Objective To investigate the clinical value of bronchofibroscope to the patients with respiratory failure treated by mechanical ventilation. Methods 44 patients with respiratory failure treated by mechanical venti-lation who were rescued with bronchofibroscope in EICU from January 2006 to June 2007 were compared the days of antibiotic application, the days of mechanical ventilation and mortality rate with 35 patients with respiratory failure treated by mechanical ventilation but not using bronchofibroscope during January 2005 to January 2006. Results Compared with the control group, the therapy group had fewer days of antibiotic application, fewer days of mechani-cal ventilation and lower mortality rate(P < 0.05). During absorbing expectoration with bronchofibroscope, compli-cation such as haemorrhage did not happen. Conclusion Bronchofibroscope application in the patients with respira-tory failure treated by mechanical ventilation can shorten the time of mechanical ventilation and cut down the mortal-ity rate,which was worth generalizing in clinical work.

Objective To determine the evaluating prognostic value of plasma Nt-proBNP in patients with congestive heart failure.Methods 107 patients with congestive heart failure were included in this study,followed the degree of rehospitalization and mortality rate of the cured patients after left hospital.The plasma concentrations of Nt-proBNP were measured by enzymelinked immunozorbent assay(ELISA).Results Concentrations of Nt-proB-NP of Ⅱ,Ⅲ,Ⅳ classincation were(1129.8±383.2),(5849.7±567.6),(9506.3±492.4)ng/L in NYHA functional classification respectively(P＜0.01);the plasma level of Nt-proBNP had significant positive correlation with NYHA functional classification(r=0.759,P＜0.01).The degree of rehospitalization were(0.85±0.96),(1.98±0.86),(2.58±0.91)respectively(P＜0.01);mortality rate were 8.3%,12.5%,45.2%respectively(P＜0.01).Conclusion Plasma Nt-proBNP level may be the more important clinic value in evaluating prognosis in patients with congestive heart failure.

Objective:To study the clinical characteristics,prognosis and drug resistance caused by the non fermenting bacteria in the infants,and to provide reference for the doctors to recognize the infection features and its treatment.Methods:A total of 91 cases of non-fermentative bacteria infection were selected and the clinical materials were retrospectively analyzed.The clinical data and prognosis of the pediatric patients were analyzed,as well as the distribution and drug resistance of non-fermentative bacteria.The bacterial resistance genes were detected by PCR method,and the positive results were analyzed by gene sequencing.Results:In the past 5 years,the nonfermentative bacteria strains were isolated in 91 infant patients,including 35 cases of newborn (19 cases were premature infants),29 cases aged less than 1 year old,27 cases aged from 0 year to 3 years old.Among these patients,60 were male and 31 were female.There were 41 cases with underlying diseases (45.05 ％),16 cases with organ dysfunction (17.58％),3 cases discharged automatically (3.29 ％),and 1 case dead (1.09 ％).A total of 102 strains of non-fermentative bacteria included 42 strains of Pseudomonas aeruginosa,33 strains of Acinetobacter baumannii,21 strains of Stenotrophomonas maltophilia and 6 strains of other non-fermentative bacteria.Forty-four strains were isolated from neonatal ward,33 strains (32.35％) from neonatal ICU (43.13 ％),25 strains (24.50％) were isolated from general pediatric ward.These strains were mainly from respiratory tract secretions and blood samples,nearly 84.31％.The isolation rates of MDR,XDR,PDR Acinetobacter baumannii and Pseudomonas aeruginosa were 63.63％ and 19.04％,respectively.There were 40.48％ of Pseudomonas aeruginosa isolates were resistant to imipenem,blaPER had the highest positive gene rate (28.57％).There were 36.36％ of Acinetobacter baumannii isolates were resistant to imipenem,all resistant strains carried blaOXA-51 and blaOXA-23 genes.Conclusion:The infants with underlying diseases or invasive diagnosis and treatment are easy to infect non fermentative bacteria.Most strains of them are drug-resistant and difficult to be treated with long duration and high risk.