Objective To assess antibiotic prescription habits,cost pattern and the prospective intervention in Intensive Care Unit was analyzed.Methods Data on antibiotic utilization and antibiotics susceptibility were col-lected prospectively from individual electronic charts from July 2014 to September 2014.Results 225 of 246 patients surveyed used antimicrobial during the ICU stay,and antibacterial drug utilization rate was 91.46%.Cefperazone-sulbactam and piperacillin-tazobactam were the most prescribed medications.Total defined daily dose ( DDDs) was 1121.1 DDDs.Bacteria culture was 98 positive in 677 cases and 101 pathogenic bacteria were isolated.Conclusion Interventional programs should focus on promoting infectious control with rational antibiotic prescription aimed at mini-mizing the future emergence of bacterial resistance and futile.

OBJECTIVE:To study the effects of modern decoction method vs. traditional decoction method on decoction rate and decoction quality. METHODS: The advantages and disadvantages were compared between the two decoction methods through analysis on the whole decoction process and the storage of the decoction before oral administration taking major components or active components as parameters. RESULTS: As compare with traditional decoction method, the modern decoction method had more advantages for in which the operation is standard, the contents of active components were high, and the quality control can be performed from many ways. CONCLUSION: The modern decoction method deserves to be popularized.

Objective To study the concentration of plasma total homocysteine(tHcy) in patients with chronic renal failure(CRF).Methods 105 chronic renal failure patients and 35 health individuals to our hospital were chosen to measure the level of tHcy using enzymatic cycling assay method.Results The mean level of tHcy in renal failure period C RF patients was significantly higher than that in normal controls (t =3.12,P ＜ 0.05),and the level of plasma tHcy was significantly higher in Uremia stage than in renal failure period in CRF patients (t =6.41,P ＜0.05),and the level of plasma tHcy was significantly higher in renal failure period than in renal function decompensated period in CRF patients (t =11.27,P ＜ 0.05).Conclusion The level of plasma tHcy were significantly elevated in patients with CRF,and there is a trend that the level of plasma tHcy increases with severity of CRF.Serum tHcy concentration have significant value in the diagnosis and understanding the condition of patients with CRF.

Objective To investigate clinical and pathological features of chronic hepatitis B ( CHB) with nonalcoholic fatty liver disease(NAFLD).Methods The clinical and pathological data of 70cases of CHB and 68 cases of CHB with NAFLD and 42cases of NAFLD were analyzed and compared .Results In this patients with CHB overlapped NAFLD , plasma ALT,AST,GGT con-centrations were higher than that in CHB and NAFLD groups ( P <0.05 , P <0.01 ) , compared with CHB group ,the levels of serum TC,TG,FBS,INS and IRI on patients with CHB overlapped NAFLD were increased ( P <0.05, P <0.01), Compared to patients B groups, serum hepatitis B virus DNA titer in patients with steatosis was significantly lower ( P <0.05) and reduced sharply with the increasea degree of hepatic steatosis ( P <0.05 ) .hepatic inflammation grade and fibrosis stage between CHB patients with and with-out steatosis ( P >0.05 ) .Conclusions The reverse association of hepatitis B virus titer with the degree of hepatic steatosis needs further investigation .Hepatic steatosis is associated with metabolic factors than virus factors .The existence of hepatic fatty degeneration dose not exacerbate liver inflammation or fibrosis .

Programmed cell death 4 (PDCD4) is a newly discovered tumor suppressor gene, whose expression is regulated by methylation of PDCD4 gene and many kinds of microRNAs.Protein of PDCD4 enco-ding can improve the sensitivity of tumor cells to anticancer agents, inhibit tumor development and metastasis process, and play an important role in a variety of tumors.It is expected to be a clinical indicator to determine the prognosis of tumor.

Objective To compare the clinical effect between CO2-1aser assisted and cold instrument assisted suspension laryngoscopic surgery for vocal fold cyst.Methods From January, 2011 to December, 2014, 72 patients with vocal fold cyst, which diagnosed by strobolaryngoscopy, were randomly divided into CO2-1aser assisted group and cold instrument group.Strobolaryngoscopy, acoustic analysis and perceptual voice analyses were performed on each patient before surgery, 1 month, and 3 months after surgery, respectively.Results All operations were successfully completed.The complete vocal fold cyst resection rate of CO2-1aser assisted group was significantly higher than cold instrument group (29/36, 80.5％ vs 21/36, 58.3％, P ＜ 0.05), especially the left vocal fold cyst (13/16, 81.3％ vs 9/19, 47.4％, P ＜ 0.05).The complete right vocal fold epidermoid cyst resection rate was significantly higher than retention cyst (17/19, 89.4％ vs 11/18, 61.1％, P ＜ 0.05).Two recurrent cases were found in cold instrument group but no recurrent cases in CO2-laser assisted group (0/36, 0％ vs 2/36, 5.6％, P ＞ 0.05).Correlation analysis showed that vocal fold cyst recurrence was related to complete resection rate and has no relation with surgical methods, histopathological types and position.Subjective and objective assessment of voice quality in preoperative, 1-month postoperative and 3-month postoperative were similer between CO2-1aser assisted group and cold instrument group (P ＞ 0.05).Conclusion The CO2-laser assisted suspension laryngoscopic surgery for vocal fold cyst, can increase the surgical precision, reduce the left hand impact, improve the complete resection rate and reduce the recurrence rate.

Objective To investigate the mutations of basal core promoter (BCP) and precore (PreC) region of hepatitis B virus (HBV) and the association with the development of hepatocellular carcinoma in patients with chronic HBV infection.Methods Totally 381 untreated HBV patients were recruited from the Department of Infectious Diseases,People's Hospital of Shangyu from Jan 2003 to Dec 2010,which included patients with chronic hepatitis B (CHB,n =166),cirrhotic hepatocellular carcinoma (cirrhotic-HCC,n =158) and noncirrhotic hepatocellular carcinoma (noncirrhotic-HCC,n=57).The mutations in HBV BCP and PreC and the genotypes of HBV were determined by polymerase chain reaction (PCR) and direct sequencing.Data were analyzed by chi square test and Logistic regression.Results The HBV genotype of most cases was genotype B (CHB,n =124;cirrhotic-HCC,n=126 ; noncirrhotic-HCC,n=50).In univariant analysis,BCP V1753 (x2 =7.927,P=0.005),BCP T1762/A1764 (x2 =12.796,P＜0.01),PreC A1896 (x2 =6.890,P=0.009) and PreC A1899 (x2=11.850,P =0.001) mutations were more frequently detected in cirrhotic-HCC patients than those in CHB patients.PreC A1896 (x2 =27.310,P＜0.01) and A1899 (x2=7.575,P=0.006) mutations were highly detected in noncirrhotic-HCC patients than those in CHB patients.Multivariate Logistic regression analysis revealed that in HBeAg positive patients,BCP T1762/A1764 (wald=6.180,P=0.016,OR=8.883) and PreC A1899 (wald=10.279,P=0.001,OR=7.475) mutations were independently associated with the development of cirrhotic-HCC; PreC A1896 (wald=4.324,P=0.038,OR=4.439) and PreC A1899 (wald=4.850,P=0.028,OR=6.010)mutations were independently associated with the development of noncirrhotic-HCC.While in HBeAg negative patients,PreC A1896 mutation (wald=15.448,P＜0.01,OR=12.128) was independently associated with the development of noncirrhotic-HCC.Conclusions BCP T1762/A1764 mutations are associated with the development of cirrhotic-HCC in HBeAg positive patients.PreC A1896 mutation is associated with the development of noncirrhotic-HCC in HBeAg positive and HBeAg negative patients.PreC A1899 mutation is associated with the development of cirrhotic-HCC and noncirrhotic-HCC in HBeAg positive patients.

Objective To compare the pre-existing mutations in reverse transcription region of HBV in patients with different HBV infection stages.Methods Totally 474 patients with chronic HBV infections,including 205 with chronic hepatitis B (CHB),153 with liver cirrhosis and 116 with hepatocellular carcinoma (HCC),were enrolled from the People' s Hospital of Shangyu and the First Affiliated Hospital of Zhejiang University during January 2011 and June 2013.All patients had not received nucleos (t)ide analogues treatment.HBV RT region mutations and genotypes were determined by PCR followed by sequencing.SPSS14.0 was used for statistical analysis.Results There were 387 (81.6％) patients with HBV genotype B,in which 156 were with CHB,124 were with liver cirrhosis,and 107 were with HCC.Nucleos(t)ide analogues-related mutations were observed in all the above 387 patients.rtS106C mutation was more popular in CHB and liver cirrhosis (14.1％ and 14.5％) patients than that in patients with HCC (4.7％) (x2 =6.126,6.207,P ＜0.05); And the positive rates of rtD134E/G/N/S mutations were also higher in CHB and cirrhotic patients (21.8％ and 20.2％) than that in HCC patients (10.3％,x2 =5.933,4.263,P ＜ 0.05).rtD134E/G/N/S and rtS106C mutations were correlated with HBeAg (P ＜0.01) and gender (P ＜ 0.05),but not with HBV virus load and age (P ＞ 0.05).The mutation frequencies in A-B interdomain were higher in CHB and cirrhotic patients (5.3％ and 5.6％) than that in HCC patients (3.5％,x2 =9.018,11.018,P ＜ 0.01).Conclusions Nucleos (t) ide analogues-related mutations exist in various HBV infection stages.rtSl06C and rtD134E/G/N/S mutations may be involved in necro-inflammation,and A-B interdomain mutations may be correlated with necro-inflammation,immune response and fibrosis in chronic liver diseases.

Objective To raise the awareness of congenital ornithine transcarbamylase deficiency (OTCD) by analyzing the clinical features and the family pedigree in a child with OTCD.Methods Clinical characteristics were analyzed in a child with OTCD.The genetic analysis was performed in ten exons and nine intron-exon boundaries in the ornithine transcarbamylase (OTC) gene of the case and his family by direct sequencing of PCR-DNA from peripheral blood.Family history including his grandparents and uncle was registered.Results The onset age of the case was 6 months old,the clinical picture was characterized by recurrent episodes of vomiting,low spirits,hyperammonemia,and abnormal liver function.His brother died of the similar performance at 6 months old.His sister was healthy.IVS1-2A＞G intron mutation of OTC gene was found in the case,while his mother and sister were the carriers and his father revealed no mutation.His maternal grandparents and his uncle's family were healthy.Conclusion OTCD is a kind of congenital genetic disease,and is one of the main causes of hyperammonemia.Misdiagnosis is very common because clinical symptoms of this disease are variable.IVS1-2A＞G mutation in OTC gene is the pathogeny of this case.The family genealogy indicates that this case is a kind of X-linked recessive hereditary disease.

ObjectiveTo understand the feature of blood pressure in children aged 7 to 12 years in Zhengzhou.Methods According to stratiifed cluster random sampling method, children aged 7 to 12 years in ifve schools from three urban and two suburban counties in Zhengzhou were analyzed. The height, weight, waist circumference, hip circumference, systolic blood pressure (SBP), and diastolic blood pressure (DBP) were measured and analyzed.Results The survey included total 6460 children aged 7 to 12 years, 3206 urban children (49.63%), 3254 suburban children (50.37%), 3525 boys (54.57%) and 2935 girls (45.43%). SBP in boys [(117.86±18.18) mmHg] was signiifcantly higher than that in girls [(113.82±13.11) mmHg (t=3.16;P=0.002). The incidence of hypertension in children in Zhengzhou was 7.52%. The blood pressure in boys was higher than that in girls (χ2=9.66,P=0.002). The blood pressure in urban boys and girls was higher than that in suburban boys and girls respectively (χ2=24.15, 14.39;P=0.000). The SBP and DBP had positive correlation with age, height, weight, BMI, waist circumference in boys (P<0.01). The SBP had positive correlation with age, height, weight, BMI, waist circumference in girls (P<0.01). Conclusions The blood pressure is higher in boys than in girls, which also is higher in urban children than in suburban children in Zhengzhou. The SBP is related to the age, height, weight, BMI, waist circumference.