Objective To learn the clinical features of severe pneumonia in northeast sichuan ,and to improve the diagnosis and treatment level .Methods Basic disease or concomitant diseases and it′s clinical features were retrospective analyzed in different age patients with severe pneumonia in 2011 .Results (1)basic diseases and fatality cases /deteriorated cases were increased in elderly patients with the increase of age .There were 4 patients infected with HIV (3 cases under 65 years old ,1 case over 70 year old) .(2) onset pattern was given first place to suffer from cold ,but 40% were showed for symptoms of nervous system ,heart disease and other respiratory system ;(3)The main respiratory failure types of severe pneumonia is Ⅰ (about 70% ) ,30% of patients needed support of machine ventilation ;(4)community pneumonia were main type(75% );detection rate of Fungal infections and G -bacteria were 25% -30% ,normal bacteria (Streptococcus and Neisser bacteria )were over 1/3 ,Staphylococcus aureus were about 10% ;(6) More than 70% of the patients with different degree of hypoalbuminemia ;(7)Cure accounts for 2/3 ,poor prognosis accounted for 1/3 ,in which death and voluntary discharge were each 16 .6% ,ventilator-dependent ,multi-organ failure ,infections and some com-plex social factors were the prognostic factors .Conclusion Understanding the features and treatment difficulty of the local commu-nity acquired pneumonia is helpful to improve the timely diagnosis ,treatment and rescue level of patients with severe pneumonia .

Objective To assess the effect of the bundles intervention for preventing ventilator-associated pneumonia(VAP) in the mechanically ventilated patients.Methods The clinical controlled trials on the bundles intervention for preventing VAP were retrieved from the databases of CBM,CNKI,VIP,Wanfang Databases,Cochrane library,Embase and PubMed database.The litera-ture screening,quality evaluation and data extract were performed by adopting the Cochrane systematic assessment method.The da-ta were analyzed by adopting the Stata12.0 software.Results Twenty-four articles were included,involving 6 000 patients.The me-ta analysis results verified that the VAP incidence rate in the intervention group was significantly lower than that in the control group(OR=0.39,95% CI:0.34-0.45,Z=12.36,P<0.01);the mortality rate in the intervention group was significantly lower than that in the control group(OR=0.35,95% CI:0.26-0.48,Z=6.43,P<0.01);the duration of mechanical ventilation and ICU stay length in the intervention group were significantly shortened compared with the control group,the effective dose standardized mean difference(SMD)and 95% CI were -0.75,-0.95 - -0.55 and -0.78,-0.98 - -0.53 respectively,the difference was statistically significant(Z=7.35,P<0.01;Z=7.72,P<0.01).Conclusion The bundles intervention can significantly reduce the incidence of VAP,mechanical ventilation time and ICU stay time,it is recommended to be used in clinic.