Objective To retrospectively analyze risk factor and outcome of VAP after treatment.Methods To retrospectively analyze the incidence of VAP in 249 patients accepted mechanical ventilation.Results Logistic regression analysis shew that age,APACHE Ⅱ scores,the time of mechanical ventilation,gastric acid secretion inhibitor therapy,conscious disturbance,combinations of antibiotics,stomach catheter insertion were associated risk factors for ventilator-associated pneumonia.A total of 91 pathogenic bacterium were identified.G pathogenic bacteriums accounted for 80.2% and G~+ pathogenic bacteriums accounted for 18.6% and true fungus accounted for 1.2%.Multidrug resistance was in most pathogenic bacteriums.All patients were treated with sensitive antibiotics and 39 cases were cured(63.9 %)and 22 cases were dead(36.1 %)after 2-6 weeks treatment.Conclusion Existence of risk factors of VAP are correlated with risk factor and G-pathogenic bacteriums are major pathogenic bacteriums and common drug resisitant microorganisma lead to bad outcome.

BACKGROUND:Santoni put forward the cortical bone trajectory technology by changing the traditional pedicle screw placement for lumbar internal fixation in order to obtain better control of the screw and bone in 2009. OBJECTIVE:To analyze biomechanical stability of cortical bone trajectory system in the lumbar fusion. METHODS:Twenty fresh newborn calf L3/4, L5/6 motion segment specimens were obtained, and their ranges of motion were detected under different states, as normal controls. Subsequently, twenty samples were divided into cortical bone trajectory screw group and traditional pedicle screw group, which underwent cortical bone trajectory screw fixation combined with posterior lumbar fusion and traditional pedicle screw fixation combined with posterior lumbar fusion, respectively. Without destruction, ranges of motion were detected under different states in both groups. In the revision group, after the test in the traditional pedicle screw group, screw was withdrawn, and cortical bone trajectory screw was used to detect its range of motion under different states. RESULTS AND CONCLUSION:Ranges of motion at bending to the left and right, anteflexion, posterior extension and axial rotation were significantly lower in the cortical bone trajectory screw group and traditional pedicle screw group than in the normal control group (P<0.05). No significant difference in bending to the left and right, anteflexion, posterior extension and axial rotation was detected between the cortical bone trajectory screw and revision groups and traditional pedicle screw group (P>0.05). These results confirmed that cortical bone trajectory technology combined with posterior lumbar fusion can obtain identical stability as the traditional pedicle screw fixation combined with posterior lumbar fusion. Simultaneously, it is a new choice for revision after traditional pedicle screw fixation.

OBJECTIVE: The aim of this study was to evaluate the safety and effectiveness of balloon sinuplasty, and to summarize the main points of its use. METHOD: Fifteeen patients (41 sinuses) were offered treatment with a new technique of balloon sinuplasty and followed for 3 to 6 months after surgery, including "balloon-only" patients and "hybrid" patients. Effectiveness was evaluated by endoscopic examination and computed tomographic (CT) scan. The effect of the operation was tested by the Lund-Mackay CT scores, and the patient's subjective symptoms were tested by the sino-nasal outcome test-20 (SNOT-20) to evaluate postoperative condition. RESULT: Fifteeen patients (41 sinuses) were followed after surgery, including 9 "balloon-only" patients and 6 "hybrid" patients. No unanticipated adverse effects were noted in any patients. Endoscopic examination showed the sinus ostium was opening well, and CT scan showed the lesions apparently disappeared. Lund-Mackay CT scores showed that all patients postoperative scores were significantly improved from baseline at 3 months and 6 months. SNOT-20 showed that all patients postoperative scores were significantly improved from baseline at 3 months and 6 months. There was no significant difference between the "balloon-only" patients and "hybrid" patients. Operation curative effect is very confirmed, and subjective symptoms improved significantly. CONCLUSION Balloon sinuplasty can not only open nasal sinus effectively, but also preserve normal tissue structure and mucous membrane of nasal cavity and nasal sinus. Balloon sinuplasty appears to be a safe, effective and minimally invasive treatment option to relieve sinus ostial obstruction. Patients who received balloon catheter sinusotomy in endoscopic sinus surgery had significant improvement after surgery. Balloon sinuplasty can also be combined with the endoscopic sinus surgery to achieve a better therapeutic effect. It is worth of clinical promotion and application.
Airway Obstruction ; Endoscopy ; Humans ; Nasal Surgical Procedures ; methods ; Paranasal Sinus Diseases ; surgery ; Paranasal Sinuses ; surgery ; Postoperative Period ; Tomography, X-Ray Computed ; Treatment Outcome

Objective: To explore the difference of intestinal flora between groups of ulcerative colitis and large intestine dampness heat syndrome and healthy group. Methods: A total of 14 stool samples from patients with ulcerative colitis and large intestine dyspepsia syndrome and 14 samples of healthy people were collected. Amplification was designed based on the 16 S r DNA V3-V4 region of the bacteria. Illumina HiSeq 2500 platform was used for high-throughput sequencing.The ultimately sample species information was get by Reads splicing, OTUs (operational taxonomic units) clustering, species annotation, the analysis of alpha diversity and the analysis of principal component. Results: There was a significant difference in intestinal flora between the ulcerative colitis group and the healthy group (P=0.008 ＜ 0.01); and the diversity of intestinal flora in patients with ulcerative colitis and large intestine dyspepsia syndrome was higher than that of healthy people. There a significant difference in the richness degree of intestinal flora patients with ulcerative colitis and large intestine dampness syndrome and the healthy group. Intestinal flora centered on Lactobacillus、Lactobacillaceae、Erysipelotrichaceae、Erysipelotrichales and Akkermansia bacteria was rich in patients with ulcerative colitis. Conclusion: There are significant differences in intestinal flora diversity and bacterial structure between patients with ulcerative colitis and large intestine dampness syndrome and the healthy group.

Objective To investigate the effect of angiotensinogen (AGT), angiotensin-converting enzyme (ACE) and AngII receptor (ATR) gene polymorphisms combined with climatic factors on the incidence of essential hypertension (EH) in Tibetan population in Gannan area. Methods A follow-up study was conducted to select 671 Tibetan people in Gannan area who were physically examined in April 2019 at the Health Management Center of the Second Hospital of Lanzhou University and agreed to be enrolled as a fixed cohort, and the blood pressure values of the enrolled subjects were measured after 3.5 years of follow-up, and a total of 501 cases were obtained. At the same time, the peripheral blood of all subjects was collected and the polymorphisms of AGT, ACE and ATR genes were detected by gene chip technology, and the possible interactions were analyzed by logistic regression model, fork generation method and multifactor-dimensionality reduction (MDR). Results Sunshine time was a protective factor for the incidence of hypertension in the Tibetan population of Gannan (OR=0.781), while relative humidity (OR=1.182), air pressure (OR=1.338) and temperature (OR=1.449) were the risk factors for the incidence of hypertension. According to the results of partial correlation analysis, temperature had no effect on the incidence of hypertension after controlling air pressure. There was an additive interaction between high air pressure and the polymorphisms of rs699 (OR=1.650, 95%CI: 1.293-2.399, P<0.001) and rs5049 (OR=1.711, 95%CI: 1.337-4.920, P<0.001) genes of AGT gene; there was a multiplicative interaction between relative humidity and rs699 (OR=0.472, 95%CI: 0.120-0.783, P<0.05);there was a multiplicative interactions between the altitude ≥ 3000m and rs699 (OR=1.503, 95%CI: 1.220-3.174, P<0.01), rs5049 (OR=1.673, 95%CI: 1.380-3.961, P<0.001) or rs2148582 (OR=0.519, 95%CI: 0.284-0.716, P<0.05).However, there was no interaction between climatic factors and ACE or ATR gene polymorphisms on the incidence of hypertension. Conclusion Climatic factors and altitude ≥3 000 m are closely related to the incidence of hypertension in the Tibetan population of Gannan area, and the interaction between AGT gene polymorphisms and climatic factors affects the incidence of hypertension in the population of this area.