Objective To study clinical effect of oral montelukast therapy in the treatment of 35 children with cough variant asthma.Methods 35 children with cough variant asthma were divided into the control group (17 cases)and observation group(18 patients).The control group was given oral procaterol hydrochloride,patients in the observation group were given oral montelukast sodium on the basis of taking procaterol hydrochloride.Results The total effective rate of the observation group (94.44%) was significantly higher than the control group (64.71%),the difference between the two groups was statistically significant (χ2 =4.832,P <0.05).In the two groups before and after treatment the maximum peak expiratory flow rate change had no statistically significant difference (P >0.05).After treatment,the FEV of the observation group (12.81 ±0.34)L was higher than that of the control group(2.32 ±0.45 )L,the difference between the two groups was statistically significant(χ2 =3.648, P <0.05).The FVC of the observation group (3.44 ±0.21)L was higher than the control group (2.98 ±0.15)L, the difference between the two groups was statistically significant (χ2 =7.417,P <0.05).The FEV1 /FVC of the observation group (68.31 ±6.44)was higher than that of the control group (58.46 ±6.49),the difference between the two groups was statistically significant (χ2 =4.505,P <0.05).The cough relief time of the observation group (4.45 ±1.32)d was lower than the control group (6.33 ±2.46)d,the difference between the two groups was statistically significant (χ2 =3.151,P <0.05).The cough symptoms disappear time of the observation group (7.63 ±1.96)d was shorter than the control group (10.61 ±1.84)d,the difference between the two groups was statistically significant (χ2 =4.639,P <0.05).In the two groups before and after treatment the liver and kidney function and blood,urine routine had no significant changes.No adverse reaction occurred during the treatment.Conclusion Steiner conven-tional therapy combined with montelukast in the treatment of children with cough variant asthma can rapidly relieve symptoms of cough,significantly improve lung function,reduce the recurrence rate,no adverse reactions,and signifi-cantly improve clinical efficacy,it is worthy of clinical application.

OBJECTIVE To investigate the status and risk factors of nosocomial infections in geriatric department and to lay down the intervention strategy.METHODS Prospective monitoring and retrospective investigation were carried out to analyze 218 cases of nosocomial infection in geriatric department.RESULTS The lower respiratory tract infection was the main one in geriatric department(69.4%),which was followed by urinary tract infection(22.5%).The risk factors included old ages,prolonged hospitalization,using broad spectrum antibiotics widely,severe underlying illness,invasive operating manipulation and so on.CONCLUSIONS General intervention strategy should be adopted to control the nosocomial infections in geriatric department in order to cut down the infection rate and increase the rate of curing.

OBJECTIVE To explore the risk factors in aged patients with ventilator-associated pneumonia(VAP) and to provide the corresponding clinical prevention strategies. METHODS The ages,underlying diseases,mechanical ventilation method,use of antibiotics,and pathogenic bacteria of the VAP patients were investigated and analyzed. RESULTS Totally 155 VAP of elderly patients had serious underlying diseases,and treated with broad-spectrum antibiotics,tracheal intubation or trachea incision.Most pathogenic bacteria were mutiple-resistant. CONCLUSIONS The prevention of VAP was in priority for control of VAP patients.In order to control the occurrence and spread of VAP,clinicians should cut the time of ventilator,pay more attention to sterilization and isolation,and strengthen the tend of the patients.

Objective To explore the application value of pulse induced contour cardiac output (PiCCO) monitoring in diagnosis and treatment of patients with neurogenic pulmonary edema (NPE).Methods With review of literature, the data of 4 patients of severe neurological disease complicated by NPE admitted into Department of Critical Care Medicine of Huangshan People's Hospital Affiliated to Wannan Medical College from 2011 to 2013 were retrospectively analyzed and discussed in their PiCCO hemodynamic characteristics and processes of treatment.Results The PiCCO of 4 patients with NPE showed that the extravascular lung water index (EVLWI) was increased significantly (EVLWI was 12 - 42 mL/kg on admission and 10 - 22 mL/kg after hospitalization for 24 hours), all revealing a high permeability pulmonary edema type. The capacity balance of the first 24 hours in the 4 cases was all of positive balance (+1 130, +1 200, +1 750, +1 120 mL respectively). In the treatment, the supplementary colloid was strengthened, the vasoactive drugs such as, dopamine, dobutamine, milrinone, etc were applied to improve the circulatory oxygenation, then the EVLWI was declined; finally the disease situation in 3 cases was improved and one died.Conclusions The clinical diagnosis and treatment of NPE is complex, and many contradictions appear in the therapeutic course. PiCCO monitoring is valuable in early diagnosis, identification of pulmonary edema type, guidance in fluid supplement and vascular active drug application, and assessment of disease severity and prognosis.