OBJECTIVE:To provide reference for clinical rational use and management of anti-HIV drugs,and to provide ref-erence basis for occupational exposure to develop free drug policy. METHODS:Using retrospective study method,according to DDD calculation method recommended by WHO,consumption sum,DDDs,DDC and B/A of anti-HIV drugs in our center during 2011-2014 were analyzed and evaluated. RESULTS:The consumption sum of anti-HIV drugs increased firstly and decreased later, increasing from 512112 yuan in 2011 to 650854 yuan in 2012,decreasing to 496473 yuan in 2014. DDDs of anti-HIV drugs in our center during 2011-2014 decreased from 35932 in 2011,to 16363 in 2014,showing decreasing tendency. The consumption sum of nucleotide reverse transcriptase inhibitors during 2012-2014 took up the first place,and DDDs of nucleotide reverse tran-scriptase inhibitors took up the first place in 2011,2013,2014. DDDs of Zidovudine tablets took up the first place in 2013,2014, and that of Tangcao tablets took up top 3 places during 2011-2014. DDC of Tenofour disoproxil fumarate tablets,Zidovudine and la-mivudine tablets,Emtricitabine and tenofovir tablets,Lopinavir and ritonavir tablets were in high level,being more than 46 yuan. DDC of Zidovudine tablets,Stavadine tablets and Nevirapine tablets were in low level,being lower than 6 yuan. B/A of Tenofovir disoproxil fumarate tablets,Stavudine tablets and Efavirenz tablets ranged 0.5-1.5 in 4 years and B/A of Tangcao tablets was equal to 1,showing good synchronism of social and economical benefits. CONCLUSIONS:Clinical application of anti-HIV drugs in our center is rational basically,and the use of drug is basically consistent with the occupational exposure prevention. The use of TCM preparation is basically in line with the requirements of drug use in the clinic.

Objective To explore the relationship between serum reproductive hormone levels and premenopausal and postmenopausal breast cancer patients.Methods We recruited healthy women and breast cancer patients who came to our hospital from September 2007 to February 2012 for routine physical examination or surgery and divided them into premenopausal healthy group Ⅰ and breast cancer group Ⅰ ;Postmenopausal healthy group Ⅱ and breast cancer group Ⅱ,with 175 cases in each group.Reproductive hormone levels was measured in all cases.Results There were significant differences among the four groups on estradiol (E2),testosterone (T),progesterone (P),luteotropic hormone (LH),follicle-stimulating hormone (FSH),and prolactin (PRL) (F =76.459,57.224,82.932,161.047,74.801 and 15.246 respectively,P ＜ 0.05).In premenopausal cases:There were significant statistical difference on the levels of E2 [(61.5 ±32.2) ng/L vs.(74.1 ±41.6) ng/L],T [(48.1 ±22.2) μg/L vs.(80.1 ±41.8) μg/L],P [(2.9±1.6) μg/Lvs.(3.5 ±1.3) μg/L],LH [(1.3 ±0.9) U/L vs.(3.5 ±1.4) U/L],FSH [(14.8 ±8.9) U/L vs.(25.1 ±23.3) U/L],PRL [(15.8 ±6.7) μg/L vs.(39.4 ±27.4) μg/L] between the healthy Ⅰ group and the breast cancer Ⅰ group (P ＜ 0.05).In postmenopausal cases:There were significant statistical difference on the E2 [(18.8 ± 8.3) ng/L vs.(55.9±34.1) ng/L],T [(34.1 ±16.2) μg/L vs.(84.7 ±66.4) μg/L],P [(1.3 ±0.9) μg/L vs.(3.5 ±1.4) μg/L],LH [(38.1 ±33.7) U/L vs.(45.6 ± 31.2) U/L] in healthy group Ⅱand the breast cancer Ⅱ group (P ＜ 0.05).The difference was statistically significant on the E2 [(74.1 ± 41.6) ng/L vs.(55.9±34.1) ng/L],LH [(3.5 ±1.4) U/L vs.(45.6 ±31.2) U/L],FSH [(25.1 ±23.3) U/L vs.(70.5±58.2) U/L],PRL [(39.4 ±27.4) μg/L vs.(15.9 ±15.5) μg/L] between the breast group of premenopausal and postmenopausal (P ＜ 0.05).Conclusion Reproductive hormone levels has important clinical significance for the onset and development of breast cancer and provides a reference point for the treatment of menopausal and post-menopausal breast cancer.

Objective To observe the effects and toxicity of paclitaxel liposome combined with cisplatin in the treatment of ad-vanced non-small cell lung cancer .Methods 80 cases of patients of advanced non-small cell lung cancer were randomly divided into study group and control group ,40 cases in each group .Study group was treated with paclitaxel liposome (135 mg/m2 ,IV drip 3 h , first days) ,control group received paclitaxel(135 mg/m2 ,IV drip 3 h ,first days) ,the two groups combined with cisplatin 75 mg/m2 ,IV drip ,for 3 days ,take 21 days as one cycle .Results The study group CR 0 .0% (0/40) ,PR 27 .5% (11/40) ,RR 27 .5% (11/40);control group CR 0 .0% (0/40) ,PR 25 .0% (10/40) ,PR 25 .0% (10/40) ,(P>0 .05) .The research group of rash ,muscle and joint pain ,peripheral neuropathy was significantly lower than that of the control group (P<0 .05) .The research group of progres-sion-free survival was 5 .3 months(95% CI 3 .713 -6 .408) ,the median survival period was 9 .3 months(95% CI 8 .337 -9 .907);control group of progression-free survival was 4 .6 months(95% CI 3 .187 -5 .547) ,the median survival period was 9 .4 months (95% CI 7 .787-11 .602) ,the two groups had no statistical significance (P>0 .05) .Conclusion Paclitaxel liposome combined with cisplatin in treatment of advanced non-small cell lung cancer clinical efficacy and long-term efficacy of taxol and quite ,but with less allergic reaction .

Objective: To reasonably allocate the hospital fixed assets, improve the use efficiency of hospital fixed assets and enhance the management level of hospital fixed assets. Methods: Literature method, observation method and expert interview are mainly adopted to launch comprehensive investigation on the current management conditions of the fixed assets of public hospitals in Quzhou from 2009 to 2011. Results: The allocation of assets is not reasonable, the utilization rate of large devices is not high and the return on assets is relatively low. Conclusion: Professional centralized management of large special equipment should be implemented, informatization management is comprehensively implemented, ABC management approach is applied to conduct classified management of fixed hospitals of the hospitals, so as to establish layered assets management accountability system.

Objective To explore of integrated traditional Chinese and Western medicine treatment for peri -menopausal dysfunctional uterine bleeding ( bleeding ) .Methods According to the digital table ,was ginen to 66 pa-tients with perimenopausal dysfunctional uterine bleeding were randomly divided into the two groups .The control group uses the conventional western medicine treatment ,the treatment group was treated by combined Western and Chinese medicine .Before and after treatment ,the endometrial thickness ,hemoglobin value of the two groups was recorded ,and the clinical efficacy of the two groups was evaluated .Results The treatment group in the treatment of uterine endom-etrial thickness,hemoglobin value and clinical effective rate was (6.69 ±1.96) mm,(97.04 ±15.48) g/L,97%, which was better than those of the control group [(8.09 ±2.44) mm,(87.13 ±20.83) g/L,85%] (t =2.575, 2.129,χ2 =9.452,all P<0.05).Conclusion The joint Chinese and Western medicine treatment for Peri-menopa-usal dysfunctional uterine bleeding and it is worthy of promotion .

Objective To study the relationship between interleukin(IL)-4,IL-12 and IL-18 and intrauterine infection of hepatitis B virus (HBV),in order to provide the basis for prevention and treatment.Methods Forty pregnant women with positive HBsAg and intrauterine infection of HBV were selected as study group,and 80 pregnant women with positive HBsAg and non-intrauterine infection of HBV were selected as control group.The levels of IL-4,IL-12,IL-18 were compared.Results The level of IL-4 was (51.56 ± 7.86) ng/L in study group,which was higher than that in control group [(31.67 ± 8.64) ng/L],and there was significant difference between two groups (P ＜0.01).The leveh ofIL-12 and IL-18 were (803.45 ± 132.64),(627.87 ± 134.38) ng/L in study group,which werelower than that in control group [(904.87 ± 231.86),(734.78 ± 165.67) ng/L],and there were significant differences between two groups (P ＜ 0.01).Conclusions The levels of IL-4,IL-12,IL-18 are correlated with intrauterine infection of HBV.The increase of IL-4 and the decrease of IL-18,IL-12 may lead to positive HBsAg pregnant women happening intrauterine HBV infection.

[Objective] Via an empirical survey, this study is aimed to explore the imparting and mastering of Chinese cultural knowledge in China ’s present col ege English teaching, so as to offer some effective strategies for dealing with“Chinese culture aphasia”in current col ege English teaching in China. [Methods] Resorting to the research methodology of tests, questionnaires and interviews, it carries out an investigation of a number of col ege students and English teachers in Zhejiang Province into their mastering of Chinese cultural knowledge and its conveying in English as wel as the curriculum design of their col eges or departments. The relevant data derived from the research are analyzed qualitatively and quantitatively. [Results] The subjects al demonstrate the phenomenon of“Chinese culture aphasia”concerning both its comprehension and its English translation to varying degrees. Besides, cross-cultural commu-nication is twofold, so it is indispensible for learners to study simultaneously their native culture,which is a solid cornerstone and the crucial foundation for foreign language learning, but has been seriously deficient in col eges’curriculum design and students’textbooks; integrating Chinese as one of the com-pulsory courses and establishing corresponding examining and evaluating systems incorporating formative assessment and summative assessment, are sure to cope with“Chinese culture aphasia”in present col ege English teaching in China effectively. [Conclusion] The research and solution above are expected to shed light on teaching syl abus formulations and curriculum designs, enhance students ’humanistic quality and their communication capabilities in reality, and consequently popularize the excellent Chinese culture.

Objective To analyze and evaluate the performance of the double antigen sandwich method reagents by comparing the detection results of three kinds of domestic hepatitis C virus(HCV)antibody detection kits with indirect method and sandwich method.Methods The different test methods were designed.The HCV antibody detection by using three kinds of reagents was performed on the collected positive and negative specimens and those specimens with positive reaction by the single and dual rea-gents were simultaneously performed the recombinant immunoblot assay(RIBA)and the nucleic acid detection;in addition,after the multiple proportion dilution,the quality control material with known content was parallelly detected with three kinds of reagents. All the detection results were conducted the comparison and the comprehensive analysis.Results Compared with the confirmation reagent,the false positive rates of two kinds of indirect method reagent and one kind of sandwich method reagent were 40.9%, 59.1% and 2.2% respectively.Their positive rates were 100%,but the analytical sensitivity of the sandwich method was higher than that of the indirect method by 1 ~4 times.Conclusion The sandwich ELISA reagent is significantly superior to the indirect EllSA reagent in the aspects of sensitivity and specificity.

We conducted a questionnaire survey among 36 community health care providers at Jingansi Health Center to learn their status quo.Our results showed that talented person aged less than 35 only accounted for 1/10.97%of the young physicians wished to have more continuous medical education and improved working environment.Proper working regulation,personnel resource management and payment system might help attract,train and retain more qualified persons,improve personnel quality,and achieve sustainable development of community health centers.

Objective To analyze influencing factors of recurrence in patients with cervical intraepithelial neoplasia (CIN) after loop electrosurgical excision procedure (LEEP).Methods CIN patients who diagnosed by cervical cytology and cervical pathologic examination were treated with LEEP.Follow-up by cervical cytology and colposcope examination,patients with abnormal cytology were given colposcope pathologic examination.High risk human papilloma virus (HPV) was examined by hybrid capture HPV DNA method HC-2.Recurrent disease was defined when the same or higher level of lesion 6 months after LEEP were found.Results A total of 451 LEEP was performed during the study period,the age was 19-68 (39.0 ±7.4) years.Pathological grading:CIN Ⅰ was in 122 patients,CIN Ⅱ-Ⅲ was in 329 patients.Ninety-eight patients were recurrent,the rate of recurrence was 21.73％ (98/451),the rate of recurrence in CIN Ⅰ was 14.75％(18/122),in CIN Ⅱ-Ⅲ was 24.32％(80/329).Single factor analysis showed that high risk HPV infection,surgical margin,pathological grading,cervical cytology abnormal changes were the influencing factors of recurrence after LEEP (P＜0.01 or ＜0.05).Multi-factor analysis showed that the influencing factors of recurrence after LEEP were followed by high risk HPV infection,cervical cytology abnormal changes,surgical margin and pathological grading.Conclusions High risk HPV infection is an important influencing factor of recurrence after LEEP in patients with CIN,and cervical cytology abnormal changes,surgical margin and pathological grading are also influencing factor of recurrence after LEEP.