OBJECTIVE To analyze pathogen distribution of lower respiratory tract infection after tracheotomy in patients with severe brain injury to offer prevention and control measures.METHODS The data of patients with severe brain injury after tracheotomy were collected and analyzed in our hospital from Jun 2005 to Dec 2005,Bacteria culture were analyzed in 74 cases twice a week.RESULTS Eighty-four strains of pathogens were identified.Gram-negative bacilli,Gram-positive cocci and fungi accounted 73.04%,11.23% and 15.73%,respectively.Through control measures,the infection rate was reduced from 90% in 2004 to 48.65%.CONCLUSIONS The infection rate of patients with severe brain injury can be reduced through effective methods of prevention and control.

Objective: To observe the influence of electroacupuncture on depression and defects of neurological functions in the patients with post-stroke depression. Methods: 90 cases of the apoplectic patients confirmed clinically by CT or MRI were selected and divided randomly into three groups by digital table, 30 cases in each group. All three groups of the patients were treated for wind stroke, with electric stimulation added for the acupuncture group,Fluoxetine added for medication group, and placebo added for control group, continuously for 60 d. Results: Compared to the control group, the scores in Hamilton Depression Rating Scale (HAMD) and Modified Edinburgh-Scandinavia Stroke Scale (MESSS) decreased in the electroacupuncture group and medication group, and the scores in Barthel index increased (P＜0.05). The general therapeutic effects were better in the electroacupuncture group and medication group than in the control group, and the general therapeutic effects were similar in the electroacupuncture group and medication group. Conclusion: Eiectroacupuncture can improve depressive behavior and promote rehabilitation of the nervous functions.

Objective To assess the effect and safety of mono and combination of intravenous flurbiprofen axetil (FP) and epidural tramadol on postoperative pain after cesarean section. Methods Eighty parturients undergoing selected cesarean section with combined epidural spinal anesthesia were randomly allocated into 4 groups (n=20 in each): Group FT treated with intravenous FP 50 mg immediately after the umbilical cord was clamped (T1) and epidural tramadol at the time of suturing peritonaeum (T2);Group FF treated with intravenous FP 50 mg at T1 and T2;Group T treated with epidural tramadol 100 mg at T2, and Group F treated with FP 50 mg at T2. Postoperative pain was assessed by parturients using visual analog scales (VAS) at 2, 4, 8, 12, 24 h after surgery. The cases that patients required rescued analgesia were recorded as well as the times of analgesics administration. The events of nausea and vomiting within 24 hours as well as the time of first breast-feeding were observed. Results All groups were similar in VAS at 2 hours after surgery, but were statistically significant different at 4, 8, 12 and 24 hours. Group FF showed significant lower VAS than the other 3 groups. However, no significant difference of VAS was observed among the other 3 groups. Rescued analgesia was administered once after surgery to 7 cases in Group F, 4 in Group T, and 2 in Group FT. No patient in Group FF required rescued analgesia. There was significant difference in the rate of rescued analgesia post surgery among the 4 groups (P=0.0149). No significance in the incidence of nausea and vomiting was observed in 4 groups. There was no significant difference in the time of first breast-feeding after surgery in the 4 groups (F=0.54,P=0.657). Conclusions Intravenous flurbiprofen axetil administration immediately after the umbilical cord is clamped and at the time of closing peritonaeum in cesarean section could relieve postoperative pain and reduce postoperative rescue analgesic requirement without increasing the incidence of nausea and vomiting.

Objective To evaluate the anesthesia and perioperative treatment for simultaneous liver-kidney-pancreas transplantation. Methods The preoperative preparation included improvement of the hepatic function, alleviation of uremia and control of blood glucose level. General anesthesia was employed and maintained with isoflurane combined with intermittent intravenous administration of midazolam, fentanyl and vecuronium. Dopamine and low dose of epinephrine were used to maintain arterial blood pressure if necessary. The parameters of blood coagulation, the indexes of hepatic and renal function, blood glucose and amylase levels in blood and urine were surveyed regularly. The treatment was adjusted according to the results of tests mentioned above. Results The circulation was stable and blood gas was normal in the course of surgery. The concentration of blood glucose was higher at the end of the operation than that of pre-operation. Normal hepatic and pancreatic function was achieved about a week after operation, while the renal function showed no satisfactory improvement. The patient was given hemodialysis until the second transplantation of kidney. Three days later, the renal function recovered to normal. Up to the present, all the grafted organs showed good function. Conclusion Appropriate preoperative preparation, optimal anesthetic procedure and management, perfect protection of function of multiple organs, and maintenance of stable hemodynamics and homeostasis were the key points of successful anesthesia and management for simultaneous liver-kidney-pancreas transplantation.

Objective This study aimed at assessing the long-term efficacy of EVL for esophageal variceal bleeding. Methods Long-term EVL was assessed in 263 patients with variceal bleeding,among them 71 were of Child- Pugh Class A,82 of Class B and 110 of Class C.EVL was repeated at two week intervals until varices were eradicated.Results Esophageal varices were eradicated in 91% of the 238 patients who survived for more than three months after 1 to 10 (average 4) successive ligations.Recurrent variceal bleeding occurred in 15% of the 263 patients and was markedly reduced after eradication of the varices.The overall cumulative survival rates at 1,3,and 5 years were 76%,62%,and 57%,respectively.The prognosis was influenced by Child- Pugh's risk grade.56 of the 263 patients died during the study period,and the major cause of death was liver failure.Conclusion EVL is effective for long-term control of esophageal variceal bleeding.Repeated EVL re- duces rebleeding rate and improves survival in patients who have bled from esophageal varices.

AIM To study the effect of TNP 470 on proliferation, cell cycle and apoptosis in the cultured human colon cancer Lovo cells. METHODS The growth inhibition of TNP 470 on Lovo cells was evaluated by an MTT.assay The effect of TNP 470 on cell cycle and apoptosis measured by flow cytometry, and ultrastructural feature of Lovo cells were observed with electromicroscope. RESULTS TNP 470 inhibited the growth of Lovo cells. flow cytometry analysis showed that G 0/G 1 phase rate was increased but S phase rate was decreased. Apoptosis rate of TNP 470 treated group was significant high than that of control and typical chang of apoptosis in Lovo cells was observed. CONCLUSION TNP 470 can inhibit proliferation of Lovo cells, and this inhibition is associated with cell cycle block and apoptosis.

Objective To evaluate the clinical effect of acupotomy therapy combined with acupuncture based on distal points selection for lumbar intervertebral disc protrusion ( LIDP) . Methods Sixty-eight LIDP patients were randomly divided into treatment group (N=33) and control group(N=35). The treatment group were given acupotomy therapy on the proximal positive response points in the lumbosacral region for relaxing the tendons,and acupuncture therapy based on distal points selection of Shugu, the Shu-stream point of the foot Taiyang bladder meridian, Zulinqi and Weizhong, the shu-stream point and the blood xi-cleft point of the foot Shaoyang gallbladder meridian respectively, twice a week, 2 weeks constituting one course of treatment. The control group was given conventional electroacupuncture therapy on Huatuo clip points, Dachangshu point, bilateral Shenshu points, Yinmen point, bilateral Zibian points and bilateral Yanglingquan points, and together with TDP radiation therapy, 5 times a week, 2 weeks constituting one course of treatment. The two groups received follow-up for one month. The low back pain scores of Japanese orthopaedic society ( JOA) and visual analog scores ( VAS) of pain were used for the evaluation of therapeutic effect after the treatment. Results ( 1) After treatment, the JOA scores were increased and VAS scores were decreased in both groups compared with those before treatment ( P< 0.05) , and the increase of JOA scores and the decrease of VAS in the treatment group were superior to those in the control group ( P< 0.05) . There was statistically significant difference of VAS scores between the two groups ( P < 0.05) during the follow-up period. ( 2) The total effective rate was 87.9%in the treatment group, and was 77.1%in the control group, the difference being significant (P<0.05) . Conclusion The acupotomy therapy combined with acupuncture based on distal points selection is effective and safe for lumbar intervertebral disc protrusion, which has the advantages of reliable long-term effect and low recurrence rate, showing good prospects for extensive clinical application.

37 cases of skin pruritus were treated by acupuncture and cupping method. After two courses of the treatments, the total effective rate was 94.6%.

Orthopedic implants are commonly clinically used to treat intertrochanteric fracture.The treatment efficacy is related with their biocompatibility and biomechanical characteristics.This paper compared various biological,physical,and chemical reactions between implants and host and analyzed the problems based on the clinical practices.

Objective: To develop a computer game addiction inventory (CGAI) for Chinese college students. Methods:A primary inventory made by the authors was applied to 477 college students from 8 universities in Beijing for exploratory factor analysis, and then to 405 college students for confirmatory factor analysis. Results: After exploratory factor analysis, a questionnaire consisted of 33 items were established, which had four factors: dependence and addict behavior, emotion arousal, functional impairment, and shame and un-satisfaction. These four factors could explain 55.1 of the total variance, were confirmed by confirmatory factor analysis (?~2/df=2.304; IFI=0.885; CFI=0.884; NFI=0.813; RSMEA=0.057). The internal consistency of the questionnaire was good (r=0.77~0.94), the test-retest reliability was 0.907. Criteria validity shown by higher scores in addiction group than normal control was also satisfying. Conclusion: The CGAI has good psychometric features and could be applied to college students.