Objective:To prevent the drug-induced hearing impairment and deafness.　Methods:To discuss the drug-induced hearing impairment from the drugs, mechanism, clinical symptom, other influencing factors and damaged therapeutics.　Results:It is progressive for the drug-induced hearing impairment, and it may be discovered and treated in early stage.　Conclusion:The preventive measures adopted and discovery in early stage of hearing impairment is the key to avoid the hearing loss.

OBJECTIVE:To investigate the current situation and developing trend of the use of antidepressants in hospitals of Shanghai.METHODS:Using DDD as index,the data of antidepressants used in47hospitals in Shanghai during the period2000～2002were analyzed.RESULTS:The average annual increase rate of sum of money for antidepressants was15.33%.The sum of money for selective serotonin reuptake inhibitors(SSRIs)accounted for92.17%,and that of fluoxetine accounted for60.02%of the total antidepressants used.CONCLUSION:SSRIs occupied the antidepressants marketing predominance.

OBJECTIVE:To evaluate the current situation and the trend of development of quinolones used in156hospitals of6cities in the Yangtze valley.METHODS:Quinolones used in156hospitals of6cities in the Yangtze valley were analyzed statistically in respect of the kind,consumption amount and DDDs etc..RESULTS:During the period of2000～2003,the annual increasing rate for consumption sum,DDDs and the defined daily cost of Quinolones used in156hospitals were22.08%,2.16%and19.50%respectively,with that of the higher defined daily cost increased faster,of which the annual increase rates in consumption sum and DDDs were up to33.22%and33.59%respectively,while the increasing percentage of oral quinolones was8.57%and-0.88%.Levofloxacin,which ranked the first in consumption,accounted for48.22%of total consumption and25.66%in DDDs.CONCLUSION:The marketing of quinolones will be further expanded.

Objective To investigate the effect of early intervention with education combined with treatment on developing intelligence of preterm infants. Methods Ninety seven preterm infants were assigned into the intervention group(n=49)and control group(n=48):Those in the former group were managed with early intervention by education combined with medical treatment and those in the latter were given routine preventive health service.The two groups were compared in terms of body length and weight at months 6,9 and 12 as well as the developmental quotient(DQ)with developmental screening test(DST). Result The scores on DQ in the intervention group were all significantly higher than those of the control at the three time points(all P<0.01).Conclusion The early intervention with education combined with treatment is effective for the early development of intelligence of preterm infants.

Objective To investigate the role of dendritic cell (DC) subsets and T cell subpopulations expressing different intracellular cytokines in the pathogenesis of syphilis. Methods Flow cytometry was utilized to measure the frequencies of peripheral DC subsets and IFN-γ-, IL-2-, IL-4-, IL-10-expressing peripheral CD4+ and CD8+ T cell subpopulations in 20 patients with syphilis before and after therapy, and in 15 healthy human controls. Results The frequency of CD11c+ DC was significantly lower in pretreated patients than that in treated patients (P<0.01), but higher than that in the normal controls (P<0.05), and the same was true for the frequency of IFN-γ-expressing T cells, IL-2-expressing T cells, and IL-12-expressing T cells. By contrast, a decrease was noticed in the frequency of IL-4-expressing T cells and IL-10-expressing T cells in pretreated patients compared with that in the normal controls. Furthermore, in patients with syphilis, the frequency of CD11c+ and CD123+ DC was unrelated to the percentage of IFN-γ-expressing and IL-12- expressing T cells (both P>0.05). Conclusions IFN-γ, IL-2 and IL-12 may exert an immunoregnlatory effect in the eliminating of Treponema pallidum, whereas IL-4 and IL-10 may perform an imrnunoinhibitory effect.

Objective To compare the effects of three kinds of Oncomelania hupensis RNA extraction methods,namely a modified SDS method,TRIzol reagent method,and CTAB method,so as to obtain an economical and efficient method for RNA extraction from O. hupensis. Methods The modified SDS method,TRIzol reagent method and CTAB method were applied to ex-tract the RNA from O. hupensis. A nucleic acid protein analyzer was used to measure the concentration and purity of RNA. The yields were calculated by the concentration of the products. The purity was indicated by A260/A280 and A260/A230. The quality of RNA was inspected by 1% agarose gel electrophoresis. The β-acting gene was selected as the target gene for RT-PCR analysis. Re-sults The RNA yields obtained by using the three kinds of extraction methods were significantly different(F = 16895.85,P <0.01)according to the analysis of variance. The LSD test showed that the yields obtained by using the modified SDS method were the highest,and those obtained by the CTAB method were the lowest. The purity of RNA extracted by the CTAB method was su-perior to that by the other two methods,and the A260/A280 and A260/A230 ratios of the CTAB method were in the range from 1.8-2.0 and 2.0-2.2. The A260/A230 ratios of the other two methods were both lower than 2.0. The RNA extracted by the modified SDS meth-od had the better integrity. The electrophoresis results showed that the 28S rRNA band,18S rRNA band and 5S rRNA band were clear,and there was no obvious smear between each band. The RNA obtained by the TRIzol reagent method had no 28S rRNA band,and that obtained by the CTAB method had no 28S rRNA and 5S rRNA bands. The β-acting gene of the RNA ex-tracted by all the three methods could be amplified by RT-PCR. The costs and time-consuming of the modified SDS method were less than those of the other two methods. Conclusion The modified SDS method is an economic and efficient method,and it is suitable for extracting the RNA of O. hupensis,especially for large sample preparation.

Objective To determine the influence of hostile neck anatomy on type Ⅰ a endoleak development after endovascular aortic aneurysm repair (EVAR) for infrarenal abdominal aortic aneurysmal disease.Methods From July 2008 to July 2011,195 consecutive patients with non-ruptured abdominal aortic aneurysms (AAA) were treated with EVAR.There were 150 males and 45 females,aging from 52 to 95 years with a mean of 69 years.Forty-three patients were with hostile neck anatomy ( HNA ).High-resolution computed tomography was abtained in all patients,with detailed measurement of proximal neck parameters.Univariate and multivariate analyses were used to compare Ⅰ a endoleak and HNA.Follow-up protocol consisted of computed tomography (CT) angiograms or ultrasound at 3,6,and 12 months,and annually thereafter.Results Twenty-three patients had intraoperative type Ⅰ a endoleaks.The adjunctive measures,such as repeated balloon angioplasty,cuff extension,Palmaz stent placement and chimney technique were used for treating type Ⅰ a endoleak.Small endoleak remained in only one patient.The technical success rate was 98.5％ (192/195).The association between type Ⅰ a endoleak development and magnitude of the infrarenal angle was statistically significant.The mean follow-up time was ( 18 ± 3 )months.The survival rates at 1- and 3-year were 97.4％ and 89.2％ respectively.Conclusions The proximal neck angle is related to intraoperative type Ⅰ a endoleak occurrence,but other factors often thought to be indicative of adverse neck anatomy are not significant predictors.Most type Ⅰ a endoleaks in this study were uccessfully eliminated intraoperatively with a satisfactory mid to long term results.

Objective To investigate and compare the clinical values of serum procalcitonin (PCT)and high sensitivity C-reac-tive protein (hs-CRP)levels for predicting the blood culture positivity in the patients with sepsis.Methods 132 adult patients with sepsis were enrolled in this study.Blood cultures were performed before the antibacterial therapy.The white blood cell (WBC) count,absolute neutrophil count(ANC),levels of PCT and hs-CRP were determined.The application value of PCT and hs-CRP for predicting the positive blood culture results were evaluated.Results The median serum PCT levels in the blood culture positive group and the blood culture negative group were 7.92 ng/mL and 0.95 ng/mL respectively,the difference had statistical signifi-cance(P <0.01).The receiver operating characteristic (ROC)curves showed that PCT had a higher predictive accuracy for blood culture positivity compared with hs-CRP,the area under the curve (AUC)was 0.810(P =0.001)and 0.690(P =0.274),respec-tively.The combined detection of PCT and hs-CRP for predicting the blood culture positive results was similar to the performance of PCT alone,AUC as 0.885 (P =0.001 ).The median cut point of PCT was 0.91 ng/mL,the sensitivity of PCT for predicting blood culture positivity was 90%.This sensitivity remained unchanged when PCT cut point was1.14ng/mL.Using the PCT cut points of 0.91 and 1.14 enabled reducing the submitted blood cultures by 51% and 56% respectively.Conclusion Compared with hs-CRP,serum PCT level could better predict the blood culture positivity in the patients with sepsis.

Objective : To learn the situation of vaccine management in Zhejiang Province by SWOT analysis,so as to provide basis for normalization and standardization of vaccine management. Methods: Through supervision and investigation,the data of vaccine management related human resources and information construction of the CDCs in Zhejiang Province were collected. The comprehensive evaluation of vaccine management in Zhejiang Province was carried out by SWOT analysis,and the SWOT matrix was established for suggestions. Results: The advantages of vaccine management in Zhejiang Province lay in the standardized management of purchase and supply,the construction of vaccine management information system and the guarantee of cold chain system;the disadvantages lay in the insufficient allocation of human resources,new problems of cold chain management,the lack of standardized vaccine management mode and the incomplete coverage of vaccine and vaccination information system;the opportunities lay in the legalization of vaccine management,“Healthy Zhejiang”initiative and the “one run at most”reform in healthcare services;the threats lay in the shortage of vaccine,the gap between the expectation of the public on vaccine management and the current situation,and the reduced capacity of vaccine deployment in the provincial CDC. We should constantly improve the construction of vaccine management system,strengthen the standardized administration,regularly carry out risk assessment on vaccine management,accelerate the full coverage of vaccine and vaccination management information system,and explore the standard operation procedure of vaccine management in Zhejiang Province. Conclusions Although some achievements have been made in vaccine management in Zhejiang Province,there is still a gap from the goals of high-efficiency,high-level,normalization and standardization. The standardization and full coverage of the information system of vaccine management should be strengthen in the next stage.

Objective To study the safety and efficacy of detachable fibered coils occlusion system for visceral artery aneurysms.Methods Thirty-three visceral artery aneurysms patients (12 males and 21 females) with an average age of 63.8±3.5 years who underwent endovascular embolization with detachable fibered coils occlusion system combined with standard pushable coils in our hospital were included in this study.Of these patients,20 (60.6％),7 (21.2％),3 (9.1％),2 (6.1 ％),and 1 (3.0％) were respectively diagnosed with splenic artery aneurysm,renal aneurysm,superior mesenteric aneurysm,celiac aneurysm,and pancreaticoduodenal aneurysm.The mean diameter of aneurysms was 16-38 (24.0±3.4)mm.The success rate of detachable fibered coils occlusion system for visceral artery aneurysms,postoperative complications and surgical procedure time were recorded.The patients received CT or ultrasonographic follow up at months 3,6,12 and every year after operation.Results The success rate of detachable fibered coils occlusion system for visceral artery aneurysms was 100％.No intraoperative bleeding and coil migration occurred.One patient with splenic artery dissection did not undergo operation.The patients were followed up for 2-24 (12.5±2.3) months,during which no enlargement or rupture of visceral artery aneurysms and no operation-related severe complication or death occurred.Conclusion Detachable fibered coils occlusion system combined with standard pushable coils is safe and effective for mild and moderate visceral artery aneurysms.