AIM: To analyze factors affecting on adverse drug reactions (ADRs) in 122 cases, in order to avoid and reduce occurrence of ADRs. METHODS: The cases of ADRs by the pharmacist and the clinical reports were collected, and then counted up and analyzed. RESULTS: In 122 cases of ADRs, there were 11 severe cases, the others are ordinary. The most common clinical displays of ADRs were the lesion of skin and the append ants ( 50.82 %), followed by the lesion of digestive system ( 20.49 %) and nervous system responses ( 18.03 %). Anti-infective drugs showed the highest proportion of ADRs, accounting for 61.48% of the total. The affected patients ranged in age over 50 years ( 34.42 %) and low age ( 21.32 %). The most of ADRs were induced by IV drop ( 91.96 %). CONLUSION: For the child and the old man crowd clinical doctors must be prudent with the medicine, avoiding the unreasonable combination of the medications, use the anti-infective drugs reasonably and strengthen monitoring of its use, in order to reduce occurrence of ADRs.

Objective To investigate the clinical manifestations, histopathological patterns, and methods of diagnosis and treatment of primary malignant duodenal tumors. Methods The data of 82 patients with primary malignant duodenal tumors confirmed by pathology and admitted to our hospital over a 10-year period were analyzed retrospectively. Results Tumor location:Tumors were located in the peripapilla region in 64 cases, at the descending portion of the duodenum in 11 cases, at other regions of the duodenum in 7 cases. The common presenting symptoms and signs were abdominal pain in 57 cases, jaundice 53 cases, and gastrointestinal bleeding in 41 cases. In these patients, radical resection of tumor was performed in 36 cases, palliative resection of tumor in 31cases,and operative intervention was not done in 15 cases.The 5-year survival rate of followed-up patients in this group was 2.4%. Conclusions The common presenting symptoms and signs of patients with primary malignant duodenal tumors were abdominal pain, jaundice and GI bleeding, but these patients usually lack specific symptoms and signs. The chief pathologic type is adenocarcinoma and the predisposed site of occurrence is the duodenal papillary region and the descending duodenum . CT, B ultrasonography and gastroduodenoscopy are the chief measures for the diagnosis of primary duodenal malignant tumors, and surgical resection is the main modality of treatment of this disease. The prognosis of primary duodenal malignant tumors is very poor.

Objective To study the induction of nitrous oxide(N2 O)and to compare safety and effec-tiveness of conscious sedation by nitrous oxide inhalation and intravenous sedation with propofol for upper gas-trointestinal(UGI)endoscopy.Methods A total of 400 patients undergoing UGI endoscopy in our hospital from April 2013 to October 2013 were randomly assigned to two groups,N2 O inhalation group(n=200)and in-travenous propofol group(n=200).The systolic pressures,diastolic pressures,heart rates and oxygen satura-tion,onset time,procedure duration,degree of sedation,recovery time,length of hospital stay,complica-tions,satisfaction ratings of doctors and patients,and the number of patients willing to accept the examination again were analyzed.Results The mean time of ideal anesthesia state for N2 O was (3. 16 ±0. 65 )min and there was no difference between the male and female(3. 16 ±0. 71)min vs.(3. 16 ±0. 58)min,t=0. 006,P>0. 05).The mean concentration was (43. 68 ±5. 05 )%,which was higher in male than that in female [(45. 3 ±4. 99)% vs.(41. 46 ±4. 30)%,t=3. 042,P<0. 05].Compared with before,the systolic pres-
sures,diastolic pressures,heart rates and oxygen saturation of patients in the propofol group significantly re-duced during the procedure(P<0. 05),while the same measurements excluding oxygen saturation for those in the N2 O group significantly increased(P<0. 05 ).Compared with the propofol group,patients inhaling N2 O had significantly shorter recovery and hospital stay time,but a longer onset time and procedure duration(P<0. 05 ).Complications that occurred in some patients of propofol group included hyoxemia,hypotension,brady-cardia,while the major complication in the N2 O group was nausea.The satisfaction ratings of doctors or pa-tients and the number of patients willing to accept the examination again in N2 O group were smaller than those in propofol group(86 ±3. 7 vs.96 ±2. 6,87 ±2. 8 vs.98 ±1. 2,87%vs.99%,P<0. 05).Conclusion Both conscious sedation by N2 O inhalation and intravenous sedation with propofol are effective for diagnostic UGI en-doscopy,but the safety of the former is superior to the latter.The key to complete the conscious sedation by ni-trous oxide inhalation is to accurately identify the ideal anesthesia state of N2 O.It is significant to pay attention to the nine factors concerning safe and effective sedation during operation.

Objective:To prepare for mAb of progesterone receptor. It would provide support for the immunohistochemistry behind. Methods:Target gene connected together with a carrier by seamless cloning method. The target protein that expression by inducing was collected. And with cell fusion method , the monoclonal antibodies were preparation. Then the mAb were detected by IHC. Results: The mAb ( clone 7C7 ) was detected and it found positive for the breast, uterine fibroid tissue, showed negative in colorectal cancer tissue, smooth muscle tissue, the goal of the claim were achieve. Conclusion: Finally, we found the method that prepare for mAb was far beyond our imagination. The result of IHC on different samples about mAb(7C7)obtained compliance with an-ticipation. Study on the difference between the PR-A and PR-B had significance.

Objective:New Zealand rabbits were immunized with VLPs-MEpS,VLPs-E2S,and the levels of neutralizing antibodies in serum were determined.Methods: New Zealand rabbits were immunized with 10 μg VLPs-MEpS and VLPs-E2S,serum was collected at diffferent time with a two-weeks interval.The neutralizing antibodies were determined by ELISA.HCV(type 1b) had been prepared and mixed with serum from immunized rabbit before infected Huh7.5 cell.The protection of neutralizing antibodies in serum was assessed.Results: Neutralizing antibodies had been induced in rabbit after immunized with VLPs-MEpS and VLPs-E2S.VLPs-MEpS group had higher titer of antibodies than that of VLPs-E2S group(P<0.05),both group had higher titer of antibodies than that of control groups significantly(P<0.01).VLPs-MEpS group had higher neutralization than that of VLPs-E2S group(P<0.05),the highest neutralization rate was 61.49%.Both groups were higher than control group notably(P<0.01).Conclusion: Protective neutralizing antibodies have been induced in New Zealand rabbit after immunized with VLPs-MEpS and VLPs-E2S.It′s the basement for development of neutralizing antibodies vaccine.

Objective:To construct the recombinant prokaryotic plasmid to express HCV HLA-A2 restricted multi-CTL epitopes and to purify the fused protein for antigenic analysis.Methods:The human ubiquitin gene and multi-CTL epitopes gene was synthesized respectively,and digested by restrict enzyme before being cloned into pRSET-A.Then it was transformed into E.coli DH5α and the positive recombinant plasmid named pRSET-Ub-Mep was sequenced.Target protein was distinctly expressed after transformed into E.coli BL21 and induced with IPTG.Thus the protein was scanned and purified on Ni~(2+)-NTA column as well as Western blot performed after solubility analysis.Results:The recombinant plasmid pRSET-Ub-Mep was successfully constructed and it could efficiently express the target gene.Protein production was mainly in inclusion body and could be purified through Ni~(2+)-NTA column.The purified protein kept the antigen activity.Conclusion:The gene encoding for HCV HLA-A2-restricted multi-CTL epitopes is efficiently expressed and the target protein is purified,which establishes a foundation of further research to evaluate the cellular immune response induced by the target gene.

Purpose:To further improve the therapeutic results of ESWL and to reduce the complications of ESWL. Methods: Clinical materials of 5 140 cases of patients with urinary calculi underwent ESWL from 1989 to 1999 were analyzed retrospectively. Results: Ignorance of the routine examination in urine, blood, hepatic func tion and specialization etc, the serious complications may be produced by ESWL. Low energy and emergency ESWL have obtained satisfactory results. Conclusions:Every routine examination is essential to secure the patient to get satisfactory therapeutic result from ESWL and prevent the complication from occurring. Complete dis charge rate of stones was affected by the tissue structure and type of the renal pelvis and calyces, beside the site of stones.

Objective:To investigate the effects of resistance exercise on mitochondrial function, muscle attenuation and muscle fiber morphology in quadriceps femoris of aged rats.Methods:The 18-month-old male rats were randomly divided into five groups( n=8, each): control(not exercise), 0% weight-bearing, 30% weight-bearing, 50% weight-bearing, and 70% weight-bearing exercise.After maximum resistance running, intermittent race table resistance exercise with 0%, 30%, 50%, 70% maximum load were performed.The treadmill placement slope was 35°, the running speed was 15 m/min, and exercise was performed every other day.At the end of the 8 th week, the mitochondrial membrane potential of quadriceps femoris muscle was measured, cytosol contents of cytochrome C(Cyt c), apoptosis-inducing factor(AIF), and apoptotic protein(Smac/DIABLO)were measured, and the morphology and structure of muscle fibers were observed. Results:Compared with the control group, the mitochondrial ΔΨmt was increased in the 0%, 30%, 50% and 70% maximum load groups, with a significant difference in the increment in the 0%, 30% and 50% maximum load groups( t=7.412, 5.611, 6.213, all P<0.01).Compared with the 0% maximum load group, the percentage of cells with mitochondrial ΔΨmt was statistically significantly decreased in the 30% maximum load group(10.6%)( t=9.356, P<0.05), while the percentage of cells with mitochondrial ΔΨmt was statistically significantly increased in the 70% maximum load group(10.03%)( t=8.341, P<0.05).Compared with the control group, the contents of Cyt c, AIF and Smac/DIABLO in the cytoplasm of quadriceps femoris of aged rats with 8-week resistance exercise were decreased, among which the contents of Cyt c and Smac/DIABLO were statistically significantly decreased in the three groups of 0%, 30%, and 50% maximum load( t=8.324, 7.516, and 6.871, all P<0.05), as well as the decrement in AIF of the three groups of 0%, 30%, and 50% maximum load was statistically significant( t =9.434, 8.78, and 7.342, all P<0.05).Compared with the control group, the vacuolar area of muscle fibers was extremely significantly decreased in the 0%, 30%, and 50% maximum load groups( t =5.567, 6.784, and 7.432, P<0.01); the protein content in the quadriceps femoris muscle was very significantly increased in the 30%, 50%, and 70% maximum load groups( t =7.478, 6.765, and 4.564, all P <0.01).Compared with the 0% maximum load group, the protein content in the quadriceps femoris muscle was very significantly increased in the 30%, 50%, and 70% maximum load groups( t=9.236, 8.342, and 6.456, all P<0.01). Conclusions:Low and medium weight-bearing resistance exercise can improve the mitochondrial function of quadriceps femoris, reduce the femoral quadriceps mitochondria-released proapoptotic proteins Cyt c, AIF, and Smac/DIABLO, and reduce the incidence of quadriceps femoris apoptosis.Low and medium weight-bearing resistance exercise can increase the protein content of muscle fibers, reduce the vacuolar area of muscle fibers, maintain muscle mass, and delay the occurrence of sarcopenia.

Objective To evaluate the effects of nitrous oxide inhalation on conscious sedation of patients during colonoscopy and analyze its risk factors. Methods From October 2016 to July 2017, a total of 154 patients undergoing colonoscopy were included in the study. The comfort level was rated using Modified Gloucester Comfort Scale ( MGCS). Factors affecting comfort level were analyzed by univariate analysis and multivariate Logistic regression, and then a comfort stratification predicting model was created. Results All 154 patients finished colonoscopy. The mean time of ideal anesthesia state was 195. 15 s. Among the 154 cases, 115 ( 74. 7%) were identified as comfort ( grade of MGCS from 1 to 3) and 39 (25. 3%) were rated as discomfort ( grade of MGCS from 4 to 5). Multivariate regression indicated that age ≥60 years ( P＝0. 000, OR＝1. 074, 95%CI: 1. 036-1. 114) and mild anxiety ( P＝0. 018, OR＝3. 338, 95%CI: 1. 227-9. 079) were associated with comfort level during colonoscopy.The established model with the age (X1) and mild anxiety (X2) was P＝eY/(1+eY), Y＝－3. 812+0. 071X1+1. 205X2(no anxiety was assigned 1, mild anxiety was assigned 2), and the area under the receiver operating characteristics curve was 0. 746 (95%CI: 0. 661-0. 830), which showed moderate predictive power of the final model. The model reached the highest predictive accuracy when the Yoden Index was 0. 838 with sensitivity of 50. 4% and specificity of 89. 7% for predicting comfort level of patients in conscious sedation status induced by nitrous oxide inhalation during colonoscopy. Conclusion Nitrous oxide can ease pain during colonoscopy, especially for patients over 60 years old and with anxiety. We can use it as an option according to actual circumstance in practice.

Objective To investigate the effects of high concentration of semen samples in detection by fully automated sperm quality analyzer for sperm concentration,progressive motility(PR),non-progressive motility(NP)and percentage of immotile sperm(IM).Methods The semen samples from the patients who visited the reproductive clinic in our hospital from February 2023 to May 2023 were analyzed using the fully automated sperm quality analyzer.A total of 155 semen samples with initial sperm concentration ≥100× 106/mL and semen volume ≥1.5 mL were set as the high concentration semen group(group A).The semen samples with self seminal plasma dilution group(group B)and 37 ℃ normal saline dilution group(group C)were prepared with their own seminal plasma and normal saline at 1∶2 dilution ratio respectively.The sperm concentration of group A was detected by the manual method as the control.The sperm concentration and motility parameters of each group were detected.The differences of sperm concentration and the values of PR,NP and IM among the group A,B and C were analyzed.The correlations between sperm concentration and PR,NP and IM were also assessed.Results The sperm concentration of group A was significantly lower than that of the control group and groups B and C(all P＜0.05).There was no statistically significant difference for the results between group B and group C(P＞0.05).The PR in group C was significantly lower than that in groups A and B(all P＜0.05),and there was no significant difference of PR between group A and group B(P＞0.05).The values of NP in group A was significantly higher than that in groups B and C(all P＜0.05),and there was no significant difference in NP between group B and group C(P＞0.05).The IM in group A was significantly lower than that in groups B and C(all P＜0.05),and there was no statistical difference of IM values between group B ang group C(P＞0.05).Conclusion The direct analysis of undiluted semen samples with high sperm concentration may lead to lower results of sperm concentration,increased percentage of NP sperm and decreased percentage of IM sperm.The dilution of semen samples may improve the accuracy of the detec-tion results.The dilution with 37 ℃ normal saline can lead to decrease of the percentage of PR sperm.The self seminal plasma should be recommended as the first choice of diluent for the semen samples with high sperm concentration.