OBJECTIVE To analyze the impact of clinical application sheets for special antibiotics on clinical medication and the existing questions in implementation and irrational phenomena caused by the use of antibiotics.METHODS All the applications sheets for the first month clinical use of special antibiotics in our hospital were analyzed retrospectively,and their used dosage before and after of was compared monthly.RESULTS It was indicated that the partial application sheets were filled out incompletely;the dosage of special antibiotics after clinical application was declined obviously,while the pathogen test rate for the sample was too low and the starting point of the preventive use of antibiotics in some departments was too high.CONCLUSIONS The applications sheets for special antibiotics promote the rational usage of antibiotics in some extent;however,there is still deficiency in operation.Meanwhile,there are some problems in the clinical medication in our hospital and need to take the comprehensive preventive measures to manage it.

Objective To investigate antimicrobial prophylaxis in clean operation,and provide evidence for formu-lating antimicrobial management measures.Methods 12 types of clean operation cases who discharged from a tertia-ry first-class hospital in May of 2011 -2014 were selected,120 cases were selected each year,patients were divided into group I and group II according to the types of operation,survey forms were designed,assessment criteria for the rationality of antimicrobial use was formulated, antimicrobial use in different years was compared. Results Prophylactic use of antimicrobial agents for clean operation decreased from 93.33% in 2011 to 35.00% in 2013 and 2014;rates of correct medication time increased from 43.75% in 2011 to 97.62% in 2013 and 92.86% in 2014 respectively;rates of medication according to indications,rational choice of antimicrobial agents,and rational treatment course increased from 42.86%,60.71 %,and 21 .43% in 2011 to 100.00% in 2014 (all P < 0.05 ). Conclusion Special rectification activities of antimicrobial use effectively promoted the standard application of anti-microbial agents for clean operation.

Objective We aimed to describe the application value of continuous glucose monitoring system in patients with advanced gestational diabetes mellitus (GDM). Methods Pregant women in the medium and late pregant phases (24～35 weeks) underwent GDM screen test from January 2006 to April 2007. They first received 50 g glucose challenge test and 100g OGTT was performed 3 days later when the blood glucose was higher than or equal to 7.8mmol/L. According to the diagnostic criteria from American Diabetes Mellitus (ADA) 47 women were diagnosed to possess GDM and they were further divided into the test group (25 cases) and the control group (22 cases). The test group received 72 hours continuous glucose monitoring (CGMS). The control group adopted peripheral blood glucose monitoring using blood from the fingertip, 7 times per day. Results There were no records of consciousness hypoglycemic symptoms and hypoglycemia during monitoring. The CGMS data suggested that the record of the percent of high blood glucose was (17.5±3.1)%, percent of low blood glucose was (2.4±0.9)%, which were higher than those of the control group, which were (14.3±2.2)% and 0. Conclusions We recommend pregant women with GDM to undergo CGMS while using peripheral blood glucose monitoring with blood from the fingertip. It could systemicly evaluate the real control condition of blood glucose and ensure the safety of both mothers and babies.

AIM: To investigate the effect of aminoguanidine (AG) on plasma and renal levels of angiogenesis Ⅱ (AngⅡ), and to identify the relationship of AGEs with AngⅡ in STZ-induced diabetic rats. METHODS: Wistar rats were randomly assigned to three groups. Diabetes was induced, rats were then received AG in treatment group. At the end of 12th week, urine albumin excretion rate (UAER) and calculate creatinine clearance (Ccr) were detected. Periodic acid-Schiff reagent was used to evaluate renal pathology. Plasma and renal AngⅡ were analyzed by radioimmunoassay and immunohistochemistry, respectively. RESULTS: AG treatment significantly prevented the increase in UAER (P<0.01), renal pathology (P<0.01), and level of renal AngⅡ (P<0.01). However, plasma concentration of AngⅡ was higher than that in diabetic rats without AG treatment (P<0.01). CONCLUSION: AG down-regulates renal Ang Ⅱ level, probably by reducing the formation of AGEs, which may be one of the renoprotective factors in diabetic nephropathy. More proofs are needed to identify the result that plasma AngⅡ concentration increases in DMA group.

OBJECTIVE To investigate the relationship of nosocomial infection with use of antimicrobial agents.METHODS A retrospective study of 171 cases admitted from Nov 2004 to Apr 2005 in a general hospital.RESULTS Sixteen thrush cases all were found to have prior use of antimicrobial agents with average time about(12.5?8.10) days.Twenty six out of 57 surgical cases had wound infection,all used antimicrobial agents preoperatively.Inadequate use of antimicrobial agents manifested as prolonged use or over frequent drug change or improper combined use of drugs etc.CONCLUSIONS Protracted use of antimicrobial agents may be related with development of thrush.Rational use of antimicrobial agents is to be emphysized.

OBJECTIVE To investigate the trends of susceptibility of Staphylococcus isolates to antimicrobial agents analyzed by the Shandong provincial nosocomial infection surveillance system.METHODS The data from Jan 2002 to Dec 2005 were summarized and analyzed by the Shandong provincial nosocomial infection surveillance system.RESULTS During this period,1644 strains of first isolate from each patient were collected.Major specimens were sputum,wounds,skin soft tissue and urine,which were 39.72%,22.08%,9.43% and 7.54% in total specimens,respectively.The drug-resistant rates of Staphylococcus isolates to antimicrobials were high,except to vancomycin.CONCLUSIONS Antimicrobial resistance of clinical isolates threatens the success of infectious disease treatment.It is very important to promote the rational use of antimicrobial agents for control of resistance and to take effective measures for the prevention of infections.

OBJECTIVE To investigate the trends of susceptibility of Enterobacter cloacae isolates to antimicrobial agents from Shandong provincial nosocomial infection surveillance system. METHODS The data from Shandong provincial nosocomial infection surveillance system from Aug 2001 to Jul 2004 were summarized and analyzed.(RESULTS) In the period of study from Aug 2002 to Jul 2004,231 strains of E.cloacae were collected.The (sputum),(urine) and wounds were major specimens,and accounted for 55.41%, 10.82% and 9.96% from total(specimens),respectively.The resistant rates of E.cloacae isolates to antimicrobials,except imipenem,increased to some extend.CONCLUSIONS Antimicrobial resistance of clinical isolates of E.cloacae threatens the success of(infectious) disease treatment.It is very important to promote the rational use of antimicrobial agents for control of resistance and to take effective measures for the prevention of infections.

Objective To investigate the distribution and antimicrobial resistance of bacteria isolates from intensive care units(ICUs) in Shandong Province.Methods Antimicrobial susceptibility data about clinical strains isolated from ICUs of 101 hospitals and general wards(non-ICUs) of 106 hospitals in Shandong Province in 2014 were analyzed statistically.Results A total of 24 458 strains of bacteria were isolated, of which gram-negative and gram-positive bacteria accounted for 80.37% and 19.63% respectively.The top five pathogens in ICUs were Klebsiella pneumoniae, Acinetobacter baumannii, Pseudomonas aeruginosa, Escherichia coli, and Staphylococcus aureus.Resistance rates of Escherichia coli, Klebsiella pneumoniae, Enterobacter cloacae, and Serratia marcescens obtained from ICUs to carbapenems, piperacillin/tazobactam, cefoperazone/sulbactam, and amikacin were all higher than those from non-ICUs(all P<0.01).Resistance rates of Acinetobacter baumannii, Pseudomonas aeruginosa, and Staphylococcus spp.from ICUs were all higher than those from non-ICUs(P<0.05).Resistance rates of Acinetobacter baumannii isolated from ICUs to imipenem and meropenem were 78.0% and 79.0% respectively;while Pseudomonas aeruginosa were 25.5% and 21.6% respectively, resistance rates to other antimicrobial agents were all <30.0%.Isolation rate of methicillin-resistant Staphylococcus aureus from ICUs was higher than that from non-ICUs(39.7% vs 26.0%, P<0.05).Conclusion Antimicrobial resistance of bacteria isolated from ICUs is serious, rational use of antimicrobial agents should be guided according to the results of antimicrobial susceptibility testing result, so as to prevent the spread of drug-resistant bacteria.

Objective: To investigate echocardiography characteristics and clinical significance in patients with diastolic mitral regurgitation. Methods: A total of 15 patients with diastolic mitral regurgitation were studied including 1 patient with large volume of aortic regurgitation, 6 with atrial ifbrillation (AF), 2 with atrial lfutter, 1 with II° type I atrio-ventricular block (A-V block), 1 with II° type II A-V block and 4 with III° A-V block. The characteristics of mitral regurgitation were observed, the heart rates, left ventricular size were measured and left ventricular function was detected in all patients. Results: There was 1 large volume aortic regurgitation patient with diastolic mitral regurgitation occurred in slow iflling phase with less volume, it was less than positive velocity; 1 AF patient occurred in mid and late diastolic phase with less volume, it was obviously less than positive velocity; the rest 8 patients all occurred in mid and late diastolic phase, the velocity reached or surpassed to positive velocity. All 15 patients had slow heart rate, increased left heart, decreased left ventricular ejection fraction, tissue Doppler imaging showed that the early diastolic peak slowed down in mitral ring. There were 93% (14/15) patients having obvious systolic regurgitation. Conclusion: The time phase, quantity and velocity of diastolic mitral regurgitation have various characteristics, most of them associated with systolic regurgitation combining abnormal cardiac structure and function. Echocardiography provides important information for clinical treatment.

OBJECTIVE To investigate the distribution and bacterial resistance of nosocomial infection.METHODS The data of 45 hospitals from Shandong Provincial Nosocomial Surveillance System from Jan 2003 to Dec 2005 were analyzed.RESULTS Of total 5 626 isolates strains from the nosocomial infection cases,G-bacilli,G+ cocci and fungi accounted for 58.27%,25.84% and 15.89%,respectively.The ampicillin-resistant rate of commonly encountered G-bacilli was above 89%.There were 72.98% of E.coli resistant to ciprofloxacin.The rates of resistance of S.aureus and coagulase negative Staphylococcus to penicillin,ampicillin and erythromycin were all above 80%;the lincomycin-resistant rate of S.aureus increased gradually to 86.64%.CONCLUSIONS Drug resistance of the nosocomial infective bacteria is a serous problem.Surveillance of bacterial resistance should be strengthened.