Objective To investigate the early prediction,diagnosis and treatment of thoracic injury complicated by adult respiratory distress syndrome (ARDS).Methods The blood gas,occurrence index of traumatic ARDS,pathogenic bacteria and drug sensitivity in ventilator associated pneumonia (VAP) were analyzed retrospectively in 18 cases of thoracic injury.Results The initial PaCO 2 was (32.1?5.2) mm Hg,PaO 2 (57.7?10.1) mm Hg,the occurrence index of traumatic ARDS (-29.00?11.50) and the mechanical ventilation time 6.4 days on average.Of the infective bacterium of VAP,gram negative bacterium took up 70.6%, gram positive bacterium 17.10%,fungus 12.30% and the mixed infection 31.60% with the total mortality of 16.6%.Conclusion The occurrence index of traumatic ARDS can be used as a parameter of the early prediction and outcome.Meanwhile multiple injuries and shock should be treated correctly,ventilator applied earlier and the mechanical ventilation time shortened.It suggests that more attention should be paid to the prevention of VAP and the reasonable use of antibiotic drugs.

Objective To obtain the matched parameters between image quality and radiation dose by exploring the influence of the exposure parameters of screening mammography on both the image quality and radiation dose.Methods The correlation between the exposure parameters and average glandular doses to 507 patients undergoing screening mammography were retrospectively analyzed.The influence of breast compression thickness on radiation dose by exposing different thickness of PMMA was obtained.The correlation with image quality was analyzed by combined testing of contrast detail test mode ( CDMAM3.4 )and different thickness of PMMAs.Results The groups aged 30 to 49 years were the main groups in 507examined patients,up to 67.06％ of the total.The mean value of average gland doses ( AGD ) in contrastprior mode was the highest in three kinds of exposure modes,accounting for 137.5％ of standard mode.In standard mode,target material/filtration board combination was Mo/Mo,Mo/Rh and Rh/Rh,accounting for 1/3 respectively.Mo/Rh and Rh/Rh were selected in dose-prior mode,accounting for 50％ respectively.Mo/Mo was mainly selected in contrast-prior,accounting for 52％.Breast compression thickness was positively correlated with average gland doses.Image quality figure inverse (IQFinv) under three kinds of modes (STD,DOSE,CNT) was 98.32,95.41 and 107.02,respectively,and IQFinv of contrast-prior mode was the highest among them.IQFinv was in general agreement in the three kinds of exposure modes when the thickness of PMMA plates plates was greater than or equal to 5 cm.Conclusions In clinical practice,when the breast is of density type and pressed thickness is less than 4 em,the dose-prior mode should be selected.When the pressed thickness is between 4 and 6 cm,the standard exposure mode should be selected.When the pressed thickness is larger than 6 cm,the manual mode should be selected.