OBJECTIVE:To analyze the postoperative application of anti-infective agents in patients undergoing stem cell transplantation. METHODS:The application of anti-infective agents in 30 patients undergoing stem cell transplantation in the pretreatment period and after operation in our hospital from 2003 to 2008 were analyzed in respect of etiology inspection,the cost of anti-infective agents,utilization frequency(cases/times),duration of medication,DDDs,DUI,drug combination and its rationality. RESULTS:The infection was found in 26 cases after operation,accounting for 86.67%. Pathogens were found out in 11 cases. The total cost of anti-infective agents was 327 598.23 yuan. The DUI of 7 kinds of top 10 anti-infective agents in terms of DDDs were less than 1 and that of other 3 were more than 1. In terms of drug combination,two-drug consisted of 73.08%(38 cases/times), three-drug 25.00%(13 cases/times)and four-drug 1.92%(1 cases/times). CONCLUSION:The postoperative application of anti-infective agents in patients undergoing stem cell transplantation in our hospital is rational on the whole.

OBJECTIVE:To analyze the drug use in the inpatients undergoing allogenic stem cell transplantation.METHODS:The drug use in 24 inpatients undergoing allogenic stem cell transplantation from 2004 to 2007 were analyzed retrospectively in respect of drug variety and drug cost etc.RESULTS:The average drug cost for the inpatients undergoing stem cell transplantation was(66 418.56?24 381.73)yuan,comprising 61.69% of the total cost of hospitalization.The top 20 drugs in terms of consumption sum were mainly drugs for immune system,drugs affecting hematological and hematopoietic system and anti-tumor drugs etc.The top 20 drugs in terms of DDDs were mainly immunosuppressants,anti-tumor drugs and adjunctive drugs,with DUI ≤1 for the majority of the drugs.CONCLUSION:The drug use in the inpatients undergoing allogenic stem cell transplantation in our hospital was rational on the whole.

Objective To investigate the effectiveness and safety of Xiyanping Injection for the treatment of children with acute suppurative tonsillitis, so as to provide evidence for the prevention and treatment of pediatric acute suppurative tonsillitis with traditional Chinese medicine. Methods Two hundred children with acute suppurative tonsillitis were randomly divided into treatment group and control group, 100 cases in each group. The control group was given routine western medicine treatment, and the treatment group was given Xiyanping Injection based on the treatment for the control group. The treatment lasted for 5 days. The clinical outcomes covered the course of disease, the overall efficacy, adverse reaction, and time for the subsiding of fever, sore throat, swollen tonsils and purulent secretion, as well as the changes of white blood cell count, hyper-sensitivity C reactive protein, alanine aminotransferase, creatinine and creatine kinase levels before and after treatment. Results (1) After treatment, the total effective rate of the treatment group was 97.0% and that of the control group was 87.0%, the difference being significant (P < 0.01). (2) After treatment, time for the subsiding of fever, sore throat, swollen tonsils and purulent secretion as well as hospitalization time of the treatment group was much shorter than that of the control group (P < 0.05 or P < 0.01). (3) After treatment, white blood cell count and hyper-sensitivity C reactive protein level of the two groups were obviously decreased compared with those beforetreatment (P < 0.01) , and the decrease in the treatment group was superior to that in the control group (P <0.01). (4) The inter-group and intra-group comparison of alanine aminotransferase, creatinine and creatine kinase levels before and after treatment showed that the differences were insignificant between the two groups (P > 0.05). No adverse reactions of rash, nausea, vomiting, diarrhea, chest distress, shortness of breath, or drug fever were found in the two groups. Conclusion Xiyanping Injection is effective and safe for the treatment of children with acute suppurative tonsillitis by increasing the total efficiency, reducing the time for the subsiding of fever, sore throat, swollen tonsils and purulent secretion, shortening hospitalization time, and decreasing white blood cell count and hyper-sensitivity C reactive protein level. No obvious hepato-renal function damage occurred during the medication.

The medical records of 108 inpatients treated with vancomycin and norvancomycinin were collected and analyzed retrospectively.And 78.7% of all cases were used for therapy and 21.3% for prevention.The pathologic examination submission rate was 88.9% ( n=96 ).The drug utilization index ( DUI) of norvancomycin was 0.95 and vancomycin 0.92.The proportion of combination use was 86.1%and a maximum of 3 antibiotics were used.There were 6.5% cases of doubtful adverse drug reaction.The inpatient uses of vancomycin and norvancomycin are basically rational.Indications should be mastered strictly.Empirical and prophylactic uses should be minimized to prevent and delay drug resistance strain from spreading and prolong effectiveness.Necessary therapeutic drug monitoring is required.

OBJECTIVE To study clinical distribution of Serratia and learn the antimicrobial susceptibility to S.marcescens in vitro in order to offer the reference to optimally selecting antibiotic.METHODS It was analyzed that the 222 Serratia strains were distributed in and the was deteted 164 S.marcescens strains were isolated from our hospital from 2001 to 2006.Their VITEK-2 of French Bio-M?rieux Company was adopted to proceed the identification of bacteria and antimicrobial susceptibility test.Data were analyzed by WHONET 5.4.RESULTS Serratia were mainly isolated from sputum,urine,blood,secretion,bile,cerebrospinal fluid,abdominal fluid,et al.Infection of both in-and out-patients could be caused by Serratia and most were in surgery ward.S.marcescens had higher drug resistance rates to piperacillin,cefazolin,cefuroxime,gentamicin and tobramycin which were all above 60%.They were all susceptible to imipenem(minimum inhibitory concentration only 1 ?g/ml) and their susceptible rates to piperacillin/tazobactam,ceftazidime,cefepime,and levofloxacin were all higher than 80%.CONCLUSIONS Serratia are less isolated from clinics,but have much higher antimicrobial resistance to the 1st and 2nd generation cephalosporin and show diversely drug resistance to 3rd cephalosporin,so physicians should pay attention to the infection caused by them.

OBJECTIVE:To investigate blood concentration monitoring data,therapeutic efficacy,toxic reaction and combi-nation of tacrolimus in patients with Allo-HSCT,and to provide reference for clinical application of tacrolimus. METHODS:The blood concentration of tacrolimus in 16 inpatients were monitored with EMIT 3 months after Allo-HSCT. The occurrence of Graft-versus-Host disease(GVHD),ADR and drug combination were analyzed and discussed. RESULTS:A large individual dif-ferences were found in blood concentration of tacrolimus. When blood concentration <8 ng/ml,there seems a greater possibility of GVHD. When >20 ng/ml,the occurrence of diabetes,kidney damage and other side effects seems increased. Tacrolimus had a good effect on treatment and prevention of GVHD,and could have an interaction with other drugs. CONCLUSIONS:Blood concentration monitoring of tacrolimus plays an important role on the prevention and treatment of GVHD,and the decrease of side effects such as diabetes and neurotoxicity. The satisfactory blood concentration is 8-20 ng/ml,when there seems a smaller possibility of GVHD and ADR 3 months after Allo-HSCT.

OBJECTIVE:To establish a HPLC method for the determination of oxymatrine(OMT)and matrine(MT)in dog plasma.METHODS:Plasma protein was precipitated with perchloric acid;OMT and MT were extracted with dichloromethane under strong base condition and then plasma levels of OMT and MT were determined by HPLC.RESULTS:The linear ranges of OMT and MT were 0.2～ 15? g? mL-1 and 0.1～ 5? g? mL-1,respectively,and the detection limits of OMT and MT were 20ng? mL-1.The absolute recoveries,relative recoveries,intra-day and inter-day precisions of OMT and MT were all in line with the standards.CONCLUSION:The method is simple,accurate and sensitive yet with little interference,and it is applicable for the determination of OMT and MT in plasma,the studying of the pharmacokinetics,the transformation process and the metabolic pathway of OMT in vivo,furthermore,it serves as guidance for the development of new OMT preparations.

ObjectiveTo investigate the value of urinary BNP for diagnosis of chronic heart failure (CHF). MethodsThe levels of Urinary BNP and plasma BNP were measured by microparticle enzyme immunoassay (MEIA) in 83 patients with CHF and 30 control subjects. The heart function was classified according totheNYHAcriteria. Leftventricularejectionfractions(LVEF)weremeasuredby echocardiology. ResultsThe level of urinary BNP in patients with CHF was[90. 0(38. 3 -209. 5 )]ng/L and the level of plasma BNP was[680. 0 ( 289. 7 - 1543.5)]ng/L, both of them were much higher than those in healthy subjects,[17. 0 ( 13.0 - 33. 0)]ng/L and[84. 5 ( 56. 0 - 158.0 )]ng/L, respectively (P＜0. 01 ). The concentrations of urinary BNP increased gradually with more severe symptoms ( NYHA cl ass Ⅰ -ⅣV ). The level of urinary BNP was positively correlated with NYHA class ( r = 0. 742, P ＜ 0. 01 )and the level of plasma BNP (r =0. 842,P ＜0. 01 ) while negatively related with LVEF (r = -0. 801 ,P ＜0. 01 ). The level of urinary BNP in patients with LVEF ＜ 40％ was[143.0 ( 85. 0 - 258.0)]ng/L , which was much higher than that in patients with LVEF≥40％ ,[31.5( 17.3 -38. 8)]ng/L, (P ＜0. 01 ). At a decision threshold of 36. 5 ng/L, the urine BNP assay demonstrated a clinical sensitivity and specificity of 84％ and 80％ ,respectively. In this study,the area under the curve(AUC) was 0. 905. ConclusionUrinary BNP is a new candidate marker for the diagnosis of CHF,it provides a similar accuracy with plasma BNP.

In order to change the situations such as students’passivity and low enthusiasm in the traditional experimental teaching of Microbiology and improve students’comprehensive qualities,exploration and attempt on experimental teaching reforms including teaching contents,teaching modes,laboratory management and evaluation system of examination were done.Teaching practices showed that the normalized ex- periment syllabus based on the correct orientation of experimental teaching of Microbiology,the actualization of teaching mode of basic skill training-integrated experiment-designed experiment and the management of opening laboratory were effective measures in improving experimental teaching of Microbiology.

Objective To investigate the diagnositic value of uhrasonography in fetuses with persistent right umbilical vein.Methods Three cases of persistent right umbilical vein diagnosed in our hospital were analyzed,including the sonographic findings and clinical outcome.Results In all cases the fetal gallbladder was located between the intraabdominal umbilical vein and the stomach,the umbilical vein was connected to the right portal vein,and the portal vein curved toward the stomach.Other intracranial malformations were detected in one case,and the baby died after birth.No addional malformations were found in the other two babies,and both of them were healthy at the age of 6 months.Conclusions Persistent right umbilical vein has typical prenatal sonographic appearances.The neonatal prognosis is favorable when other anomalies are ruled out.It's clinically important for early diagnosis and genetics consultation.