Objective To investigate the distribution of the bacteria in ascites of spontaneous bacterial peritonitis (SBP), and to find out the resistance of the bacteria to antibacterial agents. Methods 44 inpatients from 1999 to 2003 with SBP and positive bacterial culture in ascites were selected, and the bacterial distribution, resistance to drugs and the application of antibacterial agents were analyzed. Results 88.6% (39/44) of the 44 isolations were gram-negative bacillus, among them 28 isolations were E. coli. The results of drug sensitive test revealed that 90% of E. coli, Aeromonas sobria, Klebsiella pneumoniae were sensitive to the third generation of cephalosporin. The resistant rate of E. coli to cefotriaxone and cefotaxime were 11.54% and 12.50%, respectively. Conclusion The third generation of cephalosporin was the experiential selection in treating SBP before getting the report of drug sensitive test. Anti-bacterial agents combined with ?-lactamase inhibitors may be used in treating some severe cases.

Objective:To compare the characteristics of pruritus after epidural and subarchoid morphine for postoperative analgesia. Method: One hundred and twenty patients after hysterectomy were randomly allocated to receiving subarchoid morphine 0.5mg(group Ⅰ,n=60)or epidural morphine 2 mg(group Ⅱ,n=60),respectively. The pruritus incidence, pruritus scale, time and site of occurrence were observed in both groups. Result: In group Ⅰ, the pruritus incidence of 87%,27% of pruritus scale being more than 2 and total pruritus scale being 8 (0-18) were significantly higher than those[31%, 12% and 6(0-14)] in group Ⅱ (P

Objective To evaluate the use of preoperative MSCT in patients with clinically suspected colorectal disease after incomplete colonoscopy Methods After incomplete colonoscopy, 31 patients underwent MSCT before and after intravenous injection of iodinated contrast agent CT virtual colonography (CTVC), multiplanar reformation (MPR), shaded surface display (SSD), and Raysum images were obtained by using 4 different software in workstation The results of MSCT were compared with the findings of colonoscopy, intraoperative colon palpation, and postoperative pathology Results After incomplete colonoscopy, MSCT was successfully performed in all 31 cases Postoperative pathology revealed 22 colorectal cancers (one synchronous cancers, two with polyps) and 9 benign disease 22 colonic carcinomas were all correctly diagnosed by MSCT (including synchronous disease), 2 benign diseases were misdiagnosed as malignancy, and one polyp was missed Conclusion MSCT is a feasible and useful method for evaluating the entire colon before surgery in patients with occlusive disease

Objective To evaluate the reason of the complications after treating by the intermaxillary traction with the titanium screw and put forward the measures of prevention these complications in mandibular fractures.MethodsOne hundred and twenty-six cases with mandibular underwent intermaxillary traction and fixation with tapping titanium screw were observed and counted for their complications in 1-30 days after finishing the operation.Summarized and analyzed the reasons of the complications.ResultsThe rate of complications was 9.52％(12/126),4 cases of titanium screw loosen,2 cases of bad occlusion,1 case of titanium screw fallen off,1 case of titanium screw around infected,1 case of root tip damage,1 case of titanium screw maxillary penetrated into the sinus,1 case of nerve injury,1 case of dental ulcer.Conclusion The intermxillary traction with the titanium screw is simple,safety and healthy method,but the postoperative complications also don't allow to ignore,surgeons should be controlled strictly,standardized operation,try to avoid complications.

Objective To evaluate the differences of clinical features,neuroimaging,angiography and laboratory findings between different stroke subtypes according to TOAST criteria in elderly patients.Methods 91 patients (aged ≥ 80 years) with acute ischemic stroke were retrospectively reviewed in Departement of Neurology from April 2009 to August 2010.Subtypes of ischemic stroke were analyzed according to the classification of TOAST.Risk factors,clinical manifestations,complications,prognosis,neuroimaging,cerebrovascular lesions,and laboratory findings of different TOAST subtypes were compared.Results Large-artery atherosclerosis (LAA) (34/91) was the most common cause of acute ischemic stroke in elderly patients,and most criminal lesions (25/34) located at the intracranial arteries.In the LAA group,patients with intracranial (25/34) or extracranial (12/34) occlusive diseases were more than those in other groups.Patients with cardioembolism (CE) had lower lipid levels.In the CE group,patients with poor shortterm prognosis (7/15) were more than in the LAA or small-artery occlusion (SAO) group,and patients with severe cerebral edema (4/15) were more than those in other groups.In patients of the SAO group,complications occurred infrequently (4/20),and none had poor short-term prognosis.Conclusions There were some differences among different TOAST subtypes in clinical features,neuroimaging,cerebrovascular diseases,and laboratory findings.The clinical significance of our findings needs to be explored further.

BACKGROUND:The patients with porcelain-fused-to-metal crowns who do examination of magnetic resonance imaging (MRI) can cause artifacts. In recent years, researching for MRI artifacts of different porcelain-fused-to-metal materials has been some progress, but there are less quantitatively reports on the MRI artifacts of different porcelain-fused-to-metal materials.
OBJECTIVE:To evaluate the artifact sizes shown on fast spin-echo T 2-weighted sequence caused by different kinds of porcelain-fused-to-metal crowns.
METHODS:Forty-eight lower right first molar crown patients who had MRI examination in MRI room were enrol ed. The patients were divided into nickel-chromium al oy group, cobalt-chromium al oy group and titanium crown group. Al patients were examined with fast spin-echo T 2-weighted sequences by means of 1.5 T MRI apparatus. MRI artifacts areas of same sequence on the MRI images of different porcelain-fused-to-metal materials were analyzed with variance test.
RESULTS AND CONCLUSION:Forty-five cases appearing to have high signal samples with clearly curved boundary zone that can be measured were selected, 15 cases for each material. Different artifact sizes were produced on the same sequence of different porcelain-fused-to-metal materials, which were (321.67±33.29) mm in the nickel-chromium al oy group, (263.53±34.95) mm2 in the cobalt-chromium al oy group, and (143.67±31.13) mm2 in the titanium crown group. There were significant differences between groups (P<0.05). The artifact size is smal est for the titanium crown and largest for the nickel-chromium al oy crown.

Objective To analyze the clinical characteristics and treatment Methods of severe com?plications after percutaneous tracheotomy( PDT) in neurosurgery patients,and to provide reference for the treat?ment and rescue of these patients. Methods A retrospective analysis of 578 cases after PDT was performed in Neurosurgery Intensive Care Unit ( NSICU ) of Xuanwu Hospital of Capital Medical University from 2005 to 2015. The types of complications,treatment method and prognosis were analyzed. Follow?up was 3 months to 1 year. Results Eighteen cases with severe complications,including bleeding,wound infection,asphyxia caused by tracheal mucosa suffocation,airway stenosis caused by granulation tissue,subcutaneous emphysema and neu?momediastinum,etc. After treatment and active rescue,most patients recovered,no patients die directly associated with surgery. Conclusion PDT plays an important role in the treatment of patients in NSICU,but it is still pos?sible to have serious complications,so physicians must understand and be prepared for complications,and pay more attention to prevent poor prognosis.

Objective To explore the construction and application effects of extended care form for children with epilepsy based on Omaha System.Methods Based on Omaha System,the form was established by referring medical records,literature review and three rounds of focus group discussion.From February to June,2016,48 children with epilepsy were selected as the observation group and received routine care as well as management using the form based on Omaha System;from August to December,2015,48 children with epilepsy were selected as the control group and received routine care and follow-up.The effects of intervention and scores of Family Management Measure were compared between two groups.Results Nursing issues in all domains for the observation group 3 months after intervention were lower than those during hospitalization except financial situation (P＜0.05);there was statistically significant difference in scores of knowledge-behavior-status of main nursing issues before and after intervention except cognition and mental health items (P＜0.05).Duration of hospitalization,expenditure,readmission rate,EEG results and scores of FAMM in the observation group were better than those in the control group (P＜0.05).Conclusion The construction and application of the form based on Omaha System can provide references for longterm management for children.

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Objective To explore the effectiveness and safety of high frequency oscillatory ventilation(HFOV) in children with measles complicated with severe pneumonia and the acute respiratory distress syndrome(ARDS).Methods A total of 63 children with measles complicated with severe pneumonia and the ARDS were divided into conventional mechanical ventilation(CMV) group and HFOV group.The PaO2/ FiO2,oxygenation index (OI),HR and mean arterial pressure (MAP) before treatment and 12 h,24 h,48 h after treatment were detected.The rate of air leak and the motality in two groups were compared.The efficacy and safety of HFOV treatment were evaluated in children with measles complicated with pneumonia and severe ARDS.Results In HFOV group,the PaO2/FiO2 ratio was elevated and OI was decreased significantly after 12 h and maintained for at least 48 h.Compared with CMV group,OI of HFOV group improved more significantly,and the difference was statistically significant.The ventilation time in HFOV group was shorten than that in CMV group[(7.97 ±3.06) d vs.(11.03 ±3.60) d],but there was no statistical difference between two groups (P ＞ 0.05).The heart rate after treatment 48 h was gradually returned to normal,and there was no statistical difference between the two groups.There were no significant changes in the MAP of two groups after treatment.There were no significant differences in the incidence of air leak between the CMV group and the HFOV group(24.2％ vs.16.7％).The mortality rate of CMV group and HFOV group was respectively 45.5 ％ and 33.3 ％,and there was no statistically significant difference.Conclusion HFOV was effective in oxygenation and seems to be safe for pediatric patients with measles complicated with severe pneumonia and the ARDS.Also it didn't influence the occurrence of complications.It has no adverse influence on hemodynamic parameters.Early intervention of HFOV is safe and effective for the children with measles complicated with severe pneumonia and ARDS.