Objective To explore the effect of air impact method clearing out the subballonet secretion on the prevention of ventilator-associated pneumonia(VAP) for ventilation patients.Methods 108 cases from ICU who received mechanical ventilation were selected.Patients were divided into the observation group and control group according to odd and even numbers,54 cases in each group.The control group was received conventional airway management,and the observation group received air impact method on the basis of conventional management Results of blood gas analysis,vital signs,occurrence time of VAP,total incidence of VAP,mortality,OB,positive results during mechanical ventilation were observed.Results Occurrence time of VAP for observation group and control group respectively were (14.1 ± 5.2) d and (8.9 ± 3.8) d.VAP incidence in 1 week for observation group and control group respectively were 7.4% (4/54) and 27.8% (15/54).Test positive result of secretion OB for observation group and control group respectively were 16.7% (9/54) and 3.7% (2/54).Total Incidence of VAP for observation group and control group respectively were 33.3% and 37.0%.Differences of occurrence time of VAP,VAP incidence in 1 week and test positive result of secretion OB for two groups were statistically significant (t =5.933,x2 =7.728,4.960,all P ＜ 0.05).Differences of results of blood gas analysis,vital signs,total incidence of VAP,mortality for two groups had not statistically significant.Conclusion Air impact method cleating out the subballonet secretion is simple and safe.Occurrence time of VAP was delayed.Incidence of VAP in one week decreases.,which creates opportunity for rescuing patients.

Objective To evaluate the application of serum procalcitonin(PCT)eetection in patients with severe infection. Methods Seventy-six infectee patients in respiratory intensive care unit(RICU)of the First People′s Hospital of Shangqiu were selectee as our subjects. Patients were eivieee into A group(28 cases of general bacterial infection),B group(36 cases of severe bacterial infection ),C group(12 cases of viral infection). Serum PCT was eetectee at the 1st,3re,5th,7th,9th eays after hospitalization. Results PCT concentration in A,B,C groups were((2. 7 ± 0. 8),(18. 9 ± 5),(0. 6 ± 0. 2))μg/ L respectively,ane there was significant eifference between 3 groups(F = 213. 73,P = 0. 000). The PCT level in B group was higher than of A group,ane PCT in A group was higher than in C group( all P < 0. 05). In B group,PCT concentration at 1st,3re,5th,7th,9th eays after treatment were((18. 9 ± 5),(18. 3 ± 5. 7),(16. 4 ± 5. 5), (12. 2 ± 4. 1),(8. 5 ± 2. 8),(6 ± 2. 1))μg/ L. In A group,PCT concentration at before treatment,1st,3re,5th, 7th,9th eays after treatment were((2. 7 ± 0. 8),(2. 6 ± 0. 7),(2. 3 ± 0. 8),(1. 7 ± 0. 6),(1. 3 ± 0. 5),(0. 9 ± 0. 3))μg/ L respectively. There were significant eifferent between two groups(F between group = 626. 07,F inner group = 75. 21,F interaction = 43. 36,P < 0. 01). After 5 eay antibiotic treatment in two group,PCT concentration at post-treatment were significantly eecreasee comparee with pre-treatment( P < 0. 01). Conclusion The eetection of serum PCT is valuable for eiagnosis ane evaluation of the eegree of clinical bacterial infection. PCT monitor can be usee to evaluate the therapeutic effect,ane assist the clinician to juege the prognosis.

Objective To investigate the feasibility of alanine aminotransferase (ALT)/aspartate aminotransferase (AST) ratio in predicting the degree of hepatic steatosis in chronic hepatitis C (CHC) patients.Methods A total of 231 CHC patients who visited The First People's Hospital of Nanyang from May 2012 to June 2016 were enrolled,among whom 105 (45.45％) had nonalcoholic fatty liver disease (NAFLD) and 126 (54.55％) did not have NAFLD.According to the ultrasound score,the NAFLD group was divided into mild-to-moderate (1-2 points) hepatic steatosis group (n =67) and severe (3 points) hepatic steatosis group (n =38).The two groups were compared in terms of demographic data and disease data including creatinine,fasting blood glucose,ALT,AST,ALT/AST ratio,γ-glutamyltransferase (GGT),uric acid,low-density lipoprotein,high-density lipoprotein (HDL),cholesterol (CHO),and triglyceride (TG) to screen out independent risk factors for NAFLD in CHC patients.The independent samples t-test was used for comparison of normally distributed continuous data between groups,and the Wilcoxon rank sum test was used for comparison of non-normally distributed continuous data between groups;the chi-square test was used for comparison of categorical data between groups;with severe NAFLD as the dependent variable,different factors were introduced into the logistic regression equation to screen out independent risk factors.Results Compared with the non-NAFLD group,the NAFLD group had significantly higher systolic pressure,diastolic pressure,fasting blood glucose,ALT/AST ratio,and levels of ALT,GGT,HDL,CHO,and TG,as well as a significantly higher proportion of patients with diabetes,hypertension,or metabolic syndrome (all P ＜ 0.05).Compared with the severe hepatic steatosis group,the mild-to-moderate hepatic steatosis group had significantly lower systolic pressure,diastolic pressure,fasting blood glucose,ALT/AST ratio,and levels of ALT,GGT,HDL,CHO,and TG,as well as a significantly lower proportion of patients with diabetes,hypertension,or metabolic syndrome (all P ＜ 0.05).The logistic regression analysis showed that metabohc syndrome,ALT,and ALT/AST ratio were independent risk factors for NAFLD (all P ＜0.05),and metabolic syndrome,ALT,ALT/AST ratio,and GGT were independent risk factors for severe NAFLD (all P ＜ 0.05).Conclusion ALT/AST ratio is an independent risk factor for NAFLD in CHC patients and has a certain value in evaluating the degree of NAFLD.

Objective To explore the value of transvaginal combined with transabdominal ultrasound examination in diagnosing ectopic pregnancy. Methods The data of 68 cases with ectopic pregnancy examined by transabdominal ultrasound and then by transvaginal ultrasound were analyzed retrospectively. Results. Rates of discovering the diseases of combined examination were distinctly superior to that by any of the single examination. Conclusion Transvaginal combined with transabdominal ultrasound examination could improve accuracy in diagnosing ectopic pregnancy with high clinical merit.

Objective To study the clinical effects of recombinant human epidermal growth factor (rhEGF) gel combined with tacrolimus treatment on facial hormone-dependent dermatitis, and to investigate its influence in skin function and recurrence of dermatitis. Methods Forty-eight outpatients with facial hormone-dependent dermatitis were randomly divided into treatment group (n=24, treatment with tacrolimus combined rhEGF gel) and control group (n=24, treatment with tacrolimus). The moisture of skin, sebum content and transepidermal water loss (TEWL) were examined before treatment and 4 weeks after treatment in two groups. Eczema area and severity index (EASI) were calculated at 1 week, 2 weeks and 4 weeks after treatment. The adverse reactions and recurrence of dermatitis were observed during the treatment as well. Results Compared with pre-treatment, the moisture of skin and sebum content were increased (P<0.05) and the TEWL was decreased (P<0.05) after 4-week treatment. The differences were not statistically significant between two groups. The obvious effective rate of the treatment group (45.8%) was not significantly different from that of the control group (20.8%) after 1 week of treatment (P>0.05), but it is much higher in treatment group after two-week treatment (79.2%vs. 50.0%, P<0.05) and after four-week treatment (91.2% vs. 62.5%, P<0.05). Furthermore, there was no adverse reaction in the treatment group, and the recurrence rate was much lower in treatment group (12.5%) than that of the control group (37.5%,χ2=4.03,P<0.05). Conclusion Recombinant human epidermal growth factor gel has an auxiliary curative effect on facial hormone-dependent dermatitis and can significantly improve skin function, and the recurrence rate of dermatitis is low.

Object To develop and utilize a folk-medicine of Yunnan Province, Lethariella cladonioides (Nyl.) Krog. Methods The constituents were extracted with 80% ethanol and isolated with silica gel column chromatography. The structures were identified by physicochemical properties and spectral analysis. Results Two unknown constituents were elucidated from the extract as 3-aldehyde-6-methyl-2, 4-dihydroxy-ethyl-benzoate (Ⅰ), and 4-methyl-2, 6-dihydroxy-benzaldehyde (Ⅱ). Conclusion They are both new constituents obtained firstly.

Mild Cognitive Impairment(MCI)is a transitional stage during the progress of cognitive Impairment. Through the analysis of the relativity of apolipoprotein E(apoE),apoE genetic polymorphism,phlegm stagnation and blood stasis,hyperlipemia and MCI,we got this conclusion:syndrome of phlegm stagnation and blood stasis is an important underlying pathogenesis of MCI:the syndrome of phlegm stagnation and blood stasis has a close relation to apoFe4 allele,and lipid-metabolism disturbance is a key link to this relation.

18F-FDG PET-CT is of great significance in non-small cell lung cancer diagnosis, staging, treatment options, efficacy evaluation and prediction of prognosis. But it has non-specificity, and its application is limited. In recent years, a number of new non-18F-FDG imaging agents is constantly developed and used clinically, which contributes to the PET -CT's further development and application in lung cancer.

Objective To investigate the effects of oral calcium and active vitamin D on bone mineral density and balance function in senile osteoporosis patients.Methods A prospective casecontrol study was conducted on 216 senile osteoporosis patients who met the inclusion criteria.Patients were given oral calcium and active vitamin D for 12 months.The data values of BMD,balance function,falls incidence and bone pain were compared before versus 6 and 12 months after treatment.Results There were significant differences in BMD of lumbar vertebrae and femur neck,static balance function assessed by the single-leg stance timed tests with closed eyes,dynamic balance function assessed by the Star Excursion Balance Test(SEBT) in directions of east,southeast,south and southwest(all P＜0.05).The incidence of falls was decreased 12 months after treatment as compared with pre-treatment(5.6％ vs.12.5％).The bone pain had no significant difference before versus after treatment(P＞0.05).Conclusions Oral calcium and active vitamin D could increase BMD,improve the balance function and decrease the risk of falls in senile osteoporosis patients.However,it has no significant improvement on bone pain within a short period.

OBJECTIVE:To observe the efficacy of levoamlodipine besylate combined with piracetam for vascular dementia(VD).METHODS:66 patients with VD were enrolled:33(treatment group) were assigned to receive Levoamlodipine besylate 2.5～5 mg q.d plus piracetam 0.8 g tid for 3 months,and another 33(control group) to receive piracetam 0.8 g tid plus basic treatment based on patients' blood glucose,blood pressure and blood lipid levels.The patients were given 3-month follow-up.Mini-Mental State Examination(MMSE),Activity of Daily Living Scale(ADL),Hasegawa Dementia Scale(HDS) and Wechsler Memory Scale(WMS) were used to evaluate the patient's cognitional function and mental state before and after treatment.RESULTS:MMSE,ADL,HDS,and WMS scores after treatment were(22.48?3.25),(25.16?8.96),(23.14?2.91),(71.14?19.01),respectively in treatment group versus(20.56?3.18),(29.74?13.01),(20.41?6.25),(60.35?20.60),respectively in control group.The treatment had a better improvement in symptoms than control group did and there was statistical difference between groups(P