Objective To analyze the application of antibiotics in the national essential drug list used by women in obstetric medical institutions at all levels of Western Hunan ( Basic Medical and Health Institutions Part,2009 version).Methods Medical records were reviewed respectively from May,2010 to December,2010.Results The rate of the use of antibiotics in the essential medicines list in township hospitals was more than 50％,which was higher than that of the secondary and tertiary hospitals.Conclusion The management of the use of medicine in the essential medicines list in hospitals at all levels should be strengthened to control the delivery cost.

Objective To evaluate the short-term therapeutic effects for patients with primary liver cancer using three-dimensional stereotactic conformal radiotherapy(3D-CRT).Methods Twenty-eight patients with primary hepatic cancer were treated with 3D-CRT(the average overall dose was 38Gy,localized by Elscint twin flash slice CT,radiotherapy plan was designed by Leibinger three-dimensional radiotherapy planning system and operated on Varian 600C/D liner accelerator).The average follow-up time was 12 months(5-17mon.).Tumor volume response rate,rate of free from tumor progression and survival rate were analyzed.The adverse effects were studied simultaneously.Results According to follow-up CT results 3 months after radiotherapy,2 cases had full responses with disappearance of the tumors,while partial responses with decreased tumors mass were seen in 22 cases,and no response in 4 cases.Tumor volume response rate was 85.7%.The last follow-up CT results showed that in 5 patients there was tumor progression in planning target volume(PTV),in 10 cases there was intrahepatic progression but not in PTV,and in 4 cases extrahepatic tumor growth.Intrahepatic tumor free rates 6 months and 12 months after radiotherapy were 66.5% and 38.4%,respectively.6-month survival rate after radiotherapy was 88.6%,12-month survival rate was 70.5% after radiotherapy.During 3 months of radiotherapy,manifestations of subacute radiation injuries occurred in six patients:gastrointestinal hemorrhage in 2 cases,jaundice in 3 cases and subacute radiation hepatitis in 1 patient.No survivors suffered from long-term liver injury.Conclusions With little adverse effect,3D-CRT could raise the control rate of the hepatic tumor,and also short-term survival rate.There fore,3D-CRT is a valuable treatment for patients with primary liver cancer.

Objective To evaluate the therapeutic effects and adverse effects of three-dimensional conformal radiotherapy(3D-CRT) for elderly patients with non-small cell lung cancer(NSCLC).Methods From August 2001 to October 2006,36 patients over 70 years old with NSCLC were treated with 3D-CRT.Leibinger treatment planning system was used for drafting radiotherapy plan,the prescription dose was 40-80Gy(median,60Gy).Twenty-four patients received hypofractionated radiation every two days in 8-12 fractions at a dose of 5-8Gy per fraction;12 patients accepted conventional fractionated radiation with 30-40 fractions during 6 to 7 weeks.With median follow-up time of 11 months(range,5-54 mon.),tumor volume response rate,1-year and 2-year survival rate were investigated,adverse effects of the treatment were also recorded in present research.Results Of the 36 patients,clinical symptoms were improved in 33 cases,while no changes were observed in 3 cases.According to follow-up CT results 2-3 months after radiotherapy,8 patients showed complete response(CR),22 cases with partial response(PR),with the overall tumor response rate of 83.33%(30/36).In this group,1-year and 2-year survival rate was 66.67% and 36.11% with median survival time of 8 months(range,2-53 months).No patients suffered from serious adverse effects.Conclusions 3D-CRT was an effective and safe treatment for elderly patients with NSCLC,which could raise the survival rate and improve the quality of life with little adverse effects.

Objective To investigate the changes of antibiotic resistance and its correlations with antibiotics use density (AUD) in intensive care unit (ICU) after implementation of antimicrobial stewardship. Methods Data on AUDs and synchronous antibiotic resistance in ICU of the Affiliated Hospital of Taishan Medical University during 2010 and 2014 were retrospectively reviewed.Autoregressive integrated moving average ( ARIMA) model was used to identify the correlation between AUDs and antibiotic resistance.Results The total AUD which stood at 163.46 DDDs· 100 person-1 · d-1 in the year 2010 decreased to 68.20 DDDs · 100 person-1 · d-1 in 2014, and the most significant decreases were found in quinolones, imidazole, carbapenems, aminoglycosides, other beta lactam and macrolides. Synchronously, a wide range of improvements in antibiotic resistance of major pathogens were also observed from 2010 to 2014, and the improvements were positively correlated with the decrease of AUDs.However, antibiotic resistance in 2014 was not significantly improved compared with that in 2013. The rate of ciprofloxacin resistance in Pseudomonas aeruginosa and the resistant rates of amikacin, imipenem, and meropenem in Acinetobacter baumannii even increased in 2014.Conclusions With the implementation of antimicrobial stewardship, antibiotic consumption in ICU was decreasing, and antibiotic resistance rate in major pathogenic bacteria was decreasing.But the rebound in antibiotic resistance in some types of bacteria was also observed and should be put on enough caution.

Emphasizing practice is a main characteristic in Pharmacy.Insisting on taking employment as guide to do profitable research and practice on new mode of production and practice in pharmacology of senior vocational college from regulating education schedule,establishing and consummating exercitation examination and evaluation mechanism,promoting collaboration between college and corporation,and establishing exercitation-driving education mechanism,can help students improve their practice knowledge in exercitation,transform their knowledge to ability,and cultivate professional pharmacy talent of application and creation.

Objective To observe the clinical characteristics of polypoidal choroidal vasculopathy (PCV).Methods Two hundreds fifty-four PCV patients (306 eyes) were enrolled in this study.All the patients were examined for corrected visual acuity (BCVA) testing,slit-lamp microscope,indirect ophthalmoscopy,fundus photography,fluorescein angiography,indocyanine green angiography and optic coherence tomography.Results The patients included 152 males (59.8％) and 102 females (40.2％) ; the age was from 38 to 91 years,with a mean age of (65.4±8.9) years.Bilateral lesions were observed in 52 patients (20.5％) and unilateral lesions were observed in 202 patients (79.5％).BCVA varied from nonlight perception to 1.2.BCVA was lower than ＜0.1 in 167 eyes (54.6％),≥0.1 but ＜0.3 in 92 eyes(30.1％) and ≥0.3 in 47 eyes (15.4％).Vitreous hemorrhage was observed in 61 eyes (19.9％).In 202 patients with unilateral PCV lesions,drusen can be observed in the contralateral eyes of 68 patients (33.7％),exudative age-related macular degeneration changes in the contralateral eyes of 24 patients (11.9 ％),and central serous chorioretinopathy history was positive in the contralateral eyes in nine patients (4.5％).In 306 eyes,there were 43 eyes (14.1％) with high permeable choroid.PCV lesions located at macula area in 199 eyes (65.0％),under the temporal retinal vascular arcade in 49 eyes (16.0％),and peripapillary in 15 eyes (4.9％).PCV lesion formation was single in 110 eyes (35.9％),cluster in 176 eyes (57.5％),string in three eyes (1.0％),branch in four eyes (1.3％),and both single and cluster polyps in 13 eyes (4.2％).There were 125 eyes (40.8％) with sub-neuroretinal fluid,121 eyes (39.5％) with hemorrhagic pigment epithelium detachment,and 73 eyes (22.9％) with serous pigment epithelium detachment.Conclusion PCV patients have higher bilateral incidence and female prevalence,and lower rate of peripapillary lesions.

Objective To investigate the risk factors,clinical characteristics and outcomes in patients with acute myocardial infarction and history of stroke. Methods A total of 771 patients with acute myocardial infarction diagnosed and admitted to Xuanwu Hospital,Capital Medical University from January 2005 to March 2012 were analyzed retrospectively. They were divided into either a stroke group (n=387)or a control group (n=384)according to whether they had previous ischemic stroke or not. The risk factors for cardiovascular disease,clinical characteristics of the disease,and clinical outcomes of the patients in both groups were compared through the case control analysis. The endpoint events observed were acute ischemic stroke,cerebral hemorrhage,and cause of death during hospitalization. Results (1)The median age of the patients in both stroke and control groups was 71 (37-91 )and 62 (29-90 )years respectively. The female patients in the stroke group were more than those in the control group (n=125 vs. n=91). The incidence of complicated with hypertension (72. 9%[n=282]and 47. 6%[n=183]) and type 2 diabetes mellitus (39. 0%[n=151]and 20. 8%[n=80]respectively)were high. There was significant difference between the two groups (P<0. 01). (2)The time from the onset to admission in patients of the stroke group was longer than that in patients of the control group (median 11 h vs. 4 h). The incidence of non-ST segment elevation myocardial infarction (16. 0%[n = 62 ]and 1. 8%[n = 7 ] respectively)was higher. The incidences of complicated with gastric stress ulcer (7. 0%[n =27 ]and 2. 1%[n=8]respectively),atrial fibrillation (10. 6%[n=41]and 3. 9%[n=15]respectively),and acute pulmonary edema-cardiac function Killip class≥Ⅱ(51. 9%[n =201 ]and 37. 8%[n =145 ] respectively)were more higher. The findings of coronary angiography in patients of the stroke group were that the incidence of left main coronary artery or 3 -branch lesion higher than that of the control group (52. 9%[126/238]and 32. 4%[97/299]respectively). There was significant difference (P <0. 05). (3)The incidence of new stroke in patients of the stroke group (5. 7%[n =22 ]and 1. 8%[n =7 ] respectively)and in hospital mortality (13. 7%[n=53]and 7. 6%[n=29]respectively)were higher than those of the control group. There were significant differences (P<0. 01). Conclusion The age of the patients with acute myocardial infarction with previous identified history of stroke is older. The incidence of female patients is higher than that of the non-stroke patients,and most of them have risk factors that complicated with hypertension and diabetes mellitus. These patients often have the complications with peptic ulcer disease and heart failure,and their coronary angiography often show multi-branch lesions,and they are more prone to ischemic cardio-cerebrovascular events during the hospitalization.

Objective To seek a scalp venipuneture method with high success rate and less pain for patients. Methods Taking the rapid parallel straight method as the control group, and the rapid vertical straight method as the experimental group, 400 patients were randomly divided into the control group and the experimental group with 200 patients in each group. The success rate of two groups were counted, pain scores were got by VAS visual imitation assessment and the results undergoing statistical analysis. Results The success rate was 91.5% in the control group, and 99.5% in the experimental group. Distinguished sig-nificance existed in VAS visual imitation score. Conclusions The rapid vertical straight method is supe-rior to rapid parallel straight method in scalp venipuncture.

BACKGROUND: Practice has proved that organic material and inorganic materials used alone are not ideal scaffold materials. Polylactic acid (PLA) possessing excellent biocompatibility, degradability and absorbability, PLAs composites will be one of the most important biocomposite in the 21~(st) century. OBJECTIVE: To observe the effects of PLA-chitosan fiber (CF)/hydrexyapatite-calcium silicate (HA-CS) on adhesion, proliferation and differentiation of osteoblasts. METHODS: The rat osteoblasts were obtained from the cranium of newborn Wistar rats within 24 hours, and primarily cultured using modified collagenase digestion. The cells were generated and their biological characteristic was examined by inverted phase-contrast microscope, hematoxylin-eosin staining, alkaline phosphatase (ALP) staining and mineralized nodules staining. Then the cells at passage 3 were co-cultured with PLA-CF, PLA-CF/CS and PLA-CF/HA-CS in vitro. At 3, 6 and 9 days of the culture, cell morphology was observed by inverted phase contrast microscopy. In addition, MTT assay and ALP activity test were used to observe the effects of three kinds of materials on cell differentiation and proliferation. RESULTS AND CONCLUSION: Osteoblasts attached on all three scaffold materials can adhere, grow, differentiate and proliferate. The effect of three materials on cell activity was PLA-CF/HA-CS>PLA-CF/CS>PLA-CF. The composite scaffold PLA-CF/HA-CS has a good compatibility, indicating that the material has a great potential for application in bone tissue engineering.

Objective To study the expression of P16、Ki-67 gene protein in esophageal squamous cell carcinoma,and its relation with lymph node metastasis、 prognostis.Methods The SP immunohistochemical method was used to detect the expression of P16 、Ki-67 gene protein in 56 cases with esophageal squamous cell carcinoma,and its normal paraneoplastic rectal mucous tissues.Results The positive expression rate of P16 in normal paraneoplastic rectal mucous tissues was 89.29%(50/56),and 42.86%(24/56) in esophageal squamous cell carcinoma,there was significant difference between the two groups(all P＜0.05);the positive expression rate of Ki-67 in normal paraneoplastic rectal mucous tissues was 8.93%(5/56),and 33.93%(19/56) in esophageal squamous cell carcinoma,there was also significant difference between the two groups(all P＜0.05).In well differentiated groups of esophageal carcinoma the positive expression rate of P16 was significantly higher than that in moderately differentiated group、poorly differentiated group(P＜0.05);in bad progressed group of esophageal carcinoma the positive expression rate of Ki-67 was higher than that in good progressed group(P＞0.05);The positive expression rate of P16、Ki-67 in lymph node metastasis was significantly higher than that in without lymph node metastasis(P＞0.05).In the exist period after operation over three years groups,the positive expression rate of P16 57.69%(15/26) was significantly higher than that in the groups of the exist period after operation non-over three years 30.00%(9/30)(χ2 =4.36,P＜0.05),in the exist period after operation non-over three years groups the positive expression rate of Ki-67 46.67%(14/30) was higher than that in the exist period after operation over three years group 19.23%(5/26)(χ2 =4.68,P＜0.05).Conclusion P16、Ki-67 were objective markers to estimate the behaviors of esophageal squamous cell carcinoma and to evaluate the development and predict the mettastasis of tumors of patiens.