Objective To understand the clinical characteristics of lower respiratory tract infection,pathogenic distribution and drug resistance in intensive care unit to provide a basis for reasonable use of antibiotics. Methods From January 2008 to August 2010,the clinical data from our hospital ICU impatients of lower respiratory tract infection were retrospectively analyzed. The isolated strains were identified, the antibiotic susceptibility test was performed by K-B methods and the results were read according to CLSI 2007. Results There were 509 patients, 147 cases of lower respiratory tract infection were found. Lower respiratory tract infection rate was 28.9% (147/509); 283 strains of pathogens had been isolated by culture and most of which were Gram negative bacilli(86. 9%), the other pathogens included Gram positive cocci(7.4%) and fungi(5.7%). The most common pathogens were Acinetobacter spp, Pseudomonas aeruginosa, Klebsiella pneumoniae,Stenotrophomonas oligotrophic aeromons, Fungi, Escherichia coli, Staphylococcus aureus, Burkholderia cepacia,etc,accounting for 24. 7% ,20. 5% ,12. 7% ,6. 4% ,5.7% ,5. 3% ,5.3% and 4. 6% ;The main pathogens were highly resistant to the most antibiotics. Conclusion ICU had a higher lower respiratory tract infection rate, Gram negative bacilli are the main pathogen, and showed the multi-drug resistance features to the antibiotics.

Objective To observe the effect of combination therapy with methotrexate,sulfasalazine and hydroxychloroquine on serum lipids in elderly patients with rheumatoid arthritis (RA).Methods 136 patients with RA were randomly divided into group A and group B (n=68,each).Patients in group A were treated with methotrexate,sulfasalazine and hydroxychloroquine sulfate plus life style intervention.Patients in group B were treated with the therapy as same as that of group A and received xuezhikang additionally.The levels of cholesterol (TC),low density lipoprotein cholesterol (LDL-C),triglyceride (TG),high density lipoprotein cholesterol (HDL-C),C-reactive protein (CRP),erythrocyte sedimentation rate (ESR) were determined before and 6 months after treatment.Disease activity was assessed by DAS28,swelling index,joint pain index,duration of morning stiffness.Results The levels of TC,TG and LDL-C were lower and HDL-C level was higher in the two groups after 6 months of the treatment than before treatment (all P＜ 0.05).DAS28,ESR,CRP,joint tenderness,joint swelling and duration of morning stiffness were significantly reduced in two groups after 6 months of the treatment as compared with pretreatment (all P＜0.05).There was no significant difference in levels of TC,TG,LDL-C,HDL-C,DAS28,ESR,CRP,joint tenderness,joint swelling and duration of morning stiffness between the two groups after treatment.There were no obvious differences in liver and kidney function between the two groups before and after treatment.Conclusions Blood lipids levels are abnormal in RA patients.The slow acting antirheumatic drugs have certain effect on blood lipids when alleviating disease symptoms.

Objective To observe the clinical effect of point-to-point acupuncture with electric stimulation of direct current induction for facial nerve paralysis. Methods A total of 65 patients with facial nerve paralysis were randomly divided into the observation group (n=33) and the control group (n=32). The control group received routine treatment, and observation group was received Dicang (ST4)-to-Jiache (ST6) and Yangbai (GB14)-to-Taiyang (EX-HN5) by acupuncture with electric stimulation of direct current induction combined with conventional western medicine. The treatment of both groups last 3 weeks. The House-Brackmann Scale and the BR indexe at baseline and after 3 weeks treatment were observed. Results After treatment, The clinical effect of observation group was 66.7%, which was significantly higher than control group 43.8% (U=2.175, P=0.013). After treatment, House-Brackmann facial nerve scale (Ⅰ level=15 cases, Ⅱ level=4 cases, Ⅲ level=3 cases) in the observation group was significantly better than that in the control group (Ⅰ level=5 cases, Ⅱ level=7 cases, Ⅲ level=2 cases; U=2.069, P=0.018). After treatment, R1 latency (12.28 ± 2.55 ms vs. 13.84 ± 3.07 ms, t=2.227) and R2 latency (32.28 ± 7.08 ms vs. 35.95 ± 5.11 ms, t=2.396) in the observation group were significantly shorter than those in the control group (P=0.030, P=0.020). Conclusions The point-to-point acupuncture with electric stimulation of direct current induction could reduce latency of R1 and R2 for facial nerve paralysis, and improve the clinical effect.

The incidence of open-angle glaucoma has been rising year after year in China, which has caught much at-tention from ophthalmologists.There are various methods to evaluate the disease progression of an open-angle glaucoma pa-tient.These methods can be divided into two classes:functional assessment and structural assessment.We survey these two classes of methods in this paper.

BACKGROUND:Numerous studies have demonstrated that mild hypothermia has a better protective effect on neurons after cerebral infarction.
OBJECTIVE:To investigate theeffect of mild hypothermia on nerve regeneration microenvironment of infarcted area in rat models of cerebral infarction and analyze its possible effects on neural functional recovery after cerebral infarction.
METHODS:Twenty out of 65 adult femaleSprague-Dawleyrats were randomly selected as the sham group. The remaining 45 rats were subjected to carotid artery ligation to establish rat models of cerebral infarction. Five rats were rejected because of modeling failureor death, the remaining 40 rats were randomly and evenly divided into cerebralinfarction and mild hypothermia groups. The head temperature of rats in the cerebral infarction group was downregulated to (37±1)℃ using a semiconductor refrigeration instrument. The rats were transferred to the room with the temperature of 25℃ after the operation. Brain hypothermia was also induced in rats from the mild hypothermia group. At 13.0-14.0 minutes after establishing rat models of cerebral ischemia, the head on the side of cerebral ischemia was tightly connected with the probe of the semiconductor refrigeration instrument. The refrigerator temperature was adjusted to 6-8℃, so as to make the temperature of brain tissue on the lesion side at 32.0-33.0℃ for 4 hours.
RESULTS AND CONCLUSION:Compared with the cerebral infarction group, the BBB scores of rats inthe mild hypothermia group were distinctly increased, and the volume of infarcted area decreased. At 1 day after modeling, the expression level of growth associated protein 43 mRNA in brain tissue of rats in the mild hypothermia group was close to that in the cerebral infarction group. At 2 weeks after modeling, the expression level of growthassociated protein 43 mRNAin brain tissue of rats in the mild hypothermia group was significantly increased compared with that in the cerebral infarction group. These results suggest that mild hypothermia therapy can protect nerve cels against injury caused by cerebral infarction and promote the recovery of neurological function. Its underlying mechanism may be related to the up-regulation of the expression of growth associated protein 43 in ischemic penumbra .

Objective To observe the effect and safety of modified Yishen Zhuyang Huoxue Huazhuo Formula for polycystic ovarian syndrome (PCOS) in the TCM pattern of deficiency of spleen and kidney with phlegm-dampness. Methods Totally 123 cases were recruited into this study and randomized to two groups by central random approach, 64 cases in the observation group and 59 cases in the control group. Patients in the observation group were given the modified Yishen Zhuyang Huoxue Huazhuo Formula, while those in the control group were given compound cyproterone acetate tablet, for two treatment courses, three months for one course. The changes of ovarian volume and the number of follicles before and after treatment were observed. Adverse reactions were also evaluated. Results Bilateral ovarian volumes in both groups decreased after treatment (P<0.05, P<0.01), while the control group showed a significant better improvement (P<0.05). The number of follicles in the two groups decreased, but no significant difference were observed between the two groups (P>0.05). The rate of adverse reaction in the observation group was lower than the control group. Conclusion Modified Yishen Zhuyang Huoxue Huazhuo Formula is effective for PCOS patient by reducing the ovarian volume with a low incidence of side effect.

Objective To discuss incidence and related risk factors of vascular cognitive impairment (VCI) after acute subcortical infarction (SI).Methods One hundred and eighty-two patients with acute SI were divided into two groups:VCI group (81 cases) and no-VCI group ( 101 cases) according to VCI diagnostic standard.Sex proportion,age,culture degree between two groups were compared,and correlation was analyzed between the quantity of risk factors and the incidence of VCI.Results The incidence of VCI after acute SI was 44.5％(81/182).According to age stratification,the incidence of VCI in the patients of 56-65 years was 35.4％ (23/65),in the patients of 66-75 years was 45.3％ (48/106),and in the patients of 76-85 years was 90.9％ (10/11 ).The age in VCI group was significantly higher than that in no-VCI group [(69.93 ±6.91) years vs. (67.62 ±5.56) years,P =0.014],and culture degree was significantly lower than that in no-VCI group (P =0.028).The sex proportion between two groups had no significant difference (P =0.876).The more accompanying risk factors,the higher incidence of VCI.Conclusions Along with the increase of age,the incidence of VCI after acute SI is higher.The more accompanying risk factors,the higher incidence of VCI.

Objective To evaluate the technology and application of dual-source CT urography. Methods 56 cases with clinical symptoms and dual-source CT urography were analyzed retrospectively through conventional plain scan, arterial phase scan, venous phase scan, which gained data were reconstructed 3D images of MPR, MIP, CPR and VR, and the im- ages were analyzed. Results The 3D images of kidneys, ureters and bladder were reconstructed successfully, which showed clearly the detail of the entire urinary tract and the local fine structure, morphology, taking shape and the relationship with the surrounding tissue through rotating and zooming. Conclusion Through the dual-source CT to scan the entire urinary tract is suitable for a variety of data acquisition of three-dimensional reconstruction, which can greatly enhance the focal positive rate and diagnosis rate.

Objective:To retrospectively evaluate whole body ~(18)F-FDG PET/CT in depicting the primary tomors in cervical metastatic adenocarcinoma of unknown primary site.Methods:Seventeen patients were included and underwent whole body PET/CT imaging.The primary tumors and metastases were detected by visual evaluation and measurements of standardized uptake values.The PET/CT impression was verified by histopathology and(or)follow-up.Results:In 17 patienis,primary tumors of 13 patients were confirmed by pathological or clinical follow-up.Among them,8 were in the lung,1 in breast,1 in renal,2 in colon and 1 in cervix.Among the other 4 cases,3 cases were correctly diagnosed as malignant lymphoma finally by PET/CT instead of metastatic adenoearcinoma previously.The sensitivity,specificity and accuracy of PET/CT in were 92.3%,75.0% and 88.2%,identifying primary tumors respectively.After PET/CT examination,10 patients(58.8%)were detected additional metastatic lesions which were missed previously.Conclusion:Whole body ~(18)F-FDG PET/CT may be of relatively higher value in identifying the primary tumor of cervical metastatic adenocarcinoma from unknown primary site.It also may display tumor involvement extent.

Objective To explore the application of the comprehensive pain assessment scale to the treatment of postherpetic neuralgia (PHN). Methods About 100 patients suffering from PHN were randomly divided into two groups: the control group and experiment group. The former was treated with recording for pain assessment and the latter was treated with the comprehensive pain assessment scale. Two sets of data were compared and analyzed in view of quality of sleep, average length of hospitalization and the duration of side effects of drugs. Result The effect of the experiment group was better than the control group in the quality of sleep, the average length of hospitalization, reduction of side effect duration of drugs (P<0.05). Conclusion The comprehensive pain assessment scale throughout the whole process of the PHN treatment can achieve timely and effective assessment of pain and reduce the side effect duration of drugs, improve their sleep quality, and shorten the hospital stay.