Objective To analyze the characteristics and regularity of adverse drug reaction ( ADR) reports in our hospital ,and to provide reference for clinical drug use .Methods 34 ADR cases reported by our hospital to ADR monitoring center during Jan-Dec.2013 were analyzed .The gender of patients ,route of administration ,drug,cate-gories,organs or systems involved in ADR,clinical manifestations,etc.were analyzed.Results Of 34 ADR cases,the age of patients more than 70 years took up the higher proportion (6 cases,17.65%);the largest number of ADR re-ports was caused by intravenous injection (28 cases,82.35%);the main types of ADR were lesion of skin and its ap-pendents (14 cases,41.18%);ADR reports were most likely caused by anti-infective drugs (17 cases,50%);fol-lowed by TCM injections and the circulatory systems (4 cases,11.76%).The rash,itching,respiratory system,gastro-intestinal system mainly formed clinical manifestation .Conclusion The occurrence of ADR is correlated with multi-ple factors,we should pay more attention to the ADR monitoring and promote rational drug use .

Objective To explore the clinical efficacy of tension-free vaginal tape obturator inside-outside(TVT-O)in the treatment of female stress urinary incontinence.Methods In this study,we enrolled the patients with stress urinary incontinence who were treated with TVT-O(n=72)or midodrine hydrochloride(n=72).The patient self-evaluation and the Results of pad test and urodynamic test 6 and 24 months after the treatment were compared.Results These 2 kinds of treatment significantly improved the symptoms in patients with stress urinary incontinence,and in patients treated with TVT-O the clinical efficacy 24 months after the treatment was better.Conclusion TVT-O is safe and effective in treating female stress urinary incontinence,and the long-term follow-up and the improvement of urodynamic indices show it is better than simple drug treatment.

Objective To investigate the epidemiological characteristics of hemoglobin variability (Hb-Var) in dialysis patients,and to explore the factors related to Hb-Var and the relationship between Hb-Var and patients outcomes.Methods The study enrolled 178 hemodialysis and peritoneal dialysis patients in the Department of Nephrology,Peking University People's Hospital between October 2009 and March 2010.First six months were observation period,and then followed up for 12 months.The Hb-Var was described by residual standard deviation (Res-SD) and fluctuation across threshold of the Hb level.Non-fatal cardiovascular events and mortality were the primary endpoints.Results The Res-SD was (4.74±2.66) g/L in dialysis patients.Most patients fell into groups of high amplitude (HA) and low amplitude low (LAL),with frequency of 29.8％ and 33.1％ respectively.The related factors of Hb-Var were fluctuation of erythropoietin (EPO) dosage and hemodialysis.Kaplan-Meier survival curve and multivariable adjusted Cox regression indicated that Res-SD had no impact on the primary endpoints.Accumulative time to reach target hemoglobin level was an independent factor related to outcome.Conclusion Hb-Var occurs commonly in dialysis patients.The fluctuation of EPO dosage and dialysis style increase Hb-Var.Accumulative time to reach target hemoglobin level is an independent factor related to patients outcomes.

The suprachoroidal space (SCS) is the potential space between the sclera and choroid.Drugs delivered through SCS can bypass the sclera,avoiding clearance by conjunctival and scleral blood vessels and lymphatic circulation,so that more drugs can reach the disease tissues such as choroid and retina.SCS drug delivery does not disrupt the ocular integrity,is safer than the intravitreal drug injection and more effective than trans-scleral drug delivery.In addition,SCS delivery only needs a very small volume of drug,which makes it possible to be carried out in multiple parts of the sclera,and the specific disease area can be more precisely targeted.SCS drug delivery is suitable for the treatment of choroidal and retinal diseases.However,currently SCS drug delivery is still a novel field and many aspects need to be more in-depth studied,including its safety,delivery methods,drug formulation and effectiveness.

Objective To introduce the clinical apply of middle and small skin defect in finger injury with lateral arm free perforator flap.Methods (1) Ten cadavers were injected with a modified lead oxide-gelatin mixture.Later,CT scan,three-dimensional reconstruction of the cutaneous perforator vessels on the later arm.Then simulate the flap design.All cadavers were dissected before CT scanning.(2) Eighteen cases of middle and small skin defects in finger injury were treated with lateral arm free flap.The defect area were from 3 cm × 4 cm to 6 cm × 9 cm.Results Our research showed that the average caliber diameter of perforators of profunda brachial artery(PBA) was (0.71 ± 0.15) mm,and Posterior radial collateral artery(PRCA) was (0.94±0.22)mm.The results of pedicle length of perforator of PBA was (2.74 ±0.42) cm:(2.96 ±0.37) cm,and PRCA was (4.78 ±0.63) cm:(4.86 ±0.51) cm.3D reconstructive results showed that the perforators of PBA and PRCA dominated the lateral upper arm area.The flap of 18 cases survived after the operation.The wound of providing area was directly sutured or skin grafting and got healing.All cases were followed up for 6 months to 3 years,and the average follow-up time was 11 months.There was a little swelling on the outlooks of the flap,but the texture and sensation of the flap was good.Conclusion The lateral arm free perforator flap has a stable vessel pedicle,good texture and sensation,so it was a good method to repair middle and small skin defect in finger injury.

ObjectiveTo investigate changes of the level of serum thyroxine after different style operation on thyroid gland,for guiding replacement therapy after surgery. MethodsTo select patients randomly,include the excision of adenoma of thyroid、the lobectomy of unilateral thyroid、the subtotal ectomy of bilateral thyroid and total resection of bilateral thyroid quaque forty,among the total,the patients who suffererd the total resection of bilateral thyroid take thyroxine 40mg bid orally everyday. To detect the serum thyroxine in all of the patients, when preoperation、ten days after operation、one month after operation and three months after operation. ResultsThe serum thyroxine in patients who suffererd the excision of adenoma of thyroid were had no marked changes compare to preoperation; Serum FT3 、FT4 in patients suffer the lobectomy of unilateral thyroid are lower than preoperation when ten days after operation (P＜0.01) ;Serum FT3、FT4 in patients sufferred subtotal ectomy of bilateral thyroid were lower than preoperation,when ten days after operation and one month after operation( P ＜ 0.01 ), then returned to the level of preoperation when three months after operation;the serum thyroxine of patients who sufferred the total resection of bilateral thyroid had no marked changes compare to preoperation,when they taker thyroxine 40mg bid orally everyday. ConclusionThe serum thyroxine level of patients who suffer the lobectomy of unilateral thyroid、the subtotal ectomy of bilateral thyroid and total resection of bilateral thyroid is lower than preoperation at different degree, they should be given replacement therapy properly.

Objective To discuss the treatment of cranialfacial fibrous dysplasia. Methods The treatment of 10 cases of cranialfacial fibrous dysplasia was analyzed. Results The cosmetic deformity was corrected in all the cases.No new symptom of nervous system occurred. Conclusion It is important to carry out the correct surgical plan according to patients' age,location,mono-or poly-ostotic form of fibrous dysplasia,presence or absence of functional limitations,and aesthetic problem.

Objective To investigate autonomic nervous system(ANS)function of hyperthyroidism and hyperthyroidism by analyzing the heart rate variability(HRV)of patients with the diseases.Methods 12-synchronous dynamic 24-hour monitoring and man-machine dialogue were performed in 49 patients with hyperthyroidism,25 patients with hypothyroidism and 40 controls after removing interference,and 24-hour electrocardiogram wag analyzed.Heart rate variability indicators observed included 24-hour time-domain indexes[standard deviation of all experimental time RR(SDNN),root of mean square standard deviation from adjacent RR interval(RMSSD)]and 24-hour frequency domain indicators[very low frequency power(VLF),low-frequency power(LF),high frequency power(HF),low frequency power/high frequency power(LF/HF)].Results Indicators of time domain in hyperthyroidism group,such as SDNN[(69.65±13.55)ms]and RMSSD[(12.98±3.20)ms]were obviously lower than those of the control group[(136.07±11.95),(29.70±5.85)ms],the differences being statistically significant (P＜0.01).Indicators of frequency domain HF[(5331±15.84)msz]were lower than those of the control group [(223.38±50.09)ms2],butVLF[(1823.55±238.13)ms2],LF[(501.88±92.47)ms2]and LF/HF(5.89±1.15)was higher compared with that in the control group,repectively[(325.68±60.47)ms2,(405.60±5 1.41)ms2,2.14±0.56,P＜0.01).Among time domain indicators in hypothyroidism group,SDNN[(77.00±15.48)ms]and RMSSD [(14.80±2.58)ms]were also obviously lower than those in the control group(P＜0.01),the difference being significant statistically(P＜0.01).Frequency domain index HF[(57.88±12.20)ms2],VLF[(251.48±24.67)ms2],LF[(128.68±43.78)ms2]also obviously lower than those in the control group(P＜0.01),but LF/HF,being 1.83±0.63,was in a normal range and did not significantly changed(P＞0.05). Conclusion In patients with hyperthyroidism both sympathetic and vagus nerves are hyperdynamic,while in patients with hypothyroidism,vagus nerves are hyperdynamic,while sympathetic nerve hypodynamic.

Varicella-zoster (chickenpox) infection is a common infectious disease and generally considered to be selflimiting. However, severe bacterial complications associated with the disease have been reported. We describe a case of varicella-zoster infection with secondary Staphylococcus aureus bacteremia, preseptal orbital cellulitis and extensive facial abscesses. She was aggressively treated with intravenous antibiotics and repeated surgical drainage, and eventually made good recovery.