Practice of precise management of antibiotics in a children′s hospital in combination with key performance indicators / 中华医院管理杂志

Bacterial infection is the main cause of infectious diseases in children. Antibacterials play an important role in anti infection treatment of children. At present, the treatment of antimicrobial drugs in children is facing a severe situation of bacterial resistance. In January 2020, a children′s specialized hospital carried out the practice of precise management of antibiotics in combination with key performance indicators. Through the multi sectoral linkage of management and technology, eight key performance indicators and assessment methods were set up from three levels of antibiotic use, bacterial resistance and hospital infection, to standardize the clinical application of antibiotics and continue to promote the rational use of antibiotics. This practice had improved the performance indicators of antibacterial management. Among them, the use intensity of antibacterial drugs for inpatients decreased from 40.07 DDD in 2019 to 29.00 DDD in 2021, the use rate of antibacterial drugs for inpatients decreased from 81.32% to 64.40%, the percentage of antibacterial drug expenses in total drug expenses decreased from 35.41% to 26.82%, the use proportion of non restricted antibacterial drugs in antibacterial drugs increased from 71.30% to 82.21%, and the drug resistance rate of Salmonella to β-Lactam/enzyme inhibitors decreased from 4.84% to 0.03%, and the incidence of hospital infection decreased from 1.16% to 0.96%. The precise management of antibiotics in combination with key performance indicators improved the level of rational use of antibiotics, effectively curbed bacterial resistance, achieved phased results, so as to provide a reference for the scientific management of antibiotics in children′s hospitals.

Diagnostic value of magnetic resonance imaging combined with transvaginal color doppler sonography on early-stage cervical cancer / 实用放射学杂志

Objective To evaluate the predictive value of magnetic resonance imaging (MRI)and transvaginal color doppler sonography (TVCDS)for the early-stage cervical cancer.Methods MRI and TVCDS images data of thirty-five patients with early-stage cervical cancer in Kailuan general hospital were retrospectively analyzed.The clinical stage of cases wereⅠb andⅡa.All patients were performed with MRI and TVCDS pre-operation.The accuracy rate of different methods and combined application were statistically analyzed.Results There were significant difference between MRI,TVCDS,MRI combined with TVCDS for tumor diameter,cervical stromal invasion,vaginal invasion,parametrial invasion,lymph node metastases(P<0.05),which accuracy rates were 88.4%,79.2%,89.4%,97.4%, 92.3% respectively for MRI combined with TVCDS.The MRI combined with TVCDS was the best method.Conclusion MRI combined with TVCDS has key value for early diagnosis of cervical cancer pre-operation.It can help to completely understand the situation of early stage cervical cancer and to select the suitable treatment.

Effect of apigenin on protein expressions of PPARs in liver tissues of rats with nonalcoholic steatohepatitis / 中华肝脏病杂志

<p><b>OBJECTIVE</b>To investigate the effect of apigenin on the protein expression levels of peroxisome proliferator-activated receptors (PPARs) in liver tissues of rats with nonalcoholic steatohepatitis (NASH).</p><p><b>METHODS</b>The NASH rat model was established by feeding of a high-fat diet. Unmodeled rats served as the normal controls. The modeled rats were divided into a model control group, Essentiale treatment grouP(300 mg/kg/day),and three apigenin treatment groups for low-dose (15 mg/kg/day), moderate-dose (30 mg/kg/day) and high-dose (60 mg/kg/day). After 13 weeks of treatment,changes in insulin sensitivity from pre-treatment baseline were assessed by measuring the alanine aminotransferase (ALT), aspartate aminotransferase (AST),total cholesterol (TC),triglycerides (TG),low-density and high-density lipoprotein cholesterol (LDL-C and HDL-C),fasting blood glucose (FBG) and fasting insulin (FINS).The liver index and HOMA-IR were also calculated.Protein and gene expression of PPARα and PPARgamma in liver tissue were assessed by immunohistochemistry and RT-PCR.Statistical analysis was performed by the LSD test and Games-Howell test.</p><p><b>RESULTS</b>The apigenin-treated groups showed a significantly greater change in insulin sensitivity than the untreated model group,with the most significant change occurring in the high-dose grouP(P less than 0.05).Compared with the untreated model group,the apigenin-treated groups showed lower levels of ALT (95.4+/-7.3),AST (183.7+/-14.3),TC (1.61+/-0.25),TG (1.23+/-0.21),LDL-C (1.86+/-0.14),FBG (5.29+/-1.45) and FINS (0.76+/-0.86),but a higher level of HDL-C (1.04+/-0.17); again,the high-dose group showed the greatest change (all P less than 0.05).Compared to the untreated model group,the apigenin-treated groups showed significantly lower liver index (3.75+/-0.25 vs.2.90+/-0.17) and HOMA-IR (1.34+/-0.06 vs.0.18+/-0.04),with the high-dose group showing the greatest change (both P less than 0.05). Compared to the untreated model group,the apigenin-treated groups showed higher levels of protein and mRNA of PPARα (18.27+/-4.05 and 0.63+/-0.02,respectively) and PPARgamma(8.48+/-5.05 and 0.39+/-0.02),with the high-dose group showing the greatest change (all P < 0.05).</p><p><b>CONCLUSION</b>Apigenin can improve glucose tolerance,lipid metabolism and insulin resistance while decreasing blood levels of TC,TG,LDL-C,FBG,FINS and HOMA-IR,and increasing HDL-C in NASH,as shown in a high-fat diet induced rat model, and may have therapeutic potential.</p>

Association study between clinical pharmacokinetic of paclitaxel and chinical effect in patients with gynecological malignant tumor / 中国生化药物杂志

Objective To observe the association between clinical pharmacokinetic of paclitaxel and adverse reactions in patients with gynecological malignant tumor.Methods 78 patients with female malignant tumor selected from Jan.2009 to Dec.2013 in Kailuan General Hospital were treated with paclitaxel (intravenous drip 175 mg/m2 3 h).The blood drug level of paclitaxel was measured at different time after treating.The DAS software was used to calculate the parameter of pharmacokinetic of paclitaxel,and the SPSS software was used to analyze the association between clinical pharmacokinetic of paclitaxel and adverse reaction in patients with female malignant tumor.Results The peak plasma concentrations (Cmax)was (3.99 ± 1.07)mg/L,the areas under the plasma concentration-time curve (AUC)was (9.74 ±2.45)mg/(h·L),the plasma elimination half-life (t1/2z)was (13.7 ±3.2)h,the apparent volumes of distribution (Vd)was (162.9 ±49.5)L/m2,the plasma clearance rates (CL)was (8.2 ±1.0)L/(h·kg).The kinetics of paclitaxel was fitted to two-compartment model.The time of drug concentration >0.1 μmol/L (t>0.1 )in responder patients (16.8 ± 4.8)h was higher than that in nonresponder patients (13.5 ±2.9)h,and the difference was significant (P<0.05).The Cmax in patients with severity adverse reactions (4.61 ±0.86)mg/L were higher than those in patients without severity adverse reaction (3.65 ±1.13)mg/L,and the difference was significant (P<0.01).Conclusion The Cmax of paclitaxel is associated with efficacy after treatment and severity adverse reactions.

Comparison of virological response between Peg IFNα-2a and Peg IFNα-2b in treatment of chronic hepatitis C / 中华临床感染病杂志

Objective To compare the virological responses between Peg IFNαt-2a and Peg IFNα-2b in treatment of chronic hepatitis C.Methods Clinical data of 46 chronic hepatitis C (CHC) patients were retrospectively reviewed.Patients were divided into two groups:Peg IFNα-2a group ( n =24) was given Peg IFNoα-2a 180 μg/week and ribavirin; Peg IFNα-2b group (n =22 ) was given Peg IFNα-2b1.5 μg · kg-1 · week-1 and ribavirin.Serum HCV RNA load at 4th,12th and 24th week of the treatment were detected to evaluate the virological responses.Softwares SPSS 13.0 and PEMS 3.1 were used for statistical analysis.Results There was no significant difference in rapid response rate,early response rate,complete response rate and non-response rate between the two groups (x2 =0.689,0.105,0.105 and 0.105,P ＞ 0.05 ).However for patients with high viral load ( HCV RNA ＞ 6 logl0 copies/mL) at baseline,the rapid response rate in Peg IFNα-2a group ( 86.67％ ) was higher than that in Peg IFNα-2bgroup (42.86％ ) (x2 =4.365,P ＜ 0.05 ).Conclusion Peg IFNα-2a combined with ribavirin may have higher rapid response rate than that of Peg IFNα-2b combined with ribavirin in CHC patients with high viral

Clinical Syudy of Glutathione in Patients with Alcoholic Liver Disease / 医学研究杂志

Objective To approach the clinical effect and safety of glutathione in patients with alcoholic liver disease(ALD).Method The patients were divided into two groups, including the control group and treatment group.Two groups are all treated with routine therapy such as Ganlixin,potassium magnesium aspartate,mulivitamins and so on,the treatment group add glutathione,to inspect clinical menifetation and liver function changes of two groups before and after treatments.Result Among the treatment group,43.6%showed notable effective result,51.3%effective,the total dffective rate is 94.9%. Among the control group, 19.4%showed notable effective result, 58.3%effective,the total dffective rate is 78.7%.There is a significant different between the two groups (P

Detection of Phenotype and Genotype from Vancomycin-resistant Enterococci / 中华医院感染学杂志

OBJECTIVE To explore the infection rate with identifying test of vancomycin-resistant enterococci(VRE) from clinical samples,that is 3.7 percent and to genotype VRE. METHODS vanA,vanB and vanC were detected by PCR in six isolates of VRE which were identified by the broth microdilution susceptibility test and Etest.The one of vanB was further analyzed with DNA sequence and ermB,qacE△1-sul1 gentypes were detected. RESULTS Seventeen isolates of enterococci(MIC≥4 ?g/ml) were obtained of 160 isolates of enterococci which came from Jiangxi Children′s Hospital by microdilution methods.while 6 isolates were gotten by Etest.It demonstrated that susceptibilities of VRE were different in four in vitro susceptibility testing methods.VRE showed resistance to erythromycin(10/17),disinfectant/sulfanilamide(0/17). CONCLUSIONS VRE screening test and the determination of MIC are reliable in finding VRE.VRE genotype is valuable on further research and epidemiological survey of our province.

Reduced glutathione hormone' s impact on alcoholic hepatitis patient's index of hepatic fibrosis / 中国临床药理学与治疗学

AIM:To observe the changes of hepatic fibrosis index,clinical symptom,physical sign and hepatic function after the patients were treated treatment with reduced glutathione hormone.METHODS:The 72 patients were divided into two groups that one was the treatment group with 37 patients and the other was the control group with 35 patients.The control group was accepted the treatment with Ganlixin Injection,Magnesium Aminosuccinate Injection and Mulvital,etc.The treatment group was accepted reduced glutathione hormone(1.5 g,once a day)in addition.The course of treatment lasted for 8 weeks.We observed the two groups' blood-serum fibrosis indexes(HA,LN,PIII-P,C-IV)and biochemistry indxes(TBIL,ALT,AST,GGT)before and after the treatment.RESULTS:The improvements of the treatment group were much better than the control group on the sides of clinical symptom,physical sign,hepatic function and blood-serum fibrosis.The treatment group's blood-serum fibrosis indexes were much lower after the treatment(P