OBJECTIVE To establish the distribution and the drug resistance of the pathogens of lower respiratory tract infections in a comprehensive intensive care unit(ICU).METHODS The bacterial culturing and the tests on the antibiotic from the deep phlegm in an ICU of the hospital from 2004 to 2005 were retrospectively analyzed.RESULTS Totally 408 phlegm samples were tested and 216 of them had bacteria,the positive rate was 52.94%.From them were isolated 240 strains of bacteria(among them 12 samples with 2 kinds of bacteria).The strains of Gram-negative bacteria were 172 and the positive rate was 71.7%,there were 35 strains of Gram-positive cocci with the positive rate of 14.6%.And there were 33 strains of fungi,the positive rate was 13.7%.Acinetobacter baumannii occupied the first place.The lowest drug resistance rate of the Gram-negatives was to SCF(0.0%),IMP(17.8%),and LEV((20.0%)).All Gram-positive cocci were sensitive to vancomycin,no vancomycin resistant.Staphylococcus were found.Candida albicans was sensitive to all tested drugs.CONCLUSIONS The isolation rate of A.baumannii is significant higher than reported before and its drug resistance is heavier.It indicated the importance of monitoring bacterial distribution and drug resistance dynamics.

Atherosclerosis ; etiology ; metabolism ; Humans ; Inflammation

Aged ; Aged, 80 and over ; Humans ; Hypertension ; complications ; drug therapy ; Randomized Controlled Trials as Topic ; Stroke ; prevention & control

Constriction, Pathologic ; Coronary Restenosis ; Humans ; Inflammation ; Stents

Muscle spasticity is one of the common complications in the paraplegic patients who suffer from spinal cord injury (SCI). Spasticity can result in limbs pain, joint contracture and malformation, then affects walking and the capability of keeping the posture in wheelchairs. Moreover, spasticity can increase the incidence rate of heterotopic ossification and fracture and seriously affects patients' daily life and rehabilitation therapy accordingly. There are many kinds of treatments aimed at spasticity at present, such as drug, exercise therapy, physiotherapy, nerve block treatment, operation treatment, and so on. However, single treatment doesn't achieve good effect. So it is common that many kinds of treatments are combined to treat spasticity. This article simply introduces the mechanism, symptom and evaluation of the muscle spasticity after SCI and discusses in full the treatment of the muscle spasticity by reviewing recent literatures.

Transcranial magnetic stimulation (TMS) is a non-invasive technique that can activate cortical motor areas and the corticospinal tract without causing the subject discomfort. Since TMS was introduced, numerous applications of this technique have been developed for the evaluation of neurologic diseases. They allow the evaluation of cortex excitability and motor conduction in the central nervous system and have been proved useful in monitoring motor abnormalities and the recovery of motor function. TMS also gives informations on the pathophysiology of the processes underlying the various clinical conditions and contribute to investigate the mechanisms of diseases. In addition, therapeutic use in depression, Parkinson's disease, epilepsy, spinal cord injury and stroke has raised great interest over the past decade. Theapplication of TMS has great potential both as an investigational and as a therapeutical tool in neurology and psychiatry. However, as an infant techniology, there should be further investigation and large randomized trials to be conducted.

High-mobility group box 1 ( HMGB1 ) is a conserva-tive nuclear protein and plays an essential role in maintaining nu-cleosome stability, DNA recombination, replication, repair and transcription. It can be passively released by necrotic cells or ac-tively secreted into extracellular under appropriate stimulus. Re-cent studies show that the activation of HMGB1 signaling is closely related to the progress of lung diseases including lung in-jury, pulmonary fibrosis and lung cancer, while blocking HMGB1 signaling inhibits the pathological process, indicating the therapeutic potential of HMGB1 inhibition in treating these diseases. This review summarizes the role and mechanisms of HMGB1 in such diseases, in order to provide novel evidence for the diagnosis and treatment.

Cardiomyopathy, Hypertrophic ; complications ; Fatal Outcome ; Heart Septal Defects, Atrial ; complications ; Humans ; Infant

Objective To investigate the etiology of and therapy for duodenal fistula caused by distal common bile duct operation. Methods An retrospective analysis of 19 cases of duodenal fistula after distal common bile duct operation was made.All cases received surgical management after the fistula was identified.Surgical procedures included abdominal abscess drainage in 2 cases, gastrostomy and jejunostomy combined with abscess drainage in 11 cases, gastrostomy and jejunostomy combined with duodenal repair?abscess drainage in 3 cases,gastrojejunostomy with pyloric exclusion combined jejunostomy in 1 case, repair of fistula with padicled intestinal seromuscular patch combined with gastrostomy and jejunostomy in 1 case, and repair of fistula with padicled intestinal seromuscular patch combined with gastrostomy and jejunostomy plus sphincteroplasty in one case. Results Among 19 cases,15 were cured. Two died of gastrointestinal bleeding, one of severe retroperitoneal infection,one of severe pancreatitis. ConclusionsEarly diagnosis is of great importance for the treatment of duodenal injury. Drainage is the mainstay for the treatment of iatrogenic duodenal fistula, while enough enteral nutrition should be given to accelerate spontaneous closure of the fistula.

AIM: To study the visual quality, dry eye and biomechanical stability of patients with myopia and astigmatism after different corneal refractive surgeries. ·METHODS: A total of 986 patients with myopia and astigmatism were selected as the research object in our hospital from July 2015 to July 2016, according to the operation mode of the selection of the research object, the 986 patients were randomly divided into small incision lenticule extraction ( SMILE) group, femtosecond laser in situ keratomileusis ( FS-LASIK ) group, sub-bowman-keratomileusis ( SBK ) group and laser-assisted in situ keratomileusis ( LASIK ) group. The postoperative visual quality was determined by comparing the diopter, uncorrected visual acuity ( UCVA ) , best corrected visual acuity ( BCVA) and high-order image difference of 25d, 90d. The postoperative dry eye condition was determined by comparing the postoperative tear secretion test ( Schirmer Ⅰ test ) , tear film rupture time ( BUT ) and fluorescence staining ( FS) . The biomechanical stability of the patients was determined by comparing the corneal hysteresis ( CH ) and corneal resistance factor ( CRF ) values of the four groups. ·RESULTS: The diopter, UCVA, BCVA and high-order aberration comparison of FS-LASIK group, SBK group and LASIK group between before and after surgery, showed no significant difference ( P>0. 05 ); on diopter, BCVA, UCVA, there was no significant difference between before and after surgery in SMILE group (P>0. 05), but statistical significance difference on high order aberration (P<0. 05). The BUT and FS value of the four groups decreased obviously after operation, and the difference was statistically significant (P<0. 05). In LASIK group SIt after operation significantly decreased, with statistically significant compared with that before operation ( P <0. 05). After operation, CH and CRF of the four groups decreased with significant differences (P<0. 05). ·CONCLUSION: SMILE, FS-LASIK, SBK and LASIK are equally safe, effective and stable in the treatment of myopia and astigmatism.