OBJECTIVE:To carry out drug risk management so as to ensurethe safety of clinical drug use in the hospital. METHODS:The mode of drug risk management of our hospital was established,in the form of drug risk identification,risk evalu-ation,risk control and risk review,and the measures for risk management were developed and taken. The effect of drug risk man-agement was evaluated after 3 years (2012-2014) of colletion and analysis of the questionnaires given to clinical medical workers and patients and the results of evaluation by the group of pharmacy management and quality control for drug use in the hospital. RE-SULTS:Following the establishment and improvement of drug management information system,the strengthening of the manage-ment of special drugs,strict implementation of the Management System for the Return and Recall of Drugs,the establishment of specialized drug safety monitoring body,the development and implementation of the measures such as self-inspection in the hospi-tal,the problems about drug safety in our hospital had been decreasing from 2012 to 2014(88,42 and 19 cases respectively);and 96.59%,97.62% and 100% of drug safety problems were solved by the pharmacy staff to the satisfaction of the group of pharma-cy management and quality control for drug use in the hospital respectively in the three years. CONCLUSIONS:The mode of drug risk management established in our hospital has promoted the safety of drug use.

OBJECTIVE:To observe therapeutic efficacy and safety of dexrazoxane combined with Shenmai injection in the treatment of anthracycline-induced cardiotoxicity in patients with breast cancer. METHODS:120 female breast cancer patients were randomly divided into group A,B,C and D with 30 cases in each group. Group A was given CAF chemotherapy plan(cyclophos-phamide 75 mg/m2+fluorouracil 500 mg/m2 + doxorubicin 60 mg/m2),ivgtt;group B was additionally given Shenmai injection 50 ml,qd,ivgtt,on the basis of CAF plan;group C was additionally given rapid intravenous of dexrazoxane 60 mg/m2 30 min before chemotherapy,on the basis of CAF;group D was additionally given constant dose of dexrazoxane combine with Shenmai injection on the basis of CAF plan. A treatment course lasted for 3 weeks,they were given 4 courses in total. The change of ECG,LVEF, cTnT and BNP and the incidence of bone marrow suppression were observed before and after chemotherapy. RESULTS:After treat-ment,the rate of abnormal ECG,LVEF value,cTnT value and BNP value of groups B,C and D were all decreased significant-ly,with statistical significance(P<0.05). Compared with group D,above index of groups B and C were decreased significantly, with statistical significance(P<0.05). The incidence of bone marrow suppression was in ascending order,group D

AIM:To study the effect of proprotein convertases (PCs) on the transforming growth factor (TGF) ?1-induced inhibition of HBV replication.METHODS:HepG2.2.15 cells cultured regularly were exposed to recombinant TGF?1 at concentration of 2 ?g/L or 5 ?g/L and/or PC inhibitor at concentration of 20 ?mol/L for 18 h.The total RNA and HBV core particle DNA were extracted from these cells,and PC mRNA and core-associated HBV DNA were detected by real-time PCR technique.RESULTS:The mRNA expression levels of 7 PCs in HepG2.2.15 cells were observed with various degrees.Recombinant TGF?1 significantly up-regulated the mRNA expression of all PCs except for the down-regulation of PC5 /6,though PC1 /3 and PC2 were up-regulated most obviously.Furin and PACE4 were the predominant PCs before and after TGF?1 exposure when the basic mRNA expression was taken into account.Further study showed that TGF?1-induced the inhibition of HBV replication was abrogated by PC inhibitor in HepG2.2.15 cells.CONCLUSION:TGF?1-induced the inhibition of HBV replication is mediated by the up-regulation of PCs,which might be of many implications in efficient interferences of TGF?1 on HBV replication.

Objective To develop a simple method of determination of sorafenib in serum by reversed-phase high performance liquid chromatography (RP-HPLC) and to explore its application in sorafenib therapeutic drug monitoring (TDM).Methods Sorafenib extracted by ethyl ether-petroleum (9∶1) with internal standard of erlotinib from serum was wiped off in 60 ℃ water bath.Sorafenib was redissolved by mobile buffer and analyzed by 40 μl.Chromatographic column was Symmetry Rp18 (5 μm,4.6 mm×250 mm,waters) column in normal temperature.The mobile buffer was 28 mmol/L acetate buffer (pH 5.8)-acetonitrile (37∶63).Sorafenib and erlotinib were detected in 249 nm and 335 nm,respectively.Results The concentration range of sorafenib was 0.50-20.00 μg/ml (r =0.9999).The within-day and between-day accuracies of sorafenib were less than 4.77 ％ and 8.79 ％,respectively.The average recovery rate was 98.48 ％.Sorafenib was stable in serum or after extraction.The concentrations of sorafenib in two patients were detected.Conclusion Detection of sorafenib in serum by RP-HPLC is simple and accurate,which is available to determine sorafenib in serum.The TDM of sorafenib has clinical significance.

Objective To explore the causes and management of postoperative complications of laparoscopic Roux-en-Y gastric bypass (LRYGB).Methods The retrospective cross-sectional study was conducted.The clinical data of 450 patients with metabolic diseases who underwent LRYGB between June 2004 and November 2016 were collected,including 283 (58 in hospital consultation) in the First Affiliated Hospital of Jinan University,140 in the Jihua Hospital Affiliated to Jinan University and 27 in the Zhengzhou Hospital of Jinan University.Observation indicators:situations of surgical completion,follow-up situations,occurrence,treatment and prognosis of complications.Follow-up using outpatient examination and telephone interview was performed to detect postoperative complications once at month 1,3,6 and 12 within 1 year postoperatively and once every year after 1 year postoperatively up to March 2017.Measurement data with skewed distribution were described as M (range).Count data were evaluated by the ratio,and comparison between groups was analyzed using the chi-square test.Results All the 450 patients with metabolic diseases underwent successful LRYGB,including 50 receiving LRYGB during surgical internship period and 400 receiving LRYGB after surgical internship period,without conversion to open surgery.All the 450 patients were followed up for 70 months (range,1-153 months).Twenty-seven patients had postoperative complications,with an incidence of 6.00％ (27/450).The incidence of postoperative complications was 20.00％(10/50) in 50 patients receiving LRYGB during surgical internship period and 4.25％ (17/400) in 400 patients receiving LRYGB after surgical internship period,with a statistically significant difference (x2 =16.86,P＜ 0.05).Of 27 patients with postoperative complications,1 was complicated with fulminant acute pancreatitis and died from multiple organ failure at day 15 postoperatively,5 with intra-abdominal bleeding,2 with anastomotic leakage,3 with gastrojejunal anastomosis stenosis,2 with gastrojejunal anastomosis ulcer,1 with improper anastomosis,1 with respiratory failure,1 with umbilicus infection,3 with internal hernia,2 with dumping syndrome,6 with weight-loss failure (1 refused to undergo revision surgery),and patients with postoperative complications were improved or cured by surgery or conservative treatment except one death.Conclusions The incidence of complications in patients receiving LRYGB after surgical internship period is significantly reduced,and complications needs to make the individualized treatment plan.

By studying the behaviors of surfing in the Internet of the readers in our electronic reading room,we find a majority of readers are for amusement,only a minority of readers are to study and search data.Aiming at these problems,we put forward a series of measures and management countermeasures that guide readers to make good use of the electronic reading room and give some suggestions for our future work.

Objective To study the effect of pinealctomy and melatonin on the cell cycle distribution during T cell development in thymus. Methods SD rats were divided into 5 groups:normal controls,sham-operated controls,pinealectomy,pinealectomy+melatonin injection 7.5 mg/kg; and pinealectomy+melatonin injection 15 mg/kg.The animals were sacrificed at 4 or 8 weeks after operation.cycilnA +and cyclinE +T cells in thymus were dyed with immunocytochemical ABC methods, measured by computer image analysis.Cell cycle analysis was performed by flow cytometry.The expression of cyclin-dependent kinase inhibitor 1? was tested by RT-PCR method. Results The effect of pinealectomy on the expression of cyclinE was stronger than that of cycilnA. Pinealectomy promotes the synthesis of cyclinE in thymus.The percentage of G-0/G-1 phase cells was decreased and G-2/M phase cells was increased.These would be convalescente by supplement with melatonin,but the reaction to melatonin was differencet in thymus cortex and in medulla.Melatonin enhanced the expression of cyclin-dependent kinase inhibitor 1? in thymus.Conclusion Pinealectomy influences notably the T cells development in thymus.Rejuvenation of degenerative thymus could be observed by melatonin administration.

Objective:To explore the clinical efficacy of a retrograde pubic ramus intramedullary nail (RPRIN) in the treatment of anterior pelvic ring fractures.Methods:A retrospective study was conducted to analyze the 14 patients with anterior pelvic ring fracture who had been treated and followed up at Department of Traumatic Surgery, Tongji Hospital From June 2020 to February 2021. There were 10 males and 4 females with an age of (44.8±12.5) years. By the AO/OTA classification for pelvic fractures, 5 cases were type 61-A, 4 cases 61-B, and 5 cases type 61-C; by the Nakatani classification, 1 case belonged to unilateral zone Ⅰ fracture, 5 cases to unilateral zone Ⅱ fracture, 2 cases to unilateral zone Ⅲ fracture, 3 cases to right zone Ⅱ and left zone Ⅲ fracture, 2 cases to zone Ⅲ fracture on both left and right sides, and 1 case to zone Ⅱ fracture on both sides. The time from injury to operation was (7.8±1.8) days. All the anterior pelvic ring fractures were fixated with a RPRIN. The time and fluoroscopic frequency for placement of every single RPRIN, quality of fracture reduction, and pelvic function and incidence of postoperative complications at the last follow-up were recorded.Results:A total of 18 RPRINs were placed in the 14 patients. For placement of each RPRIN, the time was (35.9±8.6) min, and the fluoroscopic frequency (22.8±1.9) times. No complications such as infection occurred at any surgical incision after RPRIN placement. According to the Matta scoring, the quality of postoperative fracture reduction was assessed as excellent in 7 cases, as good in 5 cases and as fair in 2 cases. The 14 patients were followed up for (18.1+1.5) months. Their X-ray and CT images of the pelvis at the last follow-up showed that the fractures healed well and the intramedullary nails were placed in the cortical bone of the anterior ring of the pelvis. According to the Majeed scoring at the last follow-up, the pelvic function was assessed as excellent in 10 cases, as good in 3 cases and as fair in 1 case. One patient reported discomfort during squatting 2 months after operation but the symptom improved 3 months later without any special treatment. No patient experienced such complications as displacement or slippage of RPRIN, or pain at the insertion site.Conclusion:RPRIN is effective in the treatment of anterior pelvic ring fractures, showing advantages of small surgical incision, limited intraoperative fluoroscopy and short operation time.

OBJECTIVETo investigate the different outcomes by dexamethasone in adults immune thrombocytopenia purpura (ITP) with different types of platelet specific-autoantibodies.

METHODSA total of 185 ITP were enrolled, 61 males and 124 females, with a median age of 42 (18-83) years, including 117 newly diagnosed, 35 persistent, and 33 chronic cases. All the patients received the dexamethasone at an initial dose of 40 mg per day for 4 days and a low dose of 5-10 mg for 3-4 weeks. The platelet specific-autoantibodies were identified by the modified monoclonal antibody-specific immobilization of platelet antigen (MAIPA) assay.

RESULTSAmong the IgG positive patients, the response rates in anti-GPIIb/IIIa antibody, anti-GPIbα antibody, both antibody positive, and both antibody negative were 87.5%, 50.0%, 68.0%, and 72.3% (χ²=11.489, P<0.05), respectively. Among the IgM positive patients, the response rates in the four groups were 82.1%, 71.4%, 61.9%, and 68.9% (χ²=2.719, P=0.437), respectively. Among the GPIbα antibody positive patients, the response rates in IgG alone, IgM alone, both positive, and both negative were 52.4%, 59.1%, 76.1%, and 77.9% (χ²=10.811, P<0.05), respectively. Among the GPIIb/IIIa antibody positive patients, the response rates in the four groups were 73.3%, 71.0%, 78.6%, and 66.3% (χ²=1.374, P=0.719), respectively.

CONCLUSIONITP patients with GPIbα-IgG antibody have worse response to dexamethasone treatment.

Adolescent ; Adult ; Aged ; Aged, 80 and over ; Antibodies, Monoclonal ; Autoantibodies ; Blood Platelets ; Dexamethasone ; Female ; Humans ; Male ; Middle Aged ; Platelet Glycoprotein GPIIb-IIIa Complex ; Purpura, Thrombocytopenic, Idiopathic ; Young Adult