OBJECTIVE:To provide reference for rational and safe use of drugs by intravenous infusion.METHODS:Analyses were made from aspects of compatible concentration,choice of menstruum,compatibility of drugs,the infusion speed,disposal of photosensitive drugs,control of particle of the infusion etc.RESULTS & CONCLUSION:There are some problems lie in the use of drugs by intravenous infusion,but there are prewarnings for some of the mistakes and the adverse drug reactions(ADRs).It is necessary to strengthen monitoring on drug use so as to minimize the incidences of mistakes and the related ADRs in the intravenous administration.

OBJECTIVE:To investigate the effects of rosuvastatin combined with berberine hydrochloride on related indexes in patients with acute cerebral infarction.METHODS:Medical information of 120 patients diagnosed as acute ischemic cerebral infarction were analyzed retrospectively,and they divided into observation group (65 cases) and control group (55 cases) according to route of administration.Both groups were given routine treatment;control group was additionally given Rosuvastatin calcium tablets 10 mg orally before bedtime,once a day;observation group was additionally given Berberine hydrochloride tablets 0.3 g orally,3 times a day,on the basis of control group.Treatment courses of 2 groups lasted for 14 d.The levels of TC,TG,LDL-C,HDL-C,hs-CRP,ox-LDL,NIHSS score,ADL score,TPA,IMT,Crouse score,the number of unstable plaque and ADR were observed and compared between 2 groups before and after treatment.RESULTS:Before treatment,there was no statistical significance in above indexes between 2 groups (P＞0.05).After treatment,the serum levels ofTC,TG,LDL-C,hs-CRP and ox-LDL in 2 groups were significantly lower than before,and the observation group was significantly lower than the control group,with statistical significance (P＜0.05).After treatment,NIHSS score of 2 groups were significantly lower than before,and ADL score,HDL-C levels were significantly higher than before,with statistical significance (P＜0.05);there was no statistical significance between 2 groups (P＞0.05).After treatment,there was no statistical significance in IMT,Crouse score and the number of unstable plaque in control group compared to before treatment (P＞0.05),but in observation group were significantly lower than before treatment,and also lower than control group at corresponding period,with statistical significance (P＜0.05).There was no statistical significance in TPA between 2 groups before and after treatment(P＞0.05).There was no statistical significance in the indcidence of ADR between 2 groups during treatment(P＞0.05).CONCLUSIONS:Based on routine treatment,rosuvastatin combined with berberine hydrochloride could effectively reduce blood lipid levels in patients with acute cerebral infarction,stabilize or reverse atherosclerotic plaque,and reduce inflammation and oxidative stress with good safety.

Objective To investigate the clinicopathological characteristics and prognosis of serumb alpha-fetoprotein(AFP)-producing gastric cancer.Methods A total of 1396 cases of gastric cancer in our hospital from 2002 to 2007 were retrospectively reviewed.The relationship between serum AFP with clinicopathological factors,survival rate,prognosis and liver metastasis were analyzed.Results There were 90 AFP-producing gastric cancer patients accounting for 6.45％ of all the gastric cancer cases during the time period.In those patients there was bigger tumor size,more T3 and T4 invasion (82.2％ vs.69.2％),higher incidence of lymph node metastasis (80.0％ vs.60.2％)and liver metastasis(6.67％ vs.1.68％),and later clinical stage than that in the AFP-negative group.The 1,3,5 year-overall survival (OS) rate in AFP-positive group were 52.2％,31.1％,20％ while those in AFP-negative group were 82.5％,59.9％,48.8％.The 1,3,5 year-disease free survival(DFS) rate in AFP-positive group were 47.8％,24.4％,15.6％ while those in AFP-negative group were 77.5％,54.8％,44.3％.The AFP-positive group had a shorter median time period than the AFP-negative group when liver metastasis happened (5 months vs.11 months).Conclusions Serum AFP-producing gastric cancer was higher malignancy,it was deeper in invasion and later in clinical stage,more patients with lymph nodes and liver metastasis,low survival rate and poorer prognosis.

Objective To study retrospectively the relation of the number of all dissected and negative lymph nodes (LNs) to the prognosis of patients with stage Ⅲ rectal carcinoma after radical resection.Methods From 2002 to 2007,412 sage Ⅲ rectal carcinoma patients undergoing radical resection were enrolled.Patients were divided into five groups according to the number of dissected LNs as follows:1 to 6 lymph nodes,7 to 12 lymph nodes,13 to 18 lymph nodes,19 to 24 lymph nodes,and more than 24 lymph nodes.The association with the survival was analyzed.The Kaplan-Meier method was used to estimate survival as a function of time,and survival differences were analyzed with the log-rank test.The correlation between all dissected and negative lymph nodes was analyzed.The Cox proportional hazard model were used to investigate the risk factors for stage Ⅲ rectal carcinoma.Results The 1,3 and 5 years survival rates were respectively 79.9％,59.2％ and 43.0％.The 5-year survival rates increased with the increasing number of the examined LNs and the negative LNs,the differences were significant (20.0％、26.5％ 、43.9％ 、54.2％ 、53.5％,P =0.001 ; 10.3％ 、34.8％ 、51.9％ 、56.8％ 、70.8％,P =0.000).There were 7301 LNs dissected among which 5698 were pathology negative.The dissected LNs were correlated positively with negative LNs on the Pearson's correlation test(correlation coefficients r =0.899).The total number of dissected LNs and negative LNs were independent prognostic predictors.Conclusions The total number of dissected lymph node and negative lymph nodes are significantly correlated to prognosis of staged Ⅲ rectal carcinoma patient.On premise of standard procedure,we see all dissected and negative lymph nodes as a prognostic auxiliary index.

Objective To compare the anesthetic effect of ultra-sound guided thoracic paravertebral nerve block and combined spinal-epidural anesthesia in percutaneous nephrolithotomy.Methods For 80 patients in our hospital scheduled for percutaneous nephrolithotomy were randomly divided into two groups with 40 cases each.The patients in group GT were given ultra-sound guided thoracic paravertebral nerve block.And the patients in group G were given combined spinal-epidural anesthesia.Observe and compare the aesthesia effects,the hemodynamic changes during body change in perioperative period,adverse reactions after surgery and complications of two groups.Results Anesthetic effects were not significantly different between two groups (P ＞ 0.05).During body change in perioperative period,the MAP and HR of G group were significantly lower than those of GT group.They had significantly difference (P ＜ 0.05).The adverse reactions after surgery and complications of two group were significantly different between two groups(P ＜0.05).The number of patients who have headache and urinary retention are apparently more group G than in group GT.Conclusion Ultra-sound guided thoracic paravertebral nerve block for percutaneous nephrolithotomy has significant anesthetic effect.Hemodynamics is stable during body change in perioperative period.And there is less complications after surgery.

Objective: To analyze the epidemiological and etiological characteristics of aggregation epidemics of infectious diarrhea induced by norovirus, and to provide the scientific basis for the prevention and control. Methods: A descriptive epidemiological analysis of aggregation epidemics events occurred during 2016-2018 in Longhua District of Shenzhen was carried out, with subtypes identified by real-time fluorescence quantitative PCR, Region B and Region C fragment sequence determination. Results: There were 34 aggregation epidemic events,including 448 cases, the mean attack rate was 18.26%(448/2 454). The median duration of aggregation epidemic was 3 days. The peak season appeared in autumn and winter, and the peak of epidemic emerged from December 2016 to April 2017. About 91.18% (31/34) of the epidemics occurred in schools and child care centers, and among children aged 3-6 years (78.79%, 353/448). The clinical symptoms were mainly nausea and vomiting (95.77%, 408/426) in children and adolescents but diarrhea in adult group (95.45%, 21/22). The differences between vomiting and diarrhea were both statistically significant in the two age groups (χ2=98.89，99.61，P<0.01). 29 cases were transmitted through interpersonal network, of which 21 cases were found to have unregulated treatment of vomit on campus. The detection rate of biological samples was 49.15% (203/413), all of which were G Ⅱ norovirus. The genotype was mainly GⅡ.P16-G Ⅱ.2(n=49)from November 2016 to April 2017. Conclusion Norovirus can cause large-scale outbreaks in child care centers and schools easily. Early standardized patient isolation and proper management of vomit and diarrhea are the key steps in prevention and control measures.

Objective To build a supervision mechanism for independent clinical labs (ICL),surveyed the current situation of such novel institutions in China.Methods By way of the nationwide network of clinical labs,ICL in China were surveyed by written questionnaires and spot inspection.Results In the surveyed 38 ICLs,the maximum registered capital was 44 900 thousands,the minimum was 2 000 thousands.The maximum number of employee was 1 105,the minimum was 19.6 labs passed ISO15189 ratification,4 labs passed CAP ratification.17 labs participated in local external quality control,29 labs par-ticipated in national external quality control.Conclusion Although ICL in our country have developed well in the past dec-ade,such vulnerabilities as unbalanced staff ratio,full-range quality control bugs,cutthroat competition,asymmetrical infor-mation disclosure and bio-safety have loomed in the meantime.It is time to formulate a stricter industry access system and appropriate regulatory modes.

Objective:To investigate the correlations between perfused lung volumes, visual scores (using perfusion SPECT/CT) and right-heart catheter (RHC) hemodynamic parameters in patients with chronic thromboembolic pulmonary hypertension (CTEPH).Methods:A total of 51 consecutive CTEPH patients (17 males, 34 females, age (59±12) years) in the First Affiliated Hospital of Guangzhou Medical University between March 2015 and July 2019 were retrospectively analyzed. All patients underwent lung perfusion SPECT/CT imaging and RHC examinations. Perfused lung volumes were determined using threshold-based (15%-85%) segmentation. Visual semiquantitative scoring in each lung segment was performed using Begic method. RHC hemodynamic parameters including pulmonary artery systolic pressure (PASP), pulmonary arterial diastolic pressure (PADP), mean pulmonary artery pressure (mPAP), pulmonary arteriolar wedge pressure (PAWP), pulmonary vessel resistance (PVR), cardiac output (CO), cardiac index (CI) were recorded. Spearman correlation analysis was used to evaluate the correlations between perfused lung volumes, visual scores and hemodynamic parameters.Results:There were significant correlations between perfused lung volumes (30%-70% threshold) and mPAP ( rs values: from -0.414 to -0.302, all P<0.05). Among them, perfused lung volumes under the threshold of 40% and 45% were moderately correlated with mPAP ( rs values: -0.414, -0.412, both P<0.05). Perfused lung volume (40% threshold) was moderately negatively correlated with PASP, PADP ( rs values: -0.402, -0.440, both P<0.05), and slightly negatively correlated with PVR ( rs=-0.352, P<0.05). Visual scores were slightly positively correlated with the PADP ( rs=0.311, P<0.05), while there was no correlation between visual scores and other RHC hemodynamic parameters ( rs values: from -0.201 to 0.275, all P>0.05). Conclusion:Perfused lung volumes based on threshold-based segmentation in lung perfusion SPECT/CT imaging can accurately reflect hemodynamic status and may provide useful information for severity assessment of CTEPH.

Medical microbiology is one of the compulsory courses of basic medical sciences, which lays an important theoretical foundation for the follow-up study of infectious diseases, contagions, tumors, and so on. The course of medical microbiology in our college adhered to the concept of student-centered, diversified teaching, scientific evaluation, and continuous improvement. Teaching design was a cross-link of general theories, specific chapters, clinical cases, theory and practice, and the ideological and political education throughout the curriculum. Lectures adopted the mode of offline teaching (such as flipped classroom, case analysis, and comprehensive experimental design), online assistance (such as classroom test, stage test, extracurricular homework, and questionnaire survey), and combined process evaluation. This teaching mode also reflected the deep integration of information technology and classroom teaching. With the development and construction in these years, medical microbiology has completed the renewal of curriculum resources, the construction of online question bank, the construction and design of ideological and political case bank, and process evaluation (10 points of usual score + 10 points of case study + 10 points of experimental performance + 100 points of final examination multiplied by 70%). There was no significant difference in the results of qustionnaire survey in terms of the improvement of independent learning ability, curriculum evaluation system and satisfaction feedback. Students in Batch 2019 were most satisfied with the teaching of keeping pace with the times and the guidance of positive outlook on life and values.

Objective:Taking medical microbiology in the pathogen biology as an example, to explore the effects of process evaluation in basic medicine teaching.Methods:Multiple methods, including classroom performance, stage test, case analysis, final examination, questionnaire survey and so on, were used in the study to systematically evaluate the teaching process. According to the students' suggestions, feedback problems and solutions were publically given to students in the form of PPT, forming a process evaluation with "evaluation-feedback-correction" loop as the core. Collected data were analyzed statistically with SPSS 16.0.Results:The students were impressed by the contents with various teaching methods and satisfied with the evaluation system. Most of them thought that their abilities had been improved in many ways during the learning process. 96.8% of the students supported the reform, and 88.6% of the students hoped to apply this system to other disciplines. The scores of case analysis, final examination and overall evaluation in the experimental group were significantly higher than those of the control group ( P<0.01). Conclusion:Both teachers and students got profit from the process evaluation based on feedback loop. The teaching quality of medical microbiology would be further improved by a constantly enhanced evaluation system.