OBJECTIVE To evaluate the prevention of antibiotic-associated diarrhea(AAD) in surgical critical illness patients and strengthen the usage of antibacterials to AAD in hospital.METHODS Using prediction and retrospection to analyze the factors of AAD.RESULTS The main factors for AAD are changing antibiotics frequently,the age of patient,complicated disease of patient.CONCLUSIONS Rational use and rigorous control of antibiotics are the keys to prevent AAD in hospital.

BACKGROUND: It has been confirmed that platelet aggregation defect presents in patients with hemorrhagic thrombopathy, and platelet membrane glycoproteins play a significant role in the process of platelet aggregation.OBJECTIVE: To observe the expression changes of platelet membrane glycoproteins between patients with hemorrhagic thrombopathy and healthy people.DESIGN: Case-control analysis.SETTING: Department of Integrated Traditional Chinese and Western Medicine, Union Hospital, Tongji Medical College,Huazhong University of Science and Technology.PARTICIPANTS :① Seventy-nine patients with hemorrhagic thrombopathy who received treatment from January 2001 to March 2003 in the Department of Integrated Traditional Chinese and Western Medicine, Union Hospital, Tongji Medical College, Huazhong University of Science and Technology were enrolled in this study. The patients, including 31 male and48 femlae, averaged (35.76±14.14)years old. They all agreed to participate in this study and met with the diagnosis of hemorrhagic thrombopathy revised in 1996.Informed consents were obtained from all the patients and their relatives.The course of multiple bleeding symptoms was 1 to 14 years. And the bleeding sites were totally 167: extremity petechia was found in 64 cases, rhinorrhagia in 33 cases, hypermenorrhea (more than 150 mL in each cycle) in 29 cases, gingival bleeding in 28 cases, ocular fundus bleeding in 8 cases and conjunctival hemorrhage in 5 cases.②lnclusive criteria: All the cases presented clinical manifestation of multiple focal bleeding;The laboratory tests including platelet counts,bleeding time and coagulation profiles were examined with no marked abnormal changes;According to hemorrhage sites, the patients were examined by specialists of internal medicine,otorhinolaryngology, gynecology, stomatology and ophthalmology, and no specific diagnostic focuses of infection were found; They had normal blood pressure and heart rate,and those with thrombocytasthenia had been ruled out through ristocetin test. ③Another 34 healthy volunteer donors, 15 males and 19 females with an average age (30.12±7.14) years,were selected as normal control group.METHODS:① Detection of platelet aggregation ratio: Adenosine diphosphate (ADP, final concentration 1.90 μmol/L),arachidonic acid(AA, final concentration 0.37 μmol/L),and platelet activating factor(PAF, final concentration 150 nmol/L)were used as aggregation inductors, and Chronolog 430 type aggregometry was used to detect platelet maximum agglutination ratio.When maximum agglutination ratio was within 21％ and 40％, it was considered as aggregation defect, and when below 20％, it was considered as aggregation absence.② Test of platelet membrane glycoprotein: 3.6 mL cubital venous blood was drawn from the patients and mixed with 20 g/L disodium ethylenediamine tetraacetic acid(EDTA-NA2) for the purpose of anticoagulation at 1:9, and the same procedure was performed on the blood samples from the normal control group. The plasma was isolated and collected, after being centrifuged, the supernatant liquid was discarded, and paraform was added to fix the rest of the platelet solution. The platelet concentration was adjusted to 3×107 L-1. 100 μL regulated platelet solution was extracted, and fluorescein isothiocyanate (FITC)-marked CD42b (anti-GP Ⅰ b),CD41 (anti-GP Ⅱ b), CD61 (anti-GP Ⅲ a), CD42b/CD42a (anti-GP Ⅰ b/Ⅸ ), CD41/ CD61 (anti-GP Ⅱ b/Ⅲ a) and CD62p(anti-P-selectin)clonal antibodies 200 μL were added respectively and well mixed,and then cultured for 30 minutes at room temperature away from light. Finally phosphate buffer solution was added to the solution till the volume reached 1 mL,and FACS420 flow cytometer was used to analyze the samples, one sample for 10000 platelets, and the results were demonstrated by positive fluorescence percentage.MAIN OUTCOME MEASURES: ① Platelet aggregation ratio. ② Expression of platelet membrane glycoproteins.RESULTS:All the patients and the healthy subjects were involved in the analysis of results. ①All the cases were found to have platelet aggregation defect or absence which could be induced by single or more platelet aggregating agents. No abnormal platelet aggregations were found in the control group. ② The fluorescence intensities of GPIb/Ⅸ, GP Ⅱ b/Ⅲa complexes, GPIb, GPⅢa and P-selectin in patients with hemorrhagic thrombopathy were lower than those in the healthy subjects (t =2.50-5.57,all P ＜ 0.05). The fluorescence intensity of GP Ⅱb in patients with hemorrhagic thrombopathy was slightly higher than that in the healthy subjects, but no significant difference was found. (t =0.86, P ＞0.05).CONCLUSION: Abnormal expressions of platelet membrane glycoproteins may be partial pathogenesis of hemorrhagic thrombopathy.

Objective To analyze hematosis of modified homemade Buxue decoction discriminate on patients with hemorrhagic anaemia after unilateral total hip arthroplasty and prognosis.Methods88 patients with hemorrhagic anaemia who underwent unilateral total hip arthroplasty in our hospital from February 2015 to Janurary 2017 were selected, they were randomly divided into the observation group and the control group, 44 cases in each group.The control group received pure western medicine after unilateral total hip arthroplasty, the observation group added modified homemade Buxue decoction discriminate on the basis of the control group.Clinical therapeutic effect on anemia, hematosis indexes including hemoglobin (HB), red blood cell (RBC), erythrocrit (HCT) in the two groups were compared, occurrence of complications during postoperative treatment, hip scores were used to compared prognostic differences in the two groups.ResultsTotal effective rate of the observation group 95.45% was significantly higher than the control group (81.82%) (P<0.05);there was no significant difference in Hb, RBC and HCT level before the treatment in the two groups, Hb (130.23±13.09)g/L, RBC (4.16±0.71)×1012/L and HCT (0.42±0.03) in the observation group after the treatment were significantly higher than the control group (P<0.05);complication rate in the observation group 9.10% was significantly lower than the control group (25.00%) (P<0.05);there was no significant difference in hip joint function scores before the treatment in the two groups, hip joint function score in the observation group after the treatment (79.73±5.42)scores was significantly higher than the control group (P<0.01).ConclusionTreatment effect of modified homemade Buxue decoction discriminate on hemorrhagic anaemia after unilateral total hip arthroplasty is significant, can promote recovery of hematosis, hip joint and motor function effectively.

OBJECTIVE: To investigate the epidemic features of childhood allergic rhinitis (AR) and correlative risk factors in Yinchuan. METHOD: A questionnaire survey on AR was conducted among 800 children in eight communities, aged from 5 to 14 years old, by random cluster sampling, from March 2012 to March 2013 in Yinchuan. Suspects of AR, as identified by the survey, were recommended to specialist examinations for accurate diagnosis. The results were statistically analyzed. RESULT: Seven hundred and sixteen questionnaires were returned and 662 questionnaires were available. The prevalence rate of AR in children aged from 5 to 14 is 14.65% in Yinchuan. Seventy-nine point thirty-eight percent children suffered from intermittent AR, while 20.61% children suffered from persistent AR. The difference of prevalence between female (13.57%) and male (15.44%) was insignificant statistically (Χ2=0.454, P>0.05). The difference of prevalence between the Han (15.72%) and the Hui (11.35%) insignificant statistically (Χ2=2.055, P>0.05). The prevalence of AR children aged five to nine years was 13.80%, as aged ten to fourteen years was 19.72%. There was a significante differece between two groups (Χ2=4.056, P<0.05). The most explosive outbreak month in children with allergic rhinitis was July to September. The most common allergens found in patients were seasonal plants: mugwort, weed, dandelion, cereal, locust, ragweed, and willow. Fifteen point forty-six percent patients with AR also had rhinitic, 14.43% patients had asthma and 14.43% patients had allergic conjunctivitis. The history of drug allergy accounted for 12.37% in patients with AR, and food allergy accounted for 26.80%. In allergic rhinitis risk factors, family history accounted for 30.92%, non-breastfeeding representing accounted for 34.02%, animal feeding history accounted for 19.59%; exposure to passive smoking accounted for 42.26%; domestic decoration accounted for 12.37%. There were significante difference between AR children and normal in family history and non-breastfeeding (P<0.05). CONCLUSION The prevalence rate of AR in children aged from 5 to 14 in Yinchuan is 14.45%. Strategy of prevention and treatment of AR should be worked out according to the epidemic feature of AR.
Adolescent ; Allergens ; Animals ; Asthma ; epidemiology ; Child ; Child, Preschool ; Conjunctivitis, Allergic ; epidemiology ; Female ; Humans ; Male ; Pollen ; Prevalence ; Rhinitis, Allergic ; epidemiology ; Risk Factors ; Surveys and Questionnaires

Focal intrahepatic strictures (FIHS) refers to local strictures or stenosis of the intrahepatic bile duct induced by various factors. FIHS is easily leading to misdiagnosis and miss diagnosis. At present, most of the techniques or examinations for making position as well as qualitative diagnosis of FIHS have poor sensitivity. Paying more attention to the medical history and combined applications of various inspection methods might help to improve the diagnostic level of FIHS. In terms of treatment, we suggested for patients with suspected malignant strictures or those who were failure of medical treatment, dilation, drainage and pathological diagnosis of FIHS could be conducted by endoscopy before determining the indications and procedures of surgery based on a new anatomy classification system of FIHS.

Objective To explore if Ulinastai reverses hepatofibrosis in rats.Method Rat hepatofibrosis models were induced by TAA subcutaneously injection.18 rats with hepatofibrosis were divided into 2 groups,Ulinastai treatment group (9 rats),normal saline control group (9 rats).AST,ALT,HA,SOD,MDA,LN level were measured and compared between the 2 groups and that of healthy rats (3 rats).Rats liver morphology was observed using HE,Masson stain and type-B ultrasonic.TGF-β1、caspase-3 were detected by immunohistochemistry.Result After 3 weeks Ulinastai treatment,elastic index and SSS score in Ulinastai group decreased significantly compared to pretreatment (t =2.472,P ＜0.05).ALT,AST,SOD,MDA,HA and LN level significantly improved (F =3.862,5.774,3.442,4.157,4.173,3.674,P ＜ 0.05).Compared with NS treatment group HE and Masson staining showed fewer inflammatory cells infiltration in central vein,ballooning degeneration of liver cells,collagen proliferated,hepatic lobules degradation and pseudolobule arise after 3 weeks intervenion.Also in Ulinastai group,TGF-β1、caspase-3 positive cells were much less than that in NS treatment group.Conclusions Ulinastai can reverse rat hepatic fibrosis and alleviate fibrosis degree and collagen fiber deposit.

Introduction of problem-based learning (PBL) teaching is the demand of teaching reform.Teaching and research section of physiology in Chongqing medical university implemented PBL teaching throughout the whole process of clinical medicine undergraduate education.The overall quality of students and the teaching quality were improved by constructing a new mode suitable for physiology teaching,focusing on training students' active learning ability and stimulating students' enthusiasm for learning.

Objective To understand websites of public hospitals in China.Methods Website search and appraisal were called into play to analyze the percentage and present conditions of websites built by public hospitals in Shanghai,Hubei Province and Gansu Province.Rusults The study found websites in less than 55％ of the public hospitals in these three areas.Those websites in operation provide instant information on hospitals and medical services,yet their online service functions are less satisfactory and website levels vary sharply.Conclusion The authors recommend the Chinese government encourage public hospitals to build websites and enhance their online services.

Benign anastomotic stenosis after esophagogastrectomy could reduce the patients' quality of life,even resulting in severe malnutrition and death.The endoscopic treatment includes dilatation,stent insertion,locoregional injection,and a relatively new technique radial incision and cutting.This article reviewed the progress in endoscopic treatment of benign anastomotic stenosis after esophagogastrectomy.

Objective To elucidate the role of the Wnt/-catenin signaling pathway in regulating the phenotypic transformation of aortic valvular myofibroblasts to osteoblast-like cells.Methods Cultured primary valvular myofibroblastes isolated from porcine aortic valve leaflets were treated with oxidized low-density lipoprotein (ox-LDL) for different lengths of time:24 h,48 h and 72 h.The Wnt signaling pathway inhibitor Dickkopf-1 (DDK-1) was co-incubated with ox-LDL for 72 h.After cells harvest,the expression of myofibroblastic or osteoblast-like phenotype related markers,a-smooth muscle actin (α-SMA),bone morphogenetic protein 2 (BMP2),alkaline phosphatase (ALP) and corebinding factora-1 (Cbfα 1),was detected by Western blotting.The expression and sub cellular localization of β3-catenin was assessed by immunocytochemistry.Changes of the Wnt/β-catenin signaling pathway and the transformation of aortic valvular myofibroblast to osteoblast-like cells were monitored.Results BMP2,ALP and Cbfa 1 protein expression was not or barely detectable in the control group.However,after ox-LDL treatment,the expression of α SMA,BMP2,ALP and Cbfa 1 increased significantly (each P＜0.01) in a time-dependent manner (each P＜0.05).Besides,ox-LDL was also able to up-regulate the protein expression of β-catenin in a time-dependent manner (P＜0.05) and promoted its nuclear translocation.After DKK-1 treatment,the protein expression of β3 catenin and osteogenesis related markers was down regulated (P＜0.05).Conclusions The Wnt/β-catenin signaling pathway may play a crucial role in regulating the transformation of aortic valvular myofibroblasts to an osteoblast like phenotype.