Objective To evaluate the value of percutaneous endoscopic gastrostomy (PEG) in the treatment of amyotrophic lateral sclerosis (ALS) patients with dysphagia. Method Sixty-five ALS patients underwent PEG from April 2005 to July 2010 were analysed retrospectively. Results All the 65 patients underwent PEG,and 2 patients failed because of dyspnea. Totally 63 patients were intubated successfully,the successful rate was 96.9%(63/65). The operation time was 8-17 min. Two patients had local infection.After 3 months, the body mass index was increased from (18.3 ± 1.0) kg/m2 to (19.7 ± 1.2) kg/m2(t = 15.8,P ＜ 0.01), without peritonitis, migration of the gastrostomy tube and other complications. Conclusions PEG is a safe method with a low complication for ALS patients to get enteral nutrition. Dyspnea is the main reason of failure.

Objective To study the indoor air pollution characteristic and control countermeasure. Methods 10 office rooms and 100 houses that were newly redecorated for one month were chosen for the determination of formaldehyde, TVOC, ammonia and radon. The distribution characteristic of time, space of pollutants was studied. Results The concentrations of formaldehyde, TVOC, ammonia in the investigated office rooms exceeded the standard limits greatly, the average levels were 0.533, 5.57and 0.396 mg/m3 respectively. In the 100 houses, the rates of exceeding limit of formaldehyde, TVOC, ammonia were 35.0%-78.8%, 56.0%-75.0% and 37.0%-41.7% respectively. In the two kinds of sites, the concentration of radon did not exceed the limit. Along with ventilation, the concentrations of pollutants went down. Conclusion Indoor air pollution caused by redecoration is serious in a certain degree in Lanzhou.

Objective To understand the environmental lead pollution level caused by a lead smeltery.Methods From the surrounding of the investigated factory,the farmland soil,sediment,water,ambient air,courtyard dust,waste and 7 kinds of crops were collected to determine the lead level.Results Respectively,the lead concentration was 3.1 mg/L in the agriculture irrigation water,exceeded the allowed limit by 30 times,was 0.07 mg/L in the pond water,exceeded the allowed limit by 0.4 time,was 1 101.5 mg/kg in the sediment of the pond,exceeded the allowed limit by 0.10 time,was 7 400.0 mg/kg in the river sediment,exceeded the allowed limit by 6.40 times,was 47.0-287.9 mg/kg in the farmland soil and within the 400 m bound around the lead smeltery,the average level in the soil was 195.0 mg/kg.Conclusion The lead smeltery has caused the lead environment pollution in degrees,it is the main source of lead pollution that caused high blood lead in some people living in that area.

Objective To describe a new method of reconstruction of anterior crucial ligament(ACL) so as to avoid additional injury of peripatellar tissue and complications caused by procuring autograft from the patellar tendon. Methods To reconstruct the injuried ACL under arthroscopy by means of identical length of allogenic achilles tendon which was stored in deep hypothermia. At the same time, injuried medial collateral ligament(MCL) was reconstructed by using the achilles tendon. Results From January 1996 to June 2000, the ACLs in 31 cases were reconstructed by allogenic achilles tendon under arthroscopy. The average period of follow up of 25 cases(26 sides) was 18.9 months(12-49 months). Among them, 4 injuried MCLs were also reconstructed, 5 torn meniscus were sutured, and 6 were resected or partially resected. According to the Lysholm score method, the average score was 53.5 preoperatively, and 84 postoperatively, the satisfactory rate was 84.6%. The objective examination showed anterior drawer test(ADT) positive in 23 preoperatively, 1 postoperatively; Lachman test was positive in 25 preoperatively, 1 postoperatively, and weak positive in 2 postoperatively. There were 2 with pain in knee joints and 3 with limitation of activity of knee joints(5?-20?)postoperatively. Conclusion Allogenic achilles tendon, a materials can be procured in advance, and the injury and complications caused by the autograft can be decreased, and MCL can be reconstructed at the same time. With this technique, the material is convenient to obtain, the operative method is simple, and there is no need for internal fixation.

Aphasia is one of the major complications after stroke, which needs an effective assessment. Event-related potential (ERP) has been widely researched in neurology, the endogenous components, such as P300, N400, mismatch negativity (MMN), contingent nega-tive variation (CNV) have been widely used in diagnosis and evaluation of the impairment of brain function, including the language func-tion. This paper discussed the application of different endogenous components of ERP in aphasia after stroke, especially the comparative analysis of N400 and P300.

Objective To get the thresholds of single and simultaneously multiple bone conduction auditory steady-state response(BC-ASSR) of young adults with normal hearing,and to compare the thresholds obtained with the two methods.Methods BC-ASSR to single and simultaneously multiple stimuli and PTA were examined in 28(56 ears ) young adults with normal hearing.Results At 0.5,1,2,4 kHz,the thresholds of BC-ASSR to single stimuli were 53,47,53,51 dB SPL respectively;the thresholds of BC-ASSR to simultaneously multiple stimuli were 59,54,63,61 dB SPL respectively.There were significant differences between the two at each frequency. Conclusion There are some difference between the thresholds of ASSR to single and simultaneously multiple bone conduction stimuli,especially at the higher frequencies.

Objective To investigate the vicissitude of infection pathogens and their change in resistance to antibiotics in our hospital in the past 10 years, and to offer scientific information for clinical anti-infection treatment. Methods The data of pathogens identified and susceptibility test with VITEK system as well as K-B methods from 1995 to 2002 were analyzed. Results Gram negative bacteria was the predominance bacteria in recent 5 years, accounting for 60.7%-70.2% of all pathogens, with Pseudomonas aeruginosa ranked first, followed by Escherichia coli, Klebsiella pneumoniae, Serratia sp, Enterobacter sp and Acinetobacter sp. The ratio of Acinetobacter sp seemed to be increased in 1998, and it kept a high level in recent years. The isolation rate of Staphylococcus aureus from clinical specimens was the highest among pathogens since 1999, and 42.9%-74.5% of them were Methicillin-resistance S. aureus (MRSA). MRSA was found to be highly resistant to many antibiotics, and there was a tendency of increasing resistance to all kinds of antibiotics in Ps. aeruginosa and Acinetobacter species. Conclusion The significant changes in infectious pathogens in our hospital were an increase in S. aureus and decrease in E.coli in constituent ratios, as well as an elevation of drug resistance level of predominate bacteria. The results suggest that corresponding adjustment should be made in the strategy of infection treatment.

Objective To study the mechanism of resistance to antibiotics and disinfectants of Pseudomonas aeruginosa isolated from clinical specimens in a hospital, and to provide a reference for the use of aminoglycoside antibiotics for the treatment of P. aeruginosa infection as well as disinfection and sterilization. Methods 35 strains of multi-resistant P. aeruginosa were screened from clinical specimens by susceptibility test of agar dilution. Five kinds of aminoglycoside modifying enzyme gene and qzcE?1 gene were detected by polymerase chain reaction (PCR) method. Results The positive rates of aminoglycoside modifying enzyme genes, including aac(3)-Ⅱ, aac(6′)-Ⅰ, aac(6′)-Ⅱ, ant(3″)-Ⅰ and ant(2″)-Ⅰ, were 48.6%, 40%, 54.3%, 45.7% and 60%, respectively, and nearly all strains were positive for 2 or more than 2 kinds of above aminoglycoside modifying enzyme gene. The positive rate of qzcE?1 gene was 94.3%. Conclusions There was a close relationship between aminoglycoside modifying enzyme producing P. aeruginosa and its multi-resistance to antibiotics, The results suugested that aminoglycosides should be used cautiously, and it should be based on the result of susceptibility test in the treatment of P. aeruginosa infection, and it was inadvisable to use quaternary ammonium and biguanides disinfectant in disinfection and sterilization.

Objective To evaluate the therapeutic effect and safety of forward-viewing,doublechannel endoscope in the process of ERCP in patients with bile duct diseases after Billroth-Ⅱ gastroenterostomy.Methods ERCP was applied to 46 patients with bile duct diseases using forward-viewing,doublechannel endoscope.All patients had the history of Billroth-Ⅱ gastroenterostomy.The success rate of selective cannulation,complication rate and the outcome of all the patients were recorded.Results The procedure succeeded in 38 patients with a success rate of 82.6％,and failed in 8.Of all the failing cases,the afferent loop couldn't be accessed in 6,failure in biliary cannulation in 2.Of 38 successful cases,bile duct stones were successfully removed in 31,metal stents placed for malignant bile duct obstruction in 4,and endoscopic balloon dilation for benign common bile duct stricture in 3.All patients recovered without complications of perforation,delayed bleeding or pancreatitis.Conclusion For patients with history of Billroth-Ⅱgastroenterostomy,ERCP with forward-viewing,double-channel endoscope yields to a higher success rate and lower complication rate.

Objective To study the change in sodium channel current(ⅠNa)in the developement of the left ventricular hypertrophy in spontaneously hypertensive rat(SHR).Methods ⅠNa and membrane capacitance(MC)were measured in myocytes of 10,24 and 34-week SHR by the whole-cell patch-clamp technique.Systolic blood pressure(SBP)and left ventricular mass index(LVMI)were detemined.10-week old Wistar rats served as controls.Results LVMI and MC of SHR were significantly higher than those of Wistar rat(P0.05),however the density of ⅠNain 34-week SHR were higher than those of Wistar rat(-18.3?1.9)vs(-15.3?2.0)pA/pF,P