OBJECTIVE:To survey and objectively evaluate the present situation and trend of the antihistamine agents used in 18 hospitals of Hangzhou.METHODS:To make a survey of the use of above mentioned drugs in 18 hospitals of Hangzhou during the period 2000～2002 in respect to the sum of money for drugs and manufacturing factories.RESULTS:In comparison with 2001,the sum of money for consumption of antihistamine agents increased 17.89%in 2000,and decreased 4.58%in 2002.Joint venture and imported products accounted for 70%of share of market.Lortadine and Cetirizine were still the first choice in therapy of allergic reactions.CONCLUSION:Consumption of antihistamine agents decreased,but kinds of drugs had no obvious change.

Objective To investigate the clinical manifestations and the antibiotics resistance patterns in children with positive blood culture of Escherichia coli. Methods The clinical data of children with positive blood culture of Escherichia coli were retrospectively analyzed from Jan.2007 to Dec.2014. Results In a total of 154774 children who had blood culture in the study period, 8446 children were positive, among whom 408 (4.83%) children were isolated Escherichia coli. The children with the positive blood culture of Escherichia coli mainly were under one year old (51.72%), of which 36.77%was neonates. There were 275 children had underlying diseases, and the most common disease was Leukemia. 199 (48.77%) Escherichia coli strains were producing extended spectrumβ-lactamase (ESBLs) and 85.23%were resistant to ampicillin. All strains were susceptible to meropenem. Conclusions Septicemia caused by Escherichia coli is usually occurred in children with leukemia or in neonates. Since blood infections of Escherichia coil had high rate of ESBLs, the use of carbapenem antibiotics should be cautious.

Objective To investigate the efficacy and safety of percutaneous pericardial drainage with indwelling catheter via the puncturing route of left sternal broader in the third or fourth interspace Methods In the 38 patients with moderate to large pericardial effusion, the pericardial echo free space and the forecasted puncturing distance were measured with two dimensinal echocardiolgraphy (2DE) prior to pericardiocentesis in the three sites: subxiphoid, cardiac apex and the left sternal broader in the third or fourth interspace Under the guidance of 2DE, pigtail catheters were percutaneously indwelled for pericardial drainage via the location of left sternal broader in the third or fourth interspace Results Among the three sites, there were no difference of echo free space measured by 2DE, and the forecasted distance of advancing needle examined in left sternal broader was the smallest The procedures of indwelling catheter drainage for pericardial effusion were successfully performed in all the 38 patients Catheters lying in posterior pericardium were found in 94 8% of the patients (36/38) There were no cases with puncturing related complications, effusion leaking into pleurum or subcutaneous tissue Only 1 case was complicated with neural mediated syncope on the third day after indwelling catheter Conclusion Pericardiocentesis using left sternal broader route is a safe and simple approach for indwelling catheter drainage in patients with pericardial effusion This route may be a promising option for clinical use widely

Until now, the exactly effect of Kupffer cells (KCs) on inducing immune tolerance or aggravating acute rejection is still unknown. Activated by various way after liver transplantation, have the ability of phagucytosis the apoptositic T cells, up-regulated expression of FasL and many Th2/Th3 cytokines, such as interleukin-10 and transforming growth factor-lB. These up-regulated cytokines could induce the apoptosis of Th1 cells and enhance the proliferation and differentiation of the Th2 cells, finally induce the immune tolerance, However, the activated KCs also have the ability of expression many cytokine-dependent molecules,such as class Ⅱ major histocompatibility antigens, adhesion molecule and costimulatory molecules which could enhance the function of the antigen presentation, increase the expression of Thl cytokine and aggravate the acute rejection after liver transplantation. It maybe relate to the ratio of theTh1/Th2 cells determined by the complicated net of the cytokine produced by the activated Kupffer cells: the predominance of Th2 cells could induce the immune tolerance, on the contrary, the acute rejection proceed.

Objective To study the expression of muhidrug resistance( MDR1 ) ,and clinical significance of MDR1 gone expression in EOC. Methods Reverse transcription polymerase chain reaction was used to determine the expression of MDR1 in 27 cases of epithelial ovarian cancer,38 cases of benign tumor and 20 cases of normal ovarian tissue. The expression rate of MDR1 and the clinical significance was explored. Results The expression rate of MDR1 gone in malignant,benign tumor and normal tissue of ovary was74.1%, 15.7 % and 0 % respectively. The levd of MDR1 gone expression in EOC was obviously higher than that in benign tumor(P<0.01 ). The non-respond-era to combination chemotherapy exhibited higher ratio of MDR1 expression than the respondera( P<0.05 ). Conclu-sion The expression of MDR1 is higher in EOC than that in normal ovary tissue and benign tumor. The expression of MDR1 is closely related to the tumor response to chemotherapy.

Objective To observe the pharmacokinetic feature of Radix Acanthopanacis Senticosis suspension(RASS). Methods The research was conducted with pharmacodynamic endpoint approach and pharmacodynamic approach and adopted with phagocytic index as pharmacological parameter. Results Pharmacodynamic endpoint approach: K_(el)=0.2d~(-1), K_a=2.5 d~(-1), AUC(S_0)=10.4g?kg~(-1)?d, VRT=19.3d~2.Pharmacodynamic approach: K_(el(ef))=0.1d~(-1), K_(a(ef))=2.9d~(-1), AUC(S_0)_((ef))=62.7(%)?d, VRT_((ef))=43.2d~2. The data obtained by pharmacodynamic approach differed from that by pharmacodynamic endpoint approach, indicating the delay of drug effect. Conclusion Pharmacokinetic Data of RASS are first obtained in this article, which show that pharmacodynamic endpoint approach and pharmacodynamic approach is feasible.

AIM: To promote the quality standard of Senbei Beigua Oral Thick Paste (Fructus Cucurbitae, Radix Codonopsis, Radix Adepophorae, Bulbus Fritillariae Thunbergii, Rhizoma Zingiberis Recens) . METHODS: Rhizoma Zingiberis Recens, Fructus Cucurbitae were identified by TLC. Peimine content was determined by TLCS. RESULTS: The study showed that spots of samples on TLC can be well separated and the method had strong specificity. The quantification method had a good linear at the range of 0.326-1.194 ?g. The average recovery was 96.8% and RSD was 0.87%. CONCLUSION: The methods for identification and quantification are simple, accurate and reproducible. It can be used for quality control of Senbeibeigua Oral Thick Paste.

Objective To determine the mimic epitope of N-methyl-D-aspartate receptor 2B subunit (NR2B). Methods The monoclonal antibody interacting with NR2B was used as target protein to screen the binding peptide from a 12-mer Ph. D random peptide library. After three rounds of affinity screening, twelve specific clones were selected randomly and identified by sandwich ELISA. The peptide sequences were analyzed by DNA sequencing. The clones containing a common sequence were named positive clone. The competitive inhibition of the native antigen bound to monoclonal antibody against the NR2B by the positive clone was assayed by cell ELISA. Results After 3 rounds of screening the phages specifically bound with mAb NR2B were selected and amplified. Nine of the 12 clones displayed a common aminoacid sequence: SHPPVMPWPTST. The inhibitory assay showed that the mimic epitope peptides displayed on the phage surface could effectively inhibit the combination of the monoclonal antibody with native antigen. The inhibitory rate of mimic epitope was (45?3)% .Conclusion The mimic epitope of NR2B was screened successfully from the 12-mer Ph D random peptide library. This peptide mimics an epitope of the native NR2B.

Objective To make a curve of dose grads liver signal of superparamagnetic iron oxide (SPIO) in normal rats, to compare lesion to liver contrast noise ratio (C/N) and to assess the ability on MR imaging before and after SPIO injection. Methods Group one: 72 normal SD rats divided into 18 specimen groups at random, underwent MR enhancement with 0,2,5……280 ?mol Fe/kg SPIO respectively after plain scanning. The signal to noise ratio of liver was measured and a curve of dose grads liver signal was made in order to find an appropriate dose for enhancement. Group two: 38 rats with 43 implanted liver adenocarcinomas underwent T 1 and T 2 weighted MR imaging before and after the injection of SPIO agent. Evaluations included enhancing characteristics of the tumors, counting the number of lesions and statistical analysis of quantitative changes in the signal intensity of both lesions and normal liver. Results On SPIO enhanced T 2 weighted and T 1 weighted MR images, the signal intensity of liver was reduced to peripheral noise on the dose of 10 ?mol Fe/kg and 40 ?mol Fe/kg respectively. The highest contrast to noise ratio (C/N) could be acquired on the dose of 20 ?mol Fe/kg on enhanced T 2 weighted MR images; its C/N almost doubled compared with that of enhanced T 1 weighted and unenhanced T 2 weighted MR images. The C/N of unenhanced T 1 weighted MR images was lowest. The number of lesions detected on enhanced MR imaging was the same as that of the pathology, and enhanced MR imaging was superior to unenhanced MR imaging in tumors smaller than 3 mm, of 36.3% escaped detection on unenhanced MR images. Conclusion Good enhancement effect of SPIO on T 1 and T 2 weighted MR imaging could be acquired at the dose of 20 ?mol Fe/kg, its detecting ability approached that of gross pathology, and the best contrast to noise ratio was found on T 2 weighted enhanced MR image.

OBJECTIVE: To analyze the causes for misplacement of pedicle screw in thoracolumbar spine.METHODS: From January 2002 to January 2008, 19 patients with misplacement in thoracolumbar spine were treated in Department of Orthopedics, Wuxi Affiliated Hospital of Nanjing University of Chinese Medicine, including 12 males and 7 females with an average age of 52.5 years (range 23-68 years). The diagnoses were thoracolumbar fracture in 5 cases, lumbar spondylolisthesis in 8 and degenerative lumbar disease in 6. The fixation systems were Steffee used in 4 cases, DRFS in 3, RF in 6, AF in 4 and GSS in 2. X-ray and CT scanning were used to observe pedicle screw location, including screw,pedicle and membranous sac and great vessels.RESULTS: The time of misplacement of pedicle screw was 5-69 days with an average time of 18.5 days, including 7 cases of screw penetrating into lateral cortex, 4 of screw penetrating into medial cortex, 2 of screw penetrating into pedicle cortex, 2 of overplacement, 2 of intervertebral foremen placement and 2 of intervertebral space placement.CONCLUSION: The causes for screw misplacement were anatomic variation and poor surgical skills, and the key factors in precise insertion of pedicle screw are fine surgical skills, carefully study of preoperative image and the intra-operative monitoring.