Objective:To explore the effective treatment to the depression after silent cerebral infarction(SCI).Methods:Seventy-three patients suffering from depression after SCI were treated for three moths with a mono-blind experiment.Results:There was significant difference between the effect of antidepressant and the effect of nonantideressant( P

OBJECTIVE:To observe the clinical efficacy and safety of noninvasive mechanical ventilation combined with aero-sol inhalation drug in the treatment of AECOPD complicating with respiratory failure. METHODS:90 patients diagnosed as AECO-PD complicating with respiratory failure were selected and randomly divided into observation group and control group,with 45 cas-es in each group. Both groups received routine treatment as oxygen supply at low flow rate,anti-infection,relieving asthma,venti-lation,cardiotonic,spasmolysis and nutritional support. Control group received noninvasive mechanical ventilation;observation group was additionally given aerosol inhalation of Budesonide atomized liquid+terbutaline+ipratropium bromide,bid. Both groups received 7 d of treatment. Clinical efficacy of 2 groups were compared as well as pH value,PaCO2,PaO2,HR,RR and PEF lev-els before and after treatment. The occurrence of ADR was observed. RESULTS:Total effective rate of observation group was 93.3%,which was significantly higher than 73.3% of control group,with statistical significance(P<0.05). There was no statisti-cal significance in blood gas analysis indexes,HR,RR and REF between 2 groups before treatment (P>0.05). pH value,PaO2 and PEF of 2 groups increased after treatment,while PaO2,HR and RR decreased;the observation group was better than the con-trol group,with statistical significance(P<0.05). No obvious ADR was found in 2 groups. CONCLUSIONS:Noninvasive me-chanical ventilation combined with aerosol inhalation drug is effective in the treatment of AECOPD complicating with respiratory failure,and can effectively improve blood gas indexes,HR,RR and PEF with good safety.

Objective To explore the effect of laparoscopy and laparotomy surgery on immune function related indicators in ovarian benign tumor patients. Methods From January 2015 to January 2016, 86 cases of ovarian benign tumor patients were set as study objects. All the patients were randomly divided into control group and observation group, 43 cases in each. Patients in control group were given traditional laparotomy surgery, while patients in observation group were given laparoscopic surgery. The changes of immune function related indexes before and after operation were recorded, before operation, day 1 and day 3 postoperative, number of peripheral white blood cells (WBC), neutrophil ratio (NGR), immunoglobulin (IgA, IgG, IgM) levels, C reactive protein (CRP) content and the distribution of T lymphocyte subsets (CD3+, CD4+ and CD3+/CD4+ ratio) distribution were respectively determined, and the incidence of postoperative complications was recorded, and were further statistical analyzed. Results There was no significant difference in immunoglobulin IgA, IgG and IgM between the twogroups before operation (P > 0.05). Postoperative, only the IgG content of the two groups was significantly lower than that before the operation (P < 0.05 ); The levels of WBC, NGR and CRP in the control group patients in the昀rst day and the third day after surgery were significantly increased compared with preoperative period, while CRP in the observation group was higher than that before the operation, there was significant difference between the two groups (P < 0.05). There was no significant difference in CD3+, CD4+ and CD3+/CD4+ ratios between the two groups before operation (P > 0.05), the difference between the two groups was significant (P < 0.05). The complication rate of the observation group after operation was 6.98%, the control group was 16.28%. Conclusion Clinical use of laparoscopic treatment of benign ovarian tumors relative to the traditional laparotomy can effectively reduce the immune system of patients with immune function, with high safety, contribute to the recovery of patients, it is worthy of clinical promoting.

AIM: To investigate the changes of serum angiogenic factors including vascular endothelial growth factor (VEGF) and basic fibroblast growth factor ( bFGF) in Mongolia patients with diabetic retinopathy ( DR) and to explore their roles in the progress of DR.
METHODS: Eighty - three patients with diabetes were divided into three groups according to the retinopathy, no DR group ( NDR, 25 cases), background DR ( NPDR, 31 cases) and proliferative DR group (PDR, 27 cases), and 36 age - matched healthy people ( control group) were selected. Serum concentrations of VEGF and bFGF were measured using ELISA method.
RESULTS: In Mongolia patients with diabetes, the serum concentrations of VEGF and bFGF were higher than those in control group; the serum concentrations of VEGF and bFGF in PDR group was higher than those of NDR and NPDR group (P< 0. 05); the concentrations of VEGF and bFGF in NPDR group was higher than that of NDR group (P<0. 05).
CONCLUSION: High level of VEGF and bFGF may be the important pathogenic factors for DR in Mongolia patients.

Objective To determine the clinical features of Klebsiella pneumoniae pneumonia and antimicrobial resistance of Klebsiella pneumoniae, providing the basis for rational use of antibiotics. Methods Eighty-six strains of Klebsiella pneumoniae were isolated from the sputum specimen which collected from the inpatients in our hospital from Dec 2008 to Dec 2010,which were identified with Bio Merieum Vitek 2. A total of 86 children were enrolled in the study, which were divided into hospital infection/colonization group (n = 68) and community infection group (n = 18). Clinical information were recorded. Extended spectum β-lactamase (ESBLs) and antibiotic susceptibility of Klebsiella pneumoniae were determined. Results Klebsiella pneumoniae pneumonia in children mainly occured in infants, especially in infants with basic diseases.Clinical manifestations of Klebsiella pneumoniae pneumonia had no much difference from common pneumonia. The detection rate of ESBLs was high(76. 7%). ESBLs were found in 64 strains of the hospital infection/colonization group (94. 1% ,64/68) ,while in 2 strains of the community infection group (11. 1% ,2/18).There was a significant difference between the two groups (P ＜0. 01). The drug resistance of hospital infection/colonization group was significantly higher than that of community infection group. The strains of hospital infection/colonization group were sensitive with cefotan, piperacillin/tazobactam, carberpenem, amikacin and ciprofioxacin only, while were highly resistant to penicillins, cephalosporins and monoamine antibiotics.The average hospital stay of the hospital infection/colonization group was (15.0 ± 7. 1) d, while the other was (8. 2 ± 3. 8) d. There was a very significant difference between the two groups in average length of stay (P＜0.01). Conclusion Klebsieila pneumoniae pneumonia in children mainly occurs in infants with basic diseases. The symptoms are untypical. Klebsiella pneurmoniae multi-drug resistance is a serious problem,which must be paid attention to. We should make a difference between the two groups when antibiotics were prescribed.

Objective To observe the clinical efficacy and adverse reactions of docetaxel and carboplatin 21 day regimen (TC)as second -or third -line in treatment of patients with advanced triple -negative breast cancer (ATNBC).Methods 37 ATNBC patients with anthracyclines resistance were given docetaxel 70mg/m2 ,the first day of intravenous drip,carboplatin AUC =5,through intravenous drip on the first day,21 days for a course of treatment, until disease progression or not tolerated or most received six cycles of chemotherapy.Results 147 cycles of chemo-therapy were completed in 37 patients,and the median chemotherapy cycle was 4 cycles.The efficacy and adverse reactions could be evaluated in all patients.Among them,complete remission (CR)in 0 patient,partial remission (PR)in 12 patients (32.43%),stable (SD)in 11 patients (29.73%),and progression (PD)in 14 patients (41.18%).The effective rate(CR +PR)was 32.43%.The disease control rate (CR +PR +SD)was 62.15%,median TTP was 3.9 months (95%CI:4 -8months),and median OS was 10 months.Until the end of follow -up,there were 3 patients with no progress.The main adverse reactions were hematological toxicity (51.53%)and gastrointestinal reaction (56.76%).Conclusion TC regimen is effective and safe in the treatment of patients with ATNBC.

BACKGROUND:Compliance of mechanical device reduced in the prevention of deep venous thrombosis.
OBJECTIVE:To evaluate the compliance on mechanical prevention measures in the prevention of deep venous thrombosis, and to analyze the reason for compliance reduction.
METHODS:We searched Cochrane Library, PubMed, Embase, and Medline for articles on compliance of inpatients on mechanical device for prevention of deep vein thrombosis published from inception to December 2015. At the same time, the“snowbal”method was used to screen the references. After the literatures were screened, using the Newcastle Ottawa Scale tools and Agency for Healthcare Research and Quality standard, two researchers evaluated the quality of the literatures independently and strictly. Data were extracted if meet the discharge standard. The software of Meta-analyst Beta3.13 was used for heterogeneity analysis and publication bias test in the extracted data. According to the heterogeneity analysis results and literature types, a reasonable statistical analysis method was selected to col ate, summarize and discuss.
RESULTS AND CONCLUSION:Final y, 12 papers were included, 9 of which were cross-sectional studies, 2 cohort studies, and 1 case-control study. The odds ratio about compliance rate of inpatients with mechanical devices was 53.2%(95%CI:38.7-67.2). Subgroup analysis showed that the odds ratio about compliance rate of pneumatic compression devices was 54.9%(95%CI:34.9-73.4). The odds ratio about compliance rate on elastic stockings was 47.9%(95%CI:34.3-61.8). The detection of mechanical device of surgical patients showed that odds ratio about compliance rate was 66.8%(95%CI:47.4-81.7). Our results confirm that the compliance rate of the use of mechanical devices for the prevention of deep venous thrombosis in clinical inpatients requests to be improved. The reason for reduced compliance rate should be further investigated to improve the compliance rate.

Objective To understand the situation of nosocomial infections, the distribution of important pathogens of affected patients and the uses of antibacterial drugs.Methods The cross-sectional survey was ap-plied.Before the survey, the investigators were trained by the professionals of the department of hospital infection management.Medical records were reviewed one by one, checked with bedside physical examination.Results In this survey, 283 inpatients were investigated, with an actual check rate of 100%.Two inpatients were affected with nosocomial infection with the prevalence rate of 0.71%.There were two cases of infections (0.71%).Conclusion Investigation of the prevalence rate of nosocomial infection was an important means to monitor the hospital infection, which can monitor specifically, minimize the incidence of nosocomial infection and ensure medical safety by obtaining the information of the departments with high-risk nosocomial infection, the main infectious sites and pathogens.

Objective To evaluate the accuracy of continuous noninvasive partial pressure of carbon dioxide monitoring in the old diabetic patients undergoing general anesthesia.Methods Sixty-six old diabetic patients of both sexes,aged 65-76 yr,weighing 49-95 kg,of American Society of Anesthesiologists physical status Ⅰ or Ⅱ,undergoing elective surgery under general anesthesia,were included in this study.Transcutaneous partial pressure of carbon dioxide (TcPCO2) was monitored by a noninvasive transcutaneous carbon dioxide monitor.Arterial blood samples were collected at 30 and 60 min after endotracheal intubation,partial pressure of arterial carbon dioxide (PaCO2) was monitored,and TcPCO2 and end-tidal pressure of carbon dioxide (PET CO2) were recorded.Bland-Altman analysis was used to measure the agreement.Results At 30 min after intubation,the results of Bland-Altman analysis showed that the mean difference between PaCO2 and TcPCO2 was 1.3,95％ confidence interval (CI) was 1.0-1.6,and the limit of agreement was-1.1-3.7;the mean difference between PaCO2 and PETCO2 was -3.2,95％CI:-3.6--2.8,and the limit of agreement was-6.6-0.2.At 60 min after intubation,the results of Bland-Altman analysis showed that the mean difference between PaCO2 and TcPCO2 was 1.4,95％ CI was 1.1-1.7,and the limit of agreement was-1.0-3.4;the mean difference between PaCO2 and PETCO2 was-3.1,95％CI was-3.5--2.7,and the limit of agreement was-6.7-0.5.The repeatability coefficients of PaCO2,TcPCO2 and PETCO2 were 2.1,2.3 and 2.3,respectively,at 30 and 60 min after intubation.Conclusion Continuous noninvasive partial pressure of carbon dioxide monitoring provides good accuracy and can be used as an alternative to PaCO2 monitoring,and the accuracy is higher than that of PETCO2 for the old diabetic patients undergoing general anesthesia.

Scientific researchers , medical and nursing staff in Academy of Military Medical Sciences and Chinese PLA General Hospital are the main readers of Medical Library of Chinese PLA.The papers they published in CMCI-covered journals from 2010 to 2012 and their citations were analyzed by citation analysis in order to find the de-mand of users and the use of literature in militarymedical journals , and discover the demand for biological literature information in scientific researchers and nursing staff in Academy of Military Medical Sciences and Chinese PLA General Hospital.The authors proposed that library holding journals should be evaluated with the support rate of highly cited journals and zero citation rate of library holding journals to guide the development of journal resources , provide evidence for the adjustment of resource acquisition , and perfect the library holding resources ofuser-ori-ented demand.