OBJECTIVE To observe the clinical characteristic of broanchopulmonary Candida infection in acute exacerbations of chronic obstructive pulmonary disease(AECOPD).METHODS To analyze retrospectively 50 broanchopulmonary Candida infection patients with AECOPD.RESULTS From fungal infections the Candida infection occupied 56.82%.The risk factors were included: using long-term antibiotic,hypoproteinem,mechanical ventilation and complicated with diabetes or cardiovascular diseases.There were Candida albicans(56.52%),C.tropicalis(20.29%),C.parapsilosis(14.49%) and C.krasei(8.69%),after getting the microbiology result by bronchoalveolar lavage under fibrobronchocope,cultivating deep part sputum,brushing biopsy on broncho mucous membrane,lung biopsy,and cultivating blood and pleural effusion,and to think highly of preempting treatment and using medicine by fungi category and cultivating result.CONCLUSIONS The Candidia are the main pathogens in AECOPD;it is better using the local and systemic medicines in combination.

Objective To assess the efficiency,safety and indications of permanent inferior vena cava filters (VCF) placement for prevention of pulmonary embolism in cases of deep vein thrombosis (DVT). Method In this study 71 cases were treated with permanent inferior vena cava filters by way of the internal jugular vein and the common femoral vein. Cavography was performed routinely before inserting the VCF to confirm no thrombosis in IVC and access veins. The insertion site for filters is the subrenal vena cava. Results The procedure was successful in all cases. There was no case of symptomatic PE occurred during 1～41 months of follow-up. There were 2 cases of IVC thrombosis at the site of insertion and 5 cases of filter tilting less than 15?. There were no other complications. Conclusion Permanent IVC filter placement is an effective method for preventing fatal PE due to DVT. Imaging of the vena cava and access vein by venous ultrasound and cavography, strict anticoagulation therapy after VCF insertion are key to perform VCF placement, provide protection from recurrent life-threatening PE and reduce complications. The filter placement indications should be strict.

ObjectiveTo evaluate axillofemoral bypass(AxFB) for the treatment of chronic severe lower limb ischemia. Method Consecutive AxFB performed in Anzhen Hospital from January 1995 to November 2002 was retrospectively analysed, with 31 patients of aortoiliac occlusive disease undergoing axillobifemoral bypass (AxBFB) and 32 axillounifemoral bypass(AxUFB) respectively. Result On discharge, rest pain disappeared in 44 cases and intermittent claudication in 19 cases, with average ankle/brachial index changing from preoperative 0.18(0～0.49) to postoperative 0.68(0.29～1.04). Rate of limbs salvage was 87.4%, amputation rate was 7.9%. Three cases died with a perioperative mortality of 4.8%. The patency rate of 1,3,5 years were 93.2%,79.8% and 64.1%, respectively. Conclusion AxFB for aortoiliac occlusive disease is considered to be acceptable procedure in high-risk patients with poor femoral run-off and chronic critical lower limb ischemia.

Objective To summarize our surgical experience on 187 patients undergoing open repair of abdominal aortic aneurysms (AAAs). Methods Data of 187 patients with infrarenal AAA who were treated electively with open repair between January 1992 and February, 2004 were retrospectively reviewed. Results One patient (0.54%) died perioperatively due to ventricular premature beat, ventricular fibrillation 6 hours after. The mean duration of operative procedure was 3.8 hours. The mean blood loss was 445 ml. Perioperative complications included heart failure in 17 cases, respiratory failure in 8, acute myocardial infarction in 2, cerebral infarction in 1, and acute renal failure in 3. The 1? 3? 5-year survival rate was 97.0%? 84.6% and 78.3%, respectively. Conclusion The aneurysm diameter is not the absolute operative indication. Risk factors for open operation of AAA are old age, severe cardial, pulmonary diseases and renal desfunction. Open surgery is still the treatment of choice for AAA.

Objective To evaluate surgical therapy for ruptured aortoiliac artery. Method Between Apr 1984 and Dec 2003, 23 patients of ruptured aortoiliac artery were admitted with ruptured aortoiliac artery aneurysm in 18 cases and traumatic artery rupture in 5 patients. Two patients were treated with direct vascular repair and 21 patients underwent prosthetic grafts replacement. Result Four cases died perioperatively including 2 patients dying of acute renal failure, one of upper gastrointestinal heamorrhage caused by stress ulcer at 48 h after operation, and one of respiratory failure in 72 h. Conclusion Based on the etiology emergency operations should be performed on patients of ruptured aortoiliac artery by repairing or prosthetic grafts replacement.

Objective To establish the background information of physiological parameters for germ?free ( GF ) Taihu piglets. Methods In this study we selected 25 days old GF Taihu piglets and 4 conventional ( CV) littermates, the male and female ratio was 1∶3, to measure the normal clinical values of hematology and serum biochemistry, immunoglobu?lin concentration and main organ coefficients. The analysis of relative growths of main organ weight to body weight was con?ducted in the Taihu GF and CV pigs by allometric scaling model. Results (1) Twelve hematological parameters and 8 blood biochemical parameters in the GF piglets were significantly lower than those in CV pigs (P<0?05). (2) The aver?age body weight, IgM concentration of GF pigs and CV pigs had significant difference ( P <0?05 ) , and no mesenteric lymph nodes were found in the GF pigs. (3) The gut weight had the largest allometric association with body weight in the GF pigs, while spleen weight has the largest allometric association with body weight in the CV pigs. Both the weight of heart and stomach in CV and GF pigs had a negative allometric association with body weight (allometric coefficient b<1), respectively. Conclusions Different microbe control grades affect the body weight, hematology and serum biochemistry, expression of immunoglobulin and development of main organs in laboratory pigs.

Objective To sum up the experience in the diagnosis and management of acute lower extremity arterial injury.Methods Between Jan 1988 and Feb 2004,125 cases of lower limb arterial injuries were admitted and undergoing surgery, including gunshot in 3 cases, blunt trauma in 56 and stabbing in 66 cases. Associated injuries included bony injury in 36 cases, nerve injury in 11 cases, and vein injury in 23 cases. Arterial primary or patch repair was performed in 28 cases, end-to-end anastomosis in 37 cases, saphenous vein graft used in 32 cases, prosthetic graft bypass in 23 cases, thrombectomy in 2 cases and blood vessel ligation in 3 cases.Results Limb salvage rate was 85.6% and patient survival of 98.4%. Massive bleeding and multiple organ failure caused mortality in one each. The rate of amputation is 10.4%(13/125), with preoperative gangrene being present in 8 cases.Conclusion Lower extremity arterial injury carries a high amputation rate. The use of Doppler scanner is helpful for early diagnosis. An ankle/brachial index of less than 1 in the affected limb was considered as a positive sign of arterial injury. Prompt revascularization and early fasciectomy are important to reduce amputation rate and mortality.

Objective To investigate the current status of hand hygiene(HH) among health care workers(HCWs) in clinical laboratories in medical institutions in Xi'an City.Methods HH status of HCWs in clinical laboratories in medical institutions in Xi'an was performed random on-the-spot sampling and monitoring.Results A total of 240 HH specimens of HCWs in clinical laboratories in 80 medical institutions in Xi'an City were collected, 127 detected results were qualified, the total qualified rate was 52.92%.The qualified rates of medical institutions were as follows: municipal hospitals 62.67%,workers' hospitals 55.95%,private hospitals 40.74%;comprehensive medical institutions 67.68%,specialized medical institutions 42.55%;tertiary medical institutions 79.63%(n=43),secondary and below medical institutions 45.16%(n=84),there were significant differences in HH qualified rate among HCWs in different types of medical institutions(all P<0.01).Of different HH detection items, detection rates of Escherichia coli and Staphylococcus aureus were 0.83% and 8.33% respectively.There were significant differences in HH compliance rates among HCWs of all age groups(χ2=9.103,P<0.05), HCWs aged≥50 years had the highest qualified rate of HH(71.43%), followed by those aged<30 years (67.82%),HCWs in 40~ year age group had the lowest HH qualified rate (39.66%).Conclusion The qualified rate of HH of HCWs in clinical laboratory of medical institutions in Xi'an City is low, it is necessary to enhance the procaution awareness of HCWs in clinical laboratories, strengthen quality control of HH, strictly implement standard hand-washing procedures to reduce occurrence of HAI.

Shennongjia is well known as the national treasure of traditional Chinese medicine resources at home and abroad. In order to provide Shennongjia with better protection of traditional Chinese medicine and promote the sustainable utilization of its resources, based on the specific analysis of She nnongj ia′s conservation status and
available resources, we put forward primary strategies and specific measures for the sustainable utilization framework of Shennongjia traditional Chinese medicine resources, in view of resources conservation, development, utilization, as well as the resources administration.

ObjectivesTo analyse the causes of occlusion of prosthetic grafts and to explore the appropriate modality of reoperation.MethodThe clinical data of 47 patients with occlusive prosthetic grafts were analyzed retrospectively. The procedure of treatment for patients with different causes of occlusive graft included thrombectomy alone in 9 cases, thrombectomy and anastomotic plasty in 16 cases, new bypass using prosthetic graft and saphenous autograft in 22 cases. ResultsThe reoccurrence of graft occlusion in patients undergoing thrombectomy alone or thrombectomy and anastomotic plasty was 67% and 56% respectively, which was siginificantly higher than that of 9% in patients treated by a new arterial bypass with prosthetic grafts and saphenous autografts. ConclusionsThe result of new bypass for occlusive prosthetic graft is superior to thrombectomy alone or thrombectomy and anatomotic plasty.