Objective To investigate the rationality of antibiotic use in Chongqing before and after intervention and its inter vention effect.Methods 16 200 cases,54 000 outpatient prescriptions and annual average antimicrobial consumption in 2011 from Chongqing sub network of Health and Family Planning Commission antibacterial drug monitoring network were selected as control group;48 600 cases,162 000 outpatient prescriptions and annual average antimicrobial consumption from 2012 to 2014 were selected as intervention group.The use rate of antimicrobial agents in outpatients,the intensity of antimicrobial use in hospitalized patients,the percentage of antimicrobial use in hospitalized patients,the average number of antimicrobial use in hospitalized patients,the combined use of antibiotics and other antimicrobial agents in hospitalized patients were retrospectively studies.Results Except for the utilization rate of antibiotics in the outpatients and the density of antimicrobial agents in hospitalized patients,the utilization rate of antibiotics in the hospitalized patients,the microbiology inspection rate of application of antibiotics in non surgical treatment (％),the average use days of antibiotics in the hospitalized patients(days) and the combination rate of antibiotics in the hospitalized patients from 2012 to 2014 (after intervention) had significant impact in comparison with 2011 (before intervention).Conclusion Through the clinical pharmacistes' participating in the intervention in reasonable use of antibiotics and a variety of powerful intervention measures,the rationality of antibiotic use is feasible.

Objective To investigate the feasibility of macrophages as cell carriers to deliver floate modified oxygen loaded ultrasound contrast agent . Methods The phagocytic activity of macrophages was analyzed by ink phagocytose test , and the expression of folate recepters ( FRs ) on macrophages cell membrane surface was tested by immunofluofluorescence assay . Oxygen/paclitaxel loaded lipid microbubbles( OPLMB) and folate‐targeted OPLMB ( TOPLMB) were synthesized by mechanical shock method and incubated with macrophages in vitro . According to different treatment conditions ,the cells were divided into three groups:group A ( OPLMB) ,group B ( free folic acid + TOPLMB) and group C ( TOPLMB) , the fluorescence intensity of the cells were observed under fluorescence microscope ,and the phagocytic percentage and the phagocytic index of macrophages uptake OPLMB and TOPLMB were observed by bright field microscope . Results The phagocytic percentage of macrophages phagocytose ink was (99 .3 ± 1 .0)% ,FRs was highly expressed on macrophages cultured in vitro . After incubation for 30 minutes ,the fluorescence intensity of group C was significantly higher than those of A and B ,the phagocytic percentage in three groups were (19 .5 ± 0 .2)% ,(21 .0 ± 0 .2)% and (81 .2 ± 10 .0)% respetively . The phagocytic percentage of group C were significantly higher than those in group A and group B ( P <0 .05) . Conclusions Macrophages cultured in vitro possess highly phagocytic activity and these cells highly express FRs ,and can be used as cell carriers to deliver floate modified oxygen loaded multimodality ultrasound contrast agent .

Objective To investigate the effect of Nestin gene silencing on the proliferation of human esophageal cancer ECA109 cells and possible mechanism .Methods Lenti-Nestin was constructed and transfected into ECA109 cells to establish a stable Nestin-silencing cell line Lenti-Nestin.Blank group , scrambled group , Lenti-Nestin group were set up .The expressions of Nestin , c-myc and cyclin D1 mRNA and protein levels were detected by qRT-PCR and Western blot .The cell proliferation was analyzed by CCK 8 assay .Results The stable Nestin-si-lencing cell line was successfully established .The expression of Nestin mRNA ( P<0.01 ) and protein ( P<0.05 ) levels were reduced significantly and the downregulation evidently suppressed cell proliferation ( P<0.01 ) and col-ony forming capacity ( P<0.05 ) compare with the scrambled group and blank group .However ,The c-myc and cy-clin D1 expression levels in ECA 109 cells in Lenti-Nestin group were significantly lower than that of scrambled group and blank group ( P<0.05 ) .Conclusions Knockdown Nestin expression significantly inhibits the level of esophageal cancer ECA109 cells proliferation,which may act via influencing the expression of c-myc, cyclin D1.

Objective To investigate prophylactic application of antibacterial agents in perioperative period of vascular interven‐tional surgery in our hospital before and after intervention ,and to evaluate the effects of intervention measures .Methods One hun‐dred cases from March to May 2011 were selected as non‐intervention group ,and 100 cases from March to May 2012 after interven‐tion were selected as intervention group .Analysis was conducted on medical information of two groups by questionnaire about their antibiotic drugs use .we evaluated the the percentage of antimicrobial application ,drugs choice ,initial time of medicine treatment ,the course of medication and so on .Results The rational rate of antibacterial use increased from 6% (before intervention) to 99% (af‐ter intervention) (P<0 .01) .The rationality was improved significantly in respect of initial time of medicine treatment ,antibacterial agents and the course of medication .the percentage of antimicrobial application ,cost of antibacterials and the value of antibiotics use density (AUD) were decreased significantly .Conclusion The intervention of our hospital is feasible and effective ,and could signifi‐cantly improve the perioperative antibacterial application .

OBJECTIVE:To explore the role of clinical pharmacists in cancer pain management. METHODS:The cases were presented to investigate the content and method of clinical pharmacists participating in cancer pain management. RESULTS:The clinical pharmacists could provide professional analgesic recommendations and participated in the formulation of individual analge-sic plan. By carrying out pharmaceutical care and patient education,clinical pharmacists could find potential medication risk,cor-rected medication errors and improved patient compliance. By carrying out patient family members training,clinical pharmacists could help to strengthen patient support system and improve cancer pain management effectiveness. CONCLUSIONS:Clinical phar-macists participating in cancer pain management can promote rational use of analgesics,guarantee the safety of drug use,and im-prove cancer pain management.

Objective To investigate the feasibility and parameters for macrophage uptake oxygen and paclitaxel loaded lipid microbubbles (OPLMBs) in vitro.Methods OPLMBs were synthesized by mechanical vibration method and incubated with macrophages in different conditions in vitro.The ratio of macrophages uptake OPLMBs was observed by bright field microscope.Results The ratio of macrophages uptake OPLMBs was closely related to the size,concentration as well as the incubation time of OPLMBs with the macrophage.The ratio of macrophages uptake OPLMBs had a reverse relationship with the size of microbubbles.The highest rate of macrophages uptake OPLMBs was (18.9 ± 0.69)％ when the ratio of macrophages to microbubbles was 1 to 10,the time for macrophages co-incubation with microbubbles was 30 min,which was the suitable condition for macrophages uptake OPLMBs.Conclusions OPLMBs can be phagocytized successfully by macrophages in vitro.The size,concentration as well as the incubation time of OPLMBs with the macrophages are important parameters contributed to the efficiency of macrophage phagocytosis.

ObjectiveTo summarizeand the law of lymph node metastases from adenocareinoma of esophagogastric junction ( AEG),analyses the extent of lymphadenectomy for AEG.Methods198 cases of AEG had been retrospectively analyzed from 2006.6.6 to 2010.12.31,and kept detailed record of the operation type、Siewert's type、TNM stage and group of metastatic lymph nodes.ResultsThe thoraco-abdominal two field lymph node dissection had been performed for 198 AEG,the total number of lymph nodes had been dissected was 3069,the average number was 15.50,the number of metastases lymph nodes was 859.In the 198 AEG,132 cases with lymph node positive,The metastatic rate and incidence was 66.67％ and 27.99％,respectively.The manner of the metastasis about 130 cases was station by station and 2 cases was skipping over station,accout for 98.48％ and 1.52％ of all nodes-positive cases,1 case skiped to left gastric and celiac axis and another case skiped to tracheal bifurcation.The location of positive lymph nodes about Siewert Ⅰ and Ⅱ were recorded:tracheal bifurcation(6.25％,3.33％ ) 、lower posterior mediastinum and paraoesophageai(25.00％,14.67％ ),right paracardiac (47.92％,52.00％ ),left paracardiac (31.25％,36.67％ ) 、lesser curvatura(43.75％,43.33％ ),greater curvatura( 27.08％,22.00％ ) 、left gastric and celiac axis( 27.08％,30.00％ ).The lymph nodes metastastic rate of stage T1 + T2 and T3 + T4 were 40.43％,74.83％,respectively,the difference were significantly.The lymph nodes metastastic rate of different tumor length were analyzed,≤ 3cm group were 40.74％,3 ～5cm group were 70.71％ and ≥5cm group were 88.89％,the difference were significantly;but there were no significant difference related to different differentiation grades and different Siewert types.The mediastinal lymph node metastase rates between Siewert Ⅰ (27.08％) and Siewert Ⅱ (14.67％) were significant difference,but the difference were not found in pericardiac lymph nodes.ConclusionSiewert Ⅰ 、Ⅱ AEG trend to metastasized to middle and low mediastinal and pericardiac,the modified left thansthoracic route and two field lymph node dissection maybe suitable to the lymphadenectomy for AEG.

Objective: To explore the protective effect of Shenmai lyophilized preparation (SMP, 参麦冻干剂) on acute myocardial infarction (AMI) in cats. Methods: AMI cat model was induced by ligation of the left coronary artery for 4 hours. Cats were randomly divided into five groups: AMI group (4 ml/kg of normal saline ), large dose SMP group (1.76 g/kg), small dose SMP group (0.88 g/kg), Shenmai injection (参麦注射液) group (0.88 g/kg) and nitroglycerine group (0.44 mg/kg). Drugs were given 5 minutes after the left coronary artery ligation. Mean arterial pressure (MAP) and ventricle cardiac arrhythmia were monitored by multichannel biological signal analytical system. MultiCD*2lead ?ST on chest was recorded by cardiofax after myocardial ischemia for 4 hours, the area of AMI was measured by dyes with triphenyl tetrazolium chloride (TTC). Changes of creatine kinase (CK) and lactate dehydrogenase (LDH) in serum were assayed by colorimetric assay. Results: SMP at the dosage of 0.88 and 1.76 g/kg increased MAP, decreased ?ST and incidence of ventricle cardiac arrhythmia in cats with AMI, shrank the area of AMI and decreased the LDH content and CK activity in serum, respectively compared to the AMI group, the differences being significant in the aboveCD*2mentioned parameters (P

Aim To study the protective effects of sodium magnesium fructose diphosphate (FDPM) on the kidney in hemorrhagic shock rats. Methods The study utilized Wiggers hemorrhagic shock model. Sixty Wistar rats were divided into six groups randomly: normal saline control group,three doses of FDPM group (90.0,45.0,22.5 mg?kg -1 ),1,6-fructose diphosphate group(37.5 mg?kg -1 ) and magnesium sulfate group (3.4 mg?kg -1 ). Mean arterial pressure was monitored before shock, 10, 30 and 60 minuts after drug administration and 0, 30 and 60 minuts after shed blood reinfusion Blood urea nitrogen and creatinine, the content of malondiadehyde, and the activity of Na+-K+-ATPase, Ca 2+ -ATPase, Mg 2+ -ATPase, and superoxide dismutase in kidney were also measured. Results FDPM significantly improved mean arterial blood pressure of hemorrhagic shock rats, reduced blood urea nitrogen and creatinine, decreased the content of malondiadehyde and increased the activity of Na+,K+-ATPase,Ca 2+ -ATPase,Mg 2+ -ATPase and superoxide dismutase in kidney. Conclusion FDPM had protective effects on the ischemia-hypoxia injury of kidney by improving energy metabolism and attenuating tissue injury caused by free radicals in hemorrhagic shock.

OBJECTIVE: To investigate whether sodium magnesium fructose diphosphate(SM) could raise the contents of energy sustrates-ATP, ADP and AMP in the tissues of acute myocardial infarction.METHODS: 60 rat models of acute myocardial infarction were randomly divided into 6 groups(n = 10): Treatment groups(A, B, C) received SM(75mg/kg, 38mg/kg and 19mg/kg) in saline sulution respectively, and control groups (D, E) received 1,6 - fructose diphosphate (200mg/kg) or magnesium sulfate(10mg/kg), another control(F) received same volume of saline.Four hours after administration, the levels of ATP,ADP and AMP in the myocardial homogenate were determined by HPLC.RESULTS:The levels of ATP, ADP and AMP of treatment groups(A, B, C) were (612.8± 103.2)、 (538.0± 141.2) and (325.2± 113.2) nmol/g; (407.6± 113.4)、 (389.4±91.5)、 (306.1 ± 134.6) nmol/g and ( 1 637.6 ± 236.8)、 (1 366.8± 279.3)、 ( 1 186.1 ± 341.1) nmol/g; while those of control groups(F) were (119.0± 22.8)、 (146.5± 36.8)、 (436.7± 214.9) nmol/g, respectively(P＜ 0.01 of 0.05) .CONCLUSION: SM can raise the contents of energy substrates- ATP,ADP and AMP in the tissues of acute myocardial infarction.