ObjectiveTo observe the infection of continuous aspiration of subglottic secretion(CASS) for patients with ventilator associated pneumonia (VAP).MethodsOne hundred and fifty VAPpatients under mechanical ventilation whose basical information were recorded were divided into two groupsby random digits table method:control group(70 cases) and CASS group(80 cases).Conventional VAPprevention was taken in control group and CASS group,while CASS therapy was added to CASS group.ResultsSex,age,acute physiology and chronic health evaluation Ⅱ score,recent antibiotics usage,airpressure,time in ICU,hospital stay and mortality rate of two groups had no statistical significance(P ＞0.05 ).The time of ventilator treatment of CASS group was obviously shorter than that of control group [ (5.2 ±1.4) d vs.(7.8 ± 1.2) d,P =0.02 ],and VAP incidence was lower than that of control group [ 22.5％ (18/80)vs.32.9％(23/70),P =0.04 ].ConclusionCASS could reduce the incidence of VAP and short the time ofventilator treatment.

OBJECTIVE:To discuss the economic efficiency of different antimicrobials in treatment of lower respiratory tract infections(LRTI) METHODS:50 cases of LRTI collected from this hospital were divided into two groups:A,pefloxacin;B,ceftazidime Evaluation was carried out with pharmacoeconomic cost-effectiveness analysis RESULTS:The total costs were 957 60 yuans and 1 596 00 yuans and the effective rates were 84% and 92% in group A and B respectively An increase of 1%effective rate in group A saved 79 80 yuans in comparison with that in group B CONCLUSION:The therapeutic scheme of pefloxacin seems to be the best one for treating LRTI

Objective To investigate and analysis the prevalence rate of hospital infection and community infection,and to reduce the incidence of hospital infection.Methods First we investigated hospitalized patients in September 9,2013 by two ways which in-clude bedside investigation and reviewing the medical records;and then described the prevalence case of infection and the usage of antimicrobial agent by descriptive approach.Results Seven hundred and seventy patients were investigated with the rate of 100.00%;18 patients were hospital infection cases,the infection rate was 2.34%;most of the hospital infection cases was occur in lower respiratory tract;228 patients were community infection cases.The infection rate was 29.61%;the primary affected areas of community infection were respiratory and gastrointestinal tract;the structure of hospital infection pathogens were almost the same with the community infection,most of them were G- bacteria;186 patients were used antimicrobial agent in that day,the usage rate was 24.16%.Conclusion Promoting the managements of high risk departments and susceptible affected areas,making relevant rules of operation are the focus of our works in the future.

[Objective]To test the biomechanical effects of calcium phosphate cement in fixating distal tadius fractures,and to provid biomechanical foundation for clinical treating distal tadius fractures.[Method]A models of 18 human distal radius fracture of adult upper limbs specimen were made and randomly divided into three groups:fixed with Kirschner wire(Kirschner group),CPC(CPC group),and CPC combined with Kirschner wire(combination group).Wrist joint was vertically loaded with 98 N,and palmar flexion with dorsal extention motion was dimulated,which range of movement was from palmar flexion 5?to dorsal extention 30? and frequency was 2000 cycles.Displace data of distal radius were measured by sliding caliper at every 500 cycles,we had tested Young' s modulus of two samples of CPC.[Result]Multiple factor variance analysis was used,Kirschner group and others had significantly statistical difference(P0.05).[Conclusion]CPC can provide enough fixation strength for distal radius fracture with bone defect and Young' s modulus of CPC is about 30 MPa,which is between those of cancellous bone and compact bone.

Objective To investigate the anti-rotavirus effect of Gegen Qinlian decoction on rotavirus (RV)-inducing diarrhea neonatal mice model, and provide evidences for pharmacological and pharmacodynamic studies. Methods Neonatal diarrhea mice model of Kunming family infected with RV-Wa was developed. Symptom, diarrhea ratio and severity level, histological changes of neonatal mice’s small intestine and lung was assessed after Gegen Qinlian decoction (0.78 g/kg) treatment. Results Diarrhea ratio, diarrhea severity level, histological changes of neonatal mice’s small intestine and lung were obviously decreased after Gegen Qinlian decoction (0.78 g/kg) treatment. Conclusion Gegen Qinlian decoction has anti-rotavirus effect on RV induced diarrhea.

Objective To research the experience of cardiac death organ donation based on the transplant coordinator.Methods Survey was made in The Third Xiangya Hospital of Central South University,and potential donors,data were collected from March to October,2010.Through defining four concepts:potential DCD donors,effective DCD donor,success ratio of DCD donor,rejection ratio of DCD donors,the DCD work was quantitatively analyzed.Results There were 16 potential DCD donors and 5 effective DCD donors,and the success ratio of DCD donor was 31.3 0％ (5/16).In the 11 failure cases,there were 3 cases (27.3 ％) whose family refused to donate,3 cases (27.3 0％) whose family had no consentaneous opinions on denotation,4 cases (36.4 ％) whose organ quality did not meet the criteria because of delaying time when dealing with various kinds of disputes or coordinating with various departments,and one case (9.1 ％ ) whose donated organ was unqualified.Rejection ratio of DCD donors was 37.5 ％ (6/16).Conclusion We need to do efforts to further improve the potential DCD donors,discovery.Transplantation coordinator plays an important role in human organ donation work,whose communication skills and professional knowledge still need to be further trained.It is not enough to just rely on the medical department and Red Cross,human organ donation work needs the collaborative participation among the administrative department,the traffic department and the department of justice.

The main causes of early mortality after the earthquake are traumatic shock, hemorrhage and dehydration, and the ratios of shock and hemorrhage are high in patients with abdominal injuries. Prompt triage is very important to persons with abdominal injuries who were rescued in 48 hours after the earthquake. Primary triage should be carried out in the rescue field, and then followed by the secondary triage in the hospital. We improved the efficiency and accuracy of triage by following the principle of "5 steps, 3 categories and 1 indication". Nineteen persons with identified abdominal injuries and unstable vital signs received operation. The false positive rate was 5% (1/19), and the successful rate of the operation was 95% (18/19). During the process of rescue, the lives of the injured persons should be put in the first place. The operation should be performed under the principle of simpleness, rapidity and safeness.

Preoperative portal vein embolization(PVE)has become an important tool in the management of selected patients with hepatic cancer before the major hepatic resection is carried out.PVE can redirect the portal flow to the intended future remnant liver tissue in order to induce the hypertrophy of the non-diseased portion of the liver and thereby may reduce the occurrence of complications and shorten the hospitalization days after surgery.This article aims to review the technical and clinical considerations in performing PVE and to discuss the PVE-related practical points,including the relevant anatomy,the access approach,the choosing of embolic agents and the pathophysioiogy of PVE.In addition,the indications and contraindications for performing PVE,the use of combination therapies and the concern for tumor growth after PVE are also discussed.

BACKGROUND:intervertebral disc degeneration can reduce nucleus pulposus cells,and peroxiredoxin II involved in the regulation of resist oxidation damage,cell division,differentiation,signal transduction and apoptosis.Peroxiredoxin Ⅱ has promotive effect on intervertebral disc degeneration,whereas the mechanism remains poorly understood.OBJECTIVE:To observe the effects of perexiredoxin Ⅱ on human intevertebral disc cells activity and type Ⅱ collagen synthesis in vitro.METHODS:Human degenerated human lumbar disc cells were cultured in vitro,and assigned into the control and peroxidase Ⅱ groups.Peroxidase Ⅱ with doses of 10,100 and 1 000 ng/L were added into the peroxidase Ⅱ groups.The cells were identified by immunohistochemical staining,and the cell proliferation was detected using cck-8 kit.Cell supematant was collected at days 3 and 7 after operation,and the expression of type Ⅱ collagen was measured by double-antibody sandwich enzyme-linked immunosorbent assay.RESULTS AND CONCLUSION:In vitro cultured human degenerative lumbar intervertebral disc nucleus pulposus cells by adding peroxidase increased with the dose-Ⅱ,the disc nucleus pulposus cells of the volume and type Ⅱ collagen synthesis gradually reduced(P ＜ 0.01).Tips peroxidase Ⅱ on the intervertebral disc nucleus pulposus cells,the number and type Ⅱ collagen synthesis significantly inhibited in a dose-dependent manner.Thus speculated that peroxidase Ⅱ on the nucleus pulposus cells in vitro may lead to disc degeneration as a precipitating factor.

Objective To understand the basic situation of hospital infection ,relevant problems were collected so as to pro‐vide reference for making infection control program .Methods Infection data in 2013 was reviewed and input into database which was built by EpiData3 .0 ;the descriptive statistical method was used for the characters of clinical distribution of hospital infection and χ2 test was used for the rate comparison by the SPSS17 .0 software .Results Four hundred and thirteen hospital infection cases were found in 2013 and infection rate was 1 .2% ,which was higher in patients with malignant tumor .The main parts of hosipital in‐fection were respiratory and urinary system .Escherichia coli ,Pseudomonas aeruginosa ,Acinetobacter bacteria Bauman ,Staphylococ‐cus aureus and Klebsiella pneumoniae were the main pathogen in nosocomial infection .Conclusion The focus for future prevention and control work are to strengthen hospital infection training ,susceptible sites management ,and formulate relevant rules of opera‐tion .