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OBJECTIVE:To evaluate the effectiveness,safety and economics of antibiotics for inpatients with acute exacerba-tion of chronic obstructive pulmonary diseases (AECOPD),in order to promote rational use of antibiotics. METHODS:In retro-spective study,AECOPD inpatients were selected as research objects during 2013-2015 to evaluate the use of antibiotics. RE-SULTS:Three thousand one hundred and eighty-six AECOPD patients were enrolled in the study,and utilization ratio of antibiot-ics was above 90%. DDDs of Cefordizime sodium for injection ranked the first place in 3 years and was decreased in 2015,while those of β-lactam and carbapenems were increased. DDC of Meropenem for injection and Imipenem/cilastatin sodium for injection were the highest. Drug utilization index(DUI)of Cefodizime for injection was far more than 1.0,while DUI of Piperacillin sodi-um and sulbactam sodium for injection was much less than 1.0. Sort ratio(B/A)of Cefodizime sodium for injection ranged 1-2 in 3 years. B/A of Piperacillin sodium and sulbactam sodium for injection,Imipenem and cilastatin sodium for injection,Meropenem for injection were lower than 1.0. CONCLUSIONS:The indication of anti-infective treatment in AECOPD patients have been mas-tered strictly in our hospital;the utilization ratio of antibiotics is decreased year by year;the types of antibiotics are rational rela-tively,and the number of antibiotics which is rationally used is increased year by year. But the rationality of Cefodizime sodium for injection and Piperacillin sodium/sulbactam sodium for injection need to be improved.
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OBJECTIVE:To investigate the relationship of drug utilization index(DUI)of antibiotics with therapeutic efficacy of patients with acute exacorbation of chronic obstructive pulmonary disease(AECOPD). METHODS:By the method of drug utili-zation evaluation,inpatients with AECOPD in our hospital during 2013-2015 were selected as the research object. Diagnosis and treatment information prescribing information of patients were collected,and inpatients only receiving one kinds of antibiotics dur-ing hospitalization stay were selected to evaluate the relationship of therapeutic efficacy with rehospitalization indexes. RESULTS:A total of 2155 AECOPD patients were enrolled in the study. Among antibiotics with DDDs>500,antibiotics with DUI close to 1.0 was cefotiam hydrochloride for injection,and that with DUI far higher than 1.0 was Cefodizime sodium for injection,while that with DUI much less than 1.0 was Piperacillin sodium and sulbactam sodium for injection. There was statistical significance in therapeutic efficacy between Cefotian hydrochloride for injection and Piperacillin sodium and sulbaactam for injection (P0.05). There was no statistical significance in therapentic efficacy or rehospital-ization between cefotiam hydrochloride for injection and cefodizimes sodium for injection(P>0.05). CONCLUSIONS:DUI is as-sociated with therapeutic efficacy,but the rationality of antibiotics can not be simple judged according to the distance between DUI and 1.0. A variety of confounding and bias factors should be integrated to avoid misreading and misjudgment.
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OBJECTIVE:To provide reference for further promoting the rational use of antimicrobial drugs in the rural commu-nity health service stations. METHODS:4 800 prescriptions were collected from 8 community health service stations affiliated to our hospital from Jan. 1,2012 to Dec. 31,2014,the use of antimicrobial drugs in the prescriptions was statistically analyzed and the indicators were compared before and after intervention. RESULTS:The proportion of use of antimicrobial drugs in these com-munity health service stations was decreased from 52.88%in 2012 to 30.38%in 2014;the clinical diagnosis of prescription of anti-microbial drug was mainly respiratory infections;what the most used types of antibacterial drugs was cephalosporins;and the pro-portion of antimicrobial drug of irrational use was decreased from 43.50%(368/846)in 2012 to 22.84%(111/486)in 2014. CON-CLUSIONS:The combination of technique and administrative intervention is remarkable. However,the unreasonable use of antibac-terial drugs still exists. Therefore,related training should be organized,and the proportion of use of antimicrobial drugs should in-cluded in the performance appraisal to further improve the use level of antimicrobial drugs in the rural community health service sta-tions.
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OBJECTIVE:To provide reference for rational use of glucocorticoid in the clinic. METHODS:The glucocorti-coid outpatient prescriptions collected from clinical departments of a hospital during Jan. 2013 to Jun. 2015 were analyzed statisti-cally in respects of glucocorticoid use,department distribution,DDDs,distribution of prescription diagnosis,etc. RESULTS:Of 15 000 prescriptions,there were 1 562 glucocorticoid prescriptions,with utilization rate of 10.4%;189 prescriptions were recog-nized as irrational ones,with irrational rate of 12.1%. The proportion of glucocorticoid in otorhinolaryngology department was the highest(27.66%),and irrational drug use was the highest in pediatrics department(16.12%);Dexamethasone injection was the most widely applied(44.88%);most of glucocorticoid prescriptions were used for acute bronchitis and bronchitis(267 pre-scriptions). CONCLUSIONS:The irrational glucocorticoid application has existed in the hospital,which deserved special atten-tion. Hence,prescription check and evaluation should be strengthened to promote the safety and efficacy of glucocorticoid in clini-cal application.
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Objective To study the clinical efficacy of autologous cartilage following unilateral cleft lip and palate repair on correction of secondary complex deformity.Methods 17 patients with complex secondary cleft palate were enrolled in this study from December 2004 to December 2014.Correction of nasal and lip deformity and oronasal fistula were achieved at the same time.The therapeutic efficacy was evaluated after follow-up from 3 months to 2 years after operation.Results All 17 patients received satisfactory results,of which 14 patients were satisfied and three cases of general satisfaction.Conclusions Satisfactory results are received by using autologous rib cartilage to repair secondary complex deformity of unilateral cleft lip and palate.
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Objective To explore the surgical method of double flag-shaped flap to correct the shortened middle part of upper lip deformity of post burn.Methods From January 2009 to December 2013,9 cases of shortened middle part of upper lip post burn deformity were corrected by double flag-shaped flap,including 4 males and 5 females who aged from 18 to 37 years.They received the surgery from 1 to 3 years after burn.The main clinical manifestations included the upper lip eversion,too short middle part of upper lip,the destruction of the normal anatomy philtrum,philtrum column deformity and poor continuity vermilion border.Results The height of the middle of upper lip of 9 patients enrolled in the experimental treatment was lengthened by 4 to 6 mm after operation,which fundamentally corrected the shortened middle part of upper lip deformity of post burn.The patients were followed up for a period of 3 months to 2 years and received satisfactory results.The operative incisions of 9 cases were primary healing,with no flap blood supply disorders,wound infection,dehiscence and other complications.Conclusions Double flag-shaped flap of the upper lip at the nostrils bottom is a simple and good effective method to correct the shortened middle part of upper lip deformity of post burn.
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Objective To investigate the application of multiple dilators for excessive expansion of scalp with hair covering and integrated use of expanded flap to repair cicatricial alopecia in a large area.Methods stage Ⅰ surgery was performed as follows:multiple dilators were chosed and embedded below the galea aponeurotica of the scalp with hair covering according to the bald hair shape,size of the alopecia area.Excessive expansion was conducted for 3 to 6 months to get the extra hair scalp.Stage Ⅱ surgery was as follows:Dilators were removed and scar areas were resected,followed by combined use of sliding advancement flap,rotation flap and translocation flap to repair scalp alopecia.Resluts The postoperative effect of all patients was ideal with satisfied appearance.Conclusions Multiple dilator excessive expansion may obtain a large number of additional expansion scalp,combined by reasonable use of skin flap transfer technology,which can be used to repair the large scarring alopecia and get a good clinical effect.
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Objective To explore the clinical effect of auricle reconstruction with expanded auricle posterior flap on mastoidea and auto rib cartilage bracket for repair of congenital microtia.Methods Twenty-one eligible patients with congenital auricle malformation and defect were recruited into this study and three-stage operation was performed.A 50 ml kidney-shaped expander was implanted at mastoid process area to expand skin in stage Ⅰ surgery,followed by a regular affusion to expand skin for 3 to 4 months.The average total waterflood was (80.51 ± 3.87) ml.The volume remained stable for 1 month,once up to the predetermined amount.In stage Ⅱ surgery autogenous costal cartilage was taken and carved into inverted conch shape.Auricle was reconstructed with the expanded flap to cover the auto rib cartilage bracket.The stage Ⅲ surgery was performed for details dressing of the auricle after 3 months.Results All 21 cases underwent operation successfully.Reconstructed ear auricles were similar to uninjured sides in size and shape.Both doctors and patients were contented with the auricles.Conclusions Expanded auricle posterior flap on mastoidea can cover the auto rib cartilage bracket.Autologous costal cartilage can be carved to four layers cartilage bracket that likes an inverted conch,and followed by realistic postoperative auricular shape and strong three-dimensional sense after operation.
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OBJECTIVE@#To understand the usage of MP3 and effects on hearing of middle school students in Xi'an, and discuss controlling strategies.@*METHOD@#Stratified random cluster sampling method was used in the 1567 middle school students in Xi'an through questionnaire survey, ear examination and hearing examination, data were analysed by the SPSS13.0 statistical software.@*RESULT@#1) The rate of holding MP3 in the middle school students was 85.2%. Average daily use time was (1.41 +/- 1.11) h. 2) The noise group of pure tone hearing threshold was significantly higher compared with the control group (P<0.01), and increased the detection rate of hearing loss with the increasing use of MP3. 3) The detection rate of symptoms increased with the increasing use of MP3.@*CONCLUSION@#The usage of MP3 can harm hearing in middle school students, which can result in neurasthenic syndrome.
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Adolescent , Female , Humans , Male , Audiometry, Pure-Tone , Auditory Threshold , Data Collection , Hearing Loss , Hearing Tests , MP3-Player , Students , Surveys and QuestionnairesABSTRACT
OBJECTIVE To establish the optimal animal model of tympanosclerosis.METHODS Staphylococcus were inoculated into the middle ear of guinea pigs,and the guinea pigs were sacrificed periodically.The changes of their middle ears were observed by light microscope,and the hearing threshold of the animals were measured.RESULTS All the inoculated ears showed different degree of mucosal adhesions after 7 days.The most common site of tympanosclerosis was hypotympanum,followed by the anterior epitympanum,the attic,the drum,the interossicular spaces,and the tubal orifice.CONCLUSION The pathological changes of the middle ear in guinea pigs with chronic otitis are similar to those of human being.It is a favorite animal model for researching on chronic otitis media with tympanosclerosis.
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Objective The purpose of this investigation was to observe the effects of the glutamate/aspartate transporter(GLAST) antibody to auditory brainstem response(ABR) and the pathologic morphology of hair cells in the guinea pig's cochlea. Methods 20 guinea pigs were randomly divided into the experimental group and control group. By perfusing the antibody to GLAST into tympanic canal in the cochlea of guinea pigs in experimental group and artificial perilymph into the guinea's cochlea in control group,the results of ABR ,basilar membrane stretched preparation and transmission electron microscope were observed. Results After antibody perfusion,the ABR was not induced from the third day to the ninth day.In control group,the ABR was nearly absent on the third day,but could be evolved,on the sixth day and the ninth day in all guinea pigs with the average threshold of 62.50?5.25 dB SPL and 47.50?6.18 dB SPL,respectively. The ABR thresholds at different time in control group were significantly different(P
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Objective To explore the effects of treatment and mechanism of sodium salicylate on blast deafness. Methods Guinea pigs were divided into blast group, blast plus sodium Salicylate group and sodium solicylate group. The animals in the blast group were exposed to blast average peak pressure 176.7 dB(SPL); sodium salicylate was injected IP 400 mg/kg,1/d. Monitoring ABR threshold, the value of MDA of and counting the number of hair cells on the cochlea preparation, SEM for hair cells was observed. Results The ABR threshold shift in the blast group was 46.75±13.56 dB，38.0±12.4 dB,35.5±10.67 dB，41.5±12.57 dB,33.75±8.42 dB, post-blast 1 d，3 d，1 w，2 w,4 w respectively. And that of the blast plus sodium salicylate was 46.65±11.7 dB，38.25±9.52 dB,30.5±9.17 dB,30.0±9.17 dB,23.0±6.57 dB. The two groups differed significantly at 1 w，2 w，4 w(P＜0.05). The value of MDA differed significantly at 2 w,4 w(P＜0.05). And the hair cells lost also differed significantly. It was observed that sodium salicylated can raise the ABR thresbold temporarily 24 hrs during simple sodium salicylate adminastration. However it recovered 14 hrs after the injection.Conclusion Sodium salicylate can partially attenuate the hearing loss caused by blast. It is probable that sodium salicylate can clear peroxicative produced during blast and therefore protect hair cells and make hearing loss partially recover.
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Objective To investigate the regrlative role of the cervical sympathetic ganglia on the cochlear blood flow and auditory function in guinea pig.Methods The horseradish peroxidase(HRP) was given to spiral modiolar artery locally for retrograde tracing in guinea pig. Immunohistochemical double-labeled technique was used in this study. The cochlear blood flow and auditory brainstem response(ABR) was measured a week after anilateral superior cervical sympathectony. The animal model of superior cervical sympathectomy following noise exposure in guinea pigs was estableshed to observe the auditory threshold shift.Results Retrogradely labeled neurons with HRP were found in the ipsilateral superior cervical ganglion(SCG). Most of HRP-labeled neurons in SCG were tyrosion hydroxylase(TH) positive. The blood flow of the capillaries of the stria vascularis on the experimental side a week ago were more aplenty than that of the opposite side, but the ABR threshold did not changed before and after ablation of the superior cervical ganglion.A protective role against noise injury was observed after surgical ablation of superior cervical ganglion.Conclusion The superior cervical sympathectomy can influence the cochlear blood flow and auditory function in guinea pig.