Stroke-associated pneumonia (SAP) refers to the stroke patients suffering from infectious lung parenchyma (including the alveolar wall,i.e.the general pulmonary interstitial) inflammation without previous pulmonary infection.It is one of the most common major complications resulting in death and affecting functional recovery in patients with stroke.Dysphagia resulting in aspiration is the main reason of SAP.Therefore,avoiding aspiration and preventing SAP have important significance for patients with stroke through early correct tube feeding.This article reviews the tube feeding methods of preventing SAP.

Objective To evaluate the value of dual Doppler ultrasonography in the diagnosis of fetal atrial extrasystoles.Methods Seven thousands and thirteen fetuses were examined by fetal echocardiography.If fetal arrhythmias were found,information of pulsed wave Doppler signals in hepatic vein (HV) and descending aorta (DAo) using dual Doppler were colleted simultaneously.The detected times were compared between using general Doppler and dual Doppler in 20 cases.Results On dual Doppler examination,28 of the fetuses showed signals of atrial extrasystoles,14 fetuses atrial extrasystoles conducted to ventricle,8 fetuses atrial extrasystoles non-conducted to ventricle,6 fetuses with part of the extrasystoles conducted to ventricle and part of the extrasystoles non-conducted to ventricle.No case had congenital heart disease.Twenty-six fetuses with atrial extrasystole were converted to normal rhythm within the third trimester of pregnancy,and the others' were converted to normal rhythm during the first 3 days postnatally.The detected time of dual Doppler was shorter than that of general Doppler(P ＜0.05).Conclusions Dual Doppler ultrasonography of simultaneous recordings in HV and DAo is an easy,rapid method of assessing fetal atrial extrasystoles,which should allow precise diagnosis of atrial extrasystole.

Objective To evaluate the pattern of development of fetal cerebral sulei by prenatal ultrasound and its clinical significance. Methods Sixty hundred and ninety-two fetuses at age from 17 to 40 weeks were observed for the development and depth of cerebral sulci (parietal-occipital sulcus, calcarine suleus, central sulcus, eingulate sulcus, cingulate gyrus, and sylvian fissure) by transabdominal ultrasonography. Results Parietal-occipital sulcus,calcarine sulcus,and sylvian fissure were visible at about 19 weeks of gestation, central sulcus was at about 25 weeks, cingulate sulcus and cingulate gyrus were at about 26 weeks. One case of them was considered as cerebral sulei growth retardation due to the signs of invisible parietal-occipital sulcus and sylvian fissure at 24 weeks of gestation. Two cases were considered as cerebral sulci growth retardation due to the signs of invisible parietal occipital sulcus and central sulcus and the shallow blunt shape of sylvian fissure at 29 weeks of gestation. There were positive correlations between the depths of fetal cerebral sulci and gestational weeks, and negative correlations between their relative depths and gestational weeks(all P <0.05), Conclusions Transabdominal ultrasonography can be use to observe the development of fetal cerebral sulci (parietal-occipital sulcus, calcarine sulcus, central sulcus, eingulate sulcus,cingulate gyrus,and sylvian fissure). The depth of cerebral sulci is relative to gestational weeks,and would be considered for prenatal assessment of cerebral sulci maldevelopment, such as cerebral sulci growth retardation and lissencephalia.

Objective To explore the clinical value of application research in business process reengineering in transferring of inpatients for check-up. Methods We reorganized transferring of inpatients for check-up and service tache by introducing the Systematic Redesign method from the therory of Business Process Reengineering. The reengineered process was adopted and applied in the transferring processes. We randomly selected patients for check-up(126 cases for electrocardiogram,130 cases for Xrayand 128 cases for CT examination)and investigated the time cost for check-up and patients satisfaction rate. The above results were compared with those patients(112 cases for electrocardiogram,112 cases for Xrayand 120 cases for CT examination)before use of reengineered process. Results The time cost for the above mentioned check-up was shorter and patients satisfaction rate were alleviated compared with those before use of reengineered process(U=14.55,12.26,13.57;x2=17.37,14.65,10.75,P＜0.01).Conclusion Application of business process reengineering in the transferring process of inpatients for check-up proved pivotal important in that it could shorten time cost for transferring process and improve patients satisfaction rate.It possessed realistic significance for increasing benefit and competitions for hospitals.

Objective To study retrospectively the results of minute tissue flap for repairing tissue defect of hand. Methods The transposition or transplantation of ten kinds of tissue flaps were applied to repair skin or bone or joint defect of hand in 102 cases. Results The period of follow-up was one to eighteen years. All skin flaps were live and appearance is excellent. The function of hand is good. The period of bone healing was three to four months and joint motion is satisfactory' Conclusions Microsurgical repair of skin defects of hand have shorter period and good results' Skin defect with naked bone and joint or tendon in hand should apply minute skin flap to repair in onestage. Various vascularized minute bone flaps may be choiced to repair non-union of scaphoideum or lunatum necrosis and metacarpal head defect.

Objective To establish an effective method for inducing mouse bone marrow mononuclear cells(MNCs) to differentiate into hepatocytes.Methods MNCs were isolated by gradient density centrifugation,and the cells were cultured in Iscove's Modified Dulbecco's medium supplemented with 10 % new bovine serum(NBS),20 ng/ml hepatocyte growth factor(HGF),10 ng/ml fibroblast growth factor-4(FGF-4) and 10 ng/ml oncostatin m(OSM) for 21 days' induction.The medium was changed every 3 days.Results When MNCs were cultured with HGF,FGF-4 and OSM,cuboidal morphology was observed,and cells also expressed marker genes specific for liver cells in a time-dependent manner.?-fetoprotein(AFP) and cytokeratin 19(CK19) were expressed on the day 7,and CK18 and TAT were detected on the day 14-21,in common with the immunofluoresence results.Differentiated cells further demonstrated these cells also acquired functional characteristics of hepatocytes.Conclusion Mouse MNCs can differentiate into hepatocytes when induced by HGF,FGF-4 and OSM.

Objective This paper provides an anatomical and theoretic basis for the reverse transposition of proximal ulnar or radial periosteal flap to repair non-union in distal humerus.Methods The origin,course,meanwhile,the outside diameter and length of relevent vessels were measured,on 30 upper limb cadaveric specimens.Results The recurrent interosseous,radial recurrentand the posterior branch of radial collateal arteries,their origin outside diameter and length from the origin to the humerus extermal epicondyle were (1 47?0 2)mm,(65 1?9 5)mm,(2 1?0 3)mm,(63 7?0 8)mm,(1 48?0 22)mm and (104 5?8 9)mm,respectively.Anastomoses pattern existed 3 types: in vicinity of the external epicondyle"Reverse Y"73 3%(22 cases)."Meeting in one point 13 3%(4 cases)"."Arteries networks"13 3%(4 cases).Conclusions It's possible that the reverse transposition of proximal ulnar or radial periostea flap pedicled with recurrent interosseous membrane or radial recurrent vessel for repairing non-union in distal humerus.

von Willebrand factor (vWF) and factor Ⅷ (FⅧ) exist in a complex form in blood.After being activated,they mediated platelet adhesion and aggregation,and play an important role in the course of thrombosis.The levels in blood of both of them were affected by a variety of factors.vWF and FⅧ are closely associated with the risk,etiological type,severity and outcome of acute ischemic stroke.Studies on the corresponding antagonistic drugs have made a breakthrough,and these drugs may become more advantageous antithrombotic s.

OBJECTIVE Based on hospital information system operation platform,the antibacterial drugs utilization and control information system was designed to share prescriptions for antibacterial drugs and results for bacteria culture and drug sensitivity,to analyze pathogen composition and drug resistance trend,and supervise physicians to utilize antibacterial drugs properly. METHODS Adopting C/S framework,the backstage supporter adopted the large-scale database of SQL SERVER 2000 enterprises edition,the front application program used PowerBuilder7 programming.Antibacterial drugs utilization software was integrated into resident physician's working stations.Antibacterial drugs utilization control software was installed into working stations for department of nosocomial infection. RESULTS The application of the information system strengthened control of antibacterial drugs utilization and could guide physicians to utilize antibacterial drugs properly. CONCLUSIONS Antibacterial drugs utilization and control information system could reinforce management of antibacterial drugs utilization,and facilitate to utilize antibacterial drugs properly and safely.

OBJECTIVE Based on hospital information system operating platform,the Nosocomial Infection Early Warning Information System is designed to study nosocomial infection concerning its risk factors,occurrence pattern,and control measures so that the epidemic of nosocomial infection could be early found and controlled effectively,the capability of nosocomial infection supervision could be steadily increased.METHODS Adopting C/S framework,the backstage supporter adopted the large-scale database of SQL SERVER 2000 enterprises edition,the front application program used PowerBuilder7 programming.To structure a reporting,early warning,and supervising network,nosocomial infection reporting card software was integrated into resident physician′s working stations,and early warning control software was installed into working stations for department of nosocomial infection.RESULTS The application of the information system could early warn and supervise occurring nosocomial infection cases,help to find the epidemic of nosocomial infection in time and take effectively control measures as soon as possible.CONCLUSIONS Nosocomial Infection Early Warning Information System could early warn and control nosocomial infection on-the-spot,increase efficiency of nosocomial infection management and improve quality of care.