Objective:To investigate the use of antibiotics in a hospital to improve the management and proper clinical utilization.Method:A total of 1268 patients discharged from the hospital in April 2007 were surveyed,and a statistical analysis was conducted.Result:The rate of antibiotics usage was 73.50%,and the rate of preventive usage was 52.47%, and the rate of combination usage was 46.14%.The antibiotics most widely used were cephalosporins,quinolones,nitroimidazoles and penicillins.Most antibiotics were used according to experience.And the cost of antibiotics was 22.68%in the total drug expenses of the hospital.New and expensive antibiotics were mainly the drugs in high expenditure.Conclusion:The problems are the higher rate of the application of antibiotics in the hospital,unclear indication for antibiotics usage to some doctors,substandard preventive usage in perioperative period,trend of using more expensive drugs and low rate of checking the pathogen.The results show that it is very important to strengthen the management of antibiotics usage in hospitals.

OBJECTIVE:To evaluate the status quo and the tendency of calcium antagonists used in Guangdong Province.METHODS:The consumption sum,DDDs and the average daily expenses of calcium antagonists in Guangdong Province from2002to2004were analyzed statistically.RESULTS:The consumption sum of calcium antagonists from2002to2004increased year by year,with amlodipine leading the list of consumption sum and nifedipine leading the list of DDDs.CONCLUSIONS:Dihydropyridine calcium antagonists dominate Guangdong market.

Objective:To share a drug treatment experience for multiple drug resistant Pseudomonas aeruginosa.Methods:A retrospective analysis of the pharmaceutical care participated by clinical pharmacist for one case of intervertebral space infection with multiple drug resistant Pseudomonas aeruginosa was carried out.Results:Pharmacists participated in the whole treatment process,made the combined antimicrobial regimen (fosfomycin + ceftazidime + ciprofloxacin),and adjusted the time sequence.As a result,satisfactory curative effect was obtained.Conclusion:The infection with multiple drug resistant Pseudomonas aeruginosa may be treated with the three-drug therapy.Clinical pharmacists can play a positive role in the treatment of complicated infections.

Objective To acknowledge the spouse comorbid conditions of diabetes patients by comparing the average blood sugar level of the spouse of the diabetes patients with normal Guangzhou residents.Methods To sift and analyze the spouse test results of 152 hospitalized diabetes patients from January 2012 to January 2013,by testing the blood sugar level of the experimental subjects,comparing the different blood sugar level results between when they were with empty stomach and 2 hours after oral glucose tolerance test (OGTT).Results There were 32 cases with diabetes,9 cases with impaired glucose tolerance (IGT) and 11 cases with impaired fasting glucose (IFG) in the above 152 experimental subjects.The morbidity rates were 21.05％,5.92％ and 7.24％.All the above results were higher than the Guangzhou residents survey level,there were statistical differences between them.Conclusions The high morbidity rates of diabetes and impaired glucose regulation in diabetes patients spouse are obvious.The works for diabetes sifting and analyzing together with the health education instruction need to be strengthened.

OBJECTIVE To investigate the cause,diagnosis and treatment of the empyema of the anastomotic fistula after esophageal cancer resection.METHODS The clinical data of 624 cases after esophageal cancer and cardia cancer resection from Jan 2000 to Dec 2006 were analyzed retrospectively which included 14 cases of the empyema of the anastomotic fistula.RESULTS All the cases were treated with the closed thoracic drainage,in which 9 cases were cured with closing double-tube chest douching technique,3 cases were succeeded to operate secondary thoracotomy for anastomosis,1 case died after being sent to the higher grade hospital,1 case died for toxic shock and respiratory failure without the chance of reoperation.CONCLUSIONS The key measures of prevention of empyema of post-operative esophagogastrostomy anastomotic fistula inside thorax are strictly distincting between indication and contraindication,carefully preparating before operation,commanding operative time and technical skill,strengthening nursing management,and fulfilling the oral manipulation and nursing prcedures about the drainage tube after operation.

As an important component of multi-physiological-parameter tele-monitoring system, database system is characterized by its large capacity, complex data type and being realtime. According to the design flow of the database, this paper develops a multi-physiological parameter network database with EER concept model and distributed database technology.

Objective::To understand the resources distribution and varieties of crude drug Coptis chinensis Franch. on Chinese market to provide scientific basis for the resource conservation and variety collection and studies of the Chinese medicine. Methods:On the basis of literature survey, field investigation, mandatory survey and interview survey were conducted. Results:Due to the chan-ges in environment for many years and the predatory development in Coptis resources at the end of 20th century, the ecological environ-ment of wild Coptis resources changed significantly with destructed resources and decreased reserves, especially wild Yalian and Yun-lian were on the verge of extinction. The mainstream product on Chinese market was Weilian followed by Yunlian mainly used in small-scale medical clinic and medicine market in the distribution area, while Yalian commodity medicine could not found. Conclusion::The supply and demand on Coptis market should be stabilized to ensure herbalist interests. The production technology of Coptis need further improvement, cultivated area and suitable variety should be confirmed to guarantee the quality of Coptis medicinal materials. State should pay attention to the changes in Coptis resources and strengthen protection for wild Coptis resources to ensure the sustainable development of Coptis resources. Relevant government departments should guide the production of Coptis reasonably.

Objective To investigate the diagnostic value of carotid artery ultrasonography,CT angiography (CTA)and digital subtraction angiography (DSA)for carotid artery dissection. Methods The image data of carotid artery ultrasonography,CTA,and DSA of 24 patients with carotid artery dissection were analyzed retrospectively. Results Twenty-four,16,and 21 patients were examined with DSA,CTA,and carotid artery ultrasonography respectively. The detection rates of carotid artery dissection with DSA,CTA, and carotid artery ultrasonography were 95. 8%,75.0%,and 71. 4% respectively. The DSA mostly showed the line-like sign (n=12,50 %). CTA and carotid artery ultrasonography mostly showed the double lumen sign;they were 37. 5%(n=6)and 52. 4%(n=11)respectively. Compared with DSA,the concordance rates of carotid artery ultrasonography and CTA were 66. 7% and 81. 3% respectively. There was no significant difference (Kappa=0. 39,P=0. 08 and Kappa=0. 43,P =0. 22 respectively). The concordance rate of ultrasonography in combination with CTA and DSA reached 87. 5%(n=15,Kappa=0. 67,P =0.047). There was significant difference. Conclusion DSA is a gold standard for the diagnosis of carotid artery dissection,and it is irreplaceable. Carotid artery ultrasonography in combination with CTA can improve the diagnostic rate. Carotid artery ultrasonography can be used as a screening method for carotid artery dissection.

Objective To study the influence of hemodiafiltration on high-sensitivity C-reactive protein (hs-CRP),serum parathyroid hormone (iPTH) and cardiac function in uremic patients undergoing maintenance hemodialysis (MHD).Methods Forty patients with uremia were divided into hemodiafiltration (HDF) group (n =20) and hemodialysis(HD) group(n =20) by random numbers.Serum hs-CRP and iPTH were measured before treatment and at 6 months after treatment.Their left ventricular diastolic diameter (LVEDD),left ventricular end-systolic dimension (LVESD),interventricular septal thickness (IVST) and left ventricular ejection fraction(LVEF) were measured by echocardiogram.Ten healthy volunteers were recruited as the normal controls.Results After treatment,serum hs-CRP and iPTH decreased significantly in the HDF group (hs-CRP:(3.32±1.t4) mg/L vs.(7.84 ±2.21) mg/L,t =2.072,P =0.046;iPTH:(155.36 ±81.33) ng/L vs.(190.25 ±82.31) ng/L,t =2.121,P =0.023).No significant difference of serum hs-CRP and iPTH was observed in the HD group before and after treatment (hs-CRP:(7.91 ±2.11) mg/L vs.(7.68 ± 1.86) mg/L,t =1.731,P =0.111 ; iPTH:(177.43 ± 85.43) ng/L vs.(184.35 ± 87.21) ng/L,t =1.331,P =0.210).Color Doppler indices of cardiac structure of the HDF group significantly improved after treatment compared with before treatment (LVEDd:(55.3 ±3.7) mm vs.(58.8 ±4.3) mm,t =2.345,P =0.015 ;LVESd:(33.5 ±2.6) mm vs.(36.4±4.3) mm,t=2.178,P=0.046;IVST:(10.2±1.7) mmvs.(13.1 ±1.8) mm,t=2.630,P=0.012;LVEF:(55.3 ±2.6)％ vs.(42.5 ±3.3)％,t =2.860,P =0.010;LVMI:(132.5 ±9.1)g/m2 vs.(137.4 ± 8.7) g/m2,t =2.871,P =0.009).After treatment,cardiac structure of the HDF group was significantly better than that of the HD group (LVEDd:(55.3 ± 3.7) mm vs.(59.1 ± 4.2) mm,LVESd:(33.5 ±2.6) mm vs.(36.1 ±3.4) mm,IVST:(10.2±1.7) vs.(12.4 ±1.3) mm,LVEF:(55.3 ±2.6)％vs.(43.4±2.7)％,LVMI:(132.5 ±9.1) g/m2 vs.(139.4 ±8.9) g/m2;P ＜0.05).During the six month treatment,the incidence rate of cardiovascular events of the HDF group was significantly less than the HD group (36.39％(524/1440) vs.(72.08(1038/1440),x2 =21.583,P＜0.01).Conclusion HDF may efficiently remove iPTH,improve cardiac function of uremic patients,and help them recover from micro-inflammatory state.

Objective To study the clinical significances of serum lipoprotein (LP),high sensitivity C- reactive protein (hs CRP),cystatin (Cys-C),apolipoprotein (Apo) in type 2 diabetic mellitus (T2DM) patients with early renal impairment.Methods Totally 96 patients were divided into two groups:50 cases in simple diabetic group (DM) aged 60-73 years,46 cases in diabetic nephropathy group (DN) aged 61-72 years,and 50 healthy persons as normal control group aged 61-68 years.Serum levels of LP(a),hs-CRP,Cys-C,ApoA1 and ApoB were detected.Results Serum levels of LP (a) [(214.8±182.3) mg/L vs.(113.1±76.2) mg/L],Cys-C[(0.95±0.16)mg/L vs.(0.46±0.17) mg/L],hs-CRP (2.57± 1.84) mg/L vs.(1.07±0.38)mg/L] and ApoB [(1.12±0.18) g/L vs.(0.81 ±0.15) g/L ]were higher in T2DM patients than in normal control group(all P＜0.01),while ApoA1 level was lower than in control[(1.02±0.17)g/L vs.(1.27±0.14)g/L,P＜ 0.01].The levels of LP (a) (455.6 ± 263.5 ) mg/L,Cys-C (2.14 ± 0.68 ) mg/L,hs-CRP (7.24±4.55)mg/L and ApoB(1.22±0.17)g/L in DN group were increased compared with DM group (all P＜0.01).Serum levels of ApoA1 were decreased in DN group compared with DM group [(0.88±0.17) g/L vs.(1.02±0.17) g/L,P＜0.01].The serum levels of LP (a) (r=0.487,P＜0.05),Cys-C(r=0.55,P＜0.05),hs-CRP(r=0.478,P＜0.01) and ApoB(r=0.505,P＜0.05) were positively correlated with urinary mAlb in T2DM patients,while ApoA1 was negtively related with mAIb(r=-0.52,P＜0.05).Conclusions The serum LP (a),Cys C,Apo and hsCRP could be sensitive markers of early renal impairment,and their combinatorial measurement offers more value in patients with T2DM.