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.

Objectives: To evaluate the analgesic effect of electronic dental anesthesia(EDA).　Methods: Sixty patients with dental caries in need of cavity preparation and 15 patients with pulpitis in need of pulp treatment were anesthetized with EDA, another 60 patients with dental caries in need of cavity preparation and 15 patients with pulpitis in need of pulp treatment were anesthetized with traditional local anesthesia(LA).　 Results: For patients with dental caries in need of cavity preparation, the effective rates in EDA group and LA group were 93.33% and 98.33% respectively(P>0.05).For patients with pulpitis in need of pulp treatment ,the effective rates in EDA group and LA group were 26.7% and 93.33% respectively(P<0.01).　Conclusions: EDA can be an effective analgesic method for cavity preparation, but not for pulp treatment.

Objective To evaluate the clinical effectiveness of heat-sensitive moxibustion for knee osteoarthritis ( KOA) by systematic evaluation and Meta analysis methods. Methods Electronic information retrieval combined manual retrieval methods were used for collecting clinical randomized control trial of heat-sensitive moxibustion for KOA. The systematic evaluation was conducted by two individual researcher following the principles of Cochrane Review Handbook 5.1, and RevMan5.0 software was applied for the statistical analysis. Results Fifteen randomized controlled trials (RCT) were enrolled into the analysis, which involved 1228 cases. The results of systematic evaluation showed that the quality of most of the enrolled RCT were not so high. The results of Meta analysis were as follows: ( 1) Between heat-sensitive moxibustion and traditional moxibustion, the weighted mean difference (WMD) and 95%confidence index (CI) were-1.76, [-2.33, -1.18] for visual analog scale ( VAS) scores ( P<0.001) , were -2.36, [-3.42, -1.30] for the scores of guiding principle of clinical research on new drugs ( GPCRND) for KOA ( GPCRND-KOA) ( P<0.001) , and were 13.61, [7.60, -19.61]for Lysholm knee joint function scores (P<0.001), respectively; (2) Between heat-sensitive moxibustion and acupuncture, WMD and 95%CI were 6.19, [ 0.01, 11.37] for Lysholm scores ( P<0.05);(3) Between heat-sensitive moxibustion and warm-needling acupuncture, WMD and 95%CI were -10.14, [-17.47, -2.81] for the Western Ontario and McMaster Universities ( WOMAC) osteoarthritis index scores ( P<0.05). Conclusion It is indicated that heat-sensitive moxibustion shows certain therapeutic effect for knee osteoarthritis, better than traditional moxibustion.

[Summary] The general status of glycemic control and insulin initiation are not optimistic in Chinese patients with type 2 diabetes.Chinese patients experience pancreatic β-cell dysfunction and reduction of early phase insulin spike earlier and more severely compared to Caucasians.These can cause more significant postprandial hyperglycaemia which is further deteriorated by traditional carbohydrate-rich Chinese diet.Therefore,premixed insulin may be a more appropriate option of insulin initiation therapy for Chinese patients with type 2 diabetes mellitus.

[ Objective] To observe the effect of removing phlegm,softening and removing blood stasis on pulmonary morphology and hydoxyprolin of pulmonary fibrosis rats. [Methods]The experimental pulmonary fibrosis models were produced by injecting BLMA5.All animals were randomly divided into 5 groups which were control group, model group, Chinese herb high-dose group, Chinese herb low-dose group and prednisone group respectively, the drugs were given daily starting from the second day and the rats were killed on the 7th and 28th day. The shape of rats’ lung tissues was observed, the levels of hydroxyproline in lung tissues were measured. [Results] In model group, alveolitis increases(much inflammatory cell infiltration), pulmonary interstitial fibroblast increases. There is less pulmonary tissue inflammatory cell infiltration in drug-given groups than that in model group and so is fibroblast. Compared with the model group, the content of HYP of pulmonary tissues of the drug-given groups is remarkably decreased. [Conclusion] The Chinese herb of removing phlegm, softening and removing blood stasis can effectively inhibit the formation of pulmonary fibrosis caused by BLMA5.

No abstract available.
Coronary Artery Disease* ; Coronary Vessels*

Objective To evaluate the short-term effect of glucocorticoid therapy in patients with idiopathic interstitial pneumonia by high resolution CT semi quantitative score. Methods 32 cases of idiopathic interstitial pneumonia were treated with conventional treatment, combined with glucocorticoids, the use of high resolution CT semi quantitative score, the short-term efficacy of its accurate judgement. Results The analysis shows that high resolution CT semi quantitative score below 20％ idiopathic interstitial pneumonia patients with hospital mortality period is only 5.26％, and the high resolution CT semi quantitative score during the high fatality rate of 38.46％ hospitalized patients with 20.00％ or more, the difference was statistically significant (P<0.05). Conclusion The application of high resolution CT semi quantitative score of received corticosteroid therapy for idiopathic interstitial pneumonia patients with curative effect to give accurate judgment to the doctor for the future development of drug treatment and guarantee its prognosis are of positive significance.

To investigate the features of CT, ultrasonography and fundus fluorescein angiography (FFA) of morning glory syndrome, the data on CT, A/B-scan ultrasonography and fundus fluorescein angiography (FFA) were retrospectively analyzed in 8 cases of morning glory syndrome (MGS). Among those cases, 6 were examined with CT, 4 with FFA and 8 with A/B-scan ultrasonography. Results showed that the characteristics of CT, A/B-scan ultrasonography and FFA in MGS included: (1) The attachment spot of optic nerve became thin and vitreous body protruded to the posterior wall of eyeball with a spherical shape on CT image; (2) in the early period of FFA, hypofluorescence appeared on the optic, the abnormal arteriae and veins around the optic papilla were displayed clearly and in the late period, optic disc was stained with fluorescein; (3) on B-scan ultrasonogram, the vitreous cavity extended to the posterior pole and optic papilla, and projected to the basal part of muscle cones and thus the posterior part of vitreous cavity looked like an upside-down bottleneck. Sometimes the echogenic band of retinal detachment could also be seen. On A-scan ultrasonogram, both vitreous cavity and bottleneck showed no ultrasonic echoes and presented a base line without any evident wave crest. It is concluded that CT, A /B-scan ultrasonography and FFA could show the imageological features of MGS from different aspects, which helps clinicians to differentiate it from other diseases such as optic disc coloboma. CT and A /B-scan ultrasonography, in particular, are considered to be reliable imageological methods for the accurate diagnosis of MGS and are superior to the traditional techniques.

Vascular endothelial growth factor (VEGF) is a key factor for neovascular diseases of ophthalmology.Bevacizumab is a full-length,humanized monoclonal IgG antibody,which prevents VEGF-A to combine with its receptors on the endothelial surface,and inhibits the endothelial cell proliferation and new blood vessel formation.Nowadays,anti-VEGF drugs are widely used to treat neovascularization diseases in ophthalmology.Bevacizumab has been more extensively applied because of its high security and low cost.The article reviewed the advancement of laboratory researches on the permeability,safety,pharmacokinetics of bevacizumab and research in vitro.

Abstract?AlM: To study the effect of Danggui Shaoyao Powder combined with trabeculectomy and bevacizumab on neovascular glaucoma? METHODS: Neovascular glaucoma patients were enrolled from January 2011 to February 2014 in our hospital, according to the different methods of treatment were divided into observation group given traditional Chinese medicine and Western medicine combined with trabeculectomy, and control group received Western medicine combined with trabeculectomy. Visual acuity, intraocular pressure, retinal thickness were compared.?RESULTS: Visual acuity level : 1wk; 6, 12mo after treatment, visual acuity in observation group were significantly higher than that in control group (0. 41±0. 07 vs 0. 27±0. 04, 0. 52±0. 08 vs 0. 38±0. 06, 0. 72±0. 14 vs 0. 54± 0. 08 ); lntraocular pressure: 1wk; 6, 12mo after treatment, intraocular pressure in observation group were significantly lower than that in control group (15. 11±3. 22 vs 22.32±5.34, 18.64±5.08 vs 26.67±6.22, 17.18±3.76 vs 22. 42 ± 4. 32 ) mmHg; Retinal nerve fiber layer thickness:12mo after treatment, nerve fiber layer thickness in observation group was significantly higher than that in control group (90. 41±10. 52 vs 78. 64±8. 24, 88. 38±12. 12 vs 72. 37± 8. 82, 73. 21 ± 8. 46 vs 60. 25 ± 7. 23, 75. 35 ± 8. 13 vs 62. 63±7. 29)μm.?CONCLUSlON:Danggui Shaoyao Powder combined with trabeculectomy and bevacizumab on neovascular glaucoma can promote visual acuity recovery, control intraocular pressure, and improve the retinal nerve fiber layer thickness.