OBJECTIVE To investigate the distribution and resistance of pathogens in lower-respiratory tract infection in our area,and help doctors to use antibiotic reasonably.METHODS According to National Guide to Clinical Laboratory Procedures,API identification system or K-B method,the pathogens of 1326 cases sputum specimens were isolated,identified and tested in drug sensitive test.RESULTS A total of 982 strains of pathogens that included 540(20.0%) G-bacilli,196(20.0%) G+ cocci and 246(25.1%) fungi were isolated from 1326 sputum specimens and the detection rate was 74.1%.From them 176 cases which occupied 13.3% were with mixed infection.The drug resistance of G-bacilli to imipenem was the lowest,then was to cefoperazone and amikacin,but the resistance of ampicillin was the highest.From 234 strains of Klebsiella had 89 strains of ESBLs-positive;in 50 strains of Escherichia coli,the strains of ESBLs-positive were 20(40.0%).The resistance rate of Staphylococcus aureus and S.epidermidis to penicillin was 97.5% and 97.2%,respectively,both of them were sensitive to vancomycin,and less sensitive to ciprofloxacin.Fifty seven strains of MRSA were detected from 90 strains of S.aureus(63.3%);and 42 strains of MRSE were detected(56.0%).CONCLUSIONS G-bacilli are the main pathogens in lower respiratory tract infection and the infection caused by fungi is more than that caused by G+ cocci,so we must pay attention also to mixed infection which occupies certain ratio.

BACKGROUND: Distal humerus fracture is often comminuted, and is difficult to receive reduction and fixation due to its special anatomical structure. Choosing which surgical approach is still a controversy.OBJECTIVE: To compare and analyze the curative efficacy of the perpendicular double-locking plating system for the internal fixation of type C distal humerus fractures through two kinds of postcubital approaches.METHODS: Thirty-two cases of type C distal humerus fractures were enrolled and divided into groups A (osteotomy of olecranon approach) and B (tricep anconeus flap approach). There was no significant difference in the baseline data between two groups. The operation time, intraoperative blood loss, hospital stay, healing time,postoperative follow-up and complications were recorded and analyzed. The patients were followed up at 2 weeks, 1, 3,6, 12, and 18 months. The healing time and complications were recorded according to radiographs and physical examinations. The Mayo Elbow Performance Score was used to determine the elbow function at 1 year postoperatively.RESULTS AND CONCLUSION: (1) The group A had a longer operation time and more intraoperative blood loss than those in the group B (P < 0.05), but showed a better elbow flexion and extension degrees, and higher Mayo Elbow Performance Score at 1 year postoperatively (P < 0.05). (2) There was no significant difference in the healing time between two groups (P > 0.05). (3) These results suggest that the articular surface of the distal humerus fracture is displayed well through two approaches, and the perpendicular double-locking plating system for the internal fixation of type C distal humerus fractures is rational. Noticeably, the tricep anconeus flap approach dose little damage to the muscle, while the osteotomy of olecranon approach obtains better elbow function and less complications.

0.05). The durations between the start of infusion to the onset of SZ, DYS and ASYS were longer in group C than in group A(P

Objective To study surgical techniques and curative effects of laparoscopic vaginoplasty with transferring vascularized ileal flap.Methods Clinical data of 62 cases of laparoscopic vaginoplasty using vascularized ileal flap from March 2004 to March 2006 in this hospital were retrospectively analyzed.There were 16 cases of total laparoscopic surgery and 46 cases of laparoscope assisted surgery.Results The operation was successfully completed in all the 62 cases.The intraoperative blood loss was 30~50 ml(40.0?0.6 ml) and the operating time was 90~313 min(165.0?5.6 min).Intestinal obstruction occurred 1 month after total laparoscopic surgery in 1 case,requiring a re-operation of ileectomy with end-to-end anastomosis.Vaginal stenosis occurred in 3 cases because of incorrect use of the vaginal mold.The remaining 58 cases had satisfactory vaginal dilatation outcomes. Conclusions Laparoscopic vaginoplasty with vascularized ileal flap is micro-invasive and accordant to normal physiological conditions,being an ideal method for vaginoplasty.

Objective To explore the diagnostic value of CT for the vegetable stone disease in the stomach,esophagus and small intestine.Methods The clinical data and CT findings of 27 cases confirmed by endoscopy or surgery were analyzed retrospectively. Among 27 cases,6 cases performed contrast-enhanced scan.Results Among 27 cases,18 cases were the gastrolithiasis,6 cases were the intestinal stone disease,1 case was the esophagus stone disease,and 2 cases were the multiple stones of stomach and small intestine.CT missed 7 cases and misdiagnosed 1 case with the rate of missed diagnosis was 25.93%.The lesions were cylindrical or oval shape with mixed density in 27 cases,distinct boundary in 26 cases,sclerotic margin in 22 cases,ethmoid or honeycomb bub-bles in the lesion in 25 cases,no enhancement in 6 cases,and complicated small bowel obstruction in 8 cases on CT images.Conclu-sion The phytobezoars in the stomach,esophagus and small intestine have typical CT findings.Careful analyses can improve its di-agnostic accuracy.

Objective To investigate the effects of aerosolized prostaglandin E1 (PGE1) inhalation on oxygenation and intrapulmonary shunt in acute lung injury (ALI) .Methods Eighteen healthy male pigs weighing 14-18 kg were anesthetized with intraperitoneal pentobarbital 50 mg?kg-1, intubated and mechanically ventilated (VT=10-15 ml?kg-1, RR= 16 bpm, FiO2=100%) . PaCO2 was maintained at 34-45 mm Hg. Anesthesia was maintained with intravenous infusion of ketamine-procaine-succinyl-choline. Swan-Ganz catheter was placed via right femoral vein. Right femoral artery was cannulated for BP monitoring and blood sampling. ALI was induced by intratracheal instillation of HCl (0.1 mol?L-1) until PaO2 was

Objective: Effects of surfactant replacement were evaluated on graft pulmonary function in rats. Method: Forty adult Wistar rats were anesthetized with an intraperitoneal injection of pentobarbital sodium(30 mg?kg~(-1)), and intubated through tracheolomy. All rats were ventilated with a ventilator. Surfactant of 50 mg was injected into lungs through tracheal. Cold Ringer's solution(0℃-4℃)was infused into the lungs through pulmonary artery, and then they were kept in cold solution. Result: The static lung compliance (SLC)in the both surfactant-replaced S(no airway pressurc)and SP(0.98kPa airway pressure)groups did not markedly decrease after cold storage. However,SLC in the no surfactant-replaced NP (no airway pressure)and P (0.98kPa airway pressure) groups both significantly decreased after cold storage. SLC was higher after lh in the P group than NP group(P

Objective To evaluate effects of pulmonary surfactant (PS) containing ketamine on respiratory failure induced with lung-lavage in rats Methods Twenty Wistar rats were anesthetized with intraperitoneal pentobarbital sodium and were ventilated with the peak inspiratory pressure(PIP) being 1 47 kPa and E:I at 1:1 following intubation through tracheotomy In all rats whole double lung lavage were performed with normal saline (37℃, 40 ml?kg -1 ) 8 10 times after PIP and PEEP were adjusted to 1 96 kPa and 0 49 kPa respectively The rats were randomly divided into A and B groups after PaO 2 decreased to less than 12 kPa In group A (n=10): PS (25mg, 0 5ml) was injected intratracheally to lungs; in group B (n=10): PS (25mg, 0 5ml) containing ketamine 2 5 mg was injected At 120th min after PS injection, PIP and PEEP were gradually adjusted to 1 47 kPa and 0 kpa (ZPEEP), respectively Results PaO 2 in both groups decreased significantly from 59 3 kPa to 10 3 kPa after lung lavage(P0 05 vs pre-lavage) All rats in group B and 4 of 10 rats in group A survived at the end of experiment Conclusions Intratracheal administration with PS containing ketamine not only reverses hypoxemia , but also maintains the respiratory function under low airway pressure without PEEP after respiratory failure induced with lung lavage,

Objective To evaluate the accuracy of performance of Engstrom Eas 9010 vaporizerMethods Using Datex Capnomac AS/3 monitored the output of Gambro-Engstrom Eas 9010 anesthetic agent vaporizer under various situations l Determing the output of vaporizer at different gas flow rates of 0 5,1 0,2 0,4 0,6 0 and 8 0 L?min -1 2 The effects resulting from up stream oxygen flushing 3 The effects due to additional nitrous oxide as carrier gas 4 Effects of different airway pressure at the same flow rate Results 1 The output of the vaporizer was highly correlated with the dial setting at various gas flow rate except dial setting was more than 8% and gas flow rate less than 0 5L?min -1 2 Upstream oxygen flush could not decrease the concentration remarkably 3 The output of the vaporizer was not affected by additional carrier gas 4 The effect on vaporizer output was not remarkable under different airway pressure at the same flow rate Conclusions The anesthetic vaporizer principle used in the Gambro-Engstrom Eas 9010 apparatus is innovative Electronically controlled vapor quanta injection is used with safety feed back Its accuracy can't be influenced by temperature,pressure and carrier gas indicating to be safely applied to the low or even minimal flow anesthesia

Objective The reconstituted pulmonary surfactant (SP) is composed of synthetic lipid(SL) and surfactant- associated protein C (SP-C) . The purpose of this study was to determine the surface tension reducing activity of the reconstituted surfactant containing different concentrations of SP-C.Methods Pulmonary surfactant (SP) was isolated from alveolar lavage fluid of fresh porcine lungs by centrifugation, extraction and precipitateon. SP-C was extracted from PS and SL was prepared by mixing dipalmitoyl-phosphatidyl choline (DPPC), dioleoyl-phosphatidyl choline (DOPC) and palmitoyl-oleoyl-phosphatidyl glycerol (POPG) in the weight ratio of 60: 20: 20. Three synthetically reconstituted surfactants RS-1, RS-2, RS-3, were prepared by adding different concentrations of SP-C to SL. The end concentration of SP-C was 1% , 2% and 3% respectively. Five test liquids (PS, SL. RS-1, RS-2, RS-3) were prepared by suspending the materials mentioned above in nonnal saline. The dynamic surface tension of the five test liquids were measured by a pulsating bubble technique. Thirty-six PS-deficient premature rabbits were studied. The premature rabbits were delivered by cesarean section on the 26 th day of pregnancy. The animals were tracheostomized and mechanically ventilated. 0.1 ml of test liquid PS (group Ⅱ) , SL(group Ⅲ) or RS-3(group Ⅳ) was instilled into the lungs via the tracheostomy cannula. In control group (group Ⅰ) no test liquid was instill. The animals were placed in a body plethysmograph and mechanically ventilated (the maximum inspiratory pressure = 25 cm H2 O, RR = 40 bpm, I: E = 1:1, FiO2 = 100 % made of ventilation IPPV) . Tidal volume was measured at 5, 10, 15 and 20 min after onset of IPPV. Results The minimum surface tension (?min) of PS was 0.9?0.3 mN?m-1 , and of SL was 22.6 ?1.3 mN?m-1 . The ? min of RS-3 was 0.7?0.1 mN ?m-1. The mean tidal volume after 20 min of mechanical ventilation in group Ⅱ(PS) and groupⅢ(RS-3 ) was 25 ?7 ml?kg-1 and 25 ? 4 ml?kg-1 respectively, significantly larger than that in control group (Ⅰ ) and group Ⅲ (SL) . Conclusion The surface tension-reducing activity of SL alone is low. Adding SP-C to SL greatly enhances the surface tension-reducing activity of reconstituted surfactant (RS).