Objective To observe the pathogens and drug-resistance of ventilator-associated pneumonia (VAP) patients in emergency intensive care unit (EICU) for rational antibiotic therapy and the prevention of VAP. Method The sputum culture results and drug-resistance of pathogens of VAP patients in EICU from 2007 to 2009 were collected. Results One hundred and two mechanical ventilation patients were selected. VAP was occurred in 70 patients (68.6%). One hundred and fifty-seven pathogens had been examined,including 92 Gram-negative bacilli (58.6%),35 Gram-positive cocci (22.3%) and 30 fungus (19.1%). Pseudomonas aeruginosa and meticillin-resistant-staphylococcus aureus was 22 strains (14.0%)respectively, stenotrop homonas maltophilia was 21 strains (13.4%) and acinetobacter baumanii was 17 strains (10.8%). Fifty-nine patients (84.3%) had suffered from multiple pathogen infection, with 31 cases having 2 pathogens and 28 cases having 3 pathogens. Conclusions Pseudomonas aeruginosaa,methicillinresistant staphylococcus, stenotrophomonas maltophilia and acinetobacter baumanii are main pathogens of VAP in EICU patients,and candida albicans is still the main pathogens in fungal infection. The rate of multiple pathogen infection is very high, and the problem of drug-resistance is very severe.

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After an analysis of the application of medical video resources in academic conference , training of medical skills and health education of patients , the experiences in development of medical video resources in our li-brary were described.The characteristic medical video resources database was developed by establishing a naviga-tion system for free medical video resources on networks, introducing the mature academic video resources databases and collecting the medical video resources in our hospital .Service for medical video resources was popularized in forms of video reading and catalogue pushing .

Acupuncture Therapy ; Adult ; Back Pain ; therapy ; Chest Pain ; therapy ; Female ; Humans ; Pain, Intractable ; therapy

Objective To observe the effects of hemoperfusion on homeostasis in patients with acute poisoning.Methods The data of 26 acute poisoning patients treated with hemoperfusion were retrospective analyzed.The clinical data included blood pH,PvCO2,PvO2,blood lactate,potassium,free-calcium,bicarbonate and blood glucose assayed and recorded at 0 min,30 min and 120 min after hemoperfusion.The statistical software SPSS 18.0 was utilized to analyze the statistical differences in the above biomarkers among three different intervals after hemoperfusion.Results At the beginning of hemoperfusion therapy,levels of homeostasis indicators were pH (7.36 ± 0.05),PvCO2 (41.0 ± 8.8) mmHg,PvO2 (37.0 ± 11.8)mmHg,lactate (1.35 ± 1.00) mmol/L,potassium (3.1 ± 0.5) mmol/L,sodium (136.3 ± 4.8)mmol/L,free-calcium (0.95 ± 0.11) mmol/L,blood glucose (7.90 ± 3.47) mmol/L,bicarbonate (22.8±3.3) mmol/L.At30min,the levels of those were (7.36±0.04),(40.0±5.7) mmHg,(41.0±7.5) mmHg,(1.11 ±0.57) mmol/L,(3.1±0.4) mmol/L,(137.3 ±5.4) mmol/L,(0.94 ±0.12) mmol/L,(6.20 ± 1.55) mmol/L,(22.2 ±2.3) mmol/L,respectively.At 120 min,the levels of those were (7.35 ± 0.06),(38.0 ± 6.7) mmHg,(46.0 ± 7.9) mmHg,(0.69 ± 0.52)mmol/L,(3.0±0.4) mmol/L,(137.3±5.0) mmol/L,(0.97±0.10) mmol/L,(5.88±1.43)mmol/L,(22.0± 2.2) mmol/L,respectively.Apparently,there were significant statistical difference in PvO2,lactate and blood glucose (P ＜ 0.05) among three different intervals,and no significant statistical differences in other indicators (P ＞ 0.05).Conclusions There were no significant effects of hemoperfusion on relevant indicators in acute poisoning patients.

Objective To understand the sonographic feature of skin and skin nerves in the patients of herpes zoster. Methods High frequency sonography was used to examine 37 cases of herpes zoster patients with 77 pathological changes, 7 cases of sequence of neuralgia with 17 pathological changes. Compared with the healthy side of the same patient, thickness and echo feature of the skin and subcutaneous tissue, the width and echo feature of the skin nerves were recorded. Results The skin and subcutaneous tissue of the herpes zoster patients thickened (P 0.05),but the involved skin nerves widened significantly(P

Objective To analyze the clinical feature of the patients with anti -N -methyl -D -aspartate receptor (NMDAR)encephalitis and feature of brain MRI and electroencephalogram (EEG)in children.Methods We reviewed the clinical manifestations,brain MRI and EEG features of 10 patients who were diagnosed anti -NMDAR encephalitis.Results Of the 10 patients,3 cases were male and 7 cases were female.The age was ranged from 13 months to 14 years (6 years and 11 months on average).No tumor was found in those patients.Main symp-toms included seizure in 9 cases,psychiatric symptoms in 10 cases,consciousness disturbance in 4 cases,involuntary movements in 8 cases,autonomic nerve instability in 5 cases,and sleep disorders in 10 cases.7 patients of MRI exami-nation were normal,2 patients revealed abnormal signal of temporal lobe,frontal,and parietal cortex.One patient revealed brain atrophy.All patients had abnormal EEG with diffusive slow waves,and some with focal spikes or sharp waves,left side abnormal more than right side.Conclusion Anti -NMDAR encephalitis can be found in children, even young boys may be affected.They have a lower incidence of tumors.Its predominant clinical features are psychi-atrics symptoms,seizures,involuntary movements and consciousness alteration.EEG was considered more significant than brain MRI.

Objective To measure the fractional anisotropy(FA) values in the language function areas(Broca area,Wernicke area and arcuate fasciculus)by diffusion tensor imaging(DTI),discussing the pathological characteristics in cerebral palsy children with language development delay.Methods DTI was performed in twenty-seven cerebral palsy children with language development delay(observation group) and 20 children with febrile seizures(control group) by Philips 3.0T MRI scanner.The FA values of Broca area,Wernicke area and arcuate fasciculus were measured at Philips Workstation.Results The FA values of control group in the left Broca area,Wernicke area and arcuate fasciculusis were higher than those of the right side,and the difference was statistically significant (all P ＜ 0.05).The FA value of observation group in the left Broca area was lower than that of the right side,and the difference was statistically significant (P ＜ 0.05);the FA values of observation group in the left Wernick area and arcuate fasciculusis were higher than those of the right side,but the difference was not statistically significance (all P ＞ 0.05).The FA values in the bilateral Broca area and arcuate fasciculusis of observation group were lower than those of the control group,the difference was statistically significant (P ＜ 0.05),those in the bilateral Wernick area were also lower than the control group,but the difference was not statistically significant (P ＞ 0.05).Conclusions The main pathogenesis for language development delay in cerebral palsy children was extensive damage in language functional areas,and Broca area and arcuate fasciculus were markedly impaired than Wernick area.

Objective The purpose of this study was to investigate the efficacy and safety of bortezomib +doxorubicin + dexamethasone (PAD) regimen in the treatment of patients with multiple myeloma (MM) . Methods Thirty-eight patients with MM in our hospital were selected and randomly divided into observation group and control group with 19 cases in each. The observation group was treated with PAD regimen and the control group was treated with VAD regimen (vincristine+doxorubicin+dexamethasone) . Clinical efficacy and adverse reaction were compared between the two groups. Results The effective rate and total effective rate of the observation group were 52.63%and 78.95%respectively, which were significantly higher than those of the control group ( <0.05 and <0.05) . There was no statistical difference in the incidence of adverse events between the two groups ( >0.05) . Conclusion PAD regimen could improve the clinical effect of treating patients with MM, and the adverse reactions can be tolerated. It is safe and worthy of clinical application.

Objective To show epidemiological characteristics of adult emergency patients and to provide data support for grading clinics.Methods Adult emergency patients (older than 14 years) from 50 hospitals in Tianjin were included.Name,gender and age of patients,as well as visiting time/department,chief complaint,severity of the disease,prognosis were considered to cross-sectional survey from 8:00,30 Aug 2016 to8:00,31 Aug 2016.Chi-squared test,Fisher's exact test,or t test was used to statistical analysis as appropriate.Results Of 6 569 patients,most originated from medical (n =3 964,60.34％) and surgical (n =2 017,30.31％).Patients' average age was 46.90 ± 18.70 (14-99) years old and there were more patientsaged from 30 to 39 (n =1 285,19.56％).Hospital crowded periods were between 8:00-11:00 and 17:00-22:00.In these periods,average number of patients was more than 300.Concerning the severity of disease,83 patients (1.26％) were in grade 1 (the most severe cases),301 patients (4.58％) in grade 2,1 500 patients (22.83％) in grade 3,and 4 685 patients (71.33％) were in grade 4 (the less severe cases).Most ambulatory patient represented trauma (n =124,35.23％),neurological (n =68,19.32％) and cardiovascular (n =49,13.92％) diseases.However,50.57％ of them were not considered urgent.Conclusions Most patients visited emergency department were nonurgent and originated from medical and surgical department in Tianjin.Crowded periods gathered at 8:00-11:00 and 17:00-22:00.Most ambulatory patients were trauma,neurological and cardiovascular disease;however,half of them was stable and need no emergency intervention.