Objective To evaluate the effect of chlorhexidine gargle on respiratory tract infection (RTI)in patients following general anesthesia.Methods From January 2012 to June 2013,94 patients who received general anesthe-sia for removal of vertebral disc were randomly divided into two groups,with 47 cases in each group,control group gargled with normal saline,observation group accepted 2% chlorhexidine gargle.The occurrence of RTI and detec-tion of pharynx pathogens of two groups were compared.Results The incidence of RTI in observation group and control group was 8.51%(n=4)and 23.40%(n=11)respectively(χ2 = 12.95,P <0.05).4 patients in observation group were detected 4 isolates of pathogens,11 patients in control group were detected 26 isolates of pathogens,the detection rate of pharynx pathogens of observation group was lower than control group (χ2 =3.89,P <0.05).The main isolated pathogens were Pseudomonas aeruginosa ,Staphylococcus aureus ,Klebsiella pneumoniae and Esche-richia coli .Conclusion Chlorhexidine gargling can effectively reduce RTI following general anesthesia,it is worthy of clinical application.

Objective To evaluate the value of diffusion-weighted MRI in the functional study of kidney.Methods Fifteen volunteers as control group and 32 patients with chronic kidney disease(CKD) were underwent DW MR imaging in a dehydrated state.In CKD group,12 cases were with normal serum creatinine(Scr) level(CKD group 1) and 20 cases with Scr increased in different level(CKD group 2).Apparent Diffusion Coefficient(ADC) value of each kidney of all groups was measured and compared of their relationships with clinical data.Results The ADC values of 15 volunteers in different b values(50,100,400) were(405.366?35.9639)?10~(-5)mm~2/s,(339.646?23.0594)?10~(-5)mm~2/s,and(254.532?13.6763)?10~(-5)mm~2/s,respectively.The ADC values of CKD group 1 were(336.622?12.879)?10~(5)mm~2/s,(308.142?20.998)?10~(-5)mm~2/s,and(211.398?14.604)?10~(-5)mm~2/s,respectively.And of CKD group 2 were(307.717?84.930)?10~(-5)mm~2/s,(265.415?57.754)?10~(-5)mm~2/s,and(201.672?26.411)?10~(-5)mm~2/s,respectively.The ADC values in CKD group were lower than those of the normal kidneys(t values compared between the control group and CKD group 1 were 9.720,5.190,11.093 separately,between the control group and CKD goup 2 were 6.533,7.382,10.864 separately in different b values,with all P values less than 0.05).In CKD group 2,it had been showed negtive correlation between the level of Scr and ADC values of kidney,with mean level of Scr of(828.490?699.350) ?mol/L,but this was confirmed of no statistical meanings(the coefficient correlation were(-0.272、)-0.283、-0.023 separately in different b values,with p values more than 0.05).For the creatinine clearance rate(Ccr),it showed a weak positive correlation with ADC values of CKD group 2(the coefficient correlation were 0.511、0.430、0.335 separately,with P values less than 0.05).Conclusion(Diffusion-weighted) MRI imaging and in vivo measurement of ADC values have the potential for use as a noninvasive means to explore the functional status of the kidney.

Objective To investigate the trend in incidence, causative drugs, clinical types and treatment of drug eruption. Methods Clinical data were collected from 922 inpatients with drug eruption in Huashan Hospital, Fudan University from January 2009 to December 2013, and analyzed retrospectively. Results From 2009 to 2013, the percentage of inpatients with drug eruption among all inpatients in the Department of Dermatology in a given year varied from 9.45% to 10.01%, and the percentage of inpatients with severe drug eruption among inpatients with drug eruption from 17.45% to 28.24%. Of the 922 cases, 371 (40.2%)were caused by single drugs, and 551 (59.8%)by multiple drugs. Among the 371 cases of drug eruption caused by single drugs, the top five causative drugs were traditional Chinese medicine(72 cases), cephalosporins(38 cases), amoxicillin(27 cases), antipyretic analgesics(26 cases)and tetanus antitoxin (24 cases)in 278 cases of non-severe drug eruption, antiepileptic agents (33 cases), allopurinol (28 cases), antipyretic analgesics (7 cases), cephalosporins (6 cases)and traditional Chinese medicine (6 cases)in 93 cases of severe drug eruption. Of the 922 patients, 422 (45.8%)presented with maculopapular eruption, 259 (28.1%)with urticaria, 135(14.6%)with Stevens-Johnson syndrome, 49(5.3%)with toxic epidermal necrolysis, 33(3.6%)with drug reaction with eosinophilia and systemic symptoms (DRESS), and 7 (0.8%)with acute generalized exanthematous pustulosis (AGEP). A total of 791 (85.8%)patients with drug eruption received glucocorticoid treatment. The dose of glucocorticoids was(47.61 ± 12.07)mg prednisone equivalent per day in 550 patients with non-severe drug eruption, and (73.10 ± 18.23)mg prednisone equivalent per day in 221 patients with severe drug eruption. Totally, 110 (11.0%) patients with drug eruption were treated with combined intravenous immunoglobulin (IVIG)because of poor response to glucocorticoids alone. Of 224 patients with severe drug eruption, only 2 (0.9%)died. Conclusions Carbamazepine and allopurinol are the main causative drugs for severe drug eruption, while traditional Chinese medicine is the first causative drug for non-severe drug eruption. From 2009 to 2013, the annual mortality of severe drug eruption decreased considerably.

Combined training is a new training mode which combines the education of profes-sional degree of clinical medicine graduate and the resident standardization training. Xiangya hospital of Central South University has tried this kind of training mode since 2012. We draw lessons from the advanced training concept in America in combination with the practical situation of our hospital and have established theXiangya-Yalemodel of resident standardization training featuring with the Six Xiangya goals which areprofessional ethics, professional skills, patient safety, medical ethics, teamwork spirit, innovation and self-improvement, highlighting the project manager responsibility system, 360 degree examination and assess-ment, assessment of the OSCE, Mini-CEX evaluation. Through comparing and analyzing the midterm exami-nation scores between the combined training group and non-combined training group, we have found that the combined training group is significantly superior to non-combined training group on clinical skills. In addition, the questionnaire survey results show that most graduate students have positive attitude tocombined training. They believe it will be helpful for them to improve the ability of clinical skills, med-ical practice, doctor-patient communication skills and theoretical knowledge, and contributes to the future career development. Combined training is one major initiative deepening the reform of medical health system and medical education which greatly promotes the development of our country health enterprise, although there still exist some flaws including training teachers, content, implementation, management and evaluation.

The early involvement of specialty,case and scientific research were applied to forensic medicine teaching and has achieved significant effect.

Three weeks’ training, visiting and demonstrating classes in Michigan State University gave us an opportunity to understand the education system, the teaching characteristics and the “students centered”teaching principle of USA. Some reasonable teaching methods were applied in the class which may embody the student-oriented teaching aim and develop the students’ subjective initiative. The teaching effect showed that most students were fond of the teaching strategies and they also did good job in final tests.

In order to provide a new way and method for safety evaluation of Chinese materia medica (CMM) and also to provide a reference for conventional animal experiments, computer toxicity prediction technique and method were established to predict the cardiotoxicity of CMM. Mold2 software (version 2.0.0) was used to calculate molecular descriptors of 1034 chemical components. Then, the random forest (RF) method and the support vector machine (SVM) method were used to screen the descriptors. After that, boosting trees method, SVM, regularized discriminant analysis method and RF method were used to build up prediction model, respectively. Finally, the cardiotoxicity of chemical components was predicted by the quantitative structure-activity relationship (QSAR) model with the best accuracy and Kappa value. The results showed that by comparing the accuracy and Kappa value of prediction model, it was found that the RF model was the optimal algorithm model with 86.3%accuracy and the Kappa value of 0. 725. Through the prediction research on chemical components of Chinese herbs with toxicity recorded in the Pharmacopoeia of People’s Republic of China (version2010),suchasEvodia rutaecarpa,North bean root,Murraya incense,some meaningful results had been received. It was concluded that QSAR model on prediction research of chemical components of Chinese herbs provided important references for further experimental studies and clinical researches.

Objective To study computer toxicity prediction technology and predict the acute toxicity of Chinese materia medica; To provide a new way and method for safety evaluation of traditional Chinese medicine. Methods First, Mold2 software (version 2.0.0) was used to calculate molecular descriptors of 7409 chemical components. After preliminary screening of molecular descriptors, quantitative structure-activity relationship (QSAR) models were built up with Random Forest (RF) for screening the optimum prediction model. From the 83 kinds of toxic Chinese materia medica in Chinese Pharmacopoeia (2010 edition), acute toxicity of 60 kinds of Chinese materia medica reported from monomer structure (1692 chemical components) were under prediction.Results Totally 7409 pieces of data were obtained. When the descriptors were 52, RF modeling accuracy and Kappa were the highest, 0.712 and 0.436 respectively. Compound clusters were divided into 3 types according to optimum molecule descriptors (52). The accuracy and Kappa of the optimum model for the first type of compounds were 0.666 and 0.476 respectively; the accuracy and Kappa of the optimum model for the second type of compounds were 0.804 and 0.381 respectively; the accuracy and Kappa of the optimum model for the third type of compounds were 0.709 and 0.373 respectively. It was predicted that 60 kinds of Chinese materia medica containing 0 violent toxic compound, 2 high toxic compounds, 172 medium toxic compounds and 1518 low toxic compound.Conclusion QSAR model for prediction study on acute toxicity of chemical components of Chinese mareria medica can provide references combination medication and experimental studies.

Action Potentials ; Animals ; Ear, Inner ; blood supply ; Facial Nerve ; physiopathology ; Hearing Loss, Sensorineural ; etiology ; Rabbits

The purpose of this study was to describe the 16-slice detector spiral computer tomography (SCT) technique and imaging features of aortic aneurysms. We analyzed 21 patients documented aortic aneurysms, that underwent unenhanced and contrast-enhanced spiral CT with a 16-slice scanner (Sensation 16), and three-dimensional reconstructions were performed for CT scan images. The results showed that: (1) Aortic dissection (11 cases), included the true and false lumen (11 cases, 100%), intimal flaps (11 cases, 100%), intimal tear (9 cases, 81.8%) and thrombosed false lumen (5 cases, 45.5%); (2) Intramural hematoma, unenhanced CT depicted crescent-shaped areas with high attenuation extending along the walls of the aorta, no definable intimal flap, while contrast-enhanced CT showed no enhancement of attenuation in the crescent-shaped areas; (3) True aortic aneurysms (7 cases), CT revealed the size, range, thrombosis and calcification of all aneurysms; (4) Pseudoaneurysms (2 cases), the enhanced part of the inhomogeneous masses beside the aorta connected with the aorta shown on contrast-enhanced CT. Therefore, 16-slice detector SCT axial and three-dimensional images can exactly reveal the pathological and anatomical features of aortic aneurysms, and provide detailed imaging information for clinical therapy.
Adult ; Aged ; Aged, 80 and over ; Aneurysm, Dissecting ; diagnostic imaging ; Aortic Aneurysm ; diagnostic imaging ; Female ; Humans ; Imaging, Three-Dimensional ; methods ; Male ; Middle Aged ; Tomography, Spiral Computed ; methods ; Young Adult