Carcinoma ; therapy ; Humans ; Thyroid Neoplasms

OBJECTIVE:To analyze the blood drug monitoring results of vancomycin and clinical administration behavior and then to provide a clinical reference for its rational utilization. METHODS:We retrospectively collected the blood drug monitoring results of vancomycin and drugrelated information from July 2007 to October 2008 in our hospital. These data were from the electronic clinical pharmacy workstation and initial written case history. RESULTS:Among the 76 cases,non-clinical significant results due to doctor’s irregular manipulation in collecting blood sample accounted for 32.89%. In renal failure group,the rate of peak concentration above the effective blood concentration range was 44.46% . Every patient was averagely administered 21.85 kinds of drugs mainly by intravenous injection during vancomycin application. Clinical response rate of vancomycin was 65.00%. CONCLUSION:During the blood concentration monitoring of vancomycin,we should take clinical need into consideration,collect blood samples rightly,consider the factors such as special pathophysiologic status of patients,drug combination,and adjust the dosage timely.

Objective To explore the relationship between interleukin-1?(IL-1?) and group Ⅱ metabotropic glutamate receptors(mGluR2/3). Methods The rats were randomly divided into five groups:1^cotrol;2^group Glu;3^group IL-1?+Glu;4^group IL-1?;5^group IL-1?+D-AP5+Glu.The behavior of animals was observed.Expression of mGluR2/3 mRNA was assayed with RT-PCR. Results The alteration of behavior showed that the latent period of seizure in group with IL-1?+Glu was shortened significantly and the degree of seizure was also more serious as compared with that in group Glu.Expression of mGluR2/3 mRNA showed marked enhancement in group with IL-1?+Glu and group with Glu compared with control.However,expression of mGluR2 mRNA in group IL-1?+Glu was markedly decreased as compared to that in group Glu;the level of mGluR3 mRNA showed no apparent difference between group IL-1?+Glu and group Glu.Conclusion Present study suggests that IL-1? enhances the degree of seizure induced by glutamate,the mechanism may be due to its direct or indirect effects on down-regulation of expression of mGluR2 mRNA.

Objective To explore the relationship between organizational justice and turnover intention among nurses of tertiary hospitals and to provide implications for human resource management.Methods Totally 511 nurses were recruited from four tertiary hospitals of Jinan City and investigated with Organizational Justice Questionnaire and Turnover Intention Scale.Results The average scores of turnover intention and organizational justice were (2.46±0.61) and (3.55±0.62),respectively.Distributive justice and informational justice were significant predictors of turnover intention.Conclusions The turnover intention of nurses in tertiary hospitals is high.It is beneficial for mitigating nurses' tumover intention to improve their organizational justice,apply post management and performance appraisal model.

Objective To probe the periodontal ligament regeneration following the implantation of bone marrow mesenchymal cells ( BMSCs ) sheet-collagen membrane-BMSCs sheet sandwich complex.Methods BMSCs cell sheet-collagen membrane-BMSCs sheet complexes were compounded on the root surface of teeth of Beagle dogs.All the dogs were killed on 4 and 12 weeks after implantation.Periodontal ligament regeneration was observed by radiological means, HE staining and Sirus-red staining.Results Compared with collagen membrane group and blank control group, there was a clearly periodontal ligament like tissue and Sharpey′s like fibres formation in test group only.Conclustion Cell sheet-collagen membrane-cell sheet sandwich complex can effectively improve the periodontal ligament regeneration.

Objective To compare the effects of equivalent dose sufentanil,remifentanil or fentanyl on hemodynamic and cardiac output in the elderly patients during induction of general anesthesia.Methods Ninety elderly patients(ASA Ⅰ ～ Ⅱ) undergoing elective abdominal surgery under general anesthesia were randomly divided into sufentanil group(group S),remifentanil group(group R) and fentanyl group(group F),30 patients in each group.Patients in group S,group R and group F received sufentanil 0.2μg/kg,remifentanil 2μg/kg and fentanyl 2μg/kg Ⅳ,respectively,using an blind method before intubation.SBP,DBP,MAP,HR,CO,CI and SVR were recorded before of anesthesia (T0),immediately after induction (T1),1,3 minutes after tracheal intubation (T2,T3).Changes of SBP and HR during observation were also recorded.Results The MAP and HR in three groups at T1 were significantly lower than those at T0 and decreased significantly in group R than those in group F and S(P ＜0.05).The MAP and HR in group F significantly increased at T1 than T0.The MAP and HR in group R were significantly decreased after tracheal intubation.Compared with the baseline,the MAP and HR in group S at T1,T2,remained unchanged.In group R,there were two patients whose HR were under 50 bpm.In group F,the MAP at T1,T2 were significantly higher than those at T.In group S,there were no significant changes in CO,CI,SVR which were all within normal range (P ＞ 0.05).Conclusion Both sufentanil and remifentanil effectively inhibit the stress response during induction of general anesthesia.At the same time,sufentanil has better hemodynamic stability.

Comprehensive treatment dominated by surgery is the mainstay in the treatment of hepatic cancer,and hepatectomy is still the most effective treatment method.Bile duct reconstruction after hepatectomy is still the difficult point for the treatment of hepatic cancer complicated by bile duct invasion.A 45-year-old patient with hepatic cancer and gallstone was admitted to the Affiliated Hospital of Guiyang Medical College,magnetic resonance cholangiopancreatography and enhanced computed tomography indicated that intrahepatic duct was dilated and tumor had invaded both left and right hepatic ducts.Cholecystectomy,mesohepatectomy,duct to duct anastomosis of left hepatic duct and common hepatic duct,duct to duct anastomosis of right hepatic duct and cystic duct were performed during the operation.The patient was cured 2 weeks after surgery.

Objective To develop an intelligent assist order system for parenteral nutrition and embed it into hospital information system,so as to facilitate rational prescription of parenteral nutrition.Methods Comprehensive database,knowledge base and control system of parenteral nutrition orders were set up based on production rule.An intelligent assist order system for parenteral nutrition was designed and developed.Individual energy demand of patients were calculated automatically and compared with doctors' orders of parenteral nutrition.Cation concentration was calculated automatically and controlled for the stability of all-in-one parenteral nutrition admixture.Results This system achieved successful and fast calculation of individual energy demand,over-standard warning of total energy,the ratios of carbohydrates to lipids and non-protein calories to nitrogen,ion concentration,and liquid volume.It also controlled the cation concentration,thus avoiding demulsification.Conclusions The intelligent assist order system for parenteral nutrition can solve the problems of energy calculation and ensure the stability of all-in-one parenteral nutrition admixture.As a result,it can improve the utilization of parenteral nutrition in hospital.

Objective To investigate the relationship of blood pressure circadian rhythm with myocardial hypertrophy and the changes of autonomic nerve function in patients with essential hypertension (EH). Methods Eighty-two female patients with essential hypertension (EH) underwent 24-hours ambulatory blood pressure monitorings (ABPM), dynamic electrocardiogram (Holter) and echocardiography examination. Patients were classified into non-dipping group (n=40) and dipping group (n=42) according to the result of ABPM. Left ventricular mass index (LVMI), heart rate variability (HRV) in time domain (including SDNN, SDANN, rMSSD, PNN50) and heart rate turbulence (HRT) parameters (including turbulence onset [TO] and turbulence slope [TS]) were measured. Results Compared with those in dipping group, patients in non-dipping group have higher incidence of LVH (19.0% vs 52.5%, P<0.01), greater mean LVMI (112.39±12.79 g/m2 vs 121.98±13.35 g/m2, P<0.01), decreased PNN50 and rMSSD. TS value was decreased while TO was increased in non-dipping group compared with those in dipping group (both P <0.01); patients with LVH showed decreased TS and increased TO, compared with those without LVH. Conclusion In female patients with EH, non-dipping blood pressure circadian is associated with higher incidence of LVH. The HRV and HRT were more remarkably blunted in non-dipping patients, as well as those with LVH.