Objective To discuss the risk factors of ventilator-associated pneumonia (VAP) in intensive care unit(ICU).Methods From January 2008 to June 2010,the clinical data of 145 patients with mechanical ventilation over 48 hours in ICU were analyzed prospectively,and the effect was observed.Results There were a total of 53 patients with VAP,and the incidence was 36.6％ (53/145).Thirty-three cases died,and the fatality rate was higher than that in non-VAP patients [62.3％ (33/53) vs.30.4％ (28/92)],and there was significant difference (P ＜0.05).Related factors analysis results showed that indwelling gastric tube,the use of antiacids,mechanical ventilation time,nutritional status,age ≥ 60 years and chronic diseases were the risk factors of VAP (P ＜ 0.05 or ＜ 0.01).Conclusion VAP has many risk factors and higher fatality rate in ICU,and comprehensive prevention measures should be adopted to prevent the occurrence of VAP.

Objective To investigate the risk factors for death within 30 days of stroke associated pneumonia(SAP) in elderly patients of the intensive care unit (ICU).Methods Clinical data of 116 patients with SAP who were admitted to ICU were reviewed.The predicting factors of death within 30 days were analyzed through variable analysis method.Results The hospitalization periods of the SAP group and control group were (27±8) d and (12±5) d,the difference was statistically significant(t =1 1.30,P =0.002).The most common pathogenic bacteria in SAP were Klebsiella pneumoniae,Bauman Acinetobacter,Escherichia coli,and gram negative bacteria.There was significant difference between the two groups in term of mortality rate(37.9％(44/ 116) of SAP group,22.0％ (22/100) of control group,x2 =6.423,P =0.011).Logistic regression analysis showed that basic diseases(OR =2.778,95％ CI:1.205-6.401),high CRUB-65 score (OR =1.978,95％ CI:0.871-11.098),lower Glasgow coma score(GCS) (OR=3.601,95％CI:0.244-9.477),bucking(OR=3.020,95％CI:1.305-10.603),mechanical ventilation(OR=2.654,95％CI:1.176-5.990),shock(OR=2.636,95％ CI:1.164-5.969) and high plasma CRP level(OR=2.333,95％CI:1.046-5.206) were risk factors for SAP (all P＜0.05).In Cox regression analysis,a GCS score of ＜ 9 was an independent risk factor for 30 d mortality of patientswithSAP(HR=7.23,95％Cl:2.24-20.11,P=0.001).Conclusion SAP is one of the serious complications of the elderly hospitalized for the acute stroke in the ICU,which may affect the prognosis of the patients.

Objective To understand the abnormal status of alanine aminotransferase (ALT),fasting blood glucose (GLU),to-tal cholesterol (TC)and triglyceride (TG)in urban and rural residents,to provide the basis for making the effective prevention measures,health education and health promotion to community work more targeted and effective.Methods The data of physical ex-amination results of 4 042 residents were analyzed retrospectively,the levels and abnormal rates of ALT,TG,TC,GLU were com-pared between different gender and age.Results Among 4 042 residents,the abnormal rate of male was significant higher than that of female,but the abnormal rates of TG,TC of female were significant higher than those of male(P <0.05).The highest rates of ALT,TG,TC,GLU in male were in 20-<40 years old,40-<60 years old,60-<80 years old,≥80 years old.The highest rates of ALT,TG,TC,GLU in female were in 0-<20 years old,60 -<80 years old,≥ 80 years old,≥80years old.Conclusion The health status of urban and rural residents is not optimistic,the community intervention,health guidance should be strengthened to prevent and control the occurrence and development of diseases and improve the health level of urban and rural residents.

Objective To assess the reliability and validity of the Chinese version of the neuropsychiatric inventory (CNPI). Methods The CNPI was administered to 219 caregivers of patients with Alzheimer's disease (AD). Each caregiver was retested 4 weeks after initial testing. Results The Cronbach a coefficient of the total symptom scale was 0.69. The Cronbach α coefficient of the total caregiver distress subscale was 0.72. The Cronbach α coefficient of the entire inventory was 0. 82. The test-retest coefficients ranged from 0.66 to 0.98 (P < 0.01). Principal axis factoring analysis of the symptom subscale yielded a five-factor solution which contributed to 67.0% of the cumulative variance. Factor 1, which included aberrant motor behavior, hallucinations, delusion and irritability had the most significant contribution to the cumulative variance. Principal axis factoring analysis of the caregiver distress subscale also yielded a five-factor solution which contributed to 70.2% of the cumulative variance. Factor 1, which included depression, delusion, sleep/night behavior, aberrant motor behavior, and irritability had the most significant contribution to the cumulative variance. Conclusion This Chinese version of NPI is a reliable and valid tool for measuring neuropsychiatric disturbances in patients with AD.