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OBJECTIVE： To provide scientific evidence for establishing perfect rationality evaluation indicator system of antibiotics. METHODS： On the basis of literature research， Delphi method was used to conduct several rounds of consultations on 30 experts in related fields with E-mail and questionnaire field investigation. After several rounds of consultations， rationality evaluation index system for antibiotics was determined. The effective recovery rate of expert consultation questionnaire was used to express the positive coefficient of experts； the authoritative coefficient was used to express the authoritative degree of experts； the index importance assignment and the full score ratio were used to reflect the concentration degree of experts’ opinions； the coefficient of variation and the coefficient of coordination were used to express the coordination degree of experts’ opinions. RESULTS & CONCLUSIONS： After two rounds of consultations， response rates of the questionnaire in two rounds of surveys were 100％ and 96.67％， indicating experts were highly motivated. The authoritative coefficients were 0.91 and 0.88， indicating experts had a high degree of authority. Finally， an evaluation index system for rationality of antibiotics was established， which included four first-level indicators （indications， drug selection， medication process， management indicators） and 35 second-level indicators. Among them， the mean value of importance scoring of first-level indicators ranged from 4.28 to 5.00， the full score ratio from 0.93 to 1.00， the coefficient of variation from 0.00 to 0.15 and the coefficient of coordination was 0.446 （P＜0.001）. While， the mean value of importance scoring of second-level indicators ranged from 3.83 to 4.79； the full score ratio from 0.67 to 1.00； variation coefficient from 0.10 to 0.26 and the coefficient of coordination was 0.115 （P＜0.001）， which indicating the system was reliable.
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Objective To compare the short-term effect of laparoscopic surgery with open surgery for gastrointesti﹣nal stromal tumor. Methods 26 patients, whose tumor were localized and the pathologic diagnosis were gastrointesti﹣nal stromal tumor in stomach after surgery, were randomly divided into laparoscopic surgery group (n=12) and open surgery group (n= 14). The age and gender level, disease duration, clinical symptom, tumor location, and the lesion diameter were similar between the two groups (P> 0.05). Surgery achievement, intraoperative blood loss, operative time, postoperative hospital stay, postoperative flatus time, postoperative liquid time, and incidence rates of postoper﹣ative complications were compared between the two groups. Results All the patients get successful R0 resection. The volume of intraoperative blood loss, operative time, postoperative hospital stay, postoperative flatus time, and postop﹣erative liquid time in laparoscopic surgery group were lower than open surgery group (P 0.05). Conclusion Compared with open surgery, the short-term effect of laparoscopic surgery were better for patients whose gastrointestinal stromal tumor in stomach were localized, and it is worth of promoting clinical application.
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Objective To study the clinical manifestations,diagnosis and surgical treatment of tubular adenoma in the extrahepatic bile duct.Methods The clinical data of 3 patients with tubular adenoma in the extrahepatic bile duct who were admitted to the Affiliated Hospital of Inner Mongolia Medical University from July 2010 to February 2012 were retrospectively analyzed.Results The tumors were located at the middle and lower part of the common bile duct.All the 3 patients received resection of the common bile duct and Roux-en-Y cholangioenterostomy,and recovered well.The results of pathological examination showed that all the patients were with tubular adenoma,and 2 patients had moderate atypical hyperplasia.Conclusions Tubular adenoma in the extrahepatic bile duct could be diagnosed by pathological examination.Radical resection and rerouting of the bile duct can get a better outcome.
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Soluble tumor necrosis factor-related apoptosis-inducing ligand (sTRAIL) is potentially a novel anti-cancer drug due to its superior selective cytotoxicity in a wide variety of tumor cells. Zinc ion (Zn2+) insufficiency might be an important cause for weak cytotoxicity of sTRAIL prepared by gene engineering. In this paper, the sTRAIL protein is highly-expressed with insertion of the synthesized gene encoding sTRAIL into pQE30 plasmid. The polymerization and cytotoxicity in tumor cells of sTRAIL prepared in presence of different concentrations of Zinc ions were compared. It was found that the sTRAIL protein prepared in absence of Zinc ions mainly existed as monomer with weak cytotoxicity. However, in the presence of Zinc ions, sTRAIL formed homotrimer and showed strong cytotoxicity in tumor cells. These results demonstrate that Zinc ion is very important for cytotoxicity of sTRAIL. It is necessary for keeping stable activity of sTRAIL by addition of proper concentration of Zinc ion in the media.