Objective To suvey the clinical application of antibacterials and drug resistance of antibacterials in the hospital in 2013.Methods To make statistical analysis on the frequency of drug use and drug resistance rate in 2013.Results Piperacillin wasn′t used in 2013 in the hospital.No hemolytic streptococcus was detected with drug resistance.Drug resistance rate of Esche-richia coli to piperacillin was 33.22%.Conclusion Bacterial resistance might be related to the using frequency of drugs and the types of antibacterials used in a region.

Heavy-ions have the similar characteristic of depth-dose distribution with protons, but exhibit enhanced physical and radiobiological benefits. With increasing development in technical and clinical research, more facilities are being installed in the world. At the same time, many critical techniques of heavy-ion therapy facility were optimized and completed. This paper classified and reviewed the basic structure of heavy-ion system equipments, especially the accelerator, gantry, nozzle , TPS.
Cancer Care Facilities ; Heavy Ion Radiotherapy ; instrumentation ; Humans ; Neoplasms ; therapy

Objective To assess the psychometric properties of the Chinese Heartburn Version of Quality of Life in Reflux and Dyspepsia Questionnaire (QOLRAD) in patients with gastroesophageal reflux disease.Methods 130 patients with symptoms of heartburn completed the Chinese version of QOLRAD,the Short-Form-36 (SF-36).30 of them received proton pump inhibitors (PPI) for 8 weeks,which was used to test responsiveness of the Chinese heartburn version of QOLRAD.Results The Chinese version of QOLRAD had acceptable internal consistency.The overall Cronbach's alpha was 0.89 and the internal consistency of dimensions ranged from 0.70～0.90.Content validity index (CVI) was 0.82.Confirmation factor analysis revealed a 5 factor solutions accounting for 62.02％ and most of items in their dimensions had acceptable loads (＞0.4).There was acceptable concurrent validity with correlations between the Chinese heartburn version of QOLRAD and Short Form-36 health survey ranging from 0.172～0.613.As to responsiveness,after therapy of PPI for 8 weeks,except the dimension of sleep disturbance,scores for dimensions of vitality,food/drink problems,physical/social functioning,emotional distress had significant changes.Conclusions The Chinese version of QOLRAD has a good reliability,validity and responsiveness to therapy,which can be used to assess the quality of life in patients with gastroesophageal reflux disease.

Objective To evaluate the effect of dexmedetomidine on synaptic transmission in the spinal dorsal horn of rats.Methods Male Sprague-Dawley rats,aged 4-6 weeks,weighing 150-200 g,were used in the study.The lumbar enlargemnent segments of the spinal cord were harvested,and the parasagittal lumbosacral spinal cord slices with attached dorsal roots were prepared and incubated in artificial cerebro-spinal fluid.The whole-cell patch-clamp technique was used to record each index,and 4 spinal cord slices were selected and used for each index records.Experiment Ⅰ Dexmedetomidine was added cumulatively in concentration increments.Aδ and C fibers-mediated evoked excitatory postsynaptic currents (eEPSCs) were recorded before administration (baseline) and during perfusion with dexmedetomidine 4 and 10 μg/ml.Experiment Ⅱ The neurons innervated by Aδ and C fibers were selected,and Aδ and C fibers-mediated eEPSCs were recorded before administration (baseline),at 5 min of perfusion with yohimbine (alpha 2 adrenergic receptor antagonist) 2 μmol/L,and during continuous perfusion with yohimbine 2 μmol/L plus dexmedetomidine 4 μg/ml.Experiment Ⅲ The evoked excitatory postsynaptic potentials (eE-PSPs) and evoked inhibitory postsynaptic potentials (eIPSPs) were recorded before administration (baseline) and during perfusion with dexmedetomidine 4 μg/ml.Results Dexmedetomidine could dose-dependently inhibit Aδ and C fibers-mediated eEPSCs,dexmedetomidine could inhibit Aδ and C fibers-mediated eEPSPs and produced no effect on eIPSPs,and yohimbine could inhibit dexmedetomidine-induced inhibitory effect on eEPSCs.Conclusion The mechanism by which dexmedetomidine inhibits nociceptive information transmission in the spinal dorsal horn is related to inhibition of excitatory synaptic transmission through activating α2-adrenergic receptors,but not related to activation of inhibitory synaptic transmission in rats.

Objective To evaluate the clinical performance of an automated image analysis systems named CellaVision DM96 in classifying White Blood Cells.Methods A total of 2267 peripheral blood samples (male 1 235, female 1 034, average age 46) were obtained from outpatient and inpatient in Peking Union Medical College Hospital ( PUMCH ) . These samples were selected to evaluate the precision, sensitivity, specificity and the analytical error of the system.We first evaluated the coincidence rate of reclassification and manual microscopy.On the base of favourable coincidence rate, we then evaluated the correlations between the pre-classification and reclassification of segmented neutrophil, band neutrophil, lymphocyte, monocyte, eosinophile, basophile, blast cell, promyelocyte, myelocyte, metamyelocyte, plasma cell and reactive lymphocyte.Results The sensitivity and specificity of pre-classification of White Blood Cell were 46% -100% and 24%-92%, respectively.When studied on the cell level, the total coincidence rate of pre-classification was 88%.And the coincidence rates of pre-classification and reclassification of White Blood Cell were 6%-95% and 25%-100%, respectively.When assessed on the sample level, the coincidence rates of pre-classification and reclassification of leukocytes were 64%-98%and 84%-100%, respectively.The correlations of pre-classification and reclassification of leukocytes in order from high to low were: lymphocyte, segmented neutrophil, eosinophile, band neutrophil, monocyte, basophile, when r were 0.943 9, 0.915 2, 0.785 4, 0.775 6, 0.676 2 and 0.289 1, respectively.The correlations between reclassification and manual microscopy of White Blood Cell were higher than those between pre-classification and manual microscopy.Order from high to low was: eosinophile, segmented neutrophil, lymphocyte, monocyte, band neutrophil, basophile.And r were 0.972 1, 0.968 5, 0.957 0, 0.831 9, 0.800 6 and 0.648 7, respectively.The ability of this automated image analysis systems at pre-classification in distinguishing between band cell and segment cell, atypical lymphocyte and normal lymphocyte was not good. Conclusion The performance of reclassification was better than pre-classification.The reclassification can be substitute for the microscopy inspection, and be used in the Clinical practice.

Objective To investigate the effect of laparoscopic salpingotomy with suturing on prognosis of patients.Methods One hundred and thirty two cases patients of laparoscopic salpingotomy and embryo extraction in our hospital from October 2015 to Febrary 2017 were were divided into observation group (68 cases) with suturing and control group (64 cases) without suturing according to the operation procedure.The patency of fallopian tube was observed at 3 months after operation and the intrauterine gestation rate and recurrent ectopic pregnancy rate were observed 1 years after operation in two groups.Results The fallopian tube patency in the observation group and the control group was 58 cases (85.3％) and 39 cases (60.9％) respectively at 3 months after operation.7 cases (10.3％) and 12 cases(18.8％) of the fallopian tube were not smooth in the observation group and the control group respectively at 3 months after operation.The fallopian tube obstruction in the observation group and the control group was 3 cases (4.4％) and 13 cases (20.3％) respectively at 3 months after operation.The patency rate of fallopian tube in the observation group was higher than that in the control group (Z =6.215,P ＜ 0.05).The intrauterine gestation rate (69.1％ (47/68)) in the observation group was significantly higher than that in the control group (37.5％(24/64)) 1 years after operation and the difference between the two groups was statistically significant (x2 =5.41,P ＜0.05).The rate of recurrent ectopic pregnancy in the observation group (10.3％(7/68)) was significantly lower than that in the control group (26.6％(17/64)) and the difference between the two groups was statistically significant (x2 =4.826,P ＜ 0.05).Conclusion The laparoscopic salpingotomy with suturing can improve the patency rate of the fallopian tube and the rate of intrauterine gestation and reduce the rate of recurrent ectopic pregnancy in the patients after the operation.

Objective To investigate the influencing factors of persistent ectopic pregnancy (PEP) after laparoscopic conservative surgery for tubal pregnancy.Methods Three hundred and one cases of tubal pregnancy treated by laparoscopic conservative surgery in Jizhong energy Fengfeng Group Hospital from October 2007 to October 2017 were divided into PEP group ( 21 cases) and non PEP group ( 280 cases) according to whether PEP occurred after operation.The age,menopause time and preoperative serum of the two groups were analyzed.The levels of beta?human chorionic gonadotropin (beta?hCG),surgical methods, corpus luteum exfoliation, methotrexate and mass diameter were analyzed.Logistic regression was used to analyze the multiple factors.Results There was no significant difference in age between the two groups.There were significant differences in the time of menopause, preoperative serum beta?hCG level, operative methods,corpus luteum exfoliation, methotrexate application and mass diameter between the two groups (P＜0.05 or P＜0.01).Multivariate logistic regression analysis showed that short menopause time, high preoperative serum beta?hCG concentration, sac extrusion at the umbrella end of fallopian tube, no corpus luteum exfoliation, no intraoperative methotrexate and small mass diameter were risk factors for persistent ectopic pregnancy (OR(95%CI) were 1.476 ( 1.035～3.961),1.513 (1.391～3.017),5.301 (1.304～19.570),1.104 (1.015～2.769),1.180 (1.020～2.543),1.540 (1.181～5.120),respectively, all P＜0.05).Conclusion PEP is prone to occur in patients with tubal pregnancy treated by laparoscopic conservative surgery,such as short menopause time,small size of mass,high preoperative serum beta?hCG concentration,no corpus luteum exfoliation,no local methotrexate and umbrella sac extrusion.Therefore,the key measures to reduce the occurrence of PEP in clinic are to choose the right operation time,appropriate operation method,corpus luteum exfoliation and local injection of methotrexate.

Cognitive dysfunction,as a common symptom among patients with chronic fatigue syndrome (CFS) and patients with fibromyalgia(FM),impacts on life quality,occupation and study of these patients.However,the neural correlates to the cognitive impairment are unknown.Event related potentials,which reflect the information processing objectively and constantly,provide possibility for taking a insight into and estimating the dysfunction.By summarizing and analyzing studies in event related potentials about chronic fatigue syndrome,fibromyalgia,we found that CFS patients were characterized with prolonged latency of N200 and P300 accompanied by decreased P300 amplitude when they performed on Oddball paradigm,fibromyalgia patients were characterized with lower P300 amplitude when they concentrated on Oddball task,meanwhile,fibromyalgia patients also showed decreased P100/N100,P200,P300,LPC in emotional word decision task and somatic pictures decision task.It's suggests that the cognitive dysfunction in CFS is mainly caused by slowed speed of information identification and classification,whereas in FM it's dysregulation in attention control system results in the cognitive dysfunction.Limitations in current studies and prospects on researches about cognitive dysfunction in CFS for future were also discussed.

Objective:To investigate the clinical efficacy and mechanism of Ganoderma lucidum hypoglycemic formula in the treatment of insulin resistance in patients with type 2 diabetes mellitus (T2DM) with liver and kidney yin deficiency. Methods:A total of 86 patients with T2DM with liver and kidney yin deficiency who were diagnosed and treated at Yueyang Hospital of Integrated Traditional Chinese and Western Medicine, Shanghai University of Traditional Chinese Medicine from January 2021 to February 2022 were included in this study. These patients were divided into a control group and a treatment group, with 43 patients in each group using a 1:1 ratio using the sealed envelope method. Both groups were treated with standardized Western medicine. The treatment group was also treated with the Ganoderma lucidum hypoglycemic formula. All patients were followed up for 12 weeks. The clinical symptoms, curative effect, glucose and lipid metabolism, inflammatory factors, oxidative stress change, and safety were compared between the two groups. Results:The total response rate in the treatment group was 88.4% (38/43), which was significantly higher than 53.5% (23/43) in the control group ( χ2 = 12.69, P < 0.001). After treatment, the traditional Chinese medicine syndrome score, fasting blood glucose, 2-hour postprandial blood glucose, glycosylated hemoglobin, insulin resistance index, total cholesterol, triglyceride, tumor necrosis factor α, and interleukin-6 decreased in each group. The amplitudes of decrease of the above indexes were greater in the treatment group compared with the control group (all P < 0.05). C-peptide in the fasting state, C-peptide at 2 hours after a diet, and superoxide dismutase increased in each group. The amplitudes of increase of the three indexes were greater in the treatment group compared with the control group (all P < 0.05). Conclusion:Ganoderma lucidum hypoglycemic formula can greatly improve insulin resistance and glucose and lipid metabolism in T2DM patients with liver and kidney yin deficiency. The underlying mechanism may be to further reduce the inflammatory response and anti-oxidative stress by down-regulating tumor necrosis factor α and interleukin-6 levels and up-regulating superoxide dismutase level, thereby effectively alleviating insulin resistance in T2DM.

Objective: To investigate the corrective effect of modified Brisson technique to treat concealed penis in children. Methods: From July 2015 to July 2017, 32 patients(3-10 years old, mean 7.2 years old )with concealed penis were treated with the modified Brisson technique in the Children′s Hospital of Zhengzhou University. All the children with concealed penis were treated by the modified Brisson technique, complications, postoperative results and followed-ups were retrospectively analyzed. Results: 32 cases of concealed penile children had pain on the postoperative day, 2 cases required patient controlled analgesia device. No infection and dehiscence were noticed after discharge. All the children were followed up for 6 months to 1 year, and the results were satisfactory. Review showed that the penile body was similar to the appearance after circumcision, with obvious extension exposure, normal exposure of penile scrotal Angle and penile pubic Angle, and no obvious retraction. The internal plate of the prepuce in 5 cases was slightly edema, and edema dissolved within 2 months. Conclusions Modified Brisson is a better method to treat concealed penis in children, which can correct the pathological structure and retain the integrity of penile skin to the greatest extent.