Objective To investigate perioperative antimicrobial prophylaxis in arthroscopic surgery in a hospital before and after intervention,evaluate intervention efficacy,and provide evidence for the rational clinical antimicro-bial application.Methods From August 2012,measures were taken to intervene perioperative antimicrobial use, perioperative antimicrobial use and surgical site infection(SSI)in 312 patients undergoing arthroscopic surgery be-tween September 2011 and August 2013 were retrospectively surveyed.Results A total of 312 patients were investi-gated,pre-and post-intervention were 150 and 162 cases respectively,SSI rates were both 0 before and after inter-vention. Antimicrobial usage rate after intervention was lower than before intervention (26.54% vs 100.00% ,χ2=1.781,P<0.001). Irrational antimicrobial use dropped obviously;average expense of antimicrobial agents dropped from (1165.69±756.33)yuan (RMB)before intervention to (32.71 ±119.29)yuan (RMB)after intervention (t= 3.330,P<0.001).Conclusion Perioperative antimicrobial usage rate in arthroscopic surgery at this hospital decreased significantly after intervention,rational use of antimicrobial agents has improved,SSI rate still remains zero.

Objective To understand the changes of the coverage of medical insurance and the utilization of medical services from 2000 to 2009.Methods The data on medical insurance and utilization of medical services were obtained from China Nutrition Panel Survey conducted by University of North Carolina,Chapel Hill.The trend of medical insurance and use of preventative medical services were examined.And a Logistic regression model was used to estimate the relationship between some social economic status and the enrollment of medical insurance and use of medical services.Results The coverage of medical insurance expanded dramatically from 20％ in 2000 to 89％ in 2009.The rural population experienced higher expansion.The gap between rural and urban populations in terms of insurance coverage was closed.The use of preventive services remained low in both rural and urban populations,with 3.72％ and 4.62％ respectively.Conclusions Both coverage of medical insurance and use of prevention medical services imoroved from 2000 to 2009,which has provided solid foundation for further reforms.

Objective To study the sedation efficacy of propofol combined with midazolam and /or fentanyl in fibreoptic choledochoscope. Methods Ninty outpatients were randomly divided into three groups. Group PF (n=31)was given fentanyl 0. 05 m.g plus propofol 1 mg/kg intravenously, group PM (n=29) midazolam 2 mg plus propofol 1 mg/kg, and group PMF(n=30) fentanyl 0. 05 mg, midazolam 2 mg and propofol 1 mg/kg. Propofol 20 mg was used when needed. HR,MAP,SpO_2,sedation scores and amnesia were recorded. Results All patients were awakened in 20 minutes after procedures. The recovery time was shorter in group PF than that in the other two groups. There were 21(67. 70%) patients in group PF, who were aware of surgery. Fifteen(48. 4%) patients were satisfied in group PF. Conclusion Propofol combined with midazolam and /or fentanyl in fibreoptic choledochoscope has better sedation without any obvious side effects.

Objective Using second duplication checking to prevent academic misconduct of accepted papers ,and to improve the academic quality of journals for the consolidating credibility of academic journal and brand establishing .Methods Academic Mis-conduct Literature Check(AMLC)system developed by CNKI was applied to check possible academic misconduct of 90 accepted pa-pers for Chongqing Medical Journal ,then the contribution time ,duplication checking time ,words repetition percentage of the accept-ed papers with academic misconduct and similarity literature were analyzed compared with the source papers .Results After chec-king 90 accepted papers ,9 of them were suspected with academic misconduct ,including 5 papers with 30 .1% -40 .0% of coinci-dence rate ,1 paper with 40 .1% -50 .0% of coincidence rate ,and 3 papers with more than 50 .1% of coincidence rate .Most of the academic misconduct were multiple contribution of same manuscript or duplicate publication .Conclusion To avoid the multiple con-tribution of the same manuscript or duplicate publication ,we should shorten peer review and publishing period ,carry on multi-dupli-cation checking ,punish academic misconduct ,and work together with other sci-tech periodicals to eliminate academic misconduct .

OBJECTIVE:To provide suggestion and advice for the selection and utilization of essential drug. METHODS:WHO standards for the selection of essential drug and the formulation process of National Essential Drug?Part for Primary Medical and Health Institutions (2009 edition) were analyzed. The significance of theory and methods of pharmacoepidemiology in the selection, utilization and performance evaluation of essential drug were put forward. RESULTS & CONCLUSION:National essential drug should be selected according to evidence-based medicine and pharmacoeconomics based on pharmacoepidemiology, in order to take advantage of a drug epidemiology-based evidence-based medicine and drug selection based on economics, the study concludes. Dialectical thinking about safety and effectiveness of essential drug should be conducted.

Objective To evaluate the application value of the hematology analysis combined with genetic diagnosis in the prena-tal diagnosis of thalassemia.Methods 2 368 parturients were performed the prenatal diagnosis of thalassemia in the prenatal diag-nosis center of our hospital from July 2010 to April 2013,and those with positive hematological screening detection were performed the genetic diagnosis.Results The hematology analysis results showed 124 parturients of abnormal HbA2.The hematology analy-sis results in the abnormal parturients had the statistical difference compared with those in the rest healthy parturients (P <0.01). Among 124 pregnant women of hematological positive phenotype,there were 16 couples with the same genotype,in these 16 preg-nant women,15 cases were performed the prenatal diagnosis of thalassemia,there were 7 cases of αthalassemia gene,2 cases of βgenotype,6 cases of normal genotype,3 cases of severe fetal thalassemia,including 2 cases of α-thalassemia(genotype--SEA/--SEA ),1 case ofβ-thalassemia(genotype 41-42/IVS-Ⅱ-654).All pregnant women terminated pregnancy after informing the patients.Conclu-sion The hematology analysis combined with genetic diagnosis plays an important role in the construction of perfect thalassemia prenatal detection and diagnosis intervention mode,and is worthy of popularization and application.

Objective To investigate the application value of fluorescence in situ hybridization (FISH)in prenatal diagnosis and compared with karyotype analysis of cells from amniotic fluid.Methods A total of 183 high-risk pregnant women received for a FISH and karyotype analysis who taken prenatal disgnosis in Meizhou people′s hospital between April 2012 and November 2013. Results According to the test results of karyotype analysis.There were 9 cases of chromosomal abnormality in 183 pregnant women.Among 9 cases,3 cases were trisomy 21,3 cases were trisomy 18,2 cases were XO and one case of XXY.One case of tri-somy 18 was showed normal using the FISH.Other cases were consistent with karyotype analysis result.Conclusion FISH is a rapid,reliable and prompt prenatal diagnosis method,combined with karyotype analysis will maximize the detection efficacy in pre-natal diagnosis of chromosome abnormalities.

Objective: To study the effects of the different doses of midazolam in fibreoptic gastroscopy on sedation, respiratory and circulatory function. Method: One hundred and four outpatients undergoing fibreoptic gastroscopy were randomly divided into four groups. The control group(N)was not given drugs, the other groups were intravenously given midazolam 0.07mg/kg(MS),0.05mg/kg(M),diazepam 10mg(D)respectively. The sedative scores, symptom, amnesia,HR,MAP and blood gases were observed. Result: The sedative scores of MS,M and D groups were much better than that of control group. There were significant differences in sedative scores,amnesia and sedative period between MS group and D group or M group. MAP decreased one minute after administering the drugs in MS,D and M groups significantly. The results of blood gases analysis of all groups were in normal ranges. Conclusion: Midazolam 0.07mg/kg can produce safe and effective sedation for fibreoptic gastroscopy.

Juvenile idiopathic arthritis (JIA) is the most common chronic arthropathy in childhood. Immune and genetic factors take part in the development of JIA and influence its consequence. Studies have identified association between JIA and genes encoding the human leukocyte antigens (HLA) . In this article we discuss the principles behind genetic studies of complex traits like JIA, and comprehensively catalog HLA candidate gene associated with JIA to date, and review several validated associations. Studies indicate that the HLA-Ⅰ, Ⅱ gene and their products play an important role in JIA pathogenesis, clinical course, hormonal effect and prognostic judgment. Studies in different ethnic groups indicate the main relationship between JIA and HLA is concentrated upon A, DR and DQ loci, especially the HLA-Ⅱ gene and some haplotypes. The different type of JIA is always with different HLA susceptible locus and protective locus. Different race, different region and different social environment also affect the JIA's susceptible gene polymorphism. Finally we discuss the problems existed in the study of JIA susceptibility and HLA polymorphism.