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.

Objective To assess the clinical characteristics of systemic lupus erythematosus (SLE) in the elderly in Xinjiang.Methods As a retrospective study,clinical date and laboratory test results were collected from 87 elderly SLE patients and 222 non-elderly SLE patients (age ＜ 50 years) hospitalized in the People's Hospital of the Xinjiang Uygur Autonomous Region from January 2006 to July 2016.Results The female to maleratio was 5.7 ∶ 1.0 in the older-onset SLE group and the female to male ratio was 11.3 ∶ 1.0 in the younger-onset SLE group.Of the 13 patients with predisposing factors in the older-onset SLE group(14.9 ％),11 had infection (12.6 ％),whereas the 27 patients with predisposing factors in the younger-onset SLE group (12.2 ％)had pregnancy,abortion or insolation,in addition to infection.Arthritis (63.2 ％),weakness (40.2 ％),malar rashes (36.8 ％),anorexia(26.4 ％),and shortness of breath(26.4 ％) were common clinical manifestations in the olderonset SLE group.The incidence of anorexia in the older-onset SLE group was higher than that in the younger-onset SLE group(P＜0.01),while the incidence of trichomadesis was lower in the older-onset SLE group than that in the younger-onset SLE group(P＜0.01);Aminotransferase elevation,creatinine elevation and thrombocytopenia were more common in the older-onset SLE group than in the younger SLE group (P＜0.05).Lower rates of positive anti-Smanti body and anti-Acl antibody were found in the older onset SLE group,compared with the younger-onset SLE group (P＜0.05);Han older-onset SLE patients showed higher rates of oral ulcers than older-onset SLE patients of Uygur,Kazak or other ethnic minorities (P＜0.05).There were no significant differences between Han and Uygur/Kazak patients in laboratory test results.Conclusions The proportion of male SLE patients in the elderly is higher than that in non-elderly SLE patients in Xinjiang.Also,elderly SLE patients are prone to oral ulcers but often do not show typical early clinical symptoms and have low levels of specific antibodies.Therefore,clinicians should pay particular attention to older onset SLE patients in order to reduce the rates of misdiagnosis and missed diagnosis.

Objective:To investigate the role of scavenger receptor BⅡ(SR-BⅡ) in the oxidized low density lipid(ox-LDL) induced foam cells formation promoted by porphyromonas gingivalis(P.g).Methods:Peritoneal macrophages were stimulated with P.g and ox-LDL,and then foam cells formation were checked.The expression of SR-BⅡ was detected by Western blot and real-time PCR.Next,siRNA targeting SR-BⅡ was used to detect the change of foam cells formation.Results:After being stimulated with P.g and ox-LDL,the foam cells formation was significantly increased.During the process of foam cells formation,P.g infection increased the expression of SR-BⅡ.And the knockdown of SR-BⅡ by siRNA significantly reduced the foam cells formation.Conclusion:P.g infection can increase the expression of SR-BⅡ and the regulation of SR-BⅡ expression can change the foam cells formation.

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.

BACKGROUND:intervertebral disc degeneration can reduce nucleus pulposus cells,and peroxiredoxin II involved in the regulation of resist oxidation damage,cell division,differentiation,signal transduction and apoptosis.Peroxiredoxin Ⅱ has promotive effect on intervertebral disc degeneration,whereas the mechanism remains poorly understood.OBJECTIVE:To observe the effects of perexiredoxin Ⅱ on human intevertebral disc cells activity and type Ⅱ collagen synthesis in vitro.METHODS:Human degenerated human lumbar disc cells were cultured in vitro,and assigned into the control and peroxidase Ⅱ groups.Peroxidase Ⅱ with doses of 10,100 and 1 000 ng/L were added into the peroxidase Ⅱ groups.The cells were identified by immunohistochemical staining,and the cell proliferation was detected using cck-8 kit.Cell supematant was collected at days 3 and 7 after operation,and the expression of type Ⅱ collagen was measured by double-antibody sandwich enzyme-linked immunosorbent assay.RESULTS AND CONCLUSION:In vitro cultured human degenerative lumbar intervertebral disc nucleus pulposus cells by adding peroxidase increased with the dose-Ⅱ,the disc nucleus pulposus cells of the volume and type Ⅱ collagen synthesis gradually reduced(P ＜ 0.01).Tips peroxidase Ⅱ on the intervertebral disc nucleus pulposus cells,the number and type Ⅱ collagen synthesis significantly inhibited in a dose-dependent manner.Thus speculated that peroxidase Ⅱ on the nucleus pulposus cells in vitro may lead to disc degeneration as a precipitating factor.

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.