OBJECTIVE:To probe into the method suitable for centralized ARDs monitoring in hospital METHODS:Using the software made by ourselves,a retrospective analysis was carried out on the data of 462 patients who stayed in hospital from November 1999 to October 2000 and have received chlorpheniramine maleate,cyproheptadine or semprex RESULTS:42 patients suffered from ARDs induced by 9 categories,22 kinds of drug Antibiotics occupied first place among these drugs CONC_LUSION:The microcomputer drug warning system can be used to retrieve relevant information of ARDs and to prevent undetected ARDs,which will help improve the evaluation of safety of drugs

Objective To retrospective analyze the treatment of hallux valgus with the procedure of osteotomy of the base of the first metatarsal, combining with osteotomy of the base of the second and/or third metatarsal(s), and to study the indications and effects of this procedure. Methods 35 cases 56 hallux valgus feet were treated by operative procedure from January 1994 to December 2003. 26 cases 43 feet underwent the operative procedure of osteotomy of the base of the first metatarsal, 9 cases 13 feet with painful callus under the second and/or third metatarsal(s) head underwent osteotomy of the base of the first, second and/or third metatarsal(s). The axial and lateral films of all feet with loading were taken before and after operation. The change of anatomic indexes and AOFAS of the patient postoperatively were recorded and analyzed. Results In the group with osteotomy of the base of the first metatarsal, AOFAS score was 47.6?5.8 preoperatively, and 84.3?5.7 postoperatively. In the group with osteotomy of the base of the first, second and/or third metatarsal(s), AOFAS score was 44.7?5.7 preoperatively, and 85.7?4.5 postoperatively. There were significant differences between the preoperative and postoperative rontgenographic index and AOFAS in each group. Conclusion The operative procedure is effective. The operative procedure of osteotomy of the base of the first metatarsal can get good result in moderate and severe hallux valgus patients. Osteotomy of the second and/or third metatarsal(s) were recommended in cases with painful callus under the second and/or third metatarsal(s). Normal forefoot appearance and function can be restored by the procedure to reestablish the transverse arch.

Objective To carry out the quality control testing and evaluation for three digital mammography systems.Methods The performance of three digital mammography systems was assessed by applying methods recommended in the European guidelines for quality assurance in breast cancer screening and diagnosis and Chinese specification for testing of quality control in X-ray mammography.The performance of X-ray generator of three digital mammography systems were tested and evaluated.CDMAM 3.4 phantom with four different thickness(30,40,50,60 mm) were exposured in DR,PCM,and CR system,respectively.The average glandular dose (AGD) value was measured and image quality figure (IQF) analysis was performed in each thickness.Results The X-ray machine performance of DR and CR was in accordance with existing standard,however the standard was inappropriate to evaluate part of X-ray machine performance of PCM system.The AGDs for system DR were 1.20,1.42,1.75 and 2.20 mGy for 30,40,50 and 60 mm PMMA thickness,respectively.The respective AGDs for system PCM and CR were 0.82,1.19,1.33,1.70 mGy and 0.59,0.88,1.47,2.19 mGy.For the same phantom thickness sequence,the IQFs were 21.36,21.57,27.25 and 30.58 for system DR,28.02,29.10,35.90,and 41.24 for system PCM,whereas they were 39.78,39.30,43.85 and 48.08 for system CR.Conclusions The AGDs of all three systems were in accordance with the values recommended in European guideline.The AGD and IQF could provide an effective way for performance assessment and constancy checks for digital mammography systems.

Objective To evaluate the effectiveness of color doppler ultrasound(CDU)in combination of computed tomographie angiography(CTA)in diagnosis of the arteriosclerosis occlusion.Methods:43 patients with arteriosclerosis occlusion were assessed by color doppler ultrasound,CTA and digital subtraction angiography(DSA).By using DSA as the reference standard,the results were compared.Results The sensitivity.specificity,positive and negative predictive values for CDU were 82.96%,95.2%,94.92%,83.8% respectively.Those for CTA were 88.89%,96.75%,96.77%,88.81% respectively,and for the two combination,were 94.81%,99.17%,99.22%,94.44% respectively.Conclusion The color doppler ultrasound combined with CTA is an effective way in diagnosing arteriosclerosis occlusion.

Objective To assess the feasibility of ESD measurements in the mammography by the comparative study of energy dependence of the three passive solid detectors on low energy X-ray.Methods Two thermoluminescent TL) detectors ( LiF(Mg,Ti) and LiF( Mg,Cu, P) and one optically stimulated luminescence (OSL) detector( Al2O3: C ) were irradiated for the same air kerma by ten kinds of beam quality between 25-40 kV in a Mo/Mo low energy X-ray generator,respectively. Results The energy dependences of TL and OSL were 25% and 11% between 25-40 kV, respectively. Conclusions considerable potential for OSL detector can be used in routine quality control and ESD measurements in the mammography.

Objective To study the dosimetric characteristics of two different radiochromic films used to estimate peak skin dose(PSD) of patients.The characteristics of these two films were investigated and compared after exposure to ionizing radiation in the diagnostic energy range,including post-exposure gray growth,sensitivity,energy dependence and dose response.Methods GafChromic XR-RV3 film and KODAK EDR2 film were exposed to air kerma 800 mGy free-in-air using five X-ray beam qualities (60,80,100,120 and 140 kVp) in a SSDL.The measurement for each energy was normalized to 80 kV to analyze energy dependence of films.The films were calibrated to different dose level (0.025-10 Gy) onphantom by 80 kV X-rays.The response curve were plotted to analyze sensitivity and dose response.The films were scanned with Epson V750 commercial flatbed scanner.Color channel analysis was performed.Results The post-exposure gray growth of XR-RV3 film was found to be fairly stable.The change were 2％,4％,6％ at 24 h,72 h and 6 weeks after exposure respectively.EDR2 film was found to be more sensitivity than XR-RV3 film in low dose.The energy response of the XR-RV3 film and EDR2 film were within 9％ and 23％ over the clinical diagnostic x-ray energies,respectively.In the dose range of 0.025-10 Gy,for the XR-RV3 film,the red channel with the dose response curve was most obvious.For EDR2 film,the pixel value of three color channels was coincident.The EDR2 film appeared to be saturated when receiving doses greater than 500 mGy.Conclusions The XR-RV3 film is superior to EDR2 film in gray growth,energy dependence,dose-response and other aspects.This film is very suitable for measuring and analyzing PSD of patients in interventional radiology procedures.

Objective To study the angular dependence of four different mammographic dosimeters to monoenergetic X-ray beams and observe the variation tendency in angular dependence to different energy X-rays and to discuss the evaluation of average glandular dose(AGD)in digital breast tomosynthesis(DBT)system.Methods One ionization chamber and three semiconductor dosimeters were exposed by four kinds of beam quality.The signal of each dosimeter was tested over an angular range of 0° to 90°.The dosimeters were exposed for three times at each selected angular position.The measurement at each angle was normalized to the appropriate measurement at perpendicular incidence.Results The responses from all the dosimeters had a maximum at 0° and decreased with increasing angles.When the radiation incidence angle was 10°,the angular dependence were 0.99,0.99,0.96 and 0.96 for dosimeters A,B,C and D,respectively.And the angular dependence decreased to 0.96,1.00,0.78 and 0.52 when the incidence angle was up to 25°.For semiconductor dosimeters,no signal was recorded when incidence angle was beyond 45°.For ionization chamber,the magnitude of the angular dependence generally decreased with increasing energy.Conclusions All of the dosimeters will underestimate the dose if used in DBT.In order to minimize the error due to the rotation angle of X-ray tube,correction factor of mammography dosimeter should be used for the measurement of AGD in DBT systems.

OBJECTIVE:To establish a way to monitor drug-induced liver damage by using hospital centralized management system for monitoring ADR.METHODS:Using self-designed computer program,the data of inpatients with abnormal ALT,AST and TBIL,admitted in the period from Dec. 2001 to Feb. 2002,were extracted from hospital HIS system of databa_se,and ADR and irrational drug-use were retrospectively analysed.RESULTS:There were 50 ADR incidents concerned with 30 kinds of drug and 11 cases receiving irrational medication concerned 10 kinds of drug.CONCLUSION:By this way,we can timely get the information of drug-induced liver damage and set up a new way for developing centralized ADR monitoring in hospital.

Objective:To investigate the perioperative issues on the elderly patients undergoing total knee arthroplasty.Methods:Seventy nine knees from 62 patients ≥75 years of age received total knee arthroplasty from September 2000 to January 2006,the operative result and perioperative complications were reported.Results:Sixty one cases were followed up for 28 months(ranging from 6 to 58 months),according to the hospital for special surgery(HSS) knee rating scale,the HSS scores were improved after the operation from 27.18?7.01 preoperatively to 76.24?6.08 postoperatively(P

Objective To investigate the result of arthroscopic surgery in the treatment of sinus tarsi syndrome. Methods The study involved 15 patients (6 males and 9 females) with sinus tarsi syndrome admitted to First Hospital of Nanjing from July 2006 to May 2008. The age of the patients ranged from 23 to 63 years ( average 46.3 years). All the patients had one side involvement, including 10 patients with left side involvement and five with right side involvement. All the operations were performed under the tourniquet control and the patients were placed at the lateral decubitus position. The lateral, anterolateral and posterolateral portals were applied intraoperatively and the medial portal was applied when necessary. Visual analogue scale (VAS) and American orthopedic foot and ankle scale (AOFAS) ankle-hindfoot scale were used for follow-up evaluation. Results More than two lesions were found under arthroscope in all patients. The lesions included scar tissue hypertrophy and inflammation in the sinus tarsal canal, soft tissue impingement in the subtalar joint, synovitis, partial tears of subtalar capsule, interosseous talocalcaneal ligament or cervical ligament, cartilage injury and subtalar degeneration. All patients were followed up for 19-35 months (mean 26. 1 months). At the final follow-up, the VAS score was improved from preoperative 7.6 points ( range 6-9 points) to postoperative 2.5 points (range 1-4 points) (P＜0.01 ), and the AOFAS score improved from preoperative 41. 9 points (range 20-67 points) to postoperative 83. 1 points ( range 70-100 points) ( P ＜ 0. 01 ). The excellence rate of the AOFAS score reached 73% at the final follow-up. Conclusion For patients with sinus tarsi syndrome after a failed conservative treatment, arthroscopic surgery should be performed as soon as possible and the clinical result is satisfactory.