OBJECTIVE:To evaluate the rational use of antimicrobials in 160 cases undergoing orthopaedic operations.MET_HODS:To analyse and evaluate the use of antimicrobials in 160 cases undergoing orthopaedic operations in 1999 in respect to the cost of antimicrobials related cost ratio,usage,clinical efficacy,and adverse drug reactions.RESULTS:The cost of antimicrobials per person()was 1 676.55 yuans and average day of treatment()was (7.3?3.4)d.151 patients healed by first intension.9 patients recovered in delayed healing.The ratio of the total cost,cost of drugs and cost of antimicrobials was 1∶0.38∶0.14.CONCLUSION:The use of the antimicrobials in 160 cases undergoing orthopaedic operations was reasonable.

Objective To investigate the clinical manifestations,laboratory findings and genetic characteristics of two cases with simple virilizing (SV)21-hydroxylase(21OHD). Methods Clinical manifestations and laboratory data were obtained. The promoter and coding areas of CYP21A2 gene were directly sequenced. In silico analysis were used to predict the function of mutations. Results Two patients presented severe virilism. The laboratory examinations showed that plasma ACTH,aldosterone,androstendione and testosterone were significantly increased compared with normal individuals. VCT scan showed hyperplasia of bilateral adrenal. Direct sequencing of CYP21A2 gene showed two complex mutations-H62L/V69L and I2g/10InsL,which were not reported previously. In silico analysis(Polyphen)showed the novel mutation V69L could probably damage the function of CYP21A2 protein. Conclusion The combined mutations,H62L/V69Land I2g/10InsL,could be associated with SV type 21-OHD phenotype.

OBJECTIVE:To establish a method for the simultaneous determination of chlorogenic acid and vitexin in Lophather-um gracile. METHODS:HPLC was performed on the column was Waters Atlantis C18 with mobile phases of acetonitrile- water (gradient elution)at a flow rate of 1.0 ml/min,detection wavelength was 280 nm,column temperature was 35 ℃,and the injec-tion volume was 10 μl. RESULTS:The linear range was 0.041 0-1.228 8 μg for chlorogenic acid(r=0.999 8)and 0.264 0-7.920 0μg for vitexin(r=0.999 9);RSDs of precision, stability and reproducibility tests were lower than 2%;recoveries were 97.6%-102.3%(RSD=1.85%,n=9) and 97.1%-101.3%(RSD=1.19%,n=9),respectively. CONCLUSIONS:The method is simple,stable and reproducible,and can be used for the simultaneous determination of chlorogenic acid and vitexin in L. gracile.

Objective:To explore the effectiveness of comprehensive care and help system to promote the rehabilitation of patients with depression,through the case study of 1 typical college student with depression.Method:Through the establishment of the community network support system:teacher's home visits and talk,professional counseling,love and support from dormitory roommates,classmates and relatives,we provided a three-in-one community comprehensive support system and comprehensively used health education,social support,cognitive therapy and other methods,in order to promote the rehabilitation of patients with depression.Results:Through the systematic and scientific comprehensive care,the patient basically freed from the shadow of depression and put into the clinical practice with a positive attitude.Conclusion:Comprehensive Care Education is possible to promote the rehabilitation of college students with depression.

Objective Surgical treatment of lung cancer needs to follow strict quality control standard for the aims of accuracy of pathological staging and potentially improved prognosis.However,there are short of studies related to surgical quality analysis.Methods One hundred and twelve patients were enlisted with the diagnosis of lung cancer and received surgical intervention in 2007.Surgical quality of these cases were retrospectively analyzed in compliance with three international standards,National Comprehensive Cancer Network (NCCN),American College of Surgeons’ Oncology Group (ACOSOG),and International Association for the Study of Lung Cancer (IASLC).Results No surgical death was reported in this group.According to NCCN,ACOSOG and IASLC standards,qualified operations were 82 cases (80.4％),73 cases (71.6％),45 cases (44.1％) in 102 cases with R0 resection,respectively.The median total lymph nodes,median mediastinal nodes,and N1 nodes were 27 (range 0-63),16.5 (range 0-43),and 10.5 (range 0-26),respectively.The median mediastinal node stations resected were 4 (range 0-6).In the mediastinum,stations of 4R,5,6 and 7 presented the highest frequency of receiving lymph node dissection.For N1 stations,10 and 12 were among the top list.For the whole group,1-year survival,3-year survival and 4-year survival were 92％ (95％ CI,89-95),67％ (95％ CI,62-72),57％ (95％ CI,52-62),respectively.Conclusion Quality control is the essential part of surgical treatment of lung cancer,which will facilitate the baseline standardization of clinical research.Since IASLC provides the strictest standard for lung cancer surgery,we suggest that all thoracic surgeons need to follow this standard to secure the accuracy of pathological diagnosis and for a potential better prognosis.

Objective To conduct an empirical analysis of constitutes and changes of type 2 diabetes patients′ hospitalization expenses and find out the differences and influencing factors so as to provide hospitals and related departments with the decision basis of controlling medical costs, arranging medical resources and optimizing systems.Methods Information of type 2 diabetes patients who had been admitted to a certain first-class grade one hospital in Ningxia from 2013 to 2016 were collected and categorized.Hospitalization costs and influencing factors of the patients were comprehensively analyzed through descriptive statistics, variance analysis and regression analysis.Results The medicine and examination costs as the constitutes of hospitalization expenses were too high.Gender, length of stay, age and diabetic complications were main contributory factors of type 2 diabetes patients′ hospitalization expenses.Conclusion The costs of hospitalization of patients with type 2 diabetes are unreasonable and need to optimize.Type 2 diabetes patients′ hospitalization expenses should be effectively controlled and medical resources should be reasonably used through standardizing treatment behavior, shortening length of stay, intensifying publicity and education, enhancing prevention and reinforcing follow-ups, expanding health insurance coverage and upgrading its level.

Objective To compare the curative effect of nasal intermittent positive pressure ventilation (nIPPV ) and nasal con-tinuous positive airway pressure (nCPAP) method .Methods Retrospective study was took on 196 neonatal infants ,all cases were assigned into nIPPV group (n=102) and nCPAP group (n=94) according to mode of ventilation from January 2011 to December 2012 in a neonatal intensive care unit of this hospital .The ratio of requirement for endotracheal ventilation and the outcome were in-vestigated .Results Infants treated initially with nIPPV need less endotracheal ventilation and ventilation time than those treated with nCPAP (11 .8% vs .24 .5% ,P<0 .05) .Conclusion Compared with nCPAP ,nIPPV decreased the requirement for endotrache-al ventilation in neonatal infants after extubation .

Objective: To analyze the relationship between thrombin activatable fibrinolysis inhibitor ( TAFI ) and coronary heart disease ( CHD ), and to provide evidence for the prevention of CHD. Methods: The patients with CHD in Fushun Central Hospital in Liaoning Province were selected as the case group, the patients without CHD in the same hospital and period were selected as the control group. The demographic information and clinical examination results ( serum TAFI, lipid, glucose, etc. ) were collected to analyze the association between TAFI and CHD by logistic regression models.The multivariate logistic regression analysis was used to explore the relationship between TAFI and CHD. Results: There were 222 cases, including 100 cases of stable angina, 44 cases of unstable angina and 78 cases of acute myocardial infarction, and 222 controls. The median ages of cases and controls were 62 and 57 years old. The results of multivariate logistic regression analysis showed that serum TAFI>22.88 μg/mL ( P75 of controls ) was associated with the risk of CHD ( OR=1.619, 95%CI: 1.011-2.593 ), unstable angina ( OR=2.917, 95%CI: 1.433-5.939 ) and acute myocardial infarction ( OR=2.626, 95%CI: 1.007-6.847 ). Conclusion The high level of TAFI is related to CHD, unstable angina and acute myocardial infarction.

BACKGROUND:Dendritic cel s can regulate the immunological reaction in the intestinal tract, this functional deficit may induce inflammatory bowel disease. Tol-like receptor-4/nuclear factor-κB pathway is highly involved in this reaction. OBJECTIVE:To establish experimental colitis model in rats, to observe effects of resina draconis on dendritic cel s and Tol-like receptor-4/nuclear factor-κB expression in rats with experimental colitis, and to explore its action mechanism. METHODS:A total of 44 male Sprague-Dawley rats were randomly assigned to four groups (n=11):blank control group, model group, resina draconis group, 5-aminosalicylic acid treatment group. With the exception of blank control group, 2,4,6-trinitrobenzenesulfonic acid-induced ulcerative colitis models were established in the model group, resina draconis group and 5-aminosalicylic acid treatment group. After the models were successful y established, the rats in the resina draconis and 5-aminosalicylic acid treatment groups were intragastrical y treated with resina draconis [(0.75 g(kg·d)] and 5-aminosalicylic acid [100 mg(kg·d)] respectively for 10 days. RESULTS AND CONCLUSION:Disease activity index, macroscopic colonic damage score and histopathological score were significantly decreased in the resina draconis group compared with the model group (P<0.05). Symptoms and tissue damages were obviously lessened in the 5-aminosalicylic acid treatment and resina draconis groups compared with the model group. Expression rates of CD80 and CD86, as wel as expression levels of Tol-like receptor-4 and nuclear factor-κB were significantly higher in the model group compared with the blank control group, resina draconis group and 5-aminosalicylic acid treatment group (P<0.05, P<0.01). Tol-like receptor-4 and nuclear factor-κB expression was significantly lower in the resina draconis group than that in the 5-aminosalicylic acid treatment group. Experimental findings indicate that, resina draconis can partial y relieve experimental colitis symptoms in rats and effectively inhibit the activation of dendritic cel s in the mesenteric lymph node. Resina draconis can relieve enteric inflammatory reaction by suppressing the expression of Tol-like receptor-4 and nuclear factor-κB in rats.

Lymphocyte function associated antigen-1 (LFA-1) is a member of integrin family, that plays an important role in the adhesion of lymphocytes with other cells and matrix. To investigate the role of LFA-1 in collagen-induced arthritis (CIA), the incidence of CIA, histological and radiological assessments in the LFA-1 deficient (LFA-1~ -/- ) mice and control mice were examined. LFA-1~ -/- mice and control mice were immunized with 100?g collagen type II(CII) emulsified with an equal volume of Freund’s complete adjuvant (CFA), followed by the booster injection of the same amount of CII in CFA on day 21. Then, clinical, histological and radiological assessments were done. It showed that 57% control mice developed arthritis and apparently changed in the histological and radiological assessment, whereas the all of LFA-1~ -/- mice had the normal histological and radiographic response and none developed arthritis. These results suggeste that LFA-1 is indispensable for the onset of CIA.