Objective To investigate the present situation of the combination of antimicrobial drugs and to improve the rationality of antimicrobial medication.Methods Choose 1734 prescription of antimicrobial from February 2015 to May 2016 in our hospital outpatient service and emergency departments, combined with pharmacology, clinical medication instructions and drug instruction,the prescriptions were analyzed statistically,and the name of antimicrobials, combination mode, type, period of treatment, rationality and other aspects of the situation were studied.Results The total prescription of antibiotics was 45.44%, and the combination of antimicrobial drugs was 76.65 %, with the combination form of the dosage form and the injection machine with a maximum of 41.72%.Oral dosage form and oral dosage form combined drug 21.19%.The proportion of combined penicillin was 43.54 percent, followed by the cephalospora 27.81%.The rational compatibility prescription 86.92%, the prescription compatibility is unreasonable 13.08%.In the unreasonable preparation of the prescription, the majority of the formulations for pharmacodynamics were 82.28%.Conclusion The current use of antibiotics in our hospital gradually become standardized, in the process of clinical treatment, to understanded and master the drug combination medication indications, can significantly improve the treatment effect, to avoid the occurrence of adverse reaction phenomenon, the use of drug safety is effectively guaranteed.

Benign biliary strictures(BBS) have different etiologies, and the most common causes are strictures secondary to iatrogenic and ischemic injury after hepatobiliary and transplantation surgery. Fibroblast proliferating activity, extracellular matrix overdeposition and scar proliferation are closely related to BBS. The mechanism of development of BBS involves a variety of cells, cytokines and extracellular matrix. In recent years, biological treatment is emerging as an effective option for BBS, but the clinical application is not yet mature and the curative effect needs to be evaluated further in the future.

Objective:To inve tigate the value o electron beam tomography and echocardiography or diagno ing the comple congenital heart di ea e . Method :Thirty our patient with comple congenital heart di ea e underwent both echocardiography and electron beam tomography,which wa con irmed by angiocardiography in 18 patient .Twenty one patient were operated on.All data were comparatively analyzed Re ult :The rate o diagno i coincidence in diagno ing comple congenital heart di ea e wa 82 4% or electron beam tomography,and 73 5% or echocardiography.The accuracy o electron beam tomography in diagno ing e tracardiac abnormal tructure wa 97 9% and obviou ly higher than 53 2% by echocardiography.The accuracy o echocardiography in diagno ing intracardiac abnormal tructure wa 95 9% and higher than 81 6% by electron beam tomography.Electron beam tomography and echocardiography had a imilar accuracy or diagno ing abnormal tructure at the junction o ve el with cardiac chamber. Conclu ion:Electron beam tomography combined with echocardiography can greatly improve the diagno i accuracy o comple congenital heart di ea e and can al o reduce the u e o inva ive angiocardiography.

Objective To evaluate their roles of transthoracic echocardiography (TTE), cardiovascular digital imaging (CVDI) and electron beam computed tomography (EBT) in the diagnosis of complex congenital heart dieases (CHD).Methods Twenty-one patients with CHD were studied, including 12 cases of boys and 9 cases of girls. Fourteen cases of them underwent surgery. All of them were examined by two-dimensional echocardiography (2DE) , color Doppler flow imaging (CDFI) and EBT, 11 cases of them were examined by CVDI.Results The rate of coincidence between EBT and CVDI in diagnosing complex CHD was 93.3% (28/30). The accurate rate of TTE and CVDI in diagnosing complex CHD was 77.8% (35/45) and 93.3% (42/45) respectively.Conclusion In diagnosing complex CHD,combination EBT with TTE can replace the technique of CVDI partially.

Objective To investigate and analysis the prevalence rate of hospital infection and community infection,and to reduce the incidence of hospital infection.Methods First we investigated hospitalized patients in September 9,2013 by two ways which in-clude bedside investigation and reviewing the medical records;and then described the prevalence case of infection and the usage of antimicrobial agent by descriptive approach.Results Seven hundred and seventy patients were investigated with the rate of 100.00%;18 patients were hospital infection cases,the infection rate was 2.34%;most of the hospital infection cases was occur in lower respiratory tract;228 patients were community infection cases.The infection rate was 29.61%;the primary affected areas of community infection were respiratory and gastrointestinal tract;the structure of hospital infection pathogens were almost the same with the community infection,most of them were G- bacteria;186 patients were used antimicrobial agent in that day,the usage rate was 24.16%.Conclusion Promoting the managements of high risk departments and susceptible affected areas,making relevant rules of operation are the focus of our works in the future.

Objective To study the promotive effect of chitosan liquid on wound healing.Methods Wound model was established on the back of 60 rats,which were classified into 3 groups to be treated with topical chitosan liquid (group A),basic fibroblast growth factor (group B),and sodium chloride physiological solution (group C),respectively.The time required for the healing of wound was recorded.Regenerated tissues were resected from the rats on day 3,7 and 14 after the establishment of wound model,and observed with light microscopy.Results The time required for the healing of wound was 17.3 ± 1.35 days in group A,18.2 ± 1.15 days in group B,and 24.0 ± 1.37 days in group C.For the time required for the healing of wound,no significant difference was observed between the group A and B (P ＞ 0.05),but group C significantly differed from group A and B (both P ＜ 0.05).Chitosan liquid accelerated the generation of capillary sprouts and vascular endothelial cells at the early stage of wound healing,promoted the production of fibroblasts and collagen fibers at the middle stage,and improved the organization of collagen fibers at the late stage.Conclusion Chitosan liquid exerts a promising promotive effect on wound healing.

Objective To investigate the association between inflammatory biomarkers and survival in patients with stable chronic obstructive pulmonary disease(COPD).Methods A total of 1038 patients with stable COPD from January 2008 to December 2009 were included in a prospective cohort study.Clinical characteristics,pulmonary function tests,6 min walk test and a modified British Medical Research Council dyspnea scale (MMRC) were completed.Fasting blood was obtained to detect inflammatory biomarkers including neutrophils,C-reactive protein(CRP),fibrinogen,TNF-a,IL-6 and IL-8.Participants were evaluated every 3 months,all-cause mortality was used as the end event.Results 120 patients (9.2％) died in the period of follow-up.Kaplan-Meier analysis showed that 1 year,2-year-and 3-year survival rates were 94.4％,88.3％ and 84.0％,respectively.Compared with survivors,those who died had a higher level of inflammatory biomarkers.Cox multivariate regression analysis demonstrated that the independent risk factors for death were neutrophils (HR:1.262,95％CI:1.143-1.512,P=0.035),CRP (HR:1.234,95％CI:1.097-1.624,P=0.029),fibrinogen (HR:1.327,95％CI:1.141-1.619,P=0.026),TNF-α (HR:1.124,95％CI:1.043-1.659,P=0.045),IL-6 (HR:1,429,95％CI:1.237-1.816,P=0.014) and IL-8 (HR:1.188,95％CI:1.024-1.383,P=0.042).C statistical analysis showed that no single biomarker significantly improved the C statistic value on the base of clinical model,but it was further improved by the addition of all biomarkers (C =0.764,P =0.010).Conclusions The level of inflammatory biomarkers in the death with stable COPD is significantly increased.Age.BODE index,neutrophils,CRP,fibrinogen,TNF-α,IL-6 and IL-8 are independent risk factor for the prediction of mortality in patients with COPD.

Objective To study the clinical characteristics and iduronate-2-sulfatase (IDS)gene mutation of one child patient with mucopolysaccharidosis type Ⅱ (MPS Ⅱ).Methods All the 9 exons of IDS gene were amplified by polymerase chain reaction (PCR)technlogy.The PCR products were screened by direct gene Sanger sequencing.Results A missense muta-tion (c.445T>C)on exon 4 was found after the analysis of the gene sequencing results of PCR products in this patient’s IDS gene.Thi smutation leaded to the 149th codon TCT encoded serine into a CCT encoding proline (p.Ser149Pro).Mean-while,the IDS gene in the parents were widetpye,so this was a de novo mutation.Conclusion The de novo mutation of IDS gene is the cause of our patient with?mucopolysaccharidosis,one novel mutation (p.Ser149Pro)was identified.

Objective To understand the basic situation of hospital infection ,relevant problems were collected so as to pro‐vide reference for making infection control program .Methods Infection data in 2013 was reviewed and input into database which was built by EpiData3 .0 ;the descriptive statistical method was used for the characters of clinical distribution of hospital infection and χ2 test was used for the rate comparison by the SPSS17 .0 software .Results Four hundred and thirteen hospital infection cases were found in 2013 and infection rate was 1 .2% ,which was higher in patients with malignant tumor .The main parts of hosipital in‐fection were respiratory and urinary system .Escherichia coli ,Pseudomonas aeruginosa ,Acinetobacter bacteria Bauman ,Staphylococ‐cus aureus and Klebsiella pneumoniae were the main pathogen in nosocomial infection .Conclusion The focus for future prevention and control work are to strengthen hospital infection training ,susceptible sites management ,and formulate relevant rules of opera‐tion .