ObjectiveTo observe the effects of a traditional Chinese medicine Jiayijian on the matrix metalloproteinase2 (MMP2) and transforming growth factorbeta1 (TGFβ1) expression in experimental hepatic fibrosis rats.MethodsSixty male Wister rats were randomly divided into normal control group and liver fibrosis model group. Dimethylnitrosamine(DMN) was administered to induce liver fibrosis in the model group, and rats in model group were randomly divided into model control group and Jiayijian treatment groups with high concentration (22g/［kg·d］)and low concentration (5.5g/［kg·d］) 4 weeks after liver fibrosis had been induced. All rats were killed after 4 weeks intragastric administration of Jiayijian. The expression of MMP2 and TGFβ1 of rat liver tissue were detected by immunohistochemical method.ResultsThe expression of TGFβ1 in high and low concentrations of Jiayijian treatment groups was significantly lower than that in the model control group (P<0.05), and the expression of TGFβ1 in the high concentration of Jiayijian treatment group was significantly lower than the low concentration of Jiayijian treatment group (P<0.05), but there was no significant difference in the expression of MMP2 between high and low concentrations of Jiayijian treatment groups and the model control group (P>0.05).ConclusionJiayijian can downregulate the expression of TGFβ1 of experimental hepatic fibrosis model rat’s liver tissue, which is the one of the mechanisms of antiliverfibrosis.

Objective To evaluate the effect of antirespiratory syncytial virus of water extract liquid of Scutellaria Baicalensis Georgi,and to find the new drug for treatment of respiratory syncytial virus(RSV) infection.MethodsChinese medicine Scutellaria Baicalensis Georgi was turned into water extract liquid . Using in vitro cell culture technique ，the cytotoxicity of Scutellaria Baicalensis Georgi water extract was detected by 3（4，5dimethylthiazole2yl）2,5diphenyltetrazolium bromide (MTT) method. With ribavirin as the positive control drug, antiviral activity of Scutellaria Baicalensis Georgi water extract was detected with cell culture method.ResultsThe median cytotoxicity concentration(50% cytotoxicity concentration,CC50)of Scutellaria Baicalensis Georgi was 16.32 mg/mL, the median effective concentration (50% effective concentration,EC50) of the extraction of Scutellaria Baicalensis Georgi was 2.43 mg/mL. Scutellaria Baicalensis Georgi and ribavirin gave a dosedependent response in inhibiting RSV（P<0.05）.ConclusionScutellaria Baicalensis Georgi shows potent inhibition on RSV in vitro.

ObjectiveTo evaluate the effect of herbal tanreqing injection on adjuvant therapy for Acinetobacter baumannii (A. baumannii) pulmonary infection，and provide reference for more effective treatment for pulmonary infection caused by A. baumannii.MethodsFiftytwo intensive care unit patients with A. baumannii pulmonary infection between January 2012 and March 2013 were selected and randomly divided into conventional therapy group(29 cases)and tanreqing adjuvant therapy group(23 cases).Conventional therapy group were treated with antimicrobial agents according to pathogenic microbiological culture and antimicrobial susceptibility testing results; tanreqing adjuvant therapy group were treated with conventional therapy plus tanreqing injection, therapeutic effect of two groups was compared.ResultsAcute physiology and chronic health evaluationⅡ(APACHEⅡ) score and sequential organ failure assessment (SOFA) score of tanreqing adjuvant therapy group decreased more significantly than the conventional therapy group；the ICU length of stay, antimicrobial days within 28 days, mechanical ventilation days were all significantly lower than conventional therapy group（P＜0.05）. Mortality within 28 and 90 days was not significantly different between two groups(P＞0.05).ConclusionTanreqing injection and antimicrobial agents has a synergistic antimicrobial effect, and has certain therapeutic effect on A.baumannii pulmonary infection.

多重耐药菌即1种微生物对3类（比如氨基糖苷类、红霉素、β内酰胺类）或3类以上抗菌药物同时耐药。随着抗菌药物应用日益广泛，细菌耐药性已成为国际、国内医院感染和社区感染普遍存在的问题。对于难治性（多重耐药菌感染）创口的治疗，某中医院普通外科采取中医特色自制黄连纱条对难治性感染创口进行治疗。2010—2014年共治疗25例难治性创口感染患者，均已进行分泌物细菌培养及检测确诊，其中创面超过3 cm×4 cm 9例，形成窦道伴有渗出8例，采取传统抗菌药物换药无效果11例，采用黄连纱条治疗后所有患者均在30 d内出院，其中完全愈合18例（72.00%），基本愈合7例（28.00%），均取得较满意疗效。现将2例典型的难治性感染创口病例报告如下。

ObjectiveTo evaluate the preliminary efficacy and safety of compound astragalus mongholicus granule in the 24week treatment of patients infected with HIV.MethodsTwentytwo patients infected with HIV received an oral administration of compound astragalus mongholicus granule for 24 weeks. HIV RNA were detected at week 0 and week 24; CD4+, CD8+ cell counts and levels of cytokines (IL2, IL4, IFNγ) were examined at week 0, week 8 and week 24. Clinic symptoms, blood routine examination, liver and renal function and adverse events were recorded at week 0, 8, 16 and 24, respectively. ResultsThe CD4+ cell counts increased 22 cell/μL (t=2.08，P＝0.03) when compared with the baseline. IL2 and IFNγ increased 7.29pg/mL and 3.82pg/mL respectively (t＝3.46，P＝0.00；t＝5.94，P＝0.00),while IL4 reduced 3.71pg/mL(t=8.18，P＝0.00); HIV RNA deceased 0.40 lg copy/mL(t=2.65，P＝0.02); 6 patients gained weight of more than 2 kg, 10 patients gained weight of no more than 2 kg. The results of blood routine examination, liver and renal function were normal. No obvious adverse events were observed. ConclusionCompound astragalus mongholicus granule can increase the number of CD4+ cells in patients infected with HIV, inhibit HIV replication and with immune regulation function to a certain extent. It can also improve HIV infection symptoms and gain the patients’ weight. No obvious side effects were observed in this clinical trial.

ObjectiveTo determine antimicrobial activity of 80% ethanol extracts of 20 kinds of heatclearing and toxicityremoving Chinese herbal medicines(CHM) against Staphylococcus aureus(SA) and methicillinresistant Staphylococcus aureus (MRSA),so as to screen medicines with strong bacterial inhibition.MethodsEthanol extracts of 20 kinds of CHM were prepared, in vitro antimicrobial activity against SA and MRSA (MRSA 82, MRSA 92, MRSA 111,MRSA 135,and MRSA 144) were determined by agardiffusion method, minimum inhibitory concentration (MIC) and minimum bactericidal concentration (MBC) were determined by doubledilution method.ResultsThe extraction rate of ethanol extracts of 20 kinds of CHM ranged 5.33%-15.89%, Flos Carthami had the highest extraction rate(15.89%),followed by Solanum nigrum (12.64%), Cuscuta chinensis Lam had the lowest extraction rate (5.33%), 16 kinds of ethanol extracts showed different inhibitory effect on SA and MRSA, 4 kinds of extracts had high antimicrobial activity (inhibition zone diameter ［IZD］≥16 mm, including Mahonia bealei［Fort.］,Prunella vulgaris,Herba moslae, and Geranium wilfordii Maxim), 9 extracts had moderate antimicrobal activity (IZD［>10 mm，<16 mm］, including Herba Verbenae,Potentilla discolor,Oxanlis corniculata L.,Solidago decurrens Lour,Viola philippica Car,Herba artemisiae Scopariae,Plantago asiaticaL&Plantago depressa Willd, Lysima chiachristinae Hance, and Leucas ciliata Benth), 3 extracts had low antimicrobial activity (IZD ≤10mm, including Pulsatilla chinensis ［Bunge］ Regel,Campsis grandiflora, and Allium tuberosum Rottler). IZD of most extracts for MRSA were larger than that of standard strain. MIC and MBC of 13 kinds of extracts with better antimicrobial activity against standard and drugresistant strains were 64-1 024 μg/mL and 128-2 048 μg/mL respectively.ConclusionEthanol extracts of Mahonia bealei(Fort.), Prunella vulgaris, Herba moslae, and Geranium wilfordii Maxim have strong antimicrobial activity against MRSA.

近20年来，不合理、不规律化学治疗导致结核菌耐药株逐渐增加。耐药结核病已成为引起全球结核病急剧上升的四大原因之一，特别是耐多药肺结核(MDRTB)的发生对结核病控制计划的实施构成严重威胁［1］。我国是世界上第二高发结核病大国，约有500万肺结核患者，具有耐药率高，继发耐多药者逐年增多的特点，近几年甚至有初始耐多药肺结核病(initial MDRTB)的局部流行［2］。耐多药和多耐药肺结核已成为结核治疗的难点和治疗失败的主要原因。目前合理的化学药物仍是治疗MDRTB的最有效武器［3］。但由于肺结核病变的发展阶段和个体身体营养状况不同，化学治疗往往达不到满意的疗效或继发再感染。而且有些患者因长期抗结核化学治疗产生药物副作用而放弃治疗，此外医患的依从性、免疫抑制剂的应用等因素影响药物剂量，从而导致最终治疗失败。因此，更新治疗观念和研制有效、低毒的创新药物十分重要。近年来，国内研究者分别在中药对结核菌体外抑菌作用、对结核病的治疗作用、对结核菌感染免疫力影响等方面进行了研究，有的甚至已深入到分子和基因水平。现对近年来有关中药治疗肺结核，尤其是耐多药肺结核的研究进展作一综述。

ObjectiveTo evaluate the effect of traditional Chinese medicine sputum discharge liquid on preventing ventilatorassociated pneumonia(VAP). MethodsA randomized doubleblind, placebocontrolled study  was conducted, according to the inclusion and exclusion criteria, patients with respiratory failure and mechanical ventilation in the intensive care unit (ICU) of a hospital in 2011-2014 were selected and divided into treatment group and control group. Treatment group received sputum discharge liquid in addition to conventional treatment, control group adopted simulation agent based on conventional treatment. The incidence, treatment effectiveness, occurrence time, and prognosis of VAP between two groups of patients were compared. ResultsA total of 139 patients were monitored, 70 cases in treatment group and 69 in control group.  The incidence of VAP in treatment group and control group were  37.14% (n=26) and 57.97％(n=40) respectively; the average onset time of VAP in treatment group and control group were (76±3.2）hours  and （45±8.9）hours after admission to ICU respectively; treatment effectiveness rates in treatment and control group were 88.46% and 55.00% respectively; the incidence, occurrence time,and treatment effectiveness rates of VAP between two groups of patients were both significantly different (all P<0.05). There were no significant difference in blood routine, liver and kidney function, urine routine, stool routine, and  electrocardiogram results between two groups of patients (all P>0.05). ConclusionIntervention in patients with mechanical ventilation by sputum discharge liquid can reduce the incidence of VAP, and has a positive effect on the prognosis of disease and pulmonary infection in patients.

2015年CHINET中国细菌耐药性监测显示，不动杆菌属菌种占全部菌种的10.7%，其中鲍曼不动杆菌占93.4%。鲍曼不动杆菌从2011年开始在监测菌种中所占比例开始上升，其对抗菌药物的耐药性也逐年增加。鲍曼不动杆菌是一种氧化酶阴性的非发酵革兰阴性杆菌，是临床上常见的条件致病菌之一。在一定条件下容易引起机体感染，如血流系统感染、呼吸道感染、伤口感染、泌尿系统感染、菌血症等［1］。随着新型广谱抗生素在临床的广泛应用及医院管理的不当，鲍曼不动杆菌的耐药率逐年升高，已成为全球关注的重要问题，给临床治疗带来极大挑战，甚至出现泛耐药鲍曼不动杆菌，其对β内酰胺酶类、氨基糖苷类、喹诺酮类、四环素类等多种抗菌药物均出现耐药性，导致病死率增高［2］。经研究表明，多种中药有抑菌作用，具有较好的治疗前景，尤其当与传统抗菌药物联合使用后有较好的抑菌效果，且花费少，副作用低，患者易接受。因此，寻求中药天然抗菌药物已成为解决细菌耐药问题的新途径。