Objective To analyze antimicrobial use in the different grades of hospitals within 3 years after the car-rying out of rectification activities of antimicrobial use,and provide basis for making continuous improvement pro-gram of antimicrobial management.Methods Retrospective analysis was performed,outpatient and emergency pre-scriptions and medical records of discharged patients (100 were type Ⅰ incision surgery)were selected from 5 tertia-ry hospitals and 5 secondary hospitals within 3 months,antimicrobial use and management were investigated. Results 200 outpatient prescriptions,100 emergency prescriptions,and 200 medical records of discharged patients were selected from each hospital.In tertiary and secondary hospitals,antimicrobial usage rate in outpatient prescrip-tions was 17.40% and 18.00% respectively,emergency prescriptions was 31 .60% and 40.10% respectively;a-mong inpatients,antimicrobial usage density(AUD)was (28.13±8.04)and (49.67±11 .63)respectively,and anti-microbial usage rate was 41 .30% and 56.20% respectively;pathogenic detection rate of antimicrobial therapeutic cases was 45.70% and 22.70% respectively,therapeutic cases with limit level of antimicrobials was 61 .50% and 27.40% respectively;antimicrobial usage rate in type I incision surgery was 20.00% and 40.40% respectively;The rational rate of antimicrobial types was 94.60% and 59.20% respectively,rational rate of opportunity of antimicro-bial use was 95.20% and 48.20% respectively;combination rate was 8.80% and 36.60% respectively,and rational rate of treatment course was 84.00% and 52.80% respectively.Conclusion In tertiary hospitals,antimicrobial use after 3 years rectification of antimicrobial use conform to the antimicrobial management requirement of Ministry of Health,the overall quality index is better than secondary hospitals,management of antimicrobial in secondary hos-pitals use should be improved.

Objective To investigate the correlation of serum levels of soluble intercellular adhe-sion molecule-1(slCAM-1) and high-sensitivity C reactive protein (hs-CRP) in newborn infants with hypoxic-ischemie encephalopathy(HIE),as well as the clinical significance of the above two indicators in evaluating prognosis and pathogenetic condition, Methods Immunoturbidimetry(ITM) was applied to measuring hs-CRP,and enzyme linked immunosorbent assay(ELISA) was used to detect slCAM-1. Results As compared with those of healthy control group,the serum levels of hs-CRP and slCAM-1 were significantly increased in acute phase group(P＜0.01). However, the serum levels of hs-CRP and sICAM-1 were declined in recovery phase group. No statistical difference was found between recovery phase group and healthy control group(P>0.05). Conclusion Serum slCAM-1 and hs-CRP may be used as useful indicators of prognosis and pathogenetic condition.

Objective To investigate the features of multi-slice helical CT and upper gastrointestinal manifestations for primary gastric lymphoma in order to improve diagnostic accuracy.Methods Data from 24 patients with pathologically confirmed primary gastric lymphoma and applied multi-slice helical CT and upper gastrointestinal findings were retrospectively analyzed.Their characteristics were summarized.Results All 24 patients were B cell originating of non-Hodgkin' s lymphoma.The characteristics of multi-slice helical CT manifestations were as follows:multiple lesions,equal density,homogeneous enhancement,thickening widely of the stomach wall but soft,perigastric lymph nodes enlargement.Upper gastrointestinal performance:lesions varied,complex,multiple or single nodules,multiple superficial ulcers,gastric wall thicken diffusely but having squirm and stomach cavity without narrowing.Conclusion There are some specific characteristics in multi-slice helical CT and upper gastrointestinal of primary gastric lymphoma and in might be importance for diagnosis and differential diagnosis.

Objective To investigate the effect and mechanism of the icaritin on the human cronic myeloid leukemia K562 cells. Methods The K562 cells at logarithmic growth phase were divided into the control group and the icaritin group. The cells in the control group were normally treated and the cells in the icaritin group were incubated with 8 μmol/L icaritin. Methyl thiazolyl tetrazolium (MTT) method and flow cytometry were used to examine the proliferation and apoptotic changes in the two groups after incubation for 72 h, respectively. Gene expression of p85 and Akt were detected by RT-PCR. The protein changes of p85, Akt, p-p85, p-Akt cleavage-caspase-3 and caspase-3 were detected by Western blot. Results Compared with the control group, the proliferation rate of K562 cells in the icaritin group was significantly decreased (P<0.05), however the apoptotic rate of K562 cells and the expressions of p-p85, p-Akt, cleavage-caspase-3 in the icaritin group were significantly increased (all P< 0.05), but the expressions of p85 mRNA, Akt mRNA and caspase-3 protein had no difference (all P> 0.05). Conclusion Icaritin could induce the proliferation and promote the apoptosis of K562 cell, and its mechanism may be achieved through activating the PI3K-Akt signal transduction pathway.

Gene ADAM10 (a disintegrin and metalloproteinase 10) is a member of ADAMs gene family. The corresponding membrane protein contains a disintegrin domain and a metalloproteinase domain. It is involved in various biological events such as cell adhesion, cell fusion, cell migration, and membrane protein shedding and proteolysis. ADAM10 protein is overexpressed in many tumors, which interacts with adhesion molecules and critical signaling molecules associated with cancer development and tumor progression, and promotes tumor invasion and metastasis. Regulating the expression of ADAM 10 can inhibit tumor invasion and metastasis , which may become a new strategy for anticancer therapy.

Chemiluminescence method and modified nitrous acid method were applied to determine the concentration of superoxide anion radical in plasma and erythrocyte of rats and the activity of superoxide dismutase(SOD) respectively. The results showed that Isoginkgetin (0.3mg/kg ip for 3d) could reduce the level of 0_0~-in plasma and erythroeyte (p

Objective To examine how work stress influences somatization and work burnout, especially concerning for the difference between work load and interpersonal relationship stress in the correlation with work burnout. Methods Using cross-sectional design and questionnaire survey method, participants were 455 female nurses recruited from nine hospitals in Nanjing, China. Results The results revealed that work load and interpersonal relationship stress positively predicted somatization (βwork load=0.33,βinterpersonal relationship stres =0.22, P<0.01), emotional exhaustion (βwork load=0.57,βinterpersonal relationship stres =0.22, P<0.01) and cynicism (βwork load=0.49,βinterpersonal relationship stres =0.29, P<0.01), and negatively predicted personal accomplishment (βwork load=-0.18,βinterpersonal relationship stres =-0.21, P<0.01). Specially, the influence of work load on emotional exhaustion and cynicism was significantly higher than that of interpersonal relationship stress (Z=6.37, 3.57, P < 0.05), but there were no differences between them in personal accomplishment and somatization (Z=1.79, 0.47, P > 0.05). Conclusions There are significant differences between work load and interpersonal relationship stress in the correlation with work burnout.

Objective To investigate the combined effect of exemestane and low-dose methotrexate on exemestane-resistant MCF-7 human breast cancer cells( MCF-7/EXE). Methods Antiproliferative effects of exemestane and low-dose of methotrexate, alone and in combination on growth of MCF-7/EXE cells were assessed by using the MTT assay. Synergistic interaction between the two drugs was evaluated in vitro by using the combination index ( CI) method. The cell cycle distribution was analyzed by flow cytometry in a half inhibitory concentration of exemestane and low-dose of methotrexate . The changes of apoptosis on MCF-7/EXE cells exposed to two drugs alone or in com-bination were observed by fluorescence microscope. The expression of Bcl-2,AKT,P-AKT and cyclooxygenase-2 was investigated by Western blot. Results MTT assays indicated that the combination treatment apparently decreased the viability of MCF-7/EXE cells compared to single drug treatment (CI<0. 9). In addition, the combination of exemestane and low-dose methotrexate exhibited a synergistic inhibition of cell proliferation, arrested the cell cycle in the S phase significantly and produced a stronger inhibitory effects on P-AKT, Bcl-2 and cyclooxygenase-2 ex-pression than control or individual drug treatment. Conclusion The combination of the two inhibitors significantly increases the response as compared to single agent treatment, suggesting that combination treatment which can re-verse the resistance of exemestane could be a more effective approach to breast cancer.

Objective To investigate the effects of oxymatrine on liver fibrosis and its mechanism. Methods The rat model of liver fibrosis induced by CCl 4 was set up. The effect of oxymatrine anti-liver fibrosis were evaluated by comparing liver weight index, serum/tissue biochemical indices and the change of tissue pathology before and after oxymatrine intervention. The levels of serum HA,PⅢP,LN and Ⅳ-C were also measured before and after oxymatrine treatment. Results In CCL4-induced liver fibrosis model rats, the levels of serum HA,PⅢP,LN and Ⅳ-C significantly decreased(P

Objective To investigate the distribution and antibiotic resistance patterns of uropathogens in children with complicated urinary tract infection to guide the empirical antimicrobial treatment.Methods Retrospective analysis of isolated bacteria from 141 children hospitalized with complicated urinary tract infection was performed from January 2011 to January 2013.Results Gram-negative bacillus were the main pathogens [56.6％(81/143)],and Escherichia coli was the leading cause (41.3％,59/143).Gram-positive bacillus accounted for 38.5％ (55/143),including Enterococcus faecium (17.5％,25/143) and Enterococcus faecalis (14.7％,21/143).Fungi caused 4.9％ (7/143) of the infections.The resistance of Escherichia coli to amoxicillin was the highest [92.0％ (23/25)] and resistance to imipenem (4.3％,2/47),amikacin (6.8％,4/59) and nitrofurantoin (6.8％,4/59) was lower.It was observed resistance of Enterococcus faecium to linezolid,quinupristin,vancomycin and nitrofurantoin was significantly lower than other common antibiotics.The resistance of Enterococcus faecalis to quinupristin,tetracycline,erythromycin,rifampicin was significantly higher than other common antibiotics.Concluusions Escherichia coli,Enterococcus faecium and Enterococcus faecalis are the common uropathogens.These pathogens have a high antibiotic resistance to many common antibiotics.The selection of empirical treatment of children with complicated urinary tract infection should be adjusted by antimicrobial susceptibility test.