OBJECTIVE: To probe into the application of antimicrobials in our hospital and to provide reference for clinical rational use of drugs. METHODS: Retrospective analysis was applied to analyze consumption sum, DDDs and DDC of antimicrobials in our hospital from 2006 to 2009 statistically. RESULTS: The consumption sum and DDDs of antimicrobials in our hospital from 2006 to 2009 increased year by year. Majority of antimicrobials taking up the top place were injection in the list of consumption sum and were cephalosporins, macrolides and fluoroquinolones in the list of DDDs. The DDC of antimicrobials decreased year by year. CONCLUSION: The application of antimicrobials in our hospital is reasonable basically, but the application of a few categories of antimicrobials is not reasonable. The study of Guiding Principles for Clinical Use of Antibiotics should be strengthened to implement the application of antimicrobials classification system.

Objective To study the clinical effects of conservative treatment of incomplete pharmaceutical abortion. Methods 149 cases of incomplete pharmaceutical abortion were randomly divided into two groups. Group A(86 cases) was intramuscularly given progesterone or orally medroxyprogesterone. Group B (63 cases)was given methotrexate intramuscularly or orally. The therapeutic effects of two groups were observed. Results The successful rate in group A and group B was 79 07%(68/86) and 96 82%(61/63). The successful rate of the patients with lower HCG level in group A and group B was 86 89%(53/61) and 100%(32/32) respectively, which had significant difference (P

Objective To evaluate influence of patient-controlled intravenous analgesia (PCIA) and patient-controlled epidural analgesia (PCEA) on expressions of serum inflammatory cytokines in elderly patients with hemi or whole hip replacement using cemented artificial joint. Methods Elderly patients undergoing hip replacement were selected and were divided into PCIA group and PCEA group. VAS scores were calculated at 12 h postoperatively. Patients whose VAS scores were not more than 2 at postoperative 12h were included. 30 cases in each group were finally included. Fifteen cases were randomly chosen in each group and underwent sample blood drawing for assays. Expressions of serum inflammatory cytokines were detected by ELISA , RT-PCR and Western-blot. Results Gene and protein expressions of TNF-a as well as IL-6 in group PCEA were lower and expression of IL-10 was higher than that in group PCIA. Serum level of TGb-β was higher in group PCEA detected by ELISA. There was no significant difference in expression of IL-8 between groups. Conclusions PCEA may better promote expressions of anti-inflammatory cytokines and inhibit expressions of proinflammatory cytokines. PCEA is superior in maintenance of inflammatory cytokine balance.

Objective To investigate the feasibility of NR2B small interference RNA(NR2B siRNA)carried by water-soluble lipopolymer(WSLP)for treatment of neuropathic pain in rats.Methods One hundred healthy male SD rats weighing 180-200 g were randomly divided into 5 groups(n=20 each):normal control group (group C),sham operation group(group S),neuropathic pain group(group NP),group WSLP-NR2B siRNA (group W)and group WSLP-negative NR2B siRNA(group WN).Neuropathic pain was induced by partial ligation of sciatic nenre.WSLP-NR2B siRNA complex was formed by binding WSLP and NR2B siRNA.Normal saline.WSLP-NR2B siRNA complex and WSLP-negative NR2B siRNA 20μl were injected intrathecally after operation in NP,W and WN groups respectively.Mechanical withdrawal threshold(MWT)and thermal withdrawal duration (TWD)were measured before(baseline)and at 3,7,14 and 21 days after operation.Ten animals in each group were sacrificed on the 3rd day after operation and the lumbar segment(L4-6)of the dorsal root ganglia was removed for determination of the expression of NR2B mRNA and protein using RT-PCR and Western blot analysis.Results Sciatic nerve ligation significantly decreased MWT and prolonged TWD and increased NR2B mRNA and protein expression in group NP as compared with group C.WSLP-NR2B siRNA complex significantly reduced sciatic nerve ligation-induced hyperalgesia and decreased NR2B mRNA and protein expression in group W as compared with group NP.Conclusion WSLP not only mediates NR2B siRNA successfully and inhibits the expression of NR2B,but also reduces neuropathic pain in rats.

Objective To evaluate the clinical significance of rearrangements during transfection of papillary thyroid cancer (RET/PTC) 1,3 in fine needle aspiration (FNA) specimen from regional thyroid nodules by FQ-PCR.Methods Two hundred and eighty-five FNA samples were collected from patients with thyroid nodules during January 2012 to January 2013.RET/PTC1,3 rearrangements were detected with FQ-PCR.Results The frequencies of the RET/PTC1 and RET/PTC3 rearrangements in 285 FNA samples were 17.2％ (49/285) and 1.4％ (4/285),respectively.During 21.7 months of follow-up,19 (40.4％,19/47) RET/PTC1 positive patients were confirmed to have papillary thyroid carcinoma(PTC) after operation.In the patients with RET/PTC1 rearrangement PTC was found in Thy5 and Thy4 groups.In Thy 2 group,22.6％ cases with RET/PTC1 rearrangements developed PTC as compared with 3.2％ cases without it(x2 =6.667,P＜0.01).In addition,8.5％ (4/47) RET/PTC1 rearrangements emerged in benign lesions.Conclusions It is convenient and reliable to detect RET/PTC1,3 rearrangements by FQ-PCR using FNA samples.RET/PTC1 rearrangement frequently occurs in PTC,however it would be detected in benign lesions occasionally.

Teaching healthy lifestyle in combination with physiology is hardly practiced in schools of medicine. Individual lifestyle factor accounts for 60% among the factors that lead to dis-eases. Physiology contains the basic theories for health knowledge. Therefore, during physiology teach-ing , healthy lifestyle was introduced by combining such contents of physiology as digestion and absorption , energy metabolism balance and emotional physiological reaction with four “health corner-stones” such as health diet, regular physical activity, psychological balance, quitting smoking and drinking less alcohol. This teaching mode has widened the teaching ideas, which has not only in-creased the students' interest and significance in physiology learning, but also promoted them to de-velop good healthy lifestyle.

Objective To investigate the therapeutic effect of cell penetrating peptide Tat-LK15 mediating small interfering RNA (siRNA) interference with the expression of neuronal nitric oxide synthase (nNOS) in rat spinal dorsal horn on neuropathic pain. Methods The transfection reagent, Tat-LK15, was used to mediate the transfection of rat spinal dorsal horn (SDH) neuronal cells with carboxyfluorescein (FAM), and then the transfection effect was observed under inverted fluorescence microscope. Fifty healthy male SD rats were randomly divided into 5 groups (n=10): control group, sham operation group (sham group), neuropathic pain group (SNL group), Tat-LK15-nNOS siRNA group (TS group) and Tat-LK15-NC siRNA group (TN group). Neuropathic pain was induced by spinal nerve ligation (SNL), rats in control group did not receive operation and only the spinal nerve was exposed in sham group. Groups SNL, TS and TN were made into the models by SNL and implanted intrathecal catheter, intrathecal administration was performed from the 7th day after model establishment, and 10μl normal saline, 10μl TS complex (including 5μg siRNA) and 10μl TN (including 5μg siRNA) were injected intrathecally each day for 7 days. Paw withdrawal mechanical threshold (PWMT) and paw withdrawal thermal latency (PWTL) were measured at 1 day before (baseline) and 3, 7, 10 and 14 days after model establishment. Then animals were sacrificed on the 14th day after the operation and the lumbar segment (L4-6) of the spinal cord was removed to detect the expressions of nNOS mRNA and protein using q-PCR and Western blotting analysis. Results Tat-LK15 effectively mediated FAM-siRNA into SDH neuronal cells. Compared with sham group, SNL significantly decreased PWMT and PWTL and increased expressions of nNOS mRNA and protein from the 3rd day (P<0.01), but there was no significant difference between the sham and control group. Tat-LK15-nNOS siRNA complex significantly increased PWMT and PWTL and down-regulated nNOS mRNA and protein expressions in TS group compared with SNL group on the days 10 and 14. There was no significant difference between TN and SNL group. Conclusion Tat-LK15 not only can mediate successful nNOS siRNA transfection and inhibit the expression of nNOS, but also effectively relieve SNL-induced neuropathic pain in rats.

Objective To study the imaging findings of unexpected splenic autotransplantation after splenectomy and to improve diagnostic accuracy of splenic autotransplantation.Methods The findings of 10 patients with splenic autotransplantation confirmed by histology in our hospital were retrospectively reviewed.In 7 patients CT and plain and dynamic enhanced MRI scanning were carried out,and in 2 of them 99mTc-DRBC scanning were also done.In 3 patients,plain and dynamic enhanced CT scannings were done.Results (1) Multiple lesions were detected in 7 patients and a single lesion in 3 patients.The masses were round and oval.The nodules were in the splenic fossa in 9 patients,in the pancreatic tail in 4 patients,in the right liver in 2 patients and in other of parts of the abdominal cavity in 2 patients.These nodules varied in size and 94.6％ showed a maximum diameter of less than 3 cm; (2) The findings on CT and MR:all the nodules were homogeneous with soft tissue density.There was no cystic degeneration,necrosis and calcification.In one patient with a nodule in the pancreatic tail,there was a slightly short T1 and short T2 signals.Other nodules showed long T1 and long T2 signals.All the signals from the nodules were homogeneous and their outlines were clear.In a patient with a nodule in the right liver,the blood supply came from the abdominal aorta.There was a surrounding thin layer of low-density ring which showed long T1 and long T2 signals.The enhanced features on CT and MR were similar.The nodules showed homogeneous or inhomogeneous enhancement in the arterial phase,with continuous homogeneous enhancement in the portal venous phase,with an obvious decline in the delayed phase;(3) The findings of 18 F-FDG PET:The nodules had obvious increase in FDG uptake.Conclusions In patients with a history of splenic trauma or splenectomy,abdominal nodules with multiple,homogeneous density or signal,clear outline,enhanced features similar to spleen,splenic autotransplantation should be considered.99mTc-DRBC scanning is helpful in the diagnosis of splenic autotransplantation.

Objective To evaluate the feasibility, safety and efficacy of CT-guided radiofrequency ablation in treating osteoid osteoma located at femoral neck. Methods Six patients with osteoid osteomas in the femoral neck received CT-guided percutaneous radiofrequency ablation. In all patients the main complaint was pain at the hip, and the course of disease varied from one month to 2 years, with an average of 8 months. Under spinal anesthesia the surgery was performed. With the help of CT guidance , a 3.5 to 4.0 mm coaxial drill system was inserted into the nidus, and an osseous access was established, then the bone biopsy needle was used to obtain specimens for pathological examination. Subsequently, a 1.5 to 2.0 cm active tip was introduced through a non-cooled radiofrequency needle into the nidus. Radiofrequency ablation was performed with the therapeutic temperature of 90℃, lasting for 6 minutes. The pain visual analogue scale (VAS) was used to evaluate the clinical effectiveness. The postoperative MRI findings were compared with the preoperative ones. Results Three days after the treatment, different degrees of pain relief was obtained in all patients, and all patients could get out of bed and walked around in one week. Postoperative VSA was significantly decreased (P<0.01). No severe complications occurred during and after the procedure. And no recurrence was seen during the follow-up period. Conclusion For the treatment of osteoid osteoma located at femoral neck, CT-guided radiofrequency ablation is a safe and effective minimally invasive treatment with fewer complications and satisfactory clinical results.

Aim To investigate the potential applica-tion of a non-viral gene carrier Tat-LK15 for delivering siRNA targeting nNOS in vitro, which provides evi-dence of Tat-LK15 mediating siRNA targeting nNOS in vivo for treatment of neuropathic pain. Methods 1. Tat-LK15 was mixed with siRNA, then the mixture was analyzed the best ratio by Gel retardation. The trans-fection efficiency of FAM-siRNA mediated by Tat-LK15 on RGC-5 cells was examined by Flow Cytome-try. The apoptosis ratio of RGC-5 was identified by Flow Cytometry 24 h after treated with the different do-ses of Tat-LK15 (1, 2. 5, 5, 10 and 20 μg). 2. The model of RGC-5 cell overexpression of nNOS protein was prepared. 3. RGC-5 cells were randomly divided into 5 groups:control group,model group, Tat-S group ( Tat-LK15 mediate nNOS/siRNA transfection model cell) , Lipo-S group ( LipofectamineTM RNAiMAX me-diate nNOS/siRNA transfection model cell) and Tat-N group ( Tat-LK15 mediate NCsiRNA transfection model cell) . Real-time Quantitative polymerase chain reac-tion( Q-PCR) and Western blot were used to evaluate nNOS expression level assay. Results It indicated that the Tat-LK15/siRNA complex completely formed at the weight ratio of 2∶ 1 (μg/μg) , and the transfec-tion efficiency was (84. 4 ± 3. 9)%. It caused cotytox-icity when Tat-LK15 dose was 20 μg ( 6. 1 μmol · L-1 ) , and the apoptosis rate more than control group [(10. 3 ± 1. 1)% vs (7. 4 ± 0. 9)%, P<0. 05]. The nNOS protein level of RGC-5 cells was significantly el-evated after modeling. Compared with that of model group, Tat-LK15/siRNA efficiently inhibited the ex-pression of nNOS at transcriptional level or protein leve1 of Tat-S group ( P <0. 05 ) , and there was no significant difference of the efficiency inhibited between Tat-S group and Lipo-S group. Conclusions Tat-LK15’ advantage is with high efficiency, low cytotox-icity. The Tat-LK15 can deliver siRNA targeting nNOS in vitro efficiently and safely.