RESUMEN
Myocardial fibrosis （MF） is a common pathological manifestation of various heart diseases. Due to the non-renewable nature of myocardial cells， the occurrence of MF represents irreversible damage to the myocardium. Previous studies have suggested that fibroblast-mediated collagen deposition is the main mechanism of MF. Recent studies have found that there is an immune regulation mechanism in the heart itself， and macrophage activation/polarization plays an important role in MF. With the deepening of traditional Chinese medicine research， scholars have found that traditional Chinese medicine can interfere with MF by regulating the renin-angiotensin-aldosterone system （RAAS） system and the inflammatory process， repairing the extracellular matrix， managing oxidative stress， and maintaining the balance of autophagy. This process is closely related to the activation and M1/M2 polarization of macrophages. Throughout the MF process， macrophage activation is beneficial， but excessive activation will be harmful. In the early stage of MF， appropriate M1 macrophage polarization is conducive to activating immunity and removing harmful substances. In the middle and late stages of MF， appropriate M2 macrophage polarization is conducive to remodeling the damaged myocardium. If macrophage activation is excessive/insufficient， or the balance of M1/M2 macrophage polarization is broken， the effect changes from improvement to destruction. Traditional Chinese medicines that regulate the activation/polarization of macrophages have the effects of replenishing Qi and nourishing Yin， as well as regulating Qi and activating blood， but there are also some heat-clearing， dampness-drying， and detoxification products. Therefore， the occurrence of MF may be caused by Qi and Yin deficiency， damp heat accumulation， and Qi stagnation and blood stasis. By summarizing the biological processes involved in macrophage activation/polarization in MF， this paper expounded on the research progress of traditional Chinese medicine in regulating macrophage activation and M1/M2 polarization from different angles to improve MF， so as to provide a reference for the treatment of MF with traditional Chinese medicine.
RESUMEN
Objective To analyze the distribution characteristics and antimicrobial resistance of isolated Acinetobacter(A.)bau-mannii from the clinical inpatients in our hospital from 2008 to 2013 to provide the basis for rational use of antibacterial drugs in clinic.Methods The BD phoenix-100 fully automatic microbial analyzer(USA)was adopted to conduct the strain identification and the minimal inhibitory concentration(MIC)detection of clinically isolated A.baumannii.All obtained data were analyzed.Results 128,173,350,282,186 strains of A.baumannii in turn were isolated during these years,the strains in sampling from the clinically i-solated A.baumannii during 2012 was mainly originated from the sputum samples(155 strains,68.28%).In the distribution of hos-pital departments,most concentrated in ICU(65 strains,28.63%),followed by the respiratory department(47 strains,20.70%),the emergency observation wards(35 strains,15.42%)and the apoplexy and geriatric wards(24 strains,10.57%),the most of patients were older people aged more than 60 years.And according to the data within these 5 years,many kinds of different antibacterial drugs had generally the increased drug resistance rate,especially the increasing trend during 2011-2012 was more obvious,the pen-icillins all showed extensive drug-resistance.In the third,fourth generation cephalosporins,aminoglycosides and quinolones were generally drug-resistant.The drug resistance rate of cephalosporins(ceftazidime,cefotaxime,cefepime)remained at a higher level of 75.00%-85.00%.The drug resistance rate of quinolones(ciprofloxacin,levofloxacin)and aminoglycosides(gentamicin,amikacin) also showed the increasing trend year after year.The drug-resistant rate of the beta lactam compound preparations had the rapidly increasing speed,such as which of ampicillin /sulbactam was increased from 60.16% to 83.33%,which of carbapenems such as imipenem and meropenem was increased more significantly,the drug-resistant rate of imipenem was increased from 25.20% to 82.27%,and the detection rate was continually increased.And the drug resistant rate of Schupson was increased from 18.89% to 80%,but the only difference was the drug named Colistin(polymyxin E)maintained a low drug resistance rate during these five years.Conclusion Resistance of A.baumannii to various antibacterial drugs is gradually increased and the isolation rate of multi-drug-resistant and pan-drug resistant A.baumannii is increased year by year.So A.baumannii infection and its drug-resistance changes should be vigilant and be paid more attention to for preventing the emergence and spread of drug-resistant A.baumannii strains.