Objective To compare the clinical efficacy of different trough concentrations of vancomycin in patients.Methods A retrospective study in patients having at least one trough concentration of vancomycin for enrollment between January 2009 and December 2013 was carried out.The eligibility patients were divided into 3 groups according to the level of trough concentrations namely group A (＜ 10 mg/L),Group B (10 ～ 15 mg/L),and Group C (＞ 15 mg/L).The clinical efficacy,clearance of pathogens and in-hospital mortality were analyzed with the help of SPSS Statistics 17.0.The comparison of dosing days,length of hospital stay and time consumed from initial dosing to the appearance of recovery signs of survivors among the 3 groups.Results There were no significant difference among 3 groups in terms of clinical efficacy (55.6％ vs.33.3％ vs.51.7％),clearance of pathogens (38.9％ vs.25％ vs.24.1％) and in-hospital mortality (44.4％ vs.25％ vs.27.6％).After adjusting by age,the in-hospital mortality decreased along with the trough concentrations vancomycin.Along with increase in the trough concentrations vancomycin,the dosing day (14.90 ± 6.44 vs.18.75 ± 7.23 vs.17.93 ± 9.42) and length of hospitalization [(33.70 ± 18.17) vs.(79 ±45.53) vs.(66.20 ±52.48)] increased,and time required from dosageinitial dosing to the appearance of recovery signs of survivors among the 3 groups [(4.82 ± 2.62) vs.(3.75 ± 0.50) vs.(4.07 ± 3.20)] shortened.Conclusions Improving the trough concentrations of vancomycin could not increase clinical efficacy rate or bacterial clearance rate,but could lower in-hospital mortality.However,it might enhance the financial burden on patients as well.

OBJECTIVE:To strength pharmacy management,improve pharmacy stocktaking efficiency and lower the error rate of the stocktaking in outpatient pharmacy.METHODS:Based on "Army No.1" inventory management system,the data were retrieved and adjusted using Excel spreadsheet,and the inter-district small-scale inventory table of the outpatient pharmacy was designed in which certain individuals should be responsible for certain drugs and the order of drugs in the inventory table were in line with the arrangement order of drugs.RESULTS:The new drug stocktaking model reduced the error rate of traditional monthly drug stocktaking by 3%.CONCLUSION:The established drug stocktaking method reduces human and material resources,facilitates a more flexible,convenient and rapid stocktaking,and greatly enhances the conformity rate between drugs and accounts.

To discuss the protective effect of aralosides (AS) on I/R-induced rat myocardial injury. The adult rat ventricular myocyte ischemia model was established through perfusion with sodium lactate perfusate and reperfusion with Ca(2+) -containing Tyrode's solution simulation. The cell contraction and ion concentration synchronization determination system was applied to detect the effect of AS on single I/R cell contraction and Ca2+ transients. According to the findings, AS could increase resting sarcomere length, contraction amplitude, ± dL/dt(max), calcium transient amplitude and speed of post-reperfusion myocardial cells (P < 0.05, P < 0.01), and decrease in time for achieving 90.0% of maximum relaxation, time for achieving peak value, resting calcium ratio, contraction period [Ca2+] i, time for achieving 50.0% of maximum relaxation and attenuation rate of intracellular calcium transient (P < 0.05, P < 0.01). Therefore, it is suggested that AS improved the post-reperfusion cell contraction and injury of calcium homeostasis.
Animals ; Aralia ; chemistry ; Biological Transport ; drug effects ; Calcium ; metabolism ; Drugs, Chinese Herbal ; administration & dosage ; Humans ; Male ; Muscle Contraction ; drug effects ; Myocardial Ischemia ; drug therapy ; metabolism ; physiopathology ; surgery ; Myocardial Reperfusion ; Myocytes, Cardiac ; drug effects ; physiology ; Rats ; Rats, Sprague-Dawley ; Saponins ; administration & dosage

AIM:To evaluate the morphological and functional changes of retinas induced by treatment of tunicamycin with optical coherence tomography (OCT) in rats.METHODS:Totally 60 SD rats were randomly divided into 3 groups (20 in each group), 0.5mg/kg (in low dose group), 1.5mg/kg (in high dose group) tunicamycin were injected into vitreous cavity and saline (9g/L NaCl) were injected in the same dose as a control group.Changes of retinas were observed by OCT on the 1,7 and 14d after treatment of tunicamycin.Then the rats were sacrificed, retinas were taken out and embedded by the paraffin, tissue sections and the HE staining were performed.RESULTS:OCT results suggested that tunicamycin played damage effects on retinal morphology and structure which appeared a time-and dose-dependent.Fundus photography results suggested that 2wk after tunicamycin treatments, with the gradually changing of tunicamycin concentration, peripheral retinal and macular region became pale color gradually, edema occurred in optic disk, retinal vessels appeared thinner in the high dose group, optic nerve came out atrophy.Fluorescein angiography confirmed that tunicamycin injection in vitreous cavity 2wk later, retinal vessels injury occurred, resulted in leaking of intravascular contrast agent from peripheral to the central part of the retinas.Electrophysiological data showed that retinal electrogram occurred disorder induced by tunicamycin, such as the amplitude of a wave, b wave decreased gradually, even closed to zero, which was very different from control significantly (P<0.05).HE staining of paraffin sections showed that retina injuries induced by tunicamycin were in dose-time dependent, which was consistent with the results of OCT.CONCLUSION: Clinical retinal diseases could be simulated by retinal damage animal model induced by tunicamycin treatment.OCT detection offered real-time images of the retinal cross-section, which provided a helpful non-invasive method for detecting and evaluating the retinal damages.

Objective To evaluate the feasibility,safety and accuracy of endoscopic ultrasonography guided fine-needle aspiration(EUS-FNA) in patients with mediastinal benign and malignant lesions.Methods A linear array scanning endosonography (Pentax-EG3630U) and a 22-guage (Wilson-CooK) needle were used to perform EUS-FNA in 22 patients with mediastinal lesions.Results EUS-FNA revealed 15 patients with carcinoma and 6 cases with benign tumors,which were confirmed by mediastinoscopy.One patient was not diagnosed because of inadequate specimen.None of the patients had complications caused by any procedures.Conclusion EUS-FNA is safe,reliable and accurate in diagnosis of mediastinal benign and malignant lesions.

Bring up high quality medical talents with innovative consciousness and practical ability is the aim of high medical ed- ucation.Improving the innovative ability of teachers and quality of teaching with the perfect combination of science and humanities, so as to improve our understanding of the importance and necessity of innovation education,and carry out an overall quality edu- cation which chiefly works for the training of students' innovative consciousness and practical ability during practicing period.

Objective To explore the effect of lysophosphatidic acid(LPA)on blood-brain barrier(BBB) permeability and its possible mechanism.Methods LPA or LPA+suramin(L+S)were stereotaxically injected into the right eaudate nucleus in SD rats in vivo.Evans blue(EB)was used to quantitatively measure the permeability of BBB at different time points.The expression of matrix metalloproteinase-9 was detected by immunohistochemistry technique.The pathological ultrastruetural changes of BBB were assessed by transmission electron microscopy.Results The BBB permeability began to increase after LPA administered into ipsilateral eaudate nucleus,and reached the peak at 24h.Then the permeability of BBB gradually lowered after 48h.In comparison with the same time points of control group,there were quite significant differences(P＜0.01).After L+S was injected,the change of BBB permeability had differences in comparison with those of LPA group in the same time points,(P＜0.05).MMP-9 positive cells were mainly vascular endothelial cells.The numbers of MMP-9 positive blood vessels grew at 6h in LPA group,and the expression of it reached maximum at 24h,then the number of it decreased at 48h,showing significant statistical differences in comparison with the L+S group(P＜0.01),It was observed microscopically that ultrastrueture of BBB of the LPA group was changed sharply,such as basement membrane roughed and fragmented,astroeyte end-feet swolled markedly and perivaseular space enlarged obviously.But there were no remarkable changes in BBB in L+S group.Conclusion LPA can induce increase of BBB permeability and its possible mechanism is the strong expression of MMP-9 protein produeted by endothelial cells through the mediation of LPA receptor,leading to degradation of basement membrane.

The process mechanism and current application status of boron removal in reverse osmosis(RO)desalination were introduced.The characteristic and proper application range of eachboron removal process was summarized.Also,the running conditions of two practical desalination cases were analyzed and compared.Eventually,the future of application and the research direction of boron removal process in RO desalination were prospected.

Objective To verify the relationship between personality traits and clinical nurse competence in five third-A level hospitals in Shenyang. Methods A total of 1559 clinical nurses from five tertiary-level hospitals in Shenyang were recruited into this study. Two self-report questionnaires, the Nurse Competence Scale (NCS) and the Tridimensional Personality Questionnaire (TPQ), were used to collect data. Results The average score of NCS was 71.97 ± 13.25.Nursing competence increased with the increase of working years (β=0.272, P<0.01) and RD (β=0.134, P<0.01). Practicing nurses with the lower HA appear to have a higher level of competence (β=-0.117, P<0.01). Conclusions The overall level of nurses' competencies good in third-A level hospitals in Shenyang. The predicting factors of nursing competence are work experience, HA and RD. More psychological courses should be provided in fundamental nursing education and continuing nursing education for helping nurses shape their good personality traits.

ObjectiveTo assess the safety and clinical values of video-laryngoscope in spontaneous respiration tracheal intubation for emergency patients. Methods Seventy-nine patients,who needed the endotracheal intubation,were recruited in our department between January 2010 and December 2010,and were randomly ( random number) divided into two groups according to consultative sequence.Forty patients (group A ) were operated with traditional laryngoscope and thirty-nine patients (group B ) with videolaryngoscope.The operative time and success rate of tracheal intubation,Cormack-Lehane classification,as well as adverse events,were recorded.The heart rate ( HR ),mean arterial blood pressure ( MAP),respiratory rate ( RR ),and saturation of pulse oxygen ( SpO2 ) were observed pre-operation,during operation and 2 min post-operation.Results( 1 ) The Cormack-Lehane classification in group A were significantly lower than in group B. (2) The operative time of tracheal intubation in group B was significantly less than that in group A [(35.6+12.7) svs. (58.3 ± 13.5) s; P＜0.05] ; and one-time success rate of tracheal intubation in group B was higher than that in group A ( 84.6％ vs.52.5％ ; P ＜0.05).(3) Compared to group B,the HR and MAP in Group A were significantly increased at t2 and t3 ( P ＜ 0.05 ). ( 4 ) The adverse events,including restlessness,bucking and injury,were significantly decreased in group B than those in group A ( P ＜ 0.05 ).ConclusionsThe video-laryngoscope used in spontaneous respiration tracheal intubation,could improve Cormack-Lehane classification,short operative time,enhance one-time success rate and reduce adverse evevnts.