OBJECTIVE:To probe into the incidence,latency,clinical features and prevention of the antibiotic-associated diarrhea (AAD). METHODS:968 patients with chronic obstructive pulmonary diseases (COPD) treated with antibiotics in the respiratory department of our hospital were prospectively followed for 30 days immediately after administration of antibiotics. RESULTS:The incidence of AAD was 8.47% (82/968) and the latency of AAD was (8.35?5.19) days. 84.15%(69/82)of the AAD cases manifested as simple diarrhea. The AAD was chiefly induced by cephalosporins (42.68%) and penicillins (23.17%). The incidence of AAD increased markedly if the length of the antibiotic treatment was ≥7 days or if at least 3 kinds of the antibiotics were used concomitantly. After discontinuation or alteration of the antibiotics or administration of microbial ecological agents,metronidazole or vancomycin,71(86.59%) of the total 82 AAD cases were cured,10(12.20%) improved and 1 (1.21%) showed no response. CONCLUSION:AAD is a frequent complication of antibiotic therapy. A powerful measure to prevent AAD is rational use of antibiotics.

Twenty-eight children with laryngeal papilloma aged 10 months -3.5 yr weighing 8-15 kg received CO2 laser treatment under serf-retaining laryngoscope from May 2003 to May 2007. There were 17 patients without laryngeal obstruction, 7 patients with 1st degree laryngeal obstruction and 4 patients with 2rid or 3rd degree laryngeal obstruction. Different techniques of anesthesia were used for patients with different degrees of laryngeal obstruction. In patients without laryngeal obstruction anesthesia was induced with intramuscular ketamine 5 mg/kg. After the patients lost consciousness midazolam 0.1 mg/kg, ketamine 1-2 mg/kg or fentanyl 2 μg/kg was given iv. Tracheal intubation was facilitated with succinyl-cboline 1.5 mg/kg. In patients with 1st degree laryngeal obstruction, ketamine 5 mg/kg was given ira. The patients kept spontaneous breathing. Tracheal intubaiion was pedormed under topical anesthesia with 1% tetracaine. In patients with 2nd and 3rd degree laryngeal obstruction tracheal intubation was performed awake without any premedication under topical anesthesia with 1% tetracaine. The trachea was intubated with the tracheal tube 1 size smaller than the regular size. Anesthesia was maintained with propofol 3-5 mg·kg1·h-1 and intermittent iv boluses of ketamine 1-2 mg/kg and vecuronium 0.05-0. 1 mg/ kg. Dexamethasone 0.2-0.3 mg/kg was given iv at the end of operation. The patients were extubated when the patients regained consciousness and SpO2≥ 96% on air. In one patient with Ist degree laryngeal obstruction emergency tracheotomy was performed during induction of anesthesia. Anesthesia was otherwise smooth and recovery was uneventful.

Objective To study the efficacy of fixation with knee arthroscopy as adjuvant therapy for lateral tibial plateau fracture. Methods 72 cases with lateral tibial plateau fracture of our hospital from September 2011 to September 2014 were divided into experimental group (36 cases) and control group (36 cases), according to different operation method, the experimental group using arthroscopic, while the control group using traditional incision surgery. Then the incision length, operative time, hospital stay, wound healing, bone healing time were compared. Complications, knee function and reduction of the fracture were compared. Results The incision length of experimental group was significantly lower than the control group, the difference was statistically significant (P <0.05). Operative time, hospital stay, wound healing time, the bone healing time were significantly lower than the control group, the differences were statistically significant (P < 0.05). Delay healing, joint stiffness and traumatic arthritis were significantly lower than the control group, the differences were statistically significant (P < 0.05). RASMUSSEN function score and radiographic scores in the experimental group were significantly higher than the control group, the differences were statistically significant (P < 0.05). Conclusion Fixation with knee arthroscopy as adjuvant therapy for lateral tibial plateau fracture has advantages of smaller incision, shorter operative time and hospital stay and healing time, lower complication rate while better reduction of the fracture and function than conventional methods.

liver after i.v. administration. The distribution of osthole in blood and kidney were siginificantly higher( P

Objective To investigate the nursing of cancerous aching in patients during whole body hyperthermia. Methods Seventy patients with malignant tumors were carefully concerned before and after receiving whole body hyperthermia and their responses were recorded. Results The remission rate of aching was 88.55%, and the common side effects were burning of skin, bedsore, and nausea or vomiting. Conclusion The whole body hyperthermia therapy can relieve the cancerous pain, and good nursing can improve the efficacy.

Objective:To investigate the effect of silver diamine fluoride(SDF)on the bonding strength between dentine and glass ion-omer cement(GIC).Methods:1 2 extracted sound molars were prepared into dintine samples and distributed into sound dentine group and demineralized dentine group.According to the treatment methods,the samples in each group were respectively divided into 3 sub-groups:A(control group),B[coated with 38% Ag(NH3 )F2 ]and C(SDF treatment with additional lighting-curing)(n =20).Then a hand-mixed conventional glass ionomer cement Fuji IX was placed on the dentine surface.After 24 h,micro tensile bond strength test and scanning electron microscope (SEM)analysis were conducted.Results:The bonding strength of demineralized dentine was higher than that of sound dentine(P <0.01 ).SDF with additional lighting-curing treated dentine showed a higer bonding strength value than only SDF treated dentin(P <0.01 ).Conclusion:SDF may improve the bonding between dentine and GIC.

Objective To valuate the left ventricular function and myocardial fibrosis using Dopple tissue imaging(DTI) and integrated backscatter(IBS) in diabetic cardiomyopathy(DCM) rats. Methods Diabetes mellitus(DM) in healthy male SD rats was induced by single injection of streptozotocin (STZ,Sigma) into intraperitoneal at a dose of 65mg/kg body weight. Left ventricular fractional shortening (LVFS),ratio of peak early to late diastolic mitral inflow velocity(E/A) by color Doppler flow imaging-pulsed wave (CDFI-PW), ratio of peak early to late diastolic mitral annulus velocity (Ea/Aa) by DTI,myocardial calibrated IBS (IB%), cyclic variation of IBS(CVIB) by IBS, were determined in rats of 4,12 and 24 weeks after DM was induced. Heart weight index(HWI), Masson's trichrome staining, expression of connective tissue growth factor(CTGF) and activity of sarcoplasmic reticulum Ca2+ -ATPase(SERCA2a) in heart were measured, while the age-matched health rats served as control group. Results ① Diastolic dysfunction of left ventricular was found in diabetic rats detected by CDFI-PW(E/A<1) at the 4th week,and developed gradually. Pseudonormal filling(E/A>1) was found in major diabetic rats at the 24th week,which could be identified by DTI(Ea/Aa<1). The IB% of left ventricular posterior wall was significantly higher in diabetic rats than those in the control group( P<0.05), but the CVIB of the 24th week diabetic rats was lower(P<0.05). The LVFS had no great alteration in six groups(P>0.05).②Compared with the control group, the activity of SERCA2a was reduced, while HWI, collagen volume fraction(CVF),perivascular collagen area(PVCA) and the expression of connective tissue growth factor(CTGF) protein in heart were increased in diabetic rats (P<0.05), and correlation between IB% and HWI, CVF, PVCA,CTGF was significant (P<0.05). Conclusions DTI and IBS can assess early left ventrieular diastolic function and fibrosis of diabetic cardiomypathy in STZ-induced diabetic rats. DTI echoeardiography can identify "pseudonormal" mitral inflow patterns. DCM may be relatived with overexpression of CTGF and decreasion of SERCA2a activity.

Objective To investigate the relationship between the changes in intracranial excitatory amino acid(EAA) levels and the incidence of postoperative cognitive dysfunction (POCD) in eldedy patients after general anesthesia. Methods Forty ASA Ⅰ-Ⅲ patients of both sexes aged 65-79 yr weighing 48-76 kg undergoing elective non-cardiac surgery under general anesthesia were studied.Anesthesia was induced with midazolam,fentanyl,etomidate and succinylcholine and maintained with continuous iv infusion of propofol,remifentanil,isoflurane inhalation and intermittent iv boluses of vecuronium.The right internal jugular vein was cannulated with a catheter which was advanced cephalad until jugular bulb.The jugular bulb venous blood samples were taken before (T0,baseline),at the end of (T1) and at 24,48 and 72h(T2-4) after operation for measurement of plasma concentrations of glutamate (Glu),aspartate (Asp) and glycine (Gly) by RP-HPLC.The cognitive function was evaluated by mini-mental state examination (MMSE) at T0 and T4.Results Eleven of the 40 patients developed POCD (28%).The plasma Gh,Asp and Gly concentrations were significantly increased after operation as compared with the baseline values in POCD patients and were significantly higher than in non-POCD patients.The plasma concentrations of Glu and Asp were negatively correlated with MMSE score(Glu:r=-0.86.P<0.01;Asp:r=-0.99,P<0.01).Conclusion Elderly patients may develop POCD after operation performed under general anesthesia through increase in intracranial EAA levels.

Objective To investigate the relationship between hepatic fibrosis stage and clinical serum fibrosis markers in patients with chronic hepatitis B (CHB).Methods Liver puncture biopsy was performed in 189 CHB patients.The serum levels of hyalyronic acid (HA),laminin (LN),procollagen Ⅲ (PCⅢ),collagen Ⅳ (Ⅳ C),liver function and peripheral blood routine were detected simultaneously. The comparison, correlation and regression analysis were performed based on different fibrosis stages (S).Results From SO to S4 group,levels of PC Ⅲ,γ-glutamyl transpeptidase (γ-G-T),total bilirubin (TBil),protein electrophoresis γ-globulin (Ely-γ) and prothrombin time (PT) were progressively elevated,the differences were statistically significant (F value was 3.325,6.218,2.958,10.160 and 7.028,P＜0.05),while cholinesterase (CHE),total protein (TP),albumin (Alb) and platelet (PLT) were progressively declined,the differences were also statistically significant (F value was 15.984,3.768,14.919 and 4.737,P＜0.05).The differences of LN,IVC,ALT and AST between groups were statistically significant (F value was 4.618,2.795,2.649 and 3.199,P＜0.05).Fibrosis stages (s) was positively correlated with LN,PCIII,ALT,AST,TBil,γ-GT,Ep-γand PT (r=0.200,0.306,0.172,0.273,0.153,0.402,0.415,0.269,respectively);while it was negatively correlated with CHE,TP,Alb and PLT (r=-0.502,-0.208,-0.413,-0.390,respectively);I.N,AI.T,CHE,PLT and Ep-γ were the independent risk factors which affecting hepatic fibrosis stages.Conclusions Liver fibrosis stage in histopathology was correlative in certain degree with the serum markers of hepatic fibrosis,liver function,and blood routine examination.Combined analysis of clinical data may be used to early diagnose hepatic fibrosis non-invasively.

Objective To explore the correlation between apparent diffusion coefficient (ADC) and pathological grading and staging of cervical carcinoma.Methods Among 311 patients diagnosed with squamous cell carcinoma,87 patients were met the criteria for inclusion.All the patients were performed routine MR and diffusion-weighted imaging(DWI) with b=1 000 s/mm2 before treatments,and recorded the pathological grading and staging.The ADC values of the lesions were measured on GE AW4.5 workstation,and were compared among the groups with different pathological grading and staging by using LSD and paired t-test.Results The mean ADC value was (0.77±0.079)×10-3 mm2/s in the poorly-differentiated group,(0.88±0.10)×10-3 mm2/s in the moderately-differentiated group,and (1.05±0.084)×10-3 mm2/s in the well-differentiated group.There were significant differences among the different groups (P<0.05).The mean ADC value was (0.84±0.12)×10-3 mm2/s in the stage Ⅰb group, and (0.78±0.12)×10-3 mm2/s in the stage Ⅱa group.The difference was not statistical significance (P>0.05).Conclusion The increasing of the ADC values is correlated with the high levels of tumor cell differentiation, and not correlated with the pathological stages in cervical carcinoma.