OBJECTIVE To investigate the usage of antibiotics in surgical department of Chest surgery in PLA General Hospital.METHODS The antibiotics usage status among 412 cases of patients during perioperative period was retrospectively analyzed.RESULTS The utilization of antibacterials took up to 100.00%.The average of treatment course was13.89 days,Aminoglycosides,cephalosporin and penicillins was the main kinds,single use accounted for 28.64%,the bigeminy for 35.93%,and trigeminy for 30.58%,the utilization with four or more kinds of drugs were 4.85%.The rational usage and irrational usage accounted for 64.57% and 35.43% respectively.CONCLUSIONS Clinicians should strengthen the management of antibiotics in perioperative period for rational use.

Whole brain radiation therapy has become the standard treatment of non-small cell lung cancer (NSCLC) with brain metastasis,because it prolongs the survival times of NSCLC patients with brain metastases.The emergence of molecular targeted drugs is a major innovation in the traditional sense of the cancer treatment.Molecular targeted drugs have many advantages such as convenient dosing,rapid onset,improving the intracranial and extracranial tumor lesions at the same time,mild adverse reactions and good tolerance,which provide a new and better choice for the treatment of NSCLC patients with brain metastases.

A statistical analysis was conducted to evaluate the publication status in medical research of Shandong province in 2013, based on papers covered in SCI-Expanded database, aimed to provide an objective assessment of the level of medical research in Shandong Province.Factors involved in the analysis including medical papers authored by researchers in Shandong province, numbers and types of publication, distribution of author's location, institution, type of periodical, and impact factor.

Scientific research design includes specialty design and statistics design which can be subdivided into experimental design, clinical trial design and survey design. Usually, statistics textbooks introduce the core aspects of experimental design as the three key elements, the four principles and the design types, which run through the whole scientific research design and determine the overall success of the research. This article discusses the principle of randomization, which is one of the four principles, and focuses on the following two issues--the definition and function of randomization and the real life examples which go against the randomization principle, thereby demonstrating that strict adherence to the randomization principle leads to meaningful and valuable scientific research.

[Objective]To observe the effect of the nonunion of humeral shaft fracture treated by bidentate intramedullary locking nails.[Method]Twenty-five cases of fracture nonunion of humeral shaft were cured by bidentate intramedullary locking nails from January 2000 to November 2004.and they received operations to remove their previous instruments.After the bidentate intramedullary nails was inserted via antegrade approach,and autogenous cancellous bone was grafted.[Result]Twenty of the 25 cases were available for follow up.The follow up lasted 10 to 26 months.All cases achieved solid union within 4 to 10 months.There were no complication such as incision infection or occurring of osteomyelitis.[Conclusion]Bidentate intramedullary locking nails can provide the effective control of harmful shearstress,it can provide firm internal fixation,And this methods is an ideal method for treatment of humeral shaft fracture nonunion.

Objective:To study the functional status of the monocytes-derived dendritic cells (DCs) plused with HBsAg from patients with chronic hepatitis B and their capacity of inducing the HBV- special cytotoxic T lymphocytes (CTLs),and explore a new method of inducing the special anti-HBV cell-mediated immunity.Methods:Monocytes of patients were isolated from peripheral blood and incubated with GM-CSF+IL-4+TNF-? to induce DCs generation. Those DCs were pulsed with HBsAg to induce HBV- special DCs. The phenotype of DCs including CD1a,CD80,CD83,CD86,CD40 and HLA-DR was characterized by FCM and the stimulating reaction of allogenic T lymphocytes was detected by MTT assay. The concentration of cytokines such as IL-12 and IL-6 in supernate was tested by ELISA and the cytotoxicity of CTLs inducing by the DCs against HepG2 2.2.15 cells,HepG2 cells and K562 cells were detected by LDH assay.Results:The expression of CD1a, CD80, CD83,CD86, CD40, HLA-DR molecules on the DCs pulsed with HBsAg was higher than those of the control group (P

Objective To study the characteristics of mutations of gene COL4A5 encoding type Ⅳ collagen ? 5 chain in one chinese pedigree with X-linked dominant inherited nephritis (Alport's syndrome,AS). Methods Genomic DNA was extracted from 35 members of the pedigree of Alport's syndrome. All of 51 exons of COL4A5 gene were amplified by PCR with the primers synthesized according to the published intron sequences of COL4A5. The PCR products were further analyzed by agarose gel electrophoresis and single strand conformation polymorphism (SSCP). The PCR products showing polymorphism were directly sequenced. Results PCR-SSCP analysis showed that 17 PCR products had abnormal mobility of single strand DNA. DNA sequencing analysis revealed 9 suspicious mutations. But these suspicious mutations were not be confirmed by inverse sequencing analysis. Conclusion The exon mutation of COL4A5 gene of this pedigree did not be found, and the mutations of COL4A5 gene may locate in the its introns.

Objective To investigate and analyze the requirement for health education during and after hospitalizadon of patients with cerebral apoplexy.Methods 150 sober patients with cerebral apoplexy from department of neurology were investigated by questionnaires and the results were analyzed. Results The education content that most patients wanted to understand during hospitalization was treatment method and limbs activity(83.6%and 82.2%);The health education style that they prefered was to communicate directly with doctors and nurses(74.0%);The education content after hospitalization that most patients required was self-nursing knowledge.clinical manifestation and first aid when relapse(90.4%,87.7%and 87.7%).The health education style that they most needed after hospitalization Was that Some reference books would he recommended to them (56.2%).The time choice for health education was consultation whenever they had problems.Conclusion Medical workers should supply selective education and instruction according to the health education requirement and style at different stages of patients with cerebral apoplexy.

ObjectiveTo valuate the clinical effect of maintence of arteriovenous fistula by Songling Xuemaikang capsule.Methods40 cases were obtained from patients with chronic renal failure had received arterio-venous fistula operation,24 cases were observed with the combination treatment and 16 cases were served as control group,Hemorheology and difference value of vein diameter before and after treatment,blood flow of native arteivenous fistula and primary using time were observed.ResultsThe improvement degree of high shear rate and low shear rate were significantly as compared with that in the control group (P =0.000,P =0.001 ),while the blood flow after fistula maturation and ifference value of vein diameter were better than that in the control group( P =0.0356),primary using time between two groups were no significant differences ( P =0.056).ConclusionSonglinxuemaikang capsule was an effective drug for prevention high blood caogulation state,increasing blood flow of native arteivenous fistula,and enlargment vein diameter after arterio-venous fistula operation,which had certain value in clinical application.

Objective To investigate the effects of minute quantity of endogenous endotoxin originating from the lung on ventilator-induced lung injury in rats. Methods Thirty-two pathogen-free male adult SD rats weighing 370-390 g were randomly divided into 4 groups ( n = 8 each): group I spontaneous breathing (group C) ; group Ⅱ spontaneous breathing + IPS (group CL) ; group IE mechanical ventilation (group M) and group IV mechanical ventilation + LPS (group ML). The animals were anesthetized with intraperitoneal 20% urethane 0.8 ml/100 g. Right common carotid artery and left femoral vein were cannulated for BP monitoring and fluid and drug administration. The animals were tracheostomized. In group CL and ML LPS 100μg /kg was instilled into trachea. In group M and ML the animals were mechanically ventilated (V_T 20 ml/kg, PEEP=0, I = E = 1:1). P_(ET) CO_2 was maintained at 35-45 nun Hg by adjusting respiratory rate. The animals were breathing or ventilated with room air,and ECG, BP, HR and P_(ET)CO_2 were continuously monitored. Blood gases were analyzed at the beginning and 1, 2 and 3 h of experiment. The animals were sacrificed at 3 h of experiment. The lungs were removed for microscopic examination. The pathological changes of the lung were scored (0 = normal,3 = severe change) . Wet/dry lung weight ratio was determined. The left lung was lavaged. The broncho-alveolar lavage fluid (BALF) was collected. WBCs in BALF were counted. Pulmonary albumin permeability (PAP) (BALF protein concentration/plasma protein concentration) was determined. Plasma TNF-a and macrophage inflammatory protein 2 (MIP-2) concentrations were detected with ELISA. The endotoxin receptor CD14 mRNA expression in lung tissue was determined by RT-PCR and the macrophage CD14 expression in BALF was determined by immuno histochemistry in group C and M. Results Wet/dry lung weight ratio and PAP were significantly higher in group ML than in group M and C. WBC count in BALF, the pathological score and plasma MIP-2 concentration were significantly higher in group M and ML than in group C and were significantly higher in group ML than in group M. TNF-a concentration was significantly higher in group CL and ML and was not detected in group C and M. CD14mRNA expression in the lung tissue and CD14 expression in BALF macrophage were significantly higher in group M than in group C. Conclusion Minute amount of endogenous endotoxin from the lung can aggravate ventilator-induced lung injury in rats. Mechanical ventilation with large tidal volume sensitizes the lung to LPS stimulation through up-regulation of CD14 exexpression.