OBJECTIVE:To evaluate the perioperative utilization of antibacterial drugs in patients undergoing modified radical mastectomy. METHODS: In this retrospective study, the perioperative utilization of antibacterial drugs in patients who underwent modified radical mastectomy during 2006 and 2006 were analyzed statistically. RESULTS: 100% of the patients received antibacterial drugs preventively. The problems involved in the preventive use of antibacterials manifested as medication without indications, irrational application of broad-spectrum antibacterials, frequent change of drugs, blind drug combination, inappropriate time of initial administration and prolonged drug use etc. CONCLUSION: The perioperative use of antibacterial drugs in patients undergoing modified radical mastectomy in our hospital is far from rational. The Clinicians' medication behavior should be standardized and supervision on rational drug use should be strengthened.

OBJECTIVE: To discuss the clinical characteristics and the patterns of allergic reaction(ADR) caused by aminoglycosides.METHODS: 98 ADR cases induced by aminoglycosides were retrieved from domestic journals reported from Jan.1990 to June 2007 for a statistical analysis.RESULTS: The ADR of aminoglycosides was closely related to route of administration,unreasonable application,allergic history,etc.CONCLUSION: The ADR of aminoglycosides and rational use of aminoglycosides should be strengthened further in the clinical practice.

Objective To study the CT and MRI findings of ganglioneuroma and compare with pathology . Methods Clinical data of 12 patients with ganglioneuroma confirmed by surgical pathology were retrospectively ana -lyzed.All patients underwent CT and MRI , and the results were compared with pathological results .Results The average size of the lesion was (4.7 ±1.2)cm,CT scan was uneven or uniform density.In MRI plain scan,T1WI showed heterogeneous low signal ,T2 WI showed uneven contour signal ,the middle part of the strip of low signal .12 cases received enhanced MRI scan ,there were four cases of non-enhanced,mild enhancement in 3 cases,uniformity progres-sive strength enhanced with two cases ,uneven progressive enhancement in 3 cases,there was 1 patient with edge of the annular reinforcing ,in accordance with CT scan results .Conclusion When CT and MRI used as the detection means of ganglioneuroma ,its performance has a certain characteristic ,and that reflects in large part the tumor shape ,size and tis-sue composition .And pathological tumor is rich in a lot of mucus matrix has a certain relationship .

Objective To investigate the prevention effect of Ezetimibe with loaded dose on hematologic parameters and re-infarction in patients undergoing PCI.Methods 240 cases of patients with non ST segment elevation myocardial infarction performed PCI from October 2012 to October 2014 were selected and randomly divided into two groups,the control group received conventional dose Ezetimibe 10 mg every time,qd,the study group received loading dose ezetimibe 20 mg every time, qd, both two groups treatment 30 days.The inflammatory factors, myocardial injury and vascular endothelial function were compared before, 24 h and 30 d after the operation, and patients were followed up for two years,record adverse reactions. Results Compared with before treatment,levels of serum inflammatory factor,myocardial injury and vascular endothelial function index in different time points had differences by single factor analysis of variance(P<0.05),and compared with the control group, levels of serum hs-CRP,TNF-α,IFN-γand IL-6 in the study group were lower, levels of serum CK-MB,cTnI and BNP were lower,the contents of ET in serum were lower,and the contents of NO were higher(P<0.05).The improvement degree in the study group of myocardial microcirculation perfusion after treatment was higher(P<0.05).No case shedding phenomenon occurred during the two year follow-up, and there was no statistical significance in the incidence of cardiovascular events between two groups.Conclusion Loading dose of ezetimibe can protect myocardium,and it can inhibit the inflammatory reaction and vascular endothelial injury caused by operation,it also can improve myocardial microcirculation.

China ; epidemiology ; Diagnostic Techniques and Procedures ; Epidemiologic Studies ; Hematologic Diseases ; diagnosis ; epidemiology ; Humans ; Incidence ; Meta-Analysis as Topic ; Multicenter Studies as Topic ; Prevalence ; Randomized Controlled Trials as Topic

Objective To investigate the therapeutic effect of bundle treatments for critically ill patients with pulmonary tuberculosis and respiratory failure (RF).Methods A prospective study was conducted, including 56 patients with pulmonary tuberculosis and RF necessary for invasive mechanical ventilation admitted into Department of Critical Care Medicine of the Fourth People's Hospital of Nanning City from January 2013 to December 2014 as the observation group to be treated by bundle treatments. A series of treatments and cares were given to the critically ill patients, such as invasive mechanical ventilation, application of antibiotics by experience within the first hour, supportive treatment targeted to hemodynamics in early stage, correction of brain dysfunction, effective therapy for tuberculosis, establishment of enteral nutrition in early stage and prevention of ventilator-associated pneumonia (VAP), etc. All the above treatments were completed one by one in 6 hours to 12 hours. Meanwhile, 42 patients who hospitalized from January 2011 to December 2012 and treated with conventional targeted therapy were designed as the control group. The changes of vital signs, blood routine test, respiration, liver, kidney, etc organ functions, the improvement of acute physiology and chronic health evaluation Ⅱ (APACHE Ⅱ) score, expected mortality and sequential organ failure assessment (SOFA) score, the incidence of VAP, cure and improvement rate, mortality, duration of invasive mechanical ventilation, the length of stay in intensive care unit (ICU) were compared between the two groups after treatments.Results There were no statistically significant differences in the comparisons between the two groups before and after treatments in temperature, white blood cell count (WBC), blood glucose, total bilirubin (TBil), alanine transaminase (ALT), albumin (Alb) and cholesterol level (allP > 0.05), except the platelet (PLT) count in observation group was higher than that in control group before treatments. After treatments for 72 hours, in the two groups, the heart rate (HR), respiration rate (RR), APACHE Ⅱ score and expected mortality were lower than those before treatments, while the arterial partial pressure of oxygen (PaO2) and oxygenation index were higher than those before treatments. There were no statistically significant differences in pH value, PLT, arterial partial pressure of carbon dioxide (PaCO2) and SOFA score before and after treatments in the control group (allP > 0.05). In the observation group, after treatments, the pH value was increased compared with that before treatments, while PLT, PaCO2 and SOFA score were decreased compared with those before treatments (allP < 0.05). The degrees of improvement of PaCO2 and oxygenation index in the observation group were superior to those in the control group [PaCO2 (mmHg, 1 mmHg = 0.133 kPa): 43.32±9.10 vs. 56.10±9.39, oxygenation index (mmHg): 330.60±100.98 vs. 245.65±83.20, bothP < 0.05]. After bundle treatments, compared with control group, the incidence of VAP was decreased [16.07% (9/56) vs. 33.33% (14/42),P < 0.05], improvement and cure rate was increased [78.57% (44/56) vs. 59.52% (25/42),P < 0.05] and mortality was decreased significantly in observation group [10.71% (6/56) vs. 28.57% (12/42),P < 0.05]. The duration of invasive mechanical ventilation (days: 9.15±3.59 vs. 16.96±13.44) and the length of stay in ICU (days: 13.30±4.24 vs. 23.00±15.03) in the observation group were shorter than those in the control group, but no statistically significant differences were found (bothP > 0.05).Conclusion The bundle treatments can effectively reduce the incidence of VAP and elevate the improvement and cure rate in patients with pulmonary tuberculosis complicated with RF.

OBJECTIVE To investigate the changes in and clinical significance of C-reactive protein(CRP) and endotoxin in patients who are firstly examined in fever clinic.METHODS To review and study the results of CRP and endotoxin from 81 patients(including 48 patients who were diagnosed as bacterial pneumonia and 33 patients who were diagnosed as a cold) in fever clinic of our hospital in 2005.RESULTS In 81 bacterial infection patients, the analysis indicated the levels of endotoxin between the pneumonia patients and the patients with a cold had significant difference.And the levels in the first group were significantly higher than in the latter one.The levels of CRP had no difference in two groups.CONCLUSIONS The result indicates plasma endotoxin detection helps to determine the early diagnosis of serious infection.It is also of significance to select antibacterial rationally and handle syndrome in time.In fever clinic,the levels of endotoxin may be a method to help diagnosis and treatment.CRP could be help to estimate the bacterial infection or virus infection,but it could not adjudge the seriousness in bacterial infection.

AIM: To establish the co-culture mode of tissue-engineered tracheal seeding cells, and compare with the routine culture, so as to provide the fundament of tissue-engineered trachea construction by cell compound materials. METHODS: The experiment was completed at the laboratory, Department of Respiratory Diseases, Tangdu Hospital, the Fourth Military Medical University of Chinese PLA from May 2006 to May 2007.①Three healthy New Zealand male rabbits, weighed (250.00?0.75) g, were used in this study.②Co-culture mode: The tracheal epithelial cells and fibroblasts were isolated and then co-cultured for 7-10 days. The two kinds of cells were distinguished according to their different tolerances to trypsin. Subsequently, A hole received 0.5 g/L trypsinization, cells were suspended in DMEM medium containing 0.05 volume fraction of CO2 and then transplanted into B hole (fibroblasts); again, A hole was added with 2.5 g/L trypsin for digestion, afterwards cells were suspended with K-FSM medium and transplanted into C hole (tracheal epithelial cells). Routine culture: after isolation, tracheal epithelial cells were cultured and fibroblasts were purified, respectively.③The co-cultured cells and the traditionally cultured cells were compared via cell growth curve and cell proliferation detected by 3-(4,5-dimethylthiazo-2-yl)-2,5-diphenyl-tetrazolium bromide (MTT) assay. RESULTS: ①Cell growth: Co-cultured cells grew well, those in A hole increased intercellular apace after trypsinization, while cells in B hole were shaped as fusiform, without the manifestation of typical road stone-like cells, and cells in C hole were apposite, showing lamellar road stone-like morphology.②Cell growth curve: The growth curve of co-cultured cells was identical with that of cells by routine culture method.③Cell proliferation: MTT detection revealed no significant difference in the proliferation of co-cultured cells and cells cultured by traditional method (P

Objective To discuss the perioperative nursing care of patients who is going to receive interventional therapy for hepatic artery stenosis after liver transplantation and to provide useful reference for reducing surgery-related complication and for improving the prognosis of patients. Methods Based on the patient's condition and operative requirement,we provided effective nursing care for 20 patients who were admitted to receive the interventional therapy for hepatic artery stenosis after liver transplantation. The nursing care included preoperative preparation,postoperative nursing and medical guidance at the time of discharge. Results Interventional therapy was successfully performed in all 20 cases,and no hemorrhagic tendency or acute thrombosis occurred. Marked symptomatic improvement was obtained in all patients. Conclusion The interventional therapy is an effective treatment for hepatic artery stenosis after liver transplantation. Intensive perioperative nursing care can well prevent the occurrence of surgery-related complications and can surely improve the therapeutic results.