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.

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.

Objective To observe the effects and the mechanism of the thoracic pressure variation on the velocity of tricuspid regurgitation in quiet respiration, to accurately estimate the pulmonary artery systolic pressure,and to verify the new proposed mechanism of respiration effects on hemodynamics using echocardiography. Methods Continuous-wave Doppler spectra of tricuspid regurgitation were recorded with Sequoia 512 in 50 patients who had stable tricuspid regurgitation. Electrocardiogram and respiratory tracing were recorded simultaneously. The velocities and the pressure gradients were recorded during different respiration phases for analyzing. Results Respiration reliably affected on tricuspid regurgitant velocity. There were three patterns of manifestation:①The velocity increased in the inspiratory phase. ②The velocity decreased in the inspiratory phase. ③The velocity changed randomly. Conclusions Thoracic pressure variations had definite effects on the velocity of tricuspid regurgitation and tricuspid gradient. This research indicated that to obtain accurate and reliable Doppler echocardiographic measurement of the pulmonary artery systolic pressure, the measurement should be at the time between inspiration and expiration.

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 evaluate the efficacy and safety of micronised fenofibrate on lipid and uric acid metabolism in patients with hyperlipidemia.Methods: A total of 116 patients with hypertriglyceridemia and hyperuricemia received 200 mg micronised fenofibrate for 4 weeks.Physical and laboratory investigations of lipid profiles,serum uric acid,and 24 h urine uric acid,for adverse effects were assessed.Results:(1) Serum triglyceride(TG) was significantly reduced by 51%,whilst high density lipoprotein cholesterol(HDL-C) increased 24% after 4-week fenofibrate treatment.Moreover,serum total cholesterol(TC) and low density lipoprotein cholesterol(LDL-C) were reduced by 10% and 12%,respectively.(2) Serum uric acid levels were significantly reduced by 28.3% [from(462.8?73.5) ?mol/L to(320.1?83.0) ?mol/L] after fenofibrate treatment,independent of baseline uric acid le-vels.There was no difference in serum uric acid changes between male gender and female gender(29.8% and 25.1%,respectively).(3) Urine uric acid levels were increased by 36.0% [from(2 874.2?503.4) ?mol/L to(3 604.2?769.7) ?mol/L].The urine uric acid changes were 41.1% in male gender group and 33.4% in female gender group.The uric acid clearance/creatinin clearance ratio was increased in all cases after treatment.Conclusion: Micronised fenofibrate treatment could significantly improve lipid and uric acid metabolism in patients with hypertriglyceridemia and hyperuricemia,and is ge-nerally safe and well tolerated.The anti-hyperuricemic effect of fenofibrate is a result of increasing the urinary excertion of uric acid,independent of baseline level and gender.

The present report is concerned with the surface structure of the metacercaria of Pa-ragonimus iloktsuenensis as visualized with the scanning electron microscopy. The meta-cercariae were obtained from the liver of tne Sesarma dehaani collected in Yingkou county, Liaoning Province.The tegumental spines of the metacercaria are single-pointed and densely distributed over the entire body and are slightly different in size and shape in different parts of the body. On the forebody of the ventral surface, a vertical ridgeline can be seen in the middle of the spines.In addition to the short spines, there are two circles of non-ciliated papillae on both lips of the oral and the ventral suckers. Around the oral sucker, there are 12 papillae on the outer circle and 6 on the inner circle; around the ventral sucker, there are 6 papillae on both the outer and inner circles. No sensory papillae were found around the ventral sucker. On each side of the anterior part of the ventral side, 8 to 10 pairs of papillae are arranged in two rows.