Objective To explore the efficacy of borneol and Norfloxaein in treating patients with stage IV pressure sore. Methods 132 patients with pressure sore were randomly divided into the obser-vation group(applying borneol and Norfloxaein)and the control group(applying iodophors and gentamycin). The effect of the two methods was compared. Results The curative rate of the observation group was 98.5%,and 47.7% for the eantrol group. Total effective rate of the observation group was 100%,and 81.5% for the control group.The average curative time for the observation group was shorter than that of the control group. Conclusions Borneol and Norfloxaein is superior to iodophors and gentamycin in treating pa-tients with stage Ⅳ pressure sore.

Objective To study the clinical effect of trimetazidine on patients with unstable angina pectoris. Methods133 patients with unstable angina pectoris were randomly divided into regular group and trimetazidine group,the effects after two weeks' treatment were evaluated. ResultsThe therapeutic effect in trimetazidine group is much better than the regular group. ConclusionThe therapeutic effect of trimetazidine on unstable angina pectoris patients is definite.

Objective To explore the perioperative nutritional support and nursing countermeasures for laryngeal cancer patients. Methods 28 cases of hospitalized laryngeal surgery patients, in accordance with the working method of clinical pathway, finished product and homemade homogenate enteral nutrition was fed through nasogastric tube. Nutrition evaluation was finished by use of body mass index (BMI), blood biochemical indicators on 1d preoperation and 14 d postoperation, All indexes were compared between preoperation and postoperation. Results Nutrition assessment with BMI showed incidence of mild malnutrition as 10.7% and 14.3% on 1d preoperation and 14 d postoperation. Nutrition evaluation index such as HB, BUN was statistically significant, and BMI、 TLC、ALB、TP showed no statistical sisnificant difference between 1d preoperation and 14 d postoperation. Conclusions Clinical pathway in accordance with the working method, using the reasonable meal is laryngeal cancer patients homogenate perioperative enteral nutrition support a more scientific and deserves popularization of nursing countermeasures.

Brain-derived neurotrophic factor(BDNF)belongs to the neurotrophin family and abundantly expressed in the nervous system.It plays an essential role in the survival,development,function,morphogenesis and plasticity of neurons by binding to the tyresine receptor kinase B(TrkB)and subsequent downstream activation of several signal transduction pathways in the nervous system. The PI3K/Akt and the MAPK/ERK DathWays ale two major intracellular signaling network activated by BDNF involved in survival of neurons.Becently.it is investigated that BDNF and TrkB are involved in the pathophysiology of hypoxic ischemic brain damage (HIBD)and in the mechanism of action of therapeutic agents.Therefore we image changing the internal or external condIitions can increase the expression of BDNF,thsu reduce the nervous system damage of HIBD.

Objective To compare of pathogenic bacteria characteristics between praecox and tardus ventilator-associated pneumonia (VAP) in the elderly with critical illness,and to provide the guildline and evidence of clinical prevention and treatment. Methods The clinical data of 276 VAP patients aged (69.3 ± 5.3) years in our hospital were retrospectively analyzed.There were 97cases (35.14％) with praecox VAP,179 cases (64.86％) with tardus VAP.Vitek 32 system was applied to identify pathogenic bacteria. Results In patients with praecox VAP,105 pathogenic bacteria were isolated,among which 72 cases(68.57％) suffered from G- bacterium,21 cases (20.00％) from G+ and 12 (11.43％) from fungus. The most widely distributed pathogens were hemophilus (22.86％),streptococcus pneumoniae(14.28％ ) and staphylococcus aureus(14.28％).In the patients with tardive VAP,186 pathogenic bacteria were isolated including 117(62.90％) G- bacterium,54 (29.04％)G+ bacterium and 15 (8.06％) fungus; the most widely distributed pathogens were staphylococcus aureus (24.19％), pseudomonas aeruginosa (22.58％) and klebsiella pneumoniae (14.52％).The death rate of tardus VAP(24.58％) was significantly higher than of praecox VAP (10.31％ ) (x2 =8.14,P＜0.05).The durations in ICU and mechanical ventilation were much longer in tardus VAP[(10.3±4.2)d and (7.8±2.7)d] than in praecox VAP[(7.8±3.1) d and (3.7±1.1)d] (t=5.15,14.32,P＜0.05). Conclusions There is differences in pathogenic bacteria distribution between praecox and tardus VAP,and the prognosis of tardus VAP may be worse.

[Objective] To study the difference between stable angina(SA) and unstable angina(UA) on monocyte chemoattractant protein-1(MCP-1)and homocysteine(HCY)concentrations, to define its clinical meaning to angina. [Method] Select 67 cases of UA and 65 cases of SA, take 60 normal persons of similar age as healthy control group; col ect the vein blood within 12h at the last attack of UA group, col ect the vein blood in early morning for SA group and control one; measure serum MCP-1 and HCY with ELISA method. [Result] The MCP-1 and HCY levels had difference among al groups, among which, groups UA and SA were higher than control one, with difference of statistical meaning; while UA group was higher than SA group, with difference of statistical meaning. [Conclusion] In angina patients, the serum inflammatory factors MCP-1 and HCY levels are higher than healthy persons, UA higher than SA patients;to test MCP-1 and HCY levels is helpful to identifying and screening high-risk angina patients.

Objective To explore the clinical effectiveness of transcervical resection of polyps (TCRP) under hysteroscopes and dilatation and curettage in treatment for endometrial polyps infertility.Methods Ninety patients with endometrial polyps infertility from October 2010 to August 2012 were enrolled in this study.In them,45 patients were treated with TCRP under hysteroscopes (TCRP group),45 patients were treated with dilatation and curettage (dilatation and curettage group).Patients were followed up for 1 year,menstrual blood volume and endometrial thickness in ovulatory before operation and after operation for 3,6 and 12 months were recorded and compared between two groups.While the recurrence rate after operation for 6,12 months and 1-year pregnancy rate were also recorded and compared between two groups.Results The menstrual blood volume and endometrial thickness in ovulatory before operation between two groups had no significant difference (P ＞ 0.05).The menstrual blood volume after operation for 3,6 and 12 months in TCRP group was (125.2 ±56.4),(154.0 ±72.3) and (189.8 ±96.6) ml,respectively.While in dilatation and curettage group was (215.3 ± 87.8),(267.5 ± 98.4) and (297.5 ± 125.6) ml.There were significant differences (P ＜ 0.05 or ＜ 0.01).The endometrial thickness in ovulatory after operation for 3,6 and 12 months in TCRP group was significantly lower than that in dilatation and curettage group (P ＜ 0.05 or ＜ 0.01).The recurrence rate after operation for 6,12 months and 1-year pregnancy rate in TCRP group was 4.4％ (2/45),8.9％ (4/45)and 20.0％ (9/45) ; in dilatation and curettage group was 8.9％ (4/45),35.6％(16/45) and 26.7％ (12/45).The recurrence rate after operation for 12 months in TCRP group was significantly higher than that in dilatation and curettage group (P ＜0.01).Conclusions The prospective efficacy of TCRP under hysteroscopes in treatment of endometrial polyps infertility is better than dilatation and curettage.It is one of better methods and worthy to spread.

The onset of irreversibility of cardiovascular diseases caused by obesity has showed a rising trend,the underlying cause of the disease is the endothelial damage.Injury caused by obesity through four aspects:systolic and diastolic imbalance,anticoagulant and procoagulant imbalance,growth factors and growth factor imbalances and endothelial progenitor cell changes in endothelial damage.This paper reviews the reason and the mechanism of the endothelial damage through the change of the endothelial factors and progenitor cells.

Background and purpose:Patients with lung cancer often have metastases to the mediastinal and/or hilar lymph node.Three dimensional conformal radiation therapy(3-DCRT) has been used for the treatment of lung cancer.The delineation of the lymph nodes metastasis based on CT transections may be variable from doctor to doctor.It is necessary to standardize the definition of lymph nodes regions on CT scans.Methods:Retrospective studies were performed with the enhanced CT scans and/or PET/CT imaging of patients with NSCLC before treatment from November 2004 to November 2005.A series of thoracic enhanced CT scans from a middle stature female was selected as the model.Positive mediastinal and hilar lymph nodes were marked as red points on the CT model according to its relative position.Based on standardized definition of regional lymph nodes and the actual metastasized regional nodes on the images,the boundaries were delineated by Adobe Photoshop CS software and the metastasized regional lymph nodes were delineated on the Exomio 2.0 system.Results:Forty patients with enhanced CT data were enrolled in this study.Ten cases also underwent PET/CT examination.There were 278 positive lymph nodes that were detected and marked on the CT model.We defined the boundaries of regional lymph nodes of Group 1-2R,1-2L,3A,3P,4R,4L,5,6,7,8,10-11R and 10-11L,and delineated the above regional lymph nodes on template of CT model.Conclusions:Clear definition of mediastinal and hilar lymph region boundaries on CT images provides guidelines for the clinical staging of lung cancer and the contouring nodal drainage for 3-DCRT.It is essential to make target volumes more repeatable with good conformity in contour for conformal irradiation,which would benefit the clinical diagnosis,staging and therapy of lung cancer.

Implementation of the clinical pathway is key to the ongoing health reform in China. However,the hospital is faced with such hurdles as low incentive among the medical workers,low utilization rate,high pathway-deviation rate among others.Therefore,this paper combined management practices of a tertiary military hospital,analyzed factors influencing its application,and discovered the key factors for the pathway system.Then the corresponding countermeasures were formulated and implemented with significant effects.