Objective: To reveal if the use of antimicrobi als is rational in the authors hospital.　Methods: 1 025 cases were investigated retrospectively by systematic sampling from all the inp atients of the year 1997.　Results: 77.8% of the subjects were treated with antimicrobials, of whom, 55.2% treated with 2 or more antimicr obials. Yet only 39 cases had microbiological test before the administration of antimicrobials.　Conclusion: Inappropriate use of antimicr obials exists in the hospital. The management of the use of antimicrobials and c ontinuing education of medical doctors should be enhanced so as to make the use of antimicrobials more rational.

Objective To investigate the clinical significance of airway hyperresponsiveness and eosinophil(Eos)percentage and level of eosinophil cationic protein(ECP)in induced sputum in patients with asthma during their remission period.Methods Seventy-six patients with asthma during their remission period were selected.Bronchial challenge test was performed and the percentage of Eos and level of ECP in induced sputum were measured by Wrights' stain and Immuno-CAP System,respectively.Thirty patients with asthma during their exacerbation period and twenty healthy subjects were selected as controls.Results In seventy-six patients with asthma during their remission period,sixty-five(85.5%)showed positive bronchial challenge test and eleven(14.5%)patients showed negative bronchial challenge test.The percentage of Eos and level of ECP in induced sputum in patients with asthma during their remission period were 0.071?0.032 and 131.5 ?g/L respectively;those in asthma group during their exacerbation period and healthy group were 0.198?0.103 vs 0.013?0.007 and 355.3 ?g/L vs 48.0 ?g/L,respectively.There was significant difference in the percentage of Eos and level of ECP in induced sputum between three groups(P

Objective To investigate the relationship between cysteinyl leukotriene and clinical response to antileukotriene treatment,and to help select a clinical pharmacologic scheme.Methods Seventy-eight cases with acute mild-moderate asthma were treated with montelukast in a four-week trial.Asthmatic symptom score,usage of ?_2 receptor agonist,percentage of eosinophil,serumal IgE concentration,spirometry and urinary leukotriene E_4(uLTE_4)were measured pre- and post-treatment.Logistic analysis was used to access the various clinical parameters correlated with the response to montelukast.Results There were 48 responders and 30 nonresponders.The uLTE_4 level from the responders was higher than that of nonresponders(P0.05).Subjects with a uLTE_4 level of ≥1 200 pg/mL were11.5 times more likely to respond to montelukast than those with

Objective To investigate the relationship between the number of eosinophil(Eos)and level of eosinophil cationic protein(ECP)in induced sputum and asthma severity and their value of differential diagnosis.Methods From July 2002 to June 2004,59 asthmatic patients were selected in the People Hospital of Wuhan University.The number of eosinophil and level of ECP were measured by Wrights' stain and Immuno-CAP System.The lung function was also evaluated.The same index was measured in 20 patients with COPD and 10 healthy subjects as control.Results The number of eosinophil in induced sputum in asthmatic patients negatively correlated with FEV_1%(r=-0.65,P

Reform was made on traditional education mode based on the criterion of undergraduate medical education at home and aboard.The reform includes the changes in teaching content,teaching methods and assessment methods in an aim to establish independent learning mode,cultivate students' self-study ability,initiative spirit and innovation ability.

In recent years, there has been a comprehensive reform of higher medical education in the Medicine School of Wuhan University. According to the need for reform, the teaching of neurology has to be changed from the traditional form to a new form, and be integrated into the clinical pathophysiology and therapeutics (CPPT) courses. Currently neurology in CPPT takes the form of theoretical lectures, case discussions, combined with practical lessons to observe sections under the microscope and clinical practice, for the cultivation of students'!self-learning ability and clinical thinking. In the commissioning process, it exposes some problems in teaching process due to the characteristics of the course in neurology. For example, the knowledge of neuroanatomy is insufficient and review lessons relatively too short, and the teaching effect may be worse due to the fact that teachers have busy clinic work. In addition, students participate in case discussions with less enthusiasm. To solve these problems, we take some measures to promote teaching reform in neurology, such as increasing the review hours of neuroanatomy section in the CPPT neurology, training a group of specialized medical teachers to enrich and stabilize teacher team, adjusting the content and form of discussion class to improve students'!interest and participation, and increasing assistant jobs by the student to assist discussion teaching.

Plasma level of N-terminal pro brain natriuretic peptide (NT-proBNP) was measured for 362 elderly patients with acute exacerbation of chronic obstructive pulmonary disease (AECOPD), including 97 of AECOPD complicated with left-heart failure and 265 of isolated AECOPD.Results indicated that there was significant difference in plasma level of NT-proBNP between the two groups ( P = 0.000).With a cut-off value of 1643.5 ng/L NT-proBNP, its sensitivity, specificity and accuracy for identifying AECOPD complicated with left-heart failure in the elderly were 84.4%, 85.3% and 85.1%, respectively.It is suggested that assay for plasma NT-proBNP may be helpful to identify left-heart failure in elderly patients with AECOPD.

Objective To investigate clinical significance of small airway function and eosinophil (Eos) percentage,levels of eosinophil cationic protein (ECP) and IL-5 in induced sputum among patients with clinically controlled asthma. Methods Sixty-two patients with clinically controlled asthma were selected for the study. Lung function was performed and percentage of Eos, levels of ECP and IL-5 in induced sputum were measured by Wrights' stain, fluorescence immuno-CAP system and ELISA,respectively. Thirty patients of asthma at acute exacerbation period and 20 healthy subjects were selected as controls. Results In 62 patients with clinically controlled asthma, 43 (69. 4% ) showed abnormal small airway function and 19(30. 6% ) normal one. Percentage of Eos [(5. 6 ±2. 9)%], levels of ECP [( 129 ±100) μg/L] and IL-5 [(21± 12) μg/L] in induced sputum were significantly lower in patients with clinically controlled asthma than those of asthma at acute exacerbation period [( 16. 2 ± 9. 7 ) %, ( 362 ±182) μg/L and IL-5(51 ±26) μg/L, respectively] (all P ＜0. 01 ), but significantly higher than those in healthy controls ( all P ＜ 0. 01 ). Percentage of Eos, levels of ECP and IL-5 in induced sputum were significantly higher in patients with clinically controlled asthma with abnormal small airway function than those with normal ane [(6.9±3.1)% vs. (2.0±1.1)%, (148±90) μg/Lvs. (54±29) μg/L and (24 ±12) μg/L vs. ( 13 ± 5 ) μg/L, respectively] ( all P ＜ 0. 01 ). Conclusions Abnormal small airway function and airway inflammation persistently exist in patients with clinically controlled asthma and it may be helpful to guild treatment during clinical control to determine small airway function and inflammatory markers in their induced sputum.

To explore the clinical significance of changes in maximal expiratory flow in 50％ and 25％ vital capacity (Vmax50％ & Vmax25％) before and after bronchodilator reversibility testing in patients with asthma.Forced expiratory volume in one second (FEV1),Vmax50％ and Vmax25％ were measured before and after bronchodilator reversibility testing in 118 patients with asthma and 82 with chronic obstructive pulmonary disease (COPD).The rate of positive reversibility in Vmax50％ was significantly higher than that in FEV1 in 118 asthmatics (x2 =7.995,P =0.007).The rates of positive reversibility in Vmax50％ and Vmax25％ were significantly higher in asthmatics than those in COPD patients (x2 =9.335,P =0.009).

Objective To study the relationships between serum hepatitis B virus (HBV) DNA level in chronic HBV infected mothers, free maternal DNA in newborns' peripheral blood and HBV infection of newborns. Methods Free maternal DNA in newborns' peripheral blood was amplified by allele-specific polymerase chain reaction (As-PCR) and heminested polymerase chain reaction (heminPCR). Serum HBV DNA of pregnant women were detected by fluorescence quantitative real-time PCR. The relationships between mothers' serum HBV DNA level, mother-to-fetus DNA transfer and newborns HBV infection were analyzed by SPSS 13. 0 software. Results Thirty-six pairs of motherfetus informative cases were selected and free maternal DNA in the peripheral blood was detected in 26newborns (72. 2%). Statistical analysis indicated that mother-to-fetus DNA transfer was not related with HBsAg, HBV DNA DOsitive in newborns (Fisher exact Drobabilities were 0. 278 and 1.000,respectively; both P > 0. 05), while it was related with HBV infection in the peripheral bloodmononuclear cell (PBMC) of newborns (Fisher exact probability was 0. 026, P<0. 05). Freematernal DNA transfer was not related with mother HBV DNA level (X2 = 2. 097, P>0. 05). Therisk of HBV DNA positive in newborns increased with mother serum HBV DNA increasing ( total X= 62. 21, P<0. 05; tendency X2 =58. 46, P<0. 05). There was no relationship between motherserum HBV DNA level and PBMC HBV DNA positive in newborns (total X2 =4. 82, P>0. 05).Conclusions DNA transfer from HBV infected mother to fetus is related with PBMC HBV infection innewborns, which could be a risk factor of HBV infection in newborns. The risk of serum HBV DNApositive in newborns increases with mother serum HBV DNA level increasing.