OBJECTIVE To survey the antibiotic usage and its rationality in clinical.METHODS From Jan 2009 to May of 2009,950 medical records were selected to conduct a retrospective investigation.RESULTS The incidence of antibiotic usage was 88.2%,71.6% cases were intended for active treatment,28.4% for preventive regimen.72% cases in internal medicine were for active treatment whereas 94% were for surgical prophylaxis.In terms of the antibiotic use,single drug accounted for 56.2%,two-drug 38.9% and three-drug 4.9%.Inspection rate of drug treatment was 69.7% and hospital infection rates was 2.1%.CONCLUSIONS To improve antibiotic administration,systematic efforts are required to keep the medical staff updated of antibiotic principles so as to improve clinical rational use of antibiotics.

To investigate the effect of casein phosphopeptide-amorphic calcium phosphate(CPP-ACP) on the growth of Lactobacillus fermentum and to evaluate the possibility of CPP-ACP as a biological anticariogenic agent. Lactobacillus fermentum was inoculated in BHI with different concentrations of CPP-ACP and grew in anaerobic condition at 37 ℃ for 48 h. Used MTT method to evaluate the effects of CPP-ACP on the growth of Lactobacillus fermentum. CPP-ACP inhibited the growth of Lactobacillus fermentum effectively. With the concentration of CPP-ACP increasing, the values of A(550 nm) decreased. It was found that CPP-ACP had inhibitory effect on the growth of Lactobacillus fermentum, the inhibitory effect increased with CPP-ACP concentration.

Objective To study the effects of electrical stimulation of efferent vagus nerve on the endotoxic shock in rabbits. Method Sixteen Newzealand rabbits were randomly divided into 2 groups, namely group S as the stimulation group and group C as the control group). Rabbits were subjected to bilateral cervical vagotomy and had challenge with intravenous injection of lipopolysaccharide (LPS) (E. COLI O111: B4 , DIFCO, USA) in a dose of 600 μg/kg. The distal end of the left vagus nerve trunk was connected to an electric stimulator with bipolar electrode and controlled by an acquisition system. Stimuli with stable voltage (10 V,5 Hz,5 ms) were applied twice to the nerve for 10 minutes just before and after the administration of LPS in group S. At the time before and after the infusion of LPS 30 min,60 min, 120 min, 180 min,240 min and 300 min respectively, the heart rate(HR)and the mean arterial blood pressure (MABP) in each animal were recorded, and blood samples were taken for measuring serum tumor necrosis factor-αa(TNF-α) and interleukin-10 (IL-10). Results Compared with group C,the electrical stimulation of efferent vagus nerve could significantly attenuated the LPS-induced hypotension and de-creased the contents of TNF-α[(38.12±7.85) pg/mL vs. (55.12±7.89) pg/mL, P <0.01], but increased the contents of IL-10[(55.12±9.37)pg/mL vs. (40.15±5.44) pg/mL, P <0.01]afar LPS challenge. Conclusions The stimulation of the efferent vagus nerve can down-regulate systemic TNF-α, production and attenu-ate the development of shock after LPS challenge.

Objective To evaluate the effect of dexmedetomidine on the expression of brain-derived neurotrophic factor (BDNF) during lidocaine-induced spinal neurotoxicity in rats.Methods Fifty-six male Sprague-Dawley rats,weighing 250-280 g,aged 2-3 months,were divided into 7 groups (n =8 each) using a random number table:sham operation group (group S),lidocaine group (group L),normal saline group (group NS),3 different doses of dexmedetomidine groups (D1,D2 and D3 groups),and oα2-adrenoceptor antagonist yohimbine group (group Y).An epidural catheter was placed at L5.6 interspace.Ten percent lidocaine 20 μl was injected intrathecally in all groups except group S.Dexmedetomidine 5,15 and 25 μg/kg were injected intraperitoneally at 30 min before lidocaine injection in D1,D2 and D3 groups,respectively.In group Y,yohimbine 1.0 mg/kg was injected intraperitoneally at 15 min before dexmedetomidine 25 μg/kg was injected.Before intrathecal administration and at 24,48 and 72 h after intrathecal administration (T1-4),the Basso,Beattie,Bresnahan (BBB) Locomotor Rating Scale was used,and the tail flick latency to a thermal nociceptive stimulus (TFL) was measured to assess the locomotor function.The rats were sacrificed after the last behavioral test,and the lumbar segments (L3-5) of the spinal cord were removed for pathological examination and for determination of BDNF expression and cell apoptosis.The apoptosis index was calculated.Results Compared with group S,the BBB score was significantly decreased at T2-4,the TFL was prolonged,the BDNF expression was up-regulated,and apoptosis index was increased in L,NS,D1,D2 and D3 groups (P＜0.05).Compared with group L,the BBB score was significantly increased at T2-4,the TFL was shortened,the BDNF expression was up-regulated,and apoptosis index was decreased in group D3 (P＜0.05),and no significant change was found in the parameters mentioned above in NS,D1,D2 and Y groups (P＞0.05).Compared with group D3,the BBB score was significantly decreased at T2 4,the TFL was prolonged,the BDNF expression was down-regulated,and apoptosis index was increased in group Y (P＜0.05).The pathological changes of the spinal cord were significantly attenuated in group D3 as compared with group L,and there was no significant difference in pathological changes of the spinal cord between group Y and group L.Conclusion The mechanism by which dexmedetomidine reduces lidocaine-induced spinal neurotoxicity may be related to up-regulation of BDNF expression,and the mechanism by which dexmedetomidine up-regulates BDNF expression is completely related to activation of α2-adrenoceptors in rats.

Objective To summarize the treatment of 10 aortic coarctation cases ,who receive the surgery from ascending aorta to thoracic descending aorta with the prosthetic graft, discuss the valuable and appliable of this method. Methods Cardiac surgery, Chinese Acdemy of Medical Sciences, Peking Union Medical College Hospital department treated 10 patients who got the aortic coarctation from Jan. 2006 to Dec. 2015 Seven male patients and 3 cases of female patients consist of the sample, aged from 14 to 35 years old, the median age was 27. One cases consolidated aortic valve deformity and aortic root expansion, the others were simple aortic coarctation. Their upper limbs blood pressure was 20 mmHg higher compared with the low limb. Meanwhile, there was no sign of surgery contraindication. Ten cases received this operation under cardiopulmonary bypass situation. And the patient who consolidate aortic valve deformity and aortic root expansion receive the Bentall surgery at the same time. Results There was no death during perioperative time, no spinal cord ischemic and other serious complications. Those patients went back to outpatient department after discharging from hospital 3 to 6 months. The differential pressure between upperlimbs and low limbs were less than 20 mmHg, and the CTA results indicated no aneurysms. Conclusion Using artificial blood vessels to make a graft from the ascending aorta to the descending aorta is an effective method for treatment of thoracic aorta.

Objective To evaluate the effects of tempol administered via different routes on neuropathic pain (NP) in rats.Methods Thirty-two male Sprague-Dawley rats,weighing 250-280 g,aged 8-10 weeks,were randomly divided into 4 groups (n=8 each) using a random number table:sham operation group (group S),group NP,intrathecal tempol group (group T1),and intraperitoneal tempol group (group T2).Neuropathic pain was induced by chronic constriction injury in chloral hydrate-anesthetized rats.The sciatic nerve was exposed and 4 loose ligatures were placed on the sciatic nerve at 1 mm intervals with 4-0 silk thread.The sciatic nerve was only exposed but not ligated in group S.After successful establishment of the model,a catheter was inserted at L4.5 interspace into the epidural space.In S and NP groups,0.9％ normal saline 20 μl was injected intrathecally,and 0.9％ normal saline 200 μl was injected intraperitoneally once a day for 7 consecutive days.In group T1,tempol 30 μg (in 20 μl of normal saline) was injected intrathecally,and 0.9％ normal saline 200 μl was injected intraperitoneally once a day for 7 consecutive days.In group T2,tempol 30 μg (in 200 μl of normal saline) was injected intraperitoneally,and 0.9％ normal saline 20 μl was injected intrathecally once a day for 7 consecutive days.The mechanical paw withdrawal threshold (MWT) and thermal paw withdrawal latency (TWL) were measured at 3 days before operation,and at 1,3,5,7,10 and 14 days after operation.The animals were sacrificed after measurement of pain threshold at day 14 after operation.The lumbar segment of the spinal cord was removed to detect malondialdehyde (MDA) content and superoxide dismutase (SOD) activity by enzyme-linked immunosorbent assay.Results Compared with group S,the MWT was significantly decreased,and the TWL was shortened at each time point after operation,the content of MDA in the spinal cord was increased (P＜0.05),and no significant difference was detected in SOD activity in group NP (P＞0.05).Compared with group NP,the MWT was significantly increased at 5,7,10 and 14 days after operation,the TWL was prolonged at 1,3,5,7,10 and 14 days after operation,the content of MDA in the spinal cord was decreased,and the SOD activity was increased in group T1 (P＜0.05),and no significant change was found in the indexes mentioned above in group T2 (P＞0.05).Conclusion Intrathecal tempol can reduce NP in rats,and the mechanism is related to inhibition of lipid peroxidation in the spinal cord.

Objective To explore a method to culture human aortic valvular interstitial cells and identify the phenotypes,to establish the cell model which would be used to study aortic valve diseases in vitro.Methods Normal aortic valves of the patient with acute Stanford A aortic dissection in Peking Union Medical College Hospital were preserved during the surgical operation.Human aortic valvular interstitial cells were isolated and amplified in vitro by modified collagenase digestion method.The cell phenotype was identified by the immunofluorescent staining.Results Human aortic valvular interstitial cells could be successfully isolated and amplified in vitro by modified collagenase digestion method,identified by positive staining of Vimention and α-SMA.Conclusions The cell model of human aortic valvular interstitial ceils could be successfully established in vitro by modified collagenase digestion method.The cell phenotype identification proved to meet the experimental requirements.So it could provide cellular foundations for the study of pathogenesis of degenerative aortic valve disease.

Objective To evaluate the relationship between extracellular signal-regulated kinase (ERK)and ketamine-induced apoptosis in rat hippocampal neurons.Methods Sprague-Dawley rats at 18 days of gestation were anesthetized.The fetal rats were obtained under the sterile condition and decapitated.The hippocampal neurons were isolated and primarily cultured for 5 days,and were seeded in 6-well plates (2 ml/well) or in 96-well plates (100μl/well) at a density of 5 × 105/ml.The cells were randomly divided into 4 groups (n =18 each):control group (group C),fibroblast growth factor (FGF-2,an ERK agonist) group (group F),ketamine group (group K) and FGF-2 + ketamine group (group FK).The cells were cultured in the plain culture medium in group C.FGF-2 50 ng/ml was added to the culture medium in group F.Ketamine was added to the culture medium in group K.FGF-2 50 ng/ml was added to the culture medium at 20 min before ketamine 100 μmol/L was added in group FK.The phosphorylation of ERK in hippocampal neurons was detected by Western blot at 10 min after treatment.At 24 h after treatment,the neuronal apoptosis was detected by Hoechst33342/PI staining,and the cell survival rate was detected by MTT assay.The apoptosis rate was calculated.Results Compared with group C,the phosphorylation of ERK in hippocampal neurons and the cell survival rate was significantly decreased and the apoptosis rate was increased in K and FK groups (P ＜ 0.05).There was no significant difference in the parameters mentioned above between F and C groups (P ＞ 0.05).The phosphorylation of ERK in hippocampal neurons and the cell survival rat was significantly higher and the apoptosis rate was lower in group FK than in group K (P ＜0.05).Conclusion Ketamine induces apoptosis in rat hippocampal neurons by inhibiting activation of ERK in hippocampal neurons.

Objective To investigate the incidence of sharp injury (SI)among health care workers(HCWs)in dif-ferent levels of hospitals in Gansu Province,so as to improve HCWs’precaution awareness,standardize behavior, and provide guide for making occupational precaution measures.Methods From January to December 2012,HCWs in 38 medical institutes in Gansu Province were selected with stratified random sampling,HCWs were surveyed through questionnaires and interview.Results A total of 11 358 questionnaires were received,the incidence of SI was 9.87%(n=1 121),case rate was 12.60%(n=1 431),the frequency of SI was 1.05 times/(person·month).SI rates of different genders,positions and years of working were statistically different (all P <0.05).The main medical devices cau-sing SI were syringe needle,venous transfusion scalp needle and surgical suture .SI caused by known sources were 1 099 times (76.80%);980 times (68.48%)of SI were induced by contaminated sources,474 (48.37%)of which were blood-borne diseases,bloodborne disease exposure accounted for 33.12%.Among bloodborne disease exposure,hepatitis B virus accounted for 74.25%,Treponema pallidun 13.10%,hepatitis C virus 12.01% ,and human immunodeficiency virus 0.64%.Conclusion There is a high incidence rate of SI among HCWs in Gansu Province,it is a very important public health problem which needs to be solved.

Objective:To determine the dose-effect relationship of nalbuphine preventing injection pain of medium plus long chain triglyceride propofol in pediatric patients undergoing gastroenteroscopy.Methods:Pediatric patients, aged 3-8 yr, of American Society of Anesthesiologists physical statusⅠ or Ⅱ, scheduled for elective gastroenteroscopy, were enrolled in the study.The doses of nalbuphine were determined by up-down sequential allocation, nalbuphine 0.2 mg/kg was injected intravenously in the first child, and 5 min later medium plus long chain triglyceride propofol 2.5 mg/kg was given intravenously.Ambesh 4-point method was used to evaluate the injection pain of propofol.When the prevention of injection pain was ineffective, the dose of nalbuphine was increased in the next patient, otherwise the dose was reduced, and the difference between the two successive doses was 0.01 mg/kg.This process was repeated until the 7th turning point occurred.The ED 50 and ED 95 of nalbuphine and 95% confidence interval (CI) preventing injection pain of propofol were calculated by Probit regression. Results:The ED 50 and ED 95 (95% CI) of nalbuphine preventing medium plus long chain triglyceride propofol injection pain were 1.57 (1.50-1.62) and 1.71 (1.64-2.05) mg/kg, respectively. Conclusion:The ED 50 and ED 95 of nalbuphine preventing injection pain of medium plus long chain triglyceride propofol are 1.57 and 1.71 mg/kg, respectively, in pediatric patients undergoing gastroenteroscopy.