ObjectiveTo observe the infection of continuous aspiration of subglottic secretion(CASS) for patients with ventilator associated pneumonia (VAP).MethodsOne hundred and fifty VAPpatients under mechanical ventilation whose basical information were recorded were divided into two groupsby random digits table method:control group(70 cases) and CASS group(80 cases).Conventional VAPprevention was taken in control group and CASS group,while CASS therapy was added to CASS group.ResultsSex,age,acute physiology and chronic health evaluation Ⅱ score,recent antibiotics usage,airpressure,time in ICU,hospital stay and mortality rate of two groups had no statistical significance(P ＞0.05 ).The time of ventilator treatment of CASS group was obviously shorter than that of control group [ (5.2 ±1.4) d vs.(7.8 ± 1.2) d,P =0.02 ],and VAP incidence was lower than that of control group [ 22.5％ (18/80)vs.32.9％(23/70),P =0.04 ].ConclusionCASS could reduce the incidence of VAP and short the time ofventilator treatment.

OBJECTIVE:To discuss the economic efficiency of different antimicrobials in treatment of lower respiratory tract infections(LRTI) METHODS:50 cases of LRTI collected from this hospital were divided into two groups:A,pefloxacin;B,ceftazidime Evaluation was carried out with pharmacoeconomic cost-effectiveness analysis RESULTS:The total costs were 957 60 yuans and 1 596 00 yuans and the effective rates were 84% and 92% in group A and B respectively An increase of 1%effective rate in group A saved 79 80 yuans in comparison with that in group B CONCLUSION:The therapeutic scheme of pefloxacin seems to be the best one for treating LRTI

Objective To investigate and analysis the prevalence rate of hospital infection and community infection,and to reduce the incidence of hospital infection.Methods First we investigated hospitalized patients in September 9,2013 by two ways which in-clude bedside investigation and reviewing the medical records;and then described the prevalence case of infection and the usage of antimicrobial agent by descriptive approach.Results Seven hundred and seventy patients were investigated with the rate of 100.00%;18 patients were hospital infection cases,the infection rate was 2.34%;most of the hospital infection cases was occur in lower respiratory tract;228 patients were community infection cases.The infection rate was 29.61%;the primary affected areas of community infection were respiratory and gastrointestinal tract;the structure of hospital infection pathogens were almost the same with the community infection,most of them were G- bacteria;186 patients were used antimicrobial agent in that day,the usage rate was 24.16%.Conclusion Promoting the managements of high risk departments and susceptible affected areas,making relevant rules of operation are the focus of our works in the future.

[Objective]To test the biomechanical effects of calcium phosphate cement in fixating distal tadius fractures,and to provid biomechanical foundation for clinical treating distal tadius fractures.[Method]A models of 18 human distal radius fracture of adult upper limbs specimen were made and randomly divided into three groups:fixed with Kirschner wire(Kirschner group),CPC(CPC group),and CPC combined with Kirschner wire(combination group).Wrist joint was vertically loaded with 98 N,and palmar flexion with dorsal extention motion was dimulated,which range of movement was from palmar flexion 5?to dorsal extention 30? and frequency was 2000 cycles.Displace data of distal radius were measured by sliding caliper at every 500 cycles,we had tested Young' s modulus of two samples of CPC.[Result]Multiple factor variance analysis was used,Kirschner group and others had significantly statistical difference(P0.05).[Conclusion]CPC can provide enough fixation strength for distal radius fracture with bone defect and Young' s modulus of CPC is about 30 MPa,which is between those of cancellous bone and compact bone.

Informationization teaching resources contain a large number of information so rea-sonable and effective application of the resources is of great significance to the teaching. The article tries to explore and work out some teaching strategies for effective application of informationization teaching resources through action research combined with literature research , questionnaire survey method , interview and other methods. The research process: the original teaching strategies of infor-mationization teaching resources were implemented , implicated and verified in the first round action research; the problems in the first round were summarized and analyzed and the original teaching strategies were adjusted and optimized in the next round action research; finally, the teaching effec-tiveness between the two rounds action research was evaluated and analyzed by the “classroom teach-ing effectiveness criteria based on the use of information technology teaching resources”. The results show that effective application of informationization teaching resources is of great help to the teaching effect. It can enhance the learners' interest in learning and improve their academic performance. Ap-propriate and rational teaching strategy should be provided flexibly according to the learning back-ground and characteristics of students as well as learning contents.

Objective To discuss the characteristics of in-patients with Beh(c)et's disease in Xinjiang Uygur Autonomous region.Methods Clinical data of 146 cases with Behcet's disease admitted to Xinjiang Uygur Autonomous region people's hospital were analyzed.The demographic data and clinical manifestations were analyzed retrospectively.The categorical data was compared using x2 test or Fisher's exact test.Results ① Of the 146 patients with BD,99 cases were Han,47 cases were uyghurs.Oral ulcer were observed in 146 cases (100％).Genital ulcer occurred in 115 cases (78.8％),of which 76 were Han (76.8％),39 (82.9％) were uyghurs,the difference was not significant (P=0.391).The initial presentation was oral ulcer in 83 cases (56.8％),of which 60 cases (60.6％) were Han,23 cases (48.9％) were the uyghurs.The second most common presentation was oral ulcer and genital ulcer,which occurred in 42 cases (28.8％),of which 23 cases (23.2％) were Han,19 cases (40.4％) were the uyghurs.More Han patients initially presented with both oral and genital ulcers than uyghur (P=0.032).② Skin lesions were recorded in 66 cases (45.2％),of which 45 cases (45.4％) were Han,21 cases (44.7％) were the uyghurs,the difference was not significant (P=0.930).③ Joint damage occurred in 40 cases (27.4％),of which 22 cases (22.2％) were Han,18 cases (38.3％) were the uyghurs.Joint damage wasmore frequently observed in Han than in uyghur (P=0.042).④ Eye lesion happened in 21 cases (14.4％),ofwhich 9 cases (9.1％) were Han,12 cases (25.5％) were the uyghurs,ie,eye lesion of Uyghur was higher than Han (P=0.008).⑤ Vascular lesions were detected in 8 cases (5.5％),of which the 5 cases were Han,3 cases were uyghurs,the difference was not significant (P=0.712).⑥ Nervous lesions were observed in 2 cases (1.37％),1 was Han and one was uyghur,the difference was not significant (P=0.542).Conclusion The most common clinical presentations of BD in Xinjiang region are oral and genitalulcers.Skin,joints,eye,vascular,nervous system can also be affected.Joint damage in Han is higher than Uyghur,but eye lesion of Uyghur is more common than Han.

Objective To observe the effects and the mechanism of the thoracic pressure variation on the velocity of tricuspid regurgitation in quiet respiration, to accurately estimate the pulmonary artery systolic pressure,and to verify the new proposed mechanism of respiration effects on hemodynamics using echocardiography. Methods Continuous-wave Doppler spectra of tricuspid regurgitation were recorded with Sequoia 512 in 50 patients who had stable tricuspid regurgitation. Electrocardiogram and respiratory tracing were recorded simultaneously. The velocities and the pressure gradients were recorded during different respiration phases for analyzing. Results Respiration reliably affected on tricuspid regurgitant velocity. There were three patterns of manifestation:①The velocity increased in the inspiratory phase. ②The velocity decreased in the inspiratory phase. ③The velocity changed randomly. Conclusions Thoracic pressure variations had definite effects on the velocity of tricuspid regurgitation and tricuspid gradient. This research indicated that to obtain accurate and reliable Doppler echocardiographic measurement of the pulmonary artery systolic pressure, the measurement should be at the time between inspiration and expiration.

The main causes of early mortality after the earthquake are traumatic shock, hemorrhage and dehydration, and the ratios of shock and hemorrhage are high in patients with abdominal injuries. Prompt triage is very important to persons with abdominal injuries who were rescued in 48 hours after the earthquake. Primary triage should be carried out in the rescue field, and then followed by the secondary triage in the hospital. We improved the efficiency and accuracy of triage by following the principle of "5 steps, 3 categories and 1 indication". Nineteen persons with identified abdominal injuries and unstable vital signs received operation. The false positive rate was 5% (1/19), and the successful rate of the operation was 95% (18/19). During the process of rescue, the lives of the injured persons should be put in the first place. The operation should be performed under the principle of simpleness, rapidity and safeness.

Preoperative portal vein embolization(PVE)has become an important tool in the management of selected patients with hepatic cancer before the major hepatic resection is carried out.PVE can redirect the portal flow to the intended future remnant liver tissue in order to induce the hypertrophy of the non-diseased portion of the liver and thereby may reduce the occurrence of complications and shorten the hospitalization days after surgery.This article aims to review the technical and clinical considerations in performing PVE and to discuss the PVE-related practical points,including the relevant anatomy,the access approach,the choosing of embolic agents and the pathophysioiogy of PVE.In addition,the indications and contraindications for performing PVE,the use of combination therapies and the concern for tumor growth after PVE are also discussed.