OBJECTIVE: To investigate the use of antibiotics in our hospital. METHODS: All the prescriptions in Jan., Apr., July and Oct. in 2006 in dispensary for western medicine were reviewed, from which, 6 605 (17.26%) antibiotic prescriptions were selected. The categories and kinds of antibiotics were investigated; meanwhile the administration and dosage, course of treatment and drug combination were analyzed based on diagnosis and patient's age. RESULTS: The antibiotics used in 6 605 prescriptions totaled 7 categories. 87.80% used antibacterial drugs accorded with diagnose; 56.46% of the antibacterial drugs were administered orally; in terms of dosage and administration, more than 95% were up to the standard; the course of treatment in 86.99% ranged from 3 to 7 days; 91.04% of the antibacterial drugs used in single kind, about 8.80% in two kinds, and only 0.17% in three kinds concomitantly. CONCLUSION: The use of antibacterial drugs in our hospital is rational on the whole, yet it is far from perfect. Measures should be taken to further improve the rational drug use level.

Objective To evaluate the effect of fentanyl on the expression of vascular endothelial growth factor A (VEGF-A) and matrix metallopeptidase-9 (MMP-9) in the subcutaneous tumor of human gastric cancer in nude mice.Methods Thirty SPF male BALB/C nude mice,aged 4-5 weeks,weighing 15-20 g,in which the model of subcutaneous tumor of human gastric cancer cell line MGC-803 was established,were randomly divided into 6 groups (n =5 each) using a random number table:control group (C group),normal saline group (NS group) and fentanyl 0.05,0.10,0.20 and 0.40 mg/kg groups (F1-4 groups).The mice in group C received no treatment.Fentanyl 0.05,0.10,0.20 and 0.40 mg/kg were intraperitoneally injected once a day for 14 consecutive days in F1 4 groups,respectively,while the equal volume of normal saline 1.5 ml/kg was given instead of fentanyl in group NS.The nude mice were sacrificed on 1 day after the end of administration,and the tumor tissues were obtained for examination of the ultrastructure of subcutaneous tumor (with a transmission electron microscope) and for detection of the expression of VEGF-A and MMP-9 (by immunohistochemistry and Western blot) and expression of VEGF-A and MMP-9 mRNA (by real-time reverse transcriptase polymerase chain reaction).Results No abnormality in the morphology of the subcutaneous tumor cells was observed in C and NS groups.The swollen nucleus,chromatin margination,nuclear fragmentation and apoptotic bodies were found in the subcutaneous tumor cells in F1-4 groups.Compared with group C,the expression of VEGF-A and MMP-9 protein and mRNA was significantly down-regulated in F1-4 groups (P＜0.05),and no significant change was found in each parameter mentioned above in group NS (P＞0.05).There was no significant difference in the expression of VEGF-A and MMP-9 protein and mRNA among F1-4 groups (P＞0.05).Conclusion The mechanism by which fentanyl inhibits the growth and metastasis of subcutaneous tumor cells of human gastric cancer is related to down-regulation of VEGF-A and MMP-9 expression in nude mice.

Objective To evaluate the effect of morphine on the growth of subcutaneous tumor of human gastric cancer cells in nude mice.Methods Thirty SPF male BALB/C nude mice,aged 4-5 weeks,weighing 15-20 g,in which the model of subcutaneous tumor of human gastric cancer cell line MGC-803 was established,were randomly divided into 3 groups (n=10 each) using a random number table:control group (group C),normal saline group (group N),and morphine group (group M).The mice in group C received no treatment.Morphine 20 mg/kg was intraperitoneally injected once a day for 14 consecutive days in group M,while normal saline 1.5 ml/kg was given instead of morphine in group N.The caliper was used to measure the tumor size every 2 days starting from 3 days after beginning of administration,and the relative tumor volume was calculated.The nude mice were sacrificed on 15th day,and the tumor tissues were obtained for determination of nuclear factor-kappa B activity and Bcl-2 and Bax protein and mRNA expression by real-time reverse transcriptase polymerase chain reaction and Western blot.Results Compared with group C,the relative tumor volume was significantly decreased,the activity of nuclear factor-kappa B in tumor tissues was significantly decreased,the expression of Bcl-2 protein and mRNA was significantly down-regulated,and the expression of Bax protein and mRNA was significantly up-regulated at each time point in group M (P＜0.05),and no significant change was found in each parameter mentioned above in group N (P＞0.05).Conclusion Morphine can inhibit the growth of subcutaneous tumor of human gastric cancer cells in nude mice,and the mechanism is associated with promotion of apoptosis in tumor cells.

Objective To explore the relation between the Integrin alpha 2 (ITGA2)-807 C/T gene and diabetic nephropathy (DN) in Han nationality in northern part of Guangxi. Methods 206 patients with type-2 diabetes were selected from the hospital. According to the diagnosis of diabetic nephropathy (DN) standards, 206 patients with type-2 diabetes were divided into diabetes without diabetic nephropathy (T2DM) and DN group, and 90 healthy people were selected as normal control (NC) group. The plasma lipid and lipoprotein levels were measured by routine method.And the genotypes and allele frequencies distribution were assessed by Polymerase chain reaction-restriction fragment length Polymorphism (PCR-RFLP). Results compared with the control group,plasma total cholesterol(TC),triglyceride(TG) and low density lipoprotein-cholesterol (LDL-C) levels in DN group blood were significantly higher (P < 0.05). ITGA2 gene - 807 - c/T genotype distribution and allele frequency in DN group were statistically significant (P<0.05). CT+TT genotypes and T allele frequency in DN group were significantly higher than control group (P<0.05).The relative risk for DN in subjects carrying T allele was 1.72 times of that in the C allele carriers(OR = 1.72, 95% CI = 1.72 ~ 2.517). And compared with control group and the DN group, ITGA2 gene-807-c/T genotype distribution and allele frequency differences in T2DM group had no statistical significance (P > 0.05). Conclusions The polymorphism of ITGA2-807C/T gene is associated with the development of DN in Han nationality in northern part of Guangxi. The T allele may be a genetic susceptibility genes for DN, which may promote the level of TC high expression and increase the risk of DN.

Objective:To explore the current status of regional registration and practice of nurses in Guangdong Province, so as to provide a basis for policy formulation.Methods:A systematic sampling method was used to retrospectively extract regional registration related data from 5 583 regional registered nurses and 1 323 registered medical institutions in the "Guangdong Province Medical Administration Comprehensive Management Information System" from May 1, 2018 to November 8, 2019.Results:Among regional registered nurses who had filed systematically in Guangdong Province, 79.84% (4 458/5 583) were 21 to 40 years old, and there were mainly female (99.07%, 5 531/5 583) , and there were mainly nurses with junior professional titles in terms of professional titles (74.62%, 4 166/5 583) .The flow of registered institutions in the system was mainly from private medical institutions to other private medical institutions (56.90%, 3 177/5 583) . Private medical institution nurses had the least number of nurses practicing in public medical institutions ( n=69) . Institutions below ClassⅡ and private medical institutions were the institutions that mainly accepted multi-sited practice nurses, reaching 4 727 (84.67%) . Conclusions:The pilot work of regional nurse registration in Guangdong Province has achieved initial results.The establishment and improvement of the filing system, the continuous growth of the multi-sited nurse practitioner team, and the diverse flow of nurse practitioners have laid a foundation for the next step coordinated advancement and mutual promotion of the "Internet + Nursing Service" pilot work. However, on the basis of ensuring safety, how to promote the flow of existing high-quality nursing human resources to primary medical institutions is still worthy of further consideration.

Hypersplenism is an important complication of cirrhotic portal hypertension, and splenectomy is an important means to treat hypersplenism in cirrhosis. It is realized that hypersplenism played a pathological role in the course of cirrhosis. This article analyzes and compares the changes in the condition of patients with cirrhosis between splenectomy with and without hyperfunction, and comprehensively discusses the pathological role and mechanism of hypersplenism in the course of cirrhosis, in order to strengthen the clinical prevention and treatment of hypersplenism in cirrhosis and to better improve the condition and prognosis of patients with cirrhosis.

Objective:To understand the epidemiological characteristics of imported COVID-19 cases in Guangzhou and provide scientific basis for the prevention and control of the disease.Methods:The data of imported COVID-19 in Guangzhou reported as of April 1, 2020 were collected from National Notifiable Disease Report System of China. The software Excel 2010 and SPSS 19.0 were applied for data cleaning and statistical analysis.Results:As of April 1, 2020, a total of 103 imported COVID-19 cases had been reported in Guangzhou, in which 92 were confirmed cases and 11 were asymptomatic infection cases. The number of the confirmed imported cases accounted for 11.4 % (92/806) in of the total in China at the same time. The male to female ratio of the cases was 1.58∶1 (63∶40). The median age of the cases was 31 years ( P 25- P 75:22-40 years), range of age was 11-63 years. The main occupational distributions of the cases were business services (41/103, 39.8 %) and students (36/103, 35.0 %). The imported cases whose destinations were 19 provinces and municipalities rather than Guangdong after entering the country accounted for 43.7 %. The main source countries of infections were the United Kingdom (27/103, 26.2 %), the Philippines (13/103, 12.6 %), the United States (13/103, 12.6 %) and Nigeria (7/103, 6.8 %). There were 34 inbound flights from which the imported COVID-19 cases were detected, in which 10 flights (10/34, 29.4 %) were found to carry more than 3 cases, with an average voyage time of (11.14±0.53) hours. A total of 29 imported cases(28.2 %) showed symptoms before entering the country, and 65 cases (63.1 %) had been isolated before the onset of the disease. The mean free activity time of the isolated cases after the onset was (6.76±0.79) days. The average number of the imported cases’ close contacts was 53. There were 13 clusters of COVID-19 caused by the imported cases, involving 36 cases (including 1 imported associated case). Conclusions:The sources of the imported COVID-19 cases in Guangzhou were widely distributed, and no cases had been found to be infected on the flights. In the early stage of the imported epidemic, there was high risk for the spread of the epidemic. Strengthened prevention and control of imported COVID-19 effectively reduced the of transmission risk of COVID-19 in communities.

Outpatient humanistic care refered to providing a full process of caring medical services to outpatients. In order to standardize the human caring services for outpatients in medical institutions, promote the comprehensive service level of outpatient services, and improve the patient′s medical experience, Chinese Association for Life Care issued the group standard of Management Norms for Human caring of Outpatients in April 2023. This standard clarified the relevant terms and definitions of human caring for outpatients, specified the basic requirements for human caring, the humanistic quality and care responsibilities of outpatient staff, the outpatient care environment and facilities, the outpatient care process and measures, and quality management. It designed standardized and personalized full process care service norms, providing references for medical institutions at all levels to promote the development of human caring for outpatients.

In order to understand nurses’ willingness to participate in humanistic nursing training and its influencing factors, and provide reference for managers to understand the current situation and improve nurses’ enthusiasm for humanistic nursing training. The convenience sampling method was used to investigate 23 707 nurses in 28 provinces (autonomous regions and municipalities directly under the central government) through a self-designed questionnaire distributed on the Internet. The results showed that 98.1% of nurses thought that participating in humanistic nursing related training was helpful to clinical work, but only 88.6% of the respondents were willing to participate in humanistic nursing training. Thirty factors were analyzed from four aspects of basic characteristics of individuals, cognitive relevant experience and organizational atmosphere. Fifteen factors had significant significance in binary Logistic regression analysis (P<0.05). Among them, the factors that had a positive impact on training willingness were: marriage, education, professional title, post establishment, agree with humanistic care is the basic duty of a nurse praised, experience of being praised at work, family support, rapport with patients, passion of colleagues to participate in training, sustained high-quality care demonstration activities, join the humanistic care related organization, hospital reimbursement of training expenses (OR value of 6.559~1.113, P<0.001). The OR value of humanistic nursing as a nurse’s responsibility was 6.559 and the 95%CI was 5.585~7.702. The factors that hindered nurses from participating in training were: work occupied most of time and energy, think humanistic nursing is abstract and difficult to understand, think the mastered humanistic knowledge and skills meet the needs of work (OR value of 0.657~0.722, P<0.001). Through the analysis, it is considered that nurses have a extremely consistent high recognition of the significance of humanistic nursing training, but their willingness to receive training is affected by many factors such as individual experience, cognitive attitude and organizational atmosphere. In order to realize nurses’ high recognition of humanistic nursing training to high enthusiasm of behavior, the aspects of individual cognition and organizational atmosphere must be discussed.

In order to understand nurses’ willingness to participate in humanistic nursing training and its influencing factors, and provide reference for managers to understand the current situation and improve nurses’ enthusiasm for humanistic nursing training. The convenience sampling method was used to investigate 23 707 nurses in 28 provinces (autonomous regions and municipalities directly under the central government) through a self-designed questionnaire distributed on the Internet. The results showed that 98.1% of nurses thought that participating in humanistic nursing related training was helpful to clinical work, but only 88.6% of the respondents were willing to participate in humanistic nursing training. Thirty factors were analyzed from four aspects of basic characteristics of individuals, cognitive relevant experience and organizational atmosphere. Fifteen factors had significant significance in binary Logistic regression analysis (P<0.05). Among them, the factors that had a positive impact on training willingness were: marriage, education, professional title, post establishment, agree with humanistic care is the basic duty of a nurse praised, experience of being praised at work, family support, rapport with patients, passion of colleagues to participate in training, sustained high-quality care demonstration activities, join the humanistic care related organization, hospital reimbursement of training expenses (OR value of 6.559~1.113, P<0.001). The OR value of humanistic nursing as a nurse’s responsibility was 6.559 and the 95%CI was 5.585~7.702. The factors that hindered nurses from participating in training were: work occupied most of time and energy, think humanistic nursing is abstract and difficult to understand, think the mastered humanistic knowledge and skills meet the needs of work (OR value of 0.657~0.722, P<0.001). Through the analysis, it is considered that nurses have a extremely consistent high recognition of the significance of humanistic nursing training, but their willingness to receive training is affected by many factors such as individual experience, cognitive attitude and organizational atmosphere. In order to realize nurses’ high recognition of humanistic nursing training to high enthusiasm of behavior, the aspects of individual cognition and organizational atmosphere must be discussed.