OBJECTIVE To investigate the strategy of information system in antibiotics usage management. METHODS By inquisition,statistic and analytic methods the antibiotics usage information of the hospitalized patients was recorded with the information system,to realize the realtime monitoring and process management. RESULTS The usage rate of antibiotics decreased from 88.79% to 80.19% and the prophylactic usage rate of the third cephalosporin decreased from 72.34% to 11.25%.The rational usage rate increased from 57.89% to 80.18%. CONCLUSIONS The management method of antibiotics usage with information system achieves obvious effect.

[Objective]To investigate the best internal fixation methods of upper segment complicated femoral fractures(USCFF).[Method]Fifty-two cases(54 limbs) with USCFF were treated.In all patients open fracture reduction with use of internal fixation were done.Intramedullary interlocking nails(IIN) were used to treat 32 cases(34 limbs) of adult's USCFF and 130? plate were used to treat 20 cases of children's USCFF.Thirty-six limbs of them were closed fractures,and 18 limbs were opene.Measures of auto-ilium transplant(5 limbs),homolegous allograft bone transplant(10 limbs)were also taken.[Result]Fifty-two patients were followed-up from 9 to 40 months with an average of 16 months.Infection,fracture nonunions,malunion and femoral head necrosis complications were not found.The average period of union of adult and children fractures was respectively 6.8 months and 6.5 months.The long term effect was evaluated according to Ma Yuanzhang's evaluation standard,94.4 percent showed excellent function of joints and limbs.[Conclusion]Appropriate selection of internal fixation according to the age of patients and satisfactory fracture reduction are key points to improve outcome of USCFF.IIN in treating fiacture of adult and 130? plate in treating fracture of children are more ideal selections.

Objective To investigate the potential infectious of the new-Bunyavirus among the blood-donors in Guiyang area.Methods A total of 1 187 blood samples and the basic data were collected from the blood center of Guizhou.The new-Bunyavirus total antibody in serum was tested by enzyme-linked immunosorbent assay(ELISA).The samples were tested repeatedly by ELSIA,and general statistics description of the samples′ data was did by Excel2007,and the age,gender,occupation and collecting time of the samples were analyzed by SPSS19.0.Results The positive rate of new-Bunyavirus total antibody among blood-donors in Guiyang was 5.31%,and the new-Bunyavirus total antibody titers was 1∶20-1∶64.The positive were tested by PCR for identifying,PCR results of all positive samples were negative.The positive rates between different genders,ages,occupations,and nationalities were not statistically significant(P>0.05),but the difference of positive rates between epidemic period and later stages of the epidemic was statistically significant(χ2=4.623,P=0.032).Conclusion There are new-Bunyavirus total antibody positive samples in blood-donors,noticing that there is a possibility of potential infection among Guiyang blood-donors and even healthy people.

Objective To detect and explore the expression of ARD1 and its clinical significance in the nasopharyngeal in-flammatory tissue ,nasopharyngeal carcinoma group and its subgroups .Methods Expression of ARD1 in nasopharyngeal carcinoma (56 cases) and nasopharyngeal inflammatory tissue (20 cases) were detected by immunohistochemical staining SP ,the correlation between the expression of ARD1 and age ,gender ,histological grade ,TNM clinical stage and tumor metastasis were analysed . Results The positive expression rate of ARD1 were 10 .00% (2/20) ,55 .35% (31/56) in the nasopharyngeal inflammatory tissue and nasopharyngeal carcinoma ,respectively .The expression level of ARD1 in nasopharyngeal carcinoma was significantly higher than in the nasopharyngeal inflammatory tissue ,the difference was significant (P< 0 .05) ;expression of ARD1 in the nasopharynge-al carcinoma was correlated with the histological grade of nasopharyngeal carcinoma(P< 0 .05) and the expression was increased in poor differenciation tissue .But there was no statistical difference between the expression of ARD1 and the patient′s age ,gender , TNM clinical stage ,tumor metastasis(P> 0 .05) .Conclusion The expression of ARD1 is high in nasopharyngeal carcinoma ,and has a closely correlation with diffferentiation level of tumor ,which suggested that ARD1 may be involved in the the occurrence and development of nasopharyngeal carcinoma .However ,further research needs to be done for its mechanism in the nasopharyngeal car-cinoma .

Objective To evaluate the relationship between serum matrix metalloproteinase-9(MMP-9), white blood cell(WBC)count and type 2 diabetes mellitus with macroangiopathy and to investigate the mechanism of the protective effects of rusiglitazone(RSG)on blood vessel.Methods Serum MMP-9 was determined by ELISA in 30 normal controls and 80 type 2 diabetic patients(including 40 cases with macroangiopathy and 40 without maeroangiopathy).WBC count and other clinical parameters were also determined.32 type 2 diabetic patients received RSG(4rag qd)for 12 weeks.All parameters were determined after 4 weeks(17 patients)and after 12 weeks(all patients)to observe the changes in MMP-9,WBC and other parameters.Results In the diabetic patients,serum MMP-9 and WBC were markedly higher as compared with normal controls;and MMP-9 and WBC in patients with macroangiopathy[579(440-949)?g/L,(7.51?1.47)?10~9/L]were higher than those [324(275-423)?g/L,(6.22?0.79)?10~9/L]in the cases without macroangiopathy(P

Objective To assess the current status of knowledge, attitude and practice (KAP) towards antibiotic use among community residents in Hangzhou, and to explore the correlations among them. Methods A total of 449 permanent residents in Hangzhou were randomly selected using a multistage stratified random sampling method. Self-reported data on basic demographic factors, and relevant KAP information were collected by the questionnaire survey. Differences in KAP scores according to each demographic factor were assessed by the t test or ANOVA test, and AMOS 21.0 was used for the path analysis. Results Scores for knowledge, attitude and practice regarding antibiotic use were (6.17±2.45), (6.45±0.99) and (6.21±1.02) respectively. Results of the path analysis showed that education level and age had effects on the knowledge (coefficients: 0.57 and -0.38 respectively) . Age, gender and knowledge had effects on the attitude (coefficients: -0.27, 0.12 和 0.02 respectively), and attitudes, gender, monthly income and the level of education had effects on the practice (coefficients: 0.48、 0.37、 0.06 and 0.02 respectively) . Conclusion Community residents in Hangzhou lack relevant knowledge, and there are some irrational attitudes and practices regarding antibiotic use. There is a correlation between knowledge and attitudes, as well as between attitudes and practices, but the knowledge and practices are not correlated.

ObjectiveTo investigate the clinical characteristics of the inpatients suffering from dengue fever in order to provide references for better diagnosis and treatment.Methods The clinical data of 158 dengue fever patients admitted to the First Affiliated Hospital of Sun Yat-Sen University from July 23rd to October 31st, 2014 during the 2014 epidemic in Guangzhou area were retrospectively analyzed, including general clinical manifestations, conventional examinations, pathogenesis, and prognosis.Results The mean age of the 158 patients was (56±20) years, with half of them over 60 years old (79 cases). Among them, 94 (59.49%) were male.① The common manifestations included fever (100%), headache (70.89%), myalgia/bone soreness (62.03%), and skin rash (54.43%). Bleeding and plasma leakage were found in 25.95% and 14.56% of the patients respectively.② Laboratory examination:leucopenia (75.32%) and thrombocytopenia (77.85%) were found, and alanine aminotransferase (ALT) and aspartate aminotransferase (AST) were elevated in 57.59% and 77.85% of the patients respectively. However, elevation of blood hematocrit was rare (1.27%).③ It was found that in the acute phase (0 - 5 days of the onset), serum dengue virus antibody IgM (DF-IgM) was positive in 63.54% of the patients (61/96), and 92.62% (113/122) of patients were dengue virus RNA (DENA-RNA) positive.④ The rate of comorbidity in this study was 55.06% (87/158), including hypertension (27.22%) and type 2 diabetes (15.82%), which were the two most common co-morbidities.⑤ All the patients were given supportive therapy to prevent complications. They were also isolated for more than 5 days after onset, and at least for 24 hours after subsidence of fever in addition.⑥ The criteria for the diagnosis of severe dengue were fulfilled in 18 patients (11.39%). One patient died of massive hemorrhage from gastro-intestinal tract, and 1 patient voluntarily left hospital with untreated multiple organ dysfunction syndrome (MODS). Another 2 patients of dengue fever died from primary cardio-cerebrovascular disease, and the remaining 154 patients (97.47%) fully recovered with supportive therapy and complication prevention measures.Conclusions The clinical manifestations of inpatients with dengue fever in this study were typical, and they manifested a higher incidence of severe illness. DENA-RNA could be a sensitive indicator for early pathogenic diagnosis. With symptomatic and supportive therapy, most patients had a good outcome. However, early diagnosis and clinical interventions of severe dengue still need further studies.

Objective To investigate the correlation between serum bone metabolism biomarkers and bone mineral density (BMD) in chronic kidney disease (CKD) patients with different stages. Methods Seventy-eight CKD patients were enrolled in this study and were assigned to different groups according to their ereatinine clearance (Cer). Patients with Cer ≥ 15 ml/min were divided into 4 groups based on clinical CKD 1-4 stage standard, and those with Ccr<15 ml/min were divided into two groups of hemodialysis (HD) and non-HD. Their levels of serum calcium, phosphorus, alkalinity phosphatase (ALP), urea, Ser, osteocalein (gla-protein, OC), calcitonin (CT), intact parathyroid hormone (iPTH), osteoprotegerin (OPG) and BMD were detected respectively. Results (1) The serum levels of OPG, iPTH and phosphorus increased significantly in stage 3, 4, 5, respectively (P<0.01), and serum OPG level was elevated to (5.1±1.34) ng/L after HD, which was significantly higher than (3.35±0.76) ng/L before HD (P<0.05). The levels of serum OC, CT, calcium, ALP were not significantly different among patients with different CKD stages, while the level of OC was elevated in HD patients (P<0.05). The femoral WARDS triangle BMD of CKD stage 4 patients decreased to 0.77±0.09, which was less than the value of CKD stage 1 patients (P<0.01), with litde influence from hemodialysis treatment. (2) The level of serum OPG was positively correlated with the levels of serum phosphorus, iPTH, OC (r = 0.51, 0.39, 0.36,all P<0.01), and it was negatively correlated with the level of Ccr (r =-0.70, P<0.01). The femoral WARDS triangle BMD was negatively correlated with the levels of iPTH, OC, phosphorus and OPG (r =-0.59,-0.51,-0.45,-0.48, all P<0.05). Conclusions Most of serum bone metabolism biomarkers change according to the declined level of Cer. Compared with serum phosphorus, the levels of iPTH, BGP and femoral WARDS triangle BMD, serum OPG may be early diagnosticmarkers of renal osteodystrophy in CKD patients.

Objective To investigate the role of B7/CD28 costimulation pathway blockade with adenovirus-mediated CTLA4-Ig gene in macrophage and CD8~+T cell infiltration and cell apoptosis in murine liver transplantation. Methods Rat pairs were divided into three groups: SD-to-Wistar transplantation control group, CsA-treated group and CTLA4-Ig-treated group. IHC and TUNEL were used to analyze the expression of CTLA4-Ig gene in liver and immune cells infiltrate and cell apoptosis in liver grafts. Pathology was done on all harvested grafts. ResultsCTLA4-Ig gene expression was positive in the donor liver on day 7 after administering adenovirus-mediated CTLA4-Ig gene via vein, and remained positive until day 60 after liver transplantation. Infiltration of immune cells in CTLA4-Ig-treated group was less than that in rejection control group. the apoptotic index of rejection group on day 3,5,7 was significantly higher than those of CTLA4-Ig-treated. Conclusions CTLA4-Ig gene was constantly expressed in the donor liver after single intravenousely injection into rats using adenovirus as vector. Adenovirus-mediated CTLA4-Ig gene therapy can inhibit infiltration of immune cells and apoptosis in grafts, thus prolonging the survival of recipients.

Objective To compare the diagnostic value of high frequency ultrasound,mammography and breast blood-oxygen function imaging system in diagnosis of breast masses.Methods The images of 89 breast masses by high frequency ultrasound,mammography and breast blood-oxygen function imaging system were reviewed.The study compared the sensibilities and specificities of the three methods in the masses and analyzed their cause of missed diagnosis.Results The sensitivity of the diagnosis of breast cancer by high frequency ultrasound,mammography and breast blood-oxygen function imaging system were 80.00％,70.00％ and 50.00％,respectively.The specificity of the diagnosis of breast cancer by them were 94.94％,98.73％ and 97.47％,respectively.There were sigmfiacant differences in diagnosis of breast benign lesion among the high frequency ultrasound,mammography and breast blood-oxygen function imaging system.The sensitivity of high frequency ultrasound in detecting fibroadenoma of breast was 98.11％ higher than the other methods.Mammography was insensitive to the benign breast lesions,but its specificity was high.Conclusions High frequency ultrasound,mammography and breast blood-oxygen function imaging system are the highly effective diagnostic tool for breast cancer,but the diagnostic value of mammography and breast blood-oxygen in breast fibroadenoma and in cystic disease of breast aren' t high.Breast blood-oxygen function imaging system can enhance the accuracy of the diagnosis of mammary inflammation.