OBJECTIVE:To evaluate the effect of special rectification on the rational use of antibiotics and relieving bacterial resistance. METHODS:It was divided into groups based on the before and after 3 years of special rectification. The data of related index and bacterial resistance of antibiotics in the clinical use in 2 groups were compared. RESULTS:After special rectification, the use rate of antibiotics in inpatients was decreased from 77%to 55%,use intensity was decreased from 86 DDDs/(100 person· d) to 39 DDDs/(100 person·d),the prophylactic use rate of antibiotics for typeⅠincision surgery was decreased from 98% to 27%,the antibiotics prescriptions of patients in outpatient and emergency departments were respectively decreased from 36% to 12% and 49% to 23%. The submission rate of microbiological testing specimens was increased from 20.2% to 38.8%,submission rate of sterile site specimens was increased from 29.8% to 37.6%. The detection rate of fungus was decreased from 14.4% to 11.2%. The detection rates of Escherichia coli and Klebsiella pneumoniae producing extended-spectrum β- lactamases (ESBLs) strains were respectively decreased from 57.3% to 51.3% and 43.2% to 36.1%. The total detection rate of top 5 multi-drug resis-tant bacteria was decreased from 48.4% to 29.3%,however,the detection rate of Acinetobacter baumannii was increased to 80.7%,and the resistance rates of Acinetobacter baumannii to imipenem and meropenem were respectively 66.9% and 69.1%. There was an increasing trend for Klebsiella pneumoniae to 1,2 and 3-generation cephalosporins,piperacillin amoxicillin/tazobac-tam,imipenem,meropenem. CONCLUSIONS:Special rectification of antibiotics has obvious effect on the rational use of antibiot-ics and relieving bacterial resistance in the clinic,and it improves the management of clinical use of antibiotics in hospital. Howev-er,bacterial resistance situation is still grim,it needs to establish a long-term management mechanism of clinical use of antibiotics, strengthen the monitoring pathologic examination and monitoring of bacterial resistance,and strictly perform hand hygiene and dis-infection and isolation system.

nges in standard square field.

Objective To investigate the status quo and influencing factors of self-management ability in patients undergoing continuous ambulatory peritoneal dialysis (CAPD).Methods Totally 339 CAPD patients with clinical follow-up regularly were investigated for the situation of self-management with general information questionnaire and Self-management Scale for CAPD.Results The total score of patients' self-management ability was (66.03±15.57).Multiple linear regression analysis showed that education level,marital status,occupation and duration of dialysis were influencing factors of patients' self-management ability.Conclusions Patients undergoing CAPD have certain degree of self-management ability.Nurses should promote their self-management ability according to different education level,marital status,occupation and duration of dialysis.

Objective To investigate the scale of self-efficacy and the influencing factors among the elderly diabetic population in rural communities in Shanghai . Method The diabetic patients in the rural communities were involved in the study by questionnaire to analyze the patient′s self-efficacy and its influencing factors. Results The total score of self-efficacy was (77.48 ± 22.22), with the index score of 59.60%. By multiple stepwise regression analysis, the influencing factors were age, education level and annual income. Conclusions The self-efficacy of diabetic patients is at a low level. To improve their self-efficacy, we should strengthen the education to the diabetic patients with age of 40~49 or poor in education or lower in income.

Formula granule of traditional Chinese medicine (TCM) has been characterized as a safe medication with the advantages of accurate dosage and easy to carry.In this study,references over current status of the development of TCM formula granule were retrieved,so were those of the market situation and its application to intelligent pharmacy of TCM.Then the key problems restricting the development of the application of TCM granules were discussed,in hope of providing a reference for the development and its application to the intelligent pharmacy of TCM.

Objective To observe the pathological changes of heart failure caused by transverse aortic constriction in rats.Methods Partial thoracotomy was performed to the second rib and the transverse aortic constriction was performed between the innominate and left carotid arteries to establish a model of heart failure in 24 rats.The same operation was performed on another 8 rats, except for the ligation of the transverse aorta.Echocardiographic assessment, hemodynamic measurement, myocardial histopathological examination and NT-proBNP measurement were performed to the sham group at 12 weeks and model group at 4 weeks, 8 weeks, 12 weeks after the operation.Result At 4 weeks after the operation, NT-proBNP, EF, FS and -dp/dtmax of the model group was significantly increased and LVESV, +dp/dtmax of the model group were significantly decreased (P<0.05).At 8 weeks after the operation, EF and-dp/dtmax of the model group were increased and +dp/dtmax of the model group was significantly decreased (P<0.05).At 12 weeks after the operation, NT-proBNP, EF and +dp/dtmax of the model group were decreased, and LVESV, LVEDV and -dp/dtmax of the model group were increased (P<0.05).The cardiomyocytes became hypertrophic and lined up in disorder at 4 weeks after the operation.Pathologic examination of the myocardial tissue showed connective tissue proliferation and inflammatory cell infiltration at 8 weeks after the operation, and cardiomyocyte apoptosis and collagen fiber deposition at 12 weeks after the operation.Conclusions Transverse aortic constriction induces heart failure in rats.The pathological processes are compensatory hypertrophy at 4 weeks after the operation, initial reaction of decompensation at 8 weeks after the operation, and heart failure at 12 weeks after the operation.

Lipid microsphere drug delivery system is a hot issue in pharmceutics studies .In this paper , the mechanism , prep-aration method and the key influence factors of lipid microsphere drug delivery system were reviewed respectively .Some new discovery and development were introduced in order to enhance the development and application of lipid microsphere drug delivery system as a drug delivery tool .

Objectives: To implement cost effective evaluation on the interventions to personality dysfunction in adolescents, so as to provide scientific evidences for extending the interventions. Methods: Cost identification, measurement of the cost, and valuing the cost were implemented to calculate the cost of the interventions. Effects of the interventions were measured based on three indicators: (1) differences of the decreasing scores of Personality Diagnostic Questionnaire-4 (PDQ-4) between intervention group and control group from grade one to three, (2) differences of the decrease number of students with personality dysfunction between intervention group and control group from grade one to three, and (3) differences of the incidence of personality dysfunction between intervention group and control group. Cost-effectiveness ratios (CERs) were calculated for the economic evaluation of the interventions. Results: The total cost of the interventions was 67, 860 Yuan. After intervention, among all of the students in intervention group, the cost of reducing one score of PDQ-4 was 9. 25 Yuan. The cost of reducing one person with personality dysfunction was 6169 Yuan. And the cost of avoiding one person developed personality dysfunction was 2714 Yuan. The cost effectiveness were not balanced among Cluster A, Cluster B and Cluster C personality dysfunction. Similar tendency was found among 10 types of personality dysfunction. Conclusion: The "Intervention Measure on Personality Dysfunction" in adolescents is easy to implement and has relative low costs. Further interventions of the specific cluster or type of personality dysfunction can be carried out based on the findings from this study.

The purpose of this paper is to know about the review for the Sixth Vital Sign and evaluation tools in foreign countries, and to explore the important role on patients′ basic physiological state, clinical treatment and diagnosis when the different indicators as the sixth vital signs, as to better serve individual and medical services.

Objective:To compare clinical characteristics,treatment patterns and physiological indicators in bipolar disorder(BD)patients with different age of onset.Methods:Totally 380 patients with DSM-5 BD were se-lected in this study.Psychiatrists diagnosed the patients using the Mini International Neuropsychiatric Interview.The clinical information questionnaire and the Global Assessment of Functioning scale were utilized to collected clinical characteristics,treatment status,and physiological indicators.The onset age of BD was divided into 21 and 35 years as cut-off points.Multivariate logistic regression and linear regression were used to analyze related factors.Results:Among the 380 patients with BD,199 cases were early-onset group(52.4％),121 cases were middle-onset group(31.8％),and 60 cases were late-onset group(15.8％).There were 26.6％of patients in the early-onset group in-itially diagnosed as depression,23.1％in the middle-onset group,and 11.7％in the late-onset group.Multivariate analysis revealed that compared to the early-onset group of BD,the middle-onset(OR=2.22)and late-onset(OR=4.99)groups had more risk to experience depressive episodes,and the late-onset group(OR=6.74)had 6.74 times of risk to suffer from bipolar Ⅱ disorder.Additionally,patients in the middle-onset(β=-1.52)and late-on-set(β=-4.29)groups had shorter durations of delayed treatment,and those in the middle-onset(β=-1.62)and late-onset(β=-3.14)groups had fewer hospitalizations.Uric acid levels were lower in both the middle-onset(β=-28.39)and late-onset(β=-31.47)groups,and total cholesterol level was lower in the middle-onset group(β=-0.23).Conclusion:Patients with BD in different age of onset show significant differences in clinical charac-teristics,treatment conditions and physiological indicators.