OBJECTIVE: To clarify the pathogens in plateau hospital-acquired pulmonary infection and their antimicrobial susceptibility so as to provide scientific basis for clinical first-line treatment in the rational use of antibacterial drugs. METHODS: The bacteriological culture and drug susceptibility experiment on sputum and bronchial douche fluid collected from 1 396 patients with hospital-acquired pulmonary infection in our hospital from 2004 to 2006 as well as the filed medical records were analyzed retrospectively. RESULTS: 789 positive bacteria were isolated, of which, 77.82% (614/789) were gram-negative bacilli (GNB), with Klebsiella spp showing the highest percentage, accounting for 53.91% (331/614); 21.04% (166/789) were gram-positive bacteria, with staph showing the highest percentage, accounting for 46.99% (78/789).Most of the GNB were sensitive to imipenem, sulbactam/cefoperazone, then to aminoglycosides. The susceptibility rate of Gram-positive bacteria to vancomycin was 90.36%. CONCLUSION: Gram-negative bacilli were the main hospital infection pathogens, which were sensitive to imipenem, sulbactam/cefoperazone but highly resistant to ceftazidime, which calls for attention in the clinic.

Lower limb ischemia is common and refractory diseases,in severe cases,it can impact on life quality even threat life.The traditional treatment contain medical and surgical,but cannot obtain satisfactory results.And therapeutic angiogenesis has achieve satisfactory results in animal experimnents and clinical study as its put forward.In recent years,Cell Therapy as one of the research hotspot,the micle aims to introduce the research of progress about therapeutic angiogenesis in detail.

To strengthen the medical ethics education in the clinical practice stage in the department ot obstetrics and gynecology meets the requirements of the modern medical education under new situation.Aiming at the status quo of medical ethics education in China and abroad,this paper put forward specific recommendations in terms of the setting of teaching contents,the design of teaching approaches,the construction of teaching staff,as well as the evaluation of teaching achievements,and thus to enhance the understanding of medical students and interns to medical ethics and cultivate their practical capacity of analyzing and solving problems in clinical ethical dilemmas.

中国盲文是我国视力残疾人使用的触觉凸点文字。规范、统一中国盲文标准，将有力地促进视残者文化事业的发展。本文对盲文的起源与发展进行了简要的介绍，论述了“中国盲文”国家标准主要内容与制定依据。并阐明贯彻“汉语双拼盲文方案”是广大视力残疾人与盲文工作者的紧迫作务。

0.70,cluster in two pairs of medicines are similar. Conclusion:It's reliable to cluster analysis the TCM by regarding the element contents as the character of these medicines. The larger the correlation coefficient is,the more similar the nature,flavor and efficacy of the medicines are,which suggested that trace element contents were closely related to(have much to do with) the flavor,nature and efficacy. The study provides method for the cluster relationship among TCM.

Objective:To analyze the clinical features and mutation of myeloid differentiation factor 88 (MYD88) L265P in patients with diffuse large B-cell lymphoma (DLBCL) of central nervous system (CNS).Methods:The clinicopathological materials of 45 cases of DLBCL of CNS were retrospectively collected in Xuanwu Hospital, Capital Medical University from September 2014 to February 2017. The clinicopathological data were retrospectively analyzed, combined with immunohistochemistry, EB virus in situ hybridization, imaging and medical history. The mutation of MYD88 L265P gene was detected by pyrosequencing and its clinical significance was analyzed. Results:The age of the patients ranged from 42 to 82 years [(57.6±8.8) years], including 24 males and 21 females. Totally 93.3% (42/45) of the patients had supratentorial tumours, which were single or multiple. The cerebral hemisphere (31/45, 68.9%) was the most common involved site, and 21 cases (21/45, 46.7%) had multiple lesions. Histologically, DLBCL in the CNS showed diffuse infiltration of tumor tissue, some of which grew around blood vessels in a "sleeve" arrangement. CD 20 and CD 79a were diffusely and strongly positive. Thirty-nine cases (39/45, 86.7%) were non-germinal center B cell (non-GCB) subtype and 6 cases (6/45, 13.3%) were germinal center B cell (GCB) subtype. MYD88 L265P mutation was found in 64.4% (29/45) patients. There was statistically significant difference between non-GCB type (71.8%, 28/39) and GCB type DLBCL (1/6, P=0.017). Compared with the operation/biopsy group without chemotherapy, operation+chemotherapy, biopsy+chemotherapy, operation/biopsy+chemotherapy+stem cell transplantation can improve the survival and prognosis ( HR=0.05, 95% CI 0.01-0.33 , P=0.002; HR=0.04, 95% CI 0.01-0.36 , P=0.004; HR=0.01, 95% CI 0.00-0.17 , P=0.001; respectively). Conclusions:DLBCL of the CNS is aggressive tumor with poor prognosis, the clinical manifestations are complex and diverse, and the diagnosis is challenging. MYD88 L265P is a common and specific gene mutation in primary CNS lymphoma(PCNSL), which is of great significance in the diagnosis and treatment of lymphoma. The MYD88 L265P mutation was more frequently detected in non-GCB than GCB subtype. Chemotherapy can improve the survival rate of PCNSL patients. If chemotherapy achieves complete remission and autologous hematopoietic stem cell transplantation is performed, there may be a chance of long-term survival.

Osteoporotic vertebral compression fracture (OVCF) can lead to lower back pain and may be even accompanied by scoliosis, neurological dysfunction and other complications, which will affect the daily activities and life quality of patients. Vertebral augmentation is an effective treatment method for OVCF, but it cannot correct unbalance of bone metabolism or improve the osteoporotic status, causing complications like lower back pain, limited spinal activities and vertebral refracture. The post-operative systematic and standardized rehabilitation treatments can improve curative effect and therapeutic efficacy of anti-osteoporosis, reduce risk of vertebral refracture, increase patient compliance and improve quality of life. Since there still lack relevant clinical treatment guidelines for postoperative rehabilitation treatments following vertebral augmentation for OVCF, the current treatments are varied with uneven therapeutic effect. In order to standardize the postoperative rehabilitation treatment, the Spine Trauma Group of the Orthopedic Branch of Chinese Medical Doctor Association organized relevant experts to refer to relevant literature and develop the "Guideline for postoperative rehabilitation treatment following vertebral augmentation for osteoporotic vertebral compression fracture (2022 version)" based on the clinical guidelines published by the American Academy of Orthopedic Surgeons (AAOS) as well as on the principles of scientificity, practicality and advancement. The guideline provided evidence-based recommendations on 10 important issues related to postoperative rehabilitation treatments of OVCF.