OBJECTIVE:To discuss the correlation between antibacterial drug use and the bacterial drug resistance in the hospital where the authors work.METHODS:The DDDs of antibacterials during the period from2002to2004were counted,and the correlation between DDDs and bacterial drug resistance was analyzed.RESULTS:The total DDD of the antibacterials increased by47.14%in this period.To2004,the resistance rates of4major pathogens to9commonly used categories of antibacterials were more than44%.The DDDs of amoxicillin/clavulanate potassium,ampicillin sodium/sulbactam sodium,cefoperazone sodium/sulbactam sodium increased by4,19.8and7times,respectively in the3years,the resistance rates of pathogens to which also evidently increased,among which staphylococcus aureus increased by over22%.CONCLU_ SION:The hospital should strengthen the administration of antibacterial drug use in many ways to reduce the bacterial drug resistance.

Objective To study the effects of marrow mesenchymal stem cells on heart functions and ventricular remodeling after myocardial infarction in rats. Methods Myocardial infarction model was established by ligation of the left anterior descending coronary artery (LAD) in adult SD rats. 4 and 8 weeks after MMSCs implantation, he-modynamic evaluations, left ventricular weight/body weight ratio and heart weight/body weight ratio were determined. HE staining was performed for counting microvasculars and Van Gieson staining was used for measurements and calculation of the myocardial fibrillar collagen. Then we investigated the migration and evolution of MSCs in vivo by fluorescent microscope. Results HR was significantly decreased in transplantation MMSCs group. Eight weeks after transplantation, body weight in transplantation MMSCs group reached that of control group. At the same time, SBP, DBP and MBP were significantly increased in transplantation MMSCs group. HR was significantly decreased in transplantation MMSCs group. Secondly, left ventricular weight/body weight ratio and heart weight/body weight ratio were significantly decreased 4 weeks after transplantation MMSCs. Then the ratio was significantly decreased 8 weeks after transplantation MMSCs. Thirdly density of microvasculars was increased at the boundary of infarction site in the animals transplanted MMSCs. Finally, total volume of the myocardial fibrillar collagen was reduced in the MMSCs treated groups after MI. Conclusion Transplanting MMSCs can improve the ventricular remodeling and heart functions in acute MI rat models.

Objective To study the effects of marrow mesenchymal stem cells on heart functions and ventricular remodeling after myocardial infarction in rats. Methods Myocardial infarction model was established by ligation of the left anterior descending coronary artery (LAD) in adult SD rats. 4 and 8 weeks after MMSCs implantation,hemodynamic evaluations,left ventricular weight/body weight ratio and heart weight/body weight ratio were determined. HE staining was performed for counting microvasculars and Van Gieson staining was used for measurements and calculation of the myocardial fibrillar collagen. Then we investigated the migration and evolution of MSCs in vivo by fluorescent microscope. Results HR was significantly decreased in transplantation MMSCs group. Eight weeks after transplantation,body weight in transplantation MMSCs group reached that of control group. At the same time,SBP,DBP and MBP were significantly increased in transplantation MMSCs group. HR was significantly decreased in transplantation MMSCs group. Secondly,left ventricular weight/body weight ratio and heart weight/bodyweight ratio were significantly decreased 4 weeks after transplantation MMSCs. Then the ratio was significantly decreased 8 weeks after transplantation MMSCs. Thirdly density of microvasculars was increased at the boundary of infarction site in the animals transplanted MMSCs. Finally,total volume of the myocardial fibrillar collagen was reduced in the MMSCs treated groups after MI. Conclusion Transplanting MMSCs can improve the ventricular remodeling and heart functions in acute MI rat models.

Objective To investigate the value of colonoscopy with narrow band imaging (NBI) in predicting the histology of colorectal polypoid lesions. Methods A total of 173 colorectal polypoid lesions from 125 patients were included in the study. The lesions were diagnosed as neoplastic (adenoma or cancer)or non-neoplastic based on pit patterns and/or capillary patterns (CP), which was compared with the results of pathology, and the sensitivity, specificity and accuracy of each method were evaluated. Results In differentiation between neoplastic and non-neoplastic lesions, the sensitivity, specificity and accuracy of CP (94. 83% , 91. 23% and 93.64% , respectively), and those of CP combined with pit patterns (95. 69% ,96.49% and 95. 59% , respectively) were significantly higher than those of conventional colonoscopy (80. 17% , 84.21% and 81.50% , respectively, P<0.05). In differentiation between adenoma and cancer,the sensitivity, specificity and accuracy of CP were 86.90% , 100.00% and 87.93% , respectively.Conclusion NBI is superior to conventional colonoscopy in differentiation between neoplastic and non-neoplastic lesions, as well as in differentiation between adenoma and carcinoma.

Objective To summarize the clinical characteristics of liver cirrhosis complicated with chylous ascites.Methods From July,2007 to November,2012,patients diagnosed as liver cirrhosis complicated with chylous ascites were retrospectively analyzed.Analyze the etiology,liver function,ascites,imaging examination,treatment options and progonsis of these patients.Differences in measurement data were compared with U test.Results A total of 34 cases were enrolled,male 27 cases and female seven cases,average age (51.7±12.5) years old.Hepatitis B (20/34,58.8％) was the most common etiology of liver cirrhosis.Child-Pugh grading was grade B (26 cases) and C (eight cases).The appearance of aseites of 17 cases was chylous and the serm-ascites albumin gradient (SAAG) was 18.8 (2.6 to 32.5) g/L.The SAAG of 27 cases (84.4％) was no less than 11.0 g/L.The ascites triglyceride (TG) level was 2.94 (0.26 to 16.75) mmol/L,the TG of 27 cases (84.4％) was no less than 1.25 mmol/L.The level of TG (2.66(0.26 to 16.75) mmol/L) of patients with SAAG over 11.0 g/L was significantly lower than that of SAAG lower than 11 g/L (7.07(2.26 to 15.67) mmol/L,U=24.00,P=0.02).The lymphatic scintigraphy indicated that imaging agent leaked into peritoneal cavity in 29 cases (85.3 ％).Direct lymphangiography revealed lymphatic vessel structure abnormality in 15 cases (60 ％).Twelve patients received conservative treatment and four patients were effective,13 patients accepted peritoneal-venous shunting and 12 patients were effective,11 patients with microsurgical treatrnent and seven patients were effective.Conclusions Lymphatic struture is a possible cause of cirrhosis patients with chylous ascites.The characteristics of chylous ascites in cirrhosis patients are still the same as the characteristics of portal hypertension ascites.The SAAG remarkably increases,and the the level of SAAG probably depends on TG level.Lymphoscintigraphy has great value on the determination of the presence of ascites.And the direct lymphangiography could help to reveal lymphatic vessel structure abnormality.

OBJECTIVE:To provide references for the application and management of anti-infectives.METHODS:Data on sale volume,DDDs etc.of anti-infection drugs in6hospitals of Guang'an city from2001to2004were statistically analyzed.RESULTS:The DDDs of oral lomefloxacin dominated the first or2nd places for the4years;The DDDs rank orders of isoniazid and rifampin were No.4and No.5respectively in the4years;The DDDs of penicillin for injection dominated the first place on the injectable preparation lists(2001～2003);The latecomer levofloxacin assumed the tendency of surpassing the early starters not only in sale volume but also the DDDs.CONCLUSION:The proportion for anti-infectives in sales volume to the sum total drug consumption of the above mentioned area were close to those of the other medical institutions in southwest area,there are less new drug varieties and the grade of drugs used in the area was low.

Objective:To investigate the correlation between the expression of angiogenic factors (MVD, IGF-1, and STAT3) in colorectal carcinoma and adenoma and the microvascular characteristics under narrow band imaging (NBI), in order to evaluate the fea-sibility of NBI in real-time observation of angiogenesis. Methods:Patients with pathologically confirmed colorectal polyps were re-cruited and examined by NBI. Vascular patterns were classified into typeⅠ(invisible or faintly visible), typeⅡ(clearly visible and regularly arranged in a round, oval honeycomb-like pattern), and typeⅢ(clearly visible and irregularly arranged in terms of size and caliber or irregularly winded). Immunohistochemical staining was performed to determine the expression of CD34, IGF-1, and STAT3. Histological results were compared with the vascular patterns under NBI. Results:The NBI endoscopy results of 64 sites (15 adenocar-cinomas, 29 adenomas, and 20 normal tissues) from 58 patients were introduced and examined in this study. Adenomas ranked the first (82.1%, 23/28) among the vascular patternⅡcases, whereas early adenocarcinomas dominated the vascular patternⅢcases (66.7%, 10/15). The expression levels of MVD-CD34 and IGF-1 in normal mucosa, adenomas, and adenocarcinomas were significantly differ-ent (P<0.0001 and P=0.0062, respectively). All the expression levels of MVD-CD34, IGF-1, and STAT3 in sites displaying vascular pat-ternsⅠ,Ⅱ, andⅢwere significantly different (P<0.0001, P=0.0010, and P=0.0055, respectively). Spearman correlation coefficients between the NBI vascular patterns and the MVD-CD34, IGF-1, and STAT3 expression levels were 0.67, 0.41, and 0.40, respectively. Conclusion:Vascular pattern analysis through an NBI system can be a promising tool to evaluate angiogenesis of colorectal lesions in real-time endoscopic observation.

OBJECTIVE:To prepare aspirin phospholipid complex (ASP-PC) and conduct the characterization. METHODS:Using the combination rate of ASP and PC as index,single factor test was used to screen the preparation method of ASP-PC,PC type,solvent type,reaction time,reaction temperature,solvent volume and drug-lipid ratio. The verification test was conducted. UV spectrophotometry,Thermogravimetric analysis,X-ray diffraction and Fourier transform infrared spectroscopy were used for the characterization of ASP-PC. RESULTS:Magnetic stirring-condensing reflux method was adopted,drug-soybean phospholipids ratio was 1:3 (mol/mol),solvent was tetrahydrofuran,reacting for 3 h under 58 ℃. The average combination rate of prepared ASP-PC was 83.52％(RSD=1.16％,n=3). Compared with ASP,physical mixture of ASP and PC,UV spectrum showed that ASP-PC had no new absorption peak. Thermogravimetric analysis,X-ray diffraction and Fourier transform infrared spectroscopy showed the ASP and PC in ASP-PC were interacted;and ASP-PC changed little in quality within 0-300 ℃. CONCLUSIONS:ASP-PC can be successfully prepared,in which,ASP and PC were combined successfully;while there are still trace amounts of ASP in the form of crystals.

Objective To investigate the incidence,diagnosis,treatment and prognosis of abnormal lymphatic vessels in intestinal lymphangiectasia (IL) patients complicated by portal vein hypertension.Methods General information,clinical manifestations,laboratory tests,endoscopy and pathological examination,the results of direct and nuclide lymphangiography,treatment and prognosis of seven IL patients complicated by portal vein hypertension were retrospective analyzed.Results Among seven IL patients complicated by portal vein hypertension,there were five cases with abnormal lymphatic vessels and two cases were merely secondary to portal vein hypertension.The main symptoms were edema,abdominal distension and diarrhea.The results of laboratory tests mainly were lymphocytopenia (0.3× 109 to 1.7 × 109/L),hypoalbuminemia (16.0 to 27.8g/L) and hypoglobulinemia (13.2 to 17.7 g/L).Under endoscope,mucosal edema,chronic inflammatory reaction,intestinal villi spot and patched white nodular changes and polyp-like changes appeared.For treatment,the low-fat with medium-chain triglyceride diet and symptomatic support was the basic treatment.The condition could be relieved by surgical remission of abnormal lymphatic vessels or partial small-bowel resection.If the etiological factors could not be removed,the therapeutic effect was poor in the patients merely secondary to portal vein hypertension.Conclusion The suspicious IL patients complicated by portal vein hypertension need further examination to explore whether abnormal lymphatic vessels existed,and to provide evidence for surgical intervention.

ObjectiveTo determine the features of antrum gastritis by magnified narrow band imaging (M-NBI) and to evaluate the feasibility of target biopsy with M-NBI.MethodsA total of 69 consecutive patients who underwent M-NBI were recruited in the study.The gastric mucosa of antrum was observed under M-NBI and the gastric microstructure patterns were classified into 5 type.M-NBI findings were compared with the conventional histological findings.In addition,the interobserver agreement was assessed.ResultsA total of 173 gastric antral sites from 69 patients were examined by M-NBI.Type A was mainly normal sites (89.8％,44/49),while type B and C were chronic inflammation (53.3％,24/45 )and active inflammation (74.3％,26/35).Compared with the type A group,the inflammatory degree in type B (P＜0.001 ) group and type C group (P＜0.001) was significantly higher.The sensitivity,specificity,accuracy of the type B and type C pattern for predicting antrum gastritis were 87.5％,78.0％ and 81.5％.The sensitivity,specificity,accuracy of the type D and type E pattern for predicting intestinal metaplasia of antrum were 83.8％,90.4％ and 77.5％,respectively.The kappa value for the interobserver agreement was 0.734 [ 95％ CI(0.591-0.977 ) ].ConclusionMicrostructure features of antrum gastritis determined by M-NBI are highly correlated with histopathology,and can evidently help diagnosis.