OBJECTIVE:To evaluate the current situation of drug utilization in inpatients with schizophrenia in our hospital. METHODS:The medication of inpatients with schizophrenia during Nov. 2007～Nov.2008 were analyzed statistically,referring to the DDD and DUI method recommended by WHO. RESULTS:Quetiapine,olanzapine,risperidone dominated the first 3 place in DDDs,which were all atypical antipsychotic drugs. Sulpiride ranked at 17th place in the list of typical antipsychotic drugs. the DUI of most drugs were lower than 1.0. CONCLUSION:The medication of most patients with schizophrenia is appropriate. Atypical antipsychotic drugs occupy a dominant position in the clinic.

Objective To understand the sanitary quality of the blood dialysate in hospitals in Hu'nan and its influential factors. Methods Pyrogen,total count of bacteria,22 physical and chemical indexes including calcium,chloride,fluoride,zinc,sodium and other indexes in the blood dialysate samples collected from blood dialysis rooms in 99 hospitals distributed among 14 cities and states in Hu'nan were measured according to the Sanitary Standards of Drinking Water and the Sanitary Standards for Disinfection Technology. The data of analysis were evaluated based on the standards for the blood dialysate ruled by ASAIO and AAMI. The questionnaire on the status operation and maintenance of the water purification system for blood dialysate was performed simultaneously. Results The sanitary quality of the blood dialysate samples from 31 hospitals were completely accorded with the related standards with a qualified rate of 32%. The qualified rates were 44.4%,71.7%,90.9%,97.0%,99.0%,99.0%,99.0% for pyrogen,total count of bacteria,calcium,chloride,fluoride,zinc,sodium in the blood dialysate samples respectively. The blood dialysate from the water treatment system established and put into production during 2000-2003 showed higher qualified rate(45.1%)compared with that during 1995-1999(16.7%),?2=9.293,P

Objective To study the choice of initial operative approach for thyroid nodule and the necessity of reoperation after local excision of differentiated thyroid cancer.Methods Clinical data of 138 patients with differentiated thyroid cancer after local tumor excision had reoperation at our hospital during a period of four year were retrospectively reviewed.All the reoperations were bilateral thyroidectomy and cervical lymph node excision.Results There were 76.8% patients with residual cancer in thyroid and cervical lymph node.There were 23 patients(16.7%) with recurrent laryngeal nerve injury that included 22 cases with unilateral and 1 case with bilateral injury after the initial operation,and 19 of the 23 patients with recurrent laryngeal nerve injury recovered after nerve repair.After thyroid reoperation,3 cases(2.2%) had recurrent laryngeal nerve injury,2 cases(1.4%) had partial parathyroid gland injury,2 cases(1.4%) had superior laryngeal nerve injury,but there were no cases of esophageal injury or postoperative bleeding.Conclusions The incidence of residual cancer is high after local excision for differentiated thyroid cancer,therefore,reoperation with bilateral thyroidectomy and cervical lymph node excision is necessary.

Objective To explore the effect of erythropoietin (EPO) on caspase-9 mRNA expression after globe ischemia-reperfusion in rats.Methods The globe ischemia-reperfusion models of rats were divided randomly into three groups: group A, group B and group C. Both group A and group B included 5 subgroups according to different reperfusion time (6 h, 12 h, 24 h, 48 h and 72 h). The rats of group B were treated with EPO after globe ischemia-reperfusion. Brain tissues were taken out after execution at different time point. The expression of caspase-9 mRNA was detected with reverse transcription PCR (RT-PCR) technique.Results (1) After ischemia-reperfusion, the expressions of caspase-9 mRNA in group A were significantly higher than those in group B and group C (all P

Objective To introduce a new appointment registration way in the outpatient department.Methods A WeChat appointment registration platform based on HIS was established with smart phone and WeChat public platform,which was gifted with the functions of online registration and payment and etc.The processes including preliminary diagnosis and return visit,cancelling appointment,treatment of appointment breaking,and the limitations during the appointment could be accomplished by the appointment registration.Results The platform realized appointment registration,information feedback and etc.Conclusion The appointment registration based on WeChat public platform contributes to satisfying the patient,enhancing medical service and distributing medical resources rationally.

Bronchopulmonary dysplasia( BPD) is a chronic lung disease that commonly occurs in pre-term. Since the 1980s,with the advances in perinatal care,survival rate of preterm has been raised,while BPD continues to be a significant cause of morbidity and mortality for premature infants. However,the treatment effect of BPD is unsatisfactory. It is urgent to search for innovative ways to reduce the respiratory injury that caused by BPD as well as to improve the quality of life. In recent years,mesenchymal stem cells′( MSC) research has pro-vided a new way for the treatment of BPD. This review primarily summarizes the current status of the MSC ther-apies and its possible mechanism on BPD.

Objective: To observe the efficacy of contralateral needling combined with Maitland ankle mobilization in the treatment of chronic ankle sprain.Methods: A total of 106 patients with chronic ankle sprain were included in the study. They were numbered according to their order of visit, with odd numbers assigned to the control group and even numbers assigned to the observation group, with 53 cases in each group. Patients in the control group were treated with Maitland ankle mobilization, while those in the observation group were given additional contralateral needling treatment. After treatment, we observed the indicators including, ankle circumference, range of motion (ROM) of dorsiflexion, ROM of plantar flexion, thickness of ankle ligaments, and the changes in Baird-Jackson ankle score, American Orthopaedic Foot & Ankle Society (AOFAS) ankle-hindfoot score, and visual analog scale (VAS) score to compare the efficacy between the two groups. Results: After treatment, the total effective rate of the observation group was 94.3％ and was significantly higher than that of the control group (81.1％), indicating statistical significance (P<0.05). After treatment, the ankle circumference of both groups decreased, and the ROM of dorsiflexion and the ROM of plantar flexion increased (P<0.05). The changes in the observation group were more significant, indicating inter-group statistical significance (P<0.05). After treatment, the thickness of the anterior talofibular ligament, calcaneofibular ligament, and posterior talofibular ligament, as well as the VAS scores decreased in both groups; the changes in the observation group were more significant, indicating inter-group statistical significance (P<0.05). After treatment, the Baird-Jackson ankle score and the AOFAS ankle- hindfoot score increased in both groups, and the scores in the observation group were higher than those in the control group, indicating inter-group statistical significance (P<0.05). Conclusion: The efficacy of contralateral needling combined with Maitland ankle mobilization in the treatment of chronic ankle sprain is superior to that of Maitland ankle mobilization alone.

Objective To evaluate the clinical diagnostic significance of clinical laboratory indexes of anti-CCP,rheumatoid factor (RF),C reactive protein(CRP)and erythrocyte sedimentation rate(SR)in rheumatoid arthritis.Methods Anti-CCP,RF and CRP were quantitatively tested in 90 patients confirmed as rheumatoid arthritis(RA)and 93 patients with non-rheumatoid arthritis(non-RA)diseases by the electrochemiluminescence immunoassay(ECLIA),immunization rate scattering turbidimetry,etc.T test results were performed the statistical and comprehensive analysis by using the ROC curves.Results The levels of anti-CCP and RF had statistical differences between the RA group and the non-RA group(P <0.05 ),while there was no statistically significant differ-ences in the levels of CRP and SR(P >0.05 ).The areas under ROC curves(AUC)of anti-CCP,RF,CRP and SR were 94.0%, 84.0%,51.7% and 56.5% respectively;the sensitivity of anti-CCP and RF was 90.0% and 74.4% respectively,while the specifici-ty was 94.6% and 86% respectively;the Youden indexes were 84.6%and 60.4% respectively;the diagnostic sensitivity of CRP was only 52.2% and the diagnostic specificity of SR was only 50.5%.Conclusion Anti-CCP and RF have the good diagnostic value for RA,moreover the diagnostic performance of anti-CCP is better than RF;CRP and SR have the poor diagnostic preformance,the combination of above indexes has more clinical significance for diagnosing RA.

Objective To summary the experience of living donor liver transplantation (LDLT) in order to improve therapeutic effect of LDLT. Methods We retrospectively analyzed the clinical data of donors and recipients of 22 LDLT cases, evaluating patients' and donors' preoperative assessment, surgical strategies and postoperative complications. Results Donor's grafts harvested included 2 left lateral lobes, 6 left half livers, 1 extended left half liver, 5 right half livers and 8 extended right half livers. Postoperatively all donors recovered without severe post-transplantation complications. Among 13 adult and 9 child receipients, there were 8 recipients suffering from posttransplantation complications, including intra-abdominal severe infection in one case, delayed liver function recovery complicating incisional infection in one case, intra-abdominal hemorrage complicating thrombogenesis of the hepatic artery in one case. All these 3 patients died. One child recipient of hepatic failure died of heart and respiratory failure after operation. Other non-lethal complications were bile leakage in 2 cases, refractory ascites in one and deep venous thrombosis of the lower limb in one. These complications were cured without laparotomy. Finally 18 recipients were fully recovered and discharged. Late post-operative complications included strictures of biliary tract in 3 cases which were treated with PTCD and indwelling stent, the obstructive jaundice due to achalasia of sphincter of Oddi was treated with endoscopic sphincterotomy. These 4 patients' are on stable condition and the liver function is normal. Conclusions Select proper donor and optimal surgical strategy are extremely helpful to secure donors and recipients during the procedure of LDLT.

Objective To investigate the resuscitation outcome after a short period of mild hypothermia in porcine model of prolonged ventricular fibrillation (VF).Methods Fourteen male healthy domestic swine weighting 34 to 36 kg were used.VF was induced electrically and maintained untreated for 11 mins,followed by manual cardiopulmonary resuscitation (CPR) procedure.Two investigators initiated chest compression and bag-valve mask ventilation in pattern of 2 min rotation.A biphasic wave of 120 J electric defibrillation (ED) was attempted 6 mins after CPR.If there was no return of spontaneous circulation (ROSC),CPR was restored and ED was delivered when necessarily.Resuscitation was considered unsuccessful if absence of ROSC for 12 mins.However,if ROSC occurred,animals were randomly (random number) diveded into normothermia (NT) group and hypothermia treatment (CH) group.Animals in CH group were immediately cooled by using intravenous infusion of ice-cold saline and surface cooling.Core temperature was reduced to 32-34 degrees centigrade within 120 mins and maintained at this level for 2 h.Active rewarming was completed within 2 h until baseline body temperature was reached.Data of hemodynamic variables,blood-gas analysis and blood lactate before VF of two groups were recorded.Meawhile,cardiac output (CO),heart rate and Tc after ROSC were recorded.Neurological defect scores (NDS) were evaluated every 24 h until 96 h after ROSC.Variables were compared using either Fisher test or repeated measures analysis of variance,followed by Bonferroni for multiple comparisons.A two-sided P value ＜0.05 was regarded statistically significant.Results There was no significant difference in body weight,mean arterial pressure,CO,pH,pressure of end-tidal carbon dioxide (ETCO2) and lactate between groups before VF.In the period of CPR,there were also no significant difference in total resuscitation time,first shock success rate,ROSC rate,shock ROSC rate,total number of shock and doses of epinephrine.However,animals in CH group survived longer time than that in NT groups [(96.00 ± 0.00) hvs.(49.71 ±43.65) h,P=0.031].Meanwhile,the survival rate of 96 h was significantly higher in CH than that in NT (P ＜ 0.05).For neurological function,there was a obviously better NDS in CH group than that in NT group within ROSC 96 h (P ＜ 0.05).Conclusion Even a short duration of 2 hour mild hypothermia could improve resuscitation outcome in porcine model of 11 minute VF.