OBJECTIVE:To provide reference for the perfecting of hospital information system (HIS) on drug control. METHODS: The problems encountered in using two drug control systems in our hospital were analyzed, and the constructive suggestions on its improvemen was put forward. RESULTS & CONCLUSIONS: The new HIS should be designed to overcome the weaknesses of the current HIS in code design, assignment of authority limit, drug application and dispensing, drug stocktaking so as to make full use of the merit of the computer management.

Objective To evaluate the relationship between the concentration of nitric oxide (NO) and cytological change in cerebrospinal fluid ( CSF ) and the onset of neurocysticercosis in patients. . Methods. NO Level in CSF was detected in 30 cases of neurocysticercosis, 20 cases of tuberculous meningitis (TBM) and 20 healthy people as control by using Griess method. The cytological components in CSF were also examined.. Results and Conclusion . Griess method was proved to be a rapid and accurate technique for the detection of NO content in CSF. The NO concentration in cases of neurocysticercosis and TBM was significantly higher than that of control(P

Objective To investigate the level of serum procalcitonin (PCT) for exploring the clinical value in identifying microorganism strains in the intensive care unit (ICU) patients with blood stream infections.Methods A retrospective analysis of patients with positive blood culture of a single strain and with serum PCT levels detected simultaneously was carried out from January 2010 through December 2012.The comparisons of PCT levels were done among Gram-negative (G-) bacteria,Gram-positive (G +) bacteria and fungi in patients with bloodstream infections.The diagnostic performance of PCT was determined by the receiver operating characteristic curve (ROC).Results A total of 524 patients with blood stream infection were enrolled and categorized into three different groups,namely G-bacteria infection group (n =206),G + bacteria infection group (n =276),and fungi infection group (n =42).The median value of PCT level of G-bacteria group was 14.9 ng/ml,which was significantly higher than that of the other two groups with 0.14 ng/ml and 1.76 ng/ml,respectively (P ＜ 0.01).Further,the PCT level of fungi group also obviously higher than that of G + bacteria group (P ＜ 0.001).According to ROC,PCT level at 2.11 ng/ml could distinguish G-bacteria infection from G + bacteria infection with sensitivity 82.8％ and specificity 80.1％,while PCT at 5.09 ng/ml was used to distinguish G-bacteria infection from fungi infection with sensitivity 68％ and specificity 73.8％.The area under the ROC of G + bacteria and fungi was 33.0％ (P ＜ O.01).Conclusions Serum PCT level is valid for distinguishing ICU patients with blood stream infection caused by G-bacteria from G+ bacteria or from fungi,but the validity of PCT for distinguishing G + bacteria from fungi infection needs to be set up by further studies.

Objective To explore the effect of ACE-inhibitor perindopril on the expression of scavenger receptor A (SR-A) gene in the kidney of diabetic rats.Methods Diabetes were induced in male Sprague-Dawley rats by peritoneal injection with streptozotocin (60mg/kg).The rats were then random di vided into normal control group, diabetes group and ACEI treatment group [4mg/(kg·d) for 24 weeks].Blood glucose concentration and 24h urinary albumin excretion were determined.The renal morphological change was observed.Immunohistochemistry was used to analyze CD68 positive macrophages,and the Mrna of SR-A in renal tissue was detected by quantitative real-time PCR.Results Compared with normal control group,blood glucose concentration,24h urinary albumin excretion and the number of CD68 positive macrophages were significantly increased [(5.3 ± 0.6) mmol/L vs (26.7 ± 3.3) mmol/L;(2.7 ± 1.3) mg/24h vs (26.7 ± 1.8)mg/24h;(0.77 ±0.24)/gcs vs (2.55 ±0.46)/gcs;(6.13 ±0.50)/HPF vs (11.9 ±2.12)/HPF;P ＜0.05],and the expression of SR-A Mrna were significantly up-regulated in diabetes group [ (5.6 ± 1.2 vs 1.5 ±0.2),P ＜0.05].After intervention with ACE-inhibitor,the up-regulations of the above mentioned parameters,except blood glucose concentration,were all significantly inhibited [ (3.6 ±1.4)mg/24h;(1.03±0.37)/gcs;(8.28±1.19)/HPF;3.4±0.7;P ＜0.05].Conclusion ACE-inhibitor might have renoprotective effects of diabetic nephropathy,it probably was associated with inhibiting the expression of SR-A gene.

Humans ; Leg Injuries ; surgery ; Male ; Middle Aged ; Surgical Procedures, Operative ; adverse effects ; Surgical Wound Infection ; etiology ; surgery

Objective To study the safety and efficacy of therapeutic endoscopic retrograde cholangiopancreatography (ERCP) in elderly patients with biliary and pancreatic diseases under the concept of enhanced recovery after surgery (ERAS). Methods 320 patients were enrolled in ERCP operation. Both ERAS elderly group (experimental group A, n = 58, above 75 years) and young and middle-aged group (control group B, n=202,below 60 years)underwent enhanced recovery after surgery,meanwhile traditional elderly group(control group C, n = 60, above 75 years) received traditional perioperative management. It had compared multiple clinical indexes between group A with B and group A with C during the preoperative, intraoperative, and postoperative period. Results The incidence rate of cholangiocarcinoma, multiple complications, nutrition screening ≥ 3 points, ASA scored III degree and Child-Pugh scored A-level in preoperative ERAS elderly patients were higher than that of the young and middle-aged group (P < 0.05); And its incidence rate of nausea and vomiting and abdominal pain,nutritional screening < 3 points and ASA scored I degree were lower than that of the middle-aged group (P < 0.05);the fasting and water- deprivation time of the ERAS elderly group was shorter than that of the traditional elderly group (P < 0.05). The intraoperative operation time of the elderly ERAS group was slightly longer than that of the traditional elderly group (P < 0.05). The duration of electrocardiographic monitoring and the first aerofluxus time of the elderly patients with ERAS were longer than that of the young and middle-aged group (P < 0.05). The success, failure rate, and complication rate of the elderly patients with ERAS were 91.38% (53/58) and 8.62% (5 /58), 3.45% (2/58), meanwhile the young and middle-aged group were 96.53% (195/202), 3.47% (7/202), and 4.95% (10/202), and with no statistical difference (P > 0.05). The mild pain in ERAS elderly group was more than that of in traditional elderly group, while the moderate, and severe pain was less than that of traditional elderly group (P < 0.05); The opioid use rate, endoscopic nasobiliary indwelling, first-time ambulation and aerofluxus, total hospitalization, and postoperative hospitalization time of ERAS elderly group was less than the traditional elderly group (P < 0.05). Conclusions With ERAS, the treatment effect of ERCP in elderly patients is similar to that in young and middle-aged people, and it has good safety and effectiveness.

Objective To systematically evaluate the association between vascular endothelial grow th factor‐C (VEGF‐C) ex‐pression in breast cancer tissue and clinical significance in the domestic patients with breast cancer by a Meta‐analysis .Methods The published case controlled trials on the VEGF‐C expression and the clinical manifestations of breast cancer were retrieved from the CNKI ,CBM ,VIP and Wanfang databases ,and other relevant journals were also manually retrieved to identify all the relevant case controlled trials .The retrieval year limit was from the database establishment to June 2014 .The included literatures were screened according to the inclusion and exclusion standards and the quality of included case controlled trials was assessed .The Rev‐Man 5 .2 software was used to conduct the Meta analysis .Results A total of 15 case controlled trials involving 975 patients with breast cancer were included .The Meta analysis results revealed that there were statistical differences in the VEGF‐C expression be‐tween the breast cancer group and the control group[OR = 8 .16 ,95% CI(5 .77 ,11 .54)] ,between the lymph node metastasis posi‐tive group and the non‐lymph node metastasis negative group[OR = 5 .19 ,95% CI(3 .63 ,7 .44)] and between the clinical stage Ⅰ -Ⅱ group and the stage Ⅲ - Ⅳ group[OR = 0 .35 ,95% CI(0 .21 ,0 .59)] ;the difference in the VEGF‐C expression between the 0 - <50 years group and the ≥ 50 years group had no statistical significance ,indicating that the VEGF‐C expression had no obvious as‐sociation with the patient′s age .Conclusion The present evidences reveal that VEGF‐C maybe participate in the development and progression process of lymph node metastasis of breast cancer and may be become an important factor influencing the prognosis of breast cancer .

Objective To study comprehensive nursing meassures for small area of diabetic foot ulcer. Methods A total of 58 patients with small area of diabetic foot ulcer in our department were divided into two groups.The comprehensive nursing group (CN group,30 cases) adopted comprehensive nursing and treatment as follows, surgical dcbridement, infrared radiation of wound surface,sprinkling of growth factors(bFGF and rhEGF),covered by hydrocolloid dressing(Algoplaque).The control group(28cases) received hydropathic compress with 0.5% povidone iodine or 5% furacillin solution.Wound heal-ing progreasion,average healing time and the positive rate of wound germiculture of the two groups were observed. Results The average healing time of the CN group was (29.6±9.4)d,which was shorter than that of the control group,( 39.2±13.5 )d, P < 0.05. Statistical difference existed in the positive rate of wound germiculture at the 7th day and the 14th day between the two groups (P < 0.05). Conclusions Routine medical treatment and general nursing measures plus surgical debridement,infrared radiation of wound sur-face,sprinkling of growth factors and hydrocolloid dressing possess facilitative healing effect for small area of diabetic foot ulcer.

Objective To investigate the effect of an ACE inhibitor ,perindopril ,on the expression of SR‐A in renal tubuloint‐erstitium of diabetic rats .Methods Diabetes was induced in male Sprague‐Dawley rats by injection with streptozotocin .The rats were then randomly divided into 3 groups:normal control group;untreated diabetes mellitus group and diabetes mellitus group trea‐ted with perindopril .After a 24‐week treatment ,tubulointerstitial injury index was assessed with Masson′s trichrome sections .The expression of SR‐A mRNA was detected by RT‐PCR and the expression of SR‐A protein in renal tubulointerstitium was detected by immunohistochemistry .Results The tubulointerstitial injury index ,the expression of SR‐A mRNA were significantly higher in the diabetes group than those in normal control group .Perindopril treatment not only attenuated the tubulointerstitial injury ,but also reduced the overexpression of SR‐A mRNA in diabetic rats .The expression of SR‐A protein was most obvious in renal tubulointer‐stitium in diabetic rats ,which was obviously attenuated by perindopril treatment(P<0 .05) .Conclusion The findings of the this study indicate that perindopril may have renoprotective effects on diabetic nephropathy via inhibiting the expression of SR‐A in re‐nal tubulointerstitium .

Objective To explore the effect of competency based education (CBE) in the nursing training of GNS (gerontological nurse specialist).Method The CBE was used in the nursing training of GNS and the differences in knowledge and nursing skills,ability in nursing training,and aiblity in organization and scienticific research.Result After the training,the GSN was above 80 in knowledge and skills,ability in nursing training,ability in organization and scientific research and self-assessment better than that before training (P＜0.05).Conclusion The CBE for the nursing training can upgrade the abilities in the GSN in the aspects of knowledge and skills,nursing training,organization and scientific research so that they become more competent in the gerontological nursing.