OBJECTIVE To investigate the pathogens distribution and their antibiotic resistance in critically ill patients with pulmonary infection.METHODS Totally 171 isolates from sputa were studied and the drug sensitive test was analyzed in 103 critically ill patients.RESULTS These results showed that 29 G+ bacteria strains occupied 17.0%,there were 15 Staphylococcus aureus strains,11 S.epidermidis strains and 3 Enterococcus strains,respectively.In 107 G-bacteria strains occupied 62.6% were composed Stenotrophomonas maltophilia,Acinetobacter baumannii,Burkholderia cepacia and Klebsiella pneumoniae,and 35 strains were fungi,accounted for 20.5%,the main fungi were Candida albicans and C.tropicalis.The result of drug sensitive test showed that there were high rates of multiple drug resistance in most bacteria strains,but there were different drug resistance rates to different antibiotics.CONCLUSIONS G-bacilli play an important role in the pulmonary infections of these critically ill patients,the opportunistic pathogens,such as S.maltophilia are the main G-pathogens,and there are high percentages of drug resistance.The other bacteria such as S.aureus,K.pneumoniae,etc,have a multidrug resistance.Inspecting pathogens and studying the trend of their drug resistance are very important in reducing drug abuse and decreasing the rate of infection in hospital.

OBJECTIVE To highlight the characteristics of diffuse panbronchiolitis(DPB) in community hospital.METHODS One patient with DPB confirmed by clinic was described and relevant literatures were reviewed.RESULTS DPB was a chronic lower respiratory tract disease common in Japanese,rare in China,characterized by infiltration of inflammatory cells around bronchioles.Symptoms included cough,expectoration,and dyspnea after exercises.Pseudomonas aeruginosa was isolated from sputum in some cases.Some patients had the history and X-ray manifestation of sinusitis.The reason for a high misdiagnosis rate was due to unknown to its clinical findings and its diagnosis standard among doctors in community hospital.Chest high resolution CT(HRCT) could be attributed to the diagnosis of diffuse panbronchiolitis.The early treatment with macrolides was satisfied.CONCLUSIONS The patients with the history of chronic cough,expectoration and sinusitis,should be diagnosed.Long term,low dose macrolide therapy may improve the prognosis through an anti-inflammatory effect.

The Ministry of Education has carried out “the Project of Educational Assistance to the Western District Colleges” since June, 2001. Peking University is the assistance partner to help Shihezi University. The implementation of the Project has greatly promoted the development of Shihezi University in various aspects, such as talent training, discipline construction, cultural and academic exchanges, etc.

0.05). CONCLUSIONS The pathogenic bacteria from VAP subglottic secretion are mostly Gram-negative rods, in which the dominant bacteria are A. baumannii, P. aeruginosa, S. maltophilia, K. pneumoniae and Escherichia coli. Most of them are multi-drug resistant. The kinds of pathogenic bacterial strains in subglottic secretion and lower respiratory tract secretion are not only consistent but also similar to each other in terms of composition and drug resistance.

Objective:To observe the influence of Danhong injection on interleukin-17 (IL-17)expression after percu-taneous coronary intervention (PCI)in patients with ST segment elevation myocardial infarction (STEMI),and ex-plore its protective effect on myocardial ischemia-reperfusion injury (MIRI)after PCI.Methods:A total of 300STEMI patients undergoing PCI in department of cardiology were selected.They were randomly divided into routine treatment group (n=150)and Danhong injection group (n=150).Enzyme linked immunosorbent assay (ELISA) was used to measure levels of IL-17 and IL-6. Results:There were no significant difference in expression levels of IL-17 and IL-6 between two groups before PCI (P >0.05).On 12h after PCI,IL-17 levels of two groups signifi-cantly rose (P <0.05),then gradually declined,IL-17 and IL-6 levels in routine treatment group were still signifi-cantly higher than those of before PCI (P <0.05),but those of Danhong group were not significantly different from before PCI (P >0.05).Total effective rate of Danhong group was significantly higher than that of routine treat-ment group (92.7% vs.81.3%,P <0.05).Compared with routine treatment group on 72h after PCI,there were significant reductions in levels of IL-17 [(31.4±6.1)ng/ml vs.(23.2±4.3)ng/ml]and IL-6 [(60.3±11.6)ng/ml vs.(42.7±8.4)ng/ml],significant rise in left ventricular ejection fraction [(43.6±4.5)% vs.(53.7±5.6)%] and significant reduction in myocardial infarction area [(22.7±4.3)% vs.(17.2±3.7)%]in Danhong injection group,P <0.05 all.Conclusion:Danhong injection decreases expressions of IL-17 and IL-6,it may be mechanism improving MIRI after PCI,thereby diminishes myocardial infarction area,and improves heart function,which is worthy extending.

To determine appropriate surgical methods and flaps to apply plastic surgery of facial defects. Several plastic methods were introduced progressively to eight cases. From simple to complex, we discussed the direct suture, relaxation suture, Z-flap, flap-footed, combined or multiple flaps, and free flap method to decrease the tension in wounds. The skin and flaps were successful in all eight cases and healed the wounds. It is important to choose appropriate surgical techniques and flaps to repair facial injuries.
Face ; surgery ; Facial Injuries ; surgery ; Free Tissue Flaps ; Humans ; Reconstructive Surgical Procedures ; Skin ; Wound Healing

Objective To explore the treatment of the ICU ventilator associated pneumonia(VAP),and the prevention strategy.Methods Analyzed the clinical features and microbiological data of 80 ICU VAP patients. Results The main pathogenic bacterias of VAP were acinetobacter baumannii and pseudomonas aeruginosa,which were Gram negative bacteria.A total of 200 strains pathogenic bacteria were isolated,in which,Gram negative bacteria reached to 76.0%,which mainly including:acinetobacter baumannii strains,klebsiella pneumoniae,pseudomonas aeruginosa and so on.24.0% was Gram positive bacteria,including staphylococcus aureus accounted for 10.5%,and the epidermis staphylococcus,hemolysis staphylococcus and so on.Proportion of fungi was 11.0%.According to the results of microbiological data,the effective anti-microbial treatments were administered.After treatments for 10 days, the VAP infection parameters(including temperature,the white blood cell count and the number of strains)were grad-ually back to normal.Conclusion The main VAP pathogenic bacteria are Gram negative bacteria,patients commonly are infected by two or more bacterias,which lead to the multiple infection,the treatment should be fully based on mi-crobiology and clinical monitoring data,and the formulating personalization antibacterial treatment.

Objective To establish a high-performance liquid chromatography method for determination of mycophenolic acid in human plasma.Methods The method was performed with C18 column(3.9mm?300mm).The mobile phase consisted of 40mmoL/L TBA solution-acetonitrile adjusted to pH 4 with orthophosphoric acid(55∶45,V∶V),with a flow rate 0.8mL/min.The UV detection wavelength was 254nm.Plasma samples were extracted with methanol.Results The linear concentration of the calibration curve ranged from 0.8 to 51.45mg/L(r=0.9998).The relative recoveries were between 95.5% and 109.2%,and the extraction recoveries were more than 90%.Relative standard deviation(RSD) of intraday and interday assays were both less than 10%.Conclusion The method is proved to be reliable and simple for monitoring mycophenolic acid in human plasma and bioequivalence research.

BACKGROUND:Many internal fixations,such as dynamic hip screw,Gamma screw,proximal femoral nail,angle steel plate,as well as locking proximac femoral plate,are utilized in treating intertrochanteric fractures,especially the dynamic hip screw However,the failure rate is gradually increased.OBJECTIVE:To explore the application and clinical efficacy of total hip replacement for the treatment of elderly intertrochanteric fracture fixation after failure of dynamic hip screw.METHODS:A total of four cases with intertrochanteric fractures were treated by total hip replacement after failure of dynamic hip screw fixation was selected.According to Evans typing,one case were type Ⅱ,two cases were type Ⅲ A,and one case was typeⅢB.Internal fixation displacement could be found at half to 1 year after dynamic hip screw fixation.Because of bone disunion,coxa adducta and pain,the patients could not walk.Sequentially,total hip replacement was performed with 45°abduct angle and10°-15°anteversion angle The clinical efficacy was evaluated by Harris scoring criteria.RESULTS AND CONCLUSION:All the cases were operated smoothly,with 1.5-2 hour operation duration and 400-600 mL blood loss.No case appeared allergic response to bone cement.By 3-12 months follow-up,4 successful operative cases do not appear prosthesis loosening,subsidence and are satisfied with well hip function.The average Harris score were 81 points.The results revealed that application of total hip replacement after the failure of DHS in elderly intertrochanteric fracture fixation,which shortened the time patients stay in bed to reduce complications and improved the hip joint function.

Objective To investigate utilization of antenatal health care service,analyze its influential factors and intervention methods.Methtods 1685 pregnant women who were in hospitalization from January 2011 to July 2012 were selected.A self-designed questionnaire was conducted and case history information were collected,including general information,medical costs means,awareness of prenatal care knowledge,whether convenient to see doctor,the degree of attention paid to pregnant women,the utilization of antenatal health care.Results 81.19％(1368/1685)of the pregnant women used antenatal health care service.Multiple Logistic regression analysis showed that the difference between diverse age,medical costs means,the number of pregnancies,level of awareness of prenatal care knowledge,the degree of attention paid to pregnant women was significant.Conclusions The utilization of antenatal health care service in this area is on the low side.The critical of improving the utilization of prenatal care services is improving prenatal care service mode,increasing the quantity of health education,perfecting the medical security system,strengthening community health service consciousness and the improvement of technology.