OBJECTIVE To investigate current status of ventilator-associated pneumonia(VAP) and to provide prevention measures associated with nursing.METHODS Clinical data,such as incidence,categories of pathogenic bacteria and prevention measures associated with nursing,were retrospectively analyzed in 106 patients who received ventilator treatment in our hospital during 2004-2006.RESULTS The positive rate of microorganism culture in these patients was 95.3%.Totally 178 strains of microorganisms were cultured,including 63 strains of fungi,48 strains of nonfermanters,34 strains of Staphylococcus,33 strains of Enterobacteriaceae.There were many risk factors contributed to pathogenesis of VAP.Among these factors,underlying disease was one of the important internal causes and invasive medical procedure was one of the important external causes.The incidence of VAP was reducing yearly as improving of prevention measures associated with nursing.CONCLUSIONS Nurse acts an important role in prevention of VAP.Enhancing nursing management,improving nursing procedure and adopting appropriate intensive care measurement will reduce incidence of VAP.

Objective To evaluate the effect of late course accelerated hyperfractionated irradiation combined with intraluminal hyperthermia for esophageal carcinoma. Methods From March 2000 to October 2002, totally 91 such eligible patients were entered into the prospective randomized control trial of late course accelerated hyperfractionated irradiation (LCAH-, 44 patients) versus LCAH combined with intraluminal hyperthermia ( LCAH-HT-, 47 patients). Radiotherapy regimen consisted of conventional fractionation radiotherapy (1.8 ?Gy/f, 5f/w, totally 41.4 ?Gy/23fx) during the first two-thirds of the radiotherapy course, followed by accelerated hyperfractionation radiotherapy (1.5?Gy/f, 2f/d, with 6 h interval), using the cone-down fields, to a total dose of 68.4?Gy/41fx . Hyperthermia was given weekly during conventional fractionation irradiation, totally 4 times. Results The CR and PR rates were 47.7% and 72.3%, 52.3%and 27.8% in the LCAH arm and LCAH-HT group,respectively(P=0.016). The median survivals were 30.3 and 30.6 months,the 1-,2-,3-year survival rates were 77.3%,57.4% ,37.3% and 80.5%,68.6%, 46.3%(P= 0.526 ), the 1-,2-,3-year local control rates were 86.3%,70.5%,56.5% and 92.4%,72.5%,65.5% (P= 0.686 )in the LCAH group and LCAH-HT group,respectively. Grade III and severer of esophagitis were 18.2% and 27.6% in LCAH and LCAH-HT (P= 0.498 ), Grade III and severer tracheitis were 11.4% and 19.2% respectively (P=0.191). Conclusions The immediate effect of LCAH combined with hyperthermia is better than that of LCAH alone. Additional hyperthermia to LCAH does not increase the likelihood of radiation injury.

An introduction to the Basic service module featuring holistic,full flow and seamless connection built by the hospital.Authors described their experiences in achieving homogenous clinical nursing care,and pointed out that integrating medical humanistic care into the daily nursing process,can improve doctor-patient relationship and patients satisfaction,thus raising medical service quality and efficiency.