Objective To analyze the pathogens distribution and drug resistance in acute stroke with stroke associated pneumonia (SAP) patients,and provide references for proper clinical application of antibiotics.Methods A retrospective investigation was performed to analyze the pathogens and the drug resistance of 131 acute stroke with SAP patients.Results Among 148 strains of isolated pathogens,the Gram-negative bacteria accounted for 66.22％ (98/148),including Klebsiella pneumoniae,Pseudomonas aeruginosa,Escherichia coli,Acinetobacter baumannii,Enterobacter cloacae and so on.Gram-positive bacteria accounted for 26.35％ (38/148).Staphylococcus aureus ranked the first,followed by Coagulase negative staphylococcus and Enterococcus faecalis.Fungi accounted for 7.43％ (12/148),mainly including Candida albicans.They had varying degrees of resistance to commonly used antibiotics.Conclusions Gram-negative bacteria are predominant in SAP.Drug resistance is very serious,and the antibiotics should be selected in clinic according to the result of drug susceptibility test.

Objective To discuss comfort nursing effect for rehabilitation exercise compliance of hip replacement patients. Methods 76 cases of senile hip replacement patients were retrospecrively analyzed and divided into the control group and the research group with 38 cases in each group, each received rourine nursing and comfort nursing. The nursing effect was compared between two groups. Results The research group was better in nursing satisfaction degree, comfort degree, complications such as infection and prosthesis dislocation and recovery exercise compliance compared with those of the control group. Conclusions Comfort nursing has considered patients' requirement and aiming to these requirements. So it can help patients to elevate the comfort degree, improve prognosis and satisfaction degree.

Objective To analyze the distribution and drug resistance of pathogens causing hospital-acquired pneumonia (HAP) in stroke patients,and provide references for proper clinical application of antibiotics.Methods A retrospective investigation was performed to analyze the pathogens and the drug resistance of 143 stroke patients with HAP.Results Among 168 strains of isolated pathogens,the Gram-negative bacteria accounted for 61.90％ (104/168),including Klebsiella pneumoniae,Pseudomonas aeruginosa,Escherichia coli,Acinetobacter baumannii,Enterobacter cloacae and so on.Gram-positive bacteria accounted for 25.60％ (43/168).Staphylococcus aureus ranked the first,followed by Coagulase negative staphylococcus and Enterococcus faecalis.Fungi accounted for 12.50％(21/168),mainly including Candida albicans.They had varying degrees of resistance to commonly used antibiotics.Conclusions Gram-negative bacteria is predominant in stroke patients with HAP.Drug resistance is very serious,and the antibiotics should be selected in clinic according to the result of drug susceptibility test.

Objective To investigate the efficacy and safety of intramuscular injection botulinum toxin A (CBTX-A) made in China. Methods 43 post-stroke patents with upper extremity refractory spasticity were recruited in the study. The patients were randomly divided into two groups: injection combined with rehabilitation therapy (treatment group) and simple rehabilitation therapy (control group). CBTX-A was injected to the biceps brachii. The efficacy was assessed by modified Ashworth scale (MAS), range of motion (ROM),Fugl-Meyer Assessment-upper limb (FMA-upper limb) and motor-Functional Independence Measure-upper limb (mot-FIM-upper limb) at the baseline,2-week,4-week,8-week and 12- week after treatment by a physical therapist who was blind so as to which treatment they received. Results In the treatment group,85.7%(18/21) patients were benefited from the CBTX-A injection. Both groups improved on MAS,ROM,FMA-upper and mot-FIM-upper post-treatment. The score of MAS of treatment group were respectively 1.74?0.41,1.62?0.35,1.60?0.41 at weeks 2,4,8,while that of control group were respectively 2.50?0.51,2.27?0.53,2.18?0.55. The differences were significant(P0.05). After treatment,the ROM of treatment group were respectively 57.81?57.60,66.43?64.38,68.14?65.99 at 4,8, 12-week, and that of control group were respectively 27.91?30. 13,30.73?34.03, 33.73?34.50. The differences were significant (P0.05). Conclusion The result of the present study indicates CBTX-A injection combined with rehabilitation therapy decreases in local spasticity,enlarges the ROM of elbow joint. It is efficient,safe and well-tolerated. CBTX-A injection provides an additional alternative procedure for treatment of adult acquired refractory focal spasticity.

Objective To assess the effect of swallowing function training on dysphagia.Methods66 patientswith dysphagia were randomly divided into training group and control group. The swallowing function of the two groupswere evaluated before and after training.ResultsThe effective rate of training group is 78.1% which is higherthan control group (P< 0.01).ConclusionSwallowing function training can significantly improve swallowing function and activity of daily living of the patients with dysphagia.

AIM: To probe the quanlity and control of Suxiao Xiaoyan Gao. METHODS: The microscopy and TLC were applied to identify Scutellaria baicalensis; Hibiscus mutabilis; Curcuma longa; Rheum palmatum; Phellodendron chinese and borneol. The HPLC on C18column was used to determine the content of baicalin in Suxiao Xiaoyan Gao. Mobile phase was methanol∶0.4% phosphoric acid solution(47∶53). Detection wavelength was 280 nm. RESULTS： The micro-character and thin-layer chromatography was clear with no disturbance of negative sample. The average recovery of baicalin was (99±3)%, RSD was 3.35%. CONCLUSION: The method is simple and feasible. Its repetition is well. It can be used as a quality control method of Suxiao Xiaoyan Gao.

BACKGROUND: The shear bond strength between ceramic orthodontic brackets and teeth is so large that ceramic brackets are not easily eliminated safely. Whether the shear bond strength of self-etching primer/adhesive can be decreased and the injuries to enamel can be reduced has been always concerned by orthodontists. OBJECTIVE: To evaluate the bond strength between self-etching primer/adhesive system and ceramic orthodontic brackets and make a comparison with Jingjin enamel adhesive most commonly used by clinicians in China.DESIGN, TIME AND SETTING: Controlled observation, performed at Hebei University of Science and Technology in March 2006.MATERIALS: Twenty permanent premolars extracted due to orthodontic treatment were selected. The premolars were required to have excellent enamel and gloss, no cracks or carious lesions, and have not been given any chemotherapy. Ceramic orthodontic brackets were arch wire ceramic premolar brackets with 0.022-inch standard edgewide (3M company,USA). The bottom bracket area was 12.16 mm2. Self-etching sealant and TransbondTM fight-cure adhesive were purchased from 3M company, USA. Jingjin enamel adhesive, a conventional self-etching adhesive, was provided by Tianjin Institute of Synthetic Materials Industry, China.METHODS: The 20 premolars were randomly evenly divided into a self-etching primer/adhesive group, in which,self-etching sealant and TransbondTM fight-cure adhesive were applied, and a Jingiin enamel adhesive group, in which,Jingjin enamel adhesive was used.MAIN OUTCOME MEASURES: After 24 hours, shear bond strength was determined respectively in the two groups using anti-shearing testing machine. Simultaneously, residual adhesive remaining on the teeth was examined. RESULTS: The mean shear bond strength was lower in the self-etching primer/adhesive group than in the Jingjin enamel adhesive group, but there was no significant difference (P > 0.05). The mean shear bond strength in the two groups was clinically acceptable. The residual adhesive remaining on the teeth was significantly less in the self-etching prime/adhesive group than in the Jingjin enamel adhesive group (P < 0.01).CONCLUSION: Self-etching prime/adhesive system used for bonding ceramic orthodontic brackets can satisfy clinical requirements. Moreover, its bond strength can be appropriately decreased and ceramic brackets are easily removed, thereby,injuries to enamel can be reduced.

Objective To analyse the clinical features of community-acquired pneumonia(CAP)in out-patients.Methods A retrospective study was performed on 179 consecutive patients with CAP in fever clinic of Xuanwu Hospital during two months.Results Most of CAP patients were young(aged 14 to 30 years,accounting for 58.1%)and had no-existing diseases(72.6%).Within 2 to 4 days after onset of fever,50%~80% of patients were diagnosed as CAP.About 1/3 of patients had no respiratory symptoms except for fever.Cough and sputum production was seen in 52.5% of patients.WBC was normal in 63.1%.Unilateral pneumonia often occurred(accounting for 82.1%).After treatment with antibiotics,fever in 80%(42/52)of cases disappeared within 3 days in follow-up patients.Conclusion In fever clinic,most patients are young and have no-existing diseases.They can be identified as CAP quickly and have good outcomes.

Taking feasible precautions is an important step in effectively reducing medical disputes and improving medical quality. Guarding against medical disputes is a complex systematic project, which shares similarities with disease prevention. In view of the causes, evolution and various manifestations of medical disputes, it is imperative to take measures from the following three aspects and guard against them on three levels: ①taking first level(primary) precautions so as to boost overall development and tackle medical disputes at the source; ②taking second level(key) precautions so as to conduct timely imterventions and nip medical disputes in the bud; ③taking third level(emergency) precautions so as to dissolve prominent conflicts and prevent the worsening of medical disputes.

Objective To investigate the incidence of spasticity 6 months after first stroke. Methods 355 patients hospitalized from March 2012 to December 2013 were assessed with the modified Ashworth Scale 1 month, 3 months, and 6 months after stroke. Results The incidence of spasticity was 42.7% in the 1st month, and increased to 63.7% and 65.7% 3 and 6 months after stroke, respectively. The incidence of spasticity was the most 3 months after stroke both in arms and legs. The incidence of moderate to severe spasticity was more in the arms than in the legs. There was no significant difference at incidence of spasticity among foci and ages. Conclusion Spasticity usually occurs within 3 months after stroke, and more frequent in the upper limb than lower limb.