OBJECTIVE:To observe clinical efficacy and safety of escitalopram combined with ozagrel sodium for elderly pa-tients with acute cerebral infarction complicated with anxiety and depression. METHODS:140 elderly patients with acute cerebral infarction complicating with anxiety and depression were divided into control group and observation group according to random number table method,with 70 cases in each group. Control group received routine treatment and Sodium ozagrel for injection 40-80 mg added into 0.9% Sodium chloride injection 500 ml,ivgtt,bid. Observation group was additionally given Escitalopram tablet 10 mg,qd. Both groups received treatment for 8 weeks. HAMA,HAMD,NIHSS and BI were compared between 2 groups before and after treatment,and clinical efficacy and the occurrence of ADR were observed. RESULTS:There was no statistical sig-nificance in HAMA,HAMD,NIHSS,BI before treatment and NIHSS,BI 1 week of after treatment between 2 groups(P>0.05). HAMA and HAMD of observation group 1,4,8 weeks after treatment,and NIHSS and BI of it 4,8 weeks after treatment were improved significantly;above indexes of control group were improved significantly 4,8 weeks after treatment,and the observation group was better than the control group,with statistical significance (P<0.05). The total effective rate of observation group was 87.14%,which was significantly higher than 74.29% of control group,with statistical significance(P<0.05). There was no statis-tical significance in the incidence of ADR between 2 groups(P>0.05). CONCLUSIONS:Escitalopram combined with ozagrel so-dium is significantly effective for elderly patients with acute cerebral infarction complicated with anxiety and depression,and can significantly improve anxiety,depression and neurological function with good safety.

Objective To investigate the influence of fixed nurse specialists triage to improve the quality of patient triage.Methods Nurses were divided into the fixed nurse specialist triage group (group A) and the out-patient department rotation nursing group (group B),respectively,each group was responsible for triage of patients in clinic of medical department for five days.Then the number of two subdiagnosis error and the average daily working overtime for doctors were compared.Results A total of 3806 patients were in clinic triage in group A,165 patients had triage error.A total of 3812 patients were in clinic triage in group B,308 patients had triage error.The average daily working overtime of doctors in group A was(5.24 ± 0.37)hours,and(8.16 ± 0.58) hours in group B.The errors in triage and working overtime of doctors had significant differences between two groups.Conclusions Fixed specialist nurse triage can significantly improve the quality of patient triage in clinic.

Crystal power/epoxy resin composite was made with refined crystal power as filling material in different composition. The shearing strength and coefficient of thermal expansion of the crystal powder/epoxy resin composite was studied. The sectional morphology was observed under a scanning electron microscope. The results of the study indicate that the shearing strength of crystal powder/epoxy resin composite is improved while the coefficient of thermal expansion decreases with increase of the amount of crystal powder, and a well-proportioned three-dimensional structure is obtained. The augmentation of shearing strength exhibits no linear relationship to the amount of crystal powder, and there is an optimal amount for crystal powder filling. The coefficient of thermal expansion is decreased with increase of crystal powder filling, and three-dimensional structure optimization exhibits the' similar inflexion.

As a social problem,college students'Internet Addiction has drawn attention widely.A lot of domestic areas and departments have done research on college students' Internet Addiction and achieved some sucess.On the basis of retrieval of papers on students' Internet Addiction,this article analyzes former research and brought up some proposals for the future research aimed at its deficiences.

As a social problem, Internet Addiction becomes more and more serious,and it has caused wide attention. This paper will state the diagnosis,types,causes,harm,integrated prevention and treatment of Internet Addiction.

OBJECTIVE To analyze the pathogens of severe pneumonia induced by different underlying diseases in(hospital) and to evaluate the difference of the pathogens to antimicrobial susceptibility test.METHODS The(bacteria) through sputum culture with VITEK-AMS,and the antimicrobial susceptibility against(bacteria) by K-B method were tested in hospital from 2002 to 2005.RESULTS There were 106 patients with 173 strains of isolated(pathogenic) bacteria,including Klebsiella pneumoniae(KPA) 20.9%,and Escherichia coli(ECO)(16.3%) from the aspiration severe pneumonia;Pseudomonas alcaligenes(PAL) 18.9%,P.aeruginosa(PAL)(16.2%) and Staphylococcus aureus(SAU) 16.2% from the obstructive severe pneumonia;KPN 22.6%,SAU(18.9%),and PAE 17.0% from the COPD complicated with severe pneumonia and PAE 25.0% and SAU 20% from the(hospital-)acquired pneumonia(HAP).CONCLUSIONS The constructed ratio of pathogens is different between(severe) pneumonia infected by different underlying diseases and community-acquired pneumonia without any(underlying) disease.The resistant pathogens are increasing significantly in cases with HAP.

Objective To investigate the effects of biatrial infusion on pulmonary artery pressure (PAP)after cardiopulmonary bypass (CPB) in patients undergoing mitral valve replacement.Methods Twenty NYHA Ⅱ or Ⅲ patients aged 22-53 yr weighing 34-57 kg undergoing mitral valve replacement complicated by pulmonary hypertension (mean pulmonary artery pressure (MPAP) ＞ 50 mm Hg) were randomly divided into 2 groups ( n = 10 each): infusion via right atrium group (group R) and infusion via both atria group (group B). After induction of anesthesia, a three cavity floating Swan-Ganz catheter was placed via right internal jugular vein to monitor CVP,PAP, pulmonary capillary wedge pressure (PCWP) and CO. The patients received infusion of prostaglandin E1 30-150 ng· kg- 1 · min - 1 and phenylephrine 0.2-0.6 μg· kg- 1 · min- 1 via central veins in group R and infusion of prostaglandin E1 30-150 ng·kg-1 ·min-1 via central veins and phenylephrine 0.2-0.6 μg·kg-1 ·min-1 via left atrium in group B. MAP, HR, MPAP, PCWP, CVP and CO were recorded 5 min before administration (T0), and 5,10, 30 and 60 min after administration (T1-4). Pulmonary vascular resistance index (PVRI), systemic vascular resistance index (SVRI) and CI were also calculated. Results D:\1111111111\MDB\zhmzxzz98201008.mdbCompared with the value at T0, MAP, MPAP, PCWP and PVRI were significantly decreased, while CI was increased at T1-4 in group R, and MAP, CI and SVRI were significantly increased, while HR, MPAP, PCWP, CVP and PVRI decreased at T1-4 in group B ( P ＜ 0.05).MAP, CI and SVRI were significantly higher, while HR, MPAP, PCWP, PVRI and CVP lower in group B than in group R ( P ＜ 0.05). Conclusion Biatrial infusion can effectively reduce PAP and pulmonary vascular resistance after CPB in patients undergoing mitral valve replacement.

Objective To detect the DMD gene mutation sites and the regions of breakpoints in Duchenne/Becker muscular dystrophy (DMD/BMD) patients in northern China. Methods Multiplex amplifiable probe hybridization (MLPA) was used to detect the mutation in 59 cases (51 cases with DMD and 8 with BMD) from northern China and dystrophin gene mutations in their parents. Results From northern China and dystrophin gene mutations 59 families found gene deletions in 33 cases of 59 DMD/BMD patients (55.9%), duplications in 6 cases (10. 2%) and point mutation in one case (1.7%). Intron 44 was most frequently affected (n = 13, 33.3%), followed by intron 50 (n = 11, 28.2%) and intron 45 (n=8, 20.5%). The novel mutations were identified, in two patients including two independent duplications carried by patient D1 149 and a point mutation [5208del(A)] carried by patient D1 65, which were not included in Leiden database. In addition, an exon 22 deletion was found in one patient, which was the first reported case in Chinese patients. Conclusions Deletions are mostly located in the hotspot between exon 45 and 50. Duplications mostly occurred in the 5' end of the gene. Intron 44 is the most frequently affected breakpoint in northern Chinese population.

Objective To observe the effect of ulinastatin in the treatment of children with severe pneumonia. Methods 86 children with severe pneumonia were divided into two groups according to the hospital card number:treatment group(n=45) and control group(n=41).All of them were given routine treatment,while the patients of the treatment group were given ulinastatin(5 000 U· kg-1 · time-1 ,1-2times/d,7d) in addition.The time of tem-perature drop to normal,the time of dyspnea improve,the time of dyspnea disappear,the time of lung rale disappear and length of hospital stay were observed.Then,the therapeutic effect was evaluated after treatment for 7 days.Results The treatment group had 21 cases excellence,21 cases improvement and 3 cases failure, the total effective rate was 93.33%,the control group had 17 cases excellence,15 cases improvement and 9 cases failure,the total effective rate was 78.04%,there was significant difference between the two groups(χ2 =4.17,P<0.05).The time of temperature drop to normal,the time of dyspnea improve,the time of dyspnea disappear,the time of lung rale disappear and length of hospital stay in the treatment group were (3.37 ±1.51)d,(3.12 ±1.72)d,(7.15 ±2.45)d,(10.75 ±2.47)d, respectively,which in the control group were (5.02 ±1.78)d,(4.82 ±1.51)d,(9.08 ±2.85)d,(13.22 ±2.85)d, there were significant differences between the two groups(t=4.71,4.91,3.42,4.41,all P<0.01).Conclusion Ulinastatin has good effect on children with severe pneumonia.It has value in application.

Objective In order to prevent the infection of Acinetobacter baumannii and use antibiotics rationally,the clinical infection and drug resistant data of multi-drug resistance Acinetobacter baumannii (MRAB)detected in intensive care unit (ICU)of Beijing Friendship Hospital from 2011 to 2013were analyzed.Methods This study is a retrospective study.One hundred and eighty five strains of MRAB were collected from the patients in ICU from January 2011 to December 2013.Identificationand antibiotic susceptibility of strains were determined with Vitek-2 Compact automatic bacteria identification system.The annual infection rate of MRAB was counted.PCR was used to detect the resistance genes.The clinical features of the patients with MRAB were analyzed.The average age,acute physiology and chronic health evaluation (APACHE) Ⅱ score,duration in ICU and mortality ratio of the MRAB patients were compared with the patients without MRAB.Rank-sum test was used to analyze the average age,APACHE Ⅱ score and duration in ICU.Chi-squared test was used to analyze the mortality ratio and annual infection rate.Results The average age [(67 ± 17)vs (59-± 19) years old,Z =-5.365,P =0],APACHE Ⅱ score [(25.68±7.93) vs (17.62±8.39),Z=-14.821,P=0],duration in ICU [(27 ±29) vs (5 ±8) d,Z =-4.342,P =0] and mortality ratio [10.82％ (53/185) vs 28.65％ (147/1 359),x2 =45.92,P =0] of the patients infected by MRAB were significantly higher than those without the infection.The MRAB was found mostly in sputum and bronchial precipitates (83.78％,155/185).Though detection rate reduced yearly and there was a significant reduction in 2013 compared with 2011 [11.07％ (69/469) vs 8.37％ (52/621),x2 =8.755,P =0.003],the drug resistant rate was in high level and did not show any change in the 3 years.OXA-23 and OXA-51 were detected in all MRAB.Conclusions The main drug resistant mechanism of MRAB in ICU is related to OXA-23.More active methods of coutrol and prevention of MRAB should be used in elderly aud severely pneumonic patients.Intensive disinfection and isolation measures can decrease MRAB detection rate.Combined antibiotics should be used in patients with MRAB infection.