目的 分析老年慢性心力衰竭患者肺部感染的危险因素及其对降钙素原(PCT)、B型脑钠肽前体(NT-proBNP)、氧化应激指标的影响.方法 选取60例老年慢性心力衰竭合并肺部感染者为心力衰竭感染组,无肺部感染者60例为单纯心力衰竭组.检测两组患者血液中PCT、NT-proBNP及氧化应激指标水平,单因素及多因素Lo-gistic回归分析老年慢性心力衰竭患者肺部感染的危险因素.结果 单因素分析结果显示,心功能分级、吸烟史、糖尿病、高血压、肾功能不全及侵入性操作均与老年慢性心力衰竭患者肺部感染有关(P<0.05).多因素Logistic回归分析结果显示,心功能分级高、有吸烟史、合并糖尿病及接受侵入性操作均为导致老年慢性心力衰竭患者肺部感染的危险因素(P<0.05).与单纯心力衰竭组相比,心力衰竭感染组患者血清PCT、NT-proBNP及丙二醇(MDA)水平升高(P<0.05),超氧化物歧化酶(SOD)与谷胱甘肽化物酶(GSH-Px)水平降低(P<0.05).随着肺部感染程度加重,患者血清PCT、NT-proBNP及MDA水平递增(P<0.05),SOD与GSH-Px水平递减(P<0.05).结论 老年慢性心力衰竭患者肺部感染的发生与心功能分级、吸烟史、糖尿病及侵入性操作等相关,同时肺部感染可使老年慢性心力衰竭患者心功能降低,氧化应激反应增强.

目的 探讨老年下呼吸道感染的病原学特征及经鼻高流量湿化氧疗(HFNC)辅助治疗效果.方法 选取2019年1月—2023年1月承德医学院附属医院收治的98例老年下呼吸道感染患者,均采集痰标本行菌株鉴定,并以随机数字表法分为研究组和对照组,每组49例.对照组给予传统经鼻导管或面罩吸氧,研究组给予HFNC,治疗1周后观察疗效.统计老年下呼吸道感染患者感染病原菌分布情况,对比两组临床症状改善情况、临床疗效、肺功能、气道重塑情况、炎症因子及并发症情况.结果 98例老年下呼吸道感染患者中,共检出152株病原菌,其中革兰阴性菌99株,以肺炎克雷伯菌为主;革兰阳性菌43株,以金黄色葡萄球菌为主;真菌10株,以假丝酵母菌为主.研究组呼吸困难消失时间、咳嗽症状消失时间、肺部湿啰音消失时间短于对照组(P<0.05).研究组总有效率高于对照组(P<0.05).研究组治疗前后用力肺活量、第1秒用力呼气容积(FEV1)/FVC、呼吸频率、人软骨糖蛋白-39、结缔组织生长因子、转化生长因子-β1、白细胞介素-6、白细胞介素-1、单核细胞趋化蛋白-1的差值均高于对照组(P<0.05).两组总并发症发生率比较,差异无统计学意义(P>0.05).结论 老年下呼吸道感染患者中多见革兰阴性菌和革兰阳性菌感染,HFNC辅助治疗可提高疗效,改善肺功能及气道重塑,抑制炎症反应,安全可靠.

BACKGROUND: Lower respiratory tract infection (LRTI) is a clinical multi-infectious disease caused by viral, bacterial, and other microbial infections. OBJECTIVE: The present study aims to explore the therapeutic effects of high-flow nasal cannula (HFNC) oxygen therapy and its influence on the serum levels of inflammatory factors in senior patients with LRTI. METHODS: In this randomized controlled trial, 84 senior patients with LRTI were enrolled between March 2017 and December 2019 and divided into the observation group and the control group according to the random number table method, with 42 cases in each group. Conventional nasal cannula (CNC) oxygen therapy was conducted in the control group and HFNC was conducted in the observation group. After 3 days of treatment, sputum properties, sputum volume, sputum viscosity, and sputum crust formation were recorded to determine the clinical efficacy. ELISA was performed to detect the serum levels of tumor necrosis factor alpha (TNF-α) and interlukein (IL)-8 before and after treatment. RESULTS: The total efficacy in the observation group was 92.86%, which was higher than in the control group (73.81%) (P< 0.05). Three days after treatment, the percentage of grade I sputum in the observation group (73.81%) was higher than in the control group (40.48%). Moreover, the percentage of grade II sputum (23.81%), the percentage of grade III sputum (2.38%), together with the sputum crust formation rate in the observation group (4.76%) were all lower than in the control group (45.24, 14.28, and 26.19%, respectively) (P< 0.05). Three days after treatment, the levels of IL-8 (0.21 ± 0.03 pg/L) and TNF-α (1.27 ± 0.14 ng/L) in the observation group were lower than in the control group (0.30 ± 0.04 pg/L, and 1.49 ± 0.18 ng/L) (t= 6.525, 11.665, 6.252, respectively; P< 0.05). CONCLUSION: The application of HFNC in senior patients with LRTI could improve respiratory humidification, reduce the number of sputum aspirations, and improve anti-inflammatory effects. It is worthy of application in elderly patients with LRTI.

本文探讨老年肺部感染影像学评估及高流量湿化氧疗疗效.选取96例肺部感染患者为研究对象,分为常规氧疗组、高流量湿化氧疗组,各48例.检测两组炎症相关因子、血气指标水平,并对比两组肺部CT影像学及临床疗效.治疗后两组白细胞计数、中性粒细胞百分比、PCT、CRP、IL-1、IL-6、IL-8、TNF-a、PaCO2水平下降,且高流量湿化氧疗组低于常规氧疗组,治疗后两组SaO2、PaO2水平上升,且高流量湿化氧疗组高于常规氧疗组(P＜0.05).治疗后高流量湿化氧疗组胸腔积液、结节、网格或线样、磨玻璃影占比均低于常规氧疗组(P＜0.05).高流量湿化氧疗组治疗有效率高于常规氧疗组(P＜O.05).高流量湿化氧疗对老年肺部感染患者治疗效果较好,肺部CT影像学可为肺部感染患者早期诊断及疗效评价提供参考,具有一定的临床推广价值.

目的 探究高流量湿化氧疗对老年下呼吸道感染患者血清白细胞介素(IL)-6与IL-1的影响及疗效预测价值.方法 收集100例下呼吸道感染的老年患者,随机将其分为对照组与观察组,每组各50例.对照组采用传统氧疗,观察组采用高流量湿化氧疗.比较两组治疗前与治疗后(3 d)血清中IL-1与IL-6水平与临床疗效,比较两组基线资料,根据疗效将患者分为有效组与无效组,分析影响患者临床疗效的危险因素,并绘制多因素存在差异指标的受试者工作特征(ROC)曲线.结果 治疗后,两组血清IL-1、IL-6水平均明显低于治疗前,且观察组均明显低于对照组,差异均有统计学意义(P<0.001);观察组临床治疗有效率明显高于对照组,差异有统计学意义(P<0.05);两组治疗方案、治疗前IL-1水平、治疗前IL-6水平、吸烟史比较,差异有统计学意义(P<0.05);多因素分析发现治疗方案、治疗前IL-1水平、治疗前IL-6水平是影响患者下呼吸道感染疗效的独立危险因素.结论 高流量湿化氧疗可改善老年下呼吸道感染患者临床疗效,降低患者IL-6与IL-1的水平,并且通过观察治疗前IL-6与IL-1的水平对患者临床疗效存在一定的预测价值.

目的:探讨高流量湿化氧疗对老年肺炎患者临床疗效及炎症因子IL-8、IL-6的影响.方法:选取承德医学院附属医院老年病科2017年1月至2019年8月住院治疗的老年肺炎患者80例,随机分为研究组和对照组,各40例,两组都给予止咳、祛痰、抗炎等治疗措施,研究组应用气道高流量湿化氧疗,对照组采用传统鼻导管或吸氧面罩方法,比较治疗前后患者临床表现、心率(HR)、呼吸频率、血氧饱和度(SpO2)及IL-6、IL-8的变化.结果:治疗前,两组患者IL-6、IL-8指标差异无统计学意义(P>0.05);临床应用高流量湿化氧疗后,体温下降时间、痰液性状粘稠度变化时间、肺部啰音减少消失时间较对照组明显缩短,心率、呼吸频率明显低于对照组,SpO2明显高于对照组(P<0.05),血清IL-6、IL-8下降程度均高于对照组,差异比较,具有显著的统计学意义(P<0.05).结论:应用高流量湿化氧疗能显著改善临床疗效,提高氧合,降低炎症因子IL-6、IL-8的表达水平.

目的 观察不同程度阻塞性睡眠呼吸暂停低通气综合征(OSAHS)对患者超声骨密度的影响及与跌倒风险之间是否存在相关性.方法 收集通过多导睡眠监测(PSG)确诊为OSAHS的患者65例,依据睡眠呼吸暂停低通气指数(apnea hypopnea index,AHI)分为轻中度组(44例)和重度组(21例).选取经PSG排除OS-AHS的同期住院患者31例为对照组.记录所有患者的一般资料,血Ca、血P、25(OHD)、PTH、骨密度T值及跌倒风险评分,比较各组间超声骨密度差异及与跌倒风险是否存在相关性.结果 轻中度、重度组与对照组间骨密度差异无统计学意义(P>0.05).AHI与血Ca、BMI呈正相关(P<0.05),AHI与骨密度T值呈负相关,对照组与轻中度OSAHS组跌倒风险差异无统计学意义(P>0.05),对照组、轻中度组与重度组OSAHS组跌倒风险差异有统计学意义(P<0.05).结论 OSAHS可能是超声骨密度减低的危险因素,导致跌倒风险增加.

目的:比较高流量湿化氧疗与普通传统氧气疗法对老年患者肺炎的治疗效果,为高流量湿化氧疗的临床应用提供依据.方法:收集2016年10月至2019年12月本院老年病科住院治疗的下呼吸道感染老年患者80例,采用完全随机法将患者分对照组(普通传统氧气疗法)和研究组(经鼻高流量湿化氧疗,HFNC),每组40例.比较两组患者治疗前后的临床疗效及PCT、CRP、SpO2、RR、HR水平.结果:治疗前两组患者的临床症状指标及PCT、CRP、SpO2、RR、HR水平,差异无统计学意义(P>0.05).治疗后研究组肺部啰音消失、气促消失时间及住院时间明显短于对照组,差异具有统计学意义(P<0.001);研究组PCT、CRP、HR、RR水平低于对照组,SpO2水平高于对照组,差异有统计学意义(P<0.001).结论:应用HFNC治疗老年人肺炎的临床效果显著优于传统氧气疗法.

目的 探讨高流量湿化氧疗与无创正压通气在机械通气撤离序贯治疗中的疗效.方法 选取自2016年3月至2019年3月承德医学院附属医院老年病科收治的行气管插管机械通气患者48例,在机械通气撤离序贯治疗中,应用无创正压通气的患者为A组(n=24),应用高流量湿化氧疗的患者为B组(n=24).比较两组患者机械通气撤离24 h后痰液湿化效果、相关临床指标、不良事件及并发症发生情况.结果 机械通气撤离24 h后,B组湿化不足患者比例低于A组,湿化满意患者比例高于A组,差异有统计学意义(P<0.05).机械通气撤离1 h、24 h,两组患者动脉血氧分压、二氧化碳分压比较,差异均无统计学意义(P>0.05).B组患者舒适度评分、焦虑评分、总通气治疗时间、住院时间均低于A组,且呼吸机相关性肺炎发生率低于A组,差异均有统计学意义(P<0.05).两组患者28 d内再插管率比较,差异无统计学意义(P>0.05).B组患者压疮、误吸发生率及28 d内病死率均低于A组,差异有统计学意义(P<0.05).结论 在机械通气撤离序贯治疗中应用高流量湿化氧疗,可维持患者气道湿润度始终处于类似生理湿化状况,利于患者分泌物排出,确保高氧疗效果.

目的 探讨肺动脉压升高的左心衰竭患者可溶性基质裂解素2(sST2)、N端脑钠肽前体(NT-proBNP)的水平及其临床意义.方法 选取2018年11月至2019年4月在我院住院的左心衰竭患者100例,根据超声心动图结果,以肺动脉收缩压(PASP)≥40mmHg(1mmHg=0.133kPa)作为诊断肺动脉高压(PH)的标准,分为肺动脉压正常组35例,轻度肺动脉高压组(40-49mmHg)30例以及中重度肺动脉高压组(≥50mmHg)35例,采用酶联免疫吸附试验(ELISA法)测定血浆sST2水平,并收集相关临床资料及实验室指标,分析sST2、NT-proBNP与肺动脉压的关系.结果 与正常组相比较,血浆sST2、NT-proBNP浓度在肺动脉压力升高的组中明显升高,随着压力值升高血浆中sST2、NT-proBNP浓度逐渐升高,各组间比较存在差异,差异有统计学意义(P<0.05).血浆sST2、NT-proBNP均与肺动脉压力存在相关性(r=0.746,r=0.707,P<0.01).Logistic回归分析显示,sST2、NT-proBNP是左心衰竭患者继发肺动脉高压的独立相关因素.结论 sST2、NT-proBNP同左心衰竭患者肺动脉压力存在相关性.血浆sST2、NT-proBNP提示左心衰竭患者发生肺动脉高压的危险性升高.

Objective:To investigate the effect of repeated transcranial stimulation ( rTMS) on the improvement of depression in patients with cerebral infarction and the change of FTHUE-HK ( FTHUE-HK) rat-ing in patients with hemiplegia. Methods:96 patients with cerebral infarction who were treated in our hospital from September 2015 to August 2016 were selected and divided into three groups:0. 5Hz group, 1Hz group and 2Hz group , Each group of 32 cases. Three groups were using the basic drug therapy and rehabilitation training, on the basis of this group with the corresponding frequency rTMS for treatment. The improvement of depression in the three groups before and after treatment was evaluated by the Depression Self-Rating Scale ( SDS) . The changes of FTHUE-HK were observed before and after treatment. Results:There was no signifi-cant difference in SDS scores between the two groups before treatment ( P> 0.05) . However, after treatment, the scores of SDS in the three groups were significantly decreased, but the 0.5Hz group and the 2Hz group all dropped below the cut- (P <0.05), but there was no significant difference between the two groups (P <0. 05), but there was no significant difference between the two groups (P <0.05). There was no significant difference in FTHUE-HK between the two groups before treatment, and there was no significant difference be-tween the two groups and the 2Hz group ( P <0.05) . Conclusion:The use of different frequencies of rTMS in the treatment of cerebral infarction patients can improve the patient's depressive symptoms and hemiplegia up-per limb function, but in contrast, high frequency and low frequency rTMS treatment of cerebral infarction is more significant.

Objective To investigate the clinical effect of low frequency repetitive transcranial magnetic stimu-lation(rTMS)in the treatment of anxiety and depression of elderly patients with acute cerebral infarction.Methods 80 cases of elderly patients with anxiety and depression after acute cerebral infarction were selected and randomly divided into rTMS group and the conventional group.The two groups were both given conventional drug therapy and rTMS group was added with rTMS treatment at the same time.After 8 weeks of treatment,the treatment effects of the two groups of patients were compared.Results After treatment,Hamilton Depression Scale[[(9.86 ±2.04)points],Hamilton Anxiety Scale[(10.24 ±1.75)points]and Chinese brain stroke scale[16.39 ±2.27)points]in rTMS group were lower than those in the conventional group[(11.18 ±2.23)points,(12.05 ±2.11)points and(19.15 ±2.50) points,respectively],P<0.05.The serum level of brain-derived neurotrophic factor[(28.14 ± 4.42)μg· L-1· mL-1)]in rTMS group was higher than that in the conventional group[(25.26 ±4.25)μg· L-1· mL-1],P<0.05.Conclusion RTMS assisted drug in the treatment of anxiety and depression in elderly patients with acute cerebral infarction has better effect than the single drug treatment.

Objective To analyze the effect of high flow humidification oxygen therapy on pulmonary infection in elderly patients with cerebral infarction and the effect on oxygen saturation and pneumonia in patients with cerebral infarction. Methods A retrospective study was conducted on 70 elderly patients with pulmonary infarction who were hospitalized in geriatrics department of Affiliated Hospital of Chengde Medical College from May 2015 to January 2017. The patients were divided into control group and experimental group according to different oxygen feeding methods.The control group was treated with traditional nasal catheter oxygen mask,the experimental group were treated with high respiratory flow humidified oxygen. The heart rate,respiratory frequency,blood pressure,blood gas index change,change the expectoration ability of patients,the hospital infection rate and patients,the incidence of drug-resistant bacteria,antibiotic use time were observed in the two groups. Results There was no difference of blood pressure before and after treatment in two groups(P> 0.05). 1H,4H two groups,24h heart rate,respiratory rate,PaO2,PaCO2,SaO2,PH and oxygen index levels were improved dramatically after treatment than before treatment in two groups(P< 0.05),and these treatment index were better in experimental group than in control group after treatment(P < 0.05). Two groups of patients after treatment of sputum viscosity grade was improved too after treatment in the two groups(P < 0.05),and the sputum characters was better in experimental group than control group after treatment(P< 0.05). The rate of internal infection and the incidence of drug-resistant bacteria in experimental group were lower than those of the control group,and the time of antibiotics use was shorter in experimental group than that in control group(P<0.05).Conclusion High flow humidification oxygen therapy can improve the blood gas index and respiratory function of pulmonary infection in elderly patients with bedridden cerebral infarction,and improve the comfort of patients,and reduce the incidence of nosocomial infection and the incidence of drug-resistant bacteria.

目的 探究老年高血压患者的血管弹性状态、内皮功能、虚弱指数的研究.方法 选取承德医学院附属医院2017年2月 ～2018年2月收治并进行血管相关功能检测的老年高血压患者50例(高血压组),同期住院进行健康体检者50例作为健康对照组,通过肱动脉二维超声显像,并测定肱动脉内径及反应性充血变化.结果 反应性充血引起肱动脉内径的变化在高血压组减弱,高血压组的反应性充血舒张百分比较对照组低,比较差异有显著统计学意义(P<0.01).老年高血压患者的非内皮依赖性血管扩张能指标与健康对照组比较差异无统计学意义(P>0.05);内皮依赖性血管扩张功能指标明显低于健康对照组,差异有统计学意义(P<0.01).高血压组患者由于高血压、饮食、服药及年龄的原因造成了身体不健康指数的增高,其虚弱指数显著高于健康对照组,差异有统计学意义(P<0.01).结论 老年高血压患者的血管弹性状态和内皮功能受高血压影响,由于疾病相关因素导致虚弱指数上升,应在临床诊断治疗中予以关注.

Objective It is to observe the clinical curative effect of ginkgo leaf tablet combined with low frequency repetitive transcranial magnetic stimulation on anxiety and depression after lacunar infarction and effect on blood rheology.Methods 121 cases of patients with anxiety and depression after lacunar infarction were randomly divided into observation group (n =61) and control group (n =60),the control group was treated with low-frequency repetitive transcranial magnetic stimulation,the observation group was given ginkgo leaf tablet orally on the basis of treatment in control group,one tablet per day,3 times/d,the treatment course was 12 weeks.The changes of scores of Hamilton anxiety scale (HAMA) and Hamilton depression scale (HAMD),the United States national institutes of health stroke scale (NIHSS) and the Barthel index (BI) score,36 items concise health scale (SF-36) score and indexes of hemorheology before and after treatment were observed in both groups.Results After treatment,the scores of HAMA,HAMD,NIHSS and BI were significantly improved (P ＜ 0.05) in both groups (P ＜ 0.05),and the improvements of these indexes in observation group were better than that in control group (P ＜0.05);the scores of SF-36 scale such as physiological function (PF),vitality (VT),general health (GH),body pain (BP),physiological functions (RP),social function (SF),mental health (MH),emotional functions (RE) were increased significantly (P ＜ 0.05),and the improvements of these indexes in observation group were better than that of control group (P ＜ 0.05);whole blood hyposhear viscosity,whole blood middle shear viscosity,whole high blood viscosity,plasma viscosity,erythrocyte aggregation index were significantly decreased,the levels of the above indexes in observation group were lower than that in the control group (P ＜ 0.05).Conclusion Ginkgo leaf tablet combined with low frequency repetitive transcranial magnetic stimulation can significantly improve blood rheology and anxiety depression,promote the recovery of nerve function,independent life ability and quality of life in the patients with anxiety and depression after lacunar infarction.

Objective To investigate the effect of high flow oxygen therapy system on the incidence of hospital acquired pneumonia in patients with tracheotomy.Methods 70 patients who separated from the ventilator of tracheoto-my were randomly divided into treatment group (humidified oxygen humidified high flow)and conventional group (tra-ditional artificial humidification oxygen mask)35 cases,arterial oxygen partial pressure (PaO2 ),arterial partial pressure of carbon dioxide (PaCO2 ),oxygen saturation (SaO2 ),the incidence of airway humidification effect of pH value,satis-faction rate and complication were compared between two groups.Results Before the treatment,humidified oxygen ther-apy group and normal group of PaO2 ,PaCO2 ,SaO2 ,pH value of the difference was not statistically significant (P >0.05);4 h treatment,after the treatment of 24h,PaO2 ,SaO2 humidification oxygen therapy group were higher than that in control group (P <0.05 ),there was no significant difference between PaCO2 and the conventional group (P >0.05);after 1 2 h treatment,the two groups of patients with airway humidification was evaluated,humidification oxygen therapy group airway humidification satisfaction was 80% higher than the conventional group 54.29% (P <0.05);hu-midification oxygen therapy group excessive airway humidification of 0% lower than the conventional group 1 1 .43%(P <0.05);the treatment process,oxygen humidification treatment group,the complication rate was 1 1 .43% lower than the conventional group 40 (P <0.05),humidification oxygen therapy group occurs in hospital acquired pneumonia in 6 cases (1 7.1 4%)of 1 4 cases lower than the conventional group (40%),the difference was statistically significant (P <0.05).Conclusion High flow humidification oxygen therapy system can effectively reduce the incidence of hospital ac-quired pneumonia in patients with tracheotomy and maintain stable blood gas levels.

Objective To evaluate the effect of low frequency repeated transcranial magnetic stimulation (rTMS) on patients with acute cerebral infarction (ACI),and to provide a basis for the treatment of ACI.Methods A total of 200 ACI patients complicated with hemiplegia were recruited in Affiliated Hospital of Chengde Medical College from January through November 2016 and then randomly divided into a rTMS group and a routine treatment group (100 patients in each group).All the patients received routine rehabilitation treatment while the patients of rTMS group accepted rTMS at the same time.We analyzed differences in scores of National Institutes of Health Stroke Scale (NIHSS) and Fugl-Meyer,Barthel Index (BI),latency and amplitude of motor evoked potential (MEP),central motor conduction time (CMCT),and score of Hamilton Anxiety Scale (HAMA)between the two groups after 2 and 4 weeks' treatments.Resuits There were no statistically significant differences between the two groups in NIHSS score,BI index,Fugl-Meyer score,MEP latency,MEP amplitude,CMCT,and HAMA score before the treatments (P ＞ 0.05 for all).Compared to those of the routine treatment group,significantly higher BI index (69.43 ± 7.85％ vs.63.18 ± 8.40％),Fugl-Meyer score (65.20 ±6.84 vs.60.88 ±7.47),and MEP amplitude (1.04 ± 0.19 mv vs.0.91 ± 0.15 mv) and lower NIHSS score (5.13 ± 1.96 vs.5.72 ± 1.88),MEP latency (23.72 ±0.43 ms vs.24.10 ±0.38 ms),and CMCT (10.11 ±0.49 ms vs.10.67 ±0.43 ms)were observed in the rTMS group (all P ＜ 0.05) after 2 weeks' treatments;by the end of 4 weeks' treatments,the rTMS group showed significantly higher BI index (83.20 ± 8.17％ vs.76.94 ± 9.35％),FuglMeyer score (74.12 ±6.65 vs.69.36 ± 7.17),and the MEP amplitude (1.15 ± 0.16 mv vs.0.96 ± 0.18 mv) and lower NIHSS score (3.27 ± 1.05 vs.4.06 ± 1.13),MEP latency (23.12 ± 0.36 ms vs.23.70 ± 0.47 ms),CMCT (9.62 ±0.51 ms vs.10.01 ±0.64 ms),and HAMA score (7.53 ± 1.86 vs.8.96 ± 1.97) compared to the routine treatment group (all P ＜ 0.05).Conclusion rTMS could significantly improve motor function and anxiety in patients with acute cerebral infarction.

Objective To investigate the characteristics and quality of life of patients with pulmonary infections after tracheotomy.Methods Betweem November 2012 and November 2016,200 ICU cases of patients with tracheal tubes after tracheotomy were studied and divided into the infection group (126 cases) and non-infection group (74 cases) according to the occurrence of pulmonary infections.The characteristics of patients with urinary tract infections were statistically analyzed,and the quality of life was compared between the two groups.Results Among the 200 cases with tracheal tubes,126 suffered from pulmonary infections.From respiratory secretions were detected 268 strains of pathogens,including 170 strains of gram-negative bacilli (63.43％),59 strains of gram positive cocci (22.01％),and 39 strains of fungi (14.55％).The scores of mental function,physical function,social functioning and quality of life in the infection group were lower than in the non-infection group,and the difference was statistically significant (P＜0.05).Conclusion The incidence of pulmonary infections in patients with tracheal incision is high,which is mainly caused by gram-negative bacilli,and pulmonary infections can seriously affect the quality of life of patients.

目前脑血管病已成为我国城市和农村人口的第一位致残和死亡原因,短暂性脑缺血发作(TIA)是最常见的脑血管病之一,且发病有逐年增多的趋势[1].目前,国内针对TIA病人合并抑郁的情况有待于进一步研究.本研究旨在探讨TIA病人抑郁的发生情况及其与人格特征的相关性. 1 对象与方法 1.1研究对象 随机抽取我院2010年1月至2011年12月首次发病的TIA住院老年病人,共456例,其中男248例,女208例;年龄(70±10)岁.所有病人均符合美国卒中协会(ASA)发表的最新脑卒中和短暂性脑缺血发作二级预防指南的诊断标准[2],且意识清楚,无明显的理解障碍,无阳性精神障碍个人及家族史,无智力障碍和认知障碍.全部病人均经颅脑CT检查无异常,所有受试者均被告知研究方法,首次接触相关测评量表,获得书面知情同意.

Objective:To analyze the occurrence of depression of all ages through case analysis,to improve recognition and attention of depression.Methods:The ratio of depressive disorder and sex,as well as main psychological and social factors of depression of all ages were summarized and analyzed.Results:The ratio of depressive disorder: social stage(73.2%) was obviously higher than student stage(46.2%),university level(66.7%) higher than middle school stage(38.5%)(P0.01,P0.05).The depressive ratio of male of university level was fairly higher,while the depressive ratio of female of middle school stage and young and middle-aged stage was fairly higher.There had obvious differences between male and female of the 4 reasons of depression of social stage(P0.05).Conclusions:Of all the depression clients,the depressive ratio of social stage and university level is fairly higher,the male depression ratio of university level is fairly higher.The main psychological and social factors of depression of different ages are different;the main psychological and social factors of social stage has sexual differences.