Objective To study the effects and mechanism of amiodarone on P wave dispersion in preventing paroxgsmal atrial fibrillation.Methods 80 cases with coronary heart disease and paroxysmal atrial fibrillation were randomly dividedl into two groups,study groups were given amiodarone and general treatments of coronary heart disease,control group only with general treatments,to measure the maximal P wave duration(P_(max)),the minimal P wave duration(P_(min)) and P wave dispersion(P_(dis)),before administration and when administration one month,two months and three months,respectivery.Results P_(min) increased,P_(dis) got small after 3 months of adiministration of amiodarone.Compared with control group,the P_(min) of electrocardiographry of study group was obvionsly different(P

OBJECTIVE:To analyze the relative factors of ADR in our hospital.METHODS:A total of 185 ADR case reports collected in 2006 were analyzed statistically.RESULTS:Of the total 185 cases,33(17.8%) were reported by physicians,12(6.5%) were new and severe ADR,62.7% were reports from pharmacy department,infusion room and department of derma-tology.For a few departments,the ADR case reports were zero.121(65.4%) were caused by anti-infective drugs;138(74.60%) were caused by intravenous drip and 108(58.4%) manifested as lesions of skin and its appendages.CONCLUSION:The incidence of ADR is related to multi-factors;however,rational use of drugs is the key conducive to the reduction of ADR incidence.

Object To study the organosulfur compounds of Allium sativum L. Methods Compounds were separated by silica gel column and TLC, HPLC. Their structures were elucidated by spectroscopic analysis. Results One disulfied, 3-allyldisulfanyl-propenal (Ⅰ) and one dithiin, 3-vinyl-3, 4-dihydro- dithiin-1-oxide (Ⅱ) and one thiosulfinate, (E/Z) 1-propenyl allyl thiosulfinate (Ⅲ) were identified. Conclusion Compounds Ⅰ and Ⅱ are new.

OBJECTIVE To study the effect and development of centralizing management of the overall recycled medical instruments toward the hospital nursing management by the Center for Sterilization,Supply and Distribution.METHODS The centralizing method and decentralizing method toward the recycled handling of the medical instruments were adopted and compared their effect toward nursing management quality,vocational safety,hospital infection management,and of the two methods cost and benefit management,respectively.RESULTS The centralizing management group had distinct advantage than the decentralizing one on the qualified rate of cleaning,packaging,the qualified rate of the sampled incubation of the aseptic products and work efficiency.CONCLUSIONS Through the centralizing management of the Center for Sterilization,Supply and Distribution toward the overall recycled hospital instruments,it can improve the hospital′s nursing staff resource utilization and nursing quality,help to perfect the nursing staff′s vocational safety;decline the hospital infection risk;increase the output of the hospital nursing work and reduce its operational cost;and can make for improving and protecting the environment.

OBJECTIVE:To study the characteristics of ADR in our hospital and to promote rational clinical drug use.ME_ THODS:60ADR cases reported in our hospital in2005were analyzed in terms of reporters,drug categories,routes of admin-istration,clinical manifestation,etc.RESULTS:Of the total,85.0%were reported by doctors and primary nurses;83.0%were associated with anti-infection drugs;68.0%were administered by intravenous drip.The most common displays of ADR were the lesion of skin and the appendants,followed by the lesion of digestive system,and of which5were fairly serious.CONCLU_ SIONS:The control about rational use of anti-infection drugs and ADR monitoring should be strengthened.

objectives To explore the clinical significance of the triple screening method and fetal sonographic markers in Down syndrome screening. Methods The retrospective study included maternal blood serum triple-marker screening per-formed in normal singleton pregnancies at 14+1 to 19+6 weeks and ultrasonography screening for fetal chromosomal trisomy at 18+1 to 23+6 weeks from 2010 to 2013. Results In 24 368 pregancies, Karyotype analysis reveal 35 Down syndromes, the incidence is 0.14%(35/24 368). 25/35 were pregnancies with an expected date of delivery lower than 35 years old and 10/35 were pregnan-cies with an expected date of delivery higher than 35 years old. In 1 215 pregnancies, second-trimester serum screening showed high risk (cutoff>1:380), 14 were confirmed as Down syndromes ( sensitivity 40%;specificity 95.06%). In 1 142 pregnant women showed ultrasonography abnormalities, of which 11 were found to have Down syndrome (sensitivity 60%;specificity 91.09%). In 112 pregnancies, second-trimester serum screening and ultrasonography showed high risk, 4 were conformed as Down syn-drome (sensitivity 11.43%;specificity 99.56). Conclusions The most effective method of screening for Down syndrome is by maternal serum biochemistry. Ultrasonography is important in screening fetal trisomy 21. combined screening methods can improve the detection rate of trisomy 21.

ObjectiveTo summarize the clinical features and risk factors of neonatal clavicle fracture so as to decrease the incidence of this disease.MethodsA total of 85 cases of neonatal clavicle fracture admitted to the Gynecology and Obstetrics Hospital of Fudan University between January 1, 2013 and December 31, 2015 were enrolled in this study. The full-term neonates with natural delivery by the same midwives or doctors on the same day were selected as control group with 1∶1 matched. Clinical features and risk factors of neonatal clavicle fracture based on three factors: mother factors, labor factors and neonatal factors, were analyzed retrospectively. Two independent samplest-test, rank sum test andChi-square test were used for statistical analysis.ResultsThe incidence rate of neonatal clavicle fractures was 0.14% (85/59 991). There were 45 (53%) males and 40 (47%) females; 80 (94%) cases of vaginal delivery, and 5 (6%) cases of cesarean section. According to the relationship between the location of the fracture and the position of the fetus, the fracture occurred in the anterior shoulder in 65 cases (76%) and in the posterior shoulder in 20 cases (24%);and 18 cases (21%) were in the left and 67 cases (79%) in the right. Fifty-five cases (65%) were diagnosed by physical examination, and 30 cases (35%) by X-ray. Two patients (2%) were complicated with brachial plexus injury. Twenty cases (24%) were diagnosed on the day of birth, 32 cases (38%) on the second day after birth, 16 (19%) on the third day, and four (5%) on the 4-6 days. Thirteen (15%) cases were diagnosed in the outpatient department 42 days after birth. All the fractures were cured without special treatment. Compared with the control group, the birth weight of fracture group was significantly higher [(3 646±361) vs (3 447±409) g,t=2.339], and the ratio of the cases complicated with shoulder dystocia was also higher [15% (13/85) vs 2% (2/85),χ2=9.524] (bothP<0.05). The differences in the factors of maternal age, parity, times of pregnancy, gestational age, forceps delivery, time of the second stage of labor and fetal distress between the two groups were not statistically significant.ConclusionsNeonatal clavicle fracture is related to birth weight and shoulder dystocia. Not all fractures can be diagnosed through physical examination on the day of birth, therefore, daily routine physical examinations after birth are necessary. The prognosis of neonatal clavicle fracture is good.

Objective To understand the distribution and change in drug resistance of common pathogens before and after the implementation of special rectification activity on antimicrobial use in 2011-2015,and provide guidance for clinical application of antimicrobial agents.Methods Antimicrobial use in hospitalized patients and pathogens isolated from patients in a hospital from 2011 to 2015 were collected,changing trend of resistance rates of major pathogens to commonly used antimicrobial agents was analyzed.Results From 2011 to 2015,antimicrobial utilization rate in hospitalized patients dropped from 75.84%to 37.35%,antimicrobial use density decreased from 59.53 per 100 patient days to 33.63 per 100 patient days,both showed a downward trend(both P<0.05).A total of 10 091 strains of pathogens were isolated,2 338(23.17%)of which were gram-positive bacteria,7 110(70.46%)were gram-negative bacteria,and 643(6.37%)were fungi.The top five pathogens were Escherichia coli(20.85%),Klebsiella pneumoniae(15.90%),Pseudomonas aeruginosa(11.70%),Staphylococcus aureus(7.35%),and Acinetobacter baumannii(6.82%).Resistance rates of major pathogens to commonly used antimicrobial agents decreased year by year(P<0.05),resistance rates of Escherichia coli and Klebsiella pneumoniae to piperacillin/tazobactam,cefoxitin,and amikacin declined most obviously(all<4%in 2015);compared with Acinetobacter baumannii,Pseudomonas aeruginosa had higher sensitivity to commonly used antimicrobial agents,resistance rates to piperacillin/tazobactam,cefoperazone/sulbactam,ceftazidime,cefepime,amikacin,and ciprofloxacin decreased obviously,resistance rate to above antimicrobial agents was <20%,to carbapenems was higher than other commonly used antimicrobial agents.Resistance rates of Acinetobacter baumannii to amikacin,levofloxacin decreased most obviously,to meropenem and imipenem increased obviously,in 2015 were both above 50%.Resistance rate of Staphylococcus aureus to fluoroquinolones declined most obviously(<2%),vancomycin-resistant strains were not found.Conclusion After the implementation of special rectification activity,resistance rates of common pathogens decreased with the decline of antimicrobial use,rational use of antimicrobial agents may be related to delaying bacterial resistance.

The neurovascular unit (NVU) consists of neurons,gllal cells and microvessels,etc.There were complex interactions among the various cellular components,which form as a uniform entirety preferably.Anong the various cellular components of NVU,the signal transduction occurred disorders during cerebral ischemia,resulting in neuronal and extracellular ratrix destruction,and thus occurring cerebral infarction and hemorrhagic transformation.Therefore,the treatment of ischemic sttroke should be based on the protection of the overall function of NVU.This article describes the changes and protection of NVU after cerebral ischemia.

Objective To explore effects of sequel recanalization PCI therapy(primary coronary intervention,PCI) on cardiac function for the patients with acute ST segment elevation myocardial infarction(STEMI),and related factors.Methods 116 patients with STEMI enrolled were divided randomly into two groups:sequel recanalization PCI group(58 cases) and conventional PCI group(58 cases),and the patients of sequel recanalization PCI group were fully absorbed for thrombus before conventional PCI,then compared estoration of their cardiac function of the patients of two groups at once and 2 weeks after PCI procedure,respectively.Meantime to study the effect related-factors for cardiac function by Logistic regression analysis.Results There were significant differences between two groups in RESVmax(P =0.03) 、RESVmin(P = 0.00) 、REFmax(P = 0.00)、 REDVmax(P = 0.01) and the ratio of E/A(P =0.02)(all P＜0.05);it showed that the restoration of cardiac function of sequel recanalization PCI group was faster than that of conventional PCI group.If sequel recanalization PCI served as a variable for predicting REFmax being 50%,the results of logistic regression showed that OR(odds ratio) value was 3.47,95% CI(confidence interval) 1.39-9.75,P =0.04.Among other variables,as was time-to-recanalization(OR =4.59,P =0.01);infarct size(OR =4.59,P=0.01);Kiliip grades(OR = 3.99,P =0.02)and age(OR=2.75,P=0.04).Conclusion The sequel recanalization PCI could be better than conventional PCI for the patients with STEMI in restoration of heart function,but there should be some other effective factors.