Hospital-acquired pneumonia (HAP) is a very common complication in patients with neurological diseases.Its incidence and mortality are very high and result in a prolonged hospital stay and an increase in hospitalization costs.Therefore,how to effectively prevent HAP has become the focus of attention by neurologists.There are many risk factors for HAP,such as advanced age,conscious disorders,dysphagia,body position,oropharyngeal colonization,mechanical ventilation,enteral nutrition,and stress ulcer prevention drugs,etc.Clearing the risk factors for HAP and taking appropriate measures to strengthen protection may reduce the occurrence of HAP and improve the prognosis of patients.

Physical activity is limited in maintenance hemodialysis (MHD) patients, and higher level of physical activity may result in less risk of death, milder depression or ahypnosis, less fatigue and better quality of life. Physical activity may relate with many factors. MHD patients may be benefited from exercise to improve the physical activity, mainly with aerobic exercise and resistance training during hemodialysis. Nurses can do more in health education and direction of exercise for MHD patients.

Objective To investigate the distribution and drug resistance of clinical common isolated bacteria from our hospital in 2013.Methods The antimicrobial susceptibility testing was carried out by using the automated systems with the MIC method and Kirby-Bauer method.The WHONET 5.6 software was adopted to conduct the data analysis according to the CLSI standard in 2013 version.Results A total of 4 168 strains of bacteria were clinically isolated in 2013,in which Gram-positive bacterial strains ac-counted for 21 .8%(907/4 168)and Gram-negative bacterial strains for 78.2%(3 261/4 168).The prevalence of methicillin-resist-ant strains in S.aureus and coagulase negative staphylococcus was 48.7% and 80.9% respectively.No staphylococcal strain with resistant and intermediate to vancomycin and linezolid was found.Penicillin-resistant S.pneumonia strain was not found.And 1 strain of vancomycin- resistant E.faecium was found.The prevalence of ESBLs - producing strains was 58.8% in E.coli and 35.8% in K.pneumonia.Non-fermentative bacilli accounted for 37.5% in all bacterial isolates.The percentage of P.aeruginosa re-sistant to imipenem and meropenem was 19.3% and 14.2% respectively,the percentage of A.baumannii resistant to imipenem and meropenem was 68.9% and 67.0% respectively.Conclusion The isolation rate of non-fermentative bacilli is increased,the drug re-sistance rate of P.aeruginosa and A.baumannii is declined than that in 2012.Strengthening the surveillance of bacterial drug resist-ance in hospital has important significance for guiding rational selection of antimicrobial agents in clinic.

Objective To study the efficacy of recombinant human thrombopoietin (rhTPO)for the treat-ment of chemotherapy -induced thrombocytopenia with leukemia.And to explore its security.Methods 80 thrombo-cytopenia of acute leukemia after chemotherapy were selected.All patients were randomly divided into the research group and the control group according to the single and double of order registration number in clinic,40 cases in each group.The control group was treated with recombinant human interleukin -11 (rhIL -11),the research group was applied rhTPO treatment.The platelet (PLT)level of two groups,and other indicators of change were detected,and adverse reactions were observed.Results PLT resuming maximum value of the research group was (217.4 ±52.7) ×109 /L,which was significantly higher than the control group,the difference was statistically significant (t =15.63, P <0.05).The time of PLT recovery to 100 ×109 /L of the research group after chemotherapy was (15.6 ±3.6)d, which was significantly lower than the control group,the difference was statistically significant (t =10.72,P <0.05). The adverse reactions incidence of the research group was 12.5%,lower than 35.0% of the control group,the differ-ence was statistically significant (χ2 =9.87,P <0.05).Conclusion The treatment effect of RhTPO for thrombocy-topenia of the acute leukemia after chemotherapy is better than that of rhIL -11,can significantly improve the throm-bocytopenia,and has less adverse reaction and higher security.It is worthy of clinical popularization and application.

Objective To observe and compare the efficacy and safety of chloroprocaine and ropivacaine for epidural labor analgesia.Methods 86 cases of voluntary acceptance of maternal painless natural childbirth were selected in the study.43 cases were given chloroprocaine epidural analgesia (chloroprocaine group),and the other 43 cases were given ropivacaine epidural analgesia (ropivacaine group).The pain (VAS score),lower limb motor block degree(MBS score),fetal heart rate(FHR) and contractions duration of maternal prenatal and medication immediately after 10min,20min,40min,80min were compared between two groups.The first,second and third stage of labor and fetal output after 1 min,5min,10min Apgar score were compared.The incidence of adverse events were observed.Results In the chloroprocaine group,the 10min VAS score was (2.10 ± 1.02),which was significantly lower than (4.31 ± 1.13) in the ropivacaine group (t =4.565,P ＜ 0.05).In the chloroprocaine group,analgesia 20min MBS score was (0.24 ± 0.03),which was significantly higher than (0.11 ± 0.04) in the ropivacaine group (t =4.126,P ＜ 0.05).In the chloroprocaine group,4 cases occurred nerve injury,which was more than the ropivacaine group (1 case),the difference was statistically significant (x2 =4.263,P ＜ 0.05).Conclusion Chloroprocaine and ropivacaine for epidural labor analgesia have superior efficacy and the clinical efficacy is similar.Chloroprocaine has the advantage of quick results,but the medication about 20min time period that the drug might lead to a greater degree of lower limb motor block,and has the risk of nerve injury,pregnant women can choose according to their medication.

Objective To investigate the effects of respiratory training on motor function in patients with acute stroke. Methods From 2012 to 2014, 80 patients with acute stroke were randomly assigned into treatment group and control group equally. The control group re-ceived routine rehabilitation training, while the treatment group received respiratory training in addition. All the patients were assessed with Fugl-Meyer Assessment (FMA) and modified Bathel Index (MBI) before and eight weeks after treatment. Results The scores of FMA and MBI improved more in the treatment group than in the control group (t>3.938, P<0.001) after treatment. Conclusion Respiratory training may promote the recovery of motor function in acute stroke patients.

Objective To explore the effects of oxidative stress in porcine iliac endothelial cells(PIECs) induced by high glucose. Methods After being intervened by high glucose for some time, dihydroethidium (DHE) or dihydrorhodamine 123 (DHR123) was used as a reactive oxygen species(ROS) capture. The mean fluorescent intensity(MFI) of above probes which were the products of intracellular oxidation was detected by fluorescent microscopy and flow cytometry, and the level of ROS was thus measured. With lucigenin as chemiluminescence agent, luminescence changes were detected by chemiluminescence analyzer after addition of NADPH to observe the effect of high glucose on activity of NADPH oxidase(NOX). Results Intracellular MFI was markedly elevated with the concentration of high glucose and time of exposure to high glucose. It was revealed by flow cytometry that the NOX activity was significantly activated compared with normal medium treated PIECs(P

Objective To explore the curative effect and prognosis of traditional Chinese medicine combined with western medicine in the treatment of silicosis patients.Methods 74 patients with silicosis were selected as the research subjects.According to the admission time,the patients were divided into the observation group and the control group,37 patients in each group.The control group was treated with conventional western medicine,the observation group was given the combined treatment of traditional Chinese medicine and western medicine.The clinical curative effect,pulmonary function index,symptoms improved time and the reduce of lung shadow were observed and compared.Results The reduction rate of lung shadow in the observation group was 75.67％,which in the control group was 62.16％,there was statistically significant difference between the two groups (u =2.419,P =0.015).The total effective rate of the observation group was 86.49％,which of the control group was 67.57％,there was statistically significant difference between the two groups (u =2.116,P =0.034).After treatment,the vital capacity (VC),forced vital capacity(FVC) and the first second forced expiratory volume (FEV1) in the observation group were (69.15 ± 18.34)％,(71.08 ± 16.93)％,(68.91 ± 18.75)％,respectively,which in the control group were (63.37 ± 20.53) ％,(63.13 ± 18.69) ％ and (55.47 ± 17.58) ％,respectively,which in the two groups were higher than those before treatment,which in the observation group increased significantly,there were statistically significant differences between the two groups (t =6.778,P =0.000,t =8.836,P =0.000,t =10.133,P =0.000).The wheezing,cough,pulmonary rales and other symptoms improved time in the observation group were shorter than those in the control group,the differences were statistically significant (t =8220,P =0.000,t =6.836,P =0.000,t =6.909,P =0.000).Conclusion Traditional Chinese medicine combined with western medicine in the treatment of silicosis has higher reduction rate of lung shadow,lung function improved significantly,shorter improved time of cough,wheezing and other symptoms,its curative effect is better than western medicine.

Objective To investigate the efficacy and safety of low-dose ammonia sulfur-sulfur-resistant treatment.Methods 120 patients with initial depression were randomly divided into a group(40 cases), the estercalyptrin group(40)and the drug group(40).The treatment was treated by the treatment of the ammonia sulfonate, 20 mg/d, 20 mg/d, and 20 mg/d of escitaloplan tablet.The clinical efficacy and response scale(TESS)was evaluated with the Hamilton depression scale(TESS)in the treatment of 1, 2, 4 and 8 over the weekend.Results Three groups showed significant improvement(P<0.01)during the 8th weekend of treatment of the HAMD scores.Grade 1 and 2 weekend, combined treatment group compared with single drug group score had significant difference(P<0.01), and the contrast between the single drug groups had no significant difference, 4 score over the weekend, and comparison between the three way were significant differences(P<0.05), 8 scores over the weekend, and share with escitalopram phthalein general group is no difference, but tolbutamide will benefit group compared with the other two groups had significant difference(P<0.01).Conclusion Small doses of tolbutamide will benefit has antidepressant effect, but the long-term curative effect of treatment is better than the amount of escitalopram citalopram, and share small doses of escitalopram citalopram tolbutamide will benefit can obviously accelerate the antidepressant treatment work.

Objective: To study clarifying for Naoqing Oral Liquid (Radix Puerariae, Radix Astragali, etc.) with chitin instead of ethanol. Methods: By studying precipitation effect of two clarification methods, in the meantime, studying the influence of different concentration of chitin on the clarification effect of Naoqing Oral Liquid. Results: Chitin had the more effective components than ethanol, and assured the stability of the preparation and shortened production period of the preparation. Conclusion: Chitin can clarify Naoqing Oral Liquid instead of ethanol.