Objective To investigate the distribution and antibiotic resistance of pathogenic bacteria in PICU and to provide evidence for use of antibiotics rationally.Methods All the basic clinical features and pathogenic bacteria isolated from patients in PICU of our hospital from October 2009 to September 2012 were analyzed retrospectively.Results A total of 672 pathogenic bacterial strains were isolated (positive rate 16.7％ 672/4 020),75.1％ and 24.9％ were gram negative bacteria and gram positive bacteria,respectively.Pseudomonas aeruginosa was the most common bacteria isolated in gram negative bacteria,followed by Klebsiella pneumonia and Escherichia coli in this order.And Staphylococcus was the main strain in gram positive bacteria.Positive specimens were mainly from lower respiratory tract and bloodstream infection.Most Staphylococcus were resistant to penicillin,oxacillin and erythromycin but susceptible to vancomycin,teicoplanin and linezolid.Gram negative bacteria were resistant to ampicillin,ampicillin-sulbactam,piperacillin and cephalosporin,but susceptible to imipenem,cefoperazone-sulbactam,piperacillin-tazobactam,ciprofloxacin and amikacin.Conclusion Gram negative bacteria is the prevalent strains in PICU of our hospital,Pseudomonas aeruginosa,Klebsiella pneumonia and Escherichia coli are common bacterium isolated.Most isolates are highly drug-resistant.Analysis of pathogenic bacteria and drug-resistance surveillance are of vital importance to guide treatments for critically ill children and reduce drug-resistant bacterial strains.

Objective:To preliminarily discuss the career management of hospital pharmacists from the perspectives of human re-source management and psychology to provide reference for the human resource management of pharmacy department. Methods: The current situation of career management of hospital pharmacists was analyzed based on the theory of Zone of Proximal Development in de-velopmental psychology, and some concepts and measures for the career management of hospital pharmacists were proposed. Results:The managers of pharmacy department must set up dynamic developing view of their employees, establish individualized management concept, transform their role in human resource management and promote the capability of career management. Measures, such as work shift and determined posts, career guidance, potential discovery, opening up promotion ways and self-management of personal career, could be adopted to develop a scientific and effective system of career management. Conclusion:It is suggested that modern manage-ment theories be utilized in the career management of hospital pharmacists, which may help achieve the joint development of department and individuals.

OBJECTIVE: It is found that there are differences in quality of drugs on the market. In order to get safe, effective and rational drug use, we suggest that the evaluation of drugs be mandatory. METHODS: The drugs have been evaluated from angles of clinic effectiveness, bioequivalence, pharmacoeconomics and pharmaceutics. RESULTS: Different evaluating ways showed different characteristies. CONCLUSION: The quality control by pharmaceutical methods is one of the easiest and the most economic ways to do.

Objective To observe the clinical efficacy of Xuebijing injection ( XI) for the treatment of septic myocardial injury, and to study the possible therapeutic mechanism. Methods Thirty-nine qualified septic myocardial injury patients were randomly divided into XI group (N=24) and control group (N=15) . Both groups were treated with conventional therapy, including anti-inflammation treatment, transfusion for resuscitation, nutritional support, symptomatic and supportive treatment, and supportive treatment for keeping vital organ function. XI group was given intravenous drip of XI based on the conventional therapy. Before and after treatment, the peripheral blood concentrations of myocardial-specific isoenzyme of creatine kinase (CK-MB), cardiac troponin I (cTnI), brain natriuretic peptide ( BNP) and plasma calcitonin ( PCT) were detected, and the changes of electro-cardiogram ( ECG) were also observed. The mortality within 28 days was compared between XI group and the control group. Results ( 1) After treatment, cTnI, BNP and PCT concentrations in XI group were decreased significantly as compared with the control group, and there was statistical significance (P <0.05) . However, the decrease of CK-MB was not obvious in XI group ( P>0.05 compared with the control group) . ( 2) The difference of ECG was insignificant between the two groups after treatment ( P>0.05) . ( 3) The 28-day mortality was 8.33% in XI group, and was 13.33% in the control group, the difference being insignificant between the two groups (P>0.05) . (4) During the treatment, none case had adverse reaction. Conclusion XI can improve the myocardial injury, and relieve inflammation of septic myocardial injury patients.

Aim Toinvestigatetheroleofhyperglyce-mia in cerebral ischemia/reperfusion(I/R)injury with a middle cerebral artery occlusion(MCAO)rat model anditsmechanism.Methods EightyhealthymaleSD rats were randomly assigned into sham group, I/R group (normoglycemia),hyperglycemic I/R groupⅠ(HG1 )and hyperglycemic I/R groupⅡ(HG2 ).The cerebral I/R model was established by occluding the middle cerebral artery(MCA)in rats.Hyperglycemia was induced by intraperitoneal injection of 50% glu-cose solution.Neurological deficit was determined by Ludmila Belayev test;infarct size and brain edema were measured by TTC staining;mitophagy was ob-served by double immunofluorescent staining and elec-tron microscope.The expressions of autophagy-related proteins(LC3 and Beclin-1 )and apoptosis-related pro-teins(Cyt-C,AIF,caspase-9 and caspase-3 )were ex-aminedbyWesternblotfurtherly.Results Bloodglu-cose level was controlled at 4 mmol·L-1 (normoglyce-mia),10 mmol · L-1 (HG1 ) and 20 mmol · L-1 (HG2)respectively.There were no significant differ-ences between model group and HG1 group in neuro-logical deficit scores,infarct volume and edema size(P>0. 05 ).However,these indications in HG2 group were significantly increased compared with model group (P<0. 05 ).After 3 days of reperfusion,the level of mitophagy was significantly reduced accompanied with increased mitochondria damages in HG 2 group (P <0. 05 ),and the expressions of mitochondrial related ap-optotic proteins(Cyt-C,AIF,caspase-9 and caspase-3 ) were significantly increased accordingly compared to modelgroup.Conclusions Mildhyperglycemiacan not intensify the cerebal ischemic injury.In contrast, severe hyperglycemia significantly aggravates the brain ischemic injury by inhibiting the removal of injured mi-tochondria in a manner of mitophagy,thus amplifying the mitochondrial mediated cascade damage responses.

AIM: To compare the efficacy of different locations scleral tunnel incision in phacoemulsification cataract on preoperative corneal astigmatism.
METHODS:Totally 90 patients (94 eyes) in our hospital who had undergone the phaco-surgery from March 2013 to October 2014 were divided into two groups. The group A was those with 3. 2mm scleral tunnel incision at the direction of 10:00 ~11:00 points. The group B was those with 3.2mm scleral tunnel incision at the steepest corneal meridian. Incision was not sutured. Corneal astigmatism status of preoperative and postoperative at different times were detected by corneal refractive. The impact of different surgical incision on postoperative corneal astigmatism was compared. In the two groups, patients with preoperative corneal astigmatism<1. 00D, 1. 00 ~2.00D and > 2. 00D were compared respectively. The changes of the uncorrected visual acuity and corneal astigmatism at postoperative 1wk, 1 and 3mo were observed.
RESULTS:The uncorrected visual acuity of the patients who were in the group B preoperative corneal astigmatism <1. 00D and 1. 00 ~ 2. 00D was better than that in the group A. The postoperative corneal astigmatism of the patients who were in the group B preoperative corneal astigmatism <1. 00D was lower than that in the group A.
CONCLUSION: On the basis of preoperative corneal astigmatism, 3. 2mm scleral tunnel incision at the steepest corneal meridian to some extent can correct preoperative corneal astigmatism < 1. 00D, and accordingly improve the uncorrected visual acuity.

Carcinoembryonic Antigen ; metabolism ; Carcinoma in Situ ; immunology ; pathology ; virology ; Carcinoma, Ductal, Breast ; immunology ; pathology ; virology ; Cervical Intraepithelial Neoplasia ; immunology ; pathology ; virology ; DNA, Viral ; analysis ; Diagnosis, Differential ; Female ; Human papillomavirus 16 ; genetics ; isolation & purification ; Humans ; Ki-67 Antigen ; metabolism ; Uterine Cervical Dysplasia ; immunology ; pathology ; virology ; Uterine Cervical Neoplasms ; immunology ; pathology ; virology

Objective To investigate the effects of pharmaceutical interventions on parenteral nutrition.Methods Data collection sheet (with data,ward,patient general information,type of irrational prescribing,type of error,process of error,intervention content,and intervention results) for recording pharmaceutical interventions was designed.The prescriptions of total parenteral nutrition in our hospital from January 1st,2013 to December 31st,2013 were retrospectively analyzed.Pharmaceutical interventions were carried out for unreasonable prescriptions.Results A total of 6 454 prescriptions were reviewed during the research period,among which pharmaceutical interventions were provided for 154 prescriptions (2.39％).Totally 160 errors were identified,and 44 were prevented.The intervention acceptance rate was 98.70％.Conclusions Pharmaceutical interventions can adjust unreasonable prescriptions and modify errors.It is useful to promote the clinical drag use in a safe,rational,effective,and economical manner.

Objective To systematically observe the damage of pancreas and changes of serum amy-lase and lipase in septic rat at different time points after the septic rat model being established. Methods Fifty-four male rats were randomly divided into sham group,sepsis group and normal control group. In the sepsis group,rats were given cecal ligation and puncture so as to produce a model of the rat′s intestinal septic shock. In sham group,after opening the abdominal cavity of the rats,only the cecum was pulled out of the abdominal cavity,then the abdominal cavity was satisfied and stitched. The arterial blood and pancreatic tis-sues of the rats in both sepsis and sham groups were collected for detection of serum amylase and lipase and observation of damage of pancreas by light and electron microscopy at 3 h,6 h,12 h,24 h after the model be-ing established. Results The levels of serum amylase of sepsis group showed a rising trend over time,and peaked at 24 h(2 779. 83 U/L), which showed no difference among 4 time points. There was no significant difference of serum amylase among 3 groups at each time point except for 12 h value. The levels of serum li-pase in both sepsis and sham group were higher than that in normal control group at 3 h(P<0. 05),while de-creased to the level of normal control group at 24 h. By light microscope,pathological changes of pancreas in the sham groups were that lobule was slightly widened; mild interstitial edema,vasodilation and a little in-flammatory cell infiltration were occasionally found;most of the lobular structure was complete. In the sepsis group,pancreatic pathological changes aggravated with time prolonged. Pancreatic lobules gap widened,inter-stitial were infiltrated by the inflammatory cell,flocculus brim structure was fuzzy,focal necrosis was found occasionally,islet structure was complete at 3 h. Pancreatic lobule was significantly wider,more inflammatory cell infiltrated,necrosis enlarged at 6 h,and pancreatic lobule was obvious edema,more inflammatory cell in-filtration and focal necrosis were found at 12 h. Vascular of pancreatic lobule was dilatation and congestion, pancreatic lobule and islet edge blurred,more lobular necrosis at 24 h. The modified Schmidt scoring of sham group and sepsis group at 3 h,6 h,12 h,24 h were 2. 0,3. 6,3. 4,3. 6 and 4. 6,6. 0,6. 8,7. 6,respectively. By transmission electron microscope,the ultrastructure of pancreatic cell in sham group was normal,mitochondri-al and lysosomal swelling were found occasionally. When in the sepsis group,the nucleus was normal,some mitochondria was swelling and cracking, lysosomes was swelling at 3 h, nucleus was complete, a part of swelling mitochondria and lysosomes appeared vacuolated necrosis at 6 h,and karyopyknosis and chromatin condensation were found,more mitochondria and lysosomes were swelling necrosis and vacuolar degenerated, rough endoplasmic reticulum was swelling at 12 h,cell karyopyknosis and chromatin condensation were obvi-ous,a large number of mitochondria and lysosome, endoplasmic reticulum were swelling, dilatation and vacuolar necrosis at 24 h. The modified Schmidt scoring showed no significant correlation with the levels of serum amylase and lipase in sepsis group(r=0. 472,P=0. 199;r=0. 260,P=0. 499). Conclusion The pancreas was damaged in the septic rat. The pathological changes of pancreas were obvious at 6 h after sepsis onset. The characteristics of the pancreas ultrastructure change includes the changes of the mitochondria and lysosome in the early period,clear vacuoles necrosis of mitochondria and lysosome,and destruction of nucleus and the endoplasmic reticulum. There is no significant correlation between pancreatic pathological changes and serum amylase as well as lipase,serum amylase and lipase can′t indicate the extent of pancreas damage in sepsis.

Objective To explore the effect of humidified high flow nasal cannula (HHFNC) in neonatal with severe pneumonia.Methods Forty-two cases of neonatal with severe pneumonia according to different treatment methods were divided into treatment group (20 cases) and control group (22 cases).Treatment group was given HHFNC,control group was given the wet bottle oxygen nasal cannula or mask.Disappearance of symptoms and hospital stay in two groups,blood oxygen saturation (SpO2),partial pressure of oxygen (PaO2),partial pressure of earbondioxidc (PaCO2) and respiratory rate in treatment group before and after the application of HHFNC were compared.Results The effective rate in treatment group was significantly higher than that in control group [90.00％ (18/20) vs.63.64％ (14/22)],which reached statistical significance (P ＜0.05).Disappearance of symptoms and hospital stay in treatment group were shorter than those in control group,and mechanical ventilation rate was lower than that in control group [10.00％(2/20) vs.45.45％(10/22)],which reached statistical significance (P ＜ 0.05).SpO2 and PaO2 at application of HHFNC after 12,24 h and 1 h after evacuation of HHFNC were significantly increased eompared with those before [0.921 ± 0.027,0.955 ± 0.021,0.958 ± 0.016 vs.0.865 ± 0.045; (83.4 ± 28.3),(89.8 ±20.4),(92.8 ±12.6) mmHg (1 mmHg =0.133 kPa) vs.(52.8 ±10.1) mmHg],PaCO2 at application of HHFNC after 24 h and 1 h after evacuation of HHFNC were significantly reduced compared with those before [(46.1 ±6.3),(43.7 ±7.2) mmHg vs.(59.7 ± 8.3) mmHg],which reached statistical significance (P ＜0.05).Respiratory rate was decreased with the treatment time,which reached statistical significance (P＜ 0.05).Conclusion Application of HHFNC in neonatal with severe pneumonia is effective and woorth promoting.