Objective To evaluate effectiveness of clinical pharmacists'intervention in perioperative antimicrobial use in type Ⅰ incisional surgery.Methods Clinical data of 1398 patients undergoing type Ⅰ incisional surgery in a hospital between January and December 2014 were analyzed retrospectively,633 patients who underwent surgery between January and June were as pre-intervention group,765 patients who underwent surgery between July and December were as post-intervention group (clinical pharmacists were assigned to strengthen the management and control of rational antimicrobial use),antimicrobial prophylaxis between pre-intervention group and post-interven-tion group were compared.Results In pre- and post-intervention groups,antimicrobial prophylaxis were 56.71%and 28.37% respectively(χ2= 113.26,P<0.05). Rational selection rates of antimicrobial types were 60.45% and 89.86% respectively,rational rates of administration time were 49.58% and 82.49% respectively,the rates of anti-microbial prophylaxis course≤24 hours were 11.42% and 29.95% respectively,>24 hours were 88.58% and 70.05% respectively,combination antimicrobial use were 10.31% and 0 respectively,the differences between before and after intervention were all statistically significant (all P<0.05). Incidence of surgical site infection in pre-and post-intervention groups were 0.79% (5/633)and 0.26% (2/765)respectively(P= 0.255).Conclusion Through clini-cal pharmacists'intervention in perioperative antimicrobial prophylaxis in type Ⅰ incisional surgery,antimicrobial prophylax-is rate decreased dramatically,antimicrobial management is more standardized,scientific and systematic.

Autoimmune Diseases ; diagnosis ; etiology ; therapy ; Humans ; Immunoglobulin G ; adverse effects ; blood ; chemistry

Objective To investigate the applicetion value of combined ultrasonic scalpel in laparoscopic cholecystectomy(LC).Methods 140 patients with acute and chronic cholecystitis,gallbladder stone patients,received intraoperative ultrasound combined electrosurgical knife,suction devices auxiliary red line LC.The clinical effects were observed.Results 138 cases were completed cholecystectomy.Blood loss ( 8.16 ± 1.85 ) ml,operation time(38.13 ±4.35) min,Postoperative hospital stay(3.25 ± 1.18)d,4 cases of intraoperative rupture of the gallbladder,Hepatobiliary burns in 1 case,2 cases because of dense adhesions around the gallbladder and gallbladder more extensive anatomical triangle unclear laparotomy.Conclusion The rational use of combined high-frequency ultrasonic scalpel knife,suction devices auxiliary red laparoscopic cholecystectomy,surgical conditions that meet medicalrecords,are safe and reliable,quicker recovery can be achieved by minimally invasive medical treatments.

Antineoplastic agents-induced pulmonary toxicity is one of important reasons causing respiratory failure,which clinical manifestations are pulmonary inflammation,allergic reaction,vascular permeability reaction and pulmonary vascular disease.All of these may be caused by drug toxicity,immune response and increased capillary permeability and so on.Because of the nonspecific performance,it is important to exclude the other lung diseases.Once the diagnosis is clear,the antineoplastic gents should be immediately stopped and the patients should be timely administered high-dose eorticosteroid therapy.How to reduce the pulmonary toxicity induced by antineoplastic agents is becoming one of the future focuses about antineoplastic agents research.

Objective To assess the role of MRI in the preoperative characterization and local staging of testicular neoplasms.Methods A retrospective study of 24 patients suspected of testicular neoplasm was conducted.The histological diagnosis of testicular neoplasms was made and local extension of testicular malignancy was evaluated.The MRI findings were correlated with the pathologic results.Results Histological examination revealed 26 intratesticular lesions,14 of which were nalignant,including 4 cases of diffuse large B cell lymphoma,7 cases of seminoma,2 cases of embryonal carcinoma,one case of teratoma.Twelve lesions were benign,including 5 cases of epidermoid cyst,2 cases of simple cyst,2 cases of inflammatory granuloma,2 cases of testicular mediastinal tubular expansion and one case of testicular pseudo fibroma.Six malignant testicular tumors were confined within the testis,4 invaded the testicular tunicae or epididymis,2 invaded the spermatic cord,and 2 invaded the scrotal wall.The accuracy of MRI in the diagnosis of intratesticular lesions was 92％.The accuracy of MRI diagnosis in the local staging of testicular tunors was 86％.Conclusions MRI is highly accurate in the preoperative characterization and local staging of testicular neoplasms.It is of great significance to the clinical diagnosis and treatment.

Purpose:To study the effect of amifostine on ef ficacy in patients with advanced non-small-cell lung cancer(NSCLC) treated w ith chemotherapy and the protection of amifostine on myelosuppression induced by chemotherapy and to investigate major adverse reaction induced by amfostine. Methods:33 patients with advanced NSCLC were randomly divided i nto protection group (amosfostine + MMC +VDS + DDP) and control group (MMC + VDS + DDP), The regimen was given every 4 weeks , All enrolled patients were evalua ted for efficacy and hematologic toxicity after 3 cycles of treatment , Patients in both groups were well-matched for baseline disease characteristics. Results:In protection group (PG) , the response rate was 40% (1 CR , 5 PR , 6 NC , 3 PD), whereas in control group (CG) , the response rate was 33.3% (0 CR , 5 CR , 8 NC , 2 PD), the differentce of response rates betwee n two the groups was not statistically significant (P=0.705). The minimum wh ite blood cell (WBC) counts after chemotherapy in treatment group and in control group were (3.387?1.169)?109/L and (2.46?0.98)?109/L respectively (P =0.026). The minimum blood platelet cell (BPC) counts in PG and in CG were (11 4.53?48.24)?109 /L and (88.2?32.83)?109 /L respectively (P=0.091) . The minimum hemoglobin (HB) counts in CG and in CG were (94.4?14.69)g/L and (89 .33?13.98)g/L respectively (P=0.341). Grade (Ⅱ-Ⅳ) leukopenia rate in PG and in CG were 66.7% (10/15) and 33.3% (5/15) respectively (P= 0.068), Gr ade (Ⅱ-Ⅳ) thrombocytopenia rate in PG and in CG were 33.3% (5/15) and 20% (3/ 15) respectively (P= 0.409), Grade (Ⅱ-Ⅳ) hypochromia rate in PG and in CG were 53.3% (8/15) and 46.7% (7/15) respectively (P= 0.715). Major ad verse effects of amifostine were mild hypotension , nausea and vomiting , dizzin ess , malaise etc. Conclusions:Amifostine does not reduce the efficacy of chemothe rapy in patients with advanced NSCLC , it can reduce the hematologic toxicity as sociated with chemotherapy of MVP regimen , the adverse effects of amifostine ar e mild.

OBJECTIVE:To evaluate the economic effects of different doses of methylprednisolone treatment regimes on traumatic reaction in patients with cervical spondylotic myelopathy after anterior decompressive operation.METHODS:56cervical spondylotic myelopathy cases who have been subjected to anterior decompressive operation were chosen to be the sub-jects.The56cases were divided into3groups and treated with different dosage of methylprednisolone,the initial dose for group A(18cases,low dose group)was80mg;the initial dose for group B(21cases,medium dose group)was600mg and that for group C(17cases,large dose group)was1000mg,the improvement of clinical symptom of each group was observed re-spectively and the cost-effectivenesses of the three groups were compared.RESULTS:The costs of the A,B,C groups were990.00,1339.10and1886.70yuan respectively;the effectiveness rates(E)of the A,B,C groups were5.56%,14.29%and35.29%respectively;The costs for each unit of obvious effectiveness(C/E)of the A,B,C groups were178.06,93.71and53.46yuan respectively;On the basis of group A,the needed costs of group B and C were39.99and30.16yuan respectively for each obvious effectiveness unit increase(?C/?E).CONCLUSION:Compared with group A and B,the effectiveness rates of group C had a bigger increase while the needed cost for each unit of obvious effectiveness was the lowest,therefore,the dose regimen of group C is more rational.

Objectives To evaluate the therapeutic effect of argon laser photocoagulation combined with intravitreous injection of triamcinolone acetonide (TA) on ischemic central retinal vein occlusion (CRVO). Methods Argon laser photocoagulation combined with intravitreous injection of TA was performed on 17 patients (17 eyes) with CRVO between December 2003 and July 2004. Results During the follow-up of 4-10 months, the visual acuity improved in 16 patients, including alleviated or even disappeared cystoid macular edema (CME) in 5, and recurred macular edema in 5 with decreased visual acuity after 3 months. Six patients had increased ocular pressure after intra-ocular injection which alleviated after treated suitably. No neovascularization in angle or secondary neovascular glaucoma was found. Conclusion [WTBZ]Argon laser photocoagulation combined with intravitreous injection of TA may improve the visual acuity and reduce complications in ischemic CRVO, though macular edema may recur in some cases.

The effects of ketamine on the hemodynamics in the postshock stage in 10 severely burn patients were observed.Their average burn area was 53.7?14% TBSA.Anesthesia was inducedwith 2 mg/kg of ketamine and then maintained with 50?g/kg/minute of ketamine.All the patients kept on spontaneous breathing.Measurements were performed before anesthesia,5 and 30 minutes after the induction of anesthesia.and 20 minutes after the discontinuation of ketamine.Our findings indicate that the severely burn patients in the postshock stage were in a state of active hemodynamics with increased cardiac output and decreased peripheral resistance.The plasma concentrations of epinephrine and norepinephrine were apparently increased.A small dose of ketamine could further increase the release of epinephrine,which is beneficial to the restoration of normal cardiovascular functions.

China ; Industry ; standards ; Occupational Health Services ; standards ; Reference Standards