Objective To determine the optimal suetioning negative pressure based on various sputum viscosity in brain-in-jured patients with tracheotomy. Methods Forty-three traumatic brain-injured patients with traeheotomy were recruited in the study. The negative pressure was determined based on the grade of sputum viscosity. Grade Ⅰ sputum was suetioned with the negative pressure of 13.3kPa,16.0kPa,20.0kPa and 24.0kPa, while Grade Ⅱ sputum with 20.0kPa,24.0kPa,26.TkPa and 29.3kPa,and Grade Ⅲ sputum with 26.7kPa,29.3kPa, 33.3kPa and 37.2kPa. The oxygen saturation(SpO2)was mort-itored before and lmin,3min,5min after endotracheal suctioning. At the same time,the suctioning time and tissue trauma were recorded. The data were analyzed by repeated measures analysis of variance with SPSS 13.0 software. Results The results showed that the optimal negative pressure was 13.3-16.0kPa for grade Ⅰ sputum,24.0-26.7kPa for grade Ⅱ sputum and 33.3kPa for grade Ⅲ sputum,which could ensure the minimum decrease of SpO2 and control the suctioning time within 25s or 30s respectively. Conclusion For traumatic brain-injured patients,varions negative pressure should be selected based on the sputum viscosity by the clinical nurses when suctioning is performed,in order to avoid hypoxemia and tissue trauma caused by suctioning.

Objective To investigate the thyroid hormone changes and their relationship with the state of severity in critically ill patients. Methods Ninety-two patients with no thyroidal illness syndrome admitted to the ICU from January ,2009 to December,2009 were enrolled in this study. The common situations and the score of acute physiology and chronic health evaluation Ⅱ were assessed on addmission. We measured the thyroid hormone levels on the day after admission and analysed whether thyroid hormone levels were related to disease severity. Results The thyroid hormone levels in septic shock group [TT3 (1.16 ± 0.24) nmol/L, TT4 (68.93 ± 24.11) nmol/L, FT3 (3.76 ± 0.21) prnol/L, FT4 (16.40 ± 2.74) pmol/L, TSH (1.58 ± 1.01) mU/L] were significantly lower than those in non-septic shock [TT3 (1.50 ± 0.25) nmol/L, TT4 (91.70 ± 21.90) nmol/L, FT3 (4.24 ± 0.45) pmol/L, FT4(17.98 ± 3.28) pmol/L, TSH (2.43 ± 2.76) mU/L] (P ＜ 0.05). The serum thyroid hormone levels of free triiodothyronine (FT3) ,free thyroxine (FT4) were related to the score of APACHE Ⅱ in septic shock(P ＜ 0.05).Conclusions The levels of thyroid hormone were significantly lower in critically ill patients than the control group and had positive correlation with the disease severity.

OBJECTIVE To investigate and analyze the incidence and related factors of nosocomial infection in old inpatients with cancers during radiotherapy and chemotherapy.METHODS Retrospective surveys of nosocomial infection were carried out in 236 old inpatients with cancers from Jan 2005 to Oct 2008.?2 Test was used to evaluate the difference significance of the data.RESULTS The surveys indicated the infection rate was 44.36% and without the sex difference.The infection rate among old inpatients with lung cancer was the highest and counted for 69.39% and then with radiotherapy and chemotherapy that was 56.96%.Respiratory infection was the main infection and counted for 51.27%.The hospital stay time correlated well with the infection rate of the inpatients.With the hospital stay time increasing,the infection rate also increased.Moreover,the predisposing factors of inpatients infection included poor nutrition,advanced stage of tumors,aggressive procedures,leukopenia and application of antibiotics.CONCLUSIONS The nosocomial infection rate of old inpatients with cancers during radiotherapy and chemotherapy is much higher than that of the elders with common diseases and that of the youngers with cancers.The incidence of nosocomial infection is related to the sites of the primary cancers,therapy methods,hospital stay,etc.We must emphasize and control the predisposing factors effectively,and reduce the occurrence of nosocomial infection.

Objective To explore the risk factors for chronic gastritis in Yuhang district,Hangzhou.Methods All cases came from the population involved in screening for upper gastrointestinal tract diseases in 2002 and were diagnosed by histopathology.The controls were chosen in residents of the same village who had no stomach disease history and dyspeptic symptoms.All subjects were investigated with a questionnaire by interviewers on their lifestyle and health condition.Results The odds ratios of smoking,the family history of chronic gastritis,drinking,sleep quality,oral debris,regular dining,drinking tea and the intake of beans & bean products were 3.012,2.343,1.438,1.384,1.283,0.418,0.603 and 0.809,respectively.Foods taste also took significant effect on chronic gastritis.The odds ratios of sour foods,spicy foods,salty foods and sweet foods were 2.72,2.33,2.22 and 2.06,respectively.Conclusions The risk factors for chronic gastritis were smoking,family history of chronic gastritis,heavy drinking,sleep quality,oral debris,foods flavor.While regularly dining,properly drinking tea and intake of beans and bean products were protective factors.

Objective To assess the clinical value of multi-slice helical CT perfusion on the post-operative follow-up of glioma.Methods CT perfusion image was applied to 32 patients with glioma after operation.Various perfusion parameters,include cerebral blood volume(CBV),permeability surface(PS),relative cerebral blood volume(rCBV)and relative permeability surface(rPS)were measured on recurrent area,nonrecurrent area and normal cerebral area respectively.SPSS 12.0 statistical software was used.Independent t test was used to compare the differences.Results In the recurrent group(16 cases),the value of CBV in creased in 12 cases and was normal in the other 4 cases.The value of PS increased in all the cases of recurrent group.The value of rCBV exceeded 2.6 in 10 cases,among which the biggest value of rCBV was 4.01.The mean value of rCBV was 2.67 and the mean value of rPS was 6.32;In the non-recurrent group(16 cases),the value of CBV was nearly normal in 7 cases,increased in 2 cases and decreased in the remaining 7 cases.The value of PS was nearly normal in 11 case,decreased in 3 cases and increased in the remaining 2 cases.The values of rCBV were all less than 2.6 and the biggest value of rCBV was 2.14.The mean value of rCBV was 0.99 and the mean value of rPS was 1.42.The statistic significance was obtained for all the parameters when compared the recurrent group with the non-recurrent group(P＜0.01)and with the normal cerebral area(P＜0.01).When compared the non-recurrent group with the normal cerebral area,none of the parameters had statistic significance(P＞0.05);The statistic significance was obtained for rCBV and rPS when compared the recurrent group with the non-recurrent group(P＜0.01).Conclusion CT perfusion image is valuable in determining glioma recurrence after operation.

Objective To investigate the clinical features of patients with brucellosis in Fujian Province and to update the relevant physician's knowledge on brucellosis.Method Retrospective analysis of the epidemiological,clinical,laboratory,imaging,treatment and outcome data of 7 patients with brucellosis were carried out in Fujian Medical University Union Hospital between January 2011 and July 2015.Results Of the 7 patients with brucellosis,6 were males and 1 was female aged between 29 to 61 years old,and 6 cases had a history of contact with goat.The main clinical presentations were repeated limb pain in 6 cases,6 patients got fever,4 cases with hepatomegaly,6 cases splenomegaly,and 7 cases lung inflammation.Hematology examination results indicated that 4 cases were normal,1 case decreased and 2 cases increased in white blood cells.Six cases had a liver dysfunction and 4 cases with low albumin level.All patients were detected positive of Malta Brucella by blood culture or bone marrow culture.In 6 cases and 4 cases out of the 6 cases,splenomegaly and hepatomegaly were found through B ultrasonography,respectively.After treatment of the 7 cases by doxycycline combined with minocycline rifampicin,3 cases were recovered,2 cases were relapsed,and 2 cases were improved.Conclusions The clinical symptoms are typical in these brucellosis patients.What we need to do is focus on improving the clinical and related physician's awareness of brucellosis,collecting a comprehensive history,choosing suitable assistant examinations based on the conditions of patients,strengthening the contact between clinical departments and auxiliary departments,and timely diagnosis.

Objective To investigate and analyze the influencing factors of the quality of life in patients with breast cancer chemotherapy.Methods Ninety-eight breast cancer patients were evaluated by self-administered questionnaire and quality of life questionnaire for Chinese cancer patients with chemobiotherary (QLQ-CCC).The influencing factors of quality of life were analyzed.Results The total scores of QLQ-CCC improved significantly after chemotherapy compared with before chemotherapy (P ＜ 0.01),and the scores of physiological index,mind and psychological index,society index and other index improved significantly after chemotherapy compared with before chemotherapy (P ＜ 0.01 or ＜ 0.05).Age,clinical stage during chemotherapy and after chemotherapy had significant influence for the quality of life (P＜ 0.01).The level of culture had significant influence for the quality of life after chemotherapy (P＜ 0.01).Conclusions For breast cancer patients,the quality of life decline during chemotherapy.After chemotherapy,the quality of life in early stage patients is better than late stage patients.

ObjectiveTo investigate the disinfection effects of two different methods on the ventilator circuits. MethodsThe ventilator circuits which had been used by patients were disinfected by the artificial brushing method and the strict program of the full automatic cleaning-disinfecting machine,respectively.Samples from circuits were cultured after disinfection,and the numbers of bacterium colony forming unit (CFU) were counted. ResultsThe qualified rate of disinfection of the ventilator circuits by the strict program of the full automatic cleaning-disinfecting machine was 100％,which was significantly higher than that by artificial brushing method.50 samples disinfected by artificial brushing method were selected,among which 14 samples had pathogenic bacteria.100 samples disinfected by the strict program of the full automatic cleaning-disinfecting machine were selected and total bacterial count≤5 cfu/cm2. ConclusionsThe sterilization of the ventilator circuits with the full automatic cleaning-disinfecting machine is effective and safe,which can make the disinfection work more standardized.

AIM:To prepare ophiopogonin enteric microsphere and to carry out the comprehensive evaluation.METHODS:The microsphere was prepared by spray-drying technology,it was evaluated by common index、 enteric index and physical index.RESULTS:Yield was(81.7? 2.1)%,embedding ratio was(86.55? 0.86)%,drug loading was(23.1? 0.2)%.The drug released degree in artificial gastric juice within 2 hours was(9.18? 0.08)%.The drug released rate in artificial intestinal juice within 45 minutes was(73.79? 0.29)%.The equilibrium moisture content decreased from 12.9% to 5.8%.CONCLUSION:An comprehensive evaluation was established.

Objective:To evaluate the efficacy and safety of selective arterial embolization in the treatement of obstetrical and gynecological bleeding.Methods:16 cases with obstetrical and gynecological hemorrhage,including postpartum,trophoblastic disease,uterine fibroids,ectopic pregnant and artifical abortinal bleeding were treated by selective arterial embolization.Results:The embolization successfully controlled the bleeding in all patients.No serious complication happened.Conclusion:Selective arterial embolization is safe and effective,it′s complicationis is lower and patient′s fertility can also be preserved.