Objective To explore the surgical treatment of carotid body tumor(CBT). Methods The clinical data of 78 patients with CBT were retrospectively analysed. Results Seventy eight patients had 88 tumors (10 patients had bilateral CBT),of which 83 were resected. The operations included:CBT enucleation (28 tumors);CBT resection along with the external carotid artery resection(12 tumors); CBT enbloc resection with partial carotid artery(CA) resection and interposition grafting(3 tumors) or end to end anastomosis (1 tumor), and external to internal CA anastomosis (1 tumor); CBT enbloc resection with CA reconstruction(30 tumors), and CBT resection and CA ligation (8 tumors). The operative mortality was 3.8%(3/78). 65 tumors were followed up for 1～21 years,and one patient died of pulmonary metastasis seven years after the surgery. In the follow up period, 1 patient had a local recurrence two years after the surgery,and reoperation was performed,the patient did well 8 years after the reoperation. One patient with family CBT had an opposite lesion 10 years after the first lesion resection. Conclusions CBT may be bilateral,family occurrence,malignant changes and endocrine secretion charateristics. For small CBT, enucleation can be done first.If CA is involved, external CA remove along with CBT and end to end anastomosis may be a better choice . For tumors invading the internal CA, it is better to resect the lesion with reconstruction of the CA with, an autogenous internal jugular vein graft or prosthesis. For large CBT or CBT adhensed to nearby tissues seriously, end to end anastomosis can be carried out to internal CA at a transversely cutting surface of CBT.

OBJECTIVE To investigate pulmonary fungal infection spectrum and its resistance in older COPD patients with mechanical ventilation.METHODS Retrospective study were performed in 67 cases of COPD patients with mechanical ventilation treatment who were admitted to our ICU from Jan 2004 to Doc 2007.Bronchoalveolar lavage fluid was cultured,differentiation and antifungal susceptilibity testing were taken.RESULTS Seventy-eight fungi strains were cultured in 78 cases,among them,41 strains were Candida albicans(52.56%),14 of C.tropicalis,9 of C.krusei,5 of C.parapsilosis,7 of yeast-like fungi and 2 of Aspergillus.CONCLUSIONS There were increasing fungal infection rate in older COPD patients with mechanical ventilation and C.albicans is still the most frequent type.The resistance to triazole antifungal drug is also increasing.

Objective To study the effect of nasal decontamination on clinical index of elderly patients with long -term indwelling nasogastric tube.Methods 89 elderly patients with long -term indwelling nasogastric tube were randomly divided into nasal decontamination group and routine treatment group.The sputum culture positive rate of bacterial and the incidence of pulmonary complications,pharyngitis,sinusitis of the two groups were observed. Results Sputum Staphylococcus aureus positive rates in the nasal decontamination group and conventional group were 13.043% (6 cases)and 39.535% (17 cases)respectively,the difference was significant(χ2 =8.139,P =0.004).The incidence rates of pulmonary infection in the nasal decontamination group and conventional group were 4.348% (2 cases)and 18.605% (8 cases)respectively,the difference was significant(χ2 =4.529,P =0.033). The incidence rates of pharyngitis in the nasal decontamination group and conventional group were 10.870%(5 cases)and 37.209% (16 cases) respectively,the difference was significant (χ2 =8.553,P =0.003 ). Conclusion Nasal decontamination can decrease the positive rate of sputum bacterial culture,the incidence of pulmonary infection and pharyngitis in elderly patients with long -term indwelling nasogastric tube.For its efficacy and safety,it deserves clinical application.

Objective: To evaluate the operational efficiency of the division-level hospitals of Xinjiang Production and Construction Corps. Methods: Use DEA’s CCR model and BCC model to calculate the overall efficiency, pure technical efficiency and scale efficiency of Xinjiang Production and Construction Corps, and use super-efficiency model to calculate efficiency ranking of the division-level hospitals. Results: In the total pattern, there were 28.6%of the agricultural division hospitals at the stage of constant returns scale;in the medical service model, there were only 14.3% hospitals at that stage. Conclusion: From the results of two models, the technical efficiency has more room for improvement, compared with efficiency scale. The hospital needs to improve the level of health care technique, avoid blind expansion, minimize unnecessary input, strengthen internal meticulous management, and improve the overall operating efficiency of the hospital.

OBJECTIVE:To observe clinical efficacy and safety of escitalopram combined with ozagrel sodium for elderly pa-tients with acute cerebral infarction complicated with anxiety and depression. METHODS:140 elderly patients with acute cerebral infarction complicating with anxiety and depression were divided into control group and observation group according to random number table method,with 70 cases in each group. Control group received routine treatment and Sodium ozagrel for injection 40-80 mg added into 0.9% Sodium chloride injection 500 ml,ivgtt,bid. Observation group was additionally given Escitalopram tablet 10 mg,qd. Both groups received treatment for 8 weeks. HAMA,HAMD,NIHSS and BI were compared between 2 groups before and after treatment,and clinical efficacy and the occurrence of ADR were observed. RESULTS:There was no statistical sig-nificance in HAMA,HAMD,NIHSS,BI before treatment and NIHSS,BI 1 week of after treatment between 2 groups(P>0.05). HAMA and HAMD of observation group 1,4,8 weeks after treatment,and NIHSS and BI of it 4,8 weeks after treatment were improved significantly;above indexes of control group were improved significantly 4,8 weeks after treatment,and the observation group was better than the control group,with statistical significance (P<0.05). The total effective rate of observation group was 87.14%,which was significantly higher than 74.29% of control group,with statistical significance(P<0.05). There was no statis-tical significance in the incidence of ADR between 2 groups(P>0.05). CONCLUSIONS:Escitalopram combined with ozagrel so-dium is significantly effective for elderly patients with acute cerebral infarction complicated with anxiety and depression,and can significantly improve anxiety,depression and neurological function with good safety.

Objective To assess the effect of ambient air SO2 on mortality of respiratory diseases. Methods Based on the ecological theory, after the adjustment of seasons, temperature, humidity and air pressure, the observed individuals were divided into eight groups. The association between SO2 exposure and mortality rate of respiratory diseases was analyzed using Poisson regression and local auto-regression method. Results SO2 concentration increased by 0.05 mg/m3, the mortality of respiratory diseases increased by 5.90% (95%CI: 2.26%-9.68%) in all groups, in children by 10.23% (95%CI: 2.07%-19.04%), in young-middle-male group by 1.10% (95%CI: -9.51%-12.96%), in young female group by 9.58% (95%CI: -2.57%-23.23%), in young group by 10.23% (95%CI: 2.07%-19.04%), in aged male group by 5.26%(95%CI: 0.01%-10.78%), in aged female group by 8.07% (95%CI: 3.45%-12.89%) and in aged group by 4.66% (95%CI: 1.44%-7.99%) respectively. Conclusion SO2 exposure is found to be associated with the increase of mortality of respiratory diseases, especially in children, aged people and elderly females.

Leptomeningeal metastasis (LM),with a high omission rate in diagnosis in approximately 5 ％～8 ％ of all patients, is increasingly recognized as a lethality complication. The diagnosis of LM remains challenges,but commonly can be established by CSF cytology or by definitive neuroimaging. Although a combination of focal radiotherapy,intrathecal chemotherapy,and systemic chemotherapy may be necessary to achieve optimal treatment of patients, but prognosis is unacceptable and therapy remains palliative in most patients.

In this paper, we review the ultrafiltration application in the preparation of Chinese medicine injections, suggesting that ultrafiltration process possesses some features: raising the clarity of Chinese medicine injection, removing impurity and pyrogen, retaining more active components and having partial decoloration. We also discuss some variant effect factors on ultrafiltration.

This paper discussed the detection of tumor micrometastasis, and analysed the influence of chemotherapy and blood transfusion on the immunity of tumor patients. Chemotherapy and blood transfusion can increase the opportunity of tumor metastasis. By analysing the mechanism of the treatment of tumor with traditional Chinese medicine, the author put forward the new method about eliminating tumor micrometastasis with traditional Chinese medicine.

Objective To understand the gray-scale, color and pulsed Doppler sonographic feature of the corpus luteum during the early trimester of pregnancy. Methods The ovaries of 174 patients with intrauterine gestations between 5 to 9 weeks' menstrual age were examined with transvaginal sonography. Size, sonographic appearance, color Doppler feature, resistance index, peak systolic velocity of the corpus letuem were recorded. Results The corpus luteum was identified in 169 of 174 patients(97.1%) . The mean diameter was ( 1.7 ? 0.8 ) cm. The gray-scale appearances were classified into four types:a thin wall cyst(47 patients, 27.8 %), a thick wall simple cyst(45 patients, 26.6 %), a round hypoechoic structure(43 patients, 25.4 %), a thin-walled cyst containing internal debris (34 patients, 20.1 %). Color blood flow was visualized with color Doppler imaging in 92.3 %(156/169). Color Doppler imaging typically revealed a circumferential rim surrounding part or all of the corpus luteum. Low-resistance blood flow was seen with pulsed Doppler, with a mean resistance index of 0.41?0.10 . Conclusions The corpus lutuem in early pregnancy is identified with transvaginal sonography and has different sonographic appearances. It is important to recognize the various appearances of the corpus lutuem to avoidits confusion with true ovarian abnormalities and ectopic pregnancy.