OBJECTIVE To analyze the susceptible factors to offer prevention and treatment of nosocomial pulmonary fungal infection in comprehensive ICU. METHODS The clinical materials of 82 patients with pulmonary fungal nosocomial infection in our department from May 2003 to May 2008 were reviewed. RESULTS The infection rate of total 836 patients was 9.81%.Candidiasis was the most frequent type in fungal infection,59.7% of which were due to Candida.The most clinical features were a large amount of light yellow sputum after tracheotomy and intratracheal indwelling cannula.The factors related to pulmonary fungal nosocomial infection were the severity of the underlying disease,tracheal intubations,broadspectrum antibiotics abuse,long-term use of glucocorticoid,interventional treatment,etc.Fluconazole,amphotericin B and voriconazole had better clinical effects on treatment of fungal infection than other antifungal drugs. CONCLUSIONS It′s important to eliminate the susceptible factors and to provide the early diagnosis and experimental treatment.

Objective To Study on regularity of iron deficient anemia(IDA) in gravida, provide preventive methods and improve hygienic quality.Methods IDA incidence rate of 12W～19W, 20W～27W, 28W～35W, 36W～pregnant duration were anlyzed in 521 gravida.Results The incidence of IDA in gravida was 16 87% and increased with the development of pregnancy.After 20 weeks of pregnancy,the incidence of IDA markedly increased accompanied with by the decreased Fe, SF and TS, especially during the 28～35 weeks of pregnancy, which reached the peak with the anenia incidence of 26 37%,and 80 50% of cases was irom deficient symptom,it suggesting iron deficiency in this stage and Fe, SF, TS decreased to the lowest level and the stored iron was almost exhausted and ZPP increased.Conclusions After 12 weeks of pregnancy,gravida should be supplemented with iron agent. It's also suggested that those gravida with gestational age older than 28 weeks with the Hb levels of less than 105g/L should be considered as IDA and should be treated with iron supplement. [

This paper discusses the nursing cooperation in hepatectomy and splenectomy to treat liver cancer. The nurses in the operative room should provide preoperative visit,learn the results of patients' laboratory tests,provide psychological support for the patients,open enough venous channels for the operation,observe the patients' vital signs closely and cooperate with the surgeons actively. In conclusion,the sufficient preoperational preparation,careful observation and intraoperative care,active and effective cooperation of nurses are important for the success of the operation.

This paper explores the reasonable construction of disease settlement standard system based on production process and source of costs, charging standards and the quantitative relationship between disease and settlement, putting forward clinical path minimum settlement standard and regulate a major guideline for settlement standard for local diseases by excluding the excessive service from patient's wills, high value consumables and high-priced drugs based on clinical path cost variation coefficient measured by disease typing and actual cost variation coefficient determined by class of hospital.

Objective:To observe the effect of He-Ne laser combined with ammonium glycyrrhetate in the treatmnet of 62 patients.　Methods:62 cases of patients with psoriasis vulgar were divided into two groups. 36 cases (A group) received He-Ne laser combined with ammonium glycyrrhetate intravenous infusion, 26 cases(B group) received only ammonium glycyrrhetate. The therapy course of both groups were 30 days.　Results:The total effective rate of two groups was 82.2%. The effective rate of A group and B group were 88.9% and 73.1%, respectively. There was siginfinant difference by the analysis(ridit test)between two groups(U＝2.76，P＜0.01).　Conclusion:The effect of He-Ne laser combined with ammonium glycyrrhetate in the treatment of patients with psoriasis vulglar than that of ammonium glycyrrhetatealone.

Functional magnetic resonance imaging(fMRI) has been widely applied in many fields,such as neurology,psychology,etc.Recently it has also been used to study the visceral hypersensitivity of the gut.This review gives an overview of the basic principle of fMRI and its application in the visceral sensitivity of esophagus and rectum.

Objective:To analyze 3 123 cases of medical device adverse events(MDAE)and provide some suggestions for the MDAE monitoring.Method:By the retrospective case study,3 123 MDAE reports were analyzed in Hunan Province in 2007.Result:The reports mainly came from medical institutions and other drug-use units.Intrauterine devices (IUD),medical suture thread and orthopedic implants caused a higher proportion of adverse events.The quantities of MDAE reports were imbalanced in different regions.Conclusion:The MDAE monitoring should be promoted by propaganda and training in order to ensure the safe use of medical devices in public.

OBJECTIVE:To investigate the rationality of preventive use of antibiotics for patient undergoing thyroidectomy.METHODS:120 patients undergoing thyroidectomy from Jan 2005 to Mar 2007 in our hospital were enrolled.The exclusion criteria were the following:patients with infection,coronary heart diseases,diabetes,and other severe diseases or with body temperature above 38 ℃ and aged above 60.The 120 patients were assigned to antibiotic group and non-antibiotic group.Then the healing condition of incisions in two groups was evaluated.RESULTS:There was no significant difference between the two groups in incision healing.CONCLUSION:Antibiotics don't have to be used in patients undergoing thyroidectomy.

Objective To explore the efficacy and safety of the bronchoscopic high frequency electrocoagulation combined with balloon dilatation in treating tuberculosis inflammatory airway constriction. Methods According to the different methods of treatment, 55 patients with tuberculosis airway constriction were randomly divided into two groups, the balloon dilatation group (26 cases) and combination group (29 cases). The patients in balloon dilatation group underwent bronchoscopic balloon dilatation and the patients in combination group underwent bronchoscopic balloon dilatation combined with high frequency electrocoagulation. The patients of the two groups accepted endoscopic therapy once a week. Effective rate of recanalization for the narrow airway, frequency of effective treatment and the time of tuberculosis bacterium vanishing was recorded. Intraoperative and postoperative complications were also observed. Three months after the treatment, all patients accepted bronchoscopic to observe and assess the airway restenosis rate. Results After treatment, the effective rate in balloon dilatation group and combination group had no significant difference[69.2%(18/26) vs. 89.7% (26/29 )](P＞ 0.05 ),but frequency of effective treatment and time of tuberculosis bacterium vanishing had significant difference[(3.5 ±1.3) times vs. (1.5 ± 1.1) times, (23.3 ±3.6) d vs.(13.2 ±2.3) d](P<0.01). There was no significant difference on the intraoperative and postoperative complications between two groups (P＞0.05). The airway restenosis rate was 33.3%(6/18) in balloon dilatation group and 7.7%(2/26) in combination group after treatment for 3 months (P ＜0.05). Conclusions Combination of bronchoscopic balloon dilatation and high frequency electrocoagulation is an efficacy and safety way for the tuberculosis inflammatory airway stenosis. It can reduce the frequency of interventional therapy, shorten the time of tuberculosis bacterium vanishing, and may also decrease the airway restenosis rate.

Objective To explore the effect of chromofungin (CHR), a chromogranin A (CGA) derived peptide CGA47-66, on hyper-permeability of blood brain barrier in septic mice. Methods 120 healthy male C57BL/6 mice were randomly divided into groups, with 12 mice in each group. Seventy-two mice were used for dynamic observation of the contents of water and Evan blue (EB) in brain tissue after being treated with lipopolysaccharide (LPS). Another 48 mice were divided into normal saline control group (NS group), LPS induced sepsis model group (LPS group), low-dose CHR pretreatment group (CL+LPS group), and high-dose CHR pretreatment group (CH+LPS group). The septic model was reproduced by intraperitoneal injection of 10 mg/kg LPS 0.1 mL, and the mice in NS group was given equal volume of normal saline. The mice in CL+LPS group and CH+LPS group were intraperitoneally injected with 15.5 μg/kg and 77.5 μg/kg CHR 10 minutes before LPS injection. Six hours after LPS injection, 4 mL/kg of 2% EB was injected via caudal vein, the contents of water and EB in brain tissue were determined, and EB immune fluorescence in brain tissue was determined to assess the changes in permeability of blood brain barrier. Brain pathology was observed with hematoxylin and eosin (HE) staining. Results With the extension of time after LPS injection, the contents of water and EB in brain tissue were gradually increased, and the time of difference with statistical significance appeared earlier when compared with that of control group in the contents of water than that in EB contents (3 hours and 6 hours, respectively). The contents of water and EB in brain tissue in LPS group were significantly increased as compared with NS group [water content: (79.77±0.62)% vs. (78.28±0.44)%, P < 0.01; EB content (μg/g): 13.87±4.50 vs. 7.13±1.76, P < 0.05]. CHR pretreatment with either of two dosages could reverse the increase in water and EB contents in brain tissue induced by LPS, and the effect was more significant in CH+LPS group [water content: (78.15±0.73)% vs. (79.77±0.62)%, EB (μg/g): 7.09±2.59 vs. 13.87±4.50, both P < 0.05]. It was shown by EB fluorescence observation that the fluorescence signal displayed only in the meninges in NS group, and EB fluorescence was widely distributed in brain parenchyma in LPS group, indicating that the EB leakage in LPS group was more marked than that of NS group. In CHR pretreatment groups, EB fluorescence was decreased in brain parenchyma, indicating that EB leakage was significantly less marked, while it was more obvious in high dose CHR group. It was shown by HE staining that cerebral blood vessel structure was intact in NS group, and the gap around blood vessel was not significant increased. On the other hand, brain structure in LPS group appeared loose, with widening of small perivascular spaces and obvious edema. Brain edema in CHR pretreatment groups was improved as compared with that of the LPS group, and it was more apparent in high dose CHR group. Conclusions LPS induced change in blood brain barrier permeability in mice in a time-dependent manner. Exogenous CGA derived peptides CHR can inhibit LPS induced hyper-permeability of blood brain barrier in septic mice, thus reduces brain edema, protects the brain tissue, and the effect is more obvious with a high dose of CHR (77.5 μg/kg).