OBJECTIVE:To consolidate the results of special antibacterial drug rectification so as to improve the rational medi-cation of antibacterial drugs. METHODS:By using the method of retrospective analysis,the antibacterial drug application data in 2011(before rectification and initial stage of rectification),2012(middle stage thereof)and 2013(later stage thereof)were sum-marized,compared and analyzed. RESULTS:After special rectification(Jan. 2011 vs. Dec. 2013),the utilization rate of antibacte-rial drugs in perioperative period for class I incision decreased from 80.42% to 24.49%. That of antibacterial drugs in emergency treatment decreased from 53.79% to 36.23%. The examination rate of microbial samples in inpatients who would use special-grade antibacterial drugs increased from 16.12% to 94.17%. The use intensity of antibacterial drugs by inpatients decreased from 70.28 DDDs/(100 persons·d) to 27.44 DDDs/(100 persons·d). The utilization rate of antibacterial drugs by inpatients decreased from 65.99% to 46.45%. CONCLUSIONS:Special rectification has remarkable effects on rational clinical application of antibacterial drugs. Regulation and evaluation should be strengthened to maintain the effects and continuously improvement should be made.

Objective The bidirectional cavopulmonary shunt (BCPS) is a major step in the staged palliation of functionally univentricular heart defects.Whether to preserve of additional pulmonary blood flow (APBF) has been a highly controversial issue.The purpose is to mathematical model and set out to determine the significa advantages and disadvantages of bidirectional cavopulmonary shunt with additional pulmonary blood flow:a theoretical analysis nce of APBF and the appropriate APBF ratio.Methods We used models of the univentricular circulation after the bidirectional cavopulmonary anastomosis with additional pulmonary blood and to computational analyze the impact of APBF on oxygen delivery,APBF flow on the CVP and SaO2.Results The influence of APBF depends on the ratio of superior vena cava flow to inferior vena cava flow ( QSVC/QIVC ).For QSVC/QIVC ＞ 0.3,APBF may be associated with decreased oxygen delivery.For QSVC/QIVC ＜ 0.3,appropriate APBF may be associated with increased oxygen delivery.A linear relationship exists between the increase of APBF and CVP,and the slope was depended on the value of pulmonary vascular resistance.Estimating APBF from CVP measurements may be a feasible method.A nonlinear relationship between the increase of APBF and oxygen saturation,and estimating APBF from SaO2 measurements may result in errors.BCPS and appropriate APBF may optimal the oxygen delivery with the increase of age and the decrease in QSVC/QIVC.For patients who accepted BCPS without APBF,there is a decreasing tendency of oxygen delivery with the increase of age and the decrease in QSVC/QIVC.For patients who suffered pulmonary arterivenous malformation,there is a more obvious decrease in oxygen delivery.ConclusionFor patients under age who has normal pulmonary vascularbed ( that is,QSVC/QVC ＞ 0.3),elimination of additional pulmonary blood flow can improve the oxygen delivery under a given cardiac output.For patients who with hypoplastic pulmonary vascular or in older patients under age,APBF is necessary to improve oxygen delivery.For patients who have to accept BCPS as the final procedure,preserving of APBF is suggested.