Objective To investigate the application of antimicrobial agents in a tertiary first-class hospital before and after implementing special rectification activity on clinical antimicrobial use.Methods Data about antimicrobial use in a hospital in Sichuan Province between January 2011 and December 2013 were collected and analyzed retro-spectively,data included antimicrobial varieties,the ratio of antimicrobial prescription in outpatient department to emergency department,percentage of antimicrobial application expense in the total hospitalization expense,antimi-crobial use rate and use density,antimicrobial use rate and use density of special use antimicrobial agents,microbial detection for patients receiving restricted and special antimicrobials.Results Before implementing rectification of an-timicrobial use,there were 88 kinds of antimicrobial agents in hospital,after implementing rectification,there were 50 kinds of antimicrobial agents.The ratio of antimicrobial prescription in outpatient department to emergency de-partment,and the percentage of antimicrobial expense in the total hospitalization expense were both lower than be-fore rectification (both P <0.05 ).Antimicrobial use rate and antimicrobial use rate of special use antimicrobial agents before and after rectification were all statistically different(all P <0.05).Compared with before rectification, microbial detection rate of specimens from patients receiving restricted and special use antimicrobial agents improved significantly (both P <0.05 ).Perioperative antimicrobial prophylactic use rate in patients with class Ⅰincisional operation after rectification was lower than before rectification,while percentage of antimicrobials used 30 min-2 h before operation was higher than before rectification (both P <0.05).Conclusion After three year special rectifica-
tion,antimicrobial use become more rational,but management still needs further and continuous improvement.

Objective To study the impact of medicine retention time and the therapeutic effect to the chronic renal failure by retention enema with Chinese traditional Medicine at different hour.Methods Totals of 60 patients with chronic renal failure disease were randomly divided into observation group (n=30)and control group (n=30).The observation group adopted enema at 7:00-9:00, and the control group adopted enema at routine hour ( 19:00 -21:00 ) .Following items were observed and compared between two groups: subjective feeling, adverse reflection, defecating ratio before enema, the appetency of defecating after enema, medicine retention time after enema, the Scr before and after enema, the change of BUN and Ua.The observation period was 30 days ( one period of the treatment) .Results Compared with the control group, the adverse reflection, such as bellyache, abdominal distension, anus ache, downfallen pressure feeling at anus were significantly relieved in observation group (P<0.05).The times & severity of the appetency of defecating after enema in observation group was reduced apparently than that in control group (P<0.05).The average defecating ratio before enema in observation group was significantly improved (83.3%vs 20.0%;χ2 =79.452,P<0.01).The retention time in observation group was ( 324.12 ±129.47 ) min, and that in control group was ( 225.32 ± 104.21)min,and the difference was statistically significant (t=4.605,P<0.01).The blood BUN, Scr, Ua were down after enema in both groups, but the improvement in observation group was significantly better than that in the control group (P <0.05).Conclusions By practicing retention enema with Chinese traditional Medicine at 7:00-9:00, the medicine retention time in intestines can be extended, and the therapeutic effect to the chronic renal failure can be improved.

OBJECTIVE: To investigate the changes in diversity, relative abundance and distribution of intestinal flora in patients with chronic rhinosinusitis and nasal polyps (CRSwNP) using high-throughput sequencing technology identify the intestinal flora significantly related to pathogenesis and progression of CRSwNP. METHODS: Ten patients with CRSwNP hospitalized in the Department of Otolaryngology-Head and Neck Surgery of Guangdong Provincial People's Hospital were selected as the case group with 10 healthy volunteers recruited in the same period as the control group. Fecal genomic DNA extraction kit was used to extract the DNA in the fecal samples, and the DNA fragment length was measured and quantified. The V3 and V4 highly variable regions of the 16S rDNA gene of prokaryotes were amplified followed by library construction, Illumina MiSeq sequencing, sequence alignment and species identification analysis. The relative abundance, diversity and distribution characteristics of the intestinal flora were analyzed, and the relevant metabolic pathways were predicted. RESULTS: Compared with the control group, the patients with CRSwNP had significant changes in the overall structure of the intestinal flora, highlighted by increased abundance of Saccharopolyspora and decreased contents of , , and . Among the metabolic pathways predicted to be associated with CRSwNP, 9 showed significant changes in patients with CRSwNP as compared with the control group ( < 0.05). CONCLUSIONS Patients with CRSwNP have significant changes in the structural characteristics of intestinal flora related with multiple metabolic pathways, and these changes may play an important role in the development of chronic rhinosinusitis.

Purpose/Significance To explore the changes,challenges,key application scenarios and future development directions of generative artificial intelligence(AI)represented by ChatGPT in the field of hospital management,and to provide references for the ap-plication of AI natural language processing(NLP)technology in the field of hospital management in China.Method/Process Through literature review and analysis,the changes and challenges brought about by the rapid development of generative AI in the field of hospital management are sorted out,its key application scenarios and future development directions in the field of hospital management are empha-sized and explored.Result/Conclusion AI has broad application prospects in the field of hospital management,and it should focus on exploring its practical application scenarios and strategic directions to provide reference and guidance for promoting the high-quality de-velopment of public hospitals.