OBJECTIVE:To probe into the perioperative prophylactic use of antibiotics in township hospitals. MENTHODS:A total of 100 perioperative medical records in 10 township hospitals were randomly sampled from Jan. to Jun. in 2008 for retrospective analysis of the perioperative prophylactic use of antibiotics in respect of the drug kinds,drug application frequency,medication duration and drug combinations,etc. RESULTS:All of the patients received prophylactic antibiotics and the use of antibiotics was characterized by high starting point,widespread drug combination,lacking of consciousness of preoperative use of antibiotic in the initial medication time and prolonged medication duration. CONCLUSION:In order to standardize perioperative use of antibiotics and decrease incidence of adverse drug reactions and drug resistance,it is important to strengthen the training and supervision on the rational use of antibiotics among clinicians and pharmacists in township hospitals.

Objective Arrhythmias are one of the main causes of postoperative morbidity after thoracic surgery.The aim of this study was to evaluate whether video-assisted thoracoscopic surgery decreases the risk of postoperative arrhythmias compared with traditional open lung lobectomy.Methods 138 consecutive patients were enrolled from January 2011 to February 2012,after five age and risk factors matched,68 patients undergoing video-assisted thoracic surgery and 70 patients undergoing traditional open lung lobectomy were eligible for analysis.The rhythm was documented preoperatively and postoperatively with standard electrocardiogram (ECG) recording and ECG monitoring.All patients followed 3 months after hospital admission.Results There was a 17.6％ incidence (12/68) of postoperative new-onset arrhythmias undergoing video-assisted thoracic surgery and 18.6％ of patients (13/70) undergoing thoracotomy,but the difference was not statistically significant.In both groups,atrial fibrillation was the most common arrhythmia (60％).There was no significant difference in the other morbidity (P ＞0.05) and mortality rate(P =0.57,1.5％ vs 2.9％) between the two groups.Conclusion New-onset arrhythmias,most frequently atrial fibrillation,are common after lung lobectomy.Regardless of surgical approach,postoperative arrhythmias after lobectomy occurred with equal frequency.New insights in the pathophysiology of postoperative thoracic arrhythmias and advances in prevention and therapy are need future study.

Objective:To explore therapeutic effect of atorvastatin on inflammatory factor levels and vascular endothelial function in patients with coronary heart disease (CHD).Methods: A total of 112 CHD patients treated in our hospital were selected.According to random number table, they were randomly and equally divided into routine treatment group and atorvastatin group, and both groups were treated for eight weeks.Serum levels of inflammatory factors and vascular endothelial function before and after treatment, angina pectoris and ECG therapeutic effect after treatment, and incidence of adverse reactions during medication were compared between two groups.Results: Compared with before treatment, after treatment, there were significant reductions in serum levels of interleukin (IL)-6, tumor necrosis factor (TNF)-α, C reactive protein (CRP), intercellular adhesion molecule (ICAM)-1 and endothelin (ET)-1, and significant rise in nitric oxide (NO) level, left ventricular ejection fraction (LVEF) and cardiac output (CO) in both groups,P<0.01 all;compared with routine treatment group after treatment, there were significant reductions in serum levels of IL-6 [(157.42±30.13) pg/ml vs.(129.83±27.31) pg/ml], TNF-α [(25.41±2.67) ng/L vs.(21.38±2.13) ng/L], CRP [(19.87±2.78) mg/L vs.(17.13±2.04) mg/L], ICAM-1 [(81.23±19.83) pg/ml vs.(64.31±15.46) pg/ml] and ET-1 [(1.45±0.34) pg/ml vs.(0.87±0.23) pg/ml], and significant rise in NO level [(53.27±5.31) mmol/L vs.(58.72±5.46) mmol/L], LVEF [(52.37±5.38)% vs.(63.19±5.79)%] and CO [(4.58±0.78) L/min vs.(5.13±0.82) L/min] in atorvastatin group, P<0.01 all.Compared with routine treatment group, there were significant rise in total effective rates of angina pectoris (73.22% vs.89.29%) and ECG (66.07% vs.83.93%) in atorvastatin group, P<0.05 both.There were no serious adverse drug reactions in two groups.Conclusion: Atorvastatin can significantly improve inflammation state and vascular endothelial function in patients with coronary heart disease.

Objective To evaluate the clinical outcome of operative management of displaced intraarticular fractures of the calcaneus using locking plates. Methods From October 2004 to October 2006, 34patients with close displaced intraarticular fractures of the calcaneus were fixed with Calcaneal locking Plates through the extensive lateral approach. The right foot was involved in 20 patients. The mean age was 34 yesrs with a range of 19 to 42 years. Accordiing to Sanders' classification system, there were 16 patients in style Ⅱ and 18 in style Ⅲ The mean interval between injury and operation was 13 days Standard reduction and fixation techniques were performed to realign all components of the intra-articular calcaneal fracture using a locking calcaneal fracture plate. The result were evaluated with AOFAS (American Orthopaedic Foot & Ankle Society) ankle-hindfoot scale. Results Twenty-eight patients were followed up. The follow-up duration ranged from six to forty months, with the mean of twenty months. angle and were measured at, The average B(o)hler angle was 29° and 30° and the average Gissane was 122° and 125° seven days and three months after operation. Bone union was achieved in all cases. All incisons had healed smoothly. No patient sustained lateral impingement syndrome or soft tissue complications The mean AOFAS scores that was measured three months and six months after operation was 74. Conclusion The application of the calcaneal locking plates through extended lateral approach is proved to be an effective treatment for displaced intra-articular calcaneal fracture, offering the combination of good reduction and early rehabilitation.

The distribution of the ACTH_(1-39)-immunoreactive neurons in the hypotha- lamus of 4 human adults was examined with ABC immunocytochemical method. The results showed that in addition to ACTH_(1-39)-immunoreactive neurons found in the infundibular nucleus of the hypothalamus which were identical with the previous reports, negafivt ACTH_(1-39)immunoreactive neurons were also found in paraventricular and supraoptic nuclei. These cell bodies were round or elliptic in shape. More negative ACTH_(1-39)immunoreactive fibers were seen in the periventricular layer, paraventricular nucleus and dorsal area of supraoptic nucleus.

Object To observe the effect of total flavones isolated from Metasequoia glyptostroboides Hu et Cheng (FMG) on platelet aggregation, 5 HT of release, content of NO in plasma and hemorrheological parameters in rats. Methods Platelet aggregation was quantified by turbidimetry, release of 5 HT was assayed by fluorescence technique, and content of NO in plasma was determined by spectrophotometry. Results Inhibition of platelet aggregation and release of 5 HT, increase of NO content in plasma, as well as decrease of whole blood viscosity, plasma viscosity, red cell electrophoresis time, red cell specific volume, red cell count and K value in ESR equation were observed in the acute blood stasis rat, thereby the rat's hemorrheological properties were improved. Conclusion FMG is able to inhibit the platelet aggregation and improve the hemorrheological parameters in acute blood stasis rat. The inhibition of release of 5 HT, increase of NO content in plasma and antagonistic action of Ca 2+ may be the mechanism of its actions.

Objective To investigate the effects of RNA interference (RNAi) on Caspase-3 expression.Methods According to the gene sequence and the secondary structure characteristics of Caspase-3, three siRNA （Si-Caspase-3-1, Si-Caspase-3-2 and Si-Caspase-3-3） were designed with 21 basic group, and siRNAs against Caspase-3 gene were synthesized. With the liposome conduct, the synthesized siRNAs were transferred into neuroglia cells. After the cells crept the slices, cells were dyed with fluor Hoechst33258; the apoptotic cells were stained with TUNEL, the normal neuroglia cells were as control, the Caspase-3 protease activity were detected with hemi-quantitative RT-PCR and Western blot.Results The synthesized siRNAs could inhibit the expression of Caspase-3 gene. For Si-Caspase-3-3, the expression inhibition rate of Caspase-3 mRNA was 86.32% in neuroglia cell.Conclusion The synthesized siRNAs can inhibit the expression of Caspase-3 gene at cell level.

Objective To explore the effect of 1,25-dihydroxyvitamin D3 [1,25-(OH)2VitD3] on insulin resistance and inflammatory response in mice with severe burns under stress. Methods One hundred and thirty mice were randomly divided into healthy group (n=10), experimental groupⅠ(n=40), experimental groupⅡ(n=40) and control group (n=40). The model mice were scalded to 30%of total body surface area (TBSA) burnt (Ⅲ°) in experimental groupⅠ, the experi-mental groupⅡand control group. Mice in experimental groupⅠwere given by gavaging 1,25-(OH)2VitD3 (1μg·kg-1) with 0.6 mL peanut oil at 8 am for every other day. At the same time and by the same way, mice in experimental groupⅡreceived 1,25-(OH)2VitD3 (4μg·kg-1) with 0.6 mL peanut oil, and mice in control group received only 0.6 mL peanut oil. The serum levels of fasting blood glucose (FBG), fasting insulin (FIns), TNF-αconcentration, and the NF-κB positive rate in wound tis-sues were determined respectively on day1, day3, day7 and day14 after burn. Results (1) The values of insulin resistance index (HOMA-IR), serum TNF-αand the NF-κB positive rate in wound tissues were higher at different time points in exper-imental groupⅠ, experimental groupⅡand control group than those in healthy group. (2) The levels of HOMA-IR at the same time points were significantly lower in experimental groupⅠand experimental groupⅡthan those in control group, and the value was significantly lower in experimental groupⅡthan that of experimental groupⅠ(P<0.05). The level of HOMA-IR was the highest at day 3 and then gradually decreased at the different time points in the same group (P<0.05). (3) The se-rum levels of TNF-αand NF-κB positive rate of wound tissues at the same time points were significantly lower in experimen-tal group Ⅰand experimental group Ⅱ than those in control group, and the value was significantly lower in experimental groupⅡthan that of experimental groupⅠ(P<0.05). The serum level of TNF-αand NF-κB positive rate of wound tissues were gradually decreased at the different time points in same group (P<0.05). Conclusion 1,25-(OH)2VitD3 can reduce the insulin resistance and inflammatory response in mice with severe burns under stress.

A 54-year-old man diagnosed with chronic lymphocytic leukemia (CLL) was admitted in our department in June 2014. After one cycle of FC chemotherapy, a bone marrow examination revealed normalized lymphocyte count and another acute myeloid leuke-mia (AML)-M5 clone. The patient refused sequential treatment and only received follow-up examination. He had continuous hemato-logically stable disease and died of pulmonary infection on July 2015. After a multidisciplinary team discussion, we confirmed the si-multaneous diagnosis of CLL and AML-M5. Through this discussion,tumor second hit model,tumor evolution model,andtumor heterogeneitywere further defined.

The‘eighteen clashes’and‘nineteen fears’have been tought of traditional prohibited combination in long time,but many examples show ginseng and trogopterus dung could be safely used after compatibility,so many scholars fouce on the essential of compatibility.While people can not reach an accordant consideration for compatibility of Ginseng with Trogopterus Dung,therefore we have a overview based on documents for about 30 years,which will provide evidences for researching systematically on the nature of compatibility of Ginseng with Trogopterus Dung.