OBJECTIVE To survey and assess the use of antibiotic drugs in our hospital before and after the enactment of The Antibiotics Use Guideline by the Ministry of Health.METHODS To determine antibiotic drugs usage rate,combined use conditions as well as other factors in inpatients before and after the enactment of the guideline.RESULTS After the enactment of the guideline,the usage rate of antibiotic drugs was much lower than before,whereas there were still some shortcomings in the combined drug use conditions in our hospital.CONCLUSIONS The medical workers should administer antibiotic drugs in a more reasonable way in order to guarantee the safety,long term health right and living quality.

A field study on 24 weigbt--lifters and an experiment on rats imitating kuman acute food restrictionwere done in order to find out the metabolism of water and electrolytes during the acute weight-reductionperiod and the effect of appropriate supplementation. The results showed that food restriction caused very significant loss of the water and electrolytes withsigns of muscle cramp, dehydration, ketonuria etc. The experimental results in rats were observed duringfood restriction as following: 1. Serum potham and sodium decreased and the serum chloride and magnesium increased significantly. 2. Potassium and sodium contents of cardiac muscle were significantly lower than those of the control group,but potassium content of skeletal muscles was higber. 3. Blood lactic acid (3 minutes after running on a treadmill for half an hour ) was higber than thatbefote food restriction. Supplementation of appropriate minerals is beneficial to correct the above changes and keep the athletesfit and in good form.

Objective To investigate the correlation between shear wave velocity and tissue fibrosis score in thyroid space-occupying lesions.Methods The shear wave velocity of 55 thyroid space-occupying lesions was examined by virtual touch tissue quantification.The shear wave velocity of different solid parts of the lesions was detected for several times and 15 data were genarated.Then maximum and minimum value were removed.The maximum (Vmax),minimum (Vmin),mean (Vm) of shear wave velocity were calculated with the rest of 13 data.Meantime the fibrosis degree of these pathological lesions were scored by using optical micorscope.The maximum (Fmax),minimum (Fmin) and mean (Fm) fibrosis degree were calculated with these scores.Then the difference between Fmax,Fmin and Fm value of benign lesions and malignant lesions was analyzed.The linear correlation between Fmax and Vmax,Fmin and Vmin,Fm and Vm was also analysed.Results In the 55 lesions,30 lesions were benign and the rest was malignant.The Fmax,Fmin,Fm of benign lesions were 1.38 ± 1.44,0.68 ± 0.25,0.91 ± 0.73 respectively; the corresponding value of malignant lesions were 5.00 ± 1.91,3.52 ± 1.82,4.08 ± 1.75 respectively.There was significant difference between the benign group and malignant group (t test,P ＜0.01).There were linear correlation between Fmax and Vmax,Fmin and Vmin,Fm and Vm and the Pearson correlation coefficients were 0.504,0.284,0.453 respectively.Conclusions The shear wave velocity and fibrosis degree of thyroid lesions has linear relationship.The heavier the degree of fibrosis is,the faster the shear wave velocity would be.

Objective To study the effect of alpha-melanocyte stimulating hormone (α-MSH) and its novel analogue ( STY39 ) on the production of tissue factor ( TF ) and tissue factor pathway inhibitor (TFPI) stimulated by lipopolysaccharide (LPS) in primary mouse brain microvascular endothelial cells (MBMECs). Methods Female BALB/c mice were selected,purified and primarily cultured for 5 to 7 days. Immunofluorescence assay was use to detect the Ⅷ factor related antigen and identify the MBMEC model. The MBMECs were divided into eight groups:PBS control group, LPS stimulation group, after LPS stimulation 1,2,and 3 h adding 10 -7 mol/Lα-MSH groups or STY39 group (LPS+α-MSH,LPS+STY39) ( n=4 wholes in each group) . The cell culture supernatant and cells were collected at 6 and 8 h after LPS stimulation. An enzyme-linked immunosorbent assay was used to detect the concentrations of TF and TFPI in cell supernatant. RT-PCR was used to detect the expression levels of TF mRNA. Results (1) LPS could induce MBMEC to produce TF and TFPI proteins. The level of TF in the cell culture supernatant reached the peak at 6 h,and the level of TFPI reached the peak at 8 h. (2) At 1,2,and 3 h after LPS stimulating MBMEC,10 -7mol/L α-MSH or STY39 were given. They could significantly decrease the TF protein content in the cell supernatant (P<0. 01),especially the effects of giving α-MSH or STY39 were most significant at 1 h after LPS stimulation (P<0. 05). The effect of STY39 for decreasing TF content was more significant than that of α-MSH (P<0. 05);however,α-MSH and STY39 did not have significant up-regulating effects for LPS inducing MBMEC to produce TFPI. (3) After LPS stimulation,10 -7 mol/Lα-MSH or STY39 were given at different time points. They significantly down-regulated the expression level of MBMEC TF mRNA (P<0. 01). The effect was most significant at 1 h time point (P<0. 05),but there was no significant difference in the effects betweenα-MSH and STY39. Conclusion Bothα-MSH and STY39 can suppress LPS-induced primary MBMEC to produce TF protein and express TF mRNA,and the effect of administration is better after 1 h LPS stimulation. The suppressive effect of STY39 on the production of TF protein is superior toα-MSH.

Objective To evaluate the effect of α-melanocyte stimulating hormone (α-MSH) and its novel analogue STY39 on the production of tissue factor pathway inhibitor (TFPI) in mice with endotoxemia.Methods Female BALB/c mice were randomly divided into eight groups with 9 mice in each group.Endotoxemia was reproduced by intraperitoneal injection of lipopolysaccharide (LPS,25 μg/kg) and D-galactosamine (D-Gal,100 mg/kg).The animals of the control group were given phosphate buffered solution (PBS) instead.In the experimental groups,the mice were injected intraperitoneally with 2.5 mg/kg α-MSH or STY39 at 1,2 or 3 hours following LPS injection.The orbital blood was collected at different time points,and tissues of lung,liver,and kidney were collected 8 hours after the administration of LPS.The plasma TFPI levels were determined by enzyme linked immunosorbent assay (ELISA),and the expression of TFPI mRNA in different tissues was determined with reverse transcription-polymerase chain reaction (RT-PCR).Results The plasma TFPI levels (μg/L) began to increase (11.84 ± 1.55) in the endotoxemia mice 4 hours after LPS challenge and reached the peak (23.49 ± 1.12) at 8 hours.α-MSH or STY39 treatment at 1,2 or 3 hours after LPS challenge could significantly increase the TFPI content,with the best drug effect at 1 hour after LPS challenge (the blood was collected 8 hours after LPS challenge,α-MSH group:58.79 ± 2.67 vs.28.49 ± 1.69,STY39 group:71.08 ± 2.13 vs.28.49 ± 1.69,both P＜0.01),and the effect of STY39 was better than that of α-MSH (P＜0.01).A small amount of TFPI mRNA expression was observed in each tissue of the healthy mice.After LPS challenge,TFPI mRNA expression was increased in all the tissues,especially in the lung,liver and kidney.α-MSH or STY39treatment at 1 hour after LPS challenge could significantly up-regulate the expression of TFPI mRNA in the lung and liver (A value,α-MSH in lung:51.10 ±2.89 vs.32.43 ±2.51,STY39 in lung:72.11 ±3.48 vs.32.43 ±2.51;α-MSH in liver:43.21 ± 2.12 vs.29.29 ± 2.06,STY39 in liver:66.82 ± 1.76 vs.29.29 ± 2.06,both P＜0.01).The treatment with STY39 at 1 hour after LPS challenge could significantly up-regulate the expression of TFPI mRNA in the kidney (A value:45.21 ± 1.80 vs.30.44 ± 2.23,P＜0.01),but the treatment with α-MSH had no obvious effect (A value:24.61 ± 1.98 vs.30.44 ± 2.23,P＞0.05).The enhancing effect of early administration of STY39 on TTPI mRNA expression in the lung,liver and kidney tissues of endotoxemia mice was more powerful than that of α-MSH (all P＜0.01).Conclusion The early administration of α-MSH or STY39 may up-regulate TFPI production in the mice with endotoxemia,and the effect of STY39 is superior to α-MSH.

Objective To discuss the diagnostic value of distal subclavian artery flow velocity tracing for proximal segment severe stenosis.Methods 56 cases with 112 subclavian arteries were examed by ultrasonography and multidetector CT angiography respectively,then the flow velocity tracing of distal subclavian arteries had been compared with CT results.Results In all 112 subclavian arteries,there were 37without proximal segment stenosis,32 with mild stenosis,12 with moderate stenosis,and 31 with severe stenosis.Innominate arteries and other parts of subclavian arteries had no stenosis.In diagnosis of subclavian artery proximal severe stenosis using single phase single peak waveform,the sensitivity,specificity,positive likelihood ratio,and negative likelihood ratio were 83.9 ％,96.3 ％,22.7,0.063 respectively.The sensitivity,specificity,positive likelihood ratio,and negative likelihood ratio were 100 ％,93.8 ％,16.1,0 respectively,in terms of diagnosis by application of acceleration time ≥0.11s.Conclusions The statistics of acceleration time ≥0.11 s and single phase single peak waveform have high application value in diagnosis of subclavian artery severe stenosis respectively.

OBJECTIVES:The effect of water-soluble polymers polyvinylpyrrolidone(PVP) and polyethylene glycol(PEG)on the complexation of drugs with β-cyclodextrin were investigated.METHODS:the thermodynamic properties of drugs in aqueous β-CD solution and in aqueous solut.RESULTS:The maximum solubilization concentration of PVP or PEG appeared from 1.5g.L－1 to 3.0g.L－1.At this low concentration,PVP or PEG had insignificant effect on the viscosity of the aqueous β-CD solution.The solubilising effect ofβ-CD on chloramphenicol was improved by 15% when containing 2.5g.L－1 polyethylene glycol in the solution and on vitamininum B2by 98%when containing 2.5g.L－1 polyvinylpyrrolidone.In aqueous solutions water-soluble polymers were shown to increase the solubilising effect of β-CD on drugs.Additing of PEG or PVP to the aqueous complexation medium resulted in an increased negative enthalpy change,together with an increased negative entropy change.CONCLUSION：Water-soluble polymers were shown to increase the solubilising effect of β-CD on drugs.

Objective To study the effect of data envelopment analysis evaluation on nursing efficiency in general hospitals.Method The input indexes including the number of enrolled nurse,indirect nursing time,average annual nursing consumables and average annual continuing education time and the output indexes including hospitalized patient number and year-round nursing income of 10 nursing units in our hospital during October 2012 to October 2013 were collected and analyzed with C2R,C2GS2 model and C2R/ C2GS2 ratio from Data Envelopment Analysis.Result About 5 nursing units were effective in terms of overall efficiency,8 ones in terms of unit technical efficiency and 5 one in terms of nursing unite scale efficiency.Conclusions We need improve nursing efficiency in our hospital.Nursing managers should pay attention to the results and improve working process aiming at the practical situations.

Objective To evaluate the effect of penehyclidine hydrochloride pretreatment on pulmonary function during mechanical ventilation in the patients with chronic obstructive pulmonary disease (COPD) undergoing non-thoracotomy.Methods Sixty patients with COPD,aged 58-82 yr,weighing 45-76 kg,of ASA physical status Ⅱ or Ⅲ,scheduled for elective non-thoracotomy under general anesthesia,were randomly divided into Ⅰ,Ⅱ and Ⅲ groups (n =20 each) using a random number table.Anesthesia was induced with iv midazolam,sufentanil,cisatracurium and propofol.The patients were endotracheally intubated and mechanically ventilated.At 30 min before endotracheal intubation,normal saline 5 ml (group Ⅰ),penehyclidine hydrochloride 0.01 mg/kg (group Ⅱ) or penehyclidine hydrochloride 0.02 mg/kg (group Ⅲ) was injected intravenously.At 30,60 and 120 min of ventilation,airway peak pressure (Ppeak),airway plateau pressure (Pplat),airway resistance (Raw) and dynamic lung compliance (Cdyn) were recorded.At 120 min of ventilation,arterial blood samples were obtained for blood gas analysis and oxygenation index (OI),respiratory index (RI),physiologic dead space fraction (VD/VT) and alveolar-arterial oxygen gradient (A-aDO2) were calculated.At 30 min before ventilation and 120 min of ventilation,blood samples were drawn from the radial artery for determination of the serum concentrations of TNF-α,IL-8 and IL-10 by ELISA.The extubation time and pulmonary complications within 72 h after operation were recorded.Results Compared with group Ⅰ,Ppeak,Pplat,Raw,RI,VD/VT and A-aDO2 were significantly decreased,Cdyn and OI were increased,the serum TNF-α,IL-8 and IL-10 concentrations and incidence of pulmonary complications were decreased,and no significant change was found in the extubation time in Ⅱ and Ⅲ groups.There were no significant differences in the parameters mentioned above between group Ⅱ and group Ⅲ.Conclusion Penehyclidine hydrochloride pretreatment can reduce the inflammatory responses during mechanical ventilation,improve pulmonary function,and decrease postoperative pulmonary complications and is helpful for prognosis in the patients with COPD undergoing non-thoracotomy.

Autophagy ; Cardiovascular Diseases ; Humans ; MicroRNAs