Objective To analyze the distribution of pathogens and its characteristics of drug susceptibility originating from nosocomial infections in the intensive care units(ICU) ,and to provide evidence for clinical anti-infection treatments. Methods The data of the pathogens and their chug susceptibility characteristics were retrospectively analyzed. Many kinds of samples were collected in ICU from May 2008 to October 2009. Results There were 605 postive strains and the highest postive rate in sputum. The Gram-postive bacteria strains were 122 ,including 98 strains of staphylococcus where postive β-lactamases were 93. The drug susceptibility rate of linezolid, vancomycin and rifampin was 100% ,98. 2% and 86. 7% ,respectively. However,the drug resistant rate of oxacillin was 98.9%. Totallly 393 strains of the Gram-negative bacteria have been found, where pseudomonas aeruginosa, acinetobactor baumannii,enterobacter cloacae, stenotrophomonas maltophilia and klebsiella spp were 133,106,24,20 and 19 strains, respectively. The drug susceptibility rate of imipenem, aztreonam, levofloxacin and amikacin was 61. 6%, 42.0%, 38.8 % and 36. 1%, respectively. But the drug resistant rate of the third and fourth generation cephalosporin was over 70%. 90 strains of fungi were also found. The most common fungi infection was candida. Conclusion The nosocomial infections in ICU occurs mainly in respiratory tract,most infections are caused by gram negative bacilli. Imipenem and aztreonam have greater susceptibility to treat them. Gram positive coccus still plays an important role in nosocomial infections in the ICU and they high level of resist beta-lactamase-producing drugs. But they are susceptive to linezolid,vancomycin and rifampin.

Objective To observe the efficacy of intra-articular (IA) blockade of TNF-α by 3 etanercept injections in patients with rheumatoid arthritis (RA).Methods Eighteen moderate activity RA patients with resistant knee synovitis underwent three monthly IA injection of etanercept (25mg).The primary outcomes were visual analogue scale of target knee general health (VAS-TKGH) and VAS target knee Pain Score,and we also collected diameter of target knee joint,VAS fatigue Score,Health Assessment Questionnaire (HAQ),the 28-joint based disease activity score (DAS28) and joint fluid volume,which were all assessed at baseline and every four weeks after IA injection.Results All those 18 patients completed the treatment with the average disease duration of was (8 4.7 ± 54.1) months.After each IA injection,VAS-TKGH was significantly improved than baseline (P =0.03,0.02,0.02).and VAS target knee pain score was also significantly improved than baseline (P =0.03,0.00,0.00).After 3rd IA injection,VAS-TKGH was further reduced compared with those after 1 st and 2nd IA injection (P =0.02,0.03) ; while,VAS target knee pain score was further reduced after 3rd IA injection (P =0.00).Knee joint diameter,VAS fatigue score,HAQ and DAS 28 were significantly lower after 1st IA injection than baseline (P =0.03,0.02,0.03).After 2nd IA injection,VAS fatigue score,HAQ,and DAS28 were significantly further improved compared to treatment once (P =0.00,0.02,0.02) ;after 3rd IA injection,HAQ and DAS28 were further improved compared to those after 2nd IA injection (P =0.01,0.02).Joint fluid volume was significantly decreased after 2nd IA injection (P =0.01).Conclusion The tailor approach of intra-articular injections of anti-TNF agent might benefit RA patients who had resistant synovitis,and the side effect was rare.However,the sample was small and further observation is needed.

Objective:To evaluate the long-term effectiveness of free transfer of Abductor hallucis muscle plus anastomosis of blood vessels and nerves for dynamic reanimation of the established facial paralysis.Methods: Twenty-eight patients who received the above-mentioned treatment during March 1999 to November 2006 were followed up.The follow-up period was 1 to 16 years,with a median period of 4 years.The facial pictures of frontal view were analyzed before and after operation.T-FGS and facial nerve function index(FNFI) were used to evaluate the facial nerve function before and after operation.Meanwhile,the survival of the graft,the width of the face,the scar,and the function of the foot were analyzed and compared.Results: All patients obtained satisfactory symmetric faces in static state and voluntary contraction of the transferred muscles.Twenty-two patients obtained ideal smiling faces.The T-FGS score increased by(27?7.2) points and the score of FNFI increased by(57?10.7)% after transplantation(P

Humans ; Spleen ; injuries ; physiology ; surgery ; Splenectomy

Objective To summarize professor Lu Zhizheng's clinical experience in the treatment of rheumatoid arthritis,in order to better guide clinic. [Method]By analyzing professor Lu Zhizheng's treatment of two patients with rheumatoid arthritis of the medical record data, it summarized from the aspects of etiology and pathogenesis,syndrome differentiation and treatment.[Result]Professor Lu argued that invigorating spleen to remove dampness should be throughout the course of the treatment of rheumatoid arthritis.Two patients can reduce joint swel ing and pain,improve the appetite gradual y,and the symptoms were relieved obviously by replenishing qi and reconciling ying,adjusting ying and wei.[Conclusion]Professor Lu Zhizheng's Chinese medicine treatment of rheumatoid arthritis has significant curative effect,it is worthy of reference study.

Animals ; Drugs, Chinese Herbal ; chemistry ; Humans ; Medicine, Chinese Traditional ; Microscopy, Confocal ; Muscle, Smooth, Vascular ; ultrastructure

[Objective]To summarize the clinical characteristics and the treatment experience of the patients from Wenchuan earthquake area.[Method]Totally 129 patients injuried in the 5.12 Wenchuan earthquake from May 13 to June 10,2008 were admitted in this hospital.The recording content included chief complaints,diagnosis,damage locations and types,whether with infection or not,treatment,efficacy and so on.[Result]There were 95 fracture cases which included 35 open fracture with 51 fracture sites,60 closed fracture cases with 139 fracture sites;39 associated neural injuries in 26 patients(20.2%);54 cases of infection(31.8%);110 cases had operations.There was no death case,but one outside hospital amputation patient had multiple stump debridement and trimming due to severe infection.All open fracture cases were healing except 2 cases until now,no case with infection after operation.[Conclusion]The clinical characteristics of the patients being evacuated from Wenchuan earthquake are outstanding,it need individualized remedy according to the clinical characteristics and we should prevent and cure correlate complications positively in order to depress the fatality and disability rate.

By analysis on mechanism of dampness and hotness obstruction of RA in active stage,explore the relationship between RA and dampness and hotness obstruction, and the clinical status of Qingre Lishi Huoxue Tongluo method in treating RA in active stage, for more effectively guiding clinic administration.

Objective To study the ultrasonographic and acoustic contrast features of breast fibroadenoma and breast cancer and explore the value of contrast enhanced ultrasonography in the differential diagnosis of benign and malignant breast tumors. Method A retrospective analysis of 18 cases breast fibroadenoma and 12 cases breast cancer in the performance of contrast-enhanced ultrasound was done. Results After contrast agent injection, tumor dimension increased in 4 cases with breast fibroadenoma and 7 cases with breast cancer. The ultrasonographic and acoustic contrast features of breast fibroadenoma showed no significant changes. They showed stenosis, perpendicular and circumambulates vascular shape. The breast cancers significantly increased the number of tumor blood vessels with the thicker,tortuous blood vessels into the tumor. Conclusions The contrast enhanced ultrasonography assessed more accurate size of tumors. The image displayed grown sizes, more vascularity and bending vascular shape in the breast cancer. It was more accurate than gray-scale ultrasound on diagnosing breast cancer.

Adult ; Aged ; Arthritis, Rheumatoid ; complications ; Female ; Humans ; Intracranial Thrombosis ; complications ; Male ; Middle Aged ; Pulmonary Embolism ; complications ; Venous Thrombosis ; complications