Objective To investigate the characteristics of pathogens and bacterial susceptibility in the pa-tients with ventilator-associated pneumonia (VAP). Methods The clinical characteristics of aetiological germ and bacterial susceptibility in 20 patients with VAP who were treated in the hospital department of respiratory medicine were analyzed. Results 20 patients with bronchial secretions cultured bacteria was 42. It showed that the isolating rate of gram-negative bacilli(GNB), gram-positlve cocci and fungus was 71.4%, 16.7% and 11.9% respeotively. Conclusions The main bacterium in patients with VAP was GNB,which exhibited higher resistance to common anti-biotics. More attention should be paid to the cultivation of aetiological bacteria and selection of antibiotics in the treat-ment of VAP.

Objective To observe the influence of rehabilitative exercise on COPD patients in revive period in the pulmonary function, six-mlnute walking distance and activity of diaphragm as well as the number of acute attack in the last year. Methods Total 50 cases of COPD patients in revive period were randomly divided into comparison group and rehabilitative exercise group, each 25 cases. The former recaived general internal medicine for the treat-ment. In the latter on the basis of general medical treatment in patients with the disease in accordance with the formu-lation of rehabilitation programs,account of patients and their families in the light of the implementation,and stay pa-tient contact to monitor the implementation and follow-up. Results Rehabilitation treatment group compared with control group,rehabilitative exercise had mere notable effects in the pulmonary function,six-minute walking distance and activity of diaphragm of the COPD patients in revive period, the number of acute attack was significantly lower than that of the comparison group. Conclusion Rehabilitative exercise has comprehensive effects in the respect of improving life quality of patients, reducing times of hospitalization and seeking medical advices.

ObjectiveTo investigate the impact of health education and psychological intervention on quality of life of patients with asthma.MethodsNinety-six patients with bronchial asthma were assigned to the treatment group and the control group. The participants in the treatment group were treated with routine therapy and health education and psychological intervention.Results The awareness of bronchial asthma,self monitoring of health condition,and simple strategies to treat acute or serious asthma were improved in the treatment group. The overall effective rate of the treatment group was significantly higher than that of the control group (93.75％ vs 62.5％,P ＜0.01 ),and forced expiratory volume in one second (FEV1),peak expiratory flow (PEF) and ACT score were significantly improved (all P ＜ 0.01 ).Moreover,episode of bronchial asthma was significantly reduced after the combined intervention (P ＜0.01 ).ConclusionHealth education and psychological intervention may contribute to effective prevention and treatment of asthma,improved quality of life of patients,and reduced family and social economic burden.

In recent years,chimeric antigen receptor T -cells(CAR-T cells)therapy becomes the new rapid development of adoptive tumor immunotherapy .Its main characteristic is to identify specific T cell receptor of tumor antigen by genetic engineering modification and give its targeting ,killing and persistent treatment .The CAR-T was mentioned for the first time in 1989,and has developed to the fourth generation .CD19-CAR-T treatment technique shows activity in phase I clinical trials of multiple research centers .CAR-T therapy is ex-pected as a new way to cure relapse/refractory hematological malignancies .

Objective To evaluate the clinical effect of noninvasive positive pressure ventilation (NIPPV)on chronic obstructive pulmonary disease (COPD) with type Ⅱ respiratory failure. Methods Seventy-six cases of COPD with type Ⅱ respiratory failure were randomly divided into two groups.All patients were treated with antibiotics and other coventional therapy, 6 hours of intravenous drop infusion coramine was added to the control group (38 cases) and 6 hours of NIPPV was added to the treatment group (38 cases). Vital signs and arterial blood gas analysis were evaluated. Results After 6 hours of treatment, blood pressure, heart rate, respiratory rate and pH were significantly improved in the treatment group than those in the control group (P< 0.05 or < 0.01).Compared with the control group, there was a significant improvement of pH in the treatment group (P < 0.05). PaO2 increased [(81.7 ± 6.3) mm Hg (1 mm Hg = 0.133 kPa) vs (50.6 ± 4.3) mm Hg, (67.6 ± 7.4) mm Hg vs (50.8 ± 5.2) mm Hg] and PaCO2 decreased [(49.6 ± 4.5) mm Hg vs (78.5 ± 10.4) mm Hg, (60.8 ± 6.1)mm Hg vs (76.8 ± 8.3) mm Hg] was found in both groups, the amplitudes of PaO2 and PaCO2 before and after treatment were more singnificant in the treatment group (P < 0.01). Conclusion NIPPV on COPD with type Ⅱ respiratory failure can improve clinical symptom and arterial blood gas analysis more significantly than conventional therapy.

Objective To evaluate the clinical effect of ambroxol, budesonide and obstructive combinedly atomized inhalation on old patients with acute exacerbation of chronic obstructive pulmonary disease(COPD). Meth-ods 60 old patients with acute exacerbation of COPD were allocated into two groups in random, the control group(n =30) and the treated group(n =30). The control group was received conventinal theray,but the treated group re-ceived combinedly atomized inhalation on basis of conventional therapy. The two groups were treated in five-seven days, and were recorded the changes of clinical symptom, physicak sign, arterial blood gas analysis and the related side effect (for example, liver and renal function, blood sugar, etc). Results There are significant difference be-twcen the two groups in clinical effect (P < 0.05). Conclusion Ambroxol, budesonida and terbutaline combinedly atomized inhalation in the treatment of old patients with acute exacerbation of COPD was effective, little side effect and very safe.

Objective To identify the efficacy of granulocyte-macrophage colony-stimulating factor (GM-CSF) gargle in patients who had oral mucositis after allogeneic hematopoietic stem cell transplantation. Methods A total of 134 patients were enrolled in this study from 2014 to 2015. They were randomly divided into two groups:the experimental group (n=65) and the control group (n=69). Both groups received preventive measures for oral mucositis. But once oral mucositis occurred, the control group continued with the routine nursing measure, while the experimental group added GM-CSF gargle based on previous routine nursing measure. The effective rate and healing time were compared between two groups. Results The effective rate of the experimental group (81.54%, 53/65) was significantly higher than that of the control group (24.64%,17/69) (χ2=43.434, P=0.000). The median healing time in the experimental group was 4.5 days, shorter than 9.0 days in the control group (Z=-5.379, P< 0.01). Conclusions GM-CSF gargle can control the oral mucositis after allogeneic hematopoietic stem cell transplantation.

Objective:To study the effect of IL-24 on the differentiation and function of osteoclasts.Methods:Mature osteoclasts were isolated from long bones of neonate rats.Optimal multiplicity of infection(MOI)of AdCMV-EGFP was determined.Then osteo-clasts and RAW264.7 cells were transfected with AdCMV-EGFP and AdCMV-IL-24 respectively.The function of osteoblasts was studied by the observation of bone resorption lacunae,the differentiation of RAW264.7 cells was evaluated by the expression of osteo-clast related genes examined with real-time PCR.Results:Osteoclasts were TRAP positive with more than 2 neclei.MOI=400 was suitable for AdCMV-EGFP transfection.The resorption lacunae area in AdCMV-IL24 transfected cells was larger than that in AdCMV-EGFP transfected cells(P<0.05).Real-time PCR showed that under induced conditions,osteoclastic related genes NFATc1,CTSK and TRAP were changed in RAW264.7 cells transfected with AdCMV-IL-24.Conclusion:IL-24 may promote the differentiation and function of osteoclasts.

Objective To evaluate the quality of the portal images acquired by computed radiography(CR)system and conventional screen-film system,respectively.Methods imaging plates (IP)and X-ray films of a home-devised lead phantom with a leakage of 6.45% were acquired,and modulation transfer function(MTF)curves of the both images were measured using edge method.Portal images of 40 nasopharyngeal cancer patients were acquired by IP and screen-film system respectively.Two doctors with similar experience evaluated the damage degree of petrosa] bone,the receiver operating characteristic(ROC)curve of CR images and general images were drawn according to two doctors evaluation results.Results The identification frequency of CR system and screen-film system were 1.159 and 0.806 Lp/mm respectively.For doctor one,the area under ROC curve of CR images and general images were 0.802 and 0.742 respectively.For doctor two,the area under ROC curve of CR images and general images were 0.751 and 0.600 respectively.The MTF curve and ROC curve of CR are both better than those of screen-film system.Conclusion The image quality of CR portal imaging is much better than that of screen-film system.The utility of CR in linear accelerator for portal imaging is promising in clinic.

OBJECTIVETo explore regional anatomy of fasciae and spaces related to laparoscopic right hemicolectomy (LRC).

METHODSSeven cadavers and 49 patients undergoing LRC for cancer were observed. Computed tomography (CT) images of patients and healthy individuals were reviewed.

RESULTSBetween ascending mesocolon and prerenal fascia (PRF), there was a right retrocolic space (RRCS), which communicated in all directions. Anterior, posterior, medial, lateral, cranial, and caudal boundaries of the RRCS were ascending mesocolon, PRF, superior mesenteric vein, peritoneal reflexion at right paracolic sulcus, inferior margin of transverse part of duodenum, and inferior margin of the mesentery root, respectively. Between transverse mesocolon and pancreas and duodenum, there was a transverse retrocolic space (TRCS), which was bounded cranially by root of transverse mesocolon. On CT images of healthy individuals, PRF was noted as slender line of middle density, continuing to transverse fascia, and the retrocolic spaces were unidentifiable. For patients with right colon cancer, PRF and right retrocolic space might be easier to be identified.

CONCLUSIONSThe RRCS and the TRCS are natural surgical spaces. The PRF is natural surgical plane in LRC for cancer.

Adult ; Colectomy ; methods ; Colon ; anatomy & histology ; pathology ; Colonic Neoplasms ; pathology ; surgery ; Female ; Humans ; Laparoscopy ; methods ; Male ; Middle Aged ; Young Adult