Objective To investigate the present situation of the combination of antimicrobial drugs and to improve the rationality of antimicrobial medication.Methods Choose 1734 prescription of antimicrobial from February 2015 to May 2016 in our hospital outpatient service and emergency departments, combined with pharmacology, clinical medication instructions and drug instruction,the prescriptions were analyzed statistically,and the name of antimicrobials, combination mode, type, period of treatment, rationality and other aspects of the situation were studied.Results The total prescription of antibiotics was 45.44%, and the combination of antimicrobial drugs was 76.65 %, with the combination form of the dosage form and the injection machine with a maximum of 41.72%.Oral dosage form and oral dosage form combined drug 21.19%.The proportion of combined penicillin was 43.54 percent, followed by the cephalospora 27.81%.The rational compatibility prescription 86.92%, the prescription compatibility is unreasonable 13.08%.In the unreasonable preparation of the prescription, the majority of the formulations for pharmacodynamics were 82.28%.Conclusion The current use of antibiotics in our hospital gradually become standardized, in the process of clinical treatment, to understanded and master the drug combination medication indications, can significantly improve the treatment effect, to avoid the occurrence of adverse reaction phenomenon, the use of drug safety is effectively guaranteed.

Benign biliary strictures(BBS) have different etiologies, and the most common causes are strictures secondary to iatrogenic and ischemic injury after hepatobiliary and transplantation surgery. Fibroblast proliferating activity, extracellular matrix overdeposition and scar proliferation are closely related to BBS. The mechanism of development of BBS involves a variety of cells, cytokines and extracellular matrix. In recent years, biological treatment is emerging as an effective option for BBS, but the clinical application is not yet mature and the curative effect needs to be evaluated further in the future.

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 evaluate their roles of transthoracic echocardiography (TTE), cardiovascular digital imaging (CVDI) and electron beam computed tomography (EBT) in the diagnosis of complex congenital heart dieases (CHD).Methods Twenty-one patients with CHD were studied, including 12 cases of boys and 9 cases of girls. Fourteen cases of them underwent surgery. All of them were examined by two-dimensional echocardiography (2DE) , color Doppler flow imaging (CDFI) and EBT, 11 cases of them were examined by CVDI.Results The rate of coincidence between EBT and CVDI in diagnosing complex CHD was 93.3% (28/30). The accurate rate of TTE and CVDI in diagnosing complex CHD was 77.8% (35/45) and 93.3% (42/45) respectively.Conclusion In diagnosing complex CHD,combination EBT with TTE can replace the technique of CVDI partially.

Objective:To inve tigate the value o electron beam tomography and echocardiography or diagno ing the comple congenital heart di ea e . Method :Thirty our patient with comple congenital heart di ea e underwent both echocardiography and electron beam tomography,which wa con irmed by angiocardiography in 18 patient .Twenty one patient were operated on.All data were comparatively analyzed Re ult :The rate o diagno i coincidence in diagno ing comple congenital heart di ea e wa 82 4% or electron beam tomography,and 73 5% or echocardiography.The accuracy o electron beam tomography in diagno ing e tracardiac abnormal tructure wa 97 9% and obviou ly higher than 53 2% by echocardiography.The accuracy o echocardiography in diagno ing intracardiac abnormal tructure wa 95 9% and higher than 81 6% by electron beam tomography.Electron beam tomography and echocardiography had a imilar accuracy or diagno ing abnormal tructure at the junction o ve el with cardiac chamber. Conclu ion:Electron beam tomography combined with echocardiography can greatly improve the diagno i accuracy o comple congenital heart di ea e and can al o reduce the u e o inva ive angiocardiography.

Gastroesophageal reflux (GER) was very common among preterm infants, which could cause several complications and severely affects the prognosis. The standardization of diagnosis and treatment of gastroesophageal reflux was very important for preterm infants. Due to less adverse reactions, nonpharmacological therapy was the most advisable choice in preterm infants with GER. In this paper, nonpharmacological therapies including body positioning, feeding frequency and modality, changing food patterns, gastric tube, and nonnutritive sucking were reviewed. Body positioning was the safest and most effective nonpharmacological therapy. Other nonpharmacological strategies such as changes of feeding frequency and modality might also be useful. The role of some strategies was still controversial, thereby needing to be further investigated. Selection of what kind of specific nonpharmacological therapy should be based on the specific conditions.

Objective:To evaluate the clinical effects of compound Shenqi soft capsules in the children with functional dyspepsia(FD). Methods:A stratified random,parallel,control and non-blind design was used,and the children with FD were randomly divided into groups after stratified by age. The children in the trial group were given compound Shenqi soft capsules,one capsule for the children with age under three and two capsules for the children with age over three,tid. The control group was treated with compound Shenqi granules,half a bag for the children with age under three and 1 bag for the children with age over three,tid. The treatment course was one month. The two groups were compared by the symptoms of bellyache,abdominal distension,early satiety,belching and nausea. The electrogastrogram was analyzed in two groups. Results:Compound Shenqi soft capsules could improve the symptoms of ballyache,abdominal distension,early satiety,belching and nausea obviously,increase normal rhythm and reduce bradygastria obviously,and there were significant differences compared with those before the treatment(P < 0. 05). The trial group was better than the control group in the improvement of ballyache,abdominal ditension,early satiety and bradygastria,and the difference was significant(P < 0. 05). The total effective rate of the trial group was 91. 9% ,while that of the control group was 78. 3% ,and the difference was statistically significant(P < 0. 05). Conclusion:The clinical effect of compound Shenqi soft capsules is satisfied without any adverse reaction during the test,suggesting the capsules are suitable for clinical application.

Objective To compare the long-term efficacies of anterior cervical decompression and fusion (ACDF)and conservative therapy in treatment of unisegmental cervical disc herniation and to analyze the degree of the long-term adjacent segment disc degeneration in ACDF.Methods 120 patients treated in our hospital from January 2006 to January 2009 were selected,60 patients underwent ACDF as operation group and 60 patients underwent physical therapy and drug (conservative therapy)as non-operation group. All the patients were recorded when they were diagnosed with cervical unisegmental cervical disc herniation, and followed-up for 60 months, and they were evaluated with American Spinal Injury Association (ASIA)score,Visual Analogue Scale (VAS),Japanese Orthopedics Association (JOA) score and imaging (Miyazaki grading system). Results 107 patients were followed up,55 patients treated by operation were followed up for an average 59.7 months (59.7±0.4),while 52 patients treated by conservative therapy were followed up for an average 58.8 months (58.8±1.5).Compared with before treatment, the ASIA, JOA, and VAS scores of the patients in two group after treatment were improved (P<0.05),and the scores of ASIA,VAS,and JOA in operation group were superior to that in non-operation group (P<0.05),and adjacent segment disc degeneration occurred more frequently in the upper adjacent segment than the lower adjacent segment (P<0.05).Conclusion ACDF is superior to conservative therapy in alleviating symptoms and improving prognosis of unisegmental cervical disc herniation. Long-term postoperative disc degeneration mainly occurrs in the upper segment.

Objective To observe the surgical results of milling technique in treating mandibular angle hypertrophy through an intraoral approach and the effect of three-dimensional computer tomography (3D-CT) reconstruction.Methods Milling-technique was used to treat mandibular angle hypertrophy of 43 patients through intraoral approach under local anaesthesia.3D-CT was applied preoperatively and postoperatively,the data of mandibular angle and masseter muscle thickness were compared preoperatively and postoperatively.The facial contour improvement was also observed.Results Of 43 cases,33 cases were followed-up for 4 to 24 months after operation.The majority of patients were satisfied with the aesthetic results,changes of anterior and lateral view of basifacial part were obvious,the curve of the mandibular angle was smooth and the shape was natural; no major complications such as facial nerve injury or malfracture were seen.Conclusions Milling-technique is a safe,effective and simple method for mandibular angle reduction,and 3D-CT reconstruction has a positive effect preoperatively and postoperatively.

Objective To build of lentiviral mediated RNA interference of mammalian target of rapamcin (mTOR) ,because the mammalian target of rapamycin plays a important role in tumor development and the signal path .Methods According to RNA in-terference (RNAi) design rules Completely ,in view of the gene called mTOR was desiged four interference targets and Negative control (FAM ) sequence ,first of all ,synthetic oligonucleotides nucleotide fragments with artificial ,and can obtain siRNA fragments effectively by the method of PCR joining together ,then undertake transfection on lung adenocarcinoma A 549 cell by Lipofectamine transfection reagent 2000 .To begin to observe the enhanced green fluorescent protein expression in lung adenocarcinoma A 549 cells by fluorescence microscopy at high magnification after 1 days .We can use semi-quantitative RT-PCR method ,and detect of mTOR gene expression of mRNA level after 1 days ,meanwhile ,testing the expression of protein levels by Western Blot after 2 days ,in or-der to select the most efficient interference target sequence ,,afterwards ,synthetic double-stranded DNA ,and it can be make up vec-tor system with plasmid pHelper 1 .0 and pHelper 2 .0 by the pGCL-GFP carrier ,further transfect 293 T cells ,at last produce lenti-viral after packaging ,then detection GFP protein expression levels by Western-Blot method ,and consequently detect the virus drops degree of 293T cells ,at the same time ,identify the activity .Results The high efficiently target of mTOR gene has been successfully selected ;mTOR siRNA infecte of human lung adenocarcinoma A549 cells in vitro culture ,and the gene is obviously silence no mat-ter from the mRNA level or protein level ;3 mTOR gene lentivirus siRNA carrier was successfully build .geting virus supernatant al-so ,and virus drops to 1 × 108 UT/mL .Conclusion MTOR siRNA infected of human lung adenocarcinoma A549 cells in vitro cul-ture ,and could lead to mTOR gene obviously silence ;The construction was successfully gene mTOR siRNA lentivirus vectors .