OBJECTIVE To look into and analyze the application of antibacterial used in our hospital in order to enhance the rationality of clinical usage. METHODS We conducted the survey by means of picking out examples in numbers within a definite range,looking back at the records with regard to it from Jan 2004 to Dec 2004. RESULTS Altogether there were 5 302 medical records.The percentage of using antibacterial was 70.24%,from which 45.22-36.68% were used two kinds and 8.54% were used more than two kinds.As to the basis,preventive use taken up a large proportion,accounted for 48.93%;the main route was by intravenous injection,which added up to 74.03%.Of the antibacterials applied,the first three were penicillins;aminoglycosides;cephalosporins.The percentage for surgical application was 94.49%,from them 57.14% used 2 or more kinds for treatment of incision of type Ⅰ. CONCLUSIONS It is very necessary and urgent to supervise the management of the rational application of antibacterial.

Objective To assess the reliability and validity of Chinese version National Aeronautics and Space Administration Task Load Index (NASA-TLX) and Subjective Work Assessment Technique (SWAT) in evaluating mental workload of community physicians.Methods One hundred and ten community physicians selected by convenience sampling method from Shanghai were recruited.The split-half reliability,Cronbach's α coefficient and Item-total coefficients were adopted to assess the reliability and the validity of Chinese version NASA-TLX and SWAT scales in evaluating the metal workload of participants.Results For NASA-TLX,the Split-Half,Cronbach's α coefficient was 0.703 and 0.619 respectively,all Item-total coefficients (except for performance item) were greater than 0.4 (P ＜ 0.01).For SWAT,the Split-Half,Cronbach's α coefficient of was 0.647 and 0.669 respectively,Item-total coefficients were all greater than 0.4 (P ＜ 0.01).Factor analysis showed that two scales had good structure validity; item discrimination showed satisfactory item validity (except for performance item).The Spearman correlation coefficients between two scales ranged from 0.359 to 0.465 (P ＜ 0.01).Both of the modified versions of NASA-TLX had better reliability and validity than the original one,the one with removed both performance and frustrate item was better than one with removed performance item only.Conclusions The Chinese version NASA-TLX and SWAT can serve as reliable and valid instruments for assessing the community physicians' perception of mental workload in China; and the modified version of NASA-TLX especially the one with removed performance and frustrate item seems to work better than the original one.

Objective To investigate the factors related to choice of community health service centers (CHSCs) in standardized training general practitioners (GPs) in Shanghai.Methods Totally 152 GPs,(including those of Traditional Chinese Medicine) who completed the residency training in 2013 and signed employment contract with community in Shanghai were surveyed with a self-designed questionnaire.Results Among all the participants,113 (74.3％) attached the greatest importance to the salary level when choosing CHSC,58 (38.2％) expected annual salary more than 120 000 Yuan during the first 3 years.GPs tended to work in the city center(40.1％) or CHSCs near to their home(38.2％),mainly because of the job commuting (59.9％).Considering career development,the CHSCs with high level comprehensive service (51.3％) and with large population (5.0％) were more attractive.GPs paid more attention to the national demonstration community (57.2％) and CHSCs with member ofShanghai outstanding young physician training program(51.7％).In this survey,household register was the main influencing factor for choosing CHSCs,Shanghai natives paid more attention to the location of the community than those not Shanghai natives (61.8％ vs.34.2％),more inclined to CHSCs that close to their house (55.3％ vs.21.1％),non-Shanghai natives preferred authorized strength (51.3％ vs.28.9％).GPs of Western medicine expected higher salary than GPs of TCM (x2 =13.648,P ＜ 0.05),Males expected higher salary than females (x2 =7.799,P ＜ 0.05),Conclusions GPs pay the most attention on salaries and tend to work in the city central area,prefer CHSC with high level comprehensive service and large served population.The main factor influencing GPs to chose CHSCs is the household register,the category of Gps and gender.

The spermatic granuloma is a granulomatous inflammation which is the tissue reaction due to extravasated sperm. Its exact causes and mechanism are not clearly evaluated. Its clinical interest is that it often confused with tuberculous epididymitis and other epididymal conditions. We experienced a case of spermatic granuloma that was clinically confused with tuberculous epididymitis in 23-year old Korean male.
Epididymitis ; Granuloma* ; Humans ; Inflammation ; Male ; Spermatozoa ; Young Adult

OBJECTIVETo analyze the electrical activity property changes in nucleus accumbens (NAc) of heroin-induced conditioned place preference (CPP) rats during different stages of heroin dependence and to explore NAc's roles in the formation of drug dependence.

METHODSRecording electrodes were bilaterally embedded into the NAcs of rats with the aid of stereotaxic apparatus, followed by establishment of heroin-dependent rat model. The NAc electrical activity during 3 different stages of heroin dependence, including heroin pre-exposure, immediate post-exposure and heroin withdrawal, were respectively recorded using EEG wireless telemetry techniques. The frequency distribution (ranging from 0.5 to 30 Hz) and the amplitude of NAc electrical activity were analyzed and measured.

RESULTSHeroin-dependent rat models were successfully established and their withdrawal symptoms were evident. All rats showed a conditioned place preference (CPP) for the white box after 5-10 days of heroin-exposure, and displayed a maximum withdrawal symptoms on 2d after heroin- withdrawal. During all statges of heroin-dependence, the NAc electrical activity contained the highest proportion of delta rhythm and the lowest proportion of alpha2 rhythm. The discharge frequence band was similar across different stages. There was a significantly increased ratio of low-frequency discharges (delta rhythm) and decreased ratio of high-frequency discharges (beta rhythm) in NAc of rats during the immediate post- heroin exposure stage when compared with that during pre-exposure and heroin withdrawal stages. During the withdrawal stage, the ratio of at rhythm was significantly lower than during pre- and post-heroin exposure stages (P < 0.01). Further, the mean discharge amplitude in NAcs during immediate post-exposure and withdrawal stages was significantly increased relative to pre-exposure stage. However, the mean discharge amplitude during heroin withdrawal stage was significantly lower than during immediate post-exposure stage.

CONCLUSIONThe electrical activity properties in rat NAcs showed a significant change during different stages of heroin-dependence, which suggested that neuronal activities in NAcs might contribute to the modulation of drug-dependence.

Animals ; Conditioning, Operant ; Heroin ; pharmacology ; Heroin Dependence ; physiopathology ; Male ; Nucleus Accumbens ; physiopathology ; Rats ; Rats, Sprague-Dawley ; Telemetry

OBJECTIVETo study the correlation between EEG characteristics of medial prefrontal cortex (mPFC) and drug-seeking behavior of rats with morphine dependent place preference under shuttling condition.

METHODSForty rats were randomly divided into four groups (n = 10): morphine PL group, NS PL group, morphine IL group and NS IL group. After embeding the electrode in prelimbic (PL) or infralimbic (IL) cortex of each group by brain stereotaxic operation, the model of morphine dependent conditioned place preference (CPP) in rats was established. The differences of EEG wave percentage in mPFC were telemetered and analyzed when rats shuttled before and after the model.

RESULTSAfter the model, the withdrawal symptoms were evident in morphine PL and IL group, and the activity time and distance in white box were increased obviously. Compared with control group, after the model, the EEG in morphine PL group showed that: when the rats shuttled to white box, 8 wave decreased obviously, P wave increased obviously. When the rats shuttled to black box, brain waves showed opposite changes. The EEG in morphine IL group showed that: when the rats shuttled to white box, a wave increased obviously, P and a wave decreased obviously. When the rats shuttled to black box, the brain wave had no significant differences compared with control group.

CONCLUSIONThe EEG changes are different in PL and IL cortex of morphine CPP rats under shuttling condition, and the EEG changes are also different when rats shuttling to white or black box. There is possibly different mechanism, when different drug-seeking environmental cues caused EEG changes in different regions of mPFC.

Animals ; Conditioning (Psychology) ; Cues ; Drug-Seeking Behavior ; Electroencephalography ; Morphine Dependence ; physiopathology ; Prefrontal Cortex ; physiopathology ; Rats ; Telemetry

The Klinefelter's syndrome is characterized by azoospermia, gynecomastia, a variable degree of eunuchoidism elevated urinary gonadotropins, atrophic testis and hyalinization of the seminiferous tubules in which Leydig cells were preserved. Reviewing some world literatures, we have reported a case of Klinefelter's syndrome associated with right inguinal hernia in 22 year-old Korean male.
Azoospermia ; Eunuchism ; Gonadotropins ; Gynecomastia ; Hernia, Inguinal ; Humans ; Hyalin ; Klinefelter Syndrome* ; Leydig Cells ; Male ; Seminiferous Tubules ; Testis ; Young Adult

Objective To investigate the roles of phosphatidylinositol 3 kinase (PI3K) and phosphorylated Akt (P-Akt) in the pathogenesis of cervical squamous cell carcinoma and condyloma acuminatum.Methods Immunohistochemistry and Western blot were used to detect the expressions of PI3K and P-Akt in tissue specimens from the lesions of 30 cases of cervical squamous cell carcinoma,30 cases of condyloma acuminatum and the prepuce of 15 normal human controls.The average optical density and gray scale values were calculated and analyzed by t test and F test respectively.Results The expressions of PI3K and P-Akt were observed in only the basal layer of the epidermis of control specimens,but in the whole epidermis of condyloma acuminatum tissue specimens.Cervical squamous cell carcinoma tissue specimens displayed a stronger expression of PI3K and P-Akt compared with the control and condyloma acuminatum tissue specimens.As immunohistochemistry revealed,the average absorbance value for PI3K and P-Akt was 0.28 ±0.05 and 0.20 ± 0.07 respectively in cervical squamous cell carcinoma tissue specimens,0.22 ± 0.04 and 0.17 ± 0.03 respectively in condyloma acuminatum tissue specimens,and 0.16 ± 0.04 and 0.10 ± 0.02 respectively in the control tissue specimens; significant differences were observed in the expressions of PI3K and P-Akt among the three groups of tissue specimens (F =44.87,20.64,respectively,both P ＜ 0.01 ).The results of Western blot were consistent with those of immunohistochemistry,and there was a significant difference in the gray scale value for PI3K and P-Akt between cervical squamous cell carcinoma,condyloma acuminatum and control tissue specimens (3.48 ± 0.48 vs.1.99 ± 0.11 vs.1.00 ± 0.03,F=354.83,P＜ 0.01; 3.33 ± 0.26 vs.1.96 ± 0.11 vs.1.00 ± 0.03,F=302.33,P＜ 0.01 ).Conclusions The PI3K/Akt signaling pathway is abnormally activated in condyloma acuminatum and cervical squamous cell carcinoma,and human papilloma virus may cause the abnormal proliferation of infected epithelium likely by affecting the upregnlated expression of PI3K/P-Akt.

Objective To investigate the effects of enteral nutrition (EN) for diabetes mellitus on the clinical outcomes of critically ill patients with hyperglycemia.Methods Sixty-four critically il1 patients with hyperglycemia were randomly divided into the control group and intervention group.The control group was given homemade homogenized meals and the study group was given EN for diabetes mellitus.Both were given the same total energy and nitrogen content.EN was applied 3 days after ICU admission and then lasted 14 days.Blood glucose was controled at 6.1-8.5 mmol/L by insulin therapy.No albumin,blood plasma,or parenteral nutrition was provided to all patients.The lactulose mannitol ratio,biochemical indicators,total insulin dosage,and short-term and longterm outcomes were analyzed before and after EN support.The quality of life was evaluated using Stroke Specific Quality of Life Scale.Results Finally 59 patients were enrolled in the study,with 30 in the intervention group and 29 in the control group.The lactulose mannitol ratios in the intervenion group were significantly lower than those in the control group 7 days (0.221 ±0.117 vs.0.299 ±0.154,t =-2.199,P =0.032) and 14 days (0.169 ±0.122 vs.0.305 ±0.129,t =-4.191,P =0.000) after EN support.Meanwhile,the total insulin dosages were also significantly less in the intervention group [7 days,(195 ± 54) vs.(227 ± 60) U ; t =-2.096,P =0.041 ;14 days,(392 ±114) vs.(459 ±118) U; t =-2.221,P =0.030].Compared with the control group,the intervention group had significantly shorter duration of mechanical ventilation [(8.00 ± 1.75) d vs.(6.73 ±2.05) d,t=-2.547,P=0.014] and ICU stay[(10.00±1.95) vs.(8.80±2.17) d,t=-2.233,P=0.030],lower total hospitalization expenses [(56 238.39 ± 17 869.61) vs.(70 395.63 ±20 111.69) Yuan,t =-2.861,P =0.006],and faster recovery of daily activities [(17.59 ± 3.21) vs.(35.34 ± 8.65) scores,t =10.030,P =0.000] and living quality of life [(22.67 ± 4.51) vs.(40.55 ± 8.88) scores,t =9.397,P =0.000] after 90 days of treatment.Conclusion The EN for diabetes mellitus may improve the outcomes of critically ill patients with hyperglycemia compared with blend diet.

Objective To explore the CT and MRI manifestations and clinical features of juxtaglomerular cell tumor (JGCT). Methods A retrospective analysis the data of eight JGCT patients who resected by surgery and comfirmed by histopathology. Seven cases were examined by CT before operation, five of whom underwent CT scan and dynamic enhanced scan, two of whom underwent CT scan, and all of the eight underwent MRI scan and dynamic enhanced scan. The clinical manifestations of patients were also observed, whether they have hypertension and reduced blood potassium, recorded the results of lying and standing test, and collected the segmental renal vein blood to detect the renin levels. Meanwhile, the CT and MRI manifestations were also recorded. Results (1) We found that all of the eight patients appeared hypertension, and hypokalemia were found among five cases. Seven patients proceeded the lying and standing test, six of whom the plasma renin activity (PRA) were elevate in erect position, and the levels of angiotensin Ⅱand aldosterone (ALD) were rised among all of the seven cases in erect position. Four patients were collected the segmental renal vein blood, and one of whom has positive result of the renin activity. (2) The tumors of all the eight cases were single, the border was clear, and the average size was 2.7 cm (range 1.9 to 3.8 cm). The CT scan results showed there's no calcification or pseudocapsule were detected, four cases showed homogeneous iso-density, one case with slightly high density, another one showed low density with dotty high density and one case with low density. The dynamic enhanced CT scan showed that four cases performed continuous enhancement from cortical to medullary phase, and no obvious enhancement was found in one case. The T2WI results of MRI scan showed six cases had pseudocapsule, 6 cases had heterogeneous signal (4 cases with patchy low signal and 2 cases with patchy high signal), and 2 cases had homogeneous signal (one case with iso-high signal and another with high signal). The T1WI results showed two cases performed low signal, anther two cases showed iso-signal, and four cases with heterogeneous signal. The DWI results showed all of the 8 lesions with homo-or peripheral high signal. The dynamic enhanced MRI scan results showed seven cases performed gradual enhancement, and the border of another case became clear on delay phase. Conclusions JGCT has specific clinical and imaging features, and the combination will help make a correct diagnosis.