Objective To investigate antimicrobial use in 33 township central hospitals,and improve the rational use of antimicrobial agents. Methods Thirty-three township central hospitals in 1 1 counties were randomly select-ed,7 920 outpatient prescriptions,medical records of 465 non-surgery patients and 213 surgery patients were inves-tigated and analyzed. Results Of 33 hospitals,antimicrobial usage rate in outpatients and inpatients was 56.60%and 89.68% respectively,combined antimicrobial usage rate was 24.16% and 43.58% respectively. Antimicrobial use density in inpatients was 147.25DDDs. Antimicrobial usage rate in surgery patients was 97.18% ,combined an-timicrobial usage rate was 59.90% ,the percentage of one drug,two-drug combination and three-drug combination was 40.10% ,47.82% ,and 12.08% respectively. The percentage of antimicrobial use in patients of type Ⅰ,Ⅱ, and Ⅲincision was 97.56% (40/41),96.93% (158/163)and 100.00% (9/9)respectively,combined antimicrobial us-age rate was 30.00% ,67.72% ,and 44.44% respectively.Conclusion The overuse of antimicrobial agents exists in 33 township central hospitals,antimicrobial usage rate,combined usage rate,antimicrobial use density and antimi-crobial prophylaxis in typeⅠincision operations are all high.

Agenesis of Corpus Callosum ; Chromosomes, Human, X ; Gene Deletion ; Glycerol Kinase ; genetics ; Humans ; Infant ; Male ; Syndrome

[Objective]To introduce a new technique of ankle arthrodesis with trephine by lateral approach and evaluate its clinical effects.[Method]Ankle arthrodesis with trephine was performed in 20 patients with serious lesions.Lateral incision was adopted and osteotomy of fibula facilitated the exposure of the fusion site.A trephine of appropriate diameter was used for bi-osteotomy,thus inside the trephine gaining two bone blocks were then rotated 90? and replanted in situ.The pruned fibula was fixed with screws as on-lay!grafting.Proper cast was utilized postoperatively to maintain a functional position.[Result]The average follow-up period was 26 months(ranged from 6 months to 4 years).All the wounds healed well at 2 weeks and the callus appeared 4 weeks postoperatively.Sufficient pain relief was obtained in all patients at 12 weeks and appearance improved greatly.A solid union was achieved in all cases through the radiograph.[Conclusion]The use of trephine in ankle fusion by lateral approach is proved to be a simple technique with high union rate.The main advantages of the technique over other methods of arthrodesis include: excellent exposure by regular incision;less disturbance of the original joint,thereby preserving normal height of the joint and length of the extremity;no need for extra graft through in-situ grafting of the bone blocks and rigid on-lay grafting of lateral malleolus for high primary stability.

Radiotherapy is the primary treatment for nasopharyngeal carcinoma, and the disease control rate and survival time are able to be greatly improved by enhancing the radiosensitivity. Via mechanisms such as binding to target genes mRNA 3'untranslated region (3'UTR), microRNA (miRNA) inhibits translation, which therefore regulates transcription of target genes and thus affect target protein expression. Recent research showed that miRNAs play significant roles in improvement of radiosensitivity in nasopharyngeal carcinoma. This article reviews mechanism of miRNA action to strengthen radiosensitivity of nasopharyngeal carcinoma and the future of clinical practice of miRNA in this disease.
3' Untranslated Regions ; Carcinoma ; Humans ; MicroRNAs ; pharmacology ; Nasopharyngeal Carcinoma ; Nasopharyngeal Neoplasms ; drug therapy ; radiotherapy ; RNA, Messenger ; Radiation Tolerance ; Radiation-Sensitizing Agents

Objective To compare efficacy of two intensive therapies:continuous subcutaneous insulin infusion(CSⅡ) and multiple subcutaneous insulin infusion (MSⅡ) for treatment of type 2 diabetes mellitus.Methods 60 patients with type 2 diabetes mellitus were randomly divided into 2 groups. Patients in CSⅡ group were treated by insulin (Novolin R) through a infusion pump. Patients in MSⅡ group were treated by Novolin R before meals (3 times a day) and Novolin N at bedtime. Blood glucose was monitored the whole day before and after treatment. Time required for blood glucose to reach the standard level, insulin dosage and hypoglycemia incidence were compared between the 2 groups before and after treatment. Results Both of the 2 therapeutic methods effectively controlled blood glucose (P＜0.05). However, the 2 groups had significant difference in terms of the time required for blood glucose to reach the standard level ( 3.6 ± 1.2 d vs. 9.4 ± 3.2 d, P ＜ 0. 01 ), daily insulin consumption (35.2 ± 8.5 u vs. 43.2 ± 10. 1 u, P ＜0. 01 ) and hypoglycemia incidence (2. 1% vs.9.7%, P ＜0.01 ). Conclusions CSⅡ and MSⅡ are effective for treatment of type 2 diabetes mellitus. CSⅡ is superior to MSⅡ due to its advantages of quick response, safety, and less insulin consumption.

Afferent Pathways ; anatomy & histology ; Animals ; Female ; Ganglia, Spinal ; anatomy & histology ; Neurons, Afferent ; Rats ; Rats, Sprague-Dawley ; Urinary Bladder ; innervation

Purpose To implement lower artery angiography in patients with peripheral arterial occlusive disease, and to investigate the feasibility of lower extremity gemstone spectral CT angiography in improving image quality.Materials and Methods Forty-eight patients suspected with lower extremity arterial occlusive diseases were randomly divided into research group and control group. Research group (24 cases) were carried out gemstone spectral CT angiography (CTA) scan and control group (24 cases) were scanned with multi-slice spiral CT (CTA). The CT value of the common iliac artery, popliteal artery and its branches was measured and contrast to noise ratio (CNR) were calculated in both groups. The images were evaluated independently by 2 senior physicians based on a 5-level evaluation standard.Results The CT value of common iliac artery, popliteal artery, anterior tibial artery and the CNR in research group were all higher than those in control group (t=8.7, 7.9, 12.6 and 17.2,P<0.01), but the background noise was lower than that in control group (t=1.5,P<0.01). The scores of two image quality accessed by physician 1 and 2 were 110:90 and 111:93 respectively with statistical difference (Z=-7.6 and-8.0, P<0.01).Conclusion The image obtained by gemstone spectral CT optimal single energy image technique is much better than that by conventional multi-slice spiral CT in lower extremity angiography.

Objective To analyze the risk factors of 30-day mortality in patients with malignant hilar obstruction (MHO) after percutaneous transhepatic biliary metal stent deployment. Methods One hundred and fifty-nine consecutive patients with MHO caused by cholangiocarcinoma or gallbladder carcinoma were enrolled in this study. Percutaneous transhepatic biliary stent (PTBS) implantation was carried out in all the patients. Independent predictors for 30-day mortality were evaluated by logistic regression analysis. Covariates that were incorporated into the multivariate analysis were the variables that reached statistical significance (P < 0.1) in univariate analysis. Two-tailed, P value of less than 0.05 was considered to be statistically significant. Results The 30-day mortality of patient with MHO after metal stent deployment was 9.4%. Univariate analysis indicated that the differences in WBC (OR = 1.224.95%CI [1.07 - 1.44], P < 0.01), INR (OR=78.75, 95%CI [5.02-1 235.70], P<0.01), PT(OR=1.55, 95%CI [1.18-2.04], P<0.01), BUN (OR=1.19, 95%CI [1.02- 1.38], P < 0.05), CRE(OR = 1.02, 95%CI [1.000 - 1.041], P < 0.1) and lymph nodes metastasis(OR = 0.334. 95%CI[0.105 - 1.131], P < 0.1) were statistically significantly between 30-day mortality group and non-30-day mortality group. Multivariate analysis showed that statistically significant differences in WBC (OR = 1.19, 95%CI[1.026 - 1.380], P < 0.05), INR(OR = 151.5, 95%CI [3.13 - 5 440.7], P < 0.05) and CRE (OR = 1.025, 95%CI [1.002 - 1.048], P < 0.05) also existed palliative treatment for patients with malignant hilar obstruction. Active preoperative measures to improve hepatic and renal functions as well as to control infection are necessary in order to reduce 30-day mortality.

BACKGROUND:Intervertebral disc can bear load but lack vessels. Nucleus pulposus cel s have the problem of phenotype loss during in vitro culture that can lead to degenerative changes. The mechanism of intervertebral disc degeneration remains unclear.
OBJECTIVE:To explore the approaches of isolation, adherence culture, amplification and identification of the rabbit nucleus pulposus cel s in vitro, to observe the growth characteristics of nucleus pulposus cel s in different generations.
METHODS:Type Ⅱ col agenase digestion method plus explants culture method was used to isolate and purify nucleus pulposus cel s and then amplify in vitro. The morphology and growth of primary and passaged cel s was observed under the inverted microscope, the number of cel s was counted and the growth curve was draw. The morphology of the cel s was observed under light microscope after hematoxylin-eosin staining, and the expressions of col agen type Ⅱ and aggrecan were examined by immunocytochemistry.
RESULTS AND CONCLUSION:Nucleus pulposus cel s of rabbit were isolated, cultured and amplified in vitro successful y. Growth activity was observed, and found that the 1-3 generation nucleus pulposus cel s proliferated more rapidly and vigorously. The proliferation of nucleus pulposus cel s was decreased while the cel passaged more generations. These isolated and cultured nucleus pulposus cel s could positively express the col agen type Ⅱ and aggrecan. In vitro combination of type Ⅱ col agenase digestion method and explants culture method could obtain high purity nucleus pulposus cel s, and the cultured nucleus pulposus cel s were grew in round or polygonal. The 1-3 generation of cel s had strong activity.

Objective To evaluate the protective effects elicited by ClpP fusion protein in animal protection tests. Methods Pneumococcal antigens were purified from recombinant Escherichia coli express-ing CIpP cloned gene. 6- to 8-week-old female BALB/c mice were immunized intraperitoneally with either ClpP or PBS plus alum. Every mouse received three doses of 20 μg antigen or PBS in 100 mg of alum adju-vant at 14 d intervals. Sera were collected from mice and analyzed by ELISA 1 week after the third immuni-zation, Intraperitoneal-challenge experiments with 12 different serotypes of Streptococcus pneumoniae were carried out 2 weeks after the third immunization, and we compared their median survival times and survival rates respectively by Mann Whitney U test and Fisher exact test. Results ELISA analysis demonstrated high titer specific antibody responses to ClpP. The median survival times for mice immunized with ClpP pro-tein antigens in adjuvant were significantly longer than those for mice that received the adjuvants alone. Con-clusion A highly expressed recombinant ClpP protein has been successfully obtained and proved to exert the protection against invasive pneumococcal infection without relation of serotype, suggesting ClpP can be a promising candidate vaccine.