Objective To explore the etiology of pulmonary atelectasis and explore the value of fiberoptic bronchoscope in the diagnosis and treatment of pulmonary atelectasis.Methods 192 cases of pulmonary atelectasis confirmed by thoracic X-ray and CT were examined and treated under fiberoptic bronchoscope.Results The final cause of 192 cases pulmonary atelectasis was lung cancer in 122 cases,chronic inflammation in 35 cases,tuberculosis in 24 cases,foreign body in 3 cases,blood clot obstruction in 3 cases,no clear causes in 5 cases;97.4% of pulmonary atelectasis were diagnosed.The treatment of pulmonary atelectasis caused by tumor obstruction was ineffective under fiberoptic bronchoscope;Then for others,atelectasis of patients was re-expanded completely in 65.7% after treatment one week under fiberoptic bronchoscope,re-expanded partially in 27.1% and the effective rate was 92.8%.Conclusion The rate of etiologic diagnosis of pulmonary atelectasis under fiberoptic bronchoscope is high;The main causes of pulmonary atelectasis are lung cancer,chronic inflammation and tuberculosis.The pulmonary atelectasis with no clear cause should be examined with fiberoptic bronchoscope.The treatment under fiberoptic bronchscope is effective for non-tumor atelectasis.

Objective To evaluate the values of visual inspection with acetic acid( VIA) and human papillomavirus( HPV) and thinprep cytology test( TCT) in the screening of cervical cancer.Methods VIA,HPV test and TCT in 946 women was conducted.Cervical biopsy or endocenical curettage( ECC) was performed in VIA positive women or HPV positive women or TCT positive women. The pathologic outcome was as the gold standard,and the out come more and equal to cervical intraepithelial neoplasia( CIN) Ⅱ were identified as positive.Results There was no significant difference among three groups in sensitivity rate( 73.l％,96.2,88.5％ ) and negative predictive value ( 99. 1％ ,99.9％ ,99.7％ ) ( all P ＞ 0.05 ).The specificity rate (97.5％ ) and positive predictive value ( 50.O％ ) of TCT was better than those of HPV ( 93.5％,29.4％ ),and HPV was better than those of VIA( 87.0％,13.7％ ),and the difference had statistifical significance among three groups ( x2 =71.34,26.00,22.17,8.28,all P ＜ 0.05 ).Conclusion Although the rate of missed diagnosis and misdiagnosis rate was higher than that of HPV and TCT,but VIA seems to be appropriate methods in the screening of cervical cancer owing to its low price.

ObjectiveTo study the risk factors and pathogenic characteristics of ventilator associated pneumonia(YAP). MethodsRisk factors of VAP,pathogens and drug resistance in 118 patients in ICU were analyzed retrospectively. ResultsThe incidence of VAP was 44.9％, and age, the mechanical ventilation time, state of consciousness,tracheotomy,the antibiotic combination are risk factors of incidence of VAP. 53cases of VAP(68.2％ )were infected by Gram negative bacilli,25.9％ were by Gram positive cocci,and 5.9％ were by fungi. Drug resistance was observed obviously. ConclusionThe occurrence of VAP was related with multiple factors. The gram negative bacteria are the major pathogens of VAP, and the rate of drug resistance was high. The occurrence of VAP could severely affect patients' prognosis.

Objective To explore the value of E-flow technique in ultrasound examination of fetal pulmonary vein.Methods The pulmonary veins of 332 fetus were examined using lungs as acoustic window by two-dimensional echocardiography(2DE), color Doppler flow imaging (CDFI) and E-flow.Visualization ratios of the three methods were compared.Results The fetal pulmonary veins were displayed as following:7 cases were showed by 2DE,49 cases by CDFI and 73 cases by E-flow among 118 cases during 12 - 22 gestational weeks.The visualization ratio of E-flow was higher than that of the other two methods (P ＜0.001).Fourty-one cases were showed by 2DE, 171 cases by CDFI and 177 cases by E-flow among 214 cases during 23 - 40 gestational weeks.The visualization ratios of E-flow and CDFI were higher than that of 2DE (P ＜ 0.001).The visualization ratio of E-flow and CDFI has no distinct differrence (P ＞ 0.0167).Conclusions E-flow was sensitive to pulmonary vein blood flow and better than 2DE and CDFI in early stage of the second trimester.

Objective To study the influence of oral health education and the family nursing intervention on the incidence rate of gingivitis and the enamel decalcifyication for adolescent patients with fixed diorthosis.Methods Divided 146 adolescent patients who had accepted fixed diothosis into the experiment group and the control group randomly, there were 73 cases in the each group. In the experimental group, oral health education and the family nursing intervention were both used for patients and their parents, while in the control group, only traditional nursing methods were used. Compared the incidence rate of complication between the two groups at the 6th and the 12th month after the fixed diorthosis.Results The incidence rate of gingivitis and the enamel decalcifyication in the control group was significant higher than those of in the experiment group.Conclusion Oral health education and the family nursing intervention can effective decline the incidence rate of gingivitis and the enamel decalcifyication for adolescent patients who have accepted the fixed diorthosis.

Objective To explore the pulse diagram parameter changes of chronic renal insufficiency patients with five symptoms types(spleen kidney qi deficiency ,spleen kidney Yang deficiency ,kidney liver Yin deficiency and the deficiency of Yin and Yang ) , and to establish the differentiation mode of each symptoms type for assisting the clinical diagnosis .Methods The DS01-C pulse manifestation instrument made by the Shanghai Daosh company was adopted to detect and analyze the pulse manifestations in the healthy control group and the chronic renal insufficiency group .Results The healthy control group was dominated by the normal pulse manifestation .The chronic renal insufficiency group was dominated by the taut pulse and its concurrent pulse .Along with the progress of the disease ,the pulse manifestations also appeared the corresponding changes .The patients with spleen kidney qi defi-ciency and spleen kidney Yang deficiency were dominated by the taut pulse .Comparing the patients with liver kidney Yin deficiency and Qi Yin deficiency ,the taut pulse and concurrent rapid pulse were common ,in addition ,the former also had the deep pulse .The patients with Yin and Yang deficiency showed the slow pulse and the taut pulse or the taut pulse and rapid pulse .Conclusion The pulse manifestation change in the patients with chronic renal insufficiency is dominated by the taut pulse and the concurrent pulse , the pulse manifestation change of various symptoms types are complex .

Objective To investigate the feasibility, accuracy and senaitivety of echo tracking (ET) technology on carotid elasticity in rabbits. Methods Thirty-nine healthy New Zealand rabbits were divided into 4 groups,which group 1,2,3 were experimental groups and group 4 was control group. Experimental groups were fed with high cholesterol diet,control group were fed with basic diet. The parameters of elasticity of carotid were measured with ET technology, including pressure-strain elasticity modulus(Ep), stiffness parameter(β), arterial complianee(AC), pulse wave velocity( PWV), augmentation index (AI) at the interval of 0,4,8,12 weeks of the experiment respectively. Blood-fat level of all rabbits were checked and the common carotid artery was examined pathologically,which were compared and analyzed then. Results With the prolong of the experiment time,the Ep and β raised, but the AC reduced. There were significant difference between experimental group 1 (4 weeks) and basement,which were same between experimental group 2 (8 weeks) and experimental group 1, between experimental group 3(12 weeks) and experimental group 2( P<0.05). PWV increased comparing with basement in the end of 8 weeks,which increased obviously in the end of 12 weeks,meanwhile was higher than in the end of 8 weeks,which there were significant differences ( P<0.01 ). AI had no change all the time. Conclusions ET technology is accurate and reliable in detecting early atherosclerosis. Probe maintenance tool can keep the steady of checking progress, sensitive of result and repeatability.

Objective To explor the ultrasonography methodology of the fetal ductus arteriosus.Methods Based on the fetal four-chamber sight, the characteristic ultrasound images were observed by moving probe,such as "V-shape" sign,"three-finger" sign,"Z-shape" sign and"hockey-handle" sign making up of the ductus arteriosus and the nearby structures were observed by moving probe. The inner diameter,the systole flow velocity,the diastole flow velocity and the resistance index of the ductus arteriosus via the "V-shape" sign section were measured. Results Among the 365 normal fetus cases,355 "V-shape" sign cases,237 "three-finger" sign cases,298 "Z-shape" sign cases and 331 "hockey-handle" sign cases were identified. The inner diameter of the fetal ductus arteriosus increases gradually with the growth of the gestational weeks and the flow velocity increases gradually too, while the resistance index had no obvious variation with the growth of the gestational weeks. Conclusions According to the characteristic ultrasound images, such as "V-shape" sign, "three-finger" sign, "Z-shape" sign and "hockey-handle" sign, the fetal ductus arteriosus can be identified promptly.

Objective To explore the value of ductus arteriosus in ultrasound diagnosis of fetal congenital heart disease by echocardiography. Methods The fetal echocardiography was performed with three segments diagnosis method. According to the fetal position, the ductus arteriosus was examined in different sections which include the V shape sign section formed by ductus arteriosus and right pulmonary artery,the V shape sign section formed by ductus arteriosus and the gorge of aortic arch,the three fingers sign section formed by ductus arteriosus,left and right pulmonary artery,the Z shape sign section formed by left pulmonary artery, ductus arteriosus and the gorge of aortic arch. The flow velocity and the inner diameter of the ductus arteriosus were measured. Results Thirty-one cases with congenital heart disease were evaluted. Thirteen cases were approved by autopsy. Among those fetus, 4 cases went with ductus arteriosus stenosis and they all accompanied with right heart obstructing disease,3 cases went with dilated ductus arteriosus and they all accompanied with left heart obstructing disease. Retrograde were explored in 2 fetus. The flow velocity of 5 fetus ductus arteriosus were higher than the normal fetus and 4 cases of them with right heart obstruction, 1 cases with left heart obstruction. Five fetal ductus arteriosus were normal. One fetal ductus arteriosus was absent. Conclusions Assessant of ductus arteriosus by echocardiography is an important content in screening fetal congenital heart disease. It can help us to diagnose quickly.

Two pediatric heart failure patients were treated with pulmonary artery banding(PAB)at Fuwai Hospital,from December 2021 to January 2022.In the first case,an 8-month-old patient presented with left ventricular non-compaction cardiomyopathy(LVNC),left ventricular systolic dysfunction,ventricular septal defect,and atrial septal defect.The second case was a 4-month-old patient with LVNC,left ventricular systolic dysfunction,and coarctation of the aorta.After PAB,the left ventricular function and shape of both patients were significantly improved,without serious surgery-related complications.In these individual cases of pediatric heart failure,pulmonary artery banding exhibited a more satisfactory efficacy and safety compared to pharmacological treatment,especially for those with unsatisfactory medication results.Future clinical data are needed to promote the rational and broader application of this therapeutic option for indicated patients.