Objective:To analyze the use status of antibiotics and the resistance of clinic isolate bacteria against the commonly used antibiotics before and after the intervention. Methods:Using the information retrieval systems, the consumption of antibiotics in the inpatients during the 1st quarter of 2012(before the intervention) and the same period of 2013(after the intervention) was com-pared. According to the defined daily dose ( DDDs) , the antibiotics were ranked, and the resistance rate against the commonly used antibiotics was analyzed. Results:Compared with the top ten before the intervention, the top ten after the intervention was changed sig-nificantly, however, cephalosporins was still the main species. After the intervention, the overall decline in DDDs was significant, the separation rate and distribution of bacteria remained stable. ESBLs enzyme production rate of Enterobacteriaceae Escherichia coli was re-duced by 7. 61%, and that of Klebsiella pneumoniae was reduced by 1. 34%, and the resistance rate against the commonly used antibi-otics was in an overall downward trend. The resistance rate of Gram-positive staphylococci against the commonly used antibiotics was de-creased, while that of Gram-positive enterococci showed notable difference. Conclusion:The DDDs of antibiotics and bacterial resist-ance rate are in an overall downward trend in our hospital after the intervention;however, there is still exception. Therefore, the clini-cal antimicrobial susceptibility tests should be performed as soon as possible to help the choice of antibiotics.

Objective:To provide some thoughts for pharmaceutical treatment and care for the patients with pulmonary infection af-ter renal transplantation. Methods:Clinical pharmacists participated the whole treatment process of one case of pulmonary infection af-ter renal transplantation. According to the literatures combined with medical history, clinical symptoms and lab results, the drug treat-ment process of the patient was analyzed, and the key points of the optimized pharmaceutical care were summarized. Results: The pharmaceutical care included the dose adjustment of immunosuppressants at the early phase of the disease and after the improvement of clinical symptoms, attention paid to the interactions between multiple anti-infective drugs and immunosuppressive agents, dosage ad-justment based on the renal function of the patient, monitoring adverse drug reactions and drawing up personalized regimen. Conclu-sion:Through comprehensive medication monitoring, clinical pharmacists can help physicians develop timely and effective treatment programs and provide professional and effective pharmaceutical care for patients.

Objective Gastrointestinal rehydration is a simple and effective method in treatment of burn shock during war-time, fire disaster and other harsh conditions , and practice has proved the exact curative effect of HCO 3 salt sugar liquid .This article was to investigate the effect of pyruvate-enriched oral rehydration solution ( Pyr-ORS ) on intestinal mucosal blood flow ( IMBF ) , activity of Na +-K+-ATPase and intestinal absorption rate during en-teral resuscitation of a 35% TBSA third-degree scald in rats . Methods 90 male rats were randomly divided into 5 groups: scald without fluid resuscitation ( S group ); sham scald resuscitated with HCO3 salt sugar liquid ( SS HCO3 group ); sham scald resuscitated with Pyr-ORS ( SS Pyr-ORS group ); scald resuscitated with HCO 3 salt sugar liquid (S HCO3 group); scald resuscitated with Pyr-ORS (S Pyr-ORS group) (n=18).Each group was divided into 2 subgroups of 1.5 and 4.5 h after scald injury.Intestinal absorption rate of water and Na +, IMBF and activity of Na +-K+-ATPase were detected on each group . Results Compared with shame scald groups , the intestinal absorption rates of water and Na +decreased ob-viously in scald groups with fluid resuscitation (P<0.05);at 1 h after scald injury, the intestinal absorption rates of water and Na +in S Pyr-ORS groups were both higher than those in S HCO 3 groups(P<0.05).Compared with shame scald groups , IMBF and activity of Na+-K+-ATPase at 1.5 and 4.5 h after scald injury decreased obviously in scald groups with fluid resuscitation (P<0.05); at 1.5 and 4.5 h after scald injury, IMBF in S Pyr-ORS groups (95.250 ±5.096/112.765 ±7.215) were greater than those in S HCO3 group (80.764 ±7.852/94.671 ±8.469), which was of statistical significance (P<0.05). Conclusion Pyr-ORS is a simple and effec-tive method in treatment of burn shock during wartime , fire disaster and other harsh conditions .

Objective:To analyze the drug resistance of Pseudomonas aeruginosa( PA) isolated from clinical specimen to provide the guidance for the clinical treatment. Methods:The infection status of PA from January 2012 to December 2012 was reviewed retro-spectively, and the results of susceptibility test for 448 PA strains were analyzed. Results:The antibiotic susceptibility of the PA strains to cefoperazone sodium and sulbac, ampicillin aodium and aulbacta,aiprofloxacin,cefepime,piperacillin/ sulbactam,amikacin, ceftazi-dime,meropenem, imipenem, minocycline, selectrin and aefuroxime was 100%, 76%, 72. 8%, 69. 4%, 66. 3%, 65. 6%, 64. 8%, 59. 9%,28. 9%,2. 4% and 0%,respectively. Conclusion:PA is one of the main pathogenic bacteria for nosocomial infection. It is necessary to strengthen the drug resistance test and standardize the application of antibiotics in order to provide the reference for clinical rational use of antibacterial drugs.

OBJECTIVETo evaluate the clinical value of transoesophageal echocardiography on periventricular closure of ventricular septal defects (VSD).

METHODSTransoesophageal echocardiography (TEE) was performed in 27 patients with VSD diagnosed by the transthoracic echocardiography examination (TTE) and prepared to receive periventricular closure of VSD for the purposes of choosing the appropriate occluder before VSD closure and guiding occluder release during the operation and evaluating the post operative effects of VSD closure 1 week post operation.

RESULTSThree patients with VSD not suitable for periventricular VSD closure according to TEE results were not operated, periventricular closure of VSD were successfully performed in 20 patients and minimal residual shunt was seen in 1 patient post operation, periventricular closure of VSD failed in 4 patients and these patients received surgical closure. TEE at 1 week post successfully with periventricular closure of VSD in the 20 patients showed that there were no residual shunts and the pulmonary artery pressure was significantly lower post operation compared to that of preoperation value.

CONCLUSIONTEE is helpful in choosing the suitable patients and occlude size, guiding occlude release and evaluating the post operative results for periventricular closure of ventricular septal defects.

Adolescent ; Cardiac Catheterization ; methods ; Child ; Child, Preschool ; Echocardiography, Transesophageal ; Female ; Heart Septal Defects, Ventricular ; diagnostic imaging ; therapy ; Humans ; Infant ; Male ; Young Adult

OBJECTIVETo study the gastric function after esophagectomy and cardiectomy with vagus nerve preserved and reconstruction of gastric funds (VPRG)in patients with esophageal cancer (EC) and cardiac cancer (CC).

METHODSSixty-eight patients with early or middle staged EC or CC received esophagectomy and cardiectomy with vagus nerve preserved and reconstruction of gastric funds (VPRG),while other 68 patients esophagectomy and cardiectomy with vagus nerve severed and no reconstruction of gastric funds (VSNG) as control. The symptoms,the pressure of the residual esophagus and thoracic stomach, 24-hour pH monitoring, mean basic gastric acid output, gastric emptying time of the intrathoracic stomach,fasting serum gastrin level, fibreoptic endoscopic results were compared before and after operation between the two groups.

RESULTSThe patients with VPRG had less symptoms after operation than those with VSNG such as anorexia, belch, reflux, heartburn, nausea, diarrhea, postcibal satiety (P< 0.01). In VPRG group,compared with the results before operation,there were no significant differences in 24-hour pH monitoring,the mean basic gastric acid output, the fasting serum gastrin level,the gastric emptying time of intrathoracic stomach one month and one year after operation (both P > 0.05). The pressure of the residual esophagus above the anastomosis in VPRG group was significantly higher than that in VSNG group (both P< 0.05). Fibreoptic endoscopic examination revealed higher incidences of postoperative atrophic gastritis and reflux esophagitis in VPRG group one month and one year after operation than those in VSNG group (P< 0.01).

CONCLUSIONPreservation of the vagus nerve and reconstruction of gastric funds after esophagectomy and cardiectomy for esophageal and cardiac cancer can prevent digestive disorder and improve the life quality of the patients.

Adult ; Esophageal Neoplasms ; surgery ; Esophagectomy ; methods ; Female ; Humans ; Male ; Middle Aged ; Reconstructive Surgical Procedures ; methods ; Stomach ; physiopathology ; Vagus Nerve ; surgery

Aggressive Periodontitis ; genetics ; Cathepsin C ; genetics ; Child ; Humans ; Male ; Mutation ; Polymerase Chain Reaction

OBJECTIVETo study the possible association between interferon regulatory factor 5 (IRF5) gene polymorphism and allergic rhinitis (AR).

METHODSSix independent single nucleotide polymorphism (SNP, rs729302, rs4728142, rs3807306, rs2070197, rs11770589, rs2280714) were analyzed. The genotype and allele frequencies were detected in 110 AR patients and 101 healthy controls in Singapore Chinese population by polymerase chain reaction (PCR) and restriction fragment length polymorphism (RFLP).

RESULTSRs729302 was rejected as it was not polymorphic. For others SNP, no statistically significant difference was detected in genotype between AR and healthy control group (χ(2) value were 0.21, 5.02, 0.01, 2.91, 0.37, all P > 0.05). No statistically significant difference was detected in allele frequencies between AR and healthy control group (χ(2) value were 0.00, 2.78, 0.01, 2.31, 0.00, all P > 0.05).

CONCLUSIONNo association is observed between IRF5 and AR in Singapore Chinese population.

Adolescent ; Adult ; Aged ; Case-Control Studies ; Female ; Gene Frequency ; Genotype ; Humans ; Interferon Regulatory Factors ; genetics ; Male ; Middle Aged ; Polymorphism, Single Nucleotide ; Rhinitis, Allergic ; Rhinitis, Allergic, Perennial ; genetics ; Singapore ; Young Adult

AIM To establish a molecular imprinted polymers (MIPs)-HPLC method for the simultaneous content dertermination of four flavonoids in Rubus chingii Hu.METHODS Fe3O4 magnetic MIPs was added into ethyl acetate fraction solution of R.chingii to prepare mixed MIPs.The analysis of mixed MIPs methanol eluent was performed on a 30 ℃ thermostatic Diamonsil C18 column (250 mm ×4.6 mm,5 μm),with the mobile phase comprising of acetonitrile-0.1％ formic acid flowing at 1.0 mL/min in a gradient elution manner,and the detection wavelength was set at 266 nm.RESULTS Tannins,lilsonide,quercetin and kaempferol showed good linear relationships within the ranges of 2.4-1 232.0 μg (R2 =1)、7.1-3 648.0 μg (R2 =0.999 9)、4.7-4 840.0 μg (R2 =0.999 9)、4.8-2 440.0 μg (R2 =0.999 9),whose average recoveries were 98.94％,99.33％,99.26％ and 98.67％ with the RSDs of 2.04％,1.40％,1.76％ and 1.75％,respectively.CONCLUSION This accurate and reliable method eliminates impurity interference,which can be used for the content determination of flavonoids in R.chingii.

There have been several epidemiological studies evaluating the potential association between the methylenetetrahydrofolate reductase (MTHFR) A1298C polymorphism and the risk of male infertility.However,the results obtained were inconsistent.Therefore,we performed a meta-analysis to further examine the association between the MTHFR A1298C polymorphism and male infertility.A comprehensive search was conducted to identify all eligible studies from the online literature databases published prior to January 15th,2016.A total of 20 studies with 4293 cases and 4507 controls were included.An odds ratio (OR) and a 95％ confidence interval (95％ CI) were calculated to assess the strength of the association.A cumulative meta-analysis,sensitivity analysis and assessment of the publication bias were also performed in this study.The results showed that in the overall analysis,the association between the MTHFR A1298C polymorphism and male infertility was not significant.A stratified analysis by ethnicity revealed a significant increase in the risk of male infertility in the Asian population with the MTHFR A1298C polymorphism (especially in the heterozygote model:OR=l.20,95％ CI=1.01-1.44,P=0.994;the dominant model:OR=1.23,95％ CI=1.04-1.45,P=0.996;and the allele model:OR=l.20,95％ CI=1.04-1.39,P=0.985) but not in the Caucasian population.In the stratified analyses,no significant association was observed between the different types of male infertility.This meta-analysis suggests the MTHFR A1298C polymorphism may be a potential risk factor for male infertility,especially in the Asian population.