Humans ; Multiple Myeloma ; Neoplasm Recurrence, Local

Objective To analyze the application of antibiotics in the national essential drug list used by women in obstetric medical institutions at all levels of Western Hunan ( Basic Medical and Health Institutions Part,2009 version).Methods Medical records were reviewed respectively from May,2010 to December,2010.Results The rate of the use of antibiotics in the essential medicines list in township hospitals was more than 50％,which was higher than that of the secondary and tertiary hospitals.Conclusion The management of the use of medicine in the essential medicines list in hospitals at all levels should be strengthened to control the delivery cost.

Multiple myeloma is a malignancy of plasma cells,which is still incurable now.Despite dramatic improvement of the response rate and overall survival have been made due to the application of target therapy and stem cell transplantation,the treatment effect is difficult to maintain,nearly all patients will eventually relapse and become refractory.At relapse,the challenge is to select the appropriate treatment for each patient.The decision will be both disease-dependent and patient-dependent.

Objective To understand the influencing factors of satisfaction degree with nursing in our hospital by investigation in satisfaction degree in central injection room.Methods 252 patients were selected in our hospital from January to December 2011 as the research object,questionnaires were used to investigate the patients,and the influencing factors of satisfaction degree of nursing work were analyzed.Results Among the patients who accepted the investigation,patients' satisfaction scores were correlated with the patients' age,education level,income level,inpatient department,hospital stay time and whether they accepted an operation.Conclusions Nursing staff should pay attention to and strengthen the nursing work quality and efficiency,improve the satisfaction degree with nursing of clinical patients.

Objective To study the efficacy and side effects of Ganciclovir combined with L-ornithine-L-aspartate on infant cytomegalovirus(CMV) hepatitis.Methods Sixty infants with CMV hepatitis hospitalized in our hospital from Dec.2009 to Dec.2010 were treated with ganciclovir combined with L-ornithine-L- aspartate.The parameters observed in the study included the pre-and post-treatment data on total Bilirubin (TBIL),alanine aminotransferase (ALT),alkaline Phosphatase (AKP)and the retraction of liver and spleen,as well as the adverse reactions of the treatment.Results The treatment significantly decreased serum TBIL (t =5.74,P ＜ 0.05 ),ALT( t =2.92,P ＜ 0.05 ) and liver( t =8.27 P ＜ 0.05 ) and spleen volume ( t =5.03,P ＜0.05).However,side effects such as liver damage and rash occurred occasionally during the ganciclovir treatment.Intravenous infusion of L-omithine-L-aspartate caused side effects such as vomiting and other mild gastrointestinal reactions.Conclusion The treatment of Ganciclovir combined with L-ornithine-L-aspartate on infant cytomegalovirus hepatitis created good efficacy and can be considered as the first treatment choice.Though it is relatively safe,adverse reactions should be monitored during the treatment.

Objective:To investigate the vasorelaxant effect of active fraction from compound Prunella vulgaris L. ( AFCP) on the i-solated thoracic aorta of rats and underlying mechanism. Methods:The study was performed with the tension experiment of the isolate rat thoracic aorta. The changes of vascular ring tension were measured by biological signal acquisition and analysis system, and the vasodila-tor effect of AFCP was observed. Results:AFCP(100-500μg·ml-1)could induce significant relaxation in aorta rings pre-contracted by phenylephrine (PE,1 μmol·L-1), and the relaxation effect was significant(75% ±8%) in endothelium-intact aortic and endothelium-denuded aortic. The vasodilatation effect of AFCP was not significantly affected by nitric oxide synthase ( NOS) inhibitor NG-nitro-L-argi-nine( L-NNA) , guanylate cyclase inhibitor MB,potassium channel blocker TEA and glibenclamide. In Ca2+-free bath solutions, AFCP (300 μg·ml-1 ) could shift downward dose-response curve of CaCl2 and significantly reduce the maximum contraction amplitude of PE. Conclusion:AFCP can relax rat aorta rings in a dose-dependent manner, which is endothelium-independent. The mechanism may be re-lated to the inhibition of intracellular calcium release and extracellular calcium flow, and has nothing to do with NO pathway, prostacyclin generation and calcium-activated potassium channels.

Objective To study the action of enantone in chocolate cyst after laparoscopic surgery. Methods To devide the 76 patients into two groups, study group(50 patients, additional enantone after laparoscopic surgery) and the control group (26 patients, only laparoscopic surgery), to analyse their recurrence rate and pregnancy rate. Results The recurrence rate of study group was obviously lower than control group. In the 48 patients with infertility, the pregnancy rate of study group was higher than control group. Conclusions In chocolate cyst after laparoscopic surgery, enantone can decrease the recurrence rate and increase pregnancy rate.

Objective To investigate the changes of antibiotic resistance and its correlations with antibiotics use density (AUD) in intensive care unit (ICU) after implementation of antimicrobial stewardship. Methods Data on AUDs and synchronous antibiotic resistance in ICU of the Affiliated Hospital of Taishan Medical University during 2010 and 2014 were retrospectively reviewed.Autoregressive integrated moving average ( ARIMA) model was used to identify the correlation between AUDs and antibiotic resistance.Results The total AUD which stood at 163.46 DDDs· 100 person-1 · d-1 in the year 2010 decreased to 68.20 DDDs · 100 person-1 · d-1 in 2014, and the most significant decreases were found in quinolones, imidazole, carbapenems, aminoglycosides, other beta lactam and macrolides. Synchronously, a wide range of improvements in antibiotic resistance of major pathogens were also observed from 2010 to 2014, and the improvements were positively correlated with the decrease of AUDs.However, antibiotic resistance in 2014 was not significantly improved compared with that in 2013. The rate of ciprofloxacin resistance in Pseudomonas aeruginosa and the resistant rates of amikacin, imipenem, and meropenem in Acinetobacter baumannii even increased in 2014.Conclusions With the implementation of antimicrobial stewardship, antibiotic consumption in ICU was decreasing, and antibiotic resistance rate in major pathogenic bacteria was decreasing.But the rebound in antibiotic resistance in some types of bacteria was also observed and should be put on enough caution.

Objective To observe the efficacy of acupuncture plus medication in treating diarrhea-irritable bowel syndrome (IBS-D) due to liver depression and spleen deficiency, and its effect on serum 5-hydroxytryptamine (5-HT), calcitonin gene-related peptide (CGRP) and endothelin (ET). Method Sixty IBS-D (liver depression and spleen deficiency) were recruited and randomized into an observation group and a control group, 30 cases each. Patients in the observation group were intervened by acupuncture plus modified Bai Zhu Shao Yao powder, while the control group was intervened by acupuncture alone. The total effective rate, change of syndrome score of traditional Chinese medicine (TCM) and diarrhea-irritable bowel syndrome quality of life scale (IBS-QOL), as well as the levels of serum 5-HT, CGRP and ET, were observed. Result The total effective rate was 83.3% in the observation group, significantlyhigher than 63.3% in the control group (P<0.05). There were no significant differences in comparing the global and component TCM symptoms scores and IBS-QOL between the two groups before the treatment (P>0.05). The global and component TCM symptoms scores and IBS-QOL dropped significantly in both groups after the intervention (P<0.05). The global TCM symptoms score and IBS-QOL in the observation group were significantly lower than those in the control group after the intervention and 3 months after the intervention (P<0.05); the component TCM symptoms scores in the observation group were significantly lower than those in the control group after the intervention (P<0.05). There were no significant differences in comparing the serum 5-HT, CGRP and ET levels between the two groups (P>0.05) before the treatment. The levels of 5-HT, CGRP and ET decreased significantly after the treatment in both groups (P<0.05); after the intervention, the levels of 5-HT, CGRP and ET in the observation group were significantly lower than those in the control group (P<0.05). Conclusion Acupuncture plus medication can effectively mitigate the symptoms in IBS-D (liver depression and spleen deficiency) and enhance the quality of life, which is possibly achieved by down-regulating the serum 5-HT, CGRP and ET levels.

Objective To investigate the influence of cervical vagosympathetic trunk or ganglionated plexi stimulation to the inducibility of atrial fibrillation(AF) in dogs.Methods In 16 anesthetized dogs,right cervical vagosympathetic trunk(VST) were dissected.A right thoracotomy was used to expose fat pad(FP) containing the ganglionated plexi(GP) at the caudal end of the sinus node.An electrode catheter was attached along the right superior pulmonary vein to allow programmed atrial pacing.At 2?,4? and 10? threshold atrial refractory periods(ARPs) were determined with and without VST or GP stimulation.At each pacing threshold AF inducibility was measured from the window of vulnerability(WOV).A cumulative WOV sum made of all WOVs was calculated in each group.Results In the baseline state the heart rate(HR) averaged 153?22 beats/min.Slowing of the HR by VST stimulation(79?44 beats/min) was not significantly different than with GP induced slowing(87?99 beats/min,P=NS).Furthermore,there were no significant differences between the lowest ARPs with VST stimulation and GP stimulation,accounting to 90?17 ms and 91?13 ms respectively(P=NS),but both are shorter than that in the baseline state,which was 101?20 ms(P