OBJECTIVE To analyze the effectiveness and feasibility of executive intervention measures on antibiotics clinical use.METHODS To analyze statistically with the data from 748 inpatients in 2003(before intervention) and 1332 cases in 2006(after intervention),both were collected randomly.RESULTS The antibiotics use rate,the pathogenic test rate,the rate of use antibiotics for therapy,the rate of use antibiotics for prophylaxis in 2003 and in 2006 were following respectively:81.81% and 76.57%,11.11% and 47.05%,28.10% and 36.56%,71.89% and 63.43%,with significant difference.CONCLUSIONS The examination regulations of the antibiotics clinical application made up by the hospital is effective and feasible.The system that examination monthly,the results opening to the hospital staff and having relationship with the receipts of doctors is effective to normalize the behavior of clinical doctors to use antibiotics.But it still needs to improve education,and examination strictly.

OBJECTIVE To analyze the risks of nosocomial infection and establish an effective control of infection diseases in Department of Oncology of the Hospital.METHODS Prospective and retrospective studies on 943 hospitalized patients in Department of Oncology were carried out.RESULTS Amony them,161(17.07%) cases occurred the nosocomial infection and the total infection case-times were 224(23.75%);but,the average of the nosocomial infection during the period in our whole hospital was 4.8%.Two major infected sites were respiratory and gastrointestinal tracts;the major pathogens that caused nosocomial infection were Candida albicans,the next were Staphylococcus.CONCLUSIONS Nosocomial infection rate could be decreased by surveying the infection risk factors and developing effective control.

Liposome-mediated nucleic acid delivery has been a focus recently, but in the course of delivering nucleic acid, some hurdles seriously limit the nucleic acid exerting treatment effect. This review refers to a series of problems such as low blood stability, reticuloendothelial system absorption, the lower targeting of liposome and the restriction of endosomal escape which are suffered in liposome-mediated nucleic acid delivery; and gives a detail introduction of strategies such as PEGylation, ligand modification, photochemical internalization, the application of degradation liposome and membrane-lytic peptide, to overcome those problems.

Objective To examine the clinical characteristics of familial aggregation in migraineurs and to ana-lyze the risk factors. Methods Seventy-two migraineurs were recruited and divided into two subgroups according to family migraine history. The subjects were interviewed in detail with questionnaire including age, disease duration, age at migraine onset,migraine severity, frequency of headache,duration of each attack, aura, unilateral pain, pulsate pain, family history of migraine, family members and other factors. Multi-factors logistic regression analysis was performed to analysis the risk factors after single variable analysis. Results Of 72 migraine patients, 37(51.4%) reported that at least one first-degree relative had a history of migraine. There were no significant differences between migraine sub-groups with and without family migraine history in age (P=0.598), gender(P=0.675), disease duration (P=0.419), aura (P=0.669), headache severity (P=0.837), frequency of attack (P=0.465), concomitant symptoms (P=0.081), headache location (P=0.353), headache property (P=0.963), there were significant differences between migraine subgroups with and without family migraine history in age at disease onset (P=0.023), duration of headache attack (P=0.041), early age (<16 years)at disease onset (48.6% vs. 22.9%, P=0.023) and long duration (≥24 hours)of attack (35.1% vs. 14.3%, P=0.041). Multi-variables logistic regression analysis identified fist-degree relatives of probands who had ear-ly age at disease onset (OR=2.986, 95%CI:1.621~5.503) and long duration of headache attack (OR=2.320, 95%CI:1.219~4.415) had higher risk of migraine (P<0.05). Conclusion Migraineurs with family migraine history have earlier onset of migraine and longer duration of attack. Early age at headache onset and long duration of headache attack are the risk factors of family aggregation.

Objective To investigate the change of soluble P-selectin (sPsel)and von Willebrand factor (vWF)levels after ad-mission in traumatic patients and their relation with the coagulation indexes levels,coagulation disorders and prognosis.Methods 82 cases of severe trauma in ICU of Affiliated Tongji Hospital were prospectively selected and detected plasma sPsel,VWF anti-gen,protein C,activity of coagulation factor Ⅶ and routine coagulation indexes on admission and on every day within the first week after admission.The 30 d fatality rate was recorded.Results The sPsel and vWF levels on admission in the patients with coagula-tion disorders were lower than those in the patients without coagulation disorders (P <0.05)and significantly correlated with the coagulation indexes (protein C and coagulation factor Ⅶ)levels (P <0.05).The vWF level within 3 d after admission in the death patients was significantly lower than that in the survival patients,but which on 7 d after admission in the death patients was signifi-cantly higher than that in the survival patients (P <0.05 );no significant difference in sPsel level within 1 week after admission were found between the survival patients and the death patients.Conclusion Among severe traumatic patients in ICU,the low lev-els of sPsel and VWF on admission are associated with the coagulation disorders,the significant rise of vWF level on 7 d after ad-mission is associated with the increase of the 30 d fatality rate.

OBJECTIVE:To observe the effect of ondansetron on the anesthesia of cesarean section surgery with spinal-epidur-al anesthesia. METHODS:A total of 60 singletons full-term pregnancy were randomly divided into test group and control group. Test group was given 6% Hetastarch(130/0.4)electrolyte injection 500 ml by intravenous infusion 30 min before anesthesia,and Ondansetreon hydrochloric acid injection 4 ml by intravenous infusion 5 min before anesthesia;control group was given 6% Hetas-tarch(130/0.4)electrolyte injection 500 ml by intravenous infusion 30 min before anesthesia,and 0.9% Sodium chloride injection 4 ml by intravenous infusion 5 min before anesthesia. The clinic data was recorded,including the mean arterial pressure (MAP) and heart rate(HR)before anesthesia puncture(T1),after anesthesia maternal left side(T2),after fetal childbirth(T3)and at the end of surgery(T4),Apgar score and incidence of adverse reactions. RESULTS:MAP in control group at T2,T3 was obviously low-er than T1 and test group,HR was obviously higher than T1 and test group,the difference was statistically significant(P<0.05);there were no significant differences in the MAP and HR in test group at each time point(P>0.05). Apgar score of newborn after 1 min birth in test group was significantly higher than control group,the difference was statistically significant (P<0.05),and there was no significant difference in the Apgar score of newborn after 5 min birth between 2 groups(P>0.05). The ADR incidence in test group was significantly lower than control group(P<0.05). CONCLUSIONS:Ondansetron can effectively reduce the inci-dences of vomit vomitting and hypotension in on the cesarean section surgery with spinal-epidural anesthesia,with good safety.

A HPLC method for the determination of berberine in Phellodendron amurense processed by four different procedures has been established. The method is simple, specific and accurate. The recovery is 102.7% and coefficient of variation is 0.69%.

Objective To investigate the effects of Epstein-Barr virus (EBV) infection on apoptosis of cord blood monocytes-derived dendritic cells (DC) in neonates. Methods Cord blood monocytes were induced into DC by 50 ng/mL recombinant human granulocyte macrophage colony-stimulating factor(rhGM-CSF)and 10 ng/mL recombinant human interleukin-4 (rhIL-4),and DC were divided into three groups:①4G group:rhGM-CSF and rhIL-4 were added separately on the day of cell separation;②4G+0d EBV group:rhGM-CSF,rhIL-4 and B95.8 cell supernatants were added simultaneously on the day of cell separation;③4G+5d EBV group:hGM-CSF and rhIL-4 were added on the day of cell separation,and B95.8 cell supernatants were added on the 5th day.Percents of DC apoptosis were measured using Annexin V-FITC and PI staining by flow cytometry.The expression of X-linked inhibitor of apoptosis protein (XIAP) was detected by Western Blot.Results Percent of DC apoptosis in 4G+0d EBV group was significantly higher than that in 4G group on the 6th to 14th day(P<0.05),and percent of DC apoptosis in 4G+5d EBV group was significantly higher than that in 4G group on the 7th to 14th day(P<0.05).The effects of EBV infection on percent of DC apoptosis had relations with infection time points.The expression of XIAP in DC decreased significantly after EBV infection. Conclusion EBV promotes apoptosis of cord blood monocytes-derived DC,which is associated with the differentiation and maturation status of DC.

Objective:To study the relationship between serum level matrix metalloproteinase-9 (MMP-9) and atrial fibrillation (AF) and to assess its predictive value of AF recurrence in persistent AF patients after cardio-version.
Methods: Our research included in 4 groups: Control group, n=30 healthy subjects, Paroxysmal AF group, n=30, Persistent AF group, n=60 and Permanent AF group, n=30. Serum levels of MMP-9 were examined and compared among different groups. The patients in Persistent AF group received drug therapy or drug+electric cardio-version;with successful cardio-version, antiarrhythmia medication was used to maintain sinus rhythm and the patients were followed-up for prognosis, MMP-9 levels were further compared between the patients with or without AF recurrence to assess the predictive value of MMP-9 for AF recurrence.
Results: Serum levels of MMP-9 were as follows: Control group (151.43±88.14) ng/ml, Paroxysmal AF group (182.66±96.39) ng/ml, Persistent AF group (278.93±89.22) ng/ml and Permanent AF group (336.82±112.35) ng/ml respectively, which indicated that MMP-9 level in Persistent AF group was higher than Paroxysmal AF group and Control group;MMP-9 in Persistent AF group was higher than the other 3 groups, P<0.01. The patients in Permanent AF group were followed-up for (15.4±4.3) months after cardio-version, retrospective analysis found that the patients with AF recurrence had the higher MMP-9 level than those without AF recurrence (315.63±94.52) ng/ml vs (261.92±87.86) ng/ml, P=0.036. Multivariate regression analysis was conducted on age, gender, AF history, left atrial diameter and MMP-9, the consequence showed that serum MMP-9 level was the independent predictor for AF recurrence in persistent AF patients after cardio-version (P=0.035, OR=1.135, 95%CI 1.018-1.321).
Conclusion: Serum MMP-9 level was elevated in persistent and permanent AF patients;MMP-9 was the independent predictor for AF recurrence in persistent AF patients after cardio-version.

Objective to observe the efficacy and application value of PFNA and Gamma in the treatment of intertrochanteric fractures in elderly. Methods 100 patients with intertrochanteric fractures were divided into PFNA group and Gamma group, who received PFNA treatment and Gamma treatment respectively. And the operation status of patients at different ages,postoperative recovery,and complications were observed. Results The operation time,intraoperatve blood soss of PFNA group were lower than those of Gamma group(P<0. 05). There was no significant difference in fracture healing time. The Harris score of the over 75s in PFNA group was higher than that in Gamma group(P<0. 05),and the complications were less than Gamma group(P<0. 05). Conclusion PFNA was suitable for the patients at differ-ent ages with the advantages of more rigid fixation,good anti-rotation,fewer trauma and fewer complications.