OBJECTIVE To explore the risk factors in elderly patients with ventilator-associated pneumonia(VAP) and to provide the corresponding clinical prevention strategies.METHODS The ages,underlying diseases,mechanical ventilation method,use of antibiotics,and pathogenic bacteria of the VAP patients were investigated and analyzed.RESULTS Totally 105 elderly patients with VAP had serious underlying diseases,and were treated with broad-spectrum antibiotics,tracheal intubation or trachea incision.Most pathogenic bacteria were multiresistant.CONCLUSIONS Prevention of VAP is the priority of treatment for elderly patients.In order to control the occurrence and spread of VAP,clinicians should shorten the time of ventilator treatment,pay more attention to sterilization and isolation,and strengthen the attendance of the patients.

Through the analysis of the doctor-patient relationship and referring the Rawl's theory of justice,the author puts forward the significance of justice in the legislation innovation of the relationship.The article also analyzes the manifestation of the innovation.

Objective To investigate the possible role of cytokines interleukin(IL)-1?,IL-1?,IL-6 and TNF? in urinary stone formation and the inhibitory effect of ?-Linolenic acid on these cytokines and renal calcium oxalate crystallization formation in rats.Methods Forty-five male adult Wistar rats were divided receive normal forage and water as negative control(Ⅰ),normal forage and water containing 1% ethylene glycol and 1% muriat to induce renal stone as group Ⅱ,or normal forage and water containing 1% ethylene glycol and 1% muriat and l0 g?kg~(1)?d~(-1) perilla frutescens(L?) Britt?oil as group Ⅲ for 8 weeks.Then all rats were sacrificed and the renal tissue calcium,the urinary calcium,the calcium oxalate crystallization and urinary oxalate and serum IL-1?,IL-1?,IL-6 and TNF-? were detected.RMCs were pretreated with 10 ?g/L IL-6,10 ?mol/L EPA+10 ?g/L IL-6,50 ?mol/L EPA+10 ?g/L IL-6,or absolute alcohol for 24 h.RMCs without pretreatment served as normal control.The PGE_2 concentration in RMC supernatant was measured by radioimmunoassay.Results As compared with group Ⅱ,the hydronephrosis and parenchymal swelling were obviously slight,and calcium oxalate crystalization,renal tissue calcium,urinary calcium excretion,blood urea nitrogen and creatinine were significantly lower in group Ⅲ(P

Objective To investigate clinic efficacy of intravenous dexamethasone for idiopathic sudden sensorineural hearing loss.Methods Subjects received a 10-day dexamethasone(10mg/d) course.4-frequency(500,1000,2000,4000Hz) pure-tone averages(PTA) calculated using air conduction thresholds pre-treatment and post-treatment were compared.A clinically significant chanage in PTA was considered to be greater than 10dB HL.Results PTA of pre-treatment and post-treatment were(66.32?23.66)dB HL and(45.61?25.24)dB HL,respectively,in 40 patients with idiopathic sudden sensorineural hearing loss.There was significant improvement in PTA,P=0.000756.90% of patients showed improvement in hearing.Promising results were found with intravenous dexamethasone in cases with shorter time to treatment or/and without vertigo.Conclusion Intravenous dexamethasone can be beneficial in treating patient with idiopathic sudden sensorineural hearing loss.Prognostic indicators include time to treatment and vertigo.

The work in 12 years in Jiangsu Medical Imaging Academy is mainly introduced.Jiangsu Medical Imaging Academy was founded 8 years ago.Since then,it has gained Group Winning Prize twice,the title of Jiangsu Excellent Branch Academy in Specialized Subject three times,and ranked high in every examination of CT or MR technician guard mounting certificates.As a harmonious union,Medical Imaging Academy puts forward the standardization of Jiangsu medical imaging technology and makes good preparation for digital medical imaging epoch.

The equipping and management of large-scale medical imaging equipment in both private and state hospitals are discussed. Machines such as DSA, CT, MR in 15 hospitals in Zhangjiagang city were surveyed and statistically analyzed. Suggestions are also given.

There are different views about the influence of exercise on appetite,meal size and body weight.Exercise affects body weight through two mechanisms: energy expenditure,the negative impact on appetite and meal size.This article shows that acute exercise has no effect on appetite and meal size;Long term exercise increases meal size of lean subjects and has no effect on overweight and obesity.These will facilitate weight control and body-shaping.

Physicians increasingly rely on diagnostic imaging information for disease treatment. The complexity associated with image and information management in the hospital setting, including but not limited to imaging related information, is rapidly increasing. The method for addressing these issues is improvements through electronic means, and adequate access to imaging information in a timely manner is expected to be available. Radiologists using Picture Archiving and communication systems (PACS) should develop and implement quality control mechanisms to ensure that all examinations performed are successfully transmitted to PACS network and interpreted timely. When clinical information is supplemented with medical images, errors may be reduced. Although this method cannot replace direct patient contact, it can make the correct treatment instituted quickly. Problems related to photograph, including poor lighting, camera motion and improper exposure settings, can be avoided when PACS applied to copying digital radiographic images directly, and thus the quality of images in teaching file, lectures and publications can be enhanced.

Objective To explore the protective effect of Qimei Fermented Beverage against alcohol‐induced liver injury in mice .Methods Alcohol‐induced liver injury mouse model was established by continuously intragastric administration .Totally 60 male mice were randomly divided into five groups ,blank control group ,model group ,low ,middle and high doses groups(adding 5 , 25 ,50 mL/kg Qimei Fermented Beverage) .After continuous intragastric administration for 9 weeks ,the levels of serum aspartate transaminases(AST ) and alanine transaminases (ALT ) were detected in each group ,moreover the levels of malondialdehyde (MDA) ,triglyceride(TG) ,glutathione(GSH) and alcohol dehydrogenase(ADH) ,aldehyde dehydrogenase (ALDH) of liver ho‐mogenate ,and liver index change were measured .Liver histopathological changes were observed .Results The alcohol‐induced liver injury model in mice was successfully established .Compared wit model group ,different doses groups of Qimei Fermented Beverage could effectively reduce the levels of serum AST ,ALT and liver tissue TG ,increased the levels of ADH ,ALDH ,GSH .In addition , the pathological examination results of liver were consistent with those in enzymology .Conclusion Qimei Fermented Beverage has certain protective effect against alcohol‐induced liver injury and can obviously improve the alcohol‐induced liver injury .

Objective To investigate the clinical value of different methods for prevention of venous thromboembolism (VTE) for patients undergoing laparoscopic gynecological surgery with high risk factors .Methods Prospectively case controlled study was performed in 178 patients underwent laparoscopic gynecological surgery with high risk factors at the No .152 Central Hospital of PLA from January 2013 to October 2014 .All patients were divided into group A ,B and C .A total of 64 cases in group A received subcutaneous injection of LMWH (5 000 U ,once a day) at 12 hours after operation .A total of 64 cases in group B were treated with LMWH (2 500 U ,once a day) combined with Salvia miltiorrhiza(20 mL ,once a day) .A total of 50 cases in group C did not treated with prophylactic use of these drugs .The incidence of deep venous thrombosis(DVT) ,postoperative bleeding in and co‐agulation changes were recorded and compared in the three groups .Results All patients were successfully operated with laparosco‐py ,among them ,7 cases were complicated with DVT and 9 cases were complicated with postoperative bleeding .The incidence of postoperative DVT in group A ,B and C was 0 ,1 .6% and 12 .0% respectively ,the differences were statistically significant in group A and B compared with group C ,respectively (P<0 .05) .The incidence of postoperative bleeding group A ,B and C was 9 .4% , 3 .1% and 2 .0% respectively ,the differences were statistically significant in group A compared with group B and C (P<0 .05) .Af‐ter operation ,the platelet count in group A decreased ,however ,that in group B and C changed little .The platelet count in group A was statistically different compared with group B and C (P< 0 .05) .The plasma activated partial thromboplastin time and pro‐thrombin time in group A and B were prolonged ,the differences were statistically significant in group A and B compared with group C (P<0 .05) .Conclusion Early injection of LMWH after laparoscopic gynecological surgery in patients with high risk factors can significantly reduce the incidence of VTE ,LMWH combined with Salvia miltiorrhiza could improve security of anticoagulation with‐out increasing the risk of postoperative bleeding .