Hospital-acquired pneumonia (HAP) is a very common complication in patients with neurological diseases.Its incidence and mortality are very high and result in a prolonged hospital stay and an increase in hospitalization costs.Therefore,how to effectively prevent HAP has become the focus of attention by neurologists.There are many risk factors for HAP,such as advanced age,conscious disorders,dysphagia,body position,oropharyngeal colonization,mechanical ventilation,enteral nutrition,and stress ulcer prevention drugs,etc.Clearing the risk factors for HAP and taking appropriate measures to strengthen protection may reduce the occurrence of HAP and improve the prognosis of patients.

Objective To evaluate the brain function and predict the prognosis of hypoxic encephalopathy with multimodal evoked potentials. Methods Short-latency somatosensory evoked potential(SLSEP )and Brainstem auditory evoked potential( BAEP) were used to monitor 44 coma patients caused by post-cardiopulmonary resuscitation, hypotension and (or) hypoxemia, to compare simple modalities, multimodalities,and simple modalities with multimodalities according to Judson, Hall, Cant, Haupt standard. Results Simple modal and multimodal grading standards were closely related to the prognosis, the higher the grade, the poorer the prognosis . The accuracy of SLSEP (Judson standard is 84.1% )was higher than that of BAEP (Hall standard is 79.5%);and the accuracy of multimodal evoked potentials (Cant standard is 88.4%) was higher than that of the simple modality. Conclusion Multimodal evoked potentials might better indicate the degree of brain function of hypoxic encephalopathy. Cant standard might be easily carried out, which might highly show the accuracy of the prognosis, and suitably to be spread and applied in work.

100 g/d), hypernatremia and hyperglycemia were the three main risk factors resulting in plasma hyperosmolality. The 4-week survival rate of hyperosmolality group(47.1%) was significantly lower than that of non-hyperosmolality group(78.3%, P

0.05).Conclusion SjvO_2 and OEF may objectively reflect brain oxygen metabolism and cerebral blood flow after acute cerebral infarction. Furthermore, they are valuable indicators for predicting prognosis.

Objective To explore the effectiveness of using middle-latency somatosensory evoked potentials (MLSEP) to predict the prognosis in patients with acute severe stroke. Methods MLSEP, shortlatency somatosensory evoked potentials (SLSEP), and Glasgow Coma Scale (GCS) were recorded in 70 acute severe supratentorial stroke patients within 1 week after onset. All patients were evaluated with modified Rankin Scale (mRS) and follow-up in 6 months after onset. SLSEP and MLSEP were recorded in 20 normal controls. The consistency between MLSEP, SLSEP, GCS and prognosis, as well as the prognostic authenticity of MLSEP, SLSEP, and GCS were analyzed. Results Bilateral N20, N35, and N60 exited in all normal controls. Some waves of MLSEP were absent in stroke patients, and the proportion of absent waves in ipsilateral MLSEP was higher than in contralateral MLSEP. The consistency between bilateral absence of N60 and unfavorable outcome ( Kappa = 0.828, P ＜ 0.01 ), and between bilateral absence of N60 and death ( Kappa = 0.686, P ＜ 0.01 ) was satisfactory. By using the prognostic authenticity analysis of predictors, the ipsilateral absence of N60 showed the highest sensitivity ( 100% ) for unfavorable outcome and death, which added 14.3% compared with the sensitivity of ipsilateral absence of N20 ( 85.7% ). Bilateral absence of N60 showed a high specificity of 100% for unfavorable outcome, which equaled bilateral absence of N20.However, it showed a lower specificity ( 82.9% ) for death, than bilateral absence of N20 (97.1% ).Conclusions MLSEP was able to reflect the degree of brain injury and showed higher sensitivity than SLSEP for predicting unfavorable outcomes. Therefore combined use of MLSEP and SLSEP in evaluating and predicting the outcomes in brain injuries is suggested.

A HPLC method for the determination of berberine in Phellodendron amurense processed by four different procedures has been established. The method is simple, specific and accurate. The recovery is 102.7% and coefficient of variation is 0.69%.

Objective To observe nasal resistance in healthy adult people and patients with obstructive sleep apnea hypopnea syndrome (OSAHS), comparing the changes in nasal resistance after nCPAP treatment, and to explore the role of nasal resistance in development of OSAHS and the effect of nCPAP on nasal resistance. Methods Detection of nasal resistance was performed in 11 healthy people and 40 patients with OSAHS after completion of polysomnography (PSG). Three weeks after treatment with nCPAP, the patients received polysomnography and detection of nasal resistance again. Results Nasal resistance was higher in patients with OSAHS than healthy people [(0.27 ± 0.9)Pa/(cm3·s) vs. (0.21 ± 0.7)Pa/(cm3·s), t=-2.048, and P<0.05];nasal resistance was not related with age, BMI, neck circumference, waistline, AHI, MinSO2, and ODI (P>0.05). MinSO2, AHI and ODI were markedly improved three weeks after nCPAP therapy (P<0.05). Nasal resistance was increased from (0.27 ± 0.1) Pa/(cm3·s) to (0.43 ± 0.3)Pa/(cm3·s) after treatment (t = -2.733, P < 0.05). Conclusions Increased nasal resistance is one of risk factors for pathogenesis of OSAHS. Nasal resistance is not related with the severity of OSAHS. nCPAP can lead to an elevation in nasal resistance.

Objective To explore the value of Ligasure and Ultracision in total laparoscopic hysterectomy (TLH). Methods From January 2002 to December 2006,totally 225 patients received total laparoscopic hysterectomy in our hospital. Among the cases,Ligasure was used in 152 patients,and Ultracision were employed in 72. The clinical data of the patients were reviewed. Results The mean operation time in the Ligasure group was significantly shorter than that in the Ultracision group [(104.9?29.2) min vs. (152.4?46.6) min,t=-9.329,P=0.000]. And the mean blood loss of the Ligasure group was significantly less than that in the other group [(32.9?14.9) ml vs. (126.4?12.1) ml,t=-46.710,P=0.000]. In both the groups,no patient was converted to open surgery or developed complications or surgical injuries. Conclusions Both Ligasure and Ultracision are safe and effective for total laparoscopic hysterectomy. Ligasure is superior in the management of uterine vessels,while the Ultracision is more effective in opening the vesicle and separating the cardinal ligament.

Along with the transformation of the pattern of the medicine and the development of dental medicine,more and more patients accept orthodontic treatment.The patients have higher expectations of the treatment.As a result,the abilities to make clinical communication for orthodontic postgraduates should be improved.The article discusses how to improve the orthodontic postgraduates' abilities in the hope that it will be of some help to them.

Objective To evaluate feasibility and reliability of using Simplified Acute Physiology Score Ⅱ (SAPS Ⅱ)in predicting mortality in critically ill patients with neurological diseases.Methods All 653 patients hospitalized in neurological intensive care unit (N-ICU) from Jan 2005 to Dec 2007 were retrospectively studied.SAPSⅡ scores were scaled upon admission at 24,48 and 72 h,and possibility of hospital mortality (PHM) was calculated based on SAPS Ⅱ score.Neurological diseases diagnosis made initially at time of hospitalization was classified into five categories:intracranial hemorrhage,cerebral infarction,neurologic infection,neuromuscular diseases and other neurologic diseases.At each of four time points,the SAPSⅡscores were compared between the survival group and death group,and the relationship of SAPS Ⅱ score and prognosis were analyzed.The calibration of the SAPS Ⅱ were accessed with the Hosmer-Lemeshow goodness-of-fit chi-squared statistic and the discrimination with area under the receiver operating characteristic curve (AUROC).Multivariate logistic regression was used to analyze the relationship between disease category and prognosis.Results SAPS Ⅱ scores in the death group (46.53±12.22,47.28±13.84,48.58±14.18 and 49.06±14.61)at each time point were significantly higher than those in the survival group (34.70±11.78,30.28±12.24,29.79±12.36 and 29.69±12.96;t=11.12,14.02,14.43 and 13.49 at 0,24,48 and 72 h,respectively,P＜0.01).Furthermore,univariate logistic regression analyses demonstrated that SAPS Ⅱ score was correlated with prognosis (OR=1.080,1.100,1.109,1.100 at 0,24,48 and 72 h,respectively,P＜0.01).The scores at 48 and 72 h were more accurate in predicting mortality.SAPS Ⅱ had good calibration at each time points (x2=5.305,7.557,6.369 and 8.540,P＞0.05),however,the consistency of expected mortality with observed mortality was satisfactory only at 48 and 72 h(82.6%,83.4%),so was the discrimination ( AUROC=0.825,0.847 respectively).There was no correlation between disease categories and outcome.Conclusion SAPS Ⅱ scoring,best evaluated at 48 and 72 h after hospitalization,can be used as a reliable predictor of probability of mortality in patients hospitalized in N-ICU and prediction can be applied in these patients with all different neurology diseases.