Objective To investigate the clinical effect of Bella in the treatment of gastric ulcer. Methods According to the different treatment methods will be January 2015-2017 year in March in our hospital 120 cases of patients with gastric ulcer group: control group was treated with amoxicillin + clarithromycin + omeprazole treatment, the observation group used amoxicillin + clarithromycin + ray Bela with before and after treatment; the two groups were observed for clinical symptom score changes, the level of IL-2/IL-6/CRP the incidence of adverse reactions, and the relevant data for comparative analysis. Results Amoxicillin + clarithromycin + ray was Bella (observation group) in the treatment of gastric ulcer is better than omeprazole + amoxicillin + clarithromycin (control group) treatment, clinical symptoms score changes better than the control group, IL-2/IL-6/CRP levels than the control group, the difference was statistically significant (P<0.05); two groups of patients the adverse reaction rate comparison, the difference was not statistically significant. Conclusion The gastric ulcer patients choose amoxicillin + clarithromycin + ray Bella with significant curative effect, can improve the clinical symptoms and IL-2/IL-6/CRP level of patients, and will not increase the incidence of adverse reactions, it is worthy of widely used in the treatment of patients with gastric ulcer.

Objective:To investigate the hospital acquired pneumoma in ICU,including its morbidity rate,mortality rate,including factors,and pathogenic distribution and its drug resistance.Methods:A clinical retrospective analysis was carried out to investigate 40 cases of patients acquiring pneumonia in EICU.Results:Twenty-three of 40 cases (57.5%)died.Factors significantly predisposing hospital acquired pneumonia were tracheal intubations or tracheotomy(35%).Pathogenic bacteria Pseudomonas aeruginosa (35%) and Acinetobacter baumannii (20%) were found in most of 40 cases.And the analysis of drug sensitivity showed resistance among all the agents tested in different levels,also the multidrug resistance emerged.Conclusion:Mortality rate of HAP is found high in ICU.The leading causative microorganisms are Gram-negative bacteria,and drug-resistant bacteria.Antibiotics should be appropriately selected.

Objective:To discuss the effect of non-invasive mechanical ventilation on acute lung injury with pathologic pregnancy.Methods:A clinical retrospective analysis was carried out to investigate 45 cases of acute lung injury in pathologic pregnancy treated by non-invasive mechanical ventilation in central ICU.Results:Forty-four patients of forty-five were cured (97.8%).Only one patient(2.22%) developed ARDS,and changed to be treated by invasive mechanical ventilation.Conclusion: Pathologic pregnancy is the high risk group of AIS.Using NIPPV early is an effective way to treat,with high success rate of emergency care.The keys of treatment are early diagnosis,early treatment and monitoring of the development of ARDS.

Objective:To explore the impact of childcare burden on satisfaction level of the elderly medical demand in family,in order to provide the basis for policy making to realize healthy aging.Methods:Based on CFPS(China family panel studies) data,using OLS and quantile regression to conduct quantitatively study on the impact of children's dependency ratio on medical expenses for the elderly.Results:The estimates of children's dependency ratio's coefficients were significantly negative,while their absolute values presented a tendency of increasing with the increase of quantile.It showed that the crowding-out effect of childcare burden on medical expenses for the elderly was in existence.The higher medical expensed,the stronger the crowding-out effected.Conclusion:Childcare burden impacted the satisfaction level of the elderly medical demand,especially for the elderly often sick or suffering from a serious illness,whose medical demand would be even greater.

An exploration was made on the content and methodology of supply chain management of a hospital in line with the fifth edition JCI standard.By means of enhanced management of supply chain procurement,tracking validation,risk management and indicators monitoring,the speed and certainty of relevant processes are improved,with hospital operation effectiveness and efficiency enhanced.

With the ventilator associated lung injury (VALI) atracting more and more attention,lung protective ventilation strategy (LPVS) has gradually been applied to clinical practice.Obese patients are at higher risk in VALI for laparoscopic surgery,mechanical ventilation induced atelectasis is an important reason for low oxygen in intraoperative and postoperativen procedure.In laparoscopic surgery,high abdominal pressure causes the elevation of diaphragm,and increases airway pressure.The excessive pressure increases the amount of alveolar dead space and airway pressure,reduces lung compliance,and increases the possibility of barotrauma and colotrauma.In addition,carbon dioxide pnenmoperitoneum indces hypercapnia.Both of them influence the recovery of postoperative lung function.To optimize intraoperative management and improve the prognosis of patients with general anesthesia,the application of LPVS attracts more attention,including small tidal volume,positive end-expiratory pressure,and recruitment maneuvers,etc.However,LVPS may also cause lung injury.This article is a review on the application of LPVS in laparoscopic surgery of obese patients.

Objective To investigate the effects of avastin combined with As2 O3 on rabbits corneal neovas-cularization (CNV)induced by alkali burn.Methods A total of 48 Japanese rabbits were induced the CNV models by middle alkali burns.The rabbits were randomly divided into four groups.A group was subconjunctivally injected 0.5mL 1mg/mL of As2 O3 and 0.5mL normal sodium,B group was subconjunctivally injected 0.5mL 25mg/mL of avastin and 0.5mL normal sodium,C group was subconjunctivally injected 0.5mL 1mg/mL of As2 O3 and 0.5mL 25mg/mL of avastin,D group was subconjunctivally injected 1.0mL normal sodium,after corneal alkali burn,respec-tively.CNV area at 6 days,12 days,15 days,21 days and 28 days after burns were calculated,the expression of IL -1β,VCAM-1 and VEGF in corneal tissue at 7 days,14 days,28 days after burns were detected by immunohisto-chemical staining.Results Alkali burn after 28 d,the CNV,IL -1β,VCAM-1,VEGF expression rates of A group were (50.28 ±30.26)mm2 ,(6.83 ±1.74)%,(1.52 ±0.91)%,(5.02 ±0.82)%,respectively,which of B group were (55.19 ±20.03)mm2 ,(6.88 ±1.94)%,(1.41 ±0.94)%,(2.91 ±0.84)%,respectively,which of C group were (10.03 ±5.98)mm2 ,(1.96 ±0.99)%,(0.38 ±0.57)%,(1.08 ±0.77)%,respectively,which of D group were (83.18 ±33.05)mm2 ,(10.16 ±2.17)%,(3.74 ±0.83)%,(7.69 ±1.33)%,respectively.The differences among four groups were statistically significant (F =25.33,3.64,13.13,7.23,all P <0.05 ).Compared with D group,the CNV area and the expressions of IL -1β,VCAM-1 and VEGF were significantly decreased in A,B,C group(qCNV =40.294,34.281,89.590,qIL -1β =4.078,4.017,10.043,qVCAM-1 =2.719,2.854,5.791,qVEGF =3.270,8.238,11.392,all P <0.05);Compared with C group,the CNV area and the expressions of IL -1β,VCAM-1 and VEGF were significantly decreased in A,B group (qCNV =49.296,55.309;qIL -1β =5.965,6.026;qVCAM-1 =1.965,1.775;qVEGF =6.790,22.413,all P <0.05);Compared with B group,the CNV area and the expressions of IL -1βand VCAM-1 were not significantly different in A group (P >0.05);Compared with B group,the expression of VEGF was significantly increased in A group (q =4.03,P <0.05).Conclusion Avastin combined with As2 O3 can inhibit the growth of CNV induced by alkali burning in rabbits effectively,and reduce the expressions of IL -1β, VCAM-1 and VEGF in CNV.It has better efficacy than single drug,and it opens up a new way for the prevention and treatment of CNV.

Gastrointestinal bleeding in children is a potentially life threatening medical emergency requiring an appropriate diagnostic and therapeutic approach.The causes of hemorrhage are numerous and varies with age.The clinical presentation of gastrointestinal bleeding in children ranges from asymptomatic microcytic anemia to hypovolemic shock.Therefore,the primary focus in a child with gastrointestinal bleeding is rapid assessment,stabilization,and resuscitation followed by a diagnostic modalities.

Objective:To investigate the effects of the treatment of early cracked teeth with vital pulp preservation.Methods:63 early cracked teeth with vital pulp in 56 patients were treated by light cured composite resin filling with or without MTA rebasing,and restored by precious metal crown.The patients were followed up for 2 years.Results:After 2 years follow-up,57 teeth were successfully treated and failure was found in 6 teeth,the effective rate was 90.4％.Conclusion:Light cured resin filling directly or with MTA rebasing for early cracked teeth with vital pulp,and restoration by precious metal crown are effective in the treatment of early cracked teeth with vital pulp.