Objective To investigate effect of antibiotic standardized management on prophylactic application of antimicrobial agents in type I andⅡ incision.Methods The hospital implemented the rule of Clinical Use of Antibiotics Management Approach and 2013 National Clinical Use of Antibiotics Special Rectification Program of Activities, 200 clinical surgery effective surgical cases before implementation and 250 clinical surgical effective surgical cases after implementation were selected.The thyroid surgery and hernia repair surgery were chosen as type I incision, and cesarean section were chosen as type Ⅱ incision.The basic data of surgery classification and antibacterials use were collected, then the antibiotics utilization ratio, the timing of administration of antibiotics, postoperative use of antibiotics time and combination therapy were compared between pre-implementation and post-implementation.Results The condition in accordance with applicable standards of antibiotics post-implementation: the antibiotics utilization ratio of thyroid surgery was 0 and post-operative stopping time was within one day.There was no combination therapy of three types surgery ( thyroid surgery, hernia repair surgery and cesarean section).The application of antimicrobial agents improved significantly but did not reach criteria:antibiotics utilization ratio of hernia repair surgery was 62.00%, which was higher than the criterion of 30% in antibiotic standardized management.Withdrawal time of antimicrobial agents post-operation in hernia repair surgery was (1.01 ±0.15)d which was above the standard of 1d and in cesarean section was (2.02 ±0.25)d which was above the standard of 2d.Conclusion The hospital strengthens management and standardizd regulation of antimicrobial drugs could facilitate standardization in type I and Ⅱ incision, and improve the quality of hospital medication administration of antibiotics.

Objective To investigate the clinical features of systemic sclerosis( SSc)patients with pulmonary hypertension(PAH)ane its treatment approach ane prognosis. Methods The clinical information of 16 SSc patients with PAH(PAH group)were recoreee. Seventy-four SSc without PAH were servee as no-PAH group. Patients in PAH group were given the basic therapy inclueing oxygen therapy,anticoagulants,careiac, eiuretic,anti-rheumatic,pulmonary vasoeilator therapy. Results The rate of antinuclear antiboey in PAH ane non-PAH group were 87. 5%(14 / 16)ane 75. 7%(56 / 74),ane the eifference was statistically significant(P= 0. 508). Serum albumin,erythrocyte seeimentation rate at 1 h in PAH group were(32. 6 ± 4. 6)g/ L ane (48. 4 ± 29. 4)mm/ 1 h. The rate of acral lesion proteinuria,hematuria,ECG abnormal rate were 62. 5%(10 / 16),62. 5%(10 / 16),43. 8%(7 / 16),62. 5%(10 / 16)respectively in PAH group. Serum albumin, erythrocyte seeimentation rate at 1 h in PAH group were(35. 6 ± 5. 0)g/ L ane(31. 3 ± 26. 3)mm/ 1 h in non-PAH group. The rate of acral lesions,proteinuria,hematuria,ECG abnormal rate were 31. 1%(23 / 74),27. 0%(20 / 74),12. 2%(9 / 74),9. 5%( 7 / 74 ) respectively in non-PAH group. The eifferences were significant between in terms of all above ineices(P = 0. 033,0. 041,0. 018,0. 006,0. 003,0. 000). During follow-up,the eisease was in stable in 74 case of non-PAH. Among 16 case with PAH,1 mile case was lost,1 case with severe PAH eiee of severe pneumonia,pulmonary hypertension,right ventricular failure,respiratory failure,3 mile patient with PAH were with eevelopment of primary eisease ane the rest 11 cases of PAH patients were with lower interstitial lung eisease than that of the previous eetectee by chest HRCT. Oppler echocareiography measurement of pulmonary artery systolic pressure was(48. 9 ± 2. 4)mmHg before treatment ane then reeucee to(31. 5 ± 4. 5)mmHg in rest 11 cases(t = 22. 27;P = 0. 001)measuree by Doppler echocareiography. Careiac function was improvee euring followee up ane no other aeverse reactions were seen. Conclusion SSc patients merge multiple PAH show it associate with other organ eamage,ane has a poor prognosis. Early careiac Doppler ultrasoune shoule be performee in oreer to get early eiagnosis ane treatment. Treatment approaches shoule be targetee at the primary eisease ane incentives such as pulmonary besiee oxygen therapy,eiuretics,careiac ane anticoagulant erugs in oreer to improve prognosis.

Objective To study the changes of resting-state brain activity in knee osteoarthritis(KOA)patients with chronic pain.Methods The data of 21 KOA patients (KOA group) and 21 healthy controls (HC group) who underwent standard resting-state fMRI scan were analyzed with regional homogeneity (ReHo) method to observe the changes in the patients in contrast to the controls.Results Compared to HC group,patients of the KOA group showed ReHo changes in bilateral frontal lobe,bilateral parietal lobe,bilateral temporal lobe,bilateral cerebellum,limbic system and default-mode network.Conclusion Patients with chronic pain demonstrate abnormal neuron activities in the brain regions, and control loops not only related with pain but also related with emotive function disorder and cognitive impairment.

Purpose To investigate the difference of imaging features of tree-in-bud (TIB) sign at CT between stage Ⅰ central lung cancer and bronchial disseminated pulmonary tuberculosis in order to reduce the misdiagnosis rate of central lung cancer.Materials and Methods 32 patients of stage Ⅰ central type lung cancer confirmed pathologically or clinically (lung cancer group) and 47 patients of bronchial disseminated pulmonary tuberculosis confirmed pathologically or clinically (tuberculosis group) underwent chest CT scanning and were found with TIB sign.The imaging data of all the cases were analyzed retrospectively in terms of distribution range,accompanying CT findings of TIB sign,and abnormalities of segmental and (or) larger bronchus proximal to it.Results TIB sign was mainly focal (unilobar) in lung cancer group (96.88％),while it was mainly diffuse (more than one pulmonary lobe) in tuberculosis group (80.85％).The difference was significant (P＜0.01).Accompanying CT findings:① Obstructive bronchial mucoid impaction distal to the TIB was more common in lung cancer group than in tuberculosis group (100％ vs 6.38％,P＜0.01).② Consolidation and/or ground-glass opacities were found both in lung cancer group (34.38％) and in tuberculosis group (48.94％).The difference was not significant (P＞0.05).③ Cavity was less common in lung cancer group than in tuberculosis group (0 vs 38.30％,P＜0.01).④ Nodules with diameter larger than 5 mm were much fewer in lung cancer group than in tuberculosis group (0 vs 76.60％,P＜0.01).TIB sign was found in 33 lobes in lung cancer group,and the abnormity was found in all these lobes (100％);while in tuberculosis group,TIB sign was found in 144 lobes and the abnormity was found in 56 lobes (38.89％).Conclusion TIB sign shows differences between stage Ⅰ central lung cancer and bronchial disseminated pulmonary tuberculosis.The TIB signs such as focal distribution,accompanied by bronchial mucoid impaction and abnormality of segmental or (and) larger bronchus may predict the high possibility of central lung cancer.

Objective To integrate the best available evidence of preoperative care for ophthalmic patients undergoing day surgery into clinical practice,so as to improve the quality of nursing.Methods This project was performed in an ophthalmic day surgery ward,guided by the Joanna Briggs Institute(JBI)Practice Application of Clinical Evidence System (PACES) program which includes 3 procedures:baseline audit,evidence implementation,and re-audit.Eight audit criteria were made based on evidences from JBI.Twelve nurses and 267 patients were enrolled in baseline audit,and 12 nurses and 234 patients were recruited for re-audit after evidence implementation.Results Six of the audit criteria that nurses showed poor compliance in the baseline audit(0％～28.5％),such as providing preoperative telephone screening and reducing preoperative waiting time through better preparation and planning,were significantly improved in the re-audit(71.43％～100％).The preoperative waiting time was shortened from 109.70±18.34 minutes to 88.22±9.91 minutes;the correct rates of operation-related knowledge in patients increased from 63.0％ to 85.09％;the patients' satisfaction scored 84.23±17.01 in baseline audit and 95.02±7.32 in the re-audit(P＜0.001).Conclusion Application of evidence-based preoperative care of ophthalmic patients undergoing day surgery can improve nurse's behavior and compliance with the implementation of evidence into clinical practice,and increase patient satisfaction.Continuous audits are needed to continuously improve clinical nursing quality.