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.

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.

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.

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 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. [

Objective This study was designed to investigate the clinical characteristics of systemic vasculitis with cardiac involvement.Methods Clinical information of 10 patients with systemic vasculitis complicated by myocardial vasculitis,selected from 181 small vessel vasculitis patients and 114 systemic vasculitis patients were analyzed.Results The clinical manifestations were varied significantly dependent on the etiology of small vessel vasculitis.It is usually djfficult to make the diagnosis because of the insidious onset,varied etiology and the undifferentiated manifestations of heart involvement.Echocardiography is commonly used in detecting and monitoring cardiac involvement.Glueocortieoid therapy can improve left ventricular systolic function dramatically when used properly.Conclusions The cardiac involvement of systemic vasculitis is quite rare.Dyspnea of various degrees and left ventricular systolic dysfunction ale the most common clinical findings.The earlier the establishment of diagnosis and institution of appopriate treatment,the better the prognosis.

Objective To investigate effect of first, second, and third trimester placental factors (PF) on CD4, CCR5, and CXCR4 expression in human peripheral blood lymphocytes (PBLs), and to explore their influence on human immunodeficiency virus (HIV) vertical transmission.Methods Human peripheral blood mononuclear cells (PBMCs) were treated with first, second,and third trimester PF (concentration 25%) respectively for 24 hours. The expression of CD4, CCR5,and CXCR4 in PBLs, and the percentages of CCR5+, CXCR4+,and CCR5+CXCR4+ cells in peripheral blood CD4+ lymphocytes were determined with flow cytometry.Results All trimester PFs reduced CCR5 expression in PBLs. The efficiency of the first trimester PF was higher than that of the second and third trimester PF. The percentage of CCR5+ cells in peripheral blood CD4+ lymphocytes of PF groups was significantly lower than that of the control group, and the percentage of CCR5+ cells in peripheral blood CD4+ lymphocytes of the first trimester PF group was significantly lower than that of the second and third trimester group. The percentages of CCR5+CXCR4+ cells in peripheral blood CD4+ lymphocytes of PF groups were significantly decreased as compared with the control group, and the percentage of CCR5+CXCR4+ cells in peripheral blood CD4+ lymphocytes of the first trimester PF group was significantly lower than that of the third trimester PF group.Conclusion PF can reduce the expression of CCR5 in human PBLs and peripheral blood CD4+ lymphocytes, indicating that PF might reduce R5 virus infection via preventing HIV entry, and might play an important role in reducing R5 virus intrauterine infection.