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.

BACKGROUND:Ultrasound therapy can relieve pain and improve the movement function in patients with knee osteoarthritis, but there lacks of consistency in the literatures of ultrasound therapy.
OBJECTIVE:To further identify the effectiveness of ultrasound therapy in the treatment of knee osteoarthritis.
METHODS:Twenty-four rabbits were randomly divided into three groups:normal group, model group and ultrasound group. The rabbit in the normal group received no intervention;rabbits in the model group received anterior cruciate ligament transaction to establish the knee osteoarthritis model without any treatment;the rabbit in the ultrasound group received ultrasound therapy after modeling for 10 minutes once time, once per day, 0.3 W/cm2 , 1 MHz and treated for 10 times. Hematoxylin-eosin staining was conducted for histological observation of rabbit articular cartilage;western blot and reverse transcription PCR assessment were used to assess the expressions of caspases-3 and caspases-8 in rabbit articular cartilage, while Terminal deoxynucleotidyl transferase dUTP nick end labeling was used to assess the ratio of chondrocytes apoptosis of rabbit knee articular cartilage.
RESULTS AND CONCLUSION:The normal rabbit cartilage tissues and chondrocytes were neatly arranged in column;the middle cartilage layer of the model was thin;the chondrocytes were arranged disorderly and became less. After ultrasound therapy, the chondrocytes were rearranged neatly, and the number was increased. Compared with the normal group, the Mankin scores in the model group and ultrasound group were higher;the apoptotic rate of chondrocytes was higher in the model group and ultrasound group than in the normal group, and was also higher in the model group than in the ultrasound group. Compared with the normal group, the expressions of caspases-3 and caspases-8 were higher in the model group and the ultrasound group, while decreased after ultrasound therapy. The results indicate that ultrasound can improve the structure of cartilage tissues, decrease the expressions of caspases-3 and caspases-8 and reduce the apoptosis rate of chondrocytes. It is effective for the treatment of knee osteoarthritis with ultrasound therapy.

Objective To investigate the expression levels of miRNA in kidney biopsies of child patients with nephrotic syndrome and the possibility of miRNA as potential markers in differentiating the pathologic subtypes of nephrosis.Methods Kidney biopsy specimens from 41 child patients with nephrotic syndrome,including 22 with nesangial proliferative glomeplonephritis (MsPGN),8 with minimal change disease (MCD) and 11 with endocapillary proliferative glomerulonephritis (ECPGN),were collected,and adult nephridial tissues from 8 patients without renal inadequacy were selected as controls.The expression levels of miR-191,miR-151-3p,miR-150,miR-30a-5p and miR-19b in nephridial tissues were detected by RT-qPCR,and their correlations with renal function related parameters were analyzed.Results Compared with the controls,the miR-191 levels in kidney tissues of child patients with nephrotic syndrome increased significantly (P ＜ 0.01),while the miR-151-3p levels decreased obviously (P ＜ 0.01).The expression levels of miR-150 in MCD patients were significantly lower than those in MsPGN and ECPGN patients and the controls (P ＜ 0.05).The expression levels of these miRNAs were positively correlated with serum IgG,TP and Cr levels,but negatively with serum TC levels (P ＜0.05).Conclusion The expression levels of miRNA in kidney tissues of child patients with nephrotic syndrome are related to pathological typing of nephrosis,and miR-150 may be a potential marker which may differentiate MCD from other subtypes of nephrosis.

AIM: To investigate the role of nitric oxide synthase (NOS), soluble guanylyl cyclase (sGC) and protein kinase C (PKC) signaling in tumor necrosis factor-? (TNF-?)-induced cardioprotection against hypoxia/reoxygenation (H/R) injury. METHODS: Neonatal rat ventricular myocytes were pretreated with TNF-? or sodium nitroprusside (SNP) or L-arginine (L-Arg), respectively, for 12 h and then subjected to continuous hypoxia for 12 h, followed by reoxygenation for 6 h. The manganese superoxide dismutase (Mn-SOD) activity of the cells was measured after H/R. Myocyte injury was determined by the release of lactic dehydrogenase (LDH). RESULTS: TNF-? (10~5 (U/L)) significantly increased the Mn-SOD activity and decreased release of LDH from ventricular myocytes. The cardioprotection against H/R injury was induced by the pretreatment with SNP (5 ?mol/L) or L-Arg (5 mmol/L), which was blocked by ODQ (10 ?mol/L), the specific sGC inhibitor, and Chel (5 ?mol/L), the specific PKC inhibitor. Pretreatment with L-NAME (100 ?mol/L), ODQ, Chel, antoxidant 2-MPG (400 ?mol/L) or tyrosine kinase inhibitor genistein (50 ?mol/L) attenuated the increased Mn-SOD activity and reduced LDH level induced by TNF-?. CONCLUSION: The results suggest that NO may play a role in TNF-?-induced cardioprotection, which is mediated by sGC and PKC. [

AIM: To discuss the effects of preoperative vitreous cavity injection of ranibizumab on 25G minimally invasive vitreoretinal surgery (VRS) in patients with proliferative diabetic retinopathy(PDR).METHODS: From February 2013 to December 2015,74 patients with PDR received VRS (82 eyes) were retrospectively analyzed.Patients were divided into VRS + IVR group and VRS group according to preoperative VRS treatment.VRS+IVR group: preoperative injection of ranibizumab (10mg / mL) at 3-5d before operation;VRS group: VRS only.We recorded VRS operation time,filling situation,iatrogenic retinal hole and so on.RESULTS: The operation time and coagulation times of VRS+IVR group were significantly lower than VRS group.The two groups in operation time and coagulation times were statistically significant (all P<0.05).In the VRS+IVR group,the number of cases of iatrogenic retinal hole and the use of silicone oil were lower than those of VRS group,the difference between the two groups was statistically significant (P<0.05).While the use number of C3F8 and perfusion fluid were not statistically significant (P>0.05).In VRS-IVR group within 3mo after operation,4 eyes appeared to vitreous body hematocele,VRS group was 13 eyes,the difference was statistically significant (x2=4.966,P<0.05).CONCLUSION: PDR patients with 25G minimally invasive VRS with preoperative therapy can reduce postoperative ocular bleeding,rate of retinal injury and silicone oil filling,shorten the operation time,the incidence rate and improve the success rate of surgery and reduce eye bleeding,postoperative complications such as adhesion.

Objective To evaluate the diagnostic values of ultrasound elastography (UE) technology and acoustic radia?tion force impulse (ARFI) technology in the differential diagnosis of benign and malignant single solid thyroid nodule showed by ultrasonography. Methods A total of 100 patients with solitary thyroid nodule diagnosed by the Affiliated Hospital, School of Medicine of Shihezi University in December 2013 to July 2014 were selected in this study. The routine ultrasound, UE examination and ARFI technology were used in patients before operation. All patients were performed operation for thy?roid nodules and the diagnosis was confirmed by the pathologic results. A flexible classification method was used in UE. ARFI was used to detect shear wave velocity (SWV) of lesions. The diagnostic values of three methods were evaluated by the gold standard of pathologic results. ROC curves were plotted according to SWV values of benign and malignant thyroid nod?ules. Results The area under the curve (ACU) was 0.960. The best cut-off value of SWV was 2.76 for diagnosis. The diag?nostic sensitivities of malignant thyroid solid nodules were 82.61%(19/23), 82.61%(19/23) and 91.30%(21/23) for US, UE and ARFI, respectively. The diagnostic specificities were 87.01%(67/77), 88.31%(68/77) and 93.51%(72/77) respectively. And the positive predictive values (PPV) were 65.52%(19/29), 67.86%(19/28) and 80.77%(21/27) respectively;the nega?tive predictive values (NPV) were 94.37%(67/71),94.44%(68/72) and 97.29%(71/73). Conclusion ARFI technology is superior to US and UE technology in predicting malignancy in solitary solid thyroid nodule, which is worth of clinical applica?tion and promotion.

Objective To assess the efficacy and safety of minimally invasive percutaneous nephrolithotomy(mPCNL)in the treatment of upper urinary tract calculus. Methods The clinical data of 368 cases of upper urinary tract calculus from 2002 to 2006, which underwent mPCNL, were retrospectively analyzed. Among 368 cases analyzed, there were 116 cases with proximal ureteral cal-culus;190 cases of nonstaghorn kidney stones, 62 cases of staghorn stones. Results There were 344 cases(93.5%)treated with one-stage operation, 24 cases(6.5%) with two-stage. Single channel was used in 856 cases(96.70%), two-channel in 12 cases(3.3%). Complete stone clearance was a-chieved in 337 kidneys, giving an overall clearance rate of 91.6%. The average operative time was 73 min. The duration of hospital stay was 4-8 d with an average of 6 d in one-stage and complete clear-ance patients. Postoperative urinary tract infection was seen in 23 patients(6.2 %). Five(1.4 %) pa-tients required blood transfusion after operation. Two patients with severe bleeding were treated with blood transfusion and super-selective arterial embolization. Conclusion mPCNL has definite efficacy in the treatment of upper urinary tract calculus with little suffering and short recovery time.

Objective To explore the effects of ureteral stent on renal pelvic pressure and other urodynamic parameters. Methods Forty-one patients, 28 males and 13 females, with unilateral renal calculi and/or ureteral calculi were recruited in this study. The mean patient age was 47 years old (ranging from 20 to 72 years old). All cases were placed a 4.7 F ureteral stent and 16 F nephrostomy tube after minimal invasive pereutaneona nephrolithotomy (MPCNL). There was no hydronephrosis and residual crushed stone in the ureter after MPCNL in all cases. Renal pelvic pressure, intra-abdo minal pressure, detrusor pressure, bladder pressure changes during the filling and voiding phases with intravesical perfusion flow rate of 40 ml/min were recorded and analyzed. Results At the baseline, IPP0, IAP0, DP0 and BP0 were (33.1±17.0)cm H2O, (27.5±7.0)cm H2O, (3.3±2.9)cm H2O and (30. 9±7.2)cm H2O, respectively; At the maximum cystometric capacity during the filling phase, IPPvol, IAPvol Dpvol and Bpvol were (39.4±67. 3)cm H2O, (31.1±7.3)cm H2O, (10.7±6. 6) cm H2O and (41.6±10.3)cm H2O, respectively; At the maximum bladder pressure during the voiding phase, IPPmax, IAPmax Dpmax and Bpmax were (65.7±17.0)cm H2O, (33.7±9. 7)cm H2O, (41.9±7.8)cm H2O and (75.0±12. 8)cm H2O, respectively;There were statistical significance comparing between any of IPP0, IPPvol and IPPmax(P<0. 01). 27% (11/41)patients were with the pain in kidney area at voiding IPPmax (87.1±14.6) cm H2O, which was significantly higher than IPPmax (57.8±9.5)cm H2O of asyrnptomatic group (30 patients)(P<0. 01). In all cases, the renal pelvic pressure was higher than 40 cm H2O during the voiding phase. Conclusions Renal pelvic pressure increases during the filling phase after placing the ureteral stent, especially during the voiding phase. As renal function will be damaged by the high renal pelvic pressure, we should decrease the utilization of ureteral stent if possible. It is encouraged to remove the ureteral stent as early as possible.

OBJECTIVETo evaluate the efficacy and safety of Yigan Fupi Decoction (YFD) in the treatment of irritable bowel syndrome with diarrhea (IBS-D) patients.

METHODSA randomized controlled clinical trail was carried out in patients with IBS-D. All patients were randomly assigned to the treatment group (58 cases, treated with YFD) and the control group (58 cases, treated with Pinaverium Bromide Tablet). The treatment course was 4 weeks for all patients. The total effective rate, the stool property and state, the quality of life (QOL), and TCM syndrome efficacy were assessed by IBS bowel symptom severity scale (IBS-BSS), IBS defecation state questionnaire (IBS-DSQ), IBS quality of life questionnaire (IBS-QOL), and traditional Chinese medicine pattern curative effect scoring system (TCM-PES) before and after treatment.

RESULTSThere was no statistical difference in the total effective rate between the two groups (82.76% vs. 77.59%, P > 0.05). The treatment group was superior in the total IBS-BSS integral to the control group (P < 0.05). The total effective rate of improving the stool property was better in the treatment group than in the control group (81.03% vs. 72.41%, P < 0.05). Besides, the number of days for emergent defecation among 10 days was less in the treatment group than in the control group (P < 0.05). The improvement of the total IBS-QOL integral and the total integral of TCM syndrome were better in the treatment group than in the control group (P < 0.01). The total effective rate of TCM-PES was better in the treatment group than in the control group (84.48% vs. 70.69%, P < 0.05).

CONCLUSIONYFD was effective in the treatment of IBS-D patients of Gan-qi invading Pi syndrome, and could effectively relieve bowel symptoms, improve the stool property and the defecation frequency, elevate their QOL, and attenuate Gan-qi invading Pi syndrome with favorable safety and compliance.

Adult ; Diarrhea ; drug therapy ; Drugs, Chinese Herbal ; therapeutic use ; Female ; Humans ; Irritable Bowel Syndrome ; drug therapy ; Male ; Middle Aged ; Morpholines ; therapeutic use ; Quality of Life ; Treatment Outcome

Objective To investigate the risk factors for early hypoglycemia and its relationship with prognosis of patients with cerebral infarction.Methods A total of 273 patients with cerebral infarction were divided into the normal blood glucose(NBG) and severe hypoglycemia (SHG)and mild hypoglycemia(MHG) groups in our hospital.Biochemical indicators,the National Institute of Health stroke scale(NIHSS)and mortality were compared between the three groups.According to prognosis,patients were divided into death group and survival group.The NIHSS score,blood glucose concentration and incidence of hypoglycemia were compared between death and survival groups.Pearson relationship between hypoglycemia and NIHSS score,and spearman rank correlation between hypoglycemia severity and mortality were analyzed.Results Levels of lactic acid (6.3 ± 2.8) mmol/L,creatinine(268.7 ± 63.9) mmol/L,urea nitrogen (13.8 ± 3.7) mmol/L,albumin (25.6 ±4.9) g/L,alanine aminotransferase (150 ± 19.7) U/L,NIHSS (22.3 ± 9.2) scores,and mortality rates (38.1 ％)were higher in severe hypoglycemia group than in both NBG group and severe hypoglycemia group[(lactic acid:4.7±2.3 mmol/L and 3.3±1.5 mmol/L),(creatinine 134.8±51.3 mmol/L and 78.7±40.8 mmol/L),(urea nitrogen 7.9±4.2 mmol/L and 7.7±3.3 mmol/L),(albumin 36.9±3.8 g/L and 35.6±4.3 g/L),(alanine aminotransferase 85.8± 18.3U/L and 46.3± 13.8U/L),(NHISS 14.6±5.9 scores and 10.5 ± 5.4 scores)and(mortality rates 20.8％,11.0％)] (all P＜0.01).There was a negative correlation between hypoglycemia and NIHSS score(r=-0.45,P＜＜0.05).There was a positive correlation between hypoglycemic severity and mortality (r =0.41,P ＜ 0.05).Multiple Logistic regression showed that creatinine and alanine aminotransferase were correlated with hypoglycemia and prognosis of patients with cerebral infarction(both P＜0.05).Conclusions Early hypoglycemia in patients with severe cerebral infarction is closely correlated with the liver and kidney insufficiency,and a severe cerebral infarction combined with hypoglycemia often indicate a poor prognosis.