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 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 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 describe the clinical features and immunological of Uygur systemic lupus erythematosus (SLE) subjects.Methods:Atotal of 484 adult patients (≥18 years) followed in the People's Hospital of the Xinjiang Uygur Autonomous Region were included into this study including 211 Uygur patients with SLE and 273 Han patients with SLE.Results:① Of the 211 Uygur SLE patients, 195 (92.4%) were female and 16(7.6%) were male (female:male=12.2∶1), the mean age at SLE onset was 15-64(35±12) years, mean disease duration was 0.1-228(21±35) months.② Of the 211 Uygur SLE patients, the most prevalent clinical presentationswere renal involvement 56.4%(119/211), hematological 56.4%(119/211), rash 50.2% (106/211), arthralgia/arthritis 49.8%(105/211), weakness 47.9%(101/211). The significant difference observed between the Uygur and Han SLE patients was Raynaud phenomenon( χ2=6.066, P=0.014) .③ The positive rates of antinuclear antibodies were 94.8%(200/211), 54.5%(115/211) for anti-dsDNA antibodies, 47.9% (101/211) for anti-SSA antibodies, 35.1%(74/211) for anti-U 1-RNP antibodies, and 28.4%(60/211) for anti-AHA antibodies. The positivity of anti-AHA antibodies ( χ2=4.952, P=0.026) was higher in Uygur SLE patients than thatin Han SLE patients. More Uygur SLE patients were anemic ( χ2=6.904, P=0.009), with decrease of complement ( χ2=6.330, P=0.012). Conclusion:This study can not find any significant differences between the Uygur SLE patients and Han SLE patients in common clinical manifestations in Xinjiang. The Uygur SLE patients are more likely to have anemia and decrease of complement, which may be related to race and diet habits.

Objective To discuss the characteristics of in-patients with Beh(c)et's disease in Xinjiang Uygur Autonomous region.Methods Clinical data of 146 cases with Behcet's disease admitted to Xinjiang Uygur Autonomous region people's hospital were analyzed.The demographic data and clinical manifestations were analyzed retrospectively.The categorical data was compared using x2 test or Fisher's exact test.Results ① Of the 146 patients with BD,99 cases were Han,47 cases were uyghurs.Oral ulcer were observed in 146 cases (100％).Genital ulcer occurred in 115 cases (78.8％),of which 76 were Han (76.8％),39 (82.9％) were uyghurs,the difference was not significant (P=0.391).The initial presentation was oral ulcer in 83 cases (56.8％),of which 60 cases (60.6％) were Han,23 cases (48.9％) were the uyghurs.The second most common presentation was oral ulcer and genital ulcer,which occurred in 42 cases (28.8％),of which 23 cases (23.2％) were Han,19 cases (40.4％) were the uyghurs.More Han patients initially presented with both oral and genital ulcers than uyghur (P=0.032).② Skin lesions were recorded in 66 cases (45.2％),of which 45 cases (45.4％) were Han,21 cases (44.7％) were the uyghurs,the difference was not significant (P=0.930).③ Joint damage occurred in 40 cases (27.4％),of which 22 cases (22.2％) were Han,18 cases (38.3％) were the uyghurs.Joint damage wasmore frequently observed in Han than in uyghur (P=0.042).④ Eye lesion happened in 21 cases (14.4％),ofwhich 9 cases (9.1％) were Han,12 cases (25.5％) were the uyghurs,ie,eye lesion of Uyghur was higher than Han (P=0.008).⑤ Vascular lesions were detected in 8 cases (5.5％),of which the 5 cases were Han,3 cases were uyghurs,the difference was not significant (P=0.712).⑥ Nervous lesions were observed in 2 cases (1.37％),1 was Han and one was uyghur,the difference was not significant (P=0.542).Conclusion The most common clinical presentations of BD in Xinjiang region are oral and genitalulcers.Skin,joints,eye,vascular,nervous system can also be affected.Joint damage in Han is higher than Uyghur,but eye lesion of Uyghur is more common than Han.

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.