OBJECTIVE:To analyze the regularity and characteristics of adverse drug reactions (ADR) occurred in our hospital. METHODS:A total of 208 ADR cases (207 cases were valid) reported by clinical departments of our hospital were analyzed statistically in respect of patients' age and sex,routes of administration,causal relationship assessment and extent of ADR,ADR types and clinical manifestations,etc. RESULTS:Of the 207 valid ADR cases,38.65% of them aged between 30 and 49; intravenous route accounted for 87.92% in terms of the incidence rate of ADR; anti-infective drug accounted for 53.62%. The most common clinical manifestations of ADR were the lesions of skin and its appendants,which accounted for 59.91%. CONCLUSION:Anti-infective drugs and intravenously injected drugs should be used rationally to reduce the incidence of ADR.

Objective:To evaluate the risk factors of systemic inflammatory response syndrome (SIRS) in the patients with type 2 diabetes diagnosed with kidney stone after percutaneous nephrolithotomy (PCNL).Methods:In this study,461 patients with type 2 diabetes who received PCNL in Peking Uni-versity People’s Hospital from June 2006 to December 2015 were reviewed.There were 281 males and 180 females with an average age of 57 years were included,of whom,137 were diagnosed with SIRS after PCNL.The demographic data,clinical features,and test results were compared between the patients with SIRS and without SIRS,trying to identify the correlation between their clinical characters and the occur-rence of SIRS.Results:The SIRS was significantly correlated with the patients’preoperative white blood cell counting (×109 /L)[7.76 (4.00 -17.96)vs.6.31 (2.00 -17.40),P <0.001 ],preopera-tional blood glucose level (mmol /L)[7.30 (3.08 -19.90)vs.6.40 (3.42 -16.78),P <0.001], operative time (min)[75 (20 -270)vs.60 (20 -200),P <0.001 ],length of stay (d)[12 (2 -46)vs.11 (3 -29),P =0.019],staghorn stones [38.8% (33 /85)vs.27.7% (104 /376),P =0.042],and preoperational urinary tract infection [36.8% (50 /136)vs.26.6% (81 /304),P =0.032].There was no significant correlation between the SIRS and the patients’age,body mass index, preoperative hemoglobin level,preoperative serum creatinine,and transfusion.In multivariate analysis, abnormal preoperative white blood cell counting (OR =3.194,95% CI:1.531 -6.666,P =0.002), operative time longer than 60 min (OR =1.635,95% CI:1.088 -2.456,P =0.018),and preopera-tional blood glucose level higher than normal 7.1 mmol /L were significantly correlated with the presence of SIRS.Conclusion:The high level of preoperational blood glucose,abnormal preoperative white blood cell counting,and long operative time were significantly correlated with the presence of SIRS in patients with type 2 diabetes after PCNL.

BACKGROUND: Nutritional support has become one of the most important therapeutic measures for malnutrition patients with chronic obstructive pulmonary disease (COPD), but some of the patients may fail to respond to nutritional treatment, which might be attributed to excessive inflammatory reaction that increases energy expenditure. Current nutritional support strategies have primarily focused on immunonutrition and metabolic support.OBJECTIVE: To study the effect of glutamine (Gln) on immunomodulation and metabolic support for patients with COPD.DESIGN: Randomized controlled trial.SETTING: Xinhua Hospital Affiliated to Shanghai Second Medical UniversityPARTICIPANTS: Totally 44 male patients with acute episode of COPD aged (75±9) years admitted between February and July 2002 were recruited in this study and randomly divided into treatment group (n=14) and control group (n=18).INTERVENTIONS: Only nutritional support was given in the control group while the treatment group received also glutamine treatment. All the patients received nutritional support with the total calorie intake of 1.5times of resting energy expenditure and dietary counseling for a regular diet (20% protein, 30% fat, and 50% carbohydrate) provided by a nutritionist. In the treatment group, the protein intake was reduced by 30 g and replaced by 30 g of Gln given at 10 g each time for three times a day via oral therapy. The nutritional indices were measured including body mass,body mass index, triceps skinfold thickness (TSF), creatinine-height index (CHI), prealbumin (PAlb), albumin (ALB), transferrin (TRF), fat mass (FM)]and the immune indices examined including immunoglobulin, complements, T cell subsets, interleukin (IL)-2, tumor necrosis factor-α (TNF-α),and C-reactive protein etc with also measurement of resting energy expenditure.MAIN OUTCOME MEASURES: Changes in nutritional and immune indices of patients before and after treatment.RESULTS: Thirty-two patients all entered the result analysis. [1] TSF: In the treatment group, TSF increased significantly from (6.3±1.8) mm before treatment to (8.7±1.6) mm after treatment (P ＜ 0.05), which was significantly greater than that in the control group after treatment [(7.3±1.3) mm,P ＜ 0.05]. [2]Palb: Palb was significantly increased after treatment in the treatment group from (0.15±0.04) to (0.23±0.05) g/L (P ＜ 0.01), which was significantly higher than that in the control group [(0.22±0.08) g/L, P＜ 0.05)]. [3]T cell subsets: in the treatment group, CD3 in creased significantly from 59±10 before treatment to 72±10 after treatment (P ＜ 0.01), a level significantly higher than that in the control group after treatment (62±9, P ＞ 0.01). [4] TNF-α :TNF-α in the treatment group before treatment was significantly higher than that after treatment [(72±7) vs (56±5) ng/mL,P ＜ 0.05)], and after treatment TNF-α in the treatment group was significantly lower than that in the control group [(67±11) ng/mL, (P ＜ 0.05)]. [5]Immunoglobin: IgG increased slightly after treatment in the treatment group[(12±3) vs (13±3) g/L, P ＜ 0.05)], which was higher than that in the control group [(12±4) g/L], but the difference was not significant (P ＜ 0.05).CONCLUSION: Gln treatment in addition to nutritional support can promote cellular immune function, depress excessive inflammatory reaction and lower energy expenditure in patients with COPD, and such strategy also further enhance the effect of nutritional support.

Objective To analyze clinical characteristics of premenopausal and postmenopausal female patients with kidney stones.Methods The clinical data of 1 194 female adults with kidney stones from December 2004 to December 2014 were analyzed retrospectively.The incidence of kidney stones in different age groups was analyzed firstly.The post-hysterectomy patients or those taking estrogen for breast cancer were excluded, and then 1 166 patients were enrolled.The patients were divided into premenopausal group (464 cases, 39.8％) and postmenopausal group (702 cases, 60.2％), and clinic features of different groups were evaluated.Results The peak age of female patients with kidney stones is between 50 and 59 years old.There were 105 (22.6％) patients in premenopausal group and 204 (29.1％) patients in postmenopausal group complicated with urinary infection.Fifty-eight (12.5％) patients had genitonrinary malformations such as horseshoe kidney, medullary sponge kidney, ectopic kidney, duplex kidney or pyeloplasty for ureteropelvic junction (UPJ) stricture in premenopausal group, as well as 36 (5.1％) in postmenopausal group.Twenty patients (4.3％) had renal insufficiency in premenopausal group, and 66 (9.4％) in postmenopausal group.These differences were statistically significant (P ＜ 0.05).The patients complicated with hydronephrosis (251 vs.346) and ureteral calculi (63 vs.110) of two groups were not significant different (P ＞ 0.05).Multiple factors Logistic analysis indicated that age and urinary infection were statistically significant factors in the occurrence of renal insufficiency (OR =1.037,1.772, P ＜ 0.05).Conclusions The occurrence of genitourinary malformations was higher among premenopausal female patients with kidney stones, while urinary infection and renal insufficiency were more common for postmenopausal patients.Age and urinary infection were the independent factors for the occurrence of renal insufficiency.

Objective: To evaluate the effects of percutaneous nephrolithotomy (PNL) in the treatment of medullary sponge kidney with calculi. Methods: A total of 77 patients (91 renal units) of medullary sponge kidney with calculi (MSK group) and 77 patients (77 renal units) with common kidney stone (control group) received PNL at Department of Urology in Peking University People′s Hospital from September 2006 to February 2016 were analyzed retrospectively. The MSK group included 33 males and 44 females with a mean age of (42.1±13.2) years, the mean stone burden was (3.9±1.8) cm. The control group included 36 males and 41 females with a mean age of (45.3±13.0) years, the mean stone burden was (3.6±1.5) cm. The numbers of tracts, the time of operation, the drop of hemoglobin, the change of creatine, the time of hospitalization, the stone free rate and major complications were compared between the two groups. The measurement data and numeration data were compared with t test and χ² test. Results: There were no significant differences in sex, age, preoperative urinary tract infection, stone type, and stone burden between the two groups (all P>0.05). The proportion of bilateral renal calculus in MSK group was higher (18.2% vs. 0, χ²=15.400, P=0.000). There were 159 percutaneous channels were established in MSK group while 90 percutaneous channels were established in control group. Compared with the control group, the operation time ((88.1±37.5) minutes vs. (68.5±30.1) minutes, t=3.543, P=0.000) and hospitalization time ((15.1±8.3) days vs. (10.1±3.6) days, t=4.816, P=0.000) were longer, the creatinine level increased ((101.2±62.6) μmol/L vs. (71.3±23.6) μmol/L, t=3.777, P=0.000), the rate of stone free decreased (27.5% vs. 83.1%, χ²=51.840, P=0.000) and the rate of complications increased (29.9% vs. 11.7%, χ²=8.114, P=0.004) in MSK group. There was no statistically difference in hemoglobin drop ((12.5±13.2) g/L vs. (13.0±10.9) g/L, t=-0.260, P=0.795). Conclusions Using PNL for patients of MSK with calculi has a lower stone free rate and a higher complications. It is an effective method for patients of MSK with large and complex calculi.

Objective: To investigate the levels of vitamin D and the correlation between DPN and vitamin D in elderly patients with diabetic peripheral neuropathy(DPN). Methods: A total of 849 patients aged 60 years and over admitted into endocrinology department from June 2016 to September 2017 were enrolled in this retrospective case-control study.According to DPN diagnostic criteria, patients were divided into the non-DPN group(n=542)and the DPN group(n=307). The 25(OH)-vitamin D[25(OH)D]level and blood biochemical parameters were determined and compared between the two groups.The risk factors for DPN were analyzed using logistic regression analysis and plotting receiver operating characteristic(ROC)curves. Results: The mean of serum 25(OH)D level in the 849 patients was 43.9±19.4 nmol/L.Serum 25(OH)D level was lower in the DPN patients than in the non-DPN patients[(40.9±20.4)nmol/L vs.(45.7±18.6)nmol/L, P<0.05]. The incidence of 25(OH)D deficiency was higher in the DPN group than in the non-DPN group(72.3% or 222/307 vs. 64.6% or 350/542, P<0.05). Binary logistic regression analysis indicated that 25(OH)D was a protective factor for DPN(OR=0.980, 95% CI: 0.964~0.995, P<0.05)and the disease duration was a risk factor for DPN(OR=1.048, 95% CI: 1.027~1.070, P<0.001). ROC analysis indicated that the diagnostic cut-off value of serum 25(OH)D for predicting DPN was 37.5nmol/L, with a Youden index of 0.17, sensitivity of 0.65 and specificity of 0.52. Conclusions The 25(OH)D level is much lower in diabetic patients, especially in DPN patients.Higher 25(OH)VD level might be a protective factor for DPN, and vitamin D might be one of potential biomarkers for DPN in diabetic patients.

Breastfeeding plays a crucial role in the early and even later health of offspring.Epidermal growth factor(EGF)in breast milk is one of growth factor family members, which can regulate energy balance and is closely related to the growth and development of infants.In recent years, researchers at home and abroad have paid close attention to the research of EGF in breast milk.The paper summarizes the basic situation of EGF, and the content, the influencing factors, the main functions of EGF in breast milk and the risk relationship between EGF in breast milk and diseases, in order to point out the direction for further research of EGF in breast milk.

Objective:To explore the correlations between serum TNF-α, IL-6, hs-CRP levels and body composition in obese children and adolescents.Methods:A total of 105 obese children and adolescents attending the Department of Clinical Nutrition, Xinhua Hospital, Shanghai Jiao Tong University School of Medicine from April 2020 to January 2022 were investigated for serum inflammatory factors(TNF-α, IL-6 and hs-CRP)and body composition(waist-to-hip ratio, waist-to-height ratio, BMI, body fat mass, percent body fat, fat free mass, percent of fat free mass, skeletal muscle mass, percent of skeletal muscle mass and obesity degree). And based on serum inflammatory factors, they were divided into elevated TNF-α group( n=49)and normal TNF-α group( n=56), elevated IL-6 group( n=13)and normal IL-6 group( n=92)and elevated hs-CRP group( n=44)and normal hs-CRP group( n=61), respectively. Results:TNF-α was positively correlated with percent body fat( r=0.224, P=0.022), while negatively correlated with percent of fat free mass( r=-0.226, P=0.021). IL-6 was positively correlated with waist-to-hip ratio, waist-to-height ratio, BMI, body fat mass, percent body fat, and obesity degree( r=0.197, 0.370, 0.303, 0.257, 0.325, 0.348, all P<0.05), while negatively correlated with percent of fat free mass and percent of skeletal muscle mass( r=-0.316, -0.223, all P<0.05). And hs-CRP was positively correlated with BMI, body fat mass, and obesity degree( r=0.261, 0.220, 0.244, all P<0.05), while negatively correlated with percent of fat free mass( r=-0.194, P=0.047). Conclusion:Serum TNF-α, IL-6 and hs-CRP may be correlated with body composition in obese children and adolescents.

This article reports a case of Fournier gangrene after transrectal biopsy of the prostate. A 69-year-old male patient was admitted to our hospital for dysuria. The preoperative diagnosis was bladder stones and suspicious prostate cancer. During the same time, the patient underwent transurethral holmium laser lithotripsy and transrectal prostate biopsy. Fournier gangrene occurred on the second day after the operation. After active treatment such as upgraded antibiotics and debridement of the scrotum and perineum, the condition was controlled. The perineal wound healed 2 months later without secondary suture. Perioperative transurethral examination should be avoided during transrectal prostate biopsy. To avoid delayed diagnosis and treatment, it is necessary to improve the understanding of postoperative complications of Fournier's gangrene.

Objective: To establish primary immune thrombocytopenia (ITP) animal model induced by anti-platelet membrane glycoprotein GPⅠbα antibodies AN51 and R300. Methods: Twenty guinea pigs (6-8 week) were divided into 4 groups. Five guinea pigs in each group were intravenously injected with different doses of AN51 (0.05, 0.1, 0.2 μg/g) and 0.2 μg/g IgG as control. The whole blood was collected from inner angular venous plexus. Platelets number was determined by an automated cell counter and Swiss-Jim method. Then, the similar protocol was used to establish ITP nude mice model by intraperitoneal injection of different concentrations of anti-platelet GPⅠbα antibody R300, respectively. Results: ①Five minutes after intravenous injection of AN51 at 0.05, 0.1 and 0.2 μg/g, the platelet counts of guinea pigs reduced about 0-5%, 50%-60% and 70%-80% compared to the control group, respectively. The difference was statistically significant (P<0.01) . ②Six hours after intraperitoneal injection of R300 at 0.05, 0.1, 0.2 μg/g, the platelet counts of nude mice decreased about 20%-30%, 60%-70% and 80%-90% compared to the control group, respectively. The difference was statistically significant (P<0.01) . The nude mice, injected 0.2 μg/g R300 once a day for 2 weeks, showed typical ITP clinical manifestations including large number of petechiaes or ecchymoses on limbs, head and abdomen. Conclusion AN51 at 0.2 μg/g and R300 at 0.2 μg/g could establish stable ITP model in guinea pigs and nude mice respectively.