OBJECTIVE:To evaluate the perioperative utilization of antibacterial drugs in patients undergoing modified radical mastectomy. METHODS: In this retrospective study, the perioperative utilization of antibacterial drugs in patients who underwent modified radical mastectomy during 2006 and 2006 were analyzed statistically. RESULTS: 100% of the patients received antibacterial drugs preventively. The problems involved in the preventive use of antibacterials manifested as medication without indications, irrational application of broad-spectrum antibacterials, frequent change of drugs, blind drug combination, inappropriate time of initial administration and prolonged drug use etc. CONCLUSION: The perioperative use of antibacterial drugs in patients undergoing modified radical mastectomy in our hospital is far from rational. The Clinicians' medication behavior should be standardized and supervision on rational drug use should be strengthened.

OBJECTIVE: To discuss the clinical characteristics and the patterns of allergic reaction(ADR) caused by aminoglycosides.METHODS: 98 ADR cases induced by aminoglycosides were retrieved from domestic journals reported from Jan.1990 to June 2007 for a statistical analysis.RESULTS: The ADR of aminoglycosides was closely related to route of administration,unreasonable application,allergic history,etc.CONCLUSION: The ADR of aminoglycosides and rational use of aminoglycosides should be strengthened further in the clinical practice.

Objective To study the CT and MRI findings of ganglioneuroma and compare with pathology . Methods Clinical data of 12 patients with ganglioneuroma confirmed by surgical pathology were retrospectively ana -lyzed.All patients underwent CT and MRI , and the results were compared with pathological results .Results The average size of the lesion was (4.7 ±1.2)cm,CT scan was uneven or uniform density.In MRI plain scan,T1WI showed heterogeneous low signal ,T2 WI showed uneven contour signal ,the middle part of the strip of low signal .12 cases received enhanced MRI scan ,there were four cases of non-enhanced,mild enhancement in 3 cases,uniformity progres-sive strength enhanced with two cases ,uneven progressive enhancement in 3 cases,there was 1 patient with edge of the annular reinforcing ,in accordance with CT scan results .Conclusion When CT and MRI used as the detection means of ganglioneuroma ,its performance has a certain characteristic ,and that reflects in large part the tumor shape ,size and tis-sue composition .And pathological tumor is rich in a lot of mucus matrix has a certain relationship .

China ; epidemiology ; Diagnostic Techniques and Procedures ; Epidemiologic Studies ; Hematologic Diseases ; diagnosis ; epidemiology ; Humans ; Incidence ; Meta-Analysis as Topic ; Multicenter Studies as Topic ; Prevalence ; Randomized Controlled Trials as Topic

Based on the discussion of the present English teaching in medical colleges and universities in China,this paper clarifies the mission and task of English teaching in medical colleges and universities and proposes that medical colleges and universities should attach importance to the education goals and needs of the department,major and students in the information age.It is believed that a scientific,reasonable and perfect English curriculum can be achieved by integrating IT into English curriculum,applying individualized teaching mode and expanding course connotation.

The second edition physiology published by People's Health Publishing House has been re-drawn and added many illustrations. The illustrations of the new version have improved significantly in the clarity,aesthetics,science,information-rich,etc.It will help to improve the quality of teaching.Some experiences can be got by drawing: First, it is necessary to fully understand the physiological knowledge.Second,one of reference materials should be selected as a template to make creative working.Third,some basic principles should be followed,such as reasonable layout,appropriate grayscale,rich content,simple composition,etc.

Objective To investigate the therapeutic effect of bundle treatments for critically ill patients with pulmonary tuberculosis and respiratory failure (RF).Methods A prospective study was conducted, including 56 patients with pulmonary tuberculosis and RF necessary for invasive mechanical ventilation admitted into Department of Critical Care Medicine of the Fourth People's Hospital of Nanning City from January 2013 to December 2014 as the observation group to be treated by bundle treatments. A series of treatments and cares were given to the critically ill patients, such as invasive mechanical ventilation, application of antibiotics by experience within the first hour, supportive treatment targeted to hemodynamics in early stage, correction of brain dysfunction, effective therapy for tuberculosis, establishment of enteral nutrition in early stage and prevention of ventilator-associated pneumonia (VAP), etc. All the above treatments were completed one by one in 6 hours to 12 hours. Meanwhile, 42 patients who hospitalized from January 2011 to December 2012 and treated with conventional targeted therapy were designed as the control group. The changes of vital signs, blood routine test, respiration, liver, kidney, etc organ functions, the improvement of acute physiology and chronic health evaluation Ⅱ (APACHE Ⅱ) score, expected mortality and sequential organ failure assessment (SOFA) score, the incidence of VAP, cure and improvement rate, mortality, duration of invasive mechanical ventilation, the length of stay in intensive care unit (ICU) were compared between the two groups after treatments.Results There were no statistically significant differences in the comparisons between the two groups before and after treatments in temperature, white blood cell count (WBC), blood glucose, total bilirubin (TBil), alanine transaminase (ALT), albumin (Alb) and cholesterol level (allP > 0.05), except the platelet (PLT) count in observation group was higher than that in control group before treatments. After treatments for 72 hours, in the two groups, the heart rate (HR), respiration rate (RR), APACHE Ⅱ score and expected mortality were lower than those before treatments, while the arterial partial pressure of oxygen (PaO2) and oxygenation index were higher than those before treatments. There were no statistically significant differences in pH value, PLT, arterial partial pressure of carbon dioxide (PaCO2) and SOFA score before and after treatments in the control group (allP > 0.05). In the observation group, after treatments, the pH value was increased compared with that before treatments, while PLT, PaCO2 and SOFA score were decreased compared with those before treatments (allP < 0.05). The degrees of improvement of PaCO2 and oxygenation index in the observation group were superior to those in the control group [PaCO2 (mmHg, 1 mmHg = 0.133 kPa): 43.32±9.10 vs. 56.10±9.39, oxygenation index (mmHg): 330.60±100.98 vs. 245.65±83.20, bothP < 0.05]. After bundle treatments, compared with control group, the incidence of VAP was decreased [16.07% (9/56) vs. 33.33% (14/42),P < 0.05], improvement and cure rate was increased [78.57% (44/56) vs. 59.52% (25/42),P < 0.05] and mortality was decreased significantly in observation group [10.71% (6/56) vs. 28.57% (12/42),P < 0.05]. The duration of invasive mechanical ventilation (days: 9.15±3.59 vs. 16.96±13.44) and the length of stay in ICU (days: 13.30±4.24 vs. 23.00±15.03) in the observation group were shorter than those in the control group, but no statistically significant differences were found (bothP > 0.05).Conclusion The bundle treatments can effectively reduce the incidence of VAP and elevate the improvement and cure rate in patients with pulmonary tuberculosis complicated with RF.

OBJECTIVE To investigate the changes in and clinical significance of C-reactive protein(CRP) and endotoxin in patients who are firstly examined in fever clinic.METHODS To review and study the results of CRP and endotoxin from 81 patients(including 48 patients who were diagnosed as bacterial pneumonia and 33 patients who were diagnosed as a cold) in fever clinic of our hospital in 2005.RESULTS In 81 bacterial infection patients, the analysis indicated the levels of endotoxin between the pneumonia patients and the patients with a cold had significant difference.And the levels in the first group were significantly higher than in the latter one.The levels of CRP had no difference in two groups.CONCLUSIONS The result indicates plasma endotoxin detection helps to determine the early diagnosis of serious infection.It is also of significance to select antibacterial rationally and handle syndrome in time.In fever clinic,the levels of endotoxin may be a method to help diagnosis and treatment.CRP could be help to estimate the bacterial infection or virus infection,but it could not adjudge the seriousness in bacterial infection.

Objective:To observe the application of pulse indicator continuous cardiac output (PICCO) system monitoring in the treatment of patients with severe thoracic trauma with the complication of acute respiratory distress syndrome (ARDS).Methods: 60 patients with severe thoracic trauma with complication of ARDS were randomly divided into the PICCO group (30cases) and the PAC group (30cases). The differences of PaO2/FiO2 score, acute physiology and chronic health evaluation Ⅱ (APACHE Ⅱ) score, mortality, mechanical ventilation time, ICU stay time and total treatment cost between the two groups were observed.Results: The PaO2/FiO2 of PICCO group in 1d, 3d and 7d were significantly higher than that of PAC group, respectively (t=4.46,t=3.87, t=5.15,P<0.05). In the 7th day, the APACHE II of PICCO group was significantly lower than that of PAC group (t=1.94,P<0.05). Besides, the mechanical ventilation time, ICU stay time and total treatment cost of PICCO group were significantly lower than these of PAC group, respectively (t=3.36, t=2.58,t=5.53,P<0.05). While there was no difference for mortality between the two groups (x2=0,P>0.05). Conclusion: In the treatment for patients with severe thoracic trauma with ARDS, PICCO system monitoring could reduce the mechanical ventilation time, ICU stay time and total treatment costs of patients, and enhance the treatment effect of patients.