Objective:To discuss the relevant factors between occurrence rate of ventilator associated pneumonia (VAP) and sedative therapy of patients adopted mechanical ventilation in intensive care unit (ICU) so as to improve strategy of sedation and reduce occurrence rate of VAP.Methods: The clinical data of 218 patients of ICU who were implemented mechanical ventilation combined with sedative were retrospectively analyzed. All of patients were divided into observation group (61cases) and control group(157cases) according to whether happened VAP. And the differences of sedative time, score of sedation, time of mechanical ventilation and stayed time in ICU between the two groups were analyzed and compared.Results: In observation group, the total sedative time was (7.51±7.86)d, score of sedation was (-2.69±1.09), time of mechanical ventilation was (8.52±17.11)d and stayed time in ICU was (24.44±21.93)d. In control group, all of these indicators were (3.83±2.91)d, (-1.22±1.52), (6.47±5.70)d, and (11.63±7.49)d, respectively. And the differences of them between the two groups were statistically significant (t=6.8850,t=5.0334,t=7.8012,t=6.4368,P<0.05).Conclusion: The sedative time, sedative depth of patient adopted mechanical ventilation are positively relevant with the occurrence rate of VAP, and the occurrence rate can be reduced through improving the strategy of sedation.

Objective To evaluate the effect of locking plate in the treatment of proximal humerus fractures and to compare the results of two approaches used for fixation.Methods Surgical treatment of 47 cases of proximal humerus fractures in the elderly in Affiliated Hospital of Yan′an University from September 2014 to September 2015.All fractures were randomly divided into two groups and treated with Phlios plate.Deltoid splitting and deltopectoral approaches were used for fixation respectively 23 cases and 24 cases.Postoperative shoulder function was evaluated according to Neer Score.Results The operation time,length of incision,intraoperative bleeding,fracture healing time,length of hospitalization in thoracic deltoid muscle group were more than deltoid splitting pathway group((90.1±6.3) min vs.(73.0±9.5) min,(10.0±3.5) cm vs.(6.3±2.6) cm,(100.0±30.1) ml vs.(90.6±36.4) ml,(3.2±0.8) months vs.(3.0±0.7) months,(10.3±1.9) d vs.(10.1±1.9) d),the difference of operation time(t=2.133,P=0.042) and length of incision(t=2.236,P=0.036) was statistically significant between the two groups,while the difference of the intraoperative bleeding(t=1.867,P=0.063),fracture healing time(t=1.064,P=0.242) and length of hospitalization(t=0.667,P=0.256) were not statistically significant.Followed up for 6.0-12.0 months,the average was (9.0±2.0) months,all patients achieved the bony healing.During the followed up,5 complication(10.6%) were encountered,including 2 cases of varus malunion,1 case of acromial impingement(115°-124°),1 case of screw cut-out and 1 case of humerus head osteonecrosis.The patients with tow-or three parts fractrues in tow groups,Neer-Score scores were statistically significant ((76.8±2.8) points vs.(76.1±2.6) points,(78.9±2.3) points vs.(77.8±2.4) points,t=2.76,2.58,P<0.05).There was no statistically significant difference between the four parts ((71.9±2.3) points vs.(72.6±2.1) points,t=1.06,P>0.05).The excellent-good rate in triangle muscle splitting approach group was 91.3%(21/23),of thoracic deltoid muscle group was 58.3%(14/24),there were significant different existed in two groups(P=0.023).Conclusion Locking plate for the treatment of proximal humerus fractures has a good effect.Deltoid splitting approach in the prognosis of function recovery has more advantages.

Objective:To observe the clinical efficacy of back-Shu and front-Mu points combination needling on balance and walking function in patients after stroke and its mechanism. Methods:A total of 79 patients with post-stroke balance and walking dysfunction were randomly divided into a control group and an observation group.Both groups received conventional treatments such as dietary guidance and oral medications as well as rehabilitation training.On this basis,the control group was treated with additional conventional acupuncture,and the observation group was treated with additional back-Shu and front-Mu points combination needling.Both groups were treated for 4 consecutive weeks.The thickness of abdominal muscle group(transverse abdominal muscle,rectus abdominis,obliquus internus abdominis,and obliquus externus abdominis),the scores of Berg balance scale(BBS),Fugl-Meyer assessment(FMA),and functional ambulation categories(FAC),and walking velocity and stride were compared between the two groups. Results:During the trial,there was 1 dropout case in the control group and 4 dropout cases in the observation group.Before treatment,there were no statistical differences in the abdominal muscle group thickness,scores of BBS,FMA,and FAC,and walking velocity and stride between the two groups(P>0.05).After 4 weeks of treatment,the thickness of abdominal muscle groups,scores of BBS,FMA,and FAC,and walking velocity and stride in both groups were improved(P<0.01),and the observation group was superior to the control group(P<0.05). Conclusion:Both conventional acupuncture and back-Shu and front-Mu points combination needling are conducive to the improvement of balance and walking function in patients after stroke.The back-Shu and front-Mu points combination needling method has better curative efficacy.Strengthening the core muscle group strength may be one of the mechanisms of back-Shu and front-Mu points combination needling treatment.

Objective To investigate the expression of paired amino acid cleaving enzyme 4 (PACE4) protein in non-small-cell lung cancer (NSCLC), analyze the correlation of its clinicopathologic characteristics, and investigate its significance in the process of occurrence, development, and metastasis of NSCLC.Methods Between January 2006 and May 2009, the First Affiliated Hospital of Guangzhou Medical College, 172 patients with NSCLC and 15 patients with non-neoplastic tissues were chosen.Immunohistochemistry was used to detect the expression of PACE4, and clinicopathologic characteristics of NSCLC were analyzed.Results (1)The positive expression rate of PACE4 protein in NSCLC was significantly higher than that in non-tumor tissues (P ＜ 0.05).PACE4 expression was observed in 111 of 172 (64.5％) NSCLC.PACE4 had cytoplasmic expression.(2)Clinicopathologically, PACE4 expression was significantly associated with lymph node metastasis (N stage) (P =0.007), and clinical stage (P =0.024).Conclusions High expression of PACE4 indicates that PACE4 may be involved in the processes of occurrence,development, and metastasis of NSCLC.

Objective To explore the value of vascular endothelial growth factor(VEGF) in predicting and mornitoring ovarian hyper-stimulation syndrome(OHSS). Methods 11 cases of OHSS patients and 16 cases of high-responder patients were enrolled in this study, respectively from IVF-ET or ICSI programme. Serum VEGF level before giving gonadotrophin, on the days of hCG administration, OPU and ET, and at the 7th and 14th days after ET as well as the VEGF level of follicular fluid (FF) on the day of OPU were measured. The serum VEGF of hospitalized women with severe OHSS were also measured during the whole therapy. Results Compared with high-responder patients, serum VEGF level on mid luteal and late luteal phases significantly increased in OHSS patients, and FF VEGF level obviously increased as well. Serum VEGF level gradually decreased along with clinical and biological improvement of OHSS. Conclusion FF VEGF level could predict the occurrence of OHSS, and serum VEGF level could monitor the progress of OHSS.

Objective To investigate the clinical and laboratory profiles of a case of infantile chronic mucocutaneous candidiasis due to malnutrition.Methods Skin specimens were collected and examined by KOH preparation,fungus culture,biochemical tests and molecular biological study.The pathogenic strain and antimicrobial susceptibility were defined.Results A 5 month-old-girl was presented with big head,and erythema,erosion and crust on her head,auricles,nostrils,oral cavity,neck and buttocks,and itching,for 1 month.Dystrophic hair and nails were observed.Candida albicans was isolated from specimens of the buttocks and Candida glabrata from the scalp.The abnormalities,CD16+ (56 6.5%),serum IgG (6.74 g/L),IgA (0.321 g/L),and albumin (18 g/L) were found with flow cytometry and immunoassays.Conclusion The patient is diagnosed as infantile chronic mucocutaneous candidiasis,who is immunocompromised due to protein malnutrition.

Objective To explore the effects of trans-theoretical model on the behaviors of foot serf-care in patients with type 2 diabetes mellitus.Methods One hundred and twenty patients with type 2 diabetes were recruited from a community in Guangzhou.The patients were randomly divided into control group (routine diabetic foot education) and experimental group (intervention based on tram-theoretical model of behavior change).Result Repeated Measures ANOVA showed that the main effects of intervention and time,as well as the interaction effect between intervention and time were all significant (P<0.05).The incidence rates of the chap of foot skin,paronychia and destruction of foot skin were significantly different between the two groups (P<0.05),while no significant difference on the incidence rate of foot ringworm was found (P>0.05).Conclusions The application of tram-theoretical model can promote the improvement of foot self-care behaviors and thereby to improve the condition of foot skin in patients with type 2 diabetes.

The compounds from the root of Rhododendron molle G. Don were isolated, purified by various chromatographic techniques, and their structures were identified according to the physical and chemical features and spectral data. Three compounds were separated from the root of Rhododendron molle G. Don and identified as Rhodojaponin-III, taraxerol, beta-sitosterol for the first time.
Diterpenes/*isolation & purification ; Drugs, Chinese Herbal/chemistry ; Oleanolic Acid/*analogs & derivatives ; Oleanolic Acid/isolation & purification ; Plant Roots/*chemistry ; Rhododendron/*chemistry ; Sitosterols/*isolation & purification

BACKGROUND: Neonatal hypoxic ischemic encephalopahty(NHIE) is a common neonatal disease, which could cause cerebral palsy, inferior intelligence and convulsion. At present, usual examinations for this disease are CT.MRI and single photon emission computed tomography(SPECT), etc.OBJECTIVE: To investigate the character of SPECT image of NHIE, and compared with CT and MRI as well to provide a theoretical gist for function surveillance and early intervention of NHIE.DESIGN: An observatory comparative study based on NHIE patients and normal neouates as control.SETTING: Department of nuclear medicine in a medical university hospital.PARTICIPANTS: Thirty neonates hospitalized in the Department of Pediatrics, Affiliated Hospital of Jining Medical College between September 1998 and October 2000 were selected as observation group with 23 males and 7 females. Another 10 normal neonates including 7 males and 3 females were randomly selected from same period into control group.METHODS: SPECT brain blood perfusion was conducted in the subjects of two groups and the results were compared with that of CT and MRI.MAIN OUTCOME MEASURES: ① comparison of SPECT brain blood image features between NHIE and normal neonates; ② comparison of SPECT images and CT, MRI results. RESULTS: In 22 NHIE cases who received SPECT, CT and MRI simultaneously, mild group had 7 cases, and positive cases of SPECT, CT or MRI was 7, 3 or 5; moderate group had 10 cases, and positive cases of three methods was 10, 8 or 9; severe group had 5 cases, the all of them were positive in all three examinations. The total positive detectable rate of SPECT, CT or MRI was 100, 72.73% or 86. 36%. There was no significant difference of sensitivity between SPECT and MRI in mild group, while there was significant difference between SPECT and CT(x2 = 3.95, P ＜ 0.05);there was no significant difference among three methods in either moderate group or severe group(x2 =0. 83, P ＞ 0.05).CONCLUSION: SPECT brain blood perfusion image is a quite sensitive method for the surveillance of NHIE, which can provide imageological reference for the evaluation of its prognosis and early intervention.

OBJECTIVE:To establish a method for the determination of antibacterial effect of Ofloxacin eye drop. METH-ODS:According to the requirements in Chinese Pharmacopoeia(2015 edition)antibacterial effect test,using Staphylococcus au-reus,Pseudomonas aeruginosa,Escherichia coli,Aspergillus niger and Candida albicans as test bacteria,colonycount method suit-ability test was conducted for Ofloxacin eye drop samples,the verified method was used to determine the number of viable bacteria at each time point,calculate the bacteria number of 1 mL in the sample and the number of bacteria at each time point and convert to lg value. RESULTS:Ofloxacin eye drop sample can reach the standard of antibacterial effectiveness of theB. CONCLU-SIONS:The method can effectively determine whether the antibacterial effect of Ofloxacin eye drop fits the standard.