OBJECTIVE To learn the effect of performance management to enhance the proper administration of antibiotics in hospital.METHODS The performance management was applied in the proper administration of antibiotics usage.It included perfected regulation system,established the standard of the performance management,enhanced monitoring,analyzed the popular trend of drug-resistant bacteria,educated the medical staff and guided their appropriate antibiotics usage.RESULTS After taking the performance management in the administration of antibiotics,the rate of the antibiotics usage decreased from 55.1% to 44.2% and the rate of hospital infection decreased from 5.26% to 4.69%.The drug-resistant bacteria ratio obviously repressed.CONCLUSIONS Application of the performance management(a modern science management measure) in the proper administration of antibiotics usage is effective.

BACKGROUND: The design of the microstructure of human bone is in fact to construct a model, which could characterize the connecting-porosity cell frame structure. As the porosity structure is represented as irregular curve, and this irregularity has close relationship with the bone function, does the fractal theory effectively find the irregularity containing in the irregular structure?OBJ ECTIVE: To analyze the microstructure of human bone by applying the fractal property, and construct the 3D model that has structural similarity to the natural bone. With the help of Rapid Prototyping technology, a new bionic technique instead of traditional modeling method is presented to model artificial human bone.DESIGN: Computer aided bionic design.SETTING: Biomaterials and Engineering Center of Wuhan University ofTechnoiogy.MATERIALS: The experiment was carried out in the Biomaterials and Engineering Center of Wuhan University of Technology from January to June 2005. The material is the original gray chart of hip joint of one healthy middle-aged male.METHODS: The contour of the human bone microstructure was obtained by exaltation and extraction of the grey chart.B-spline technique was used for vectorization. ①The fractal theory was adopted to compute the fractal dimension of typical aperture structure and the result was represented by dimensions (D=2s, s is the slope of fitting line) to find the inherent relation among apertures. ② Monte Carlo method was used to generate the two-dimensional model of microstructure of bone with the appropriate porosity. The 3D model was manufactured by rapid prototyping technology.MAIN OUTCOME MEASURES: ①Fractal dimension of porous structure of human bone; ② Results of 2D and 3D model of the microstructure of human bone.RESULTS: ①The fractal dimensions of some representative apertures were between 1.14and 1.28. The fractal dimensions of these micro-apertures are rather close, which testified the self-similarity in the edge contour of the microstructure of human bone. ②3D model was generated by cumulating the plane model layer by layer with the rapid prototyping technology. If the high porosity of plane model was ensured, the porosity and connectivity of 3D model could meet the high requirement. Through the computer simulating, the porosity of the model was greater than 40%, which meets the design requirement.CONCLUSION: Fractal theory is applied in the construction of 2D model of human bone based on the requirements in bionic design of the microstructure model of human bone. The fractal characteristics of the grey chart of human bone and the edge contourof its typical micropore are analyzed. The software suitable for 2D tissue engineered bionic microstructure of human bone is developed with VC++, meanwhile, 3D cell scaffold model is constructed by cumulating the planer model, which meets the human bone functions.

Data Collection ; methods ; Metabolomics ; methods

Aim To monitor the whole blood trough concentration of cyclosporine A (CsA) in renaltransplant recipients reciving triple therapy with mycophenolate mofetil, cyclosporine andprednisone and to establish an optimal therapeutic window of CsA. Methods Sampleswere measured by specific fluorescence polarization immunoassay. According to the timeafter operation and different therapy plan, the whole blood trough concentration of CsA ineach group was compared with that in control group.Results The optimal therapeuticwindow of CsA with MMF plan was 150~300 ?g? L-1 (less than one month after op-eration), 120~260?g?L-1 (1~

Objective To evaluate the b value of diffusion-weighted(DW)MRI in distinguishing between benign and malignant breast lesions.Methods Three diffusion-weighted sequences were implemented with 500,1000 and 2000 s/mm~2 b values respectively on 95 breast lesions in 83 patients.All lesions were confirmed by pathology.The apparent diffusion coefficient(ADC)values and signal intensity (SI)were recorded and compared in different lesions(breast cancer,benign lesion,cyst and normal beast tissue)with the same b value and the same lesions with the different b values.Results(1)The mean ADC value and SI of breast cancer were 1.375?0.378 and 839.713?360.493 respectively with b= 500 s/mm~2,1.176?0.311 and 459.314?229.609 with b=1000 s/mm~2,0.824?0.198 and 243.825? 110.616 with b=2000 s/mm~2.The differences in the mean ADC value were significant between two type lesions(cancer and benign lesion,cancer and cyst,cancer and normal breast tissue)with b values of 500 s/mm~2 and 1000 s/mm~2.But the significant differenee was only seen between cancer and benign lesions when b value was 2000 s/mm~2.(2)The one-side upper limits of 95% confidence interval of mean ADCs were adopted as the point to separate the malignant from the benign lesions,the sensitivity was 70.92%, 70.73% and 69.77%,the specificity was 77.19%,75.70% and 54.76%,the accuracy was 77.12%, 74.32% and 62.35% respectively with b values of 500 s/mm~2,1000 s/mm~2 and 2000 s/mm~2.The areas under ROC eurves were Az_(500)=0.775?0.046(P0.05).Conclusion DWI MRI is useful for the differential diagnosis of breast lesions with b values of 500 s/mm~2 and 1000 s/mm~2.

Objective To evaluate the narrow-band imaging (NBI) in differential diagnosis of colo-rectal proliferative lesions. Methods Suspected lesions in colon were examined with white light and NBI colonoscopy, respectively. The ensitivity and specificity in diagnosing colorectal inflammatory hyperplasia, adenoma, early cancer and advanced cancer were compared between NBI and conventional colonoscopy with reference to pathology as gold standard. The pit patterns and the surface microvessels of the lesions were also determined and scored with NBI combined with magnifying endoscopy, and were compared with pathological diagnosis. Results (1) A total of 368 lesions were detected in 280 patients with conventional colonoscopy and NBI. The sensitivity and specificity of NBI in differential diagnosis of colorectal lesions were superior to those of conventional colonoscopy. (2) The pit patterns of colorectal inflammatory hyperplasia were mainly type Ⅰ and Ⅱ , while in adenomas were mainly type Ⅱ and Ⅲ (94. 2%). The pit patterns of early cancer were type Ⅲ (18. 8%), Ⅳ (56. 3%) and Ⅴ (25.0%), and those of advanced cancer were mainly type Ⅴ (94. 0%). (3) The average scores of surface microvesseis of colorectal inflammatory hyperplasia, ade-noma, early cancer and advanced cancer were 1.35 ± 0. 72, 3. 86 ±1.07, 6. 52±2. 59 and 11.42 ± 3.59, respectively. Scores over 6. 5 was a strong indicator of malignant lesions. Conclusion NBI is superior to conventional eolonoscopy in differential diagnosis of colorectal lesions. Observing pit patterns and microves-sels of the lesion with combination of NBI and magnifying endoscopy is helpful in diagnosis.

Objective To investigate the effect of simulated microgravity on the proliferation and differentiation of the human megakaryocyte cells in vitro. Methods The fourth generation rotating cell culture system (RCCS-4) was used to generate the simulated microgravity environment. The cell viability was assessed by trypan blue staining method. The proliferation of cells was assessed by cell counting method and CCK8 method. The CD41+/CD61+ cells rate and the cells cycle were detected by flow cytometry. The expression levels of thrombopoietin receptor (c-mpl) and transcription factors were detected with RT-PCR. Results After 24, 48, 72 h, culture under simulated microgravity resulted in a significant decrease in the cell number , proliferative activity, cells in the G2/M phase and levels of c-mpl mRNA expression in comparison with that under the normal gravity (P < 0.05). After 48 h and 72 h culture, CD41+/CD61+ cells ratio decreased and RUNX-1 mRNA expression was down-regulated in cells of the group SMG compared with that of the group NG (P < 0.05). Conclusion Microgravity can inhibit the proliferation and differentiation of human megakaryocyte cells in vitro. The mechanism may be that TPO/c-mpl pathway was inhibited by down regulating the expression of c-mpl which transcriptional inhibition lead to.

Objective To establish the clinical reference of serum homocysteine in Xi’an region.Methods 310 cases of serum of healthy persons were collected to test the homocysteine concentrations using Enzyme circulation method.Results Health-y adult male homocysteine value was significantly higher than female and its reference range was:men 0~1 6.3 5μmol/L and women 0~12.89μmol/L.Conclusion Have established the healthy crowd in Xi’an region serum HCY reference for the re-gion’s heart cerebrovascular disease treatment and prognosis.

OBJECTIVETo analyze medication laws of Chinese medicine (CM) treatment in hypertension patients with yin deficiency yang hyperactivity syndrome.

METHODSChina National Knowledge Infrastructure (CNKI, Jan. 1979-Dec 2014), Chinese Scientific Journals Database (VIP, Jan 1989-Dec2014), Chinese Biomedical Literature Database (CBM, Jan.1978-Dec.2014), Wanfang Database (Jan 1990-Dec 2014) were retrieved by using "hypertension", "CM", "Chinese herbs", "syndrome" as keywords. Totally 149 literatures concerning CM treatment for hypertension patients with yin deficiency yanghyperactivity syndrome were included in this study. The herbs database was established by SPSS20.0,and correlation laws were analyzed by SAS9.3. With the Pajek3.1, results were presented visually withcomplex networks.

RESULTSThere were 149 literatures including 131 kinds of herbs with 1,598 frequencies. The conventional compatibility program of herbs for asthenic yin and predominant yang syndrome of hypertension were two toothed achyranthes root, tall gastrodia rhizome, Cassia obtusifolia L., eucommiabark, baikal skullcap root, and so on, about 29 kinds. Of them, core herbs were two toothed achyranthes root, tall gastrodia rhizome, Cassia obtusifolia L., poria, prepared rhizome of rehmannia, oriental water-plantain tuber, asiatic cornelian cherry fruit, Uncariae Rhynchophylla, common yam rhizome, the rootbark of the peony tree, and so on.

CONCLUSIONMedication laws of CM treatment in hypertension patientswith yin deficiency yang hyperactivity syndrome obtained by analysis of complex networks reflected thetherapeutics of nourishing yin to suppress yang, which could further provide reference for clinical studies.

Asian Continental Ancestry Group ; China ; Drugs, Chinese Herbal ; therapeutic use ; Humans ; Hypertension ; therapy ; Medicine, Chinese Traditional ; Yin Deficiency ; therapy ; Yin-Yang

OBJECTIVETo evaluate the reliability, validity, and responsiveness of traditional Chinese medicine (TCM) clinical outcomes rating scale for heart failure (HF) based on patients' report.

METHODSTCM clinical outcomes rating scale for HF (TCM-HF-PRO) were evaluated based on 340 HF patients' report from multiple centers. The completion of the investigation was recorded. Cronbach's α coefficient and split-half reliability were used for reliability analysis, and factor analysis was used to assess the construct validity of the rating scale. Pearson correlation analysis was then used for criterion validity analysis. Discriminant analysis was used to assess the responsiveness of the scale. All 340 HF patients having complete TCM-HF-PRO data were assigned to the treatment group and the control group by central randomization. The total TCM-HF-PRO scores of the two groups were compared using paired t-test to reflect the longitude responsiveness of the scale before treatment and at week 2 after treatment.

RESULTS(1) The recycling rate of the scale was 100.0%. One of them was not filled completely, which was rejected thereby. So the completion rate was 99.7%. The completion time for TCM-HF-PRO scale ranged 15 to 25 min. (2) The Cronbach's α coefficient of rating scale was 0.903, split-half reliability was 0.844 and 0.849. (3) Confirmatory factor analysis showed that 7 factors and items formed according to maximum load factor basically coincided with the construct of the rating scale, 7 factors accumulated contribution rate was 43.8%. TCM clinical outcomes rating scale for HF based on patients' report was relatively better correlated with the Minnesota living with HF questionnaire (r = 0.726, P < 0.01). (4) Discriminant analysis showed that the rating scale correctly classified more than 78.8% of case studies having confirmed initial differential diagnosis by experts. The total scale of the rating scale decreased more in the two group after treatment, with significant difference as compared with before treatment (P < 0.01.

CONCLUSIONTCM clinical outcomes rating scale for HF based on patients' report had good reliability, validity and responsiveness, hence it could be used to assess clinical efficacy for HF patients.

Diagnosis, Differential ; Discriminant Analysis ; Factor Analysis, Statistical ; Heart Failure ; diagnosis ; Humans ; Medicine, Chinese Traditional ; methods ; standards ; Reproducibility of Results ; Surveys and Questionnaires