OBJECTIVE To investigate the distribution and drug resistance of pathogenic bacteria from lower respiratory tract infection in elderly patients.METHODS A total of 1739 strains of bacteria isolated from sputum and lower respiration secretion culture of the elderly patients were identified and their drug resistance was tested by K-B method.RESULTS From 1739 strains of pathogens isolated,Gram-negative bacilli accounted for 63.8%.The main Gram-negative bacilli were Escherichia coli and Pseudomonas aeruginosa,Acinetobacter baumannii,Enterobacter cloacae and Klebsiella pneumoniae.Gram-positive cocci accounted for 22.9% and Candida albicans accounted for 13.3%,respectively.The resistance rates of Gram-negative bailli to imipenem,cefoperazone/sulbactam and amikacine were relatively low.And all Gram-positive cocci were sensitive to vancomycin.CONCLUSIONS The antimicrobial resistance of pathogens in elderly patients with lower respiratory tract infection is serious.It is important to mornitor the antimicrobial resistance.

This paper describes the characteristics of post-apoplectic talipes varus at the early and middle-late stages and puts forward the acupuncture and rehabilita -tion-therapy.

Controlling serum phosphorus levels is critical in patients with renal failure. Currently phosphate-binding agents are widely used to reduce phosphate absorption in patients with endstage renal disease. If possible,serum phosphorus level should be reduced without disturbing calcium homeostasis or increasing accumulation of potentially toxic elements. Aluminum hydroxide and traditional calcium -based phosphate binders are commonly used to control serum phosphorus level. Aluminum hydroxide can effectively lower serum phosphorus level,but aluminum can accumulates in the body and results in toxic effect. Traditional calcium-based phosphate binders tend to promote hypercalcemia and calcium overloading,and accelerate cardiovascular calcification. Therefore aluminum -free and calcium-free phosphate-binding agents have become the focus of study; however,agents like sevelamer hydrochloride and lanthanum carbonate are not widely used due to high price,although they are effective in controlling serum phosphorus level. New generation of phosphate binders,such as colestilan,nicotinic acid and magnesium salt,are cheaper than their previous counterparts,but their long -term effect still needs to be observed. This article summarizes the progress of non-calcium phosphate binders in treatment of end-stage renal diseases,hoping to help clinical drug usage.

Objective To develope a new method producing ventricular septal defect (VSD) model by transcatheter puncture and evaluate its feasibility and practicability. Methods Ten dogs underwent transcatheter ventricular septal puncture with Brockenbrough puncture needle via right jungular vein under fluoroscopy, and then dilated the defect with 6-8mm balloon catheter. Left ventricular (LV) angiography was performed with pigtail catheter by transaortic access after puncture. Right after the procedure and 1-4 months later, the dogs were sacrificed and the defects were inspected. Results VSDs were successfully made in 8 dogs, which were demonstrated by LV angiography with one defect at membranous part. The defects in other dogs were shown near membranous septum or muscular septum not far away from the membranous part. The distance from aortic valves to the rims of defect was 4-16mm, from tricuspid valves 4-10mm. Ⅲ?AVB was found in 1 dog which died 1 week later, with ruptured membranous part at autopsy. CRBBB was found in another dog. Conclusion Establishment of VSD animal by transcatheter puncture is feasible, practicable and of high successful rate and less complication.

Objective To explore the novel method to establish animal model of controllable sized atrial septal defect. Methods Fourteen dogs of both sexes were selected,with weight ranging from 15 to 20kg. Under guidance of fluoroscopy,ASD was established by using Brokenbrough needle and balloon dilatation. Results Tow dogs died of cardiac tamponade.Other twelve dogs had ASD created successfully without complication. Conclusion The method has the advantages of easy manipulation , size controllable and small amount of fluoroscopy exposure.

Objective To investigate the influence of combined kinetotherapy with non-drug sleep on delirium in patients with mechanical ventilation. Methods 107 cases with acute exacerbation of chronic obstructive pulmonary diseases (COPD) respiratory failure and mechanical ventilation were randomly divided into the treatment group of 54 cases, and the control group of 53 cases. Two groups of patients were given conventional treatment, the treatment group while giving to kinetotherapy and non-drug sleep:an eye mask earplugs at night. Observe the difference of the incidence of delirium, duration of delirium, number of days of mechanical ventilation, case fatality rate. Results The incidence of delirium in the treatment group was 59.3%(32/54), while that was 77.4%(41/53) in the control group, the difference was significant, χ2=4.042,P=0.044. The duration of delirium in treatment group was (1.75 ± 1.05) d, while that was (2.56 ± 1.25) d in the control group, the difference was significant, t=-2.955, P=0.004. The number of days of mechanical ventilation in treatment group was (6.41 ± 2.84) d, while in the control group was (8.68 ± 3.85) d, the difference between the two groups was significant, t=-3.478,P=0.001. The case fatality rate in treatment group was 5.6%(3/54), while in the control group was,11.3%(6/53) , the difference between the two groups was no significant, P=0.283. Conclusions Kinetotherapy cooperate with non-drug sleep can reduce the incidence of delirium, duration of delirium and number of days of mechanical ventilation in patients with mechanical ventilation. This method are simple and it is worth spreading.

Objective To investigate the effect of surgical trauma on the expression of COX-2 and PGE2in the hippocampus in aged rats. Methods Forty-five 18-month-old male SD rats weighing 500-600 g were randomly divided into 3 groups (n = 15 each): group Ⅰ control (group C); group Ⅱ anesthesia (group A) and group Ⅲ surgery + anesthesia (group S). Anesthesia was induced by intraperitoneal 1% pentobarbital sodium 50 mg/kg in group A and S. The animals underwent appendectomy and splenectomy under anesthesia in group S.Cognitive function was assessed by open field test and Y-mase test on the 1st, 3rd and 7th day after anesthesia and surgery (T1-3). The animals were sacrificed after behavior tests at T1.2.3 and the hippocampi were removed for determination of the expression of COX-2 mRNA (by RT-PCR) and PGE2 content (by ELISA). Results The time the animal spent in the central square was significantly prolonged, the number of crossing grid and standing on the back legs and the number of right response were decreased, the total reaction time was prolonged and the COX-2mRNA expression at T1 and PGE2 content in the hippocampus were increased at T1,2 in group S as compared with group C and A. There was no significant difference in the variables mentioned above between group C and A. Conclusion Surgical trauma can induce early postoperative cognitive dysfunction through up-regulation of COX-2 mRNA expression and by increasing PGE2 content in the hippocampus in aged rats.

By analyzing and summarizing the previous research results regarding acupuncture for insomnia, factors influencing the efficacy of acupuncture on insomnia were discussed, and a summary was made from aspects of age, gender, duration of insomnia, use of medication, types of syndrome differentiation, acupoint selection, acupoint combination, acupuncture timing, etc. With respect to the influencing factors, precautions during the clinical syndrome differentiation were briefly reviewed, and the treatment plan of acupuncture for insomnia was optimized, which could provide new methods and thoughts for clinical and scientific research regarding acupuncture for insomnia.
Acupuncture Points ; Acupuncture Therapy ; Female ; Humans ; Male ; Sleep ; Sleep Initiation and Maintenance Disorders ; physiopathology ; therapy

Objective To investigate the correspond of microsatellite instability (MSI) on the prognosis and the effect of chemotherapy for colorectal cancer.Methods The publications about the MSI of colorectal cancer from January 2011 to October 2012 were searched.The Web of Knowledge and MEDLINE (PubMed) databases were used for searching English articles.The CNKI and WanFang databases were used for searching Chinese articles.Statistical analysis and graphics were performed with Comprehensive Meta Analysis V2 software.Results Thirty papers were included in this study.For the prognostic Meta-analysis,MSI-H was a protective factor for the overall survival of patients (OR =0.634,0.558-0.720; P ＜ 0.001).Simultaneously,MSI-H was a protective factor for the disease-free survival of patients (OR =0.571,0.479-0.681; P ＜ 0.001).After using of 5-Fu,the survival rate of MSS/MSI-L patients could be significantly elevated (OR =0.515,0.433-0.611; P ＜ 0.001).However,the survival rate of MSI-H patients did not increase significantly (0.631,0.302-1.318; P =0.220).Conclusions Both the overall survival and disease-free survival of MSI-H patients were significantly better than that of MSS/MSI-L patients.For MSS/MSI-L patients,the chemotherapy effect was remarkable.However,for MSI-H patients,there was no statistics difference between chemotherapy and no-chemotherapy group.

Intra-atrial re-entrant tachycardias (IARTs) are common late after heart surgery. Conventional mapping and ablation is relatively difficult because of the complicated anatomy and multiple potential re-entry loops. In this study we aimed to evaluate the electrophysiological characteristics and radiofrequency catheter ablation of atrial tachycardia (AT) induced by myocardial scar or incision. Methods In 6 patients (three male and three female, aged 33.3+ 11.8 years) who had AT related to myocardial scar or incision,electrophysiological study and radiofrequency catheter ablation (RFCA) were performed. Earliest activation combined with entrainment mapping was adopted to determine a critical isthmus. Results Re-entry related to the lateral atriotomy scar was inducible in 5 of6 patients. With entrainment mapping, the PPI (post-pacing interval)-TCL (tachycardia cycle length) difference was ＜30 ms when pacing at the inferior margins of the right lateral atriotomy scar. Among them, 3 patients had successful linear ablation between scar area to inferior vena cava, and 2 patients between scar area to tricuspid annulus. Re-entry involving an ASD patch was demonstrated in 1 of 6 patients. PPI-TCL differences ＜30 ms were observed when entraining tachycardia at sites near the septal patch. But linear ablation failed in terminating AT. There was no complication during procedure. No recurrence of AT related to incision was observed during follow-up except for the failed patient. Conclusion Under conventional electrophysiological mapping, adopting linear ablation from scar area to anatomic barrier, successful ablation can be obtained in patients with IRATs related to myocardial scar or incision.