Barium ; urine ; Spectrophotometry, Atomic ; methods

OBJECTIVE To investigate the application of antibacterials in patients accepted operation in grass-roots(hospitals),so to standardize the application of antibacterials and cut down the medical cost.METHODS Full-time administrators for nosocomial infection investigated the application of antibacterials in patients who accepted(operation) in Sep 2004,and filled in the questionnaires.RESULTS In 1 383 cases of 11 hospitals the application rate of antibacterials was 98.63%;in which 86.50% were for prophylactic usage and 13.50% for therapeutic usage;(29.90%) for single antibiotics treatment and 50.15% for bigeminy,18.70% were for trigeminy.Time of(application) differentiated(6.90,7.00,6.60d) fromⅠto Ⅲ kinds of operation.Per capita cost of antibacterials was $956.50(47.60%).CONCLUSIONS High cost of antibacterials results from such factors as multiple kinds,long time and(combined) application.

0 05); C group compares to B group, P

Objective To compare and evaluate the effect of PBL in clinical teaching of Pediatrics.Methods Among students of Grade 2002 in our university,two types of PBL,pre-learning and case-discussion,were used in their clinical learning of Pediatrics. And then,their effects were evaluated and compared with those of traditional learning method.Results More than 60% of the students agreed with PBL methods,and they considered PBL favorable to practice scientific logical thinking of clinical affairs,to increase their capabilities of learning,oral expression,communication and cooperation.The teachers agreed with PBL methods too for the better learning effect resulting from PBL.Conclusion PBL fits the needs of medical learning reformation.To train new type of doctors in century 21st,it is necessary to use kinds of new learning methods,including PBL methods and standardized patient (SP)in clinical teaching.

Acute Disease ; Adult ; Aged ; Cyanides ; poisoning ; Emergency Nursing ; Emergency Treatment ; Female ; Humans ; Male ; Middle Aged ; Young Adult

Objective To explore the influence of type 2 diabetes mellitus combined with subclinical hypothyroidism on diabetic vascular complications.Methods One hundred and two patients with type 2 diabetes mellitus were selected.The serum free triiodothyronine (FT3),free thyroxine (FT4),thyroid stimulating hormone (TSH),anti-thyroid peroxidase antibody (TPO-Ab),thyroglobulin antibody (TG-Ab) levels were measured by chemiluminescence method.The patients were divided into type 2 diabctes mellitus combined with subclinical hypothyroidism group (47 cases) and type 2 diabetes mellitus with normal thyroid function group (55 cases) according to the thyroid function.The glycated hemoglobin (HbA1c),total cholesterol (TC),low-density lipoprotein cholesterol (LDL-C),triacylglycerol (TG),high-density lipoprotein cholesterol (HDL-C),urea nitrogen,creatinine and albumin levels were measured.The estimated glomerular filtration rate (eGFR) was calculated according to the formula of modification of diet in renal disease (MDRD).The presence of diabetic retinopathy was examined by fundus examination,and the presence of lower limb artery lesions was measured by vascular ultrasound.All indicators were compared between 2 groups.Results There were no statistical differences in age,disease course,HbA1c,body mass index (BMI),TC,TG,HDL-C,LDL-C,incidence of lower limb artery lesions and incidence of diabetic retinopathy between 2 groups (P＞ 0.05).TheeGRF in type 2 diabetes mellitus combined with subclinical hypothyroidism group was significantly lower than that in type 2 diabetes mellitus with normal thyroid function group:(83.74 ± 21.55) ml/(min· 1.73 m2) vs.(115.02 ± 12.29) ml/(min· 1.73 m2),and there was statistical difference (t =4.274,P ＜ 0.01).The incidence of diabetic nephropathy in type 2 diabetes mellitus combined with subclinical hypothyroidism group was significanlty higher than that in type 2 diabetes mellitus with normal thyroid function group:48.9％ (23/47) vs.23.6％(13/55),and there was statistical difference (x2 =7.103,P＜ 0.01).Logistic regression analysis showed that subclinical hypothyroidism was a risk factor for diabetic nephropathy (OR =0.524,95％ CI 0.12-0.93,P ＜ 0.05),but it was not the risk factor for diabetic retinopathy (OR =0.618,95％ CI0.19-2.16,P =0.475) and lower limb artery lesions (OR =0.485,95％ CI 0.32-2.13,P =0.689).Conclusion Subclinical hypothyroidism in patients with type 2 diabetes mellitus has no obvious effect on lower limb arterial complications and diabetic retinopathy,but may increase the risk of diabetic nephropathy.

Objective To analysis of the thyroid hormone test results of Abbott Architect ci16200 automatic biochemical-im-mune analyzer (Abbott system) and Roche Cobas e601 automated immunoassay analyzer (Roche system) .Methods The thyroid hormone(including T4 ,FT4 ,T3 ,FT3 ,TSH ) levels of 93 cases of serum samples were respectively detected by Abbott system (CMIA) and Roche system (ECLIA) ,and the results were analyzed .Results The thyroid hormone test results of the two systems had a good correlation ,and the coefficients of T4 ,FT4 ,T3 ,FT3 ,and TSH were 0 .960 ,0 .962 ,0 .976 ,0 .900 ,and 0 .999(P<0 .01) . However ,there were significant difference of the detection results of the two systems(P<0 .05) .Conclusion The thyroid hormone test results of Abbott system and Roche system are not comparable .

Objective To explore the effect of different doses of dobutamine on acute lung injury (ALI) in rabbits with septic shock and to clarify the possible mechanism.Methods The rabbits model of septic shock was made by cecal ligation and puncture combined with intravenous injection of endotoxin,70 male New Zealand white rabbits were randomly divided into five groups (14 rabbits in each groups):shamc operation group (group A),ALI group (group B),dobutamine low-dose group (group C),dobutamine medium-dose group (group D) and dobutamine high-dose group (group E),7 rabbits from each group were sacrificed 3 h and 6 h after septic shock.The level of cyclic adenosine monophosphate (cAMP) in lung tissue was detected by ELISA.The expression of aquaporin 5 (AQP5) protein was determined by western blotting.The wet to dry weight (W/D) ratio was measured.The pathological and ultrastructural changes of lung tissue were evaluated by optical microscopy and electron microscope,and lung injury score was assessed.The differences among the different groups were analyzed by one-way ANOVA (LSD test).Results The level of cAMP and expression of AQP5 protein in lung tissue at 3 h and 6 h were dramatically lower in group B than those in group A (3.53 ±0.43) pmol/mLvs.(21.18 ±0.62) pmol/mL; (0.44 ± 0.04) pmol/mLvs.(0.99±0.06)pmol/mL; (2.71±0.56)pmol/mLvs.(21.78±0.62)pmol/mL; (0.29 ±0.05) pmol/mLvs.(0.91 ±0.06) pmol/mL; all P ＜0.001,while the W/D ratio was obviously higher in group B than those in group A (all P ＜0.001).Compared with group B,the level of cAMP and AQP5 protein expression in lung tissue were significantly increased at 6 h in group C (8.48 ±0.61) pmol./ mLvs.(2.71±0.56) pmol/mL,P＜0.01; (0.49 ±0.04) pmol/mLvs.(0.29 ±0.05) pmol/mL,P=0.001 and at3 hand6 hin groupDandE (10.86±0.66) pmol/mLvs.(3.53±0.43) pmol/mL; (0.60±0.05) pmol/mLvs.(0.44±0.04) pmol/mL; (13.80±0.49) pmol/mLvs.(2.71±0.56) pmol/mL; (0.64 ± 0.03) pmol/mLvs.(0.29 ± 0.05) pmol/mL; (15.57 ± 0.60) pmol/mL vs.(3.53±0.43) pmol/mL; (0.91 ±0.05) pmol/mLvs.(0.44 ±0.04) pmol/mL; (19.30±0.42) pmol/mL vs.(2.71 ±0.56) pmol/mL; (0.89 ±0.08) pmol/mL vs.(0.29 ±0.05) pmol/mL; all P ＜ 0.01,while the W/D ratio in group E was decreased obviously (P =0.002; P =0.001).Compared with group C and D,the level of cAMP and the expression of AQP5 protein at 3 h and 6 h in group E increased significantly (all P ＜0.01.The pathological and ultrastructural changes of lung tissue were more intensive in group B than those in group A and the lung injury scores were obviously higher (P ＜0.01).The degree of lung pathological and ultrastructural lesion was ameliorated after administration of dobutanmine.Additionally,histological scores decreased significantly (P ＜ 0.01).Conclusions Our study demonstrated that dobutamine could improve ALI induced by endotoxin,the mechanism of protective effect may involve in increasing the level of cAMP and up-regulating the AQP5 protein expression,and high-dose dobutamine had better effects.

Objective To observe the effect of low molecular weight heparin calcium combined with astraga-lus injection in the treatment of diabetic nephropathy.Methods From January 2013 to December 2014,78 patients with stage III diabetic nephropathy in our hospital were enrolled into the study.They were randomly divided into con-trol group(41 cases) and treatment group(37 cases).The control group received general therapy,such as low protein diets,compound alpha keto acid,insulin,irbesartan,simvastatin.The treatment group was treated with low molecular weight heparin calcium and astragalus injection on the basis of general therapy.The changes of urinary albumin and 24 hours urinary protein after treatment in the two groups were observed.Results After treatment,the negative rate of urinary micro albumin in the treatment group ( 75.68%) was significantly higher than that of the control group (29.27%)(χ2 =16.765,P<0.01).24 hour urinary protein of the treatment group[(176.2 ±82.3)mg/24h]was significantly lower than that of the control group[(223.8 ±87.8)mg/24h](t=2.471,P<0.05).Conclusion Low molecular weight heparin calcium combined with astragalus injection can reduce the proteinuria of diabetic nephropa-thy,it is an effective intervention therapy for early diabetic nephropathy.

In the magnetic induction tomography(MIT) system,the electrical conductivity of biological tissue is direct proportion to the phase difference between the excitation signal and the detection signal.To obtain the image of the contribution of tissue's electrical conductivity,the system must have the function of phase detection with high accuracy.The paper focuses on the means of digital phase detection,including FFT method,the correlation method and the classic method,which are ultimately compared with analogue phase detection method.The experimental results show that FFT method and the correlation method,with low error level and high linearity,can better detect the phase difference with the level of 0.1?.The digital phase difference detection provides a kind of effective method for MIT system.