OBJECTIVE:To discuss the economic efficiency of different antimicrobials in treatment of lower respiratory tract infections(LRTI) METHODS:50 cases of LRTI collected from this hospital were divided into two groups:A,pefloxacin;B,ceftazidime Evaluation was carried out with pharmacoeconomic cost-effectiveness analysis RESULTS:The total costs were 957 60 yuans and 1 596 00 yuans and the effective rates were 84% and 92% in group A and B respectively An increase of 1%effective rate in group A saved 79 80 yuans in comparison with that in group B CONCLUSION:The therapeutic scheme of pefloxacin seems to be the best one for treating LRTI

ObjectiveTo observe the infection of continuous aspiration of subglottic secretion(CASS) for patients with ventilator associated pneumonia (VAP).MethodsOne hundred and fifty VAPpatients under mechanical ventilation whose basical information were recorded were divided into two groupsby random digits table method:control group(70 cases) and CASS group(80 cases).Conventional VAPprevention was taken in control group and CASS group,while CASS therapy was added to CASS group.ResultsSex,age,acute physiology and chronic health evaluation Ⅱ score,recent antibiotics usage,airpressure,time in ICU,hospital stay and mortality rate of two groups had no statistical significance(P ＞0.05 ).The time of ventilator treatment of CASS group was obviously shorter than that of control group [ (5.2 ±1.4) d vs.(7.8 ± 1.2) d,P =0.02 ],and VAP incidence was lower than that of control group [ 22.5％ (18/80)vs.32.9％(23/70),P =0.04 ].ConclusionCASS could reduce the incidence of VAP and short the time ofventilator treatment.

Objective To investigate and analysis the prevalence rate of hospital infection and community infection,and to reduce the incidence of hospital infection.Methods First we investigated hospitalized patients in September 9,2013 by two ways which in-clude bedside investigation and reviewing the medical records;and then described the prevalence case of infection and the usage of antimicrobial agent by descriptive approach.Results Seven hundred and seventy patients were investigated with the rate of 100.00%;18 patients were hospital infection cases,the infection rate was 2.34%;most of the hospital infection cases was occur in lower respiratory tract;228 patients were community infection cases.The infection rate was 29.61%;the primary affected areas of community infection were respiratory and gastrointestinal tract;the structure of hospital infection pathogens were almost the same with the community infection,most of them were G- bacteria;186 patients were used antimicrobial agent in that day,the usage rate was 24.16%.Conclusion Promoting the managements of high risk departments and susceptible affected areas,making relevant rules of operation are the focus of our works in the future.

[Objective]To test the biomechanical effects of calcium phosphate cement in fixating distal tadius fractures,and to provid biomechanical foundation for clinical treating distal tadius fractures.[Method]A models of 18 human distal radius fracture of adult upper limbs specimen were made and randomly divided into three groups:fixed with Kirschner wire(Kirschner group),CPC(CPC group),and CPC combined with Kirschner wire(combination group).Wrist joint was vertically loaded with 98 N,and palmar flexion with dorsal extention motion was dimulated,which range of movement was from palmar flexion 5?to dorsal extention 30? and frequency was 2000 cycles.Displace data of distal radius were measured by sliding caliper at every 500 cycles,we had tested Young' s modulus of two samples of CPC.[Result]Multiple factor variance analysis was used,Kirschner group and others had significantly statistical difference(P0.05).[Conclusion]CPC can provide enough fixation strength for distal radius fracture with bone defect and Young' s modulus of CPC is about 30 MPa,which is between those of cancellous bone and compact bone.

Objective To investigate the serum level of NT-pro-BNP in patients with acute ischemic stroke and to determine whether NT-pro-BNP levels were associated with the death within 15 days of stroke onset. Methods Two hundard twenty-six consecutive patients with acute ischemic stroke within 48 hours of onset were enrolled in this study. We measured plasma NT-pro-BNP within 72 h and recorded the NIHSS score on admission. Patients were divided into two groups: the deceased group, who died within 15 days, and the survival group. The factors associated with the death within 15 d of stroke onset were investigated by using multivariate logistic regression analysis. Results Twenty-four (10.6%) patients died with 15 days of stroke onset. The incidence of atrial fibrillation, cardioembolism and large infarc?tion, the mean ± SD of NIHSS score, age, glucose level and creatinine were significantly higher in the deceased group than in the survival group (P<0.001). On the other hand, the mean ± SD of LVEF, albumin, LDL-C, and total-cholester?ol were significantly lower in the deceased group than in the survival group(P<0.05 ). The median of the plasma NT-pro-BNP level was significantly higher in the deceased group than in the survival group (2598.5 vs. 190.4 pg/mL, P<0.001). The optimal cut-off level, sensitivity, specificity and ROC area of NT-pro-BNP levels to distinguish the de?ceased group from the survival group were 955.2 pg/mL, 83.3%and 82.2%, 0.906, respectively. Binary logistic regression analysis demonstrated that NIHSS score of ≥13 (OR=56.18, 95% CI=9.06 to 348.40, P =0.000) , plasma Lg NT-Pro-BNP level (OR=38.79, 95%CI=6.52 to 230.95, P=0.000) , and the size of infarction (OR=8.73, 95%CI=1.11~68.88, P=0.040) were independent factors associated with the death within acute phase of stroke. Conclusions The plas?ma NT-pro-BNP level can predict the death of stroke patients within 15 days of stroke onset.

Objective: To explore the mechanisms of emodin in protecting intestinal mucosal barrier in rat with severe acute pancreatitis (SAP). Methods: Sixty SD rats were randomly divided into three groups: sham-operation group, untreated group, and emodin group. SAP in rats of the untreated group and the emodin group was induced by retrograde pumping of 3.0% sodium cholate to the common bile duct. Specimens were obtained 24 hours after the severe acute pancreatitis was induced. Serum level of leptin, serum activity of amylase and plasma content of endotoxin were measured. Ileum mucosa from ileocecal junction was observed by light microscopy and electron microscopy to measure pathological and ultrastructural changes. Apoptosis of ileum mucosal cells was detected by terminal deoxynucleotidyl transferase-mediated dUTP nick end labeling method, and expression of Bax in ileum mucosal cells was measured by immunohistochemical method. Results: Compared with the sham-operation group, there was significant increase in the levels of leptin, endotoxin, the activity of amylase, apoptosis index and Bax expression in the untreated group (P<0.01). Compared with the untreated group, the level of endotoxin, apoptotic index and Bax expression level in the emodin group were significantly reduced (P<0.01) and the leptin level was increased (P<0.05). More severe pathological changes appeared in the untreated group than in the sham-operation group under the light and electron microscopes; meanwhile less severe damage was observed in the emodin group as compared with the untreated group. Conclusion: Emodin can inhibit the apoptosis of intestinal mucosa cells and up-regulate the serum leptin content to protect the intestina1 barrier function and prevent the translocation of bacteria and endotoxin.

Objective To explore the lowest and most effective dose of dezocine in preventing postoperative pain after painless artificial abortion.Methods A total of 180 ASA Ⅰ ～ Ⅱ patients who accepted painless artificial abortion were randomly divided into 6 groups (n =30 patients per group).Group 1 (control) was given the placebo (0.9％ NS; 2 ml) by vein while other groups were given dezocine by vein with 0.01 mg/kg (group 2),0.02 mg/kg (group 3),0.03 mg/kg (group 4),0.04 mg/kg (group 5),and 0.05 mg/kg (group 6),respectively.The dosage of propofol,BP,HR,SpO2 during the operation,operation time,consciousness recovery time,analgesic effect (VAS score),leaving time,defecation feeling,and untoward reaction of each group were recorded and compared.Results The dosage of propofol in the 5 dezocine groups were significantly lower than that in the control group,respectively (t =2.38,4.72,6.03,4.57,3.96,P ＜ 0.05),while the difference in the operation time,consciousness recovery time and leaving time between the 5 dezocine groups and the control group had not statistical significance (P ＞0.05).The effect of postoperative analgesia and defecation feeling were apparently improved in the group 3,4,5 and 6,compared to the control group(group 3:x2 =3.36,6.94,P ＜ 0.05;group 4:x2 =7.17,15.01,P ＜ 0.05 ; group 5:x2 =15.5,24.3,P ＜ 0.01 ; group 6:x2 =13.01,20.24,P ＜ 0.01).Conclusions The lowest and most effective dose of dezocine was 0.05 mg/kg in preventing postoperative pain after painless artificial abortion.

Objective To investigate the anti-rotavirus effect of Gegen Qinlian decoction on rotavirus (RV)-inducing diarrhea neonatal mice model, and provide evidences for pharmacological and pharmacodynamic studies. Methods Neonatal diarrhea mice model of Kunming family infected with RV-Wa was developed. Symptom, diarrhea ratio and severity level, histological changes of neonatal mice’s small intestine and lung was assessed after Gegen Qinlian decoction (0.78 g/kg) treatment. Results Diarrhea ratio, diarrhea severity level, histological changes of neonatal mice’s small intestine and lung were obviously decreased after Gegen Qinlian decoction (0.78 g/kg) treatment. Conclusion Gegen Qinlian decoction has anti-rotavirus effect on RV induced diarrhea.

Objective To understand the basic situation of hospital infection ,relevant problems were collected so as to pro‐vide reference for making infection control program .Methods Infection data in 2013 was reviewed and input into database which was built by EpiData3 .0 ;the descriptive statistical method was used for the characters of clinical distribution of hospital infection and χ2 test was used for the rate comparison by the SPSS17 .0 software .Results Four hundred and thirteen hospital infection cases were found in 2013 and infection rate was 1 .2% ,which was higher in patients with malignant tumor .The main parts of hosipital in‐fection were respiratory and urinary system .Escherichia coli ,Pseudomonas aeruginosa ,Acinetobacter bacteria Bauman ,Staphylococ‐cus aureus and Klebsiella pneumoniae were the main pathogen in nosocomial infection .Conclusion The focus for future prevention and control work are to strengthen hospital infection training ,susceptible sites management ,and formulate relevant rules of opera‐tion .

Objective To establish an HPLC method for the determination of ceftazidime for injection. Methods HPLC column was TSK-GEL G2000SWXL gel column. Mobile phase of phosphate buffer ( pH 7. 0) was 0. 005 mol · L-1 disodium hydrogen phosphate solution-0. 005 mol · L-1 sodium dihydrogen phosphate solution ( 61 : 39 ). The detection wavelength was 231 nm; column temperature was 30 ℃ ; the injection volume was 20 μL. Results Ceftazidime reference linear range was 0. 51-25. 64 μg·mL-1(r=0. 999), ceftazidime for injection polymer linear range was 0. 20-3. 92 mg·mL-1 (r=0. 99), and the limit of quantification polymer was 0. 71 μg. Conclusion The method is rapid and the separation was good. It can be used for the detection of ceftazidime for injection.