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.

Objective To evaluate the effects of exogenous adenovirus-mediated gene transfer of human apM1 gene (Ad-apM1) on malonaldehyde (MAD) and superoxide dismutase (SOD) levels in human umbilical vein endothelial cells (HUVEC). Methods HUVEC proliferation was measured by MTT after infection by AdapM1. Adiponetin protein level in cell culture medium of HUVEC cells infected with Ad-apM1 was detected by double antibody sandwich ELISA. The levels of MAD and SOD were measured by chromatometry. Results MTT assay showed that Ad-apMl had no effect on HUVEC proliferation. Human adiponectin protein levels in cell culture medium significantly increased after HUVEC was infected with Ad-apM1 for 24, 48, and 72 h, along with decreased MAD and increased SOD ( all P<0.05 ). MAD levels markedly increased and SOD levels decreased after HUVEC were incubated with 100 μmol/L H2O2 for 6, 12, and 24 h, and these reactions were reversed by AdapM1 transfection (all P<0.05 ). Conclusions HUVEC infected with Ad-apM1 effectively secrete human adiponectin. Ad-apM1 exerts antioxidation effect and antagonizes H2O2 -induced endothelial injury.

Objective: To investigate the anti-oxidation activity of astaxanthin. Method: Free radical scavenging properties were investigated in modified chemical system. The antioxidation activity of astaxanthin and vitamin E for linoleic acid autooxidation, hydroxy radical and DPPH radical was detected by spectrophotometry. Results: Astaxanthin could inhibit autooxidation of linoleic acid effectively and its inhibition and elimination rate to hydroxy radical was higher than vitamin E. The elimination rate was 95.98% at the concentration of 50 ?g/ml astaxanthin. Although the effect of astaxanthin on eliminating DPPH radical was slightly lower than vitamin E, but the elimination rate still high to 97.0% at concentration of 80 ?g/ml. Conclusion: Astaxanthin has obvious anti-oxidation activity.

Object To develop a capillary GC-MS analytical method for identification and deter- mination of ginkgolide A, B, C and bilobalide (GA, GB, GC and BB) in Ginkgo biloba L. leaves. Methods The leave samples were extracted in ultrasonic bath with ethanol-water (20∶80). The extract was purified by liquid-liquid extraction with ethyl acetate followed by solid-phase extraction on a column mixed with acid Al 2O 3, active carbon and celite. The terpenes were trimethylsilylated by BSTFA (with 1% TMCS) for 60 min at 100 ℃ and determined by GC-MS with HP-5 MS capillary column in the selected-ion monitoring mode. The intense fragment ions were chosen as monitoring ions for quantitative analysis. Cholesterol was used as an internal standard. Column temperature gradient: initial temperature 180 ℃, maintained 1 min, and then increased at 20 ℃/min to 260 ℃, and finally at 2 ℃/min up to 300 ℃, maintained 2 min. Results The retention times of GA, GB, GC and BB were 13.7,14.3,15.3 and 6.8 min, the major fragmentation ions (monitoring) were at m/z 537, 625, 713 and 455 (299), the average recoveries of GA, GB, GC and BB were 102.0%, 99.4%, 96.0%, 96.3%, RSD were 0.54%, 2.40%, 1.98% and 2.43%, respectively. Conclusion This method is repeatable, specific, accurate and easy to operate. It is adoptable for quality and quantity analysis of terpene lactones from G. biloba leaves.

Objective To explore the effect of remifentanil postconditioning on rats subjected to ischemia reperfusion injury and the relative mechanisms.Methods Seventy-eight Sprague-Dawley rats, weighing 200-250 g, were randomly divided into six groups (n=13): sham group (group S), ischemia/reperfusion group (group IR), naloxone group (group NAL), 5 μg·kg-1·min-1 remifentanil postconditioning group (group R1), 10 μg·kg-1·min-1remifentanil postconditioning group (group R2) and 20 μg·kg-1·min-1remifentanil postconditioning group (group R3).Group IR was given 45 min ischemia in the left descending anterior (LAD), followed by a 24-h period of reperfusion.Groups R1, R2, R3 received 10 min of remifentanil infusion of 5, 10 and 20 μg·kg-1·min-1 after 35 min ischemia followed by a 24 h period of reperfusion.Group NAL was given injection of naloxone 0.1 mg/kg at the point of 25 min myocardial ischemia, after 10 min, then remifentanil 10 μg·kg-1·min-1 for 10 min.The myocardial infarct size and pathological changes of myocardial tissue were observed, serum cTnI, LDH and CK-MB level were measured.Results Compared with group S, serum cTnI, LDH and CK-MB and myocardial infarct size were markedly increased in groups IR, NAL, R1, R2 and R3 (P<0.05), and pathologic injury of myocardial cells were augmented.In comparison with group IR, the indexes were decreased in groups R1, R2 and R3 (P<0.05).Conclusion Remifentanil postconditioning could protect against myocardial ischemia reperfusion injury in rats.The protection may be related to remifentanil activating the opioid receptors.There were ceiling effects of remifentanil postconditioning induced myocardial protection.

Objecfive To explore the value of endoscopic uhrasonography(EUS)in diagnosis and preoperative assessment of esophageal cancer.Methods A total of 57 patients with esophageal cancer were examined by EUS.The image features,depth of invasion and lymph node metastasis obtained by EUS were analyzed and compared with postoperative outcomes.Results Esophageal cancer was characterized as an irregular hypoeehoic mass with partial or total destruction of normal esophageal wall structure under EUS.Compared with post-operative pathological findings,the consistent rates of EUS diagnosis in depth of invasion,T staging,and N staging were 84.2%(48/57),87.7%(50/57)and 84.2%(48/57),respectively.Conclusion EUS exhibited high diagnostic accuracy in T staging of esophageal cancer,which is valuable in managements and prognosis of esophageal cancer.

Objective To prospectively evaluate the risk factors of complete resection in early gastric cancer (EGC) with endoscopic submucosal dissection (ESD),and to guide the choice of treatment methods.Methods This study prospectively evaluated the endoscopic features of 66 EGCs,including the lesion size,presence or absence of ulceration,the extent of differentiation,invasion depth and entire margins of the EGC,then compared them with postoperative pathologic results and analysed these factors.Results The lesion size of the high grade intmepithelial neoplasia (H) group and the intramucosal carcinoma (M) group were mainly less than 30 mm (90.9％ vs.88.5％),but 57.1％ of the submucosal carcinoma (SM) were more than 30 mm.There was a significant difference between any two of three groups (P ＜ 0.05).Fourteen EGCs who got ulceration without invasion beyond mucosal muscularis underwent ESD successfully,and the basal or dissected margin had no residual tumor cells confirmed pathologically.And no tumor cell infiltration or lymph node metastasis was discovered.Of 45 EGCs with ESD,the underestimation rate for horizontal extent determined by white light and chromoendoscopy was higher than that of magnifying endoscopy with narrow-band imaging (ME-NBI) (15.6％ vs.2.2％,P ＜0.05).Diagnostic accuracy for the extent of differenciation by conventional endoscopy was 93.9％ (31/32,P ＞ 0.1),but it's unable to determine the extent of differentiation by ME-NBI.The accuracy of the group H was 84.8％ (28/33),that of M was 57.7％ (15/26),that of SM was 71.4％ (5/7),and there was a significant difference between group H and group M (P ＜ 0.05).Conclusion To achieve complete resection of EGC with ESD,the lesion more than 30 mm,presence of ulceration,undifferentiated type,deep infiltration should be considered as the risk factors,and it's also important to identify the horizontal extent of EGC to avoid unnecessary operation.

Objective To evaluate the effect of remifentanil preconditioning on hepatic ischemiarepeffusion (I/R) injury in rats with liver cirrhosis.Methods Healthy male Sprague-Dawley rats,weighing 160180 g,received 40％ tetrachloride carbon 3 ml/kg (in peanut oil) intragastrically twice a week for 8 weeks to induce liver cirrhosis.Thirty-five rats with liver cirrhosis were randomly divided into 5 groups (n =7 each) using a random number table:sham operation group (group S),group I/R,and preconditioning with different does of remifentanil groups (R1,R2 and R3 groups).Hepatic I/R injury was induced by clamping the branches of hepatic artery,portal vein and common bile duct in the left and median hepatic lobes for 30 min followed by 90 min reperfusion in anesthetized rats with liver cirrhosis.In R1,R2 and R3 groups,remifentanil was infused intravenously at 0.4,2.0 and 10.0 μg· kg-1· min-1 for 15 min,respectively,and the rats were exposed to ischemia for 30 min followed by 30 reperfusion starting from 10 min after infusion was stopped.At 90 min of reperfusion,blood samples were collected from the abdominal aorta for determination of serum alanine aminotransferase (ALT) and aspartate aminotransferase (AST) activities.The rats were then sacrificed and livers were removed for determination of superoxide dismutase (SOD) activity,malondialdehyde (MDA) content,and expression of activated caspase-3 (using immunohistochemistry and Western blot analysis) and for detection of cell apoptosis in hepatic tissues.Apoptotic index was calculated.Results Compared with group S,the serum ALT and AST activities,MDA content and apoptotic index were significantly increased,SOD activity was decreased,and the expression of activated caspase-3 was up-regulated in I/R,R1,R2 and R3 groups.Compared with group I/R,no significant changes were found in the indexes mentioned above in group I/R,and the serum ALT and AST activities,MDA coment and apoptotic index were significantly decreased,SOD activity was increased,and the expression of activated caspase-3 was down-regulated in R2 and R3 groups.Conclusion Remifentanil preconditioning can reduce hepatic I/R injury in rats with liver cirrhosis,and the mechanism is related to inhibition of the lipid peroxidation and cell apoptosis.

Objective To investigate the impact of polyclonal neural cell adhesion molecule antibody (P-NCAM-Ab) on the potency of botulinum toxin A (BTX-A).Methods Ninety male Sprague-Dawley rats were randomly divided into 3 equal groups:a normal control group,a BTX-A group and a P-NCAM-Ab group.The rats in the normal control group were injected with 100 μl of saline solution in their right gastrocnemius,while those in the BTX-A and P-NCAM-Ab groups were injected with 100 μl of BTX-A (0.5 U).In addition,the rats in the P-NCAM-Ab group were also injected with 100 μl of P-NCAM-Ab (the dosage was 20 U) at the same site on the 3rd day after the BTX-A injection.The rats' gastrocnemius muscle strength was evaluated with a self-made system for evaluating neuromuscular function before and after the toxin injection,on the 3rd day,as well as 1,2,4,6,8,10 and 12 weeks after the BTX-A injection.Any wet weight changes in the muscles were observed,and immunochemistry methods were employed to observe any structural changes in the motor endplates and nerve fibers at the different time points.Results After the saline injection,the average gastrocnemius muscle strength of the control group increased with time,while strength in the BTX-A and P-NCAM-Ab groups demonstrated a decrease in strength followed by a gradual increase.The average gastrocnemius muscle strength of the rats in the BTX-A and P-NCAM-Ab groups was significantly lower than that of the control group at all time points.Compared with the BTX-A group,the muscle strength of the P-NCAM-Ab group rats decreased further.Strength recovery in the BTX-A and P-NCAM-Ab groups was significantly slower than in the control group.The wet weight percentage in the BTX-A and P-NCAM-Ab groups at first decreased and then recovered with time.After the BTX-A injection,the average wet weight percentage of the P-NCAM-Ab group rats was significantly lower than that of the BTX-A group after 3 days,and 1,2 and 4 weeks.Karnovsky-Roots AchE staining showed that the motor endplates' color in the BTX-A and P-NCAM-Ab groups deepened gradually,though the color of the P-NCAM-Ab group was lighter than that of the BTX-A group at each time point.The mean optical density of the motor endplates' positive reaction area increased with time in both groups,but the P-NCAM-Ab group was lower than that of the BTX-A group at 1,2,4,8 and 12 weeks.Counting the nerve fibers dyed by gold chloride showed similar trends with both experimental groups significantly different from the control group.Conclusion P-NCAM-Ab can increase the potency of BTX-A and prolong its action.

Objective To investigate the effect of remifentanil preconditioning on hypoxia-reoxygenation (H/R) injury to human hepatocytes.Methods Human HL7702 hepatocytes were cultured in vitro and randomly divided into 6 groups (n =16 each):control group (group C),H/R group,preconditioning with low,median and high concentrations of remifentanil groups (groups RP1-3) and normal saline group (group NS).H/R was produced by 8 h exposure of cells to 94％ N2-5％ CO2-1％ O2 in glucose-free DMEM liquid culture medium followed by 4 h reoxygenation.Remifentanil with the final concentrations of 0.5,5.0 and 50.0 ng/ml were added before hypoxia in groups RP1-3 respectively.Normal saline equal to the volume of remifentanil was added before hypoxia,the culture medium was replaced with glucose-free DMEM liquid culture medium 1 b later and H/R was produced in group NS.At 4 h of reoxygenation,the cell viability was measured by MTT,and activities of alanine aminotransferase (ALT),aspartate amino transferase (AST) and lactic dehydrogenase (LDH) in the culture medium and malondialdehyde (MDA) content in the cells were determined.The cell morphology was also examined.Results Compared with group C,the cell viability was significantly decreased,the activities of AST,ALT and LDH in the culture medium and MDA content in the cells were significantly increased in the other groups (P ＜ 0.05).Compared with groups H/R and NS,the cell viability was significantly increased,the activities of AST and LDH in the culture medium and MDA content in the cells were significantly decreased in group RP2 (P ＜ 0.05),and no significant change was found in the parameters mentioned above in groups RP1 and RP3 (P ＞ 0.05).The degree of damage to the hepatocytes was significantly reduced in group H/R compared with group RP2,and comparable in groups H/R,RP1 and RP3.Conclusion Preconditioning with the median concentration of remifentanil (5 ng/ml) can reduce H/ R injury to the human hepatocytes,while the low (0.5 ng/ml) or high (50 ng/ml) concentration of remifentanil has no such effect.