OBJECTIVE:To investigate the preventive application of antibacterials during perioperative period in Guangdong area.METHODS:By a retrospective study,a total of 285 discharged medical histories collected from 25 hospitals in 2006 were analyzed statistically.RESULTS:Of the 285 discharged medical records reviewed,three cases from one hospital were not given antibacterial,but irrational problems in medical indications,pertinences of choosing drugs,course of treatment,application opportunities,dosages and routes of administration and combined use of antibacterial were seen respectively or simultaneously in all the other cases,among which using antibacterial without indications,choosing drugs without pertinence and application in a long course were the most serious.CONCLUSION:Irrational application of antibacterial during perioperative period is an ubiquitous problem existing in the 25 hospitals investigated.It is urgent to tighten control on the rational use of antibacterials.

OBJECTIVE:To evaluate the pharmacoeconomic effectiveness of three therapeutic schemes for lower respiratory tract infections.METHODS:The cost-effectiveness analysis of three therapeutic schemes for lower respiratory tract infections was carried out.RESULTS:The cost-effectiveness ratio of penicillin-piperacillin schemes(L1)was minimum in respect to the effective rate.However,the cost-effectiveness ratios had no significant difference between cefotaxime scheme(L3)and L1 scheme in regard to cure rate(P>0.05),the cost-effectiveness ratio of ciprofloxacin-clinadmacin scheme(L2) was higher significantly than those of L1 and L3 schemes(P<0.05,both schemes).CONCLUSION： L1 is the best therapeutic scheme.Although L3 scheme had higher cost,it had higher cure rate and lower ADRs occurrence.L3 scheme is benefitial to improvement of patient's life quality.

OBJECTIVE:To establish a reasonable formulation and preparation technique of Ketorolac Tromethamine eye drops and to study the stability.METHODS:The content,related substances and pH value were taken as the observing pa?rameters to design the formulation and preparation technic.The stability of3batches of sample was tested.RESULTS&CONCLUSION:The eye drops was rational in formulation and feasible in preparation technic.The preparation in commercial packing was stable after6-month acceleration test and9-month storage at room temperature.

Objective To detect the levels of MBP and IL 16 in cerebrospinal fluid(CSF) and serum, investigate the correlation between them and the role in multiple sclerosis attacking process.Methods The levels of MBP and IL 16 of cerebral fluid and serum of 31 patients with MS were detected by ELISA and compared with those of 24 cases of inflammatory demyelinating polyneuropathy or 22 cases of healthy persons.Results CSF and serum levels of MBP were found increaed significantly in MS patients compared with those in IDP and in healthy controls(HC)(all P 0.05).The concentrations of MBP in CSF of MS significantly correlated with that of IL 16 in CSF( r =0.468, P 0.05).The concentration of MBP in CSF of MS significantly correlated with CSF that in serum( r =0.505, P 0.05).Conclusion MBP is one of the autoantigens that induce MS,IL 16 may be mainly produced in CNS due to MBP stimulation; IL 16 may act within CNS.

Objective To sum up clinical experience on subfascial endoscopic perforator surgery (SEPS) for the treatment of severe chronic venous insufficiency (CVI) of the lower extremities. Methods Fifty-one patients (64 limbs) with severe CVI received SEPS from Nov. 1999 to Aug.2002. CEAP classification, scoring of venous dysfunction (SVD), Color Doppler, Color Doppler velocity profile (CDVP), venography and air plethysmography (APG) were applied to assess the status of the affected limbs before and after operation. Results The postoperative follow-up was made from 3 to 35 months with the follow-up rate of 90.6% (58/64 limbs). No limbs suffered from recurrent superficial varicose. Venous ulcer was healed in 40 limbs (97.6%) and the ulcer ameliorated significantly in one limb. Ulcer healing time ranged from 9 to 91 days with the average time of (32?5) days. The average SVD was (13.9?1.7) preoperatively , while (6.4?0.8)postoperatively ( P

Objective To investigate the practicability and safety of laparoscopic anatomical hepatectomy.Method 40 patients with space occupying lesions in the liver underwent laparoscopic anatomical hepatectomy between Jan.2008 and Mar.2012.The diagnoses were hepatocellular carcinoma (HCC) (n=13),recurrent HCC (n =1 ),cholangiocarcinoma ( n =1 ),metastatic cancer ( n=6),hepatolithiasis (n=10),hemangioma (n=7),FNH (n=1) and liver cell adenoma (n =1).Intraoperative ultrasound was routinely performed to locate lesions and intrahepatic structures.Selective hemihepatic vascular occlusion was applied during resection. High frequency cautery,CUSA and Ligasure were used to transect liver parenchyma. Hemolocks were applied when large blood vessels and bile ducts were encountered.Endo-GIA was used if necessary.The operations included right hemihepatectomy (n =3),left hemihepatectomy (n =10),resections of segment Ⅴ and Ⅵ (n=5),segment Ⅴ (n=3),segment Ⅵ (n =4),and segment Ⅳb (n =1).Result34 hepatectomics were performed laparoscopically.6 patients were converted to open surgery.There was no perioperative death. The operating time was 250.21±50.94 min,and intraoperative blood loss was 420.20± 120.10 ml.Bile leakage was diagnosed in 2 patients after operation.Conclusion With careful patient selection,and improvement in surgical technique and apparatus,laparoscopic anatomical hepatectomy has become safe and practicable.The operation has the advantages of minimal invasion and rapid recovery. It can be regarded as a standard procedure for selected benign and malignant lesions.

Objective To build three-dimensional (3-D) finite element models for local advancement skin flap, by which the post-operative local strain and local stress of skin were figured out to assist in the design of skin flap in clinic. Methods The biomechanical parameters of human forehead skin were obtained in vitro from biomechanical experiments. The 3-D finite element model of local advancement skin flap was set up by MSC Marc/Mentat 2005 (3-D finite element software). Six models were built with the same flap but different skin defects, to simulate post-operative local strain of skin and local stress of skin in different models. Results Post-operative local stress of skin increased with the skin flaps stretching, but the relationship between increase and stretching did not meet the linear rule. Skin flap was able to stretch to 40 % of its initial length in theory if we did not consider blood supply of it. When the skin flap stretched over 40 % of its initial length, the maximal stress could exceed the yield limit. Conclusion It is an effective and workable way to simulate local advancement skin flap using 3-Dfinite element model and biomechanical parameters of human skin. The stretch ratio of local advancement skin flap should be not over 40% for safety.

Objective Radius of curvature (RC) and velocity vector imaging (VVI) were joined to evaluate the deformation and motion of interventricular septum(IVS). Methods VVI was performed in fifteen healthy volunteers and obtained dynamic images at chordae tendineae of mitral valve in short axis view. The images were stored and analyzed to obtain circumferential peak stain of IVS. In the same short axis view, the static images were captured at end-systole and end-diastole respectively before they were analyzed by self-made software. The length of arc and RC were measured automatically by the software, so the shortening rates of them could were calculated. Results The length of arc and RC were longer at end-diastole than those at end-systole(P<0.0001). The shortening rate of length of arc was compared with circumferential peak stain of IVS (P=0.123) and they were correlation (r = 0. 840, P = 0. 0001 ). Blant-Altman analysis indicated that the concordance was well. Conclusions The length of arc and RC can evaluate the deformation and motion of IVS.

Objective To study the etiology, diagnosis and treatment of acute occlusion of abdominal aorta(AOAA). Methods Clinical data of 35 patients with AOAA admitted to our hospital from January 1980 to August 2001 were analyzed retrospectively. Results There were 17 patients with acute aortic embolism(AAE) and 18 patients with acute aortic thrombosis(AAT) . All cases had total occlusion of abdominal aorta,and bilateral iliac arteries were involved. All the 35 cases underwent operations, including bilateral transfemoral thromboembolectomy by Fogarty balloon catheter in 18 cases, thromboembolectomy via laparotomy aortotomy in 11 cases, aortobiiliac reconstruction in 2 cases, aortobifemoral bypass in 2 ( 1 had profundaplasty) and axillobifemoral bypass in other 2 cases. Operative mortality was 25.7%(9/35). After the operations, artery embolism recurred in 3 cases; 3 patients required amputation; renal failure occurred in 3 cases and paraplegia in 4; ischemic colitis occurred in 5, impaired sexuality in 1 and incomplete intestinal obstruction in 1. Conclusions AOAA is an urgent disease with high mortality. Fast preoperative diagnosis and prompt operation are the keys to salvage the patient. Color Doppler is the first choice of diagnosis. Fogarty balloon catheter thromboembolectomy and vascular reconstruction are effective treatments for this disease.

Objective: To overview the experience of postoperative nutritional management in live transplant patients. Methods: Postoperative nutritional therapy and nutritional status assessment in 18 liver transplantation (2 patients undergone retransplantation) were retrospectively analyzed. During the first 3 days after operation, patients were supported with total parenteral nutrition (TPN) and supplied with human albumin. On the 4th and 5th days after operation, patients were provided with parenteral nutrition (PN) and enteral nutrition (EN). And on days 6～10 after operation, patients were gradually transferred to total enteral nutrition and they restored the oral intake completely on days 12～18 after operation. Recombinant human growth hormone was postoperatively injected for 4～7 days. Results: Despite 3 cases who died from brain hemorrhage, respiratory failure and acute rejection respectively, other 13 cases recovered fluently. Conclusions: Appropriate postoperative nutritional therapy facilitated the recovery of liver transplant patient.