OBJECTIVE To investigate and analyze the application of prophylactic antibiotics in perioperative period in hospital and offer the scientific basis for reasonable usage and management of antibiotics through surveying the situation.METHODS Totally 120 cases under operation were investigated prospectively from Jan to Aug in 2007.RESULTS The rate of antibiotics usage was 100% among the 120 cases.40% of the patients received single antibiotic treatment,56% and 4% received 2 or 3 kinds of antibiotics combined therapy respectively.The rate of prophylactic usage was 80.3%,the rate of therapeutic one was 19.7%;50% of the patients treated with antibiotics had the duration of postoperative prophylaxis of 7 days or more,the longest one was 30 days.the antibacterials used in turns were cephalosporins,penicillins,lincomycin,macrolides and nitroimidazole.CONCLUSIONS The duration of antibiotic used after operation is too long and the rate of combined anti-infective drugs is too high.It means that their are some problems existed in prophylactic use of antibiotics during cardiovascular surgery at perioperative period in condition of extracorporeal circulation,it is necessary that the antibiotic administration should be standardized.

Objective To study the characteristics of diffusion tensor imaging (DTI) in brain tumor and it's diagnosis and differential diagnosis value.Methods Thirty-nine patients with brain tumors proven by pathologically (10 meningioma,17 glioma,12 metastatic tumors) were enrolled,by using Philips Achieva 1.5 T MRI,conventional MRI and DTI were underwent on them,fractional anisotropy (FA) maps,apparent diffusion coefficient (ADC) maps and three dimensional white matter fiber bundle map were reconstructed in the workstation.The core substance of the tumor area and the contralateral mirror area were selected as the region of interest,and FA and ADC values of them were measured,and t test was performed.Results The FA values of meningioma,metastases tumors and gliomas were 0.36 ± 0.08,0.28 ± 0.03,0.18 ± 0.06,respectively,and the differences among them were significant( P ＜ 0.05).The ADC values of meningioma,metastases tumors and gliomas were 1.72 ± 0.10,1.52 ± 0.22,1.34 ± 0.14,respectively,and the differences among them were significant( P ＜ 0.05).Conclusion DTI has high clinical value in identification of meningiomas,metastatic tumors and glioma.

OBJECTIVE To investigate the association between 592C/A and-819C/T of interleukin-10 gene polymorphism in patients with immediate ?-lactam drug allergy in Chinese Han population.METHODS The genotype and allele frequency of interleukin-10 gene were studied by polymerase chain reaction-restriction fragment length polymorphism(PCR-RFLP)in 44 Chinese Han patients with evidence of immediate ?-lactam drug allergy and 44 controls subjects.They all matched for sex and atopy,the production was investigated by sequence analysis.RESULTS Our analysis did reveal differences in the distribution of the single nucleotide polymorphism(SNP)between female allergic patients and controls.Among allergy subjects,we found two distinct significant associations between immediate drug allergy women and two linked IL-10 promoter genes polymorphism,-592C/A and-819C/T(P

Objective To study the value of MR diffusion weighted imaging(DWI)and apparent diffusion coefficient(ADC)in differentiating benign and malignant lesions of prostate.Methods Twenty-two patients with prostate cancer and 17 patients with benign prostatic hyperplasia confirmed by pathology or biopsy,and 20 healthy volunteers were underwent prostate plain MRI,DWI and enhanced MRI,and measuring the value of ADC in the regions of interest in the workstation,and the ADC values of prostate cancer,benign prostatic hyperplasia,normal prostate were analyzed statistically.Results The ADC of prostate cancer,benign prostatic hyperplasia,normal prostate in central gland and peripheral zone were 1.08 ±0.23,1.43 ±0.27,1.51 ±0.26 and 1.26 ±0.47,1.72 ±0.40,1.75 ± 0.28,respectively,the ADC of prostate cancer was significantly lower than that of benign prostatic hyperplasia and normal prostate,and there was significant difference(P＜ 0.05),but there was no significant difference between benign prostatic hyperplasia and normal prostate(P ＞0.05).Looking the ADC was 1.30 and 1.60 in central gland and peripheral zone as the threshold to distinguish benign and malignant lesions of prostate,had high sensitivity and specificity.Conclusion The application of DWI combined with ADC,has improved the capability of diagnosis and differential diagnosis in benign and malignant lesions of prostate greatly.

Objective To evaluate the usefulness of diffusion-weighted magnetic resonance imaging (DWI) and apparent diffusion coefficients (ADC) in differentiating tumor, edema, and normal brain tissue, and in classification of cerebral gliomas. Methods Using Philips Achieva 1.5T super conduct MR scanner, 46 patients with gliomas underwent conventional MR imaging and DWI. The ADC of regions of interest ( ROI ) were measured with two different b values, 0s/mm2 and 1000s/mm2. ROIs were manually placed over areas of tumor,edema, and normal brain tissue. Results The signals of DWI and ADC map in tumor tissue were respectively higher and lower than those in normal brain tissue. The ADC values in tumor were 1.68 ± 0.18,1.65 ± 0.20,1.29 ±0.16,1.21 ±0.21 for grade Ⅰ、Ⅱ、Ⅲ、Ⅳ gliomas, respectively; the corresponding figures in edema were 1.74 ±0.22,1.72 ±0.19,1.35 ±0.20,1.28 ±0.19, respective. The ADC values in tumor were not significantly different from the values in edema (P ＞0.05); however, both values were significantly different from those in normal brain ( P ＜0.05 ). The ADC value of low grade ( grade1-2 ) gliomas was significantly higher than that of high grade (grade3-4) glioma (P＜0.05). Conclusion ADC values can aid in distinguishing tumors from normal tissues, but can not distinguish tumors from adjacent edema. Individually, ADC values overlapped considerahly. ADC value is associated with cellularity of gliomas. DWI can help characterizing the malignancy of gliomas.

Objective To observe CT features of struma ovarii (SO) in comparison of pathologic findings. Methods CT features of 9 patients with pathologically confirmed SO were analyzed retrospectively and compared with pathological findings. Results All tumors were unilateral and had smooth margins, 3 were cystic and 6 were cystic-solid lesions, 5 were high attenuation lesions in the cyst portion of the mass on contrast CT. The cyst wall moderately (n=3) or markedly (n=5) enhanced after administration of contrast medium. Scattered, stripe-like or ring-like calcifications were found in 6 patients. On pathology, most of cystic portions were filled with high proteinaceous gelatinous fluid of eosinophiclic colloid, and the solid portion of tumors consisted of the thyroid tissue and stoma containing abundant blood vessels and fibrous tissue. Conclusion SO appears as a smooth marginated multicystic mass with calcification, high attenuation lesionin plain CT, and marked solid part enhancement on contrast CT.

Objective To assess influence factors of imaging quality with 64-slice spiral CT angiography (CTA) of renal artery. Methods A total of 305 hypertension patients underwent CTA of renal artery, and 108 of them were examined with DSA. The imaging quality was classified as Ⅰ, Ⅱ, Ⅲ, Ⅳ, Ⅴ, and the degree of stenosis wass classified as <50%, 50%-74%, 75%-99% and occlusion. The sensitivity and specificity of CTA of renal artery was analyzed taking DSA as the standard. Results The influence factors of CTA of renal artery included the delayed time set, rotation time, the units dose of contrast medium and the speed of injection, breath-holding, the patients age and vascular calcification. The sensitivity and specificity of CTA of arterial stenosis <50%, 50%-74%, 75%-99%, occlusion was 76.30% and 76.80%, 89.70% and 90.40%, 96.30% and 97.10%, 100% and 100%, respectively. Conclusion The influence factors of CTA of renal artery are the delayed time set, rotation time, the units dose of contrast medium and the speed of injection, breath-holding, the patients age and vascular calcification. CTA of renal artery can meet the clinical requirements in assessing the renal arterial stenosis.

ObjectiveTo analyze the characteristics of magnetic resonance diffusion tensor imaging(DTI)and diffusion tensor tractography (DTIT) in patients with cerebral infarction, and explore the diagnosis values and prognosis of diffusion weighted imaging (DWI) and diffusion tensor imaging (DTI) in patients with cerebral infarction in different stages. Methods58 patients with cerebral infarction in different stages and 25 healthy volunteers were examined by magnetic resonance imaging(MRI), including conventional T1 and T2 weighted imaging, DWI and DTI. Fractional anisotropy (FA) images were reconstructed. The values of FA and apparent diffusion coefficient (ADC) were measured in the infarcted regions, corresponding contralateral normal regions and corresponding normal regions in normal control group. Results①DWI and DTI showed size of infarction focus was more accurate and clearer than that of conventional MRI; ②The FA and ADC values of the infarcted regions during superacute stage, acute stage, subacute stage and chronic stage were (0.24±0.02, 0.31 ±0.11), (0.20±0.02, 0.32±0.12), (0.18±0.02, 0.34±0.11) and (0.16±0.02, 0.37±0.13), respectively, lower than those in the contralateral corresponding regions which were (0.40±0.03, 0.70±0.21), (0.37±0.03, 0.71±0.21), (0.39±0.03, 0.72±0.22) and (0.40:±0.03, 0.72±0.23), respectively. The differences were statistically significant (P＜0.05). The FA and ADC values had no significant differences between the uninjured sides in patients with cerebral infarction and the corresponding regions in the normal control group (P＞0.05); ③The FA and ADC values in brain tissues changed regularly with the time of infarction after cerebral infarction. The FA values in the affected sides had no consistent changes as compared with the contralateral sides in the superacute stage. They increased or decreased slightly, then (during acute stage, subacute stage and chronic stage) decreased irreversibly. The ADC values in the affected sides changed with time regularly, they decreased significantly, gradually returned to normal, and then increased again. Conclusion DTI and DTT examination contribute to the diagnosis of cerebral infarction. The combination of the FA and ADC values may more accurately conduct clinical staging and evaluate the time of the occurrence of cerebral infarction.

OBJECTIVE:To compare therapeutic efficacy and safety of different chemotherapy regimens in the treatment of small cell esophageal cancer. METHODS:In retrospective analysis,58 patients with small cell esophageal cancer were divided into group A(18 cases),B(26 cases)and C(14 cases)according to chemotherapy regimens. Group A was given Cisplatin injection 75 mg/m2 intravenously,d1-3+Paclitaxel injection 175 mg/m2,d1-3. Group B was given Cisplatin injection 30 mg/m2 intravenously,d1-3+Et-oposide injection 100 mg/m2,d1-3. Group C was given Vinorelbine tartrate injection 25 mg/m2 intravenously,d1-3+Gemcitabine hydro-chloride for injection 1000 mg/m2,d1-3. A treatment course of 3 groups lasted for 21 d,and they all received 2 cycles of treatment. Clinical efficacies,1,2,3-year survival rate and the incidence of Ⅲ-Ⅳ degree toxic reaction(cough,fever,expectoration,short-ness of breath,fatigue,chest pain,bone marrow suppression,gastrointestinal reactions) were compared among 3 groups. RE-SULTS:Total response rate and 1,2,3-year survival rate were in descending order:group C>group B>group A;the incidence of Ⅲ-Ⅳ degree cough,fever,expectoration,shortness of breath,fatigue,chest pain were in ascending order:group C0.05). CONCLUSIONS:Therapeutic efficacy and 1,2,3-year survival rate of vinorelbine combined with gemcitabine are significantly higher than those of cisplatin combined with paclitaxel or etoposide with better safety.

OBJECTIVE The diagnosis of drug allergy is difficult and is usually based on clinical history,skin tests(for some drugs) and,in a few specialized allergy centers,provocation tests.To establish the method for analyzing basophil activation test(BAT) by flow cytometry(FCM) and evaluate its clinical significance in the diagnosis of drug allergy.METHODS The protocol for FCM analysis of basophil degranulation in allergy dustmite by CD63,CD203c and CD45 combination was established.The clinical significance of activated basophil by FCM was evaluated by comparing with the results of sIgE by fluorescence enzyme-linked absorbent assay(FELISA),regarding the skin prick test as the gold standard.RESULTS Pure basophils were got by CD45 and CD203c gating,CD63 was the best marker for activated basophil;Spearman′s correlation coefficients indicated a moderate positive correlation between SIgE class categorized by Unicap class and activated basophil;there was no significant difference between activated basophil by FCM and sIgE by FELISA in the diagnosis of allergic reaction,but the former was better than the latter in specificity and positive likelihood ratio.CONCLUSIONS Quantification of activated basophil by CD63 expression with FCM is a valuable new and safe method in vitro for diagnosis of immediate type hypersensitization.