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Objective To find out the main pathogenic bacteria distribution and sensitivity to antibiotics in patients post PTCD for malignant biliary obstruction ,to evaluate the therapeutic effectiveness of antibiotics and provide evidences for rational use of antibiotics .Methods The clinical data were collected and analyzed retrospectively from 423 PTCD cases with malignant biliary obstruction from September 2013 to October 2014 .Results Among 423 patients underwent PTCD ,101 patients were confirmed with infections .67 patients showed positive pathogenic bacteria culture .A total of 94 strains of pathogenic bacteria were detected .There were 62 strains of gram negative bacteria (65 .96% ) and 32 strains of gram positive bacteria (34 .04% ) . The main pathogenic bacteria were klebsiella pneumoniae , Escherichia coli ,enterococcus faecalis and Enterobacter cloacae . Klebsiella pneumoniae and Escherichia coli are the two gram negative bacteria most resistant to antibiotics .The three popular gram negative bacilli in this study had the lowest resistance to imipenem/cilastatin ,piperacillin/tazobactam and amikacin .The three main gram positive bacteria were most sensitive to daptomycin ,linezolid and vancomycin .The total effective rate of anti-biotic treatments for post PTCD infections was 88 .1% .Conclusion Our hospital had an appropriate treatment plan with antibi-otics to control the infections post percutaneous transhepatic cholangio-drainage for malignant biliary obstruction .According to the results of drug sensitivity test ,ceftriaxone had high resistance rate .The outcome with ceftriaxone treatment was unsatis-factory .Clinical pharmacists should advise doctors to reduce the usage of ceftriaxone .Glycopeptide antibiotics can be used to control methicillin-resistant staphylococcus (MRS) gram positive bacteria .
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Objective Experimental study on effects of Yangxinshi tablets in the prevention and treatment of chronic is-chemic heart failure and acute myocardial ischemia reperfusion injury in order to provide a theoretical basis for its clinical appli-cation .Method Rat model of chronic ischemic heart failure and acute ischemia reperfusion mouse model of myocardial infarc-tion were constructed through coronary artery ligation .Those animals were randomized to sham operation group ,model group , positive drug group ,high Yangxinshi tablet dose group ,middle Yangxinshi tablet dose group ,low Yangxinshi tablet dose group .Rat electrocardiogram ,ultrasound ,ACE ,ACD ,TNF-a ,mouse myocardial infarction area ,CK ,LDH ,SOD and relat-ed factors were recorded during pre-dosing and post-dosing after modeling .Morphological changes were observed with cardiac pathological section .Results The biochemical indicators in model group were significantly different from sham operation group with statistical significance (P<0 .001) .Compared to the model group ,positive drug group and high Yangxinshi tablet dose group exhibited biochemical differences with statistical significance (P<0 .001 ,P<0 .01 ,P<0 .05) ,significant myocardial in-farction area reduction (P<0 .01 ,P<0 .05) ,improvement in myocardial cells and reduction in the cell infiltration .Conclusion Yangxinshi tablets have preventive and therapeutic effects on chronic ischemic heart failure and acute ischemia reperfusion in-jury .
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Objective To assess the use of human albumin (ALB) after hepatectomy in hepatocellular carcinoma patients in our hospital .Methods 150 hospital medical records from June 2012 to June 2013 were analyzed ,which used the human ser-um albumin during the perioperative period of hepatectomy at hepatocellular carcinoma (preoperative Child-Pugh A or B) retro-spectively ,the rationality of human blood albumin use was evaluated .Results Among the 150 medical records ,the total appli-cation amount of albumin was 11 212 .5 g (897 bottles) ,the total cost was 527 ,744 yuan ,nearly 20 percent of total drug costs ,accounting for nearly 10% of the total cost of hospitalization .By using human serum albumin after surgery ,the patients'liver function was significantly improved (P<0 .05) ,there was a positive correlation between the Child-Pugh score and dosage of human albumin (P<0 .05) .Conclusion The use of human serum albumin was rational during the perioperative period of hepatectomy in hepatocellular carcinoma patients in our hospital ,which had achieved the desired therapeutic effect .