Objective Statistics and analyze the effect of comprehensive prevention measures for the ventilator associated pneumonia (VAP) morbidity and mortality,and investigate its actual applicate situation in the clinical.Methods Statistics and analyze the clinical date of 183 cases of our ICU mechanical ventilation patients in 2012 (group A),including morbidity,mortality,time of endotracheal intubation,length of stay and the primary pathogenic bacteria,and to compared with the relevant clinical data of 192 cases of our ICU mechanical ventilation patients in 2011 (group B),summarize and analysis the actual applicate situation of the comprehensive prevention measures in the clinical through the data contrast.Results The incidence of VAP in group A was lower than that in group B [31.7％(58/183) vs.58.3％(112/192)] (P ＜ 0.05),but the mortality was no statistical difference in both groups (P ＞ 0.05) ; the endotracheal intubation time and the average length of stay in group A were less than those in group B [6.3 d vs.10.6 d,7.6 d vs.11.9 d](P＜0.05); the main pathogenic bacterium of VAP with mainly gram-negative bacilh.Conclusions Comprehensive prevention measures can effectively reduce the incidence of VAP,but the mortality rate has no significant effect,need further clinical research;comprehensive prevention measures to reduce patients with tube time also confirm its effectiveness.Comprehensive prevention measures are economical and practical,is worth in clinical promotion.

Brachytherapy ; Cicatrix ; radiotherapy ; Humans ; Male ; Middle Aged ; Tracheal Stenosis ; radiotherapy

It is common in bacterial genomes of the integration of prophages. As an important participant of the vital movement of their hosts, prophages affect closely the biological properties of the hosts. Therefore, if we want to comprehend a bacterial genome fully, it is essential to recognize and understand accurately prophages in it. This article is a compendious review about the classification, distribution, identification, evolution of prophages and the interaction with their hosts.

Objective To compare the effect of enteral administration and intravenous infusion of hypertonic electrolyte glucose solution (HEGS) in the resuscitation of burn shock. Methods Fifteen beagle dogs with 35% TBSA third degree burn were used in present study, and divided into three groups randomly: noresuscitation group, intravenous infusion resuscitation group and enteral administration resuscitation group. For the animals in the latter two groups, 1.8% HEGS was administrated intravenously or enterally for resuscitation 30 min after burn. The volume of fluid infusion in the first 8h was 1ml/(kg?1% TBSA), and the transfusion velocity was equilibrated. The mean arterial pressure (MAP), cardiac index (CI), plasma volume (PV), and sodium concentration in plasma were obtained to evaluate the effect of resuscitation used HEGS. Results The MAP, CI and PV were similar in both enteral and intravenous groups, which were higher than those in noresuscitation group. In both enteral and intravenous groups, MAP was raised after burn and then lowered after resuscitation, meanwhile CI and PV were raised and then lowered after resuscitation, but there were no differences between the two groups. The sodium concentration in plasma was stable in the noresuscitation group and increased in enteral and intravenous groups, and it was higher in intravenous groups than in enteral group. Conclusion In the resuscitation of early shock of 35% TBSA three degree burns, the effect of 1.8% HEGS administrated enterally on CI, PV, MAP and sodium concentration in plasma was similar to that of intravenous infused.

With the advances in techniques of localization, numerous minimally invasive parathyroid surgery were developed including open minimal incision and endoscopic approaches. According to the research results and the experiences from Peking Union Medical College Hospital, the indication and preoperative preparation were discussed in this paper. Some suggestions were given for minimally invasive parathyroid surgery in China.
Beijing ; China ; Humans ; Minimally Invasive Surgical Procedures ; Parathyroidectomy ; methods ; Preoperative Care

Adult ; Coronary Angiography ; Coronary Vessel Anomalies ; complications ; Heart Atria ; Humans ; Male ; Vascular Fistula ; complications

Objective To evaluate the application of ZEEK thrombus aspiration catheter in treatment of acute myocardial infarction (AMI) in elderly patients. Methods The 52 patients with ST-elevation myocardial infarction(STEMI)were treated with percutaneous coronary intervention (PCI) plus thrombus aspiration by using ZEEK thrombus aspiration catheter (ZEEK group), and 42 STEMI patients were treated only with PCI (control group). The regression rate of ST segment, left ventricular ejection fraction (LVEF), incidence of no-reflow and mortality were followed up after PCI during hospitalization. Results No-reflow occurred in 5 (11.9%) patients and 1 (1.9 %) patient in the control group and ZEEK group, respectively. And 2 deaths were encountered only in the control group. The differences between the two groups were statistically significant (P＜0.05).Conclusions AMI treatments with PCI and application of ZEEK aspiration thrombus catheter are safe and effective. The two methods could lower thrombosis burden, may improve distal myocardium perfusion and cardiac function after the procedure.

Rheological properties of poloxamer 407 (brand named Pluronic F127) were examined by changing shear rate, temperature and the recovery properties of apparent viscosity after heating for several times. The results indicated that poloxamer 407 aqueous solution showed a Newtonian behavior at a low concentration while it might be a pseudoplastic fluid when the concentration reached a certain point. The thixotropy and the sol-gel transition temperature decreased with increasing the concentration (it could be an in situ gel at body temperature when the concentration of poloxamer 407 up to 15.25%). The results that obtained from the theological data would be useful in the application of poloxamer 407 such as in situ gel preparation.

Objective To compare the effects of propofol intravenous balanced anesthesia with infusion of remifentanil combined with fentanyl to simple infusion of remifentanil or fentanyl during laparoscopic cholecystectomy(LC).Methods Sixty patients scheduled for LC were randomly divided into three groups(n=20): simple remifentanil group(R),remifentanil combined with fentanyl group(RF) and simple fentanyl group(F).Mean arterial pressure(MAP),heart rate(HR) and SpO2 during the anesthesia induction phage,maintenance phage and analepsia phage,the recovery time of spontaneously breathing and consciousness from withdrawal,extubation time,pain score(verbral report score,VRS) and conscious state score(observers assessment of alertness/sedation scale,OAAS) at instant,1 h,3 h,7 h,12 h after extubation and complications of analepsia phage were recorded.Results As compared with the RF Group,the F Group and pre-induction intro-group,the R Group showed lower MAP and quicker HR when induction intubation,higher MPA and quicker HR after operation,and no obvious difference in maintenance phage was found.MAP and HR showed no obvious difference between the RF and F Group as well as within groups in induction and maintenance phage.MAP increased and HR became quicker in the RF Group when extubating and leaving operating room.All observed index at every time showed no significant differences between the R and RF Group after operation,but it prolonged significantly in the F Group.Complications of the three groups showed no statistical difference.VRS of the R Group was significantly higher than that of RF and F groups after operation(P

Objective To accurately detect ECG P wave,a P wave detection algorithm based on fitting function in the optimal interval is proposed and evaluated in this paper,for resolving very difficult problems.Such as differences of positions and figures in ECG P wave as well as easily suffered diversified interferences.Methods In this algorithm the quadratic function to fit the P wave with least square method in every interval was used,which was shifted in local range.Then the optimal fitting interval of P wave was found by comparing the error of fitting.Finally,the characteristic points of P wave were obtained with the fitting function to fit P wave in the optimal interval.Results The performance of this algorithm tested with the records of the MIT-BIH database was effective and accurate.Conclusion This algorithm on the wide range of heart rate variation and small P wave of ECG P wave detection has good effect.Also it has some capabilities of anti-interference and quite low dismissal probability in particular.