Objective To investigate the pathogenic bacteria types and distribution characteristics of critical patients with lower respiratory tract infection in neurosurgery department,and to analyze the high risk fac?tors of lower respiratory tract infections. Methods A retrospective analysis of 80 cases of critical patients with lower respiratory tract infection in neurosurgery department of General Hospital of People Liberation Army from April 2013 to April 2014 was carried out. The pathogenic bacteria types and distribution characteristics of lower respiratory tract infection were analyzed by means of bacterial identification,and single factor and multi factor Lo?gistic regression analysis was carried out to analyze the related factors of lower respiratory tract infection.Results One hundred and thirty?four strains of pathogenic bacteria were cultured from sputum of 80 cases of patients. Among which the gram negative bacteria were 109 strains,accounting for 81.34%(109/134),while the Gram positive bacteria were 17 strains,accounting for 12.69%(17/134) and the fungi were 2 strains,accounting for 1.49%(2/134).The proportion of three kinds of pathogenic bacteria had statistical significance(P=0.004, 0.001). The single factor Logistic regression analysis showed that,younger age,use of ventilator,use of antimi?crobial drugs and pulmonary infection rate were protective factors of lung infection(OR(95%CI)=0.586(0.475-0.722),0.708(0.574-0.873),0.827(0.697-0.981);P=0.043,0.007,0.000);disturbance of consciousness, tracheotomy,insert gastric tube, surgery and pulmonary infection incidence were risk factors for lung infection (OR(95%CI)=4.769(1.069-21.276),11.612(5.438-24.792),22.989(19.385-27.263),10.426(8.789-12.361);P=0.001,0.008,0.005,0.002).The multi factor Logistic regression analysis showed that there was a significant correlation between the trachea incision, the consciousness and the lower respiratory tract infection (OR(95%CI)=4.627(2.143-20.645),10.412(2.334-46.455);P=0.009,0.002).Conclusion Patients with conscious disturbance and tracheotomy were more likely to have lower respiratory tract infections. The pathogens of lower respiratory tract infections are Gram?negative bacteria,and the majority of pathogens are high resistance, and it is multi drug resistance.

Oral imaging techniques have been widely and increasingly used in clinical practice.This article reviews the functions,characteristics and principles of three kinds of oral imaging instruments including panoramic x-ray unit,intraoral x-ray unit and stomatology endoscope.

Cardiovascular and cerebrovascular diseases have be-come a great health threat.Increasing evidence has shown that both asymmetric dimethylarginine (ADMA)and symmetric dim-ethylarginine (SDMA)play important and independent roles in the development of cardiovascular and cerebrovascular diseases as well as in the prediction of cardiovascular and cerebrovascular events.Alanine-glyoxylate aminotransferase 2 (AGXT2 )is re-cently observed to be involved in ADMA metabolism.Deficiency in the expression and activity of AGXT2 may thus play a role in the development of cardiovascular and cerebrovascular diseases by affecting ADMA levels in vivo.Several single-nucleotide poly-morphisms at AGXT2 locus are observed to be associated with plasma SDMA level.This review summarizes recent advances in AGXT2 and its role in ADMA metabolism and the clinical rele-vance.

Objective To investigate the feasibility of minimally invasive muscle-sparing thoracotomy for gastric cardia tumor. Methods Minimally invasive muscle-sparing thoracotomy through the left 7th intercostal space was performed in 25 patients with gastric cardia tumor. Results Proximal gastrectomy and lower esophagectomy combined with esophagogastroanastomosis was performed in 20 patients with adenocarcinoma of gastric cardia and 4 patients with squamous cell carcinoma. Gastric fundus incision and tumor resection was conducted in 1 patient with hyperplastic polyps of gastric cardia. No perioperative mortality or serious complications were seen. Conclusions Minimally invasive muscle-sparing thoracotomy is simple and offers good exposure, being an alternative for carcinoma of gastric cardia in relatively early stages.

Objective To analyze the outcomes of arthroscopy for secondary osteoarthrosis of the ankle joint. Methods From March 2000 to February 2006,62 patients with osteoarthrosis of the ankle joint were treated with arthroscopy in our department. Among the cases,52 received follow-up. We analyzed the therapeutic outcomes by evaluating the AOFAS,McGuire,and Mazur scores. Results The 52 cases were followed up for 12 to 84 months (mean,36.2 months). During the follow-up,we observed significantly increased scores of AOFAS,McGuire,and Mazur [postoperation vs. peroperation:57.6?12.8,56.5?14.9,and 61.5?12.6 vs. 82.4?11.5 (t=11.02,P=0.00),84.8?12.6 (t=9.52,P=0.00),and 84.1?14.7 (t=8.70,P=0.00)] with the rate of excellent and good results of 80.8% (42/52),82.7% (43/52),and 84.6% (44/52).Conclusions Arthroscopic treatment is effective for osteoarthrosis of the ankle joint with satisfactory results especially in patients with mild or moderate osteoarthrosis or those with loose bodies.

Objective:To study the detecting rate of nonfermenters and their resistance to the antibiotics in nosocomial infections in our hospital. Methods:The bacteria were identified by VITEK-AMS, the susceptibility tests(K-B method) were done according to the NCCLS standard and the results were analyzed. Results: The detecting rate of nonfermenters was 14. 29%. The most common bacterium was P. aeruginosa (the component ratio was 44. 22%). followed by A. baumannnii (32. 17%) and S.maltophilia(9.23%). The infectious rates of nonfermenters were different at different infectious sites, with the highest rate in the respiratory system and the lowest in central nervous system. The resistant rate to the antibiotics of P. aeruginosa was 45. 21% ,of A. baumannnii 47. 85% and of S. maltophilia 64. 02%. Conclusion:The detecting rate of nonfermenters is rather high in the nosocomial infection in our hospital. Due to the high resistant rates of nonfermenters to the antibiotics , the drugs should be chosen accoding to the result of the drugs susceptibility test.

ObjectiveTo explore the value of 64-slice CT perfusion imaging(CTPI) in the early diagnosis of radiation-induced lung injury ( RILI ).MethodsForty-eight patients with upper esophageal cancer resection underwent CTPI before and after radiotherapy,and the TNF-α and TGF-β1 were measured from patient's peripheral blood.Serum cytokine,conventional CT appearances and CTPI parameters (rrBF,rrBV,rrPS) in patients with RILI (Group A) and non-RILI (Group B) were compared and analyzed.A randomized block design t-test was used for comparison of serum cytokines and perfusion values between the two groups.The Chi-square ( x2 ) test was used for comparison of detection rate between conventional CT and CTPI.ResultsRILI occurred in 18 of 48 cases ( 18/48,Group A).In Group A,TNF-α and TGF-β1 preand pos-radiation were (36.1 ± 15.0),(30.4 ±t 14.9) ng/L and (17.5 ±9.8),(14.3 ±7.6) μg/L,respectively,and there were no statistically significant differences (t =1.14,1.I0,P =0.264,0.279).At half-dose time point of radiation,there were no significant differences for TNF-α and TGF-β1 pre- and posradiation [ ( 30.4 ± 14.9),( 28.9 ± 14.7 ) ng/L and ( 14.3 ± 7.6),( 14.4 ± 6.0 ) μg/L,respectively ]between Group A and B ( t =0.33,1.23 ; P =0.746,0.227).The rrBF,rrBV and rrPS of post-radiation from Group A were significantly higher than those of pre-radiation ( t =5.67,5.97,6.11,P =0.000,0.000,0.000),the rrBF and rrBV of post-irradiation from Group B were significantly higher than those of pre-irradiation (t =6.52,7.84,P =0.000,0.000).There was no significant difference for rrPS in Group B pre- and post-radiation (t =1.36,P =0.178 ).There were significant differences for all perfusion values detected from radiation lung fields between Group A and B ( t =2.32,2.18,6.04,P =0.025,0.034,0.000).Taking rrPS =1.28 as a threshold value on ROC,the sensitivity and specificity of CTPI for diagnosis of RILI were 77.8％,93.3％,respectively,which were much higher than those ( 11.1％,90.0％,respectively) of conventional CT (x2=13.61,P=0.000).ConclusionCTPI parameters may reflect the hemodynamic changes of post-radiation lung and have potential values for the early diagnosis of RILI.

Objective To explore the effects of two-dimensional code on nursing instruments management.Methods Information regarding nursing instruments were edited and corresponding two-dimensional codes were generated which would be pasted on both the instruments and the registration book,and nurses were notified about the twodimensional codes.The effects of the application of two-dimensional code were assessed among 145 nurses using questionnaires,and 40 nurses were evaluated for theoretical and operational skills of the instrument.Results After applying two-dimensional code in management of nursing instruments,nurses' scores for utilizing,maintenance,addressing malfunction,storage and counting were higher than previous management method for instruments(P＜0.05),and the performance of theoretical and operational skills of 40 nurses were increased significantly(P＜0.05).Conclusion Two-dimensional code provides valuable benefits for information storage,instrument tracking,etc.,shows great convenience and efficiency to nursing instruments management,and helps to improve nurses' application skills of instruments.

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Objective To assess the characteristics of abdominal hernia and summarize the therapeutic efficacy of mesh plug tension-free hernioplasty in elderly ventral hernia. Methods All 207 elderly patients with abdominal hernia who were admitted to our hospital during January 1999 to December 2001 and received the mesh plug tension-free hernioplasty were analyzed retrospectively. Results There were 405 patients receiving the mesh plug tension-free hernioplasty from 1999 to 2001, in whom 207 had elderly ventral hermia. Among the 207 elderly patients, 144 had inguinal oblique hernia, 38 direct hernia, 11 direct and indirect hernia, 6 sliding hernia, 6 incisional hernia, 1 femoral hernia, and 1 femoral and inguinal direct hernia. Postoperative complications were urinary retention(8 cases), hypoincisional hematoma(4), scrotal hydroceles(1), and incisional infection (1). One hundred eithty-seven patients were followed-up for 4-40 months and no recurrence was found. Conclusions The mesh plug tension-free hernioplasty is of advantages for elderly abdominal hernia, such as simpleness in performance and a good therapeutic effect. It is especially suitable for the elderly patients due to less trauma and low recurrence rate. It is also important to pay attention to the postoperative complications to the elderly.