OBJECTIVE:To evaluate inpatients' use of antibiotics in our hospital.METHODS:The inpatients' use of antibiotics in our hospital during 2004～2006 was analyzed retrospectively in respect of the consumption sum and DDDs etc.RES-ULTS:The proportion of antibiotics in the total western medicines were decreasing year on year in terms of consumption sum.Cephalosporin,quinolones,lincomycins and penicillins had been dominated the first 4 places during the 3 consecutive years.Leading the list in terms of consumption sum and DDDs was Clindamycin injection during the 3 consecutive years.CONCLUSION:The inpatients' use of antibiotics was characterized by high starting point,excessively depending on empirical treatment,which needs to be further monitored to achieve a rational use of antibiotics.

Objective To explore the effect of ultrasound assisted liposuction in vivo on clinical aesthetic plastic surgery. Methods Ultrasonic lipoplastics combined with swelling liposuction were used in 153 cases of the beauty seekers. Application of rountine tissue swelling technique with the transduction of ultrasound into fatty areas made atipose cells broken and emulsified, and it also easy to move the atipose tissue rich in connective fibres. Results All the patients were satified with the aesthetic effects after the operation. Smoothness and softness of the operated areas with obvious shrinkage of the skin were found with few complications. Conclusion Ultrasound assisted liposuction is an effective and simplified method and deserves to be widely used.

ObjectiveTo probe into the influence of the zero price margin for drugs on the revenue-expenditure structure at primary healthcare organizations.MethodsOne of the pilot districts experimenting with this system in Ningbo city was earmarked as the research object.Within this district,the data of their revenue,expenditure and surplus were collected from 20 primary healthcare organizations prior to and after the zero price margin for drugs was in place for classification analysis.ResultsThe percentage of service revenue among the total revenue has dropped from 68.34％ before the system was in place to 65.44％ after,reducing 4.24％.The percentage of drug revenue has dropped from 71.68％ before to 63.57％ after,reducing 11.31％.The percentage of service surplus has dropped from 15.81％ before to - 23.07％ after,reducing 245.94％.The total standard workload has increased 61.77％.Average medical expense per outpatient and per inpatient has reduced 32.85％ and 57.18％,from 71.44yuan and 2642.08 yuan before to 48.33 yuan and 1131.28 yuan after respectively.ConclusionThe deficit rise and higher percentage of drug revenue at primary healthcare organizations deserve attention.A comprehensive reform is recommended to establish a regular government financial support mechanism,further adjust the revenue-expenditure structure,set up the system of rational drug use,and effectively reduce the medical expense of patients.

Objective To study a new method of minimally invasive balloon kyphoplasty (PKP)for treatment of chronic osteoporotic vertebral compression fractures. Methods The study involved 27 patients with chronic osteoporotic vertebral compression fractures treated with PKP in our hospital from February 2007 to February 2009. There were 11 males and 16 females, at mean age of 72.4 years (range 55-86 years). The history of chronic osteoporotic vertebral compression fractures ranged 3-17 months (mean 7.6 months). The pathological changes were determined at one stage in 25 patients and at two stage in two. According to the Genant classification, there were 10 patients (11 vertebrae) at grade two and 17 patients (18 vertebrae) at grade three. Before operation, the visual analog scale (VAS) score was average 8.3, the ratio of compression height of the anterior vertebral body to the posterior vertebral body was 39% by X-ray measurement and the kyphosis angle was average 15.60°. All patients received PKP under local anesthesia. Results Patients were followed up for average 11.2 months, which showed that all the patients achieved significant pain relief and ambulation at days 3 or 4 after operation. Cardiorespiratory function was significantly improved, with no reoccurrence of pain or severe complications found.After operation, the VAS score was average 2.8, ratio of compression height of the anterior vertebral body to the posterior vertebral body was average 47.6% and the kyphosis angle was average 15.60°. Conclusions Minimally invasive PKP can achieve rapid relief of pain, help early ambulation, decrease various complications resulting from long-term confinement to bed and improve cardiorespiratory function for elderly patients with chronic osteoporotic vertebral compression fractures of the vertebral body mainly with pain but without nerve injury.

Objective The aim of this study was to investigate the masculinizing effects of progesterone ( PRO) exposure at different concentrations on the morphology of female mosquitofish (Gambusia affinis).Methods Immature female G.affinis individuals were put into static water with 0.5, 5, 50 and 500 nmol/L progesterone (n=56), respective-ly.In addition, control group and parallel groups were set up .After 42-day-long exposure, we measured four main indexes of the G.affinis:the body length, body weight, morphological changes in the anal fin 3rd fin and the 14, 15 and 16 verte-bral ribs.We also observed the state of ovarian development .Results The body lengths (BL) of experimental groups ex-posed at concentration of 50 and 500 nmol/L progesterone for 42 d showed significant differences , respectively ( P<0.01 for both), when compared with those of the control group .The body weights (BW) of experimental groups exposed to pro-gesterone at all concentrations were significantly or very significantly decreased (P<0.05 or P<0.01).Only the proges-terone at 5 nmol/L concentration showed significant effect on the body health index (CF) (P<0.05).The section number (FJ) of the anal fin 3rd fin, the section length (FL)and the widest portion width (FW)in the experimental groups had sig-nificant difference (P<0.05), respectively, showing significant changes in morphology after the exposure to 500 nmol/L progesterone .However , there was no significant difference between the values resulted by progesterone in other concentra -tions (P>0.05).When exposed to 500 nmol/L PRO, the L, D and L:D values of the 14th, 15th and 16th vertebral ribs of the female G.affinis had very significant difference ( P<0.01 for all ) , respectively , indicating significant changes of morphological masculinization .Histological examination revealed that the developmental status of the ovaries of G.affinis in the experimental groups were to different degrees inhibited , and the nuclei appeared swelling in stage II and III oocytes . Conclusions The results of this study indicate apparent masculinizing effects of progesterone on immature female mosquit -ofish.

Objective To evaluate the efficacy of epidural anesthesia combined with different doses ropivacaine and sufentanil for stepwise labor analgesia in latent phase.Methods Two hundred and ten ASA Ⅰ or Ⅱ primiparas with a singleton and vertex presentation at full term in our hospital from February 201 5 to April 201 5 were randomized into seven groups (n =30 each):0.125% ropiva-caine with 0.5 μg/ml sufentanil (group 1);0.075% ropivacaine with 0.5 μg/ml sufentanil (cervical dilatation < 3 cm),0.125% ropivacaine with 0.5 μg/ml sufentanil (cervical dilatation ≥ 3 cm) (group 2);0.1% ropivacaine with 0.5 μg/ml sufentanil (cervical dilatation < 3 cm),0.125% ropiv-acaine with 0.5 μg/ml sufentanil (cervical dilatation≥3 cm)(group3);0.1 5% ropivacaine with 0.5μg/ml sufentanil (group 4);0.075% ropivacaine with 0.5 μg/ml sufentanil (cervical dilatation < 3 cm),0.1 5% ropivacaine with 0.5 μg/ml sufentanil (cervical dilatation≥ 3 cm)(group 5 );0.1%ropivacaine with 0.5 μg/ml sufentanil (cervical dilatation<3 cm),0.1 5% ropivacaine with 0.5 μg/ml sufentanil (cervical dilatation≥3 cm)(group 6);0.125% ropivacaine with 0.5 μg/ml sufentanil (cervical dilatation<3 cm),0.1 5% ropivacaine with 0.5 μg/ml sufentanil (cervical dilatation≥3 cm) (group 7).The intensity of pain was assessed by visual analog scale (VAS).Meanwhile,1abor process,postpartum hemorrhage,Bromage score,postpartum adverse reactions and Apgar score of the neonates were also observed.Results No significant difference was found in VAS score after epi-
dural block between groups at each time.The latent period of group 2 and 3 were shorter than that in group 1 (P <0.05)and that of group 5 and 6 were shorter than that in group 4 (P <0.05);the ac-tive phase of group 4 were longer than that in group 1 (P <0.05 ).The postpartum hemorrhage of group 2 and 3 were less than that in group 1 (P <0.05),the postpartum hemorrhage of group 5,6 and 7 were more than that in group 2 (P <0.05)and group 3 (P <0.05).The motor nerve block of group 2 and 3 were slightly less than that in group 1 (P <0.05)and the motor nerve block of group 5,6 and 7 were slightly less than that in group 4 (P <0.05).There was no difference of the postpar-tum adverse reactions of maternal and Apgar score in the neonates.Conclusion The dosage of 0.075% or 0.1% ropivacaine with 0.5 μg/ml sufentanil (cervical dilatation < 3 cm),0.125% ropiv-acaine with 0.5 μg/ml sufentanil (cervical dilatation ≥ 3 cm),while producing the exact analgesic effect,hardly interferes with the 1abor process,the amount of postpartum hemorrhage and the lower limb activity,thus they have no significant effect on the safety of the maternal and the infant.

Objective To explore the effective measurements of integrated therapy for the ear keloids in the Oriental. Methods Surgical excision was performed for keloid, and the cut then sutured directly or with flap transfer. At early stage of surgery (within 24 hours), X-ray or electron-ray radiotherapy was used for 3-5 times once daily; and steroids injected after cutting lines at 7th day every two weeks and gradually ended. Results A total of 48 patients were treated, and followed, in which 12 patients were lost of follow-up. The total effective rate was 94. 4 % based on the data of follow-up in 36 patients for 1-3 years. Therefore, the curation rate was 83. 3 % (30 cases) and effective rate 11. 1 % (4 cases). Conclusions Surgical cutting combined with early radiotherapy and steroids injection is the effective integrated therapy for the ear keloids in the Oriental.

BACKGROUND:Rheumatoid arthritis is an autoimmune disease, and traditional treatment methods are difficult to effectively solve the patient's lack of immune tolerance mechanisms. With the development of stem cel s in regenerative medicine, stem cel therapy has become a hot spot in the treatment of autoimmune diseases.
Currently, studies on cel transplantation for the treatment of rheumatoid arthritis are rarely reported.
OBJECTIVE:To study the influence of umbilical cord mesenchymal stem cel therapy on the changes of Th1/Th2 and Treg in rheumatoid arthritis patients, thereby seeking new therapies for rheumatoid arthritis.
METHODS:We selected 180 cases of rheumatoid arthritis, including 27 patients as control group undergoing non-steroidal anti-inflammatory drugs and anti-rheumatic drugs and 153 patients as cel treatment group undergoing intravenous infusion of 40 mL umbilical cord mesenchymal stem cel s at a density of 4×107. Dosing regimen was same in the two groups. The 76 of 153 patients accepted second cel therapy at 3-4 months after the first cel therapy. After fol ow-up of 3 and 6 months, clinical effectiveness evaluation (DAS28, HAQ, ACR20), rheumatoid factor, anti-CCP antibodies, T cel subsets, Th cytokine were detected;for patients with second cel therapy, T cel subsets and Treg were detected at 8 months after treatment.
RESULTS AND CONCLUSION:(1) At 3 months after treatment, the DAS28, HAQ and ACR20 scores were significantly lower in the cel treatment group than the control group (P<0.01). (2) At 3 and 6 months after cel therapy, the DAS28 and HAQ scores were significantly decreased in the cel treatment group (P<0.01), and these scores were decreased continuously after second cel therapy (P<0.01). (3) Interferon-γlevel in cel s did not change obviously at 3-6 months after treatment, but the interleukin-4 level was gradual y increased at 6 months after treatment (P<0.05). (4) The number of Treg cel s was significantly increased at 3-6 months after treatment (P<0.01), which was closely related to ACR, especial y ACR70 percentage (P<0.05);the ratio of CD4+Treg was increased significantly at 3 months after treatment (P<0.05), and this increasing trend was also maintained at 6 and 8 months after treatment, but there was no significant difference (P>0.05). (5) B cel levels were significantly decreased at 6 months after treatment (P>0.05);the rheumatoid factor value was significantly decreased at 3-6 months after treatment (P<0.05). (6) There was no change in anti-CCP antibody and interleukin-17 levels at 3-6 months after treatment. These findings indicate that after treatment with umbilical cord mesenchymal stem cel s, the Th1/Th2 tends to balance and Treg level is elevated in rheumatoid arthritis patients, which are directly related to clinical trials and symptomatic relief. Therefore, standard rheumatism medication combined with umbilical cord mesenchymal stem cel transplantation can improve immune network effects, adjust the immune tolerance and prevent il ness progress in rheumatoid arthritis patients.

To study the umbilical cord mesenchymal stem cells impact of inflammatory factors in rheumatoid arthritis patients.Methods:94 cases of patients with RA hospitalized in our department from April 2011 to December 2012 were treated with umbilical cord mesenchymal stem cells (MSCs) UC,during which the cell therapy scholastic ethics was committed approvally and patients′informed consents were separately signed .94 patients were directly intravenous infusion with 40 ml UC-MSCs ( 4×107 cells/ml),including 57 cases with two UC-MSCs therapy.We used multifunctional flow lattice Luminex 200 analysis to detect contents of 13 kinds of factors in serum such as TNF alpha,IFN-gamma,IL-1β,IL-4,IL-6,IL-8,IL-10,ie,and detected CPR,ESR,assessment DAS28,HAQ,and ARA.Follow-up treatments were performed after 1 week,3 months,6 months ( two cells treatment of 60 cases).Results:①DAS28,HAQ grading standards,were decreased (P<0.01) in 3 months and 6 months before the patients treatment ,2 times than one continue treatment decreased ( P<0.01 );the ESR and CRP in 1 week dropped significantly after treatment ( P<0.01),3 months,6 months before the treatment also decreased (P<0.05).②IL-6,TNF alpha were in falling levels after 1 week,3 months and 6 months treatment ,( P<0.05 ).Conclusion: We proved the inflammatory factors directly related with clinical indicators and symptoms of RA patients .94 cases of patients with other inflammatory factor (IL-17,IL-4,IL-10,etc.) also had some change,we still needed further observation.According to drug rheumatism guide at the same time , collaborative using with UC-MSCs could make RA patients improve local and systemic inflammatory response ,prevent disease progression.

Objective: To observe the safety and efficiency of face-lift combined with fat grafting in facial rejuvenation. Methods: We performed a retrospective study, which included 23 patients. SMAS suspension and multi-site suspension were combined to correct the nasolabial fold, mid-cheek aging and malar mounds. Structural fat grafting was performed to treat the volume loss in mid-face. Results: All patients demonstrated a significant improvement in midfacial appearance. No infection or nerve injury were found in this study. Only three patients did not get primary healing in temple region, which led to temporal hair loss from secondary healing. Conclusions This study demonstrates that fat grafting and multiple layers face-lift are efficient method for facial rejuvenation. These approaches appear to be very promising for facial anti-aging techniques.