Rational drug-use is an extremely important component part in morden medical and health work. And irrational drug-use will aggravate drug misadventure, increase overpreseribing, waste medicinal resources and harm the reputation of medical workers. The tendency of polypharmacy just for more hospital income, regardless of drug-related adverse effects, comes to be a serious problem and hard to control in recent years. No perfect management system and lack of information may be the major factors of the problem. In order to overcome the irrational drug-use characterized by polypharmacy, we should learn something from the Diagnosis Related Groups/Prepayment System (DRGS/PPS). Now, under the cooperation of The Chinese Pharmacological Society ,The Chinese Pharmaceutical Association and The Public Health Ministry of PLA, a Diagnosis Related Rational Drug-use Management System and a Computerized/Telecommunication Based Dynamic Knowledge Bank are able to be developed. We consider that it will contribute to the modernization of medical and health work in China in the near future.

A total of 178 patients with the time of mechanical ventilation beyond 48 hours in the second affiliated hospital of Wenzhou medical college from January 2010 to December 2013 were enrolled in this study,and there were fifty-six patients with ventilator-associated tracheobronchitis (VAT).The associated factors included age,sex,blood pressure,blood glucose,BMI,the time of mechanical ventilation,tracheal intubation methods,raise head to 30-45°,proton pump inhibitors (PPI),prophylactic antibiotic treatment,glasgow coma scale (GCS),acute physiology and chronic health evaluation (APECHE) Ⅱ score.The related factors of VAT were evaluated by using univariate logistical regression analysis,and the statistical significant variables were analyzed by using multivariate logistical regression analysis.By using univariate logistical regression analysis age,blood glucose,the time of mechanical ventilation,raise head to 30-45°,prophylactic antibiotic treatment,GCS and APECHE Ⅱ score were the important factors of VAT (P ＜ 0.05),but sex,blood pressure,BMI,tracheal intubation methods and PPI were insignificant related to VAT(P ＞ 0.05).By using multivariate logistical regression analysis the time of mechanical ventilation (OR =4.072,95％ CI 2.036-8.146),GCS[2.198(1.155-4.184)],age[2.128 (1.119-4.046)],APECHE Ⅱ score [2.109 (1.084-4.104)] and raise head to 30-45 ° [0.488 (0.243-0.979)] were associated independently with the VAT.The time of mechanical ventilation,GCS,age over 60 years,APECHE Ⅱ score and raise head to 30-45°were the independent factors associated with VAT.