OBJECTIVE To investigate the associated risk factors for the infected patients in respiratory intensive care unit(RICU) and to study the resistance of isolates.METHODS To study the bacterial spectrum and drug resistance test of all the patients with hospital acquired infection from Jan to Dec 2005.Identification and antimicrobial susceptibility were determined with the methods of API and K-B,respectively.RESULTS A total of 265 strains were isolated from 117 patients,the rate of isolation of Gram-negatives was the highest(74.3%),the species were predominated by Pseudomonas aeruginosa,Acinetobacter baumannii and Klebsiella pneumoniae,the rates of isolates were 28.68%,23.02% and 5.66%,respectively.The predominated species of Gram-positives was Staphylococcus aureus.Gram-negative bacilli were susceptible to imipenem and meropenem,there were not vancomycin-resistant strains.CONCLUSIONS It is important to realize the associated risk factors of infected patients in RICU and to promote the rational use of antimicrobial agents.

Objective To provide a clinical anatomic basis for the bi-pedicled gastrocnemius myocuta- neous flap which is to be used to repair defects of the Achilles tendon and posterior skin of the ankle.Methods In anatomic study,out of 30 cadaver specimens,bi-pedicled V-Y gastrocnemius myoeutaneous flaps were harvested to measure the downward sliding lengths of the flap when the knee was at flexion of different degrees.In clinic,12 patients with the Achilles tendon and posterior ankle skin defects were repaired with the bi-pedicled gastrocnemius myocutaneous flaps.The areas of composite defects ranged from 10 cm?6 cm to 6 cm?4 cm.They were followed up for four months to 12 years.Results The maximal sliding length of the flap reached (9.2?0.9)cm when the knee was at flexion of 90?.All the clinical flaps survived and ambulation of the patients recovered.The dorsiflexion and plantarflexion of the ankles reached 11.0??1.4?and 35.0??4.6?respectively.Conclusion This flap is suitable for one-stage repair of composite Achilles tendon defects.

0.05 ) when two doctors measured the same group patients with the same method. The coefficient of variation of IVRTd was bigger than that of IVRTm when two doctors measured the same group patients with two different methods. In four sets of data, three ones showed significant difference(P

0.05).But transitional PBL had much priority in enhancing students' learning interests. Conclusion The applicational of transitional PBL requires to be further deepened and improved in the realm of medical education.

Photothermal therapy (PTT) has attracted significant attention due to minimal side effects and high treatment specificity. However, it often requires very high temperature to achieve complete tumor ablation under a single PTT. Such high temperature brings obvious thermal damage and inflammatory response to the body, affecting the therapeutic effect. In recent years, nitric oxide (NO) has been used to significantly inhibit tumor growth and enhance the sensitivity of tumor cells of temperature and drugs, thus enhancing the therapeutic effect. However, compounds as NO donors often have some disadvantages such as poor biocompatibility and untargeted delivery, etc., therefore, this medical application based on NO therapy is limited. In conclusion, the organic combination of NO donors and photothermal agents (PTAs) is expected to overcome the shortcomings of single therapy and achieve the antitumor effect of "1 + 1 > 2". In view of the rapid development of NO combining with PTT in tumor therapy, this review firstly introduces the antitumor mechanisms of different types of NO donors. Then the treatment strategy based on NO combined with PTT is discussed. Finally, the prospects and challenges of this combination therapy strategy in the clinical treatment of cancer are discussed.

ObjectiveTo observe the effects of Jiuqiang Naoliqing(JNQ) on the microcirculation of the cheek pouch of golden hamsters. MethodsAutomatic measuring device was used to evaluate the changes of microcirculation. ResultsAfter the disorder of microcirculation of cheek pouch made by noradrenaline(NA), the JNQ group recovered better and more rapidly than other groups. ConclusionJNQ can prevent and reverse the disorder of microcirculation made by NA, and do better than NQ.

Objective: To evaluate the service competence of 99 smoking cessation clinics in Zhejiang Province, so as to provide reference for the improvement. Methods: The questionnaire, prepared by Tobacco Control Office of Chinese Center for Disease Control and Prevention, was used to investigate all the smoking cessation clinics in Zhejiang Province, to score the basic and developmental indicators, and to assess the qualified rates ( basic indicators >50 points and total scores >60 points ). Results: There were 99 smoking cessation clinics, with 52 in secondary hospitals and 47 in tertiary hospitals. The overall assessment scored from 11 to 96 points, with an average of ( 53.99±16.56 ) points. The smoking cessation clinics in secondary and tertiary hospitals scored ( 53.92±15.88 ) points and ( 54.06±17.45 ) points. The scores of basic and developmental indicators were ( 45.66±12.16 ) points and ( 8.33±5.39 ) points, with the scoring rates of 65.23% and 27.77%. The overall assessment of 43 smoking cessation clinics were qualified and the rate was 43.43%, which was 44.23% in secondary hospitals and 42.55% in tertiary hospitals. Conclusion The qualified rate of smoking cessation clinics in Zhejiang Province was 43.43%, which was similar between second hospitals and tertiary hospitals.

Objective To investigate the epidemiological characteristics of incipient neonatal hyperbilirubinemia. Methods The clinical data of admitted neonates with hyperbilirubinemia were retrospectively analyzed from June 2012 to May 2013. Results Two hundred and eight-four neonates with hyperbilirubinemia were enrolled and the ratio of male:female was 1.51:1. For the causes of hyperbilirubinemia, the incidences of ABO hemolytic and sepsis were higher in term infants than those in preterm infants, and the incidences of pneumonia, necrotizing enterocolitis and intracranial hemorrhage were higher in preterm infants than those in term infants (P<0.05). Compared with the preterm infants, the term infants had jaundice appearance and peak at earlier time, shorter duration of jaundice, faster decline rate of jaundice, higher levels of albumin and indirect bilirubin at the peak of jaundice (P<0.01). In the term infants, the time of jaundice appearance and peak were earlier in hemolytic group than those in non-hemolytic group (P<0.05). In preterm infants, the peak of transcutaneous bilirubin was higher in hemolytic group than that in non-hemolytic group (P<0.05). Six cases with bilirubin encephalopathy had abnormalities cranial MRI imaging, and the MRI was not entirely consistent with the peak level of bilirubin. Conclusions There are clinical differences between hemolytic and non-hemolytic hyperbilirubinemia in both term and preterm infants.

UNLABELLEDObjective: In order to assess the integrative cardiopulmonary function after percutaneous coronary intervention (PCI) in patients with stable coronary artery disease (CAD), we used symptom limited maximum cardiopulmonary exercise testing (CPET).

METHODSAll 59 patients diagnosed stable CAD by coronary angiography and echocardiography from August to December of 2014 in our hospital, were divided two groups. PCI group, 31 patients received PCI and drugs. Control group, 28 patients received drugs therapy only. All patients performed CPET before and after the treatment.

RESULTSAll patients safely completed CPET without any complications. The control group, all functional parameters were unchanged (P > 0.05). PCI group, the anaerobic threshold, peak oxygen uptake and peak oxygen pulse increased significantly (P < 0.05) from baseline,but not for others (P > 0.05). For individual analysis, PCI group had higher rates of increase (≥ 10% of baseline) in both peak oxygen uptake and peak oxygen pulse than those of control group (P < 0.05).

CONCLUSIONCPET is an objective, quantitative, safe and effective method to evaluate the clinical therapeutic efficiency. PCI can improve the integrative cardiopulmonary function in CAD patients.

Anaerobic Threshold ; Coronary Angiography ; Coronary Artery Disease ; surgery ; Exercise Test ; Heart Rate ; Humans ; Oxygen ; Oxygen Consumption ; Percutaneous Coronary Intervention

ObjectiveTo explore the applied effects of microsurgical treatment on mesial temporal lobe epilepsy(MTLE)under the guidance of the intraoperative magnetic resonance imaging neuronavigation system.MethodsThe anterolateral temporal lobe,hippocampus and amygdala was resected by microsurgery under the guidance of the intraoperative magnetic resonance imaging neuronavigation system in 26 patients with intractable MTLE,with the help of electrocorticography monitoring during operation.ResultsAnterolateral temporal lobes were all resected in postoperative MRI and mesial structures certified to have atrophy or cirrhosis by pathology.All the patients were followed up from 3 to 6 months after the surgery.In 26 patients,twenty-three cases (88.5％) belonged in Engel grade I,two cases (7.7％) in grade Ⅱ and 1 case (3.8％) in gradeⅢ.No severe complications occurred and nervous functions were preserved well.ConclusionMicrosurgical treatment on MTLE under the guidance of the intraoperative magnetic resonance imaging neuronavigation system is effective due to epileptic focus all resected and protection for nervous functions,resulting in an accurate and safe improvemention of operation.