OBJECTIVE:To analyze the rationality of the preventive use of antibiotics in Chinese ophthalmologic patients with type Ⅰ incision.METHODS:By means of retrospective study,a total of 1 273 ophthalmologic cases from 113 hospitals of 2006～2007 from National Monitoring Network of Ministry of Health for Clinical Application of Antibiotic with type Ⅰ incision involving preventive administration of antibiotics via different routes were analyzed.RESULTS:The local administration (eye drops and local injection) was rational on the whole,but the systemic administration (intravenous or oral administration) was irrational to some degree in which the drug grade was on the high side,the antibacterial spectrum was inappropriate,and the medication time was delayed.CONCLUSION:Preoperative local administration and rational use of dosage forms should be emphasized in the preventive use of antibiotics for patients undergoing ophthalmologic surgery.

Objective To investigate the value of ultrasound-guided Mammotome minimal invasive system in the treatment of breast fibroadenoma.MethodsFrom January 2007 to October 2008,266 benign breast lesions of 183 cases were treated by ultrasound-guided Mammotome minimal invasive system.The diameter of the masses ranged from 4 to 25 mm(≤ 10 mm in 73 cases,10-20 mm in 148,and ≥ 20 mm in 45).ResultsThe 266 lesions in the 183 patients were excised completely by using the Mammotome system.The excision was performed for a mean of 15 times in each case(ranged from 5 to 44 times) with an average operation time of 26 minutes(10 to 60 minutes).No complication was found after the surgery except slight subcutaneous ecchymosis in 2 cases.The length of the incisional scar,which was not apparent,ranged from 2.5 to 4 mm.The 183 cases were followed up by ultrasonography for 2 to 22 months(mean,12 months),during which their BI-RADS scales ranged from Ⅰ to Ⅱ,no local recurrence was found.ConclusionsUltrasound-guided Mammotome minimally invasive system is feasible for total resection of breast fibroadenoma with appropriate sizes.The technique leads to fewer complications and good cosmetic results.Further studies on the system are necessary for the treatment of multiple breast fibroadenomas.

Objective To investigate the change of lung morphology and the mechanism in the brain-dead state. Methods Ten Ba-Ma mini pigs were randomized into 2 groups: brain-dead group (group B, n=5) and control group (group C, n=5). Brain-dead model was established in group B by increasing intracranial pressure in a modified, slow and intermittent way, and brain-dead state maintained for 24 h by respiration and circulation support. The serum TNF-?, IL-1?, and IL-6 were determined at 3, 6 12, 18 and 24 h after the initial confirmation of brain death. Lung tissues were taken at 24 h. The alterations of lung tissues were observed by HE staining, and the expression of PKC-? detected by immunohistochemistry. PKC-? mRNA at each time point was detected by RT-PCR. The microstructure of hepatic tissues was observed under an electron microscope. Results (1) Under the light microscopy, broadened lung alveolar septum, edematous, extravasate in the alveolar congestive capillary vessel, infiltration of lymphocyte were observed. Under the election microscopy, cytoplasm edema, swollen mitochondria of the type-Ⅱ epithelial cells, partial membrane dissolution of mitochondria were observed and the microtomentum disappeared. No obvious morphological injury was observed under light microscopy and election microscopy. (2) Compared with control group, the serum IL-1?, IL-6 and TNF-? in brain-dead group began to increase at 3 h after brain death, and become more and more higher when the maintained state was prolonged. The expression of PKC-? and PKC-? mRNA in brain-dead group was increased at 24 h in the lung tissue. Conclusion Brain death may evoke lung morphological injury and increase the level of inflammatory mediators; After brain death the levels of PKC-? mRNA transcription and protein translation is increased. The activation of PKC-? and the alteration of inflammatory mediators are supposed to be one of the mechanisms of the lung injury.

This study is to investigate the effects of ubenimex on tumor cell invasion and apoptosis, dose relationship and mechanism. Immunofluorescence staining was performed to detect the expression of CD13 in HT-1080 cells. MTT assay was used to analyze the effect of ubenimex on cell proliferation. Annexin V-EGFP/PI was used to detect apoptotic cells by flow cytometry. Cell cycle was analyzed using flow cytometry. Ala-pNA was used as substrate to evaluate the effect of ubenimex on the aminopeptidase activity. Transwell assay was used to analyze the effect of ubenimex on cell invasion and migration ability. Western blotting was used to detect the expression level of CD13. MMP activity was analyzed using gelatin zymography. The results showed that ubenimex at high concentration inhibited the proliferation of HT-1080 cells (IC50: 3.8 mg x mL(-1)), and induced cell apoptosis. Cell cycle was blocked at G1 phase. Ubenimex at low concentration inhibited the aminopeptidase activity of HT-1080 cells (IC50: 8.3 microg x mL(-1)) and inhibited cell invasion, but it had no effects on the cell migration and proliferation. Ubenimex had no effects on CD13 expression and MMP activity. In conclusion, ubenimex at low concentration can inhibit the invasion ability of tumor cells by directly inhibiting the aminopeptidase activity; ubenimex at high concentration can inhibit the proliferation of tumor cells and induce cell apoptosis by a CD13-independent pathway.

Objective To investigate the influencing factors involved in the long-term effect after interventional treatment of diabetic lower extremity vascular disease.Methods The data of 358 diabetic patients with lower extremity vascular disease were collected retrospectively.The ankle-brachial index (ABI) values at the 6th, 12th and 24th month after interventional treatment were documented and the factors may influence ABI value werc analyzed.Results Single factor analysis showed that after 24 months treatment, the proportion of ABI＜0.5 (severe ischemia) in the patients combined with obesity, smoking, older age were 15.0％ (31/206), 18.4％ (25/136) , 12.1％(19/157) ,7.5％(15/200) ,while non obesity,younger age,no smoking,no hypertension were 6.6％ (10/152), 14.8％ (33/222), 6.5％ (13/201), 1.9％ (3/158), and the differences were significant (P ＜0.05).Logistic regression analysis showed that old age (OR =1.341,95％ CI: 1.281-1.496, P =0.045), smoking(OR=2.301,95％ CI: 1.903-4.844,P=0.028) and obesity(OR=1.299,95％ CI: 1.270-1.588,P =0.038) were the independent factors influence the long-term therapeutic effects on diabetic lower extremity vascular disease.Conclusion Obesity, smoking, old age are the main factors influence the long-term therapeutic effects on diabetic lower extremity vascular disease.

Objective To evaluate ultrasound combined with thri-operators and the blood-oxygen functional image (TOBOFI) technology in diagnosis of breast cancer in young women. Methods 221 breast tumor patients under 45 years old were selected to analyze their TOBOFI and ultrasonographic characteristics respectively. Based on pathological result, the two diagnostic methods were compared to determine the accurate rate. Results Of all the 221 patients, 82 (37.1%) were malignant and 139 benign. The sensitivity of TOBOFI and ultrasonography was 90.24% and 83.57% respectively, while the accurate rate of the two was 89.14% and 84 62% respectively. Accurate rate was improved to 93.90 % (77/82) if the two were combined. Conclusion TOBOFI has unique clinical value in diagnosing breast cancer in young women, especially in combination with ultrasound.

Objective To explore the association of suprapatellar pouch effusion with knee pain and serum levels of interleukin (IL)-6,IL-17,IL-23 in patients with knee osteoarthritis measured by magnetic resonance imaging (MRI).Methods 204 patients with knee osteoarthritis were enrolled into the study.Suprapatellar pouch effusion was measured by OSIRIS in both grade (0-3) and maximum area (cm2).Serum IL-6,IL-17,IL-23 were measured.Knee pain was assessed by Western Ontario and McMasters osteoarthritis index (WOMAC) questionnaire and Lequesne index.Characteristics of patients were recorded and body mass index (BMI) was calculated.Student t test or Chi-square test was used to compare means or proportions.Multivariable linear regression or logistic regression was used to determine risk factors (α=0.05).Results ① In the 204 patients [mean age (55±8) years,86.3％ were females],the prevalence of physiologic effusion (≤ 1) was 47.9％ while moderate or larger (≥2) effusion was 52.1％.② The age,labour intensity,serum levels of uric acid (sUA) and Lequesne index of higher grade effusion group were higher (P＜0.05) compared with lower grade effusion group.③ Suprapatellar pouch effusion maximum area was positively correlated with age (r=0.208,P=0.006),BMI (r=0.171,P=0.027) and labour intensity (r=0.189,P=0.013).④ Adjusted for age,gender and BMI,the results of Logistic regression analysis showed that:suprapatellar pouch effusion grades were positively correlated with Lequesne index [OR=1.120,95％CI(1.011,1.241),P=0.029] and negatively correlated with IL-23 [OR=0.768,95％CI (0.598,0.986),P=0.038].Suprapatellar pouch effusion was not independently associated with WOMAC index,IL-6 and IL-17.Conclusion The prevalence of suprapatellar pouch pathological effusion is 52.1％ in knee osteoarthritis.Suprapatellar pouch effusions is positively correlated with knee pain (Lequesne index) and negatively conrelated with IL-23.

OBJECTIVE:To provide reference for improving pharmaceutical consultations and the quality of pharmaceutical care. METHODS:The records of pharmaceutical consultations were collected from medication consultation center of Huilong-guan district in our hospital during Jan. 2014-Dec. 2016,and then summarized in terms of consultants composition,consultation form,consulting contents and drugs consulted,while Pareto Diagram was used to analyze the main and minor factors of consult-ing contents. RESULTS:The medication consultation center provided pharmaceutical consultations 20353 cases during 2014-2016. Main consultants were patients (20039 cases,98.5%). A total of 6307 persons were involved,mostly female (3646 persons,57.8%). Face to face was the most common consulting method (19440 cases,95.5%). There were 13 types of consulting contents,among which usage and dosage and guidance for special formulation use were the main factors,including 10392 cases (51.1%) and 3844 cases (18.9%). Among 20353 cases of pharmaceutical consultations,18874 cases of in-volved drugs,and involved 11 categories,mostly respiratory drugs (11756 cases,62.3%). CONCLUSIONS:Usage and dos-age and guidance for special formulation use are the main contents of pharmaceutical consultations in the hospital district. The services of pharmaceutical consultations for patients,physicians and nurses provided by pharmacists can solve the questions on medications,and can promote rational drug use in clinic.

Objective To investigate the effect of CYP3A5 * 3 and MDR1C3435T polymorphisms on the blood trough concentration of sirolimus in the Chinese renal transplantation recipients with stable renal function and the influencing factors for individual differences.Method 112 cases of Chinese renal transplantation recipients with stable renal function were recruited in this study.Related data of the recipients,including gender,age,height and body mass,were recoded.CYP3A5 and MDR1 genotypes were determined by the direct sequencing.Blood trough concentration of sirolimus was measured by using chemiluminescence microparticle immuno assay (CMIA).The influencing factors of individual differences in sirolimus blood trough concentration was analyzed,and the correlation of CYP3A5 * 3 and MDR1C3435T gene polymorphisms with sirolimus blood trough concentration was evaluated.Result Of the 112 cases,there were 10 cases (8.93％) of CYP3A5 * 1/* 1,49 cases (43.75％) of CYP3A5 * 1/* 3,and 53 cases (47.32％) of CYP3A5 * 3/* 3.Allele frequencies of CYP3A5 * 1 and * 3 were 30.81％ and 69.19％,respectively.There were 31 recipients (27.68％) with MDR1 3435CC,60 (53.57％) with MDR1 3435CT,and 21 (18.75％) with MDR1 3435TT.Allele frequencies for C and T at position 3435 of MDR1 were 54.46％ and 45.54％,respectively.In this study,recipients' CYP3A5 * 3 genotype was the main factor (P =0.000) of sirolimus blood trough concentration,but dose,gender,age,height,postoperative time,the level of serum creatinine,hemoglobin levels,combined use of CsA and MDR1C3435T genotype had no effects on sirolimus blood trough concentration (P ＞ 0.05).sirolimus blood trough concentration/(dose weight) in * 1/* 1,* 1/* 3 and * 3/* 3 recipients was (0.0721 ± 0.0202),(0.1055 ± 0.0395),and (0.1395 ± 0.0537) μg·L-1 ·mg-1 ·kg-1,respectively,The sirolimus blood trough concentration/ (dose weight) in * 1/* 3 recipients was 1.46 times higher than that in * 1/* 1 recipients,and that in * 3/* 3 recipients were 1.93 times higher than that in * 1/* 1 recipients.There was significant difference in sirolimus blood trough concentration/(dose weight) between recipients with different CYP3A5 * 3 genotypes (P =0.000).Conclusion The CYP3A5 * 3 gene polymorphism is closely related to the blood trough concentration/dose of sirolimus,and is the main factor of the blood trough concentration of sirolimus between individuals.

Objective To explore the incidence and risk factors of bacterial infection after othtotopic liver transplantation (OLT). Methods Altogether 56 OLT recipients from January 2005 to October 2007 were included in the study. The incidents and the related variables of the infection were analyzed retrospectively. The related variables were evaluated using multivariate logistic regression model to identify the significant risk factors. Results Bacterial infection was confirmed in 29 recipients (51.8%). Among them, the lung infection was the most common site (53.7%). The Gram-positive cocci were 46.3%, while the Gram-negative bacilli were 53.7%. The risk factors for bacterial infection included duration of the operation and detained respirator using. Conclusion Bacterial infection is a major complication following OLT. Surveillance for the risk factors, enhancement the skill of operation, and improving the recovery of respiratory function is the key to decreasing the incidence of bacterial infection after transplantation.