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.

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%.

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.

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 determine whether the anti-proliferation effect of L-arginine is due to inhibiting the expression of cyclin dependent kinase-2 (CDK2)、 CyclinE and proliferation cell nuclear antigen (PCNA) in blood vessel after balloon injury. Methods Rats were randomized into three groups: Group S (sham operation group), Group C (balloon injury control group) and Group L (balloon injury + L-arginine group). After 14 days, blood samples were collected for biochemical studies, and the thoracic aortas were harvested for immunohistochemistry. The expression of CDK2、 CyclinE and PCNA were measured by means of computer image analayzer. Results The levels of plasma nitric oxide (NO) in group C were significantly lower than those in group S. Compared with group C, the levels of plasma NO increased (P

Objective To explore the effect and mechanism of taking sibelium long term for treatment and preventing the attack again of cerebral infartcion.Methods 339 patients with cerebral infarction were divided into 2 groups randomly,namely preventing group(120 cases) and control group(119 cases).The basic treatment in the two groups are the same.The preventing group was taken siblium 10 mg once every evening,at least 6 months.To observe the clinical effect in 1 month and the rate of attack again in 1 year.The two groups were measured on hemorrheology,blood lipid and platelet aggregation rate before and after treatment one year.Results After treatment one month,the significant effective rate in sibelium preventing group is 80%,the total effective rate is 98.3%,but the control group is 54.6% and 74.8%(all P

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 To evaluate the effects of fentanyl and lidocaine on hypnotic effect of propofol in total intravenous anesthesia(TIVA) Methods One hundred and sixty ASAI Ⅲ patients(86 male,74 female) aged (55 0?12 4)yr,weighing (58 0?9 8)kg,scheduled for elective surgery were randomly divided into propofol group(group P,n=30), propofol fentanyl group(group PF,n=52) and propofol lidocaine group (group PL,n=78) Patients with kidney and liver dysfunction, hypertension, neurological and mental disease were excluded All patients were premedicated with intramuscular phenobarbital 0 1g and atropine 0 5mg BP,HR,SpO 2 and BIS were continuously monitored The patients were anesthetized by TIVA with TCI The target plasma concentration for fentanyl was 2?g/L(group PF) and for lidocaine 4mg/L(group PL) The initial target plasma concentration of propofol was set at 1mg/L When pre set concentration was reached, target propofol plasma concentration was increased by increments of 0 5mg/L until loss of consciousness Blood samples were taken before anesthesia(T 0), loss of consciousness(T 1), immediately after intubation(T 2), at skin incision(T 3), 5 and 10 min after skin incision(T 4,T 5), when TIVA was ended (T 6) and when the patient waked up(T 7) for determination of plasma concentrations of propofol, fentanyl and lidocaine Results ED 90 and ED 50 of propofol for loss of consciousness were lower in group PF and PL than those in group P but the difference was of no statistical significance (P

OBJECTIVE:To observe clinical efficacy and safety of lanthanum carbonate in the treatment of hyperphosphatemia in uremic patients underwent maintenance hemodialysis. METHODS:A total of 142 uremic patients with hyperphosphatemia under-went maintenance hemodialysis were selected from Xinqiao Hospital of Third Military Medical University and Chongqing Banan District Hospital of TCM during Jan. 2012-Dec. 2016. They were given Lanthanum carbonate chewable tablets with initial dose of 250 mg,tid,when serum phosphate level ranged 1.78-2.26 mmol/L or with initial dose of 500 mg,tid,when serum phosphate lev-el was >2.26 mmol/L. Drug dosage was adjusted according the level of serum phosphate during treatment. After 1,2,3 months of treatment,the levels of serum phosphate,serum calcium,albumin,parathyroid hormone(PTH)and alkaline phosphatase were de-tected and the corrected product of serum calcium and calcium phosphorus was calculated. The occurrence of ADR was observed. RESULTS:After 1,2,3 months of treatment,the levels of serum phosphate and the product of serum calcium and calcium phos-phorus were all decreased significantly compared to before trreatment,with statistical significance (P<0.05). After 3 months of treatment,the level of corrected serum calcium was decreased significantly compared to before treatment,with statistical signifi-cance(P<0.05). There was no statistical significance in the levels of plasma albumin,calcium phosphorus or PTH before and af-ter treatment (P>0.05). Total response rate was 93.7%. There were 19 cases of patients with mild adverse reactions. CONCLU-SIONS:Lanthanum carbonate in the treatment of hyperphosphatemia in uremic patients underwent maintenance hemodialysis shows good clinical response rate,can significantly reduce the levels of serum phosphate and the product of serum calcium and calcium phosphorus with good safety.