OBJECTIVE:To investigate the utilization of vancomycin in a hospital,and provide reference for the rational use of vancomycin. METHODS:Retrospective survey was conducted for the medical records of 180 inpatients using vancomycin from Jan. to Jun.,2015 in the hospital. The general information,usage and dosage and pathogenic examination were summarized,do-mestic vancomycin rational use evaluation criteria was conducted to evaluate the medication rationality,summarize and analyze cor-responding inappropriate questions. RESULTS:The vancomycin drug utilization index(DUI)of 180 cases was 0.88(mainly elder-ly patients);the microbial test sample submission rate was 84.44%(152 cases);there were 74 cases (41.11%) about the drug combination;32 cases(17.87%)about unauthorized use;37 cases(20.56%)about inappropriate use,in which inappropriate sol-vent(12 cases,32.43%)and inappropriate drug combination(11 cases,29.73%)were the main types. CONCLUSIONS:The clin-ical application of vancomycin is good with no abusing phenomenon,and the microbial inspection rate is qualified in the hospital. But there still exists some problems or shortcomings when using vancomycin,it is necessary to further standardize the medication monitoring of vancomycin to ensure patients’safety.

AIM To explore the effects of Sini Decoction (Aconiti lateralis Radix Praeparata,Zingiberis Rhizoma,Glycyrrhizae Radix et Rhizoma) on rat myocardial fibrosis induced by isoproterenol.METHODS Forty SD rats were randomly divided into blank,model,captopril [100 mg/(kg · d)] and Sini Decoction [3.8 g/(kg · d)] groups,with ten rats in each group.Except for the blank group,the rest rats were given subcutaneous injection of isoproterenol [5 rg/(kg · d)] to prepare myocardial fibrosis model,and successive administration lasted for four weeks.At 20 h after the last administration,hemodynamics changes of heart were detected;heart weight indexes were calculated;the changes of myocardial pathological morphology were observed by HE and Masson staining;NO level in serum was measured by nitrale reduetase;SOD activity in serum was measured by xanthinoxidase method;MDA level in serum was measured by thiobarbituric acid method;the protein expressions of RhoA,ROCK1 and eNOS in myocardial tissue were detected by Western blot method.RESULTS Compared with the model group,the cardiac function of rats was significantly improved;the myocardial collagen content was significantly decreased;the MDA level in serum was obviously decreased;the NO level and SOD activity were significantly increased;the protein expressions of RhoA and ROCK1 in myocardium tissue were significantly reduced,and the protein expression of eNOS was markedly increased in the Sini Decoction group.CONCLUSION Sini Decoction can improve the isoproterenol-induced myocardial fibrosis in rats,and its mechanism may be related to inhibiting the RhoA/ ROCK signaling pathway,in turn,raising the expression of eNOS,which leads to reduced oxidative stress.

Objective To evaluate the clinical feasibility of performing the placement of drainage tube via transnasal route in treating mediastinal anastomotic fistula after surgery of esophageal cancer.Methods A total of 6 patients with mediastinal anastomotic fistula after surgery of esophageal cancer,who were admitted to authors' hospital during the period from August 2015 to January 2016,were included in this study.The diagnosis was confirmed by esophageal radiography and thoracic CT scan in all the 6 patients.Under X-ray monitoring,the drainage tube was inserted into the cavity of mediastinal fistula with the help of a guide wire guidance,and continuous negative pressure suction was adopted.The jejunum nutrition tube was inserted via the same nostril if feeding tube was not placed.Results Successful placement of fistula drainage tube and jejunum nutrition tube was achieved in all the 6 patients.In one patient the fistula drainage tube had to be re-placed as the drainage tube was obstructed five days after initial placement.Under X-ray monitoring the mean time used for the drainage tube placement was 33 min (range of 23-48 min).The procedure was well tolerated by all the 6 patients,and no procedure-related complications occurred.After continuous negative pressure suction that lasted for 6-40 days (mean of 23 days) the fistulae healed.Conclusion For the treatment of mediastinal anastomotic fistula after surgery of esophageal cancer,the placement of fistula drainage tube under X-ray monitoring is simple,safe and effective.(J Intervent Radiol,2017,26:250-252)

OBJECTIVE:To explore the characteristics and regularities of the adverse drug reactions(ADRs)induced by irino-tecan,in order to provide reference for clinical application. METHODS:In retrospective study,56 cases of irinotecan-induced ADR collected from our hospital during Jun. 2011-Jan.2015 were analyzed statistically in respects of gender,age,disease types, ECOG score,medication,organs/systems involved in ADR,clinical manifestations,outcome,etc. RESULTS:All 56 patients suf-fered from ADR,among which the percentage of hematopoietic system accounted for the highest(100%),and followed by diges-tive system;the grade Ⅰ-Ⅱ ADRs accounted for 87.20%,the grade Ⅲ-Ⅳ ADRs accounted for 12.80%. 64.50% of ADRs oc-curred within 1 week. In respect of conversion,85.71%(48/56)of the patients recovered with supportive care and continued che-motherapy,the remaining 8 cases had to reduce the dose of chemotherapy and then recovered. CONCLUSIONS:With regular dose,irinotecan is well tolerated. Since ADRs induced by irinotecan are slight,all the ADRs are well managed. It is important to enhance follow-up observations of patients to prevent some serious ADRs.

Objective To investigate the changes in prevalence of nutritional risk and undemutrition in patients with head and neck cancer during radiotherapy.Methods In this longitudinal observational study,a convenience sampling method was used to recruit patients with head and neck cancer who were receiving radiotherapy in Beijing Cancer Hospital.Nutritional Risk Screening 2002 (NRS 2002) was applied to assess the prevalence of nutritional risk in the patients,and Patient-Generated Subjective Global Assessment (PG-SGA) and body composition test to determine the prevalence of malnutrition (undernutrition) before,during and after radiotherapy.Results 56 patients finished the three follow-up exams.Along with the progress of radiotherapy,the scores of NRS 2002 increased gradually (1.64±1.09 vs.2.30 ±1.06 vs.3.14 ±1.07,x2 =46.639,P＜0.001),and the prevalence of nutritional risk also increased gradually (21.43％ vs.37.50％ vs.71.43％,x2 =29.700,P ＜0.001);the total scores of PG-SGA [1 (1-13) vs.6 (1-15) vs.12 (1-18),x2 =63.206,P＜0.001] and dimensions of weight [0 (0-4) vs.1 (0-4) vs.3 (0-6),x2 =40.798,P＜0.001],intake [0 (0-2) vs.1 (0-2) vs.2 (0-4),x2=64.707,P＜0.001] and symptoms [0 (0-7) vs.2 (0-10) vs.6 (0-11),x2 =61.562,P ＜ 0.001] all increased gradually with statistical significance.The prevalence of malnutrition in different stage of radiotherapy were significantly different (x2 =64.999,P ＜ 0.001).The body composition analysis in 40 patients showed that all the indicators of body composition decreased significantly along with the progress of radiotherapy.There was a great loss in patients' body weight during radiotherapy,especially the fat-free mass.Conclusions The prevalence of nutritional risk and undernutrition may increase in patients with head and neck cancer during radiotherapy.Lean body mass accounted for most of the weight loss.We should pay more attention to those patients' nutritional status during radiotherapy.

Adenoma ; diagnosis ; etiology ; Adult ; Esophageal Neoplasms ; complications ; diagnosis ; Humans ; Male ; Parathyroid Neoplasms ; diagnosis ; etiology

Objective To discuss the nursing intervention of Rey syndrome in children patients.so as to search effective nursing measures.Methods 12 children patients with Rey syndrome received comprehensive nursing treatment with reducing intracranial pressure and were under continuous close observation.Slightest changes were feeded back timely,then effective nursing measures were taken to stabilize their illness,patients also received dietary therapy,medication nursing and rehabilitation training,etc.Results All patients ameliorated after 3 to 7 days,and achieved clinical recovery after 20 to 30 days without sequelae.Conclusions Early diagnosis and correct effective nursing care can improve curative rate and avoid the occurrence of complications and sequelae.

Objective To study the consistency and complementarity of endoscopic ultrasonography (EUS),white light endoscopy (WLE) and magnifying endoscopy (ME) in diagnosis of ulcerative colitis (UC).Methods We collected 125 cases of UC patients diagnosed by WLE and EUS (including 51 cases of WLE + ME + EUS).According to UC mucosal morphology under WLE and crypt openings under ME,we divided all the cases into several groups and analyzed intestinal wall thickness (TWT) under EUS in each group.Results According to the results of UC inflammation degree under WLE,all patients were divided into four groups: 16 severe cases,46 moderate cases,44 mild,and 19 remission stage.TWT results were (5.903 ± 1.551 ) mm,(4.673 ± 1.235 ) mm,(3.756 ± 1.322 )mm and ( 3.464 ± 0.970) mm,respectively.Differences were significant between any two groups ( P ＜ 0.05 ),except for that between mild and remission groups.According to the results of UC inflammation degree under ME,all patients were divided into six groups: 9 cases of villous-like structure,9 cases of typical coral reef-like structure,8 severe coral reef-like structure,13 regular crypt opening,6 epithelial minimal defect and 6 small yellow spot (SYS).TWT results were (5.701 ±0.941 )mm,(5.518 ±0.581 )mm,(5.181 ±0.751 )mm,(3.763 ±0.659) mm,(3.587 ±0.461 )mm and (2.505 ± 0.330 )mm,respectively.Differences were significant between any two groups ( P ＜ 0.05 ) except for those between epithelial minimal defect and regular crypt opening,typical coral reeflike structure,villous-like and severe coral reef-like structure.EUS results showed SYS (6/6) and regular crypt opening ( 10/13 ) were mostly located in mucosa,while lesions of severe coral reef-like structure (8/8) invaded the muscularis propria.Conclusion EUS shows high consistency with WLE and ME in diagnosis of UC inflammation degree and invasive depth.It could assist and even substitute ME for evaluation.

Objective To explore the role of intercellular adhesion molecule-1(ICAM-1)and lym- phocyte function-associated antigen-I(LFA-1)in the pathogenesis of Sjgren's syndrome(SS)and provide a theoretical basis for clinical therapy.Methods Immunohistochemical method was used to detect these two cellular adhesion molecules in labial salivary glands of primary Sjgren's syndrome patients and 15 healthy controls.Semiquantitative analysis was performed by image analysis software.Results①In salivary gland samples,the expression of both ICAM-1 and LFA-1 was significantly higher compared to that of controls(P