Objective To compare the clinical efficacy of different trough concentrations of vancomycin in patients.Methods A retrospective study in patients having at least one trough concentration of vancomycin for enrollment between January 2009 and December 2013 was carried out.The eligibility patients were divided into 3 groups according to the level of trough concentrations namely group A (＜ 10 mg/L),Group B (10 ～ 15 mg/L),and Group C (＞ 15 mg/L).The clinical efficacy,clearance of pathogens and in-hospital mortality were analyzed with the help of SPSS Statistics 17.0.The comparison of dosing days,length of hospital stay and time consumed from initial dosing to the appearance of recovery signs of survivors among the 3 groups.Results There were no significant difference among 3 groups in terms of clinical efficacy (55.6％ vs.33.3％ vs.51.7％),clearance of pathogens (38.9％ vs.25％ vs.24.1％) and in-hospital mortality (44.4％ vs.25％ vs.27.6％).After adjusting by age,the in-hospital mortality decreased along with the trough concentrations vancomycin.Along with increase in the trough concentrations vancomycin,the dosing day (14.90 ± 6.44 vs.18.75 ± 7.23 vs.17.93 ± 9.42) and length of hospitalization [(33.70 ± 18.17) vs.(79 ±45.53) vs.(66.20 ±52.48)] increased,and time required from dosageinitial dosing to the appearance of recovery signs of survivors among the 3 groups [(4.82 ± 2.62) vs.(3.75 ± 0.50) vs.(4.07 ± 3.20)] shortened.Conclusions Improving the trough concentrations of vancomycin could not increase clinical efficacy rate or bacterial clearance rate,but could lower in-hospital mortality.However,it might enhance the financial burden on patients as well.

OBJECTIVE:To strength pharmacy management,improve pharmacy stocktaking efficiency and lower the error rate of the stocktaking in outpatient pharmacy.METHODS:Based on "Army No.1" inventory management system,the data were retrieved and adjusted using Excel spreadsheet,and the inter-district small-scale inventory table of the outpatient pharmacy was designed in which certain individuals should be responsible for certain drugs and the order of drugs in the inventory table were in line with the arrangement order of drugs.RESULTS:The new drug stocktaking model reduced the error rate of traditional monthly drug stocktaking by 3%.CONCLUSION:The established drug stocktaking method reduces human and material resources,facilitates a more flexible,convenient and rapid stocktaking,and greatly enhances the conformity rate between drugs and accounts.

To discuss the protective effect of aralosides (AS) on I/R-induced rat myocardial injury. The adult rat ventricular myocyte ischemia model was established through perfusion with sodium lactate perfusate and reperfusion with Ca(2+) -containing Tyrode's solution simulation. The cell contraction and ion concentration synchronization determination system was applied to detect the effect of AS on single I/R cell contraction and Ca2+ transients. According to the findings, AS could increase resting sarcomere length, contraction amplitude, ± dL/dt(max), calcium transient amplitude and speed of post-reperfusion myocardial cells (P < 0.05, P < 0.01), and decrease in time for achieving 90.0% of maximum relaxation, time for achieving peak value, resting calcium ratio, contraction period [Ca2+] i, time for achieving 50.0% of maximum relaxation and attenuation rate of intracellular calcium transient (P < 0.05, P < 0.01). Therefore, it is suggested that AS improved the post-reperfusion cell contraction and injury of calcium homeostasis.
Animals ; Aralia ; chemistry ; Biological Transport ; drug effects ; Calcium ; metabolism ; Drugs, Chinese Herbal ; administration & dosage ; Humans ; Male ; Muscle Contraction ; drug effects ; Myocardial Ischemia ; drug therapy ; metabolism ; physiopathology ; surgery ; Myocardial Reperfusion ; Myocytes, Cardiac ; drug effects ; physiology ; Rats ; Rats, Sprague-Dawley ; Saponins ; administration & dosage

AIM:To evaluate the morphological and functional changes of retinas induced by treatment of tunicamycin with optical coherence tomography (OCT) in rats.METHODS:Totally 60 SD rats were randomly divided into 3 groups (20 in each group), 0.5mg/kg (in low dose group), 1.5mg/kg (in high dose group) tunicamycin were injected into vitreous cavity and saline (9g/L NaCl) were injected in the same dose as a control group.Changes of retinas were observed by OCT on the 1,7 and 14d after treatment of tunicamycin.Then the rats were sacrificed, retinas were taken out and embedded by the paraffin, tissue sections and the HE staining were performed.RESULTS:OCT results suggested that tunicamycin played damage effects on retinal morphology and structure which appeared a time-and dose-dependent.Fundus photography results suggested that 2wk after tunicamycin treatments, with the gradually changing of tunicamycin concentration, peripheral retinal and macular region became pale color gradually, edema occurred in optic disk, retinal vessels appeared thinner in the high dose group, optic nerve came out atrophy.Fluorescein angiography confirmed that tunicamycin injection in vitreous cavity 2wk later, retinal vessels injury occurred, resulted in leaking of intravascular contrast agent from peripheral to the central part of the retinas.Electrophysiological data showed that retinal electrogram occurred disorder induced by tunicamycin, such as the amplitude of a wave, b wave decreased gradually, even closed to zero, which was very different from control significantly (P<0.05).HE staining of paraffin sections showed that retina injuries induced by tunicamycin were in dose-time dependent, which was consistent with the results of OCT.CONCLUSION: Clinical retinal diseases could be simulated by retinal damage animal model induced by tunicamycin treatment.OCT detection offered real-time images of the retinal cross-section, which provided a helpful non-invasive method for detecting and evaluating the retinal damages.

Objective To evaluate the feasibility,safety and accuracy of endoscopic ultrasonography guided fine-needle aspiration(EUS-FNA) in patients with mediastinal benign and malignant lesions.Methods A linear array scanning endosonography (Pentax-EG3630U) and a 22-guage (Wilson-CooK) needle were used to perform EUS-FNA in 22 patients with mediastinal lesions.Results EUS-FNA revealed 15 patients with carcinoma and 6 cases with benign tumors,which were confirmed by mediastinoscopy.One patient was not diagnosed because of inadequate specimen.None of the patients had complications caused by any procedures.Conclusion EUS-FNA is safe,reliable and accurate in diagnosis of mediastinal benign and malignant lesions.

Objective To study of the imaging diagnosis and differential diagnosis of cystitis glandularis. Methods The clinical data and imaging findings of 8 cases with cystitis glandularis proved by pathology were retrospectively analyzed with literaures re-view. Results The lesions on images appeared as nodular mass in 4 cases, diffuse in 2 cases and mixed type in 2 cases,1 case with cystic degeneration. The lesions in 2 cases obviously reduced in size after treatment. The CT value of the lesions post contrast-en-hanced scan averagely increased up to 15.8 HU compared with that of plain scan. The lesions were localized in 6 cases and diffuse in 2 cases. Conclusion cystitis galandularis has some imaging characteristics, but the final diagnosis is depended on pathology.

Objective To verify the relationship between personality traits and clinical nurse competence in five third-A level hospitals in Shenyang. Methods A total of 1559 clinical nurses from five tertiary-level hospitals in Shenyang were recruited into this study. Two self-report questionnaires, the Nurse Competence Scale (NCS) and the Tridimensional Personality Questionnaire (TPQ), were used to collect data. Results The average score of NCS was 71.97 ± 13.25.Nursing competence increased with the increase of working years (β=0.272, P<0.01) and RD (β=0.134, P<0.01). Practicing nurses with the lower HA appear to have a higher level of competence (β=-0.117, P<0.01). Conclusions The overall level of nurses' competencies good in third-A level hospitals in Shenyang. The predicting factors of nursing competence are work experience, HA and RD. More psychological courses should be provided in fundamental nursing education and continuing nursing education for helping nurses shape their good personality traits.

ObjectiveTo assess the safety and clinical values of video-laryngoscope in spontaneous respiration tracheal intubation for emergency patients. Methods Seventy-nine patients,who needed the endotracheal intubation,were recruited in our department between January 2010 and December 2010,and were randomly ( random number) divided into two groups according to consultative sequence.Forty patients (group A ) were operated with traditional laryngoscope and thirty-nine patients (group B ) with videolaryngoscope.The operative time and success rate of tracheal intubation,Cormack-Lehane classification,as well as adverse events,were recorded.The heart rate ( HR ),mean arterial blood pressure ( MAP),respiratory rate ( RR ),and saturation of pulse oxygen ( SpO2 ) were observed pre-operation,during operation and 2 min post-operation.Results( 1 ) The Cormack-Lehane classification in group A were significantly lower than in group B. (2) The operative time of tracheal intubation in group B was significantly less than that in group A [(35.6+12.7) svs. (58.3 ± 13.5) s; P＜0.05] ; and one-time success rate of tracheal intubation in group B was higher than that in group A ( 84.6％ vs.52.5％ ; P ＜0.05).(3) Compared to group B,the HR and MAP in Group A were significantly increased at t2 and t3 ( P ＜ 0.05 ). ( 4 ) The adverse events,including restlessness,bucking and injury,were significantly decreased in group B than those in group A ( P ＜ 0.05 ).ConclusionsThe video-laryngoscope used in spontaneous respiration tracheal intubation,could improve Cormack-Lehane classification,short operative time,enhance one-time success rate and reduce adverse evevnts.

Aim To assay the mutagenicity of Enphorbia lunulata(EL) decoction and to modify the Ames test for evaluation the mutagenicity of herbal medicine samples.Method The mutagenicity of EL decoction was assayed by standard Ames test; the teratogenicity was done by mammalian bone marrow chromosomal aberration test. In modified Ames test system,the influence of histidine EL decoction was excluded by additional negative control, in which the test media was supplied with histidine (histidine amount equaled to the histidine in different concentration of EL decoction).Result The mutagenicity of EL decoction was positive in the standard Ames test. The teratogenicity of EL decoction was negative in mammalian bone marrow chromosomal aberration test. By the modified Ames tests,the mutagenicity of EL decoction was negative.Conclusion The standard Ames test is not suitable for evaluating the mutagenicity of EL decoction, but the modified Ames test is. The mutagenicity in vitro and the teratogenicity in vivo of EL decoction are all negative.

Objective To detect the mRNA expression of mesenchymal-epithelial transition factor (MET)gene in patients with non-small cell lung cancer (NSCLC),and to investigate the relationship and clinical significance between the mRNA expression of MET gene and clinical pathological characteristics. Methods From June 201 1 to November 201 3,48 patients with pathologically confirmed NSCLC in Chinese People′s Liberation Army General Hospital were selected.All patients included in the study were not treated before surgery.The branched DNA liquid chip technology was used to detect mRNA expression of MET gene in tumor tissues.The relationship between mRNA expression of MET gene and clinical pathological characteristics was analyzed.Results The constituent ratios of low,moderate and high mRNA expression level of MET gene were 22.9%,50.0% and 27.1 % respectively,mainly for the moderate expression.The mRNA expression of MET gene was related to the pathologic type (χ2 =7.1 83,P =0.020)and TNM stage (χ2 =24.566,P =0.01 7)of the patients;but it was not related to the gender (χ2 =0.566,P =0.754),age (χ2 =1 .857,P =0.395),smoking history (χ2 =4.959,P =0.084),degrees of differentiation (χ2 =5.749,P =0.067), lymph node metastasis (χ2 =1 .631 ,P =0.442)and distant metastasis (χ2 =4.261 ,P =0.1 1 9).Conclusion mRNA expression of MET gene is more likely to present moderate and higher level in NSCLC patients.MET gene can also be used as a biomarker for judging tumor pathological type.