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.

Bilingual teaching is a challenge to university.Biochemistry Department of Guilin Medical College made research on relationship between bilingual teaching and professional courses learning,restrictive factors of bilingual teaching and how to further bilingual teaching,and so on.Training teachers,exploring teaching methods and establishing rational evaluation system are most important for bilingual teaching nowadays.

Objective To investigate the resistant status and to type the phenotype and plasmid profiles of prevalent gonococcal strains. Methods A total of 98 gonococcal strains isolated from 1998 to 1999 in Zhanjiang was identified systemically. The susceptibilities of 98 strains of gonococci to penicillin,tetracycline and ciprofloxacin were detected by agar dilution method. The β － lactamase production was tested by iodometric method. The plasmids were extracted by alkaline lysis technique. Results The prevalence of gonococcal strains resistant to penicillin, tetracycline and ciprofloxacin were 22.44％ ,45.94％ and 55.12％ ,respectively. There were 6 positive strains for β － lactamase, accounting for 6.12％ (6/98). The most common phenotypes were susceptiblePT、 CMRNGT、 CMRNGPT and TRNG, accounting for 43.86％ ,23.46％ ,10.20％ and 10.20％ ,respectively. The detection rate of plasmids were 91.84％ .Among them, the percentages of 42.5 kb,39.5 kb,7.4 kb and 4.2 kb plasmids accounted for 11.22％ ,41.82％ ,59.16％ and 67.32％ ,respectively.There were 12 types of plasmid profiles(PP), the predominant types were 7.4kb＋ 4.2kb and 39.5kb＋ 7.4kb＋ 4.2kb, accounting for 21.42％ and 17.34％ ,respectively. Conclusion The gonococcal strains resistant to ciprofloxacin are very high in Zhanjiang. The phenotype and plasmid profiles of the strains have characteristic distribution.

Objective To investigate the occurrence,types and therapeutic effect of malignancies in renal allograft recipients. Methods A retrospective study of 1200 renal allograft transplantations in 1189 patients performed between July 1977 and September 2001 was carried out. Results After transplantation among the 1189 recipients,19 cases (an incidence rate of 1.6%) were diagnosed with malignancies,including hepatocarcinoma in 4 cases,breast cancer in 3,Kaposi sarcoma in 2,lung cancer in 2,and squamous carcinoma of bladder,non-Hodgkin lymphoma,stomach carcinoma,carcinoma of head of pancreas,carcinoma of gingival,colon carcinoma,gallbladder carcinoma each in 1,and 1 intensive metastasis case without concerned source.The mean postoperative duration of immunosuppressive treatment before the diagnosis of malignancies was (36.7?24.2)months (range,2 to 112 months).Surgical operations were performed in 12 cases,all of whom survived with normal renal function.A mean follow-up of 15.4 months (range,1 to 73 months) showed that no recurrent malignancy developed and no rejection of transplanted kidneys occurred.Five of the 7 cases who had malignancies at advanced stage and lost surgical treatment opportunity died within 1 year after the diagnosis. Conclusions The incidence of malignancy in renal allograft recipients is much higher than normal population,closely related to the long term use of immunosuppressants.Radical surgery of the malignancies is preferred option and use of immunosuppressants can be reduced or discontinued;meanwhile the function of the transplanted kidney should be maintained as much as possible.

Objective Imaging and clinical manifestations of melioidosis were analyzed in order to improve our understanding of the disease and to reduce the rate of misdiagnosis.Methods From 2001 to 2006,12 melioidosis cases were confirmed by blood,pus and sputum culture.All cases were examined with radiography,and nine of them with CT and 2 with US.The imaging and clinical data were assessed retrospectively.Results Ten of 12 cases revealed lung abnormalities,the main organ involved by melioidosis in the body.The appearances were observed as follows:diffused sheets and sheets fused partly in bilateral fields of the lungs can be seen on chest radiograph;homogeneous dense shadow of the lobe or segment were observed on plain chest film and CT;blurred strips radiated from hilum were revealed on plain chest film;multitude nodules in 2 lungs showed on CT;cavity with air and liquid be seen on plain chest film and CT;patches and granules in superior and middle fields or(and)inferior fields be seen on plain chest film and CT;arc shadow of water attenuation in dorsal thorax showed on CT.Infections outside the lung can be observed in orbital,lumbar muscle,liver and spleen in 1 case,and thighbone osteomyelitis with multi abscesses in one case.Conclusion Alhough medioidosis has no characteristic imaging appearances,the disease's location,extent,severity and quantity objectively can be demonstrated by imaging,final confirmation is necessary using the culture of blood,pus and sputum.

Objective To explore the effect of trimetazidine on myocardial structure injury induced by pyran adriamycin and to clarify the protective effect of trimetazidine on. the changes of myocardial structure and its mechanism.Methods 36 Wistar rats were randomly divided into control group,model group and treatment group. The rats in model group and treatment group were injected with pyran doxorubicin 2.5 mg·kg-1 (concentration 2 g·L-1 )by the caudal vein once a week.The rats in control group were injected with equivalent normal saline for 6 weeks.The rats in treatment group were intragastricly infused with trimetazidine 5.4 mg · kg · d-1 one day before making the model.The rats in control group and model group were injected with equivalent normal saline for 8 weeks.At the end of the experiment, the myocardial enzymes in serum of the rats in various groups were measured. The morphology of myocardium tissue was detected by light microscope and electron microscope. Results Compared with model group,the levels of myoglobin,troponin I and alanine transaminase (ALT)of the rats in treatment group were significantly decreased (P<0.05).Under light microscope the myocardium of the rats in model group arranged disorderly, the structure was severely damaged, emyocardial was seen, the myofilament was dissolved;the myocardium of the rats in treatment group arranged in order, the structure was nearly integrated,partial dissolution and fracture were found.Under electron microscope in model group the myocardial muscle bundle dissolved, fractured and disappeared, and the mitochondria was decreased,and the cytoplasmic matrix cavitation was seen;the cardiomyocytes sarcomeres of the rats in treatment group arranged in order,local myofilaments were reduced slightly, the surrounding mitochondria were oval and arranged in parallel between the muscle bundles.Conclusion Trimetazidine has protective effect on the cardiomyocyte injury caused by pyran adriamycin,and its mechanism may be related to decreasing the injury of mitochondria and myocytes.

Objective To explore the effects of trimetazidine on myocardial free radical inj ury induced by pirarubicin,and to clarify the protective effect and mechanism of trimetazidine on myocardial inj ury induced by pirarubicin.Methods 3 6 Wistar rats were randomly divided into pirarubicin group (n= 1 3 ), trimetazidine intervention group(n=13)and control group (n=10).The rats in pirarubicin group and trimetazidine intervention group were inj ected with pirarubicin 2.5 mg · kg-1 by the vena caudal once a week for 6 weeks. The rats in trimetazidine intervention group were intragastricly infused with trimetazidine 5.4 mg · kg-1 · d-1 one day for 8 weeks before making the model. At the end of the experiment,the malonaldehyde (MDA)level,nitrogen oxide (NO)level,superoxide dismutase(SOD)activity,and nonprotein sulfhydryl (NPSH)level in myocardium tissue were measured. The histological changes of myocardium tissue were detected by electron microscope. Results Compared with control group ,the levels of MDA and NO in pirarubicin group were increased(P<0.05), and the SOD activity and NPSH level in pirarubicin group were decreased(P<0.05).Compared with pirarubicin group,the levels of MDA and NO in trimetazidine intervention group were decreased(P<0.05),the SOD activity and NPSH level in trimetazidine intervention group were increased(P<0.05).Under electron microscope,the myocardiocytes of the rats in pirarubicin group showed irregular arrangement in sacromere structure, shrinkage in nuclear membrane, vacuolation in nuclear matrix, obvious mitochondria swelling, deposition of metachromatin throughout the nucleus,and an indistinct view of intercalated disc with isolation;while in trimetazidine intervention group the nucleus was round and nuclear membrane was indented,myofilament bundles were decreased slightly with a regular arrangement, intercalated disc oriented transversely with partial vague in cell j unction structure, and mitochondria slightly swelled.Conclusion Trimetazidine has the protective effects on the damaged myocardiocytes caused by pirarubicin,and its mechanism may be related to reducing the production of free radicals and decreasing the injury of structures within the cells,such as the nucleus,mitochondria and intercalated disc.

Adolescent ; Adult ; Carotid Artery, Internal ; surgery ; Carotid Body Tumor ; surgery ; Female ; Follow-Up Studies ; Humans ; Male ; Methods ; Middle Aged ; Time Factors

Objective To evaluate the outcomes of open reduction and internal fixation of complex tibial plateau fractures with improved three combined approaches.Methods In the period from July 2014 to February 2016,7 complex tibial plateau fractures underwent surgical treatment.These patients included 5 male and 2 female,aged from 24 to 68 years old (average,39.7± 15.3 years).According to Schatzker classification,they were all of type V.And all of type 41B-3.1 by AO/OTA classification.All these fractures were exposed and reduction via three combined approaches.First let the patients lied in lateral prone position,expose the anterolateral and the posterolateral of the tibia1 plateau,and fix the fractures of the posterior in the posterolateral approach,then fix the fractures of the lateral in the anterolateral approach.Then turn the patients to supine position,fix the fractures of the medial in the anteromedial incision.All patients received regular reexamination.The knee function was evaluated at the final follow-up using The Hospital for Special Surgery (HSS) score,the activity of the knee was evaluated by Lysholm score,and the stability of the knee was checked by Lachmantest and Pivot-shift test.The tibial plateau angle,the posterior slope angle and Rasmussen X-ray score were assessed on the X-ray films.Results The average time of operation is (3.3±0.9) h,and the hemorrhage volume in operation was (341± 106) ml for the 7 patients.The wounds of 6 patients healed by (11.8± 1.3) days,while the wound of the rest one of them occurred fat liquefaction after operation who is very fat (BMI ＞ 30) and suffered from diabetes.His wound healed by 21 days.These patients obtained follow-ups of 8 to 14 months (average,11.4±2.8 months).The average full weight-bearing time was 2-3 months (average,2.5±0.4 months).The fractures healed after 8 to 16 weeks (average,11.1 ±2.8 weeks).No displacement of the fractures or breakage of the implants occurred in our series.Nobody has activity limitation of the knee or pain because of the implant,and no never symptoms were noted postoperatively,so we would not take out the implant for these patients.The mean HSS score was 93.1±4.8 (range,from 85 to 100) at the final follow-up,and the excellent rate is 100％.The Lysholm score was 97.1±3.6 (range,from 90 to 100) at the final follow-up.The Lachman test and the Pivot-shift test were negative in our patients,and the mean knee flexion was 128.6±12.8°(range,from 105°to 140°).The fractures were all anatomical reduction by the X-ray after operation,and there had being no displacement of the fractures or breakage of the implants occurred during the follow-up period.The mean posterior slope angle was 8.29±2.87° (range,from 4 °to 12°),which was 8.71±2.63° (range,from 5 °to 14°) 6months after operation.The mean tibial plateau angle was 86.00± 1.41° (range,from 84 °to 88°),which was 86.43± 1.62° (range,from 84 °to 89°) 6 months after operation.The mean Rasmussen X-ray score was 16.86±1.57 (range,from 14 to 18),which was 16.57±1.51 (range,from 14 to 18) 6 months after operation,and the excellent rate are 100％.Conclusion For the complex tibial plateau fractures which simultaneous involved the medial,the lateral and the posterior,the improved three combined approaches showed the advantages of the convenient operation,the satisfactory results of reduction and fixation,and the less trauma and secondary damage,and could be worth for clinic.

Adolescent ; Adult ; Aged ; Blood Coagulation Disorders ; Blood Coagulation Factors ; Case-Control Studies ; Child ; Female ; Humans ; Male ; Middle Aged ; Retrospective Studies ; Vitamin K ; Vitamin K Deficiency ; Young Adult