Healthcare-associated pneumonia(HCAP)is a new concept defined by the 2005 American Thoracic Society/Infectious Diseases Society of America(ATS/IDSA)guidelines for the management of adults with hospital-acquired,ventilator-associated,and healthcare-associated pneumonia.In order to provide helpful advice for clinicians,this review recommends how to choose the site of treatment,general management strategies and initial empirical antibiotic therapy in patients with HCAP,and introduces some new antibiotics may be useful in treatment of HCAP.

Objective To explore the expression of caudal type homeobox transcription factor 2 (Cdx2) and liver intestinal cadherin (LI-CD) in intestinal metaplasia ( IM ) of gastric mucosa and gastric adenocarcinoma of the intestinal type (GAIT). Methods By using immunohistochemical method, the ex-pressions of Cdx2 and LI-CD were detected in biopsy sample including 30 cases of GAIT, 30 IM and 30 nor-mal controls. Results The positive rate of Cdx2 expression was 0, 93.3% and 46.7% in normal stomach mucosa, IM and GAIT, respectively. The positive rates of Cdx2 expression in IM and GAIT were significant-ly higher than that in normal stomach mucosa ( P < 0. 005 ), and the expression of Cdx2 in IM was signifi-cantly higher than that in GAIT (P<0. 005). Similarly, LI-CD was also negative in normal stomach muco-sa, and positive rates were 96. 7% and 73. 3% in IM and GAIT group, which were significantly higher than that in normal stomach mucasa (P < 0. 005 ), and LI-CD expression was also significantly higher in IM than in GAIT (P < 0. 05 ). In addition, the staining intensity of Cdx2 and LI-CD expressions in IM exhibited sig-nificant correlation (r=0. 827, P<0.01), but those in GAIT did not (r =0.438, P=0. 117). Conclu-sion Ectopic expression of Cdx2 and LI-CD can be found in IM and GAIT tissues, which could be an early marker in the disease progression. There is correlation between Cdx2 and LI-CD expression in IM tissue of human, and presumably, Cdx2 regulates LI-CD in IM development.

Objective To evaluate the clinical application of ultrasound-guided Mammotome system in the treatment of breast lesions.Methods A total of 1081 patients with 1913 breast lesions received Mammotome minimally invasive excision,and the efficacy of treatment and follow-up results were retrospectively analyzed.Results All 1913 lesions in 1081 patients were treated with the Mammotome system.The duration of operation was 4 minutes,and the average excision times was 15 for every lesion,1894 lesions (99.01%) in 1063 patients were benign breast masses,19 lesions (0.99%) in 18 patients were breast carcinoma.Complication occurred in 39 lesions (2.04%).Conclusion Ultrasound-guided Mammotome system is one of the effective ways in the clinical diagnosis and treatment of breast lesions.

Humans ; Positive-Pressure Respiration ; Respiration, Artificial ; Severe Acute Respiratory Syndrome ; therapy

Objective To evaluate the effect of different health education methods on inhospital pa-tients in sports medicine department and establish the most appropriate health education method. Meth-ods Sixty patients in the sports medicine department of a certain class-3 and grade-1 hospital were inves-tigated by questionnaires in the 10 aspects (such as the acceptability,comprehension,practicablity,vividness,instruction,etc) of 7 different health education methods.The quantitative score of O to 10 grade was adopted.Results The scores of 7 different health education methods were statistically different.The highest score was DVD which was followed by special explanation.The difference of the seven different health education methods was demonstrated in the following aspects such as mutual communication,vividness and memory holding.While the difference in practicability and instruction was not statistically different. Conclusions The health education methods were various and each had its characteristic,so they should be combined.The more satisfying health education effect will be obtained by carrying out health education with DVD as the major style complemented with special explanation,group explanation and multimedia teaching style.

Through study on Bianque Shenying Zhenjiu Yulong Jing (Bianque's Classic of Effective Acupuncture Prescriptions), acupuncture experiences and ideology of WANG Guo-rui, an acupuncture physician of the Yuan Dynasty (1271-1368), is discussed in this article. Inherited and carried forward DOU's acupuncture theory, WANG Guo-rui encouraged to use experiential points and to expand extra points. Penetrating needling method was created, and the application of acupoints according to needling opportunities and seasonal factors were enriched by him. Great importance was also attached on treatment according to differentiation of syndromes, which including the simultaneous acupuncture and moxibustion, simultaneous reinforcing and reducing, reducing after reinforcing, reinforcing after reducing, predomination of reducing and predomination of reinforcing. The flexible treating methods are still extensively adopted in clinic nowadays. WANG Guo-rui is a master of clinical acupuncture who made great contribution to the development of acupuncture and moxibustion.
Acupuncture ; education ; history ; Acupuncture Therapy ; history ; China ; History, Ancient ; Humans ; Male

Objective To observe the neuroprotective effect of celecoxib against degeneration of dopaminergic neurons caused by lipopolysaccharide in vivo.Methods The rat model of Parkinson disease(PD)was established by intranigral injection of lipopolysaccharide.Sprague-Dawley rats were randomly divided into control group,PD group,and celecoxib group.Behavioural changes were recorded,and the expressions of tyrosine hydroxylase(TH)and cyclooxygenase-2(COX-2)were determined by immunohistochmistry and Western blot.Results No behavioral change was found in control group.There was significant difference in the number of circling behavior between PD and celecoxib groups(196.90±9.52 vs 109.30±9.38,P＜0.01).The number of TH-positive cells and the expression of TH protein in rat substantia nigra were significantly higher in celecoxib group than in PD group(P＜0.01).Compared with PD group,the number of COX-2positive cells and the expression of COX-2 protein were significant lower in celecoxib group(P＜0.01).Conclusion Celecoxib has neuroprotective effect on the degeneration of dopaminergic neurons caused by lipopolysaccharide in vivo.

Objective To check serum protein of children′s Hirschsprung′s disease(HD) and sift specific protein marker which was used in constructing of HD screening and early diagnosis of serum protein fingerprint model.Methods Surface-enhanced laser desorption/ionization time of flight mass spectrometry(SELDI-TOF-MS) was applied to detect protein mass spectrometry of serum specimens in 82 cases(HD group 42 cases,20 cases of other types of obstruction,healthy control group 20 cases) and data were analyzed by bioinformatics methods(support vector machine).Results 1.For HD group and healthy control group:selected 3 M/Z in 3 221.7,5 639.2,6 884.2 protein markers were selected,HD early screening and diagnostic model was established,3 markers in HD low expression,the expressions of them in HD group and healthy control group were 378.29?273.34,295.65?159.38,444.13?254.06 and 1 428.18?1 192.61,1 039.60?785.64,1 115.72?680.48,respectively.There were significant differences in two groups(Pa0.05).Conclusions The establishment of serum protein fingerprint model of HD by SELDI-TOF-MS support vector machine could screen and diagnose HD early,which is a new method of better specificity,high sensitivity and is worthy of further research and application.

AIM:To disscus the clinical effect of the silicone tube implantation under the guidance of memory wire in the treatment of lacrimal canaliculus.
METHODS:One hundred and fifteen cases (115 eyes ) of traumatic canalicular laceration were treated by canaliculoplasty from September 2012 to June 2014. Finding the end of lacrimal canaliculus under microscope, guided by memory wire which was probed in lacrimal passage to the nasal cavity, intubating double-passage silicone tube as a support and end-to-end anastomosis. The condition of epiphora and irrigation of lacrimal passage were observed after extubation.
RESULTS: All 115 cases were experienced successful operation. All patients were followed up for 6mo ~ 1a (mean 9. 3mo) after extubation. Lacrimal passage was unobstructed in 96 cases 96 eyes(83. 5%), stricture in 13 cases 13 eyes (11. 3%), and blocked in 6 cases 6 eyes (5. 2%).
CONCLUSION:Double-passage silicone tube guided by memory wire may be an optional technique in the treatment of traumatic lacrimal duct laceration, which is a feasible, minimally - invasive, safe and effective method.

Bacteremia ; diagnosis ; Humans ; Infant, Newborn ; Male ; Pseudomonas Infections ; diagnosis