Adult ; Anemia, Aplastic ; chemically induced ; immunology ; therapy ; Benzene ; poisoning ; Cyclosporine ; therapeutic use ; Female ; Humans ; Immunity, Cellular ; Immunosuppressive Agents ; therapeutic use ; Male ; Middle Aged

Objective To study the risk factors for ventilator associated pneumonia (VAP) in ICU and pathogens antimicrobial resistance.Methods 220 patients were selected and divided into observation group (88 patients) and control group(132 patients) depending on whetherhe has VAP or not.The clinical data were reviewed to explore the risk factors.And the secretions of respiratory tract were investigated by the routine bacterial culture and drag-resistance methods to analysis the distribution of pathogens.Results The risk factors associated with VAP were COPD,mechanical ventilation,the extensive use of antibiotics,age ＞ 60 years,APACHEII score ＞ 30(P ＜ 0.01).157 bacterial were cultured,68.9％ of pathogens was Gram-negative bacteria in which Pseudomonas aeruginosa was rated as the top one,and 26.1％ of pathogens was Gram-positive bacteria in which MRSA was the majority.The results of the antibiotic resistance monitoring indicated that all Gram-positive and Gram-negative bacteria showed high drugresistance to common antibiotics.Conclusion We should control these risk factors which are closely related to VAP,and select suitable antibiotics on the basis of etiological analysis and drug-resistance.

Objective To investigate the operative treatment of displaced intra-articular fractures of the calcaneus using a small lateral incision approach.Methods Thirty-one patients with 32 intra-articular calcaneal fractures,were treated with open reduction and internal fixation through a small lateral incision approach from October 2004 to April 2006.The skin incision was made from the distal tip of the fibula to the base of the fourth metatarsal.According to Sanders classification,there were 21 typeⅡfractures and 11 typeⅢfractures.The first change of dressing was done on the second day after operation.The residual blood clots in the wounds were cleaned as much as possible when the drainage sheet was removed.The operated foot was bandaged with pressure dressing of cotton pad.Results After an average follow-up of 10.5 months(range,3 to 18 months),no soft tissue com- plications were found,and all had acceptable reduction.The preoperative X-ray film showed that B(?)hler angle was 6.84??9.36?,Gissane angle was 106.04??12.03?.The postoperative X-ray film demonstrated that B(?)hler angle was 32.06?+6.87?,Gissane angle was 115.81??9.48?,and the difference was statistically significant(P＜0.01).According to the AOFAS evaluation system for Ankle-Hindfoot,two feet scored 60-70 points,nine feet 70-80 points,16 feet 80-90 points and five feet 90-100 points.Condusion The small lateral incision approach is a good option for management of calcaneus fractures,because it causes minimal soft tissue damage,provides excellent exposure,and leads to convenience for later removal of internal fixators and subtalar arthrodesis.

Three-dimensional syndrome differentiation is a new mode of syndrome differentiation of exopathic febrile diseases, which is based upon the six meridian syndrome differentiation initiated in Treatise on Cold Attack and defence-qi-nutrient-blood and triple-Jiao syndrome differentiation in the art of warm disease of traditional Chinese medicine. Syndromes appeared in the course of cold pathogenic diseases and warm diseases were differentiated through the survey of clinical cases and observation on syndrome features of exopathic febrile diseases, by applying means of analyzing, reasoning, concluding and deducting, from the stadium, location and nature of the disease. Three-dimensional syndrome differentiation theory explains and generalizes pathological mechanism and types of syndrome on acute exopathic febrile diseases roundly, has constructed theoretical frame and synthetical model of syndrome differentiation of exopathic febrile diseases. However, any new method of syndrome differentiation can not be leave nothing to be desired in the beginning, so it is proposed that we must develop epidemiologic investigation on syndromes of exopathic febrile diseases sequentially, make models of clinical commonly seen syndromes of exopathic febrile diseases and dispose fuzzy phenomenon of syndrome by applying mathematical method. By above measures, three-dimensional syndrome differentiation will be perfected gradually, therefore, it can provide scientific theoretical basis for the treatment of exopathic febrile diseases.

Objective To investigate the therapeutic effect of buflomedil hydiochoride for on jection inpro- gressive ischemic stroke.Methods 60 patients with cerebral infarction were divided into buflomedil hydrochoride for injection treatment group and control treatment.Then the nepal function deficits of patients were evaluated before and after 15 days.Serum MMP-9 levels in vein blood samples of ischemie stroke were detected.Results The inci- dence rate of progressive ischemic stroke in treatment group of buflomedil hydrochoride for injection was lower than that of control treatment group(P

Objective Summarize the interventional nursing experiences for patients with coronary chronic total occlucion by transraidal approach. Methods Preoperative evaluation, careful psychological nursing, perioperative observation and prevetion complications were used for 105 patients with coronary chronic total occlusion when curred by transraidal approach intervention. Results There were 97 cases had successful operation, while 8 cases failure. There were 14 cases of perioperative hypotension, 6 cases of coronary acute occlusion, 4 cases of coronary perforation and 3 cases of no- reflow. There were no radial- as-sociated complication in any patients. Conclusions Effective and careful nursing measures can prevent complications.

Objective Little is known about the influence of congenital heart disease on the phannacodynamies of neuromuscular blocking agents. The aim of this study was to compare the pharmacodynamics of rocuronium in children with cyanotic and acyanotic heart disease. Methods The study was conducted in two parts. In part Ⅰ , 36 children with congenital heart disease scheduled for open heart surgery were allocated into 3 groups (n=12) : acyanotic group; slightly cyanotic group and severely cyanotic group. Neuromuscular blockade was monitored after administration of 0.6 mg ? kg-1 rocuronium. In part Ⅱ , 40 children with congenital heart disease were allocated into acyanotic and cyanotic group ( n = 20). The children in each group were further divided into 4 subgroups of 5 patients according to the dose of rocuronium the children received : 120, 180, 240 and 300 ?g? kg-1 . The dose- response curve for neuromuscular blockade was constructed and ED50 , ED90 and ED95 were calculated. SPSS 8.0 software was used for statistical analysis.Results In part Ⅰ the onset time (the time from injection of rocuronium to 95% depression of neuromuscular transmission) was significantly longer in severely cyanotic group [(2.25 ? 1.27) Min] than in acyanotic group [(1.17 ? 0.15) min] . There was no significant difference in the duration of action and recovery time among the 3 groups. In part Ⅱ the dose-response curve shifted to the right in cyanotic group compared with acyanotic group. ED50, ED90 and ED95 were significantly higher in cyanotic group than in acyanotic group. Conclusion The onset time of rocuronium is prolonged and the sensitivity of the patients to rocuronium is decreased in patients with cyanotic heart disease.

Objective To investigate a novel therapeutic strategy in the treatment of lung cancer with diffuse pleural metastasis accompanied by malignant pleural effusion. Methods From December 1978 to February 2003, 55 patients of carcinoma of lung with pleural metastasis underwent the comprehensive therapy characterized by pleuropneumonectomy. A follow-up of all the patients after hospital discharge was conducted. Results Death due to complications was found in 2 out of the 55 patients, but remission and significant improvement of symptoms were found in the rest. A follow-up period ranging from 1 to 25 years revealed that 48 patients survived for 5-40 months (median survival time: 14 months), and 5 patients were still living and well. Conclusion Strict control of the surgical indications and radical removal of the malignant tumor can improve the quality of life and prolong the survival time of patients, even there is already metastasis to the pleura.

Objective: To explore pathogeny and clinical effect of physiotherapy in young patients with lumbar disc hemiation (LDH). Method: Eighteen young LDH patients at 20-30 years old were administered comprehensive physiotherapy including lumbar traction, pulsed short wave therapy, pulsed magnetotherapy or low frequency modulated medium frequency electrotherapy. Before and after treatment, lumbar function was assessed with JOA scale. Result: Nine patients had specific trauma history; nine patients had sedentary lifestyle; five patients worked lor more than 8h/d in standing position; four patients had body mass index (BMI) 24-28. There was no significant difference in age, BMI and JOA scores between male and female group (P＞0.05). Patients scored significantly higher after treatment (P＜0.05). The remarkable effective rate of physiotherapy was 72.22%. Conclusion: Trauma, sedentary lifestyle, standing for long time, overweight or obesity are primary risk factors of LDH for youth and should be prevented by health education. Physiotherapy is significant efficient for young LDH patients.

We have reported previously a peculiar type of neurons in the submucous nerve plexus in the intestine of guinea pigs, and named them tentatively the ′paralymphatic neurons′. In order to further study this type of neurons, the immunohistochemical observation for neuron specific enolase (NSE) reactivity of the enteric nerve plexus in guinea pigs was carried out in this investigation. We found that all the neurons in the enteric nerve plexus showed NSE positive reaction. The paralymphatic neurons located closely against to lymphatic vessels in submucous nerve plexus in small intestine and colon also exhibited same NSE positive reaction as other neurons. All the smooth muscle and connective tissue cells were NSE negative. Most of the paralymphatic neurons exhibited typical morphological features of neurons. Although some cells did not show obvious neuronal characters, but they all presented the same positive reactivity. Hence, this study provide another reliable evidence to confirm the exact neuronal nature of the paralymphatic neurons.