Objective To analyze the application of antimicrobial agents before and after the improvement of prescription evaluation system in Green Town Cardiovascular Hospital.Methods One thousand outpatient prescriptions of antimicrobial agents were randomly selected from our hospital from January 2014 to January 2016,serving as the data before intervention.These prescriptions were analyzed according to the prescription evaluation system and effective interventions were proposed according to the existing problems in prescriptions.Another 1 000 effective prescriptions of antimicrobial agents during February 2015 to January 2016 in our hospital were taken as the data after intervention.Unreasonable use of antimicrobial agents and the satisfaction degree of physicians,nurses and patients towards the prescription were compared before and after intervention.Results After intervention,the percentage of unreasonable use of antimicrobial agents from May 2015 to May 2016 (2.10%) was significantly lower than that from April 2014 to April 2015 (30.00%),the difference was statistically significant (χ2=288.857,P<0.05).The satisfaction degree of physicians,nurses and patients towards the prescription from May 2015 to May 2016 [(93.23±5.93)points,(95.29±6.01)points,(68.99±4.27)points] was significantly higher than that from April 2014 to April 2015 [(75.34±5.32)points,(71.46±5.13)points,(68.99±4.27)points],the difference was statistically significant (t=110.706,95.368,123.711,all P<0.05).Conclusion The improvement of prescription evaluation system can obviously improve unreasonable use of antimicrobial agents,increase the satisfaction degree,avoid drug abuse,produce obvious effect and great significance.

Objective:To examine the soft tissue changes of early skeletal Class III malocclusion patients after maxillary protraction treatment. Methods:60 skeletal anterior crossbite patients, 27 males, 33 females in the late mixed dentition were selected. The age ranged from 8 to 11 years. Mean age was 9.3 years. The patients were divided into treatment group and control group. Average treatment time was 12.1 months. Pre- and post-treatment lateral cephalograms of both groups were traced and analyzed. Difference between pre- and post-treatment was analyzed with paired t-tests. Results:After treatment, Ns-Sn-Pos, Ns-Prn-Pos, Sn-S-Si and Cm-Sn-UL decreased significantly,while Sn-Ns-Si and UL-E increased significantly. No significant change was found in S-Ns-Sn and LL-E. Conclusion:Soft tissue profiles are significantly improved by maxillary protraction treatment in the late mixed dentition. The concave profiles were changed to straight or nearly normal profiles. The relationship among nose, upper lip, lower lip and chin become harmonious. The curve of the lips tends to be smooth and harmonious.

Objective: To compare the effect of urapidil at different doses on blood pressure and prognosis of patients with acute ischemic stroke (AIS) so as to provide data evidence for its clinical use.Methods: Totally 62 patients with AIS were divided into 3 groups in a prospective study: 20 cases in high dosage group, 21 cases in middle dosage group and 21 cases in low dosage group.All the patients were treated with urapidil and urokinase, and the initial dose of urapidil was 25 mg, 15 mg and 5 mg, respectively.Systolic blood pressure (SBP) and diastolic blood pressure (DBP) of the patients before and after the treatment were observed, and the US national institutes of health stroke scale (NIHSS), modified Rankin scale (mRS) and activity of daily living scale (ADL) were also evaluated in the follow-ups.Results: The time of blood pressure up to standard in the middle dosage group and low dosage group was longer than that in the high dosage group.At the same time, the time of blood pressure up to standard in the low dosage group was longer than that in the middle dosage group, and the difference had statistical significance (P＜0.05).After the treatment, SBP and DBP at T1 in all the groups were notable lower than those at T0,and those at T2 and T3 were lower than those at T1, and the differences had statistical significance (P＜0.05).After the treatment, the SBP and DBP levels in the high dosage group were lower than those in the middle dosage group and low dosage group, and those in the middle dosage group were lower than those in the low dosage group, and the differences had statistical significance (P＜0.05).The NIHSS, mRS and ADL scores of the middle dosage group were lower than those of the low dosage and the high dosage group (P＜0.05), and there was no significant difference between the latter two groups (P＞0.05).Conclusion: With the initial dose of 15 mg, urapidil can ensure good prognosis on the premise of effective decompression.

Objective:To observe the effect of Chinese herbal fumigation combined with three-step tuina manipulation on concentration of endothelin (ET) and calcitonin gene-related peptide (CGRP) and vertigo in patients with vertebral artery cervical spondylosis (VACS).
Methods:A total of 120 eligible cases were randomly allocated into an observation group and a control group, 60 in each group. Cases in the observation group were treated with Chinese herbal fumigation combined with three-step tuina manipulation, whereas cases in the control group were treated with oral Flunarizine Hydrochloride Capsules.
Results: After treatment, vertigo in both groups was alleviated; there were intra-group significant differences in ET decrease and CGRP increase (P<0.01, P<0.05);and there were also inter-group significant differences (both P<0.05).
Conclusion: Chinese herbal fumigation combined with three-step tuina manipulation can regulate the levels of ET and CGRP and improve vertigo in patients with VACS. Its therapeutic efficacy is superior to oral Flunarizine Hydrochloride Capsules.

This article elaborated on the necessity and importance of reform of medical education administration system in comprehensive university in promoting comprehensive development of medical education,from the point of merging of universities.It also emphasized the long-term nature and complexity of the reform process.In the meantime,it introduced the reform measures and effects of the reform in the author's university.

Objective To evaluate the changes of growth hormone(GH), brain natriuretic peptide(BNP) and adrenomedullin(ADM) in congestive heart failure patients. Methods The blood samples were obtained from 60 pa-tients with congestive heart failure(CHF) and 30 patients without CHF,and their serum/plasma levels of GH,BNP and ADM were measured by enzyme-labeled immunosorbentassay(ELISA) and radioimmunoassay. At the same time all the patients received colorful Doppler ultrasonocardio-gram to determine left ventricular end-dilation diameter (LVED) and left ventrieular ejection fraction(LVEF). Results The levels of BNP and GH in heart failure group were[(0.83±1.06) μg/L,(115.31±191.16) ng/L] higher than eontrol group[(0.15±0.42) μg/L, (33.51±49.85) ng/L] (t = 2.689, t = 2.765, P < 0.01); The efficiency and total efficiency in heart failure group was (39.7% ,76.5%) higher than control group (32.3%, 61.3%) (t = 1.894, P > 0.05, t = 2.265, P < 0.05); The sensitivities and specificities of BNP were 89.3% and 63.0%; The sensitivities and specificities of GH were 85.7% and 59.3%; The BNP combined with GH were 75.0% and 74.0%. Condusion The combination of GH and BNP is better than application alone in the diagnosis of CHF.

Objective To investigate the influence of intraoperative posture intervention on drainage in patients after gynecological laparoscopic surgery. Methods A total of 1250 patients who were scheduled for gynecological laparoscopic surgery including laparoscopic-assisted salpingoplasty,oophorocystectomy,ectopic pregnancy,vaginal hysterectomy,myomectomy and appendectomy were randomly divided into two groups. The patients' posture was changed from Trendelenburg position to level lithotomic position during suction by the circulating nurses in the experimental group,while after surgery in the control group. The volume and time of drainage,and the length of stay after surgery were compared between the two groups. Results The volume and time of drainage,as well as the length of stay after surgery had significant differences between the two groups (P<0.05). Conclusions Intraoperative posture intervention is helpful for the treatment effect of drainage after gynecological laparoscopic surgery.

Objective To establish a statistical model that can quantitatively analyze the dosimetric sparing of the bladder based on individual patient’ s anatomy in the static intensity-modulated radiotherapy (IMRT) plans for rectal cancer.Methods Static IMRT plans (7 AP fields) for 100 rectal cancer patients were used to train the model from 2012 to 2013.The anatomical features were quantitatively analyzed by the sizes of overlap regions of bladder-planning target volume (PTV) and bladder-PTV+0.5(0.5 cm margin around the PTV) .The mathematic relationship between anatomical features and dosimetric sparing of the bladder was evaluated after the bladder sparing dose was analyzed using dose-volume histogram.The established model was verified in the IMRT plans for additional 20 rectal cancer patients.Results Bladder V50 was linearly correlated with the ratio of bladder-PTV overlap size to bladder volume ( denoted as x%) , with an equation of V50=0.89x-0.99.Bladder V40 showed an approximately linear correlation with the ratio of bladder-PTV+0.5 overlap size to bladder volume (denoted as y%).The mean dose depended on both x%and y%.For the additional 20 plans, the absolute deviation between predicted and actual values for V50 and V40 were (-3.13%-3.78%) and (-5.30%-5.66%) , respectively, and the relative deviation for the mean dose was (-3.94%-3.76%) .Conclusions The model obtained in this work provides an effective method for quantitatively estimating the bladder sparing dose in IMRT plans for rectal cancer.

Objective To analyze the β-lactamases-producing Escherichia coli which were isolated from hospital specimens from Jun 2012 to Dec 2014,and provide a more accurate evidence to guide drug-selecting for antibacterial use.Methods An-alyzed 1 587 E.coli from patient sample selected between Jun 2012~Dec 2014 using the microbial analysis system manufac-tured by ZHUHAI DL BIOTECH CO.LTD,A phenotypic test was also conducted to test ESBLs.Results 1 587 stains of E-.coli were isolated,which counted for 23.9% of the specimens;901 stains (56.8%)out of total 1 587 stains appeared to be ESBLs-producing E.coli,and others were non-ESBLs-producing E.coli.The 1 587 Escherichia coli mainly came from De-partment of Urology (408,weight 25.7%),Department of Endocrinology (271,weight 17.1%),Department of Respiration (249,weight 15.7%).Rine specimen contributed 609 stains (47.3%),411 E.coli stains (31.9%)were discovered in spu-tum samples,and 83 stains (6.5%)showed in blood samples.The resistance to imipenem were discovered in the analysis. The rates of resistance to penicillins,cephalosporins were over 90.0%,the rates of resistance to Levofloxacin,ciprofloxacin were above 70.0%,and resistance rates to amoxicillin-clavulanic acid,Ticarcillin-clavulanic acid,piperacillin/tazobactam, amikacin were lower than 7.7%.Conclusion The drug-resistance of the E.coli were increasing over the past three years. There was a significant portion of MDR and PDR present in the trend.Thus,the reinforcement of the drug-resistance survey and testing have a far-reaching meaning to promote rational drug selecting.

Objective To investigate the effects of irbesartan hydrochlorothiazide combined with candesartan cilexetil in the treatment of elderly patients with hypertension and its protective effect on cardiac function.Methods 180 elderly patients with hypertension were selected,and they were randomly divided into observation group and control group according to the digital table,90 cases in each group.The observation group was given irbesartan hydrochlorothiazide combined with candesartan treatment,the control group was given candesartan.The heart function improvement after treatment,clinical efficacy and patients in hospitalization,complications,critical events and new death of the two groups were compared.Results After treatment,the heart rate,EVDD,SBP and other indicators of the two groups declined,which of the observation group[(56.14 ± 6.15)mm,(112.12 ± 20.12)mmHg,(70.45 ± 8.69/min)]were lower than the control group[(60.12 ± 6.78) mm(119.45 ± 21.45) mmHg,(82.12 ± 9.12/ min)],there were significant differences between the two groups (t1 =4.124,P =0.000;t2 =2.364,P =0.019;t3 =8.788,P =0.000).The total effective rate of the observation group was 93.33％,which was higher than 74.44％ of the control group,there was significant difference between the two groups (x2 =11.879,P =0.000).Conclusion Irbesartan hydrochlorothiazide combined with candesartan in the treatment of elderly hypertensive patients can effectively improve the heart function of patients,has significant effect.