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 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.

Stent fracture has been implicated as a cause of drug-eluting stent failure. The authors report here 2 cases with stent fractures which were diagnosed by coronary artery angiography and intravascular ultrasound (IVUS). Both of them received multiple-stent-implantation. Five stent fractures altogether were detected in two patients. All the involved stents were sirolimus-eluting ones. Angiographic study showed that three stent fractures were complete transverse linear fracture with stent displacement. IVUS demonstrated that three stent fractures were complete break and two were partial break. One fracture was located close to the overlapping site of two stents and another fracture was accompanied by the formation of a coronary aneurysm. Angiography and IVUS are helpful to identify stent fracture. In addition, IVUS is more likely to clarify the cause of stent failure as well as the mechanism of stent fracture.

Objective To investigate the effect of surgical treatment in left colorectal carcinoma with acute colorectal obstructive.Methods Clinical data of 70 patients with acute left obstructive colorectal carcinoma treated by emergent operation were collected.65 cases received one stage tumor resection and 5 cases received two stage tumor resection were retrospectively analyzed.Results The complication rate was 20.0%(14/70),mortality rate was 1.0%(1/70);radical surgery after 1,3,5-year cumulative survival rates were 100.0%,93.6%,66.7% wich were higher than the palliative surgery 69.2%,0.0%,0.0%(all P＜0.01);With univariate analysis,radical resection,Dukes stage,tumor differentiation,and chemotherapy were found to be significant factors associated with the overall survival(χ2 = 16.546,20.649,5.953,all P＜0.01);with the overall survival.With multivariate analysis,radical resection independently affected the overall survival(Wald = 5.877,P＜0.01).Conclusion One stage radical resection was feasible for left obstructive colorectal carcinoma,and could improve survival rate after operation.

PurposeTo investigate the permeation of model drug,propranolol hydrochloride, through the excised porcine buccal mucosa. To study the influences of various factors on the buccal absorption also studied. MethodsUsing excised porcine buccal mucosa permeation test in vitro. By means of changing the medium pH, osmotic concentration, drug concentration, the concentration of various penetration enhancers including sodium glycodeoxycholate (GDC), sodium glycocholate (GC), dimethy1-β-cyclodextrin (DMβCD), and hydropropyl-β-cyclodextrin(HPβCD). The permeation rates and permeability coefficients(P) were determined and evaluated. The solubilities and apparent partition coefficients also determined in some tests. ResultsThe result showed that the P were increased when porcine buccal mucosae were pretreated with every penetration enhancement of certain concentration, increased as the pH of test solution rose from 4.9 to 9.1. The P remained constant as the concentration of propranolol hydrochloride increased from 5 to 80 mg/ml, decreased with the increasing of osmotic concentration Conclusions The absorption of propranolol hydrochloride through porcine buccal mucosa is a typical passive process, and affected by penetration enhancers, medium pH, osmotic concentration.

OBJECTIVE:To study protective effects of Ketorolac tromethamine ophthalmic gel against Staphylococcus aureus corneal ulcer in rabbits. METHODS:S. aureus corneal ulcer in rabbits model was induced by corneal substance layer inoculation, and then divided into model group,positive control group (Clarithromycin ophthalmic gel),gel high-dose,medium-dose and low-dose groups(Ketorolac tromethamine ophthalmic gel 120,80,40 mg/ml),with 20 rabbits in each group. They were given re-levant medicine,once a day for 2 weeks. The keratopathy of rabbits was observed;the clinical efficacy and keratopathy score were compared. The change of ratina was observed under micrescope. RESULTS:Compared with model group,the keratopathy score de-creased while total effective rate increased in positive control group and gel groups after medication, and the effects of gel high-dose and low-dose groups were significantly lower than that of positive control group,with statistical significance(P<0.05). The retina of rabbits had not affected by the experiment. CONCLUSIONS:Ketorolac tromethamine ophthalmic gel has protective effect against S. aureus corneal ulcer in rabbits.

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.

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.