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OBJECTIVE To look into and analyze the application of antibacterial used in our hospital in order to enhance the rationality of clinical usage. METHODS We conducted the survey by means of picking out examples in numbers within a definite range,looking back at the records with regard to it from Jan 2004 to Dec 2004. RESULTS Altogether there were 5 302 medical records.The percentage of using antibacterial was 70.24%,from which 45.22-36.68% were used two kinds and 8.54% were used more than two kinds.As to the basis,preventive use taken up a large proportion,accounted for 48.93%;the main route was by intravenous injection,which added up to 74.03%.Of the antibacterials applied,the first three were penicillins;aminoglycosides;cephalosporins.The percentage for surgical application was 94.49%,from them 57.14% used 2 or more kinds for treatment of incision of type Ⅰ. CONCLUSIONS It is very necessary and urgent to supervise the management of the rational application of antibacterial.

Objective To investigate the factors related to choice of community health service centers (CHSCs) in standardized training general practitioners (GPs) in Shanghai.Methods Totally 152 GPs,(including those of Traditional Chinese Medicine) who completed the residency training in 2013 and signed employment contract with community in Shanghai were surveyed with a self-designed questionnaire.Results Among all the participants,113 (74.3％) attached the greatest importance to the salary level when choosing CHSC,58 (38.2％) expected annual salary more than 120 000 Yuan during the first 3 years.GPs tended to work in the city center(40.1％) or CHSCs near to their home(38.2％),mainly because of the job commuting (59.9％).Considering career development,the CHSCs with high level comprehensive service (51.3％) and with large population (5.0％) were more attractive.GPs paid more attention to the national demonstration community (57.2％) and CHSCs with member ofShanghai outstanding young physician training program(51.7％).In this survey,household register was the main influencing factor for choosing CHSCs,Shanghai natives paid more attention to the location of the community than those not Shanghai natives (61.8％ vs.34.2％),more inclined to CHSCs that close to their house (55.3％ vs.21.1％),non-Shanghai natives preferred authorized strength (51.3％ vs.28.9％).GPs of Western medicine expected higher salary than GPs of TCM (x2 =13.648,P ＜ 0.05),Males expected higher salary than females (x2 =7.799,P ＜ 0.05),Conclusions GPs pay the most attention on salaries and tend to work in the city central area,prefer CHSC with high level comprehensive service and large served population.The main factor influencing GPs to chose CHSCs is the household register,the category of Gps and gender.

Objective To assess the reliability and validity of Chinese version National Aeronautics and Space Administration Task Load Index (NASA-TLX) and Subjective Work Assessment Technique (SWAT) in evaluating mental workload of community physicians.Methods One hundred and ten community physicians selected by convenience sampling method from Shanghai were recruited.The split-half reliability,Cronbach's α coefficient and Item-total coefficients were adopted to assess the reliability and the validity of Chinese version NASA-TLX and SWAT scales in evaluating the metal workload of participants.Results For NASA-TLX,the Split-Half,Cronbach's α coefficient was 0.703 and 0.619 respectively,all Item-total coefficients (except for performance item) were greater than 0.4 (P ＜ 0.01).For SWAT,the Split-Half,Cronbach's α coefficient of was 0.647 and 0.669 respectively,Item-total coefficients were all greater than 0.4 (P ＜ 0.01).Factor analysis showed that two scales had good structure validity; item discrimination showed satisfactory item validity (except for performance item).The Spearman correlation coefficients between two scales ranged from 0.359 to 0.465 (P ＜ 0.01).Both of the modified versions of NASA-TLX had better reliability and validity than the original one,the one with removed both performance and frustrate item was better than one with removed performance item only.Conclusions The Chinese version NASA-TLX and SWAT can serve as reliable and valid instruments for assessing the community physicians' perception of mental workload in China; and the modified version of NASA-TLX especially the one with removed performance and frustrate item seems to work better than the original one.

The spermatic granuloma is a granulomatous inflammation which is the tissue reaction due to extravasated sperm. Its exact causes and mechanism are not clearly evaluated. Its clinical interest is that it often confused with tuberculous epididymitis and other epididymal conditions. We experienced a case of spermatic granuloma that was clinically confused with tuberculous epididymitis in 23-year old Korean male.
Epididymitis ; Granuloma* ; Humans ; Inflammation ; Male ; Spermatozoa ; Young Adult

The Klinefelter's syndrome is characterized by azoospermia, gynecomastia, a variable degree of eunuchoidism elevated urinary gonadotropins, atrophic testis and hyalinization of the seminiferous tubules in which Leydig cells were preserved. Reviewing some world literatures, we have reported a case of Klinefelter's syndrome associated with right inguinal hernia in 22 year-old Korean male.
Azoospermia ; Eunuchism ; Gonadotropins ; Gynecomastia ; Hernia, Inguinal ; Humans ; Hyalin ; Klinefelter Syndrome* ; Leydig Cells ; Male ; Seminiferous Tubules ; Testis ; Young Adult

Objective To investigate the effects of enteral nutrition (EN) for diabetes mellitus on the clinical outcomes of critically ill patients with hyperglycemia.Methods Sixty-four critically il1 patients with hyperglycemia were randomly divided into the control group and intervention group.The control group was given homemade homogenized meals and the study group was given EN for diabetes mellitus.Both were given the same total energy and nitrogen content.EN was applied 3 days after ICU admission and then lasted 14 days.Blood glucose was controled at 6.1-8.5 mmol/L by insulin therapy.No albumin,blood plasma,or parenteral nutrition was provided to all patients.The lactulose mannitol ratio,biochemical indicators,total insulin dosage,and short-term and longterm outcomes were analyzed before and after EN support.The quality of life was evaluated using Stroke Specific Quality of Life Scale.Results Finally 59 patients were enrolled in the study,with 30 in the intervention group and 29 in the control group.The lactulose mannitol ratios in the intervenion group were significantly lower than those in the control group 7 days (0.221 ±0.117 vs.0.299 ±0.154,t =-2.199,P =0.032) and 14 days (0.169 ±0.122 vs.0.305 ±0.129,t =-4.191,P =0.000) after EN support.Meanwhile,the total insulin dosages were also significantly less in the intervention group [7 days,(195 ± 54) vs.(227 ± 60) U ; t =-2.096,P =0.041 ;14 days,(392 ±114) vs.(459 ±118) U; t =-2.221,P =0.030].Compared with the control group,the intervention group had significantly shorter duration of mechanical ventilation [(8.00 ± 1.75) d vs.(6.73 ±2.05) d,t=-2.547,P=0.014] and ICU stay[(10.00±1.95) vs.(8.80±2.17) d,t=-2.233,P=0.030],lower total hospitalization expenses [(56 238.39 ± 17 869.61) vs.(70 395.63 ±20 111.69) Yuan,t =-2.861,P =0.006],and faster recovery of daily activities [(17.59 ± 3.21) vs.(35.34 ± 8.65) scores,t =10.030,P =0.000] and living quality of life [(22.67 ± 4.51) vs.(40.55 ± 8.88) scores,t =9.397,P =0.000] after 90 days of treatment.Conclusion The EN for diabetes mellitus may improve the outcomes of critically ill patients with hyperglycemia compared with blend diet.

Objective To evaluate the clinical value of fiberoptic ductoscopy in diagnosis and treatment of patients with galactophoritis or mammary duct ectasia. Methods From November 2005 to March 2008, fiberoptic ductoscopy were performed in 120 women with nipple discharge. The duct of 95 cases as non-malignant lesion were insufflated and perfusioned with entamycin and dexamethasone. Results Ninty-five of 120 cases were non-malignant disease,which contained one side 81 and two sides 14; the discharge was bloody,ivory, stramineous in 21, 17, 57 patinents, respectively; and the dignosis were 17 mammary duct ectasia, 53 galactophoritis, and 25 mammary duct ectasia with galactophoritis. Of the 95 cases, hich were intradutal insufflated and perfusioned with gentamycin and dexamethasone, the nipple discharge were decreased or disappeared in 81 cases, the effective rate was 85.3%. Conclusion Fiberoptic ductoscopy is a convenient,safe, accurate method in diagnosis and treatment of patients with galactophoritis or mammary duct ectasia.

Objective To discuss the effects of implants of different thread face angles on the primary stability of immediately loaded implant using the 3-dimensional finite element analysis with the models of the immediately loaded implants. Methods Using the commercial code of Pro/E software, Hypermesh software, and ABAQUS software we created 3-dimensional finite element models. The micromotions of the finite element models with different screw face angles (V-shape, buttress, square-shape and inverse buttress) were computed with the ABAQUS software. Results Concerning different thread face angles, the micromotion of buttress implant was the minimum and the micromotion of inverse buttress implant was the maximum with vertically loading; the micromotion of inverse buttress implant was the minimum and the micromotion of buttress implant was the maximum with horizontal loading. Conclusions Different screw-types have great influence on vertical interfacial micromotions but little influence on horizontal interfacial micromotions. There are two angles which are formed by top /bottom edge and the implants. The larger are the angles, the smaller are the vertical interfacial micromotions, but the weaker of the strength. Thus in designing the screw-type implants, we should consider the angles of thread faces and the strength.

OBJECTIVETo analyze the electrical activity property changes in nucleus accumbens (NAc) of heroin-induced conditioned place preference (CPP) rats during different stages of heroin dependence and to explore NAc's roles in the formation of drug dependence.

METHODSRecording electrodes were bilaterally embedded into the NAcs of rats with the aid of stereotaxic apparatus, followed by establishment of heroin-dependent rat model. The NAc electrical activity during 3 different stages of heroin dependence, including heroin pre-exposure, immediate post-exposure and heroin withdrawal, were respectively recorded using EEG wireless telemetry techniques. The frequency distribution (ranging from 0.5 to 30 Hz) and the amplitude of NAc electrical activity were analyzed and measured.

RESULTSHeroin-dependent rat models were successfully established and their withdrawal symptoms were evident. All rats showed a conditioned place preference (CPP) for the white box after 5-10 days of heroin-exposure, and displayed a maximum withdrawal symptoms on 2d after heroin- withdrawal. During all statges of heroin-dependence, the NAc electrical activity contained the highest proportion of delta rhythm and the lowest proportion of alpha2 rhythm. The discharge frequence band was similar across different stages. There was a significantly increased ratio of low-frequency discharges (delta rhythm) and decreased ratio of high-frequency discharges (beta rhythm) in NAc of rats during the immediate post- heroin exposure stage when compared with that during pre-exposure and heroin withdrawal stages. During the withdrawal stage, the ratio of at rhythm was significantly lower than during pre- and post-heroin exposure stages (P < 0.01). Further, the mean discharge amplitude in NAcs during immediate post-exposure and withdrawal stages was significantly increased relative to pre-exposure stage. However, the mean discharge amplitude during heroin withdrawal stage was significantly lower than during immediate post-exposure stage.

CONCLUSIONThe electrical activity properties in rat NAcs showed a significant change during different stages of heroin-dependence, which suggested that neuronal activities in NAcs might contribute to the modulation of drug-dependence.

Animals ; Conditioning, Operant ; Heroin ; pharmacology ; Heroin Dependence ; physiopathology ; Male ; Nucleus Accumbens ; physiopathology ; Rats ; Rats, Sprague-Dawley ; Telemetry