Objective: To investigate the application and tendency of carbapenems in the hospitals of Wuhan area.Methods: The application of carbapenems in 34 hospitals of Wuhan area during 2007-2014 was analyzed statistically in terms of consumption sum, DDDs, DDC and so on.Results: The total consumption sum of carbapenems increased year by year.Compared with that in 2007, the total consumption sum increased by 4-fold in 2014.The growing rate of total consumption sum of biapenem was the fastest among various varieties.Since 2009, three injections including meropenem, biapenem and imipenem / cilastatin predominated the market of Wuhan area, followed by faropenem with oral administration.The changing trend of DDDs was basically consistent with the total consumption sum.DDC of all the drugs was relatively high and demonstrated decreasing tendency, and that of biapenem decreased most notably, while still ranked the first place.DDC of meropenem and imipenem/cilastatin both exceeded 400 yuan.The price of faropenem fluctuated notably during 2007-2009, while increased by 2-fold in 2009 (453 yuan) and then remained stable.Conclusion: The special rectification measures show positive impact on the selection of antimicrobial agents in Wuhan area.The drug varieties are proper, while the average daily cost is still high.The government should continue to strengthen the management of antibiotics to ensure the rational use of carbapenems.

Objective To evaluate the clinical significance of the detection of the Human Papilloma Virus (HPV) DNA typing in therapy of cervical diseases. Methods 780 cases have been studied. These cases which showed HPV-DNA positive and were diagnosed by biopsy as cervical cancer or cervical intraepithelial neoplasia( CIN Ⅰ-Ⅲ) were treated by operation or physical therapy. And 6 months and 12 months after the treatment,TCT and HPV DNA test were carried out. Results The prevalence of HPV-DNA types among the 780 cases descended from HPV 16 to 52,58,18,33 and 31. Detection rates of HPV-52 and 58 were highest among the patients with CIN Ⅰ. In patients with CIN Ⅱ,CIN Ⅲ,carcinoma in situ and invasive carcinoma,the positive rate of HPV-16 was obviously higher than other genotypes,and the difference was significant (P＜0. 01 ). 520 cases were followed-up after treatment,we found that HPV-DNA subsided within 3 months to 1 year in 432 cases. 88 cases still showed the HPV-DNA positive, among this group 48 cases were cytology diagnosed as normal or inflammation,but 14 cases were ASC-US,22 cases were LSIL and 4 cases were HSIL. Cytology abnormal cases were mere often detected in patients with persistent HPV-positive than in patients with HPV-negative. Conclusion Referring patients with cervical diseases the common HPV genotypes are 16,52,58,18,33 and 31. Especially HPV-16 are closely related with cervical cancer and high-level cervical intraepithelial neoplasis. HPV-DNA turn negative in most patients in 12 months after treatment. Persistent infection of HPV-DNA is related with the pathological changes persist.

Objective To summarize the experience of nursing patients undergoing NovaSure endometrial ablation. Methods Two hundred and eleven patients with abnormal uterine bleeding claiming no need of giving birth,who were hospitalized in our hospital during August 2011 to April 2013,were managed with NovaSure endometrial ablation and nursing care was performed.Follow-ups were conducted for investigating the curative effects.Results All the patients lived through the operations,their life signs were stable.As for the adverse effects,124 of them had mild abdominal pains,7 medium-level or severe hypogastralgia,1 dizziness and nausea,10 uterial hematocele,and 1 cystitis.All of them got recovered after treatment.One-month follow-up after hospitalization showed a success rate of 98.0%.Conclusions NovaSure is a new approach to abnormal uterine bleeding.It is advantageous for its simplicity,shortness in operation duration,less trauma to patients and good effects.Meanwhile,preoperative mental care and cooperative care during operation may facilitate their recoveries.

Mild cognitive im pairm ent caused by craniocerebral traum a is the key points and difficulties in judicial authentication. This article has com parative analysis of eachmode of event-related potential (classical O ddball, E riksen flanker task and so on), which can provide a more objective m ethod for such craniocerebral traum a cases in clinical forensic judicial authentication.

Objective T o explore the com position characteristic of event related potential (E R P ) in dif-ferent visual acuity levels, and to provide theoretical basis for the objective assessm ent of visual acuity. Methods M onocular stim ulus w as perform ed on 16 selected subjects. T he subjects w ere required to look straight at the screen ahead and count the am ount of stim uli from different directions. T he pictures of optotype stim ulus w hich corresponding to three different visual acuity levels w ere show ed in the center of the screen. The ERP results w ere recorded separately. Results (1) The P1 am plitudes of m atch stim uli recorded under the supra-threshold visual acuity level w ere higher than that of m atch stim uli recorded under the threshold and sub-threshold visual acuity levels. T here w as no significant difference betw een the P 1 am plitudes of m atch stim uli recorded under the threshold and sub-threshold visual acuity levels. T he tendency of conflict stim uli w as sim ilar to that of m atch stim uli under three visual acuity levels. (2) In the 340-500 m s post-stim ulus range, P 300 com ponent w as found under supra-threshold and threshold visual acuity levels; no P 300 com ponent w as found in corresponding tim e w indow under sub-threshold visual acuity. T he differences of P 300 am plitudes am ong three visual acuity levels w ere statistically significant. T he am plitudes from high to low w ere the supra-threshold, threshold and sub-threshold visual acuity levels. Conclusion E R P can be a potential new m ethod for the objective assessm ent of visual acuity in forensic m edicine.

Objective To investigate the correlation between sTREM-1 and inflammatory factors expression in critical patients and its effect on severity of disease and clinical prognosis .Methods sTREM-1 ,TNF-α,IL-6 ,IL-10 levels were checked in serum of 54 patients who admitted to intensive care unit (ICU) on the first day and only sTREM-1 was checked again on the third day .At the same time ,APACHEⅡand survival situation in 28 days were recorded .Results sTREM-1 level in critical patients was positive correlated with TNF-α,IL-6 and APACHEⅡ(P<0 .01) .There was positive correlation between APACHE Ⅱ and TNF-α,IL-6 ,but pearson correlation coefficient between sTREM-1 and APACHE Ⅱ was higher than TNF-α,IL-6 .Compared with the survivor group ,the concentrations of serum sTREM-1 was significantly higer in non-survivor group on the first day and the third day after entering ICU(P<0 .05) .Conclusion sTREM-1 level is positive correlated with inflammatory reaction and the severity of disease .It also has prognostic value for outcome in patients with critical illness .

Objective T o study the effect of different attentional conditions on the event-related potential (E R P ) com ponents generated by the visual inform ation stim uli related to visual acuity, and provide a theoretical reference for clinical forensic visual objective evaluation. Methods W ith visual acuity opto-types as norm al form of visual inform ation stim uli, 15 volunteers as study subjects w ere supposed to ac-count the visual acuity optotypes under the attentional condition of visual stim uli. Furtherm ore, the sub-jects w ere required to listen to the storytelling carefully under the non-attentional condition of visual stim uli, and after the exam ination, they needed to answ er the story-related questions. A ll the E E G re-sults of tw o different attentional conditions from the subjects w ere recorded by 32 channel E R P system . Results U nder tw o attentional conditions, P 1 and P 300 com ponents w ere evoked by the visual acuity opto-types on supra-threshold and threshold visual acuity levels, w hile only P 1 com ponent w ere evoked by the visual acuity optotypes on sub-threshold levels. In the E R P w aveform s evoked by the visual acuity optotypes on supra-threshold, P 1 and P 300 am plitudes under attentional condition w ere larger than that un-der non-attentional condition. Conclusion A ttentional conditions can influence the detection of visual acuity. P 300 com ponent can be used to distinguish the visual acuity levels w ith supra-threshold and sub-threshold under non-attentional condition.

Objective To evaluate long term effect and related factors in patients with menorrhagia treated by microwave endometrial ablation(MEA).Methods Total of 334 women with menorrhagla were treated hy MEA,the range of age was from 29 to 59 years old.Among them,59 cases were complicated by adenomyosis.All the patients were followed up on the change of menstrual cycle.the amount of flow,improvement of anaemia and complication.Fifty-three women underwent outpatient diagnostic hysteroscopy,the biopsy tissue was taken from the endometrium for histopathological examination.The mean duration of follow-up was 64.7 months (3-96 months).Results The overall curative rate wag 91.3%(305/334),of which amenorrhea rate was 49.7%(166/334),menstruation reduction rate was 41.6%(139/334):71.1%(140/197) of the cases who previously had dysmenorrhea had relieved their pelvic pain and the satisfactory rate was 91.9%(307/334).Among patients＞40 years,92.9%(196/211) of operation effective rate,93.8% (198/211) of satisfactory rate and 64.9% (137/211) of amenorrhea rate were obtained.while patients≤40 years,88.6%(109/123) of operation effective rate,88.6%(109/123) of satisfactory rate and 23.6%(29/123) of amenorrhea rate were obtained.There was significant difierence in rate of operation effectiveness,satisfaction and amenorrhea (P＜0.05).Forty-two cases required subsequent treatment due to recurrence,of which 9 cases were given by secondary MEA and 33 cases (9.9%、33/334) underwent hysterectomy indicated by frequent menorrhagla,adenomyosis or leiomyoma.A completely destroyed endometrium was observed by hysteroscopy after MEA,pathologic characteristics of MEA showed two zones of necrotic tissue:the inner zone was coagulation necrosis and the outer zone of necrosis was hypocellular hyalinized myometrium.Conclusions MEA is the safe and efficacious management to treat menorrhagia.Incomplete removal of endometrium was the major reason resulting in postoperative recurrence.Young age and complicated with adenomysis were the main factors influencing long term clinical effect of MEA.

Objective To optimize the extraction process of Kanglao Qingfei granules. Methods Orthogonal test design was used to study the influence of soaking time, water content, extraction time on extraction technology with bergenin's extraction rate, total polysaccharides's extraction rate and extract yield as evaluation indexes. Results The optimum extraction process conditions were as follows:the raw materials were immersed in water for 1.0 h and extracted two times under reflux, and the ratio of water volume to raw materials weight was 10 and 8 (mL/g), and extraction time was 2.5 h and 2.0 h, respectively. Conclusion The optimized extraction process was simple and stable, which can provide foundation for industrial production of Kanglao Qingfei granules.

Objective To explore the influence of different administration time on antidepressant effect of seven clinical common antidepressants. Methods Male mice were randomly divided into eight groups:venlafaxine (75 mg/kg), sertraline (20 mg/kg), fluoxetine (20 mg/kg), doxepin (15 mg/kg), mirtazapine (15 mg/kg), citalopram (40 mg/kg), trazodo?ne (50 mg/kg) and control (saline) groups. Each group contained 36 mice. Drugs were administered to 6 mice per group 30 min before forced swimming test at the 6 time points (9:00, 13:00 and 17:00 as light phase and 21:00, 1:00 and 5:00 as dark phase). Forced swimming test was applied to determine the influence of dosing time on anti-immobility effect of seven antidepressants at each time point. Results Immobility time in venlafaxine group and sertraline group significant?ly decreased compared with that of control group at all time points(all P<0.05). Moreover, anti-immobility effects of ven?lafaxine, fluoxetine, mirtazapine and doxepin were better during the dark phase than during the light phase (all P<0.05). In addition, immobility time in sertraline group decreased at the late part of dark phase (5:00) and the early part of light phase (9:00) compared with other phases (P<0.05). Conclusions Most antidepressants show 24-h rhythm dependent an?ti-immobility effects, but rhythmic patterns are not completely consistent among different antidepressants. Further study is needed to explore the chronopharmacological mechanism and clinical applications of these antidepressants.