OBJECTIVE:To investigate the application of clindamycin phosphate for inpatients in a third grade class A hospital, and provide reference for the specication of its application. METHODS:Retrospective investigation was adopted to randomly obtain the medical information of inpatients who used Clindamycin phosphate for injection in a third grade class A hospital in May 2014, and its rationality was evaluated and analyzed by referred the instructions,relevant provisions and principles. RESULTS:Totally 205 patients used Clindamycin phosphate for injection,among which 174 were for the purpose of prevention medicine,31 cases for treatment purposes. There were reasonable use of 130 cases(63.4%);unreasonable prophylaxis of 71 cases(34.6%),unreason-able treatment of 4 cases(2.0%),it was mainly no indication of medicine,usage and dosage,treatment course and use of antibac-terial drugs. CONCLUSIONS:There still remains unreasonable phenomenon in the clinical application of the Clindamycin phos-phate for injection,the safe and effective clinical application can only be ensured if the drug regulatory system is improved and anti-bacterial drugs in clinical medicine guidelines is strictly enforced.

Objective To investigate the effect of dexmedetomidine on postoperative renal function of patients with rheumatic heart disease following valvular heart surgery. Methods Fifty patients following valvular heart surgery were randomized into experimental group and control group,with 25 cases in each group. The patients in experimental group receiveddexmedetomidine 0.5 μg/kg infusion 15min before induction, and then 0.5 μg/(kg·h) infused to the end of surgery, while those in control group received the same amount of saline in the same way. Blood from central venous was collected before surgery, at the end of surgery, 24 h and 48 h after surgery in order to detect Src, BUN and Cys C and the length of ICU duration was also recorded. Results Src and Cys C of the patients in both groups obviously elevated 24h after surgery when compared with pre-operation , while BUN elevated at both 24 h and 48 h after surgery(P < 0.05). Compared with those in control group, Src, BUN and Cys C were lower in experimental group ( P < 0 . 05 ) , and the length of ICU duration was shorter (P < 0.05). Conclusion Dexmedetomidine could improve the postoperative renal function after valvular heart surgery and lead to a better prognosis.

Objective evaluate the role of vagus nerve?muscarinic cholinergic receptor ( M recep?tor) pathway in mitigation of myocardial ischemia?reperfusion (I∕R) injury by intrathecal morphine postcon?ditioning in rats. Methods Seventy adult male Sprague?Dawley rats in which intrathecal catheters were suc?cessfully placed without complications, weighing 250-350 g, were randomly assigned into 7 groups ( n=10 each) using a random number table:sham operation group (Sham group), I∕R group, intrathecal morphine postconditioning group ( MP group) , vagal transection ( VT) group, VT+ intrathecal morphine postcondi?tioning group (VT+MP group), atropine (ATP, M receptor antagonist) + morphine postconditioning group ( ATP+MP group) , and ATP group. Myocardial I∕R was produced by occlusion of the anterior descending branch of left coronary artery for 30 min followed by 2 h of reperfusion. Morphine ( 3μg∕kg, 10μl) was in?trathecally infused over 5 min starting from onset of reperfusion in MP group. Normal saline 10 μl was in?trathecally infused over 5 min starting from onset of reperfusion in NS group. The bilateral vagus nerves were transected at 10 min before reperfusion in VT+MP group. Atropine ( 0?1 mg∕kg, 0?5 ml) was intravenously infused over 5 min starting from 10 min before reperfusion in ATP+MP group. The occurrence of cardiac ar? rhythmia ( premature ventricular contractions ( PVCs) and ventricular tachycardia ( VT)∕ventricular fibrilla?tion ( VF) ) within the first 30 min of reperfusion was recorded. The rats were sacrificed at 120 min of reper?fusion, and myocardial specimens were obtained for determination of myocardial infarct size ( IS) as a per?centage of area at risk (AAR). IS∕AAR ratio was calculated. Results Compared with Sham group, the number of PVCs and VT∕VF and IS∕AAR ratio were significantly increased in the other groups. Compared with I∕R group, the number of PVCs and VT∕VF and IS∕AAR ratio were significantly decreased in MP group. Compared with MP group, the number of PVCs and VT∕VF and IS∕AAR ratio were significantly in?creased in VT+MP and ATP+MP groups. Conclusion Vagus nerve?M receptor pathway is involved in miti?gation of myocardial I∕R injury by intrathecal morphine postconditioning in rats.

Objective To explore the relationship between serum HBeAg、the qualification of HBV DNA and the liver pathologic change in chronic hepatitis B virus (HBV)carriers with normal liver function.Methods Two hundred and forty-four chronic hepatitis B virus carriers with normal liver function were performed pathology examination by Liver biopsy.Meanwhile liver function,HBV DNA level and serological serum markers of B-hepatitis examination were detected.Results Pathology results showed that,of all 244 cases,7 cases was cirrhosis(2.9％),143 for slight CHB (58.6％),32 for moderate CHB (13.1％) and 9 for severe CHB (3.6 ％).And 53 (21.7％)chronic hepatitis B virus carriers were the normal histology morphology.Fony-eight cases (19.7％) were in inflammation stage G≥2 and 54(22.1％) were with fibrosis stage S≥2.For cases with HBV DNA positive,The inflammation and ftbrosis stages in HBeAg negative group were more severe than that in HBeAg positive group (P ＜ 0.05).The fibrosis stages in patients with low HBV DNA level were severe than that in high HBV DNA levels (P ＜ 0.05).No significant differences were observed in the inflammation stage between subjects with high or low HBV DNA level.Conclusion Most chronic HBV carriers with normal liver function were with different degrees of liver inflammation and fibrosis.HBeAg and HBV DNA associated with liver pathological change.

Objective:To evaluate the expression of apoptosis related gene Fas Ligand(FasL) in human hepatocellular carcinoma(HCC) cells HepG2 and its significance in apoptosis.Methods:The recombinant eukaryotic expression plasmid pcDNA3.1hisB- FasL was transfected into HCC cells HepG2 by lipofection, and then soluble FasL was examined in the supernatant of culture cells by EIA, FasL expression in HepG2 cells were detected by immune histochemistry. After stained by annexin V and propidium iodine, cells were passed throw flow cytometer and examined by fluorescence microscope and sym-focus laser scaning microscope.Results:In comparison with untransfected cells,the soluble FasL could be detected in the supernatant of transfected cells, Fas L can be expressed in the membrane and cytoplasm of transfected cells. The apoptotic cell rate in transfected cells was 36.30%, as the control, untransfected cells was 11.53%.Moreover, the different stage of apoptotic cells could be distinguished by annexin V and propidium iodine stain.Conclusion:This supports a novel pathway of HCC cells were apoptotic itself via the CD95-CD95 ligand system without involvement of immune cells.

Objective To construct Four in One informational teaching model based on cloud platforms, simulation training, nursing micro-lectures and multidimensional evaluation investigate, and to explore the effect of theFour in Oneinformational teaching model applied in Medical Nursing teaching. Methods Two classes students of 2014 were selected by randomized sampling and were divided into experiment group and control group, the experiment group operated the Four in One informational teaching mod, the control group operated regular teaching. After the experiment,using the medical nursing theory test, the skill test, the questionnaire survey to evaluate the teaching effectiveness. Results The theoretical examination score, skill examination score and overall results of experiment group were (78.81±6.44), (82.01±5.22), (80.41±6.32) points, while (71.12±8.12), (76.74±6.3), (75.57±5.51) points of control group, and the difference was statistically significant (t=5.47, 4.86, 3.22, P<0.01 or 0.05). The students' interested in the informational teaching model of the experimental group reached 78.72%(37/47) and learning satisfaction reached 91.48% (43/47). Conclusions The Four in One informational teaching model applied in Medical Nursing teaching can improve the study effect .

Objective To explore the significance of serum cytokine interferon-gamma (IFN-γ) ,interleukin-4(IL ) ,transforming growth factor-beta 1 (TGF-β1) ,interleukin-9 (IL-9) ,interleukin-17 (IL-17) in detection of youth first-episode depression .Methods Ninety cases of youth first-episode depression as the experimental group were equally divided into 3 groups according to different disease courses(<6 months ,6 months to 2 years ,>2 years)and other 30 normal persons served as the control group .The levels of serum cytokines were measured by ELISA .The level of each cytokine and Hamilton Depression Scale (HAMD) score were per-formed the Spearman correlation analysis .Results The IL-9 level in the 6 months to 2 years group and > 2 years group was high-er than that in the control group (P< 0 .05);the IFN-γlevel was negatively correlated with psychic anxiety (P<0 .05);the IL-9 level was positively correlated with the somatic anxiety and systemic symptoms (P<0 .05);the IL-17 level was positively correla-ted with the depressive mood and suicide (P<0 .05);the IFN-γlevel was positively correlated with difficulty falling asleep ,early a-wakening ,work and interest in the 6 months to 2 years group ,while positively correlated with somatic anxiety (P<0 .05);the IFN-γ level was positively correlated with depressive mood and block in the >2 years group(P<0 .05);the IL-4 level was positively correlated with the depressive mood (P<0 .05) .Conclusion Different cytokines play different roles in youth first-episode depres-sion ,cytokines may involve in the occurrence and development of depression .

50.0%.CONCLUSION:The extensive use of antibacterials results in increased drug resistance,while rational use of antibiotics is the key of decreasing drug resistance and multidrug resistance.It is of great importance to analyze the variation of bacterial drug resistance in area hospital.

Aim To investigate the role of NO/cGMP in the cardioprotective effects of intrathecal morphine preconditioning against myocardial ischemia-reperfu-sion injury in rats. Method 54 Male Sprague-Dawley Rats were used to establish the model of intrathecal catheter placement. The rats were randomly assigned to
9 groups. SHAM (sham group), CON (control, sa-line) , ITMP ( intrathecal morphine preconditioning, 3μg·kg-1 ) , L-NAME+ITMP ( NO synthetase inhibi-tor,L-NAME ) , ODQ + ITMP ( guanylate cyclase in-hibitor, ODQ ) , KT5823 + ITMP ( PKG inhibitor, KT5823),L-NAME,ODQ,KT5823,6ratsineach
group. ITMP were produced by three cycles of 5 min intrathecal injection of morphine and 5 min intermis-sion before myocardial ischemia, CON were achieved by intrathecal injection of saline in the same way, L-NAME+ITMP, ODQ +ITMP, KT5823 +ITMP were prepared by intrathecally administering L-NAME ( 30 nmol), ODQ(11 nmol) and KT5823(20 pmol) 10 minutes prior to ITMP respectively, L-NAME, ODQ, KT5823 worked as the control of inhibitors themselves respectively without ITMP. Subsequently, all rats were subjected to 30 min of left coronary artery occlusion followed by 2 h of reperfusion except the SHAM group. Myocardial infarct size, as a percentage of the AAR,
was determined by 2 , 3 , 5-triphenyltetrazolium stai-ning. Results Compared with CON, the volumes of IS and IS/AAR were reduced in ITMP ( P <0.01 );the protective effects of ITMP were abolished by pre-treatment with L-NAME, ODQ and KT5823 ( P <0.01 );Conclusions NO/cGMP might be involved in the cardioprotective effect of intrathecal morphine pre-conditioning against myocardial ischemia and reperfu-sion injury in rats.

Objective:To construct an integrated medical care service mode in hemodialysis and explore the application effect of the concept of integrated medical service in hemodialysis patients.Methods:In 2016,100 patients who had regular hemodialysis(lasting for more than 3 months) were selected from July to Septembe ras the control group,while another100 patients who had the regular hemo dialysis (lasting for more than 3 months) and received the concept of integrated medical care service were selected from October to December as the observation group.The treatment compliance,the incidence of hemodialysis complications,and patient satisfaction of twogroups were compared.Results:Both the treatment compliance and patient satisfaction of the participants in the observation group were significantly higher than those in the control group (P ＜ 0.05),while the incidence of hemodialysis complications in the observation group was significantly lower than that in the control group (P ＜ 0.05).Conclusion:The implementation of integrated medical careservice concept can fully deepen the service concept of people-oriented and patient-centered,carry out humanized services,improve the treatment compliance of hemodialysis patients,reduce the complications,promote the cooperation of doctors and nurses,enhance the effect of health education,and improve the patient satisfaction.