hospital as'coronary heart disease'.Recalling the case history,the patient said that several days before he got angry with others because of some affairs in work,and he was not so used to the life pattern since he had just retired from his busy working post.At usual times,he was quick tempered and peevish.In recent days,he had poor appetite,and loose stool.     

Instructions to Contributors

The English edition of Chinese Journal of Integrative Medicine is edited and published by the Chinese Journal of Integrated Traditional and Western Medicine Press.Original scientific papers of advanced clinical and experimental medicine in the field of complementary/alternative medicine or integrative medicine are expected.     

Development Is A High Level Inheritance for China Time-honored Brand Products

<正>As culture is the soul of a nation,the three books,"History of Chinese Philosophy,""History of Chinese Culture"and"History of Chinese Science and Technology"have demonstrated the superiority of our great Chinese culture,and its significant impact in the field of international culture.Both core value and practical value of the Chinese culture are very clear,reflected in the views of universe,nature,life,health,disease,and therapy and related considerations,concepts,and technical methods.