Objective To understand the clinical characteristics of lower respiratory tract infection,pathogenic distribution and drug resistance in intensive care unit to provide a basis for reasonable use of antibiotics. Methods From January 2008 to August 2010,the clinical data from our hospital ICU impatients of lower respiratory tract infection were retrospectively analyzed. The isolated strains were identified, the antibiotic susceptibility test was performed by K-B methods and the results were read according to CLSI 2007. Results There were 509 patients, 147 cases of lower respiratory tract infection were found. Lower respiratory tract infection rate was 28.9% (147/509); 283 strains of pathogens had been isolated by culture and most of which were Gram negative bacilli(86. 9%), the other pathogens included Gram positive cocci(7.4%) and fungi(5.7%). The most common pathogens were Acinetobacter spp, Pseudomonas aeruginosa, Klebsiella pneumoniae,Stenotrophomonas oligotrophic aeromons, Fungi, Escherichia coli, Staphylococcus aureus, Burkholderia cepacia,etc,accounting for 24. 7% ,20. 5% ,12. 7% ,6. 4% ,5.7% ,5. 3% ,5.3% and 4. 6% ;The main pathogens were highly resistant to the most antibiotics. Conclusion ICU had a higher lower respiratory tract infection rate, Gram negative bacilli are the main pathogen, and showed the multi-drug resistance features to the antibiotics.

Objective To assess the efficacy of clinical intervention of early swallowing syndrome on neonates. Methods Eighty-six cases of normal newborns were enrolled in the study, including 44 cases of natural delivery,32 cases of cesarean section,8 cases of premature infant. The cases started vomitting before feeding the milk, became more severe after feeding the milk. once the pathological factors were excluded, the cases were treated with breastfeeding, warm water enema, massaging the lower abdomen, 1% sodium bicarbonate solution to the gastric lavage. Results A variety of clinical interventions on the control of neonatal swallowing syndrome results are obvious. Conclusions Early detection early intervention can prevent complications occurring.

Objective To explore the accurate position for the intersect between the short axis of the tibial tray and patellar ligament through studying the relationship among the femoral epicondylar(FE) axis, posterior femoral(PF) axis, posterior tibial(PT) axis, patellar(PAT) axis and patellar ligament(PL). Methods Magnetic resonance imaging (MRI) scans of 40 knees are included in this study. Using the computer workstation, these axial scans were used to construct the FE axis,PF axis, PT axis, PAT axis and PL. Angles between the axes of the selected landmarks were calculated, and linear regressions were performed to assess the relationship between the axes. Template of the tibial tray were positioned along both the FE axis and PT axis and the resultant points of patellar ligament intersection were recorded, and the difference of the intersect was analyzed with the matched t test. Results Strong relationship were found between the FE and PAT axes(1.8?? 3.6?, R2=0.70), as well as between the FE and PF axes(6.1?? 3.0?, R2=0.79). When the tibial template was aligned along the FE axis, 65% of the cases were in an ideal position, and the intersect is at the 10%-60% width of the patellar tendon. When the PT axis was used, 35% were optimal, and the intersect is at the -15%-35% of the width. And the difference in the mean value of the intersect is of statistical significance. Conclusion During total knee arthroplasty, if the short axis of the tibial tray is aligned with the intersects of the PL between its midpoint of the medial third to a half of its entire width, the rotation of the tibial component will fit the FE and PAT axes closely, so the component's position is appropriate.

Objective To investigate the clinical characteristics of hospital infection and the pathogen type,distribution and drug resistance,in the intensive care unit of our hospital,to direct proper antibiotics use and supply the scientific basis for hospital infection control. Methods The clinical data of 392 inpatients in our intensive care unit from April 2008 to March 2010 were monitored prospectively and analyzed retrospectively. Results Of the 392 impatients,78 cases had hospital infection (19.89% 78/392),112 time-case infection (28.57% 112/392). The most common infection was the main respiratory tract infections accounted for 54.46% (61/112) ,followed by urinary tract infections accounted for 15. 19% ( 17/112 ), blood infection accounted for 11.61% (13/112). 152strains pathogens were identified in the study,in which G- bacilli accounted for 69.7%, G+ bacteria accounted for 17. 8% and fungi accounted for 12.5%. Main pathogens such as acinetobacter baumannii ,pseudomonas aeruginosa,klebsiella pneumoniae, staphylococcus aureus showed multiple drug resistance in different degrees. Conclusions Intensive care unit has a high nosocomial infection rate,lower respiratory tract infection is the most frequent type and the main pathogens have different degrees of multi-drug resistance. Standardized, rational use of antibiotics,prevention of the multi-drug resistant bacteria spread may help to reduce the occurrence of hospital infection in intensive care unit.

OBJECTIVE:To explore the factors,general rule and characteristics of adverse drug reactions(ADR)for references of safe and rational clinical medication.METHOD:A total of 412 ADR reports were collected and statistically analyzed in respect of age and sex of patients,route of administration,ADR degree,drug category,ADR-involving organs and clinical manifestations etc.RESULTS:ADR-involving drugs totaled 412 kinds,of which anti-infective agents occupied the first place,followed by Chinese patent medicines.274 ADR cases(66.50%)were induced by intravenous route.ADR occurred systemically and were characterized predominantly by allergic reactions of skin and its appendants,followed by damage of nervous system.70 were new but common ADR cases,while 2 were new severe cases.CONCLUSION:It is necessary to strengthen ADR monitoring and publicizing of ADR-related knowledge to guide the clinical rational use of drugs and reduce the repetitive occurrence of ADR.

ObjectiveTo analyze the serum creatinine level among apparently healthy primary and secondary school students in Inner Mongolia and explore the distribution of serum creatinine by ethnic,regional,gender and age,and establish the reference interval of serum creatinine in different gender and different age groups of primary and secondary school students.MethodsLargesample clinical epidemiological investigation was applied by two-stage clustering sampling method.Random sample of 2630 primary and secondary school students from 9 to 18-year-old was selected from four district in Inner Mongolia including Hohhot,Wulanchabu,Xilin Gol and Bayan Drow from July 2009 to June 2010.After screening outlier individual,the total of 2614 subjects were enrolled,involving 1288 male and 1326 female subjects,1584 Han and1030 Mongolian.The venous blood was collected and serum was separated.The serum creatinine concentration was measured as soon as possible.Furthermore, creatinine levels of different regions,ethnic,gender and age group were compared by analysis of variance or t-test and that of different group were compared by SNK method.Percentile was used to describe the distribution of serum Cr level of different age groups.The reference interval of serum Cr for primary and secondary school students were established by gender and age (P2.5 -P97.5 ).The curve was smoothed using age-specific percentile ( LMS )curve smoothing method.ResultsThe differences of Cr levels were statistically significant between different regions,ethnic,gender and age groups.The reference intervals of creatinine for 9 - 11,12,13 - 14,15,and 16 - 18 year-old males were 35 - 66,37 - 73,39 - 78,47 - 87 and 49 - 91 μmol/L,respectively.The intervals for 9 - 10,11 - 12,13 - 15,and 16 - 18 year-old females were 32 - 60,34 - 63,38 -73 and 40 -74 μmol/L,respectively.Conclusion The reference intervals of serum creatinine for health primary and secondary school students in the Inner Mongolia is established,which is useful for clinicians,especially pediatricians to judge and assess renal function for 9 to 18 year-old patients.( Chin J Lab Med,2012,35:805-809 )

Extremity compartment syndrome can cause neuromuscular ischemia and deposition of metabolites in the compartment,leading to irreversible lesions which harm limb functions in the end.It is a great challenge for surgeons to make a timely and accurate diagnosis of the syndrome in adults and children.The key is evaluation of the clinical symptoms and intracompartmental pressure.In this paper we summarize the epidemiology,etiology,pathophysiology,and current diagnosis and treatment of acute extremity compartment syndrome of the upper and lower extremities in adults and children.