Objective To assess antibiotic prescription habits,cost pattern and the prospective intervention in Intensive Care Unit was analyzed.Methods Data on antibiotic utilization and antibiotics susceptibility were col-lected prospectively from individual electronic charts from July 2014 to September 2014.Results 225 of 246 patients surveyed used antimicrobial during the ICU stay,and antibacterial drug utilization rate was 91.46%.Cefperazone-sulbactam and piperacillin-tazobactam were the most prescribed medications.Total defined daily dose ( DDDs) was 1121.1 DDDs.Bacteria culture was 98 positive in 677 cases and 101 pathogenic bacteria were isolated.Conclusion Interventional programs should focus on promoting infectious control with rational antibiotic prescription aimed at mini-mizing the future emergence of bacterial resistance and futile.

OBJECTIVE:To study the effects of modern decoction method vs. traditional decoction method on decoction rate and decoction quality. METHODS: The advantages and disadvantages were compared between the two decoction methods through analysis on the whole decoction process and the storage of the decoction before oral administration taking major components or active components as parameters. RESULTS: As compare with traditional decoction method, the modern decoction method had more advantages for in which the operation is standard, the contents of active components were high, and the quality control can be performed from many ways. CONCLUSION: The modern decoction method deserves to be popularized.

Objective To study the concentration of plasma total homocysteine(tHcy) in patients with chronic renal failure(CRF).Methods 105 chronic renal failure patients and 35 health individuals to our hospital were chosen to measure the level of tHcy using enzymatic cycling assay method.Results The mean level of tHcy in renal failure period C RF patients was significantly higher than that in normal controls (t =3.12,P ＜ 0.05),and the level of plasma tHcy was significantly higher in Uremia stage than in renal failure period in CRF patients (t =6.41,P ＜0.05),and the level of plasma tHcy was significantly higher in renal failure period than in renal function decompensated period in CRF patients (t =11.27,P ＜ 0.05).Conclusion The level of plasma tHcy were significantly elevated in patients with CRF,and there is a trend that the level of plasma tHcy increases with severity of CRF.Serum tHcy concentration have significant value in the diagnosis and understanding the condition of patients with CRF.

Programmed cell death 4 (PDCD4) is a newly discovered tumor suppressor gene, whose expression is regulated by methylation of PDCD4 gene and many kinds of microRNAs.Protein of PDCD4 enco-ding can improve the sensitivity of tumor cells to anticancer agents, inhibit tumor development and metastasis process, and play an important role in a variety of tumors.It is expected to be a clinical indicator to determine the prognosis of tumor.

Objective To investigate clinical and pathological features of chronic hepatitis B ( CHB) with nonalcoholic fatty liver disease(NAFLD).Methods The clinical and pathological data of 70cases of CHB and 68 cases of CHB with NAFLD and 42cases of NAFLD were analyzed and compared .Results In this patients with CHB overlapped NAFLD , plasma ALT,AST,GGT con-centrations were higher than that in CHB and NAFLD groups ( P <0.05 , P <0.01 ) , compared with CHB group ,the levels of serum TC,TG,FBS,INS and IRI on patients with CHB overlapped NAFLD were increased ( P <0.05, P <0.01), Compared to patients B groups, serum hepatitis B virus DNA titer in patients with steatosis was significantly lower ( P <0.05) and reduced sharply with the increasea degree of hepatic steatosis ( P <0.05 ) .hepatic inflammation grade and fibrosis stage between CHB patients with and with-out steatosis ( P >0.05 ) .Conclusions The reverse association of hepatitis B virus titer with the degree of hepatic steatosis needs further investigation .Hepatic steatosis is associated with metabolic factors than virus factors .The existence of hepatic fatty degeneration dose not exacerbate liver inflammation or fibrosis .

Objective To compare the clinical effect between CO2-1aser assisted and cold instrument assisted suspension laryngoscopic surgery for vocal fold cyst.Methods From January, 2011 to December, 2014, 72 patients with vocal fold cyst, which diagnosed by strobolaryngoscopy, were randomly divided into CO2-1aser assisted group and cold instrument group.Strobolaryngoscopy, acoustic analysis and perceptual voice analyses were performed on each patient before surgery, 1 month, and 3 months after surgery, respectively.Results All operations were successfully completed.The complete vocal fold cyst resection rate of CO2-1aser assisted group was significantly higher than cold instrument group (29/36, 80.5％ vs 21/36, 58.3％, P ＜ 0.05), especially the left vocal fold cyst (13/16, 81.3％ vs 9/19, 47.4％, P ＜ 0.05).The complete right vocal fold epidermoid cyst resection rate was significantly higher than retention cyst (17/19, 89.4％ vs 11/18, 61.1％, P ＜ 0.05).Two recurrent cases were found in cold instrument group but no recurrent cases in CO2-laser assisted group (0/36, 0％ vs 2/36, 5.6％, P ＞ 0.05).Correlation analysis showed that vocal fold cyst recurrence was related to complete resection rate and has no relation with surgical methods, histopathological types and position.Subjective and objective assessment of voice quality in preoperative, 1-month postoperative and 3-month postoperative were similer between CO2-1aser assisted group and cold instrument group (P ＞ 0.05).Conclusion The CO2-laser assisted suspension laryngoscopic surgery for vocal fold cyst, can increase the surgical precision, reduce the left hand impact, improve the complete resection rate and reduce the recurrence rate.

Objective To investigate the mutations of basal core promoter (BCP) and precore (PreC) region of hepatitis B virus (HBV) and the association with the development of hepatocellular carcinoma in patients with chronic HBV infection.Methods Totally 381 untreated HBV patients were recruited from the Department of Infectious Diseases,People's Hospital of Shangyu from Jan 2003 to Dec 2010,which included patients with chronic hepatitis B (CHB,n =166),cirrhotic hepatocellular carcinoma (cirrhotic-HCC,n =158) and noncirrhotic hepatocellular carcinoma (noncirrhotic-HCC,n=57).The mutations in HBV BCP and PreC and the genotypes of HBV were determined by polymerase chain reaction (PCR) and direct sequencing.Data were analyzed by chi square test and Logistic regression.Results The HBV genotype of most cases was genotype B (CHB,n =124;cirrhotic-HCC,n=126 ; noncirrhotic-HCC,n=50).In univariant analysis,BCP V1753 (x2 =7.927,P=0.005),BCP T1762/A1764 (x2 =12.796,P＜0.01),PreC A1896 (x2 =6.890,P=0.009) and PreC A1899 (x2=11.850,P =0.001) mutations were more frequently detected in cirrhotic-HCC patients than those in CHB patients.PreC A1896 (x2 =27.310,P＜0.01) and A1899 (x2=7.575,P=0.006) mutations were highly detected in noncirrhotic-HCC patients than those in CHB patients.Multivariate Logistic regression analysis revealed that in HBeAg positive patients,BCP T1762/A1764 (wald=6.180,P=0.016,OR=8.883) and PreC A1899 (wald=10.279,P=0.001,OR=7.475) mutations were independently associated with the development of cirrhotic-HCC; PreC A1896 (wald=4.324,P=0.038,OR=4.439) and PreC A1899 (wald=4.850,P=0.028,OR=6.010)mutations were independently associated with the development of noncirrhotic-HCC.While in HBeAg negative patients,PreC A1896 mutation (wald=15.448,P＜0.01,OR=12.128) was independently associated with the development of noncirrhotic-HCC.Conclusions BCP T1762/A1764 mutations are associated with the development of cirrhotic-HCC in HBeAg positive patients.PreC A1896 mutation is associated with the development of noncirrhotic-HCC in HBeAg positive and HBeAg negative patients.PreC A1899 mutation is associated with the development of cirrhotic-HCC and noncirrhotic-HCC in HBeAg positive patients.

Objective To investigate the expression of hypoxia inducible factor-1α(HIF-1α) and vascular endothelial growth factor C(VEGF-C) in colon carcinoma,and their relation with clinical pathological parameters and prognosis. Methods Immunohistochemistry was used to detect the expression of HIF-1α and VEGF-C in 65 tissues of colon carcinoma. Results In all cases,the expression of HIF-1α had a positive correlation with the expression of VEGF-C(r= 0.638,P＜0.01).The expressions of HIF-1α and VEGF-C had significant correlation with clinical stage and nodal metastasis(P＜0.05) ,but had no relationship with sex,age and tumor size(P＞0.05). Conclusion The expression of HIF-1α and VEGF-C was correlated with nodal metastasis, tumorigenesis and prognosis of colon/carcinoma.

Objective To summarize the correlation between cytotoxic T lymphocyte associated antigen-4 (CTLA-4) promoter-49 A/G polymorphism and Graves' disease (GD)in China.Methods The publications before Sep.30,2011 about the correlation between CTLA-4 promoter-49 A/G polymorphism and GD in China were collected by searching CNKI,CBM,and Wanfang database.Meta-analysis was performed to check the difference of genotypes such as AG,GG,GG + AG,and G allele between GD group and the control group.Results A total of 6 studies involving 570 cases in GD group and 486 cases in the control group were included in the meta-analysis.According to the heterogeneity of these studies,meta-analysis was performed to analyze the correlation between AG,GG,GG + AG genotype,G allele and GD by fixed effects model.The pooled OR value(95％ CI) of various studies was 1.97 (1.37-2.82),3.66 (2.42-5.53),2.55 (1.82-3.58),and 1.99 (1.49-2.65).Conclusion The meta-analysis demonstrates that CTLA-4 promoter-49 A/G polymorphism increases the possibility of getting GD in Chinese.

Objective Boy sexual development is affected not only by age, but also by environment factors .The present study was to survey and evaluate the status of sexual development in boys from Zhengzhou area and to explore their influencing factors. Methods The height, weight, waist circumference, hip circumference, penis and testicles in 3779 boys aged from 6 to 13 years old in Zhengzhou were measured .The penis length and testicular volume of different ages and their influencing factors were compared, and the beginning age and sexual development characteristics were explored .The development of genitalia and pubes were evaluated by Tanner staging criteria and standards, which were divided into five stages. Results There were 3779 boys, including 395 overweight cases (10.45%) and 208 obesity cases (5.50%).The testicular volume and penis length increased by age, which increased slowly at the age of 6 to 11, followed by a rapid increase after the age of 11 year old.Testicular volume increased more rapidly than that of penis length. The medians quartile of testicular volume in overweight group ,obese group and normal group were 2.50 mL, 2.50 mL, 2.00 mL, 2.00 mL,2.00 mL,1.00 mL respectively .The testicular volume in overweight group and obese group were significantly greater than that in nor -mal group (P<0.01) and there were no difference between overweight group and obese group .The penis length in overweight group and obese group were significantly less than that in normal group (P<0.01), and there was no difference between overweight group and obese group.Testicular volume and penis length were positively correlated with age, height, weight, body mass index, waist circumference and hip circumference; the correlation between testicular volume and height, penis length and age were the strongest. The age of development of testicle (average 12.02 years) in urban area was later by 2.73 years than that in the rural area (average 9.9 years), the difference was statistically significant (P<0.001).The age of pubic development (P2) and maturity (P5) was (12.34 ±0.83) years and (12.39 ±1.24 ) years.The incidence of precocity in boys was 0.40%. Conclusion The sexual development of boys from Zheng-zhou area is similar to the results of large scale survey from China .Attention should be paid to the effect of obesity on sexual develop-ment, and early intervention should be given, the occurrence of adverse events of sexual development can be avoided .