OBJECTIVE:To provide reference for the rational application of antimicrobial drugs. METHODS:Medical records of all acute exacerbation of chronic obstructive pulmonary disease(AECOPD)hospitalized patients were collected from respiration department of our hospital during Sept. 2013 to Apr. 2014 and May 2014 to Dec. 2014,73 and 88 cases respectively. The applica-tion of antimicrobial drug was analyzed comparatively,and the rationality of drug use in AECOPD patients was evaluated. RE-SULTS:After the special rectification activities,the antimicrobial use intensity dropped from 217.74 to 91.58;drug combination rate dropped from 67.12% to 6.82%;no reason to change the antimicrobials conditions dropped from 15.07% to 0;hospital stay shortened from(10.21±3.44)d to(7.13±3.14)d;the total cost of medical treatment dropped from(6 117.73±1 164.52)yuan to (4 574.82±997.28)yuan;percentage of medicine expenses and antimicrobial drug expenses dropped from(61.83±11.49)% and (28.84±9.55)% to(43.52±9.97)% and(20.07±6.43)%,respectively;there was statistical significance(P<0.05),and the clinical treatment effect were uninfluenced. CONCLUSIONS:The special rectification activities of antimicrobial drugs could effec-tively improve the rational application of antimicrobial drugs and enhance the efficacy of antimicrobial drugs and decrease the cost of drug use.

Objective To assess the high risk factors associated with the positive margin of conization in patients with cervical intraepithelial neoplasia (CIN). Methods From January 2000 to February 2008, 1699 consecutive patients with CIN undergoing conization was reviewed retrospectively in order to analyze the relationship between the positive margin of conization with clinical prognostic factors,such as patients age, disease grade, size of lesion, the procedure of excision and menopause. X<'2> tests was used to compare the different frequencies of factors in groups of positive and negative margin conization, then seven factors with positive margin were processed into unconditional logistic regression analysis. Results The rate of the positive margin in 1699 patients was 14.01% (238/1699). The mean age of patients with positive margins was (39±9 ) years old, while patients with negative margins was ( 39±8 ) years old, which didn't reach statistical difference(P>0.05). The rate of the positive margin was 8.63% in cold knife cone (CKC) and 18.66% in loop electrosurgical excision procedure (LEEP), which showed significant difference( P<0.01 ). Among 1699 patients, 90 patients were with CIN Ⅰ ,339 patients were with CIN Ⅱ ,1113 patients were with CIN Ⅲ [ including 972 with severe dysplasia and 141 with cancer in situ(CIS) ],87 patients were with cervical cancer stage Ⅰ al, 70 patients were with stage Ⅰ a2 or advanced stages. The rate of positive margin was 1.11% ( 1/90), 3.83% ( 13/339), 10.70% (104/972), 26.24% (37/141),35. 63% (31/87) and 74.29% (52/70),respectively. There was statistic difference among them, except CIN Ⅰ and CIN Ⅱ . When combined CIN Ⅰ with CIN Ⅱ , then compared with CIN Ⅲ, cervical cancer withⅠ al and Ⅰ a2, it also showed statistical difference (P<0.05 ) . The rate of positive margin in postmenopausal women was 21.54% (28/130), which was significantly higher than 13.38% (210/1569)in premenopausal women (P=0.010 ). The logistic regression analysis showed that the procedure of excision, grade of disease, size of lesion, surface of cervix, and menopause were high risk factors associated with the positive margin, the risk ratio were 5.147, 3.048, 1.271, 1.905 and 1.860, respectively.Conclusions High grade, the extent of CIN disease, LEEP and postmenopausal age are high-risk factors associated with positive margin in patients treated by conization. It should be warranted in those patients when designing conization treatment.

Objective:To explore the clinical value of qualitative determination of C-reactive protein (CRP) in the differential diagnosis of benign and malignant pleural effusions or ascites .Methods :CRP in 3820 cases of pleural effusions and ascites were qualitatively examined by latex agglutination method .Specimen and latex reagent were added to the wells of the reaction plate successively .The result was observed after 2 minutes’ thorough mixing .The result was judged as positive if agglutination par-ticles were visible .Results:The positive rate of CRP in 672 cases of malignant pleural effusions and ascites was 6 .1% .The positive rate of CRP in pleural effusions and ascites was 75 .0% in 32 cases of hematopoietic and lymphoid tissue tumors ,and 2 .7% in 640 cases of epithelial malignant tumors .The positive rate of CRP in pleural effusions and ascites in 3148 cases of be-nign diseases was 21 .8% .The positive rate of CRP in benign pleural effusions and ascites was higher than that in malignant pleural effusions and ascites(P<0 .05) .The positive rate of CRP in pleural effusions and ascites of patients with hematopoietic and lymphoid tumors was higher than that of patients with epithelial malignant tumors .Conclusions :Qualitative determination of CRP in pleural effusions and ascites can be used to differentiate benign and malignant pleural effusions and ascites ,and to differentiate pleural effusions and ascites of hematopoietic and lymphoid tissue tumors and epithelial malignant tumors .