OBJECTIVE:To investigate the application of clindamycin phosphate for inpatients in a third grade class A hospital, and provide reference for the specication of its application. METHODS:Retrospective investigation was adopted to randomly obtain the medical information of inpatients who used Clindamycin phosphate for injection in a third grade class A hospital in May 2014, and its rationality was evaluated and analyzed by referred the instructions,relevant provisions and principles. RESULTS:Totally 205 patients used Clindamycin phosphate for injection,among which 174 were for the purpose of prevention medicine,31 cases for treatment purposes. There were reasonable use of 130 cases(63.4%);unreasonable prophylaxis of 71 cases(34.6%),unreason-able treatment of 4 cases(2.0%),it was mainly no indication of medicine,usage and dosage,treatment course and use of antibac-terial drugs. CONCLUSIONS:There still remains unreasonable phenomenon in the clinical application of the Clindamycin phos-phate for injection,the safe and effective clinical application can only be ensured if the drug regulatory system is improved and anti-bacterial drugs in clinical medicine guidelines is strictly enforced.

Diagnosis, Differential ; Fetus ; Fibroma ; metabolism ; pathology ; Fibrosarcoma ; congenital ; genetics ; metabolism ; secondary ; Hemangiopericytoma ; metabolism ; pathology ; Humans ; Kidney Neoplasms ; pathology ; secondary ; Liver Neoplasms ; pathology ; secondary ; Lung Neoplasms ; pathology ; secondary ; Male ; Nerve Sheath Neoplasms ; metabolism ; pathology ; Rhabdomyosarcoma, Embryonal ; metabolism ; pathology ; Soft Tissue Neoplasms ; congenital ; genetics ; metabolism ; pathology ; Vimentin ; metabolism

Objective To identify the determinants of average length of stay of 16 upper first-class general hospitals from 2000 to 2007.Methods Relative data of 16 upper first-class general hospitals from 2000 to 2007 were collected, and descriptive analysis and multiple linear regression analysis were employed to explore the determinants of average length of stay. Results Operation ratio and days before operation of inpatients, ratio of salary to medical income, ratio of doctors to nurses, successful rescue rate in emergency, number of operation tables and staff had impact on average length of stay. Conclusion Resource allocation should be optimized, health care quality be enhanced, reasonable salary scheme be designed, and rational medical insurance policies be implemented in hospitals to shorten average length of stay.

Objective To comprehensively evaluate the competitiveness of hospitals so as to provide objective referrences for the long-term development. Methods Competitiveness evaluation index system and evaluation model were established. Using related data of 2007, 16 hospitals nationwide were evaluated and factor scores and comprehensive scores were obtained by means of factor analysis. Results Four factors were extracted, which were "technical efficiency factor", "economic income factor", "sustainable development factor" and "resource allocation factor". All hospitals were ranked by each factor score and comprehensive score. Conclusion Each hospital has its advantages and disadvantages, therefore, hospital managers should constitute individual development strategy accordingly.

To explore the model of the standardized training for health management talents by referring to the standardized training for resident-doctors.This article analyzed the necessities of the model of the standardized training for health management talents from two aspects.After that,it elaborated on the significance of standardized training.At last,it proposed some ideas about constructing the standardized training for health management talents.

There are many subjects related to anesthesiology and the band between anesthesiology and clinical practicevery is close. So students can not be proficient in anesthesiology by traditional teaching methods. The use of three-dimensional case teaching method in anaesthesiology teaching is a good attemptment. three-dimensional case teaching method integrate case method, multimedia technology and clinical case. It can help medical students analyze and solve clinical problems, improvetheir academic performance and enhance their clinical basic skills.

Based on the request for high quality talents of social development and the status quo of medical humanistic education,this article comes up with the conclusion that cultivation of humanistic spirit for medical students should be conducted from the following aspects.Firstly,humanistic spirit should be included in every link of the teaching course.Secondly,humanistic quality of the teaching staff should be strengthened.Last but not least,humanistic spirit should also be applied to the practice.

Objective To investigate the long-term effects and risk factors of arterial polyvinyl alcohol resin (PVA) embolization for ⅢB and IV non-small cell lung cancer(NSCLC) patient.Methods 126 patients with 1 B or V NSCLC were performed the perfusion with 5-FU,THP,DDP by PVA grain embolization under fluoroscopic control.All patients were followed up.Kaplan-Meier was used to calculate the survival rate and the median survival time,and Cox regression model was adopted to analyze related risk factors which affected curative effect.Results The median survival time was( 11.78 ± 3.24) months and 1 -,2-year survival rate was 39.1 ％,25.59％ in 126 patients with NSCLC.Cox model analysis showed that of the tumor staging,tumor size,location and combination chemotherapy were all independent risk factors of prognosis (all P ＜ 0.01 ).Conclusion Arterial embolization of PVA for treatment of NSCLC is effective.Tumor size,stage,location and combination chemotherapy are associated with prognosis of NSCLC.

Objective To explore the clinical features and diagnosis of primary immunodeifciency disease caused byTyk2 gene mutations.Methods Clinical data from the ifrst case in China diagnosed of primary immunodeifciency disease caused by Tyk2 gene mutation were retrospectively analyzed, and related literature was reviewed.Results One year and 3 month old boy suffered with repeated pulmonary infection, chronic otitis media, intractable eczema like rash, repeated skin abscess, HSV infection, intracellular bacterial infection, and remarkedly increased total IgE. It was detected that compound heterozygous mutations of c.2269C>G in No. 16 exon and c.149delC in No. 3 exon inTyk2 gene. Literature searching found other 8 cases (5 males and 3 females) of immune deifciency patients caused byTyk2 gene defects, all of which hadTyk2 gene homozygous mutations and presented with repeated infection of paranasal sinus and lung. In the 8 cases 6 cases were combined with mycobacterium tuverculosis infection, 4 cases had repeated virus infection, 4 cases had meningonecephalitis, 3 cases had intractable eczema like rash, 2 cases had salmonella enteritis, 1 case had remarkedly increased total IgE, one case had elevated eosinophils, 5 cases were born in intermarriage family and 1 case died of meningitis caused by unknown etiology.Conclusions When patients have repeated paranasal sinus infection and lung infection, combined with intracellular bacterial infection (including mycobacterium tuberculosis infection), and repeated virus infection or intractable eczema like rash, with or without increased total IgE, immunodeifciency disease caused by Tyk2 gene defection should be considered. Gene sequence analysis can assist in early diagnosis.

BACKGROUND:Ultrasound therapy can relieve pain and improve the movement function in patients with knee osteoarthritis, but there lacks of consistency in the literatures of ultrasound therapy.
OBJECTIVE:To further identify the effectiveness of ultrasound therapy in the treatment of knee osteoarthritis.
METHODS:Twenty-four rabbits were randomly divided into three groups:normal group, model group and ultrasound group. The rabbit in the normal group received no intervention;rabbits in the model group received anterior cruciate ligament transaction to establish the knee osteoarthritis model without any treatment;the rabbit in the ultrasound group received ultrasound therapy after modeling for 10 minutes once time, once per day, 0.3 W/cm2 , 1 MHz and treated for 10 times. Hematoxylin-eosin staining was conducted for histological observation of rabbit articular cartilage;western blot and reverse transcription PCR assessment were used to assess the expressions of caspases-3 and caspases-8 in rabbit articular cartilage, while Terminal deoxynucleotidyl transferase dUTP nick end labeling was used to assess the ratio of chondrocytes apoptosis of rabbit knee articular cartilage.
RESULTS AND CONCLUSION:The normal rabbit cartilage tissues and chondrocytes were neatly arranged in column;the middle cartilage layer of the model was thin;the chondrocytes were arranged disorderly and became less. After ultrasound therapy, the chondrocytes were rearranged neatly, and the number was increased. Compared with the normal group, the Mankin scores in the model group and ultrasound group were higher;the apoptotic rate of chondrocytes was higher in the model group and ultrasound group than in the normal group, and was also higher in the model group than in the ultrasound group. Compared with the normal group, the expressions of caspases-3 and caspases-8 were higher in the model group and the ultrasound group, while decreased after ultrasound therapy. The results indicate that ultrasound can improve the structure of cartilage tissues, decrease the expressions of caspases-3 and caspases-8 and reduce the apoptosis rate of chondrocytes. It is effective for the treatment of knee osteoarthritis with ultrasound therapy.