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 clinical features of lissencephaly and the detection ofLISI gene.MethodsThe characteristic of clinical features, laboratory examination and gene detection in one case of lissencephaly was retrospectively analyzed. Meanwhile, the related literatures were reviewed.ResultsA 5-month-old female child diagnosed with epilepsy 20 days ago was hospitalized for convulsive seizure more than 30 times in 3 days. The manifestations were eyes staring, and turning upward, cyanosis of lips and face, froth at the mouth, extremities rigidity and loss of consciousness, and the symptoms can spontaneously remitted in 2-3 minutes. Laboratory examination showed that peripheral blood white cell count was 13.67×109/L, hemoglobin 108 g/L, red blood cell count 3.90×1012/L, lymphocyte 10.26×109/L; maocardial enzyme and hepatic and renal function were normal; blood ammonia was 23 μmol/L and lactic acid 2.11 mmol/L. Long-range video EEG showed highly arrhythmia, and frequent partial epilepsy, and sometimes secondary generalized epilepsy. Head MRI showed lissencephaly. The child was treated with oral administration of Keppra 27 mg/(kg·day), Topiramate 6.5 mg/(kg·day), currently no seizure. The detection ofLIS1 gene found that heterozygous mutation of c.232delG, which lead to protein shift mutation (p.E78NfsX25). No mutation was found in her parents.ConclusionsChild with lissencephaly may combine with epilepsy which may cause by mutation inLIS1 gene. And there was no information about point mutation of c.232delG inLIS1 gene being reported at home and abroad so far.

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.

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.

Objective To analyze the real world status of traditional known cardiovascular risk factors in patients with coronary heart disease ( CHD ) .Methods 6040 in-hospital patients with CHD or suspected CHD undergoing angiography from 01/01/2013 to 02/28/2015 were retrospectively analyzed . According to angiography result , patients with severe coronary artery lesion and undergoing percutaneous coronary intervention (PCI) were enrolled in the PCI group (n=2808) and patients without severe coronary artery lesion and not undergoing PCI or CABG were enrolled in the No-PCI/CABG group (n=3232).Patients in the PCI group were further divided into 3 subgroups which were STEMI group , NSTEMI/UA group and stable angina (SA) group.Results (1) Compared with the No-PCI/CABG group, patients in the PCI group have higher ratio of male patients (75.4% vs.53.1%, P<0.0001), older average age (64.83 ±0.20 vs. 63.39 ±0.18 years old , P <0.0001 ) , and higher existing rates of traditional risk factors including hypertension (66.7%vs.54.7%, P<0.0001 ) , diabetes/impaired glucose tolerance ( IGT ) ( 37.0% vs. 20.8%, P<0.0001), stroke(7.0%vs.5.4%,P=0.0098)and chronic kidney disease (CKD) (4.3%vs. 2.8%, P=0.001 ) , but there was no statistic difference in existing rates of dyslipidemia between the two groups.(2)In the PCI group,female patients had higher prevalence of hypertension (74.1%vs.64.3%, P<0.001), diabetes/IGT (42.5%vs.35.3%, P=0.0007) and stroke (9.4%vs.6.2%, P=0.0054) than the male patients.There were no significant sex difference in these comorbidities as above in No-PCI/CABG group.Female patients had higher prevalence of dyslipidemia than male patients in both PCI and No -PCI/CABG groups.(3) Among all the 3 PCI subgroups, STEMI patients presented with youngest average age (62.54 ±0.45 vs.65.15 ±0.28 vs.66.17 ±0.34 years old, P<0.0001) and highest male patient ratio (83.9%vs.72.9% vs.72.3%, P<0.0001).Patients in the SA subgroup had the highest prevalence of hypertension and prior revascularization including PCI and CABG .Patients in the NSTEMI/UA subgroup had the highest rates of diabetes/IGT.No significant differences were observed in the prevalence of dyslipidemia , CKD and stroke among all the subgroups .Conclusions Hypertension and diabetes are the leading risk factors of coronary artery disease , and prior revascularization is also an important cause of stable angina and NSTEMI /UA undergoing PCI.Patients requiring PCI were found to be more of male gendor , but female patients has higher prevalence of traditional cardiovascular risk factors including hypertension , diabetes/IGT or stroke than male patients.

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 .

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.