OBJECTIVE:To find out the regulareity of adverse reactions(ADRs)induced by oral Penicillins(QMSK)and evaluate the safety of QMSK in clinical use.METHODS:Data of ADRs of QMSK,which collected from published articles were retrieved from CHINESE PHARMACEUTICAL ABSTRACT issued between January1995and April2003.According to the given standard,the data were statistically analysed.RESULTS:There were334cases which had24kinds of ADRs of QMSK,of which,121cases were male while213cases were female.There were drug eruption in249cases(74.55%),allergic shock34(10.18%),exfoliative dermatitis9(2.7%)and toxic epidermalnecrolysis7(2.1%),miscellaneous reactions31(8.97%)and5(1.5%)deaths.CONCLUSION:QMSK caused ADRs apparently.QMSK should be used according to penicillins for injections and safe of patients should be ensured in use of QMSK.

OBJECTIVE:To explore the effects of Xinnaoxin pills on CAT score,cardiopulmonary function and hemorheology of patients with pulmonary heart disease complicating with coronary heart disease. METHODS:In retrospective study,80 cases of pulmonary heart disease complicating with coronary heart disease were randomly divided into control group and observation group with 40 cases in each group. Control group was given routine treatment as relieving asthma,eliminating phlegm and oxygen inhala-tion,anti-infective treatment,correcting acid-base balance,cardiotonic and diuretic treatment. Observation group was additionally given Xinnaoxin pills 1.0 g/time,bid after meal,on the basis of control group. CAT score,cardiopulmonary function and hemorhe-ology index were compared between 2 groups before and after treatment as well as ischemic ECG improvement effect and the occur-rence of ADR after treatment. RESULTS:After treatment,hematocrit hematocrit had changed slightly among hemorheology index-es,and CAT score,other hemorheology indexes and cardiopulmonary function indexes were improved significantly;the improve-ment of observation group was better than that of control group,with statistical significance(P<0.05). Total effective rate of isch-emic ECG was 90.0% in control group and 92.5% in observation group,there was no statistical significance(P>0.05). There was no statistical significance in the incidence of ADR between 2 groups (P>0.05). CONCLUSIONS:Xinnaoxin pills can effectively improve CAT score and cardiopulmonary function of patients with pulmonary heart disease complicating with coronary heart dis-ease. It also can improve hemorheology and shows good clinical efficacy,but great importance should be attached to the safety of drug use in the clinic.

OBJECTIVE:To understand the proportion of university faculty suffering from hypertension,and the regularity,ratio-nality and affordability of antihypertensive drugs under closed medical environment. METHODS:Empirical research and research methods were adopted to collect indicators during 2011-2014,such as average daily wage in Wuhan,the total number of staff in Wuhan University,the number of staff with hypertension,antihypertensive drugs amount/DDDs ranking ratio,affordability ratio,relative av-erage affordability, etc. The rationality and affordability of antihypertensive drug prices were evaluated. RESULTS:During 2011-2014,the prevalence rate of hypertension in the staff were about 23%,and the proportion increased year by year;the annual in-crease of antihypertensive drug amount was larger than that of the number of patients;the type of antihypertensive drugs with affordabil-ity ratio>1 in 4 years was ARB varieties,and affordability ratio of other drugs was less than 1. CONCLUSIONS:More than half of drugs is high in price,that result in heavy burden of patients receiving ARB;on the whole,antihypertensive drugs are affordable of the teaching staff of Wuhan University.

Objective To investigate the effect of remimazolam on intraoperative neurophysiological monitoring(IONM)in spinal surgery.Methods Sixty patients undergoing elective spinal surgery for IONM were selected strictly according to the criteria,33 males and 27 females,aged 18-55 years,BMI 18-24 kg/m2,ASA physical status Ⅰ-Ⅲ.The patients were randomly divided into two groups:remimazolam group(group R)and propofol group(group P),30 patients in each group.Remimazolam was used in group R and propofol was used in group P during induction and maintenance of anesthesia.HR,MAP,and BIS values were recorded when patients entered the room(T0),immediately after endotracheal intubation(T1),at the time of muscle relaxant withdrawal(T2),30 minutes after muscle relaxant withdrawal(T3),and 50 minutes after muscle relaxant withdrawal(T4).The current intensity and amplitude of the first motor evoked potential(MEP)were recorded.The waiting time from drug withdrawal to the first induced MEP was recorded.The amplitude and latency of somatosensory evoked potential(SEP)and MEP at T4 were recorded.Operation time,anesthesia time,intraoperative remifentanil dosage,the use of vasoactive drugs,recovery time,extubation time,and adverse reactions were recorded.Results Compared with group P,HR and MAP were significantly increased at T1-T4(P＜0.05),the amplitude of MEP induced for the first time were significantly increased(P＜0.05),the amplitudes of SEP and MEP at T4 were significantly in-creased and the latency period was significantly shortened(P＜0.05),the dosage of remifentanil was sig-nificantly decreased(P＜0.05),the number of bradycardia or hypotension were significantly decreased(P＜0.05),and the recovery time and extubation time were significantly shortened in group R(P＜0.05).Conclusion Remimazolam can be safely used in spinal surgery requiring IONM,with small circu-lation fluctuation,quick recovery,less postoperative adverse reactions,little effect on SEP and MEP,which is conducive to improving the quality of IONM.

Objective To compare the acute toxicities between two prospective, non-randomize phase Ⅱ trials on adjuvant radiochemotherapy of capecitabine with or without oxaliplatin in patients with stage Ⅱ and Ⅲ rectal cancer. Methods From March 2005 to November 2007,based on two fulfilled phase Ⅰ studies,two phase Ⅱ trials were launched respectively to further observe the tolerance and toxicity. In one tria1,118 patients were treated with concurrent capecitabine and radiotherapy (Cap-CRT trial), with radio-therapy of DT50 Gy/25 F/5 wks to the pelvis, and capecitabine at a dose of 1600 mg/m2/d(d1-d14,3 weeks per cycle). In the other trial, 90 patients received concurrent oxaliplatin, capecitabine and radiothera-py(Cap-Oxa-CRT trial), with the same radiotherapy schedule, while oxaliplatin at a dose of 70 mg/m2(d1, d8) and capecitabine of 1300 mg/m2/d(d1-d14,3 weeks per cycle). Results There was no significant difference in the delay of radiotherapy (10.2% vs 6.7%, X2=0.80, P=0.460) or chemotherapy (9.3% vs 19.1%, X2=4.80,P=0.090) between Cap-CRT and Cap-Oxa-CRT trials. Grade 1-4 leukopenia,diar-rhea and nausea were the most common acute side-effects in the both trials, accounting for 70.2%, 65.9% and 42.3%, respectively. When comparing with Cap-CRT trial, Cap-Oxa-CRT trial had significantly more grade 1-4 non-hemotological toxicities, mainly in Gl,including nausea (68.9% vs 22.0%, X2=46.90, P= 0.000), diarrbea(76.7% vs 57.6%, X2=13.50, P=0.009), fatigne(47.8% vs 13.7%, X2=18.90,P= 0.000), hand-foot syndrome (14.4% vs 4.2%, X2=7.10, P=0.029), and inappetence (50.0% vs. 27.9%, X2 = 25.70, P=0.000), but not in hematological toxities of leukopenia, anemia or thrombocytope-nia. Of all the patients,grade 3 and grade 4 toxicities were diarrhea(24.0% and 1.0%),leukopenia(4.3% and 0.0%),radiation-induced dermatitis(3.8% and 0.0%),cramping abdominal pain(1.0% and 0.0%) and fatigue(0.5% and 0.0%). Only grade 3 and 4 diarrhea was significantly more in Cap-Oxa-CRT trial than in Cap-CBT trial(33.0% vs 18.6%, X2=5.90,P=0.023). Conclusions For patients with stage Ⅱ and Ⅲ rectal cancer,both the postoperative concurrent radiochemotherapy regimens are tolerable,though Cap-Oxa-CRT trial has more grade 3 and 4 diarrhea.

Objective To evaluate the toxicities and long-term survival of a pilot study of radical surgery followed by concurrent capecitabine and radiotherapy for stage Ⅱ/Ⅲ rectal cancer patients.Methods From March 1,2005 to December 31,2007,131 pathologically proved stage Ⅱ and Ⅲ rectal cancer patients received radical surgery followed by chemoradiotherapy and adjuvant chemotherapy.Capecitabine was delivered daily in twice,for 2 weeks followed by a 2nd cycle after a rest of 7 days during radiotherapy,with the dosage of 1600 mg/m2/d.Three-dimensional conformal radiotherapy was encouraged to the dose of 50 Gy in 25 fractions,and Oxaliplatin/5-fluorouracil or leucovorin based adjuvant chemotherapy was recommended.Results Grade 3 +4 toxicities during concurrent chemoradiotherapy were observed in 28.2％ of patients.The follow-up rate was 93.9％.The 3-year overall survival (OS),locoregional-free survival and distant metastasis-free survival rates were 85.1％,96.7％ and 79.5％,respectively.Among the 31 patients with relapse,5 had loco-regional recurrence and 28 had distant metastasis.Univariate analysis indicated that patients with low and moderate-low differentiated adenocarcinoma,no adjuvant chemotherapy,stage ⅢC disease or positive lymph node ratio (LNR) more than 30％ had lower OS ( x2 =15.49,15.85,8.80 and 9.76,P ＝ 0.000,0.000,0.011 and 0.002 ).Patients with N2 disease had more loco-regional recurrence.Patients with stage ⅢC,without adjuvant chemotherapy,or LNR more than 30％ were at higher risk of distant metastasis ( x2 =6.51,11.57 and 9.70,P =0.034,0.001 and 0.002 ).However,patients who didn ' t receive adjuvant chemotherapy were likely to have low differentiated adenocarcinoma and T4 stage disease ( x2 =7.20,6.48,P =0.027,0.039).Conclusions After radical surgery and concurrent eapecitabine and radiotherapy for stage Ⅱ/Ⅲ rectal cancer patients,loco-regional recurrence rate is pretty low.Distant metastasis is the main treatment failure.

Objective To investigate the expression of fibroblast growth factor 4 (FGF4) in serum of active rheumatoid arthritis (RA) and its role in RA synoviocyte proliferation. Methods The serum level of FGF4 were detected by protein arrays in 20 patients with RA, and 20 age and gender matched healthy controls. FLSs were isolated from RA synovium,and were co-cultured with recombinant human FGF4 (rhFGF4). Cell proliferation was quantified by Cell Counting Kit-8 assay and cell cycle distribution was evaluated by flow-cytometry. The protein levels of cyclin D1, phospho-Akt (p-Akt) and phospho-p38 (p-p38) were measured by western blot. Results The serum expression of FGF4 in RA group was higher than that in control group (P=0.041). After being treated with different concentrations of rhFGF4 (12.5, 25, 50, and 100 ng/ml), RA-FLS showed significant increase in cell proliferation, with different rates of [(121 ±8)％], [(126 ±12)％], [(129 ± 12)％], a nd [(134 ±14)％] respectively, comparing with that of the controls [(100 ±0)％, (P12.5=0.049, P25=0.009, P50=0.004, P100=0.001).]. Among them, the percentage of G2/M+S phase cells were [(12.6±3.6)％], [(15.3±4.5)％], [(17.1±5.1)％], [(19.6±4.1)％] respectively, and except the lowest rhFGF4 concentration treatment group of 12.5 ng/ml, G2/M+S phase cells in other groups was significantly increased compared with the controls [(5.4±2.4)％] (P12.5=0.159, P25=0.042, P50=0.018, P100=0.005). And the protein expression of cyclin D1 was up-regulated after being treated with 50 ng/ml and 100 ng/ml rhFGF4 (P50=0.035, P100=0.027). FGF4 transiently increased the expression of p-Akt and p-p38 protein at the concentration of 50 ng/ml. Comparisons of data between groups were performed by independent sample Student's t-test. Statistical significant differences among groups were tested by one-way analysis of variance (ANOVA) or the Kruskal-Wallis test. The Dunnett's t-test was used for multiple comparisons. A P-value of <0.05 was considered statistically significant. Conclusion Our results suggest that FGF4 is highly expressed in the serum of active RA patients. FGF4 may promote the proliferation of RA-FLS via modulating PI3K/Akt and p38-MAPK signaling pathways, which subsequently contributs to synovial hyperplasia.

OBJECTIVE: To compare the effect of 7 antipsychotic drugs on the life quality of schizophrenia patients including chlorpromazine, sulpiride, clozapine, risperidone, olanzapine, quetiapine, and aripiprazole. METHODS: A total of 1,227 stable schizophrenic patients within 5 years onset who took 1 of the 7 study medications as maintenance treatment were followed up for 1 year at 10 China sites. Patients were evaluated by the short form-36 health survey (SF-36) at the baseline and at the end of 1 year. RESULTS: The life quality was improved obviously at the end of the follow-up. There was significant difference in body pain, vitality, and mental health (P<0.05) among these antipsychotic drugs. CONCLUSION All 7 antipsychotic drugs can improve the life quality of schizophrenia patients. Atypical antipsychotic drugs, especially olazapine and quetiapine, are superior to typical antipsychotic drugs in improving life quality.
Adolescent ; Adult ; Antipsychotic Agents ; therapeutic use ; Benzodiazepines ; therapeutic use ; Dibenzothiazepines ; therapeutic use ; Female ; Follow-Up Studies ; Humans ; Male ; Middle Aged ; Olanzapine ; Quality of Life ; Quetiapine Fumarate ; Schizophrenia ; drug therapy ; Surveys and Questionnaires ; Young Adult

Objective:To investigate the current situation of the use of transjugular intrahepatic portosystemic shunt (TIPS) for portal hypertension, which should aid the development of TIPS in China.Methods:The China Portal Hypertension Alliance (CHESS) initiated this study that comprehensively investigated the basic situation of TIPS for portal hypertension in China through network research. The survey included the following: the number of surgical cases, main indications, the development of Early-TIPS, TIPS for portal vein cavernous transformation, collateral circulation embolization, intraoperative portal pressure gradient measurement, commonly used stent types, conventional anticoagulation and time, postoperative follow-up, obstacles, and the application of domestic instruments.Results:According to the survey, a total of 13 527 TIPS operations were carried out in 545 hospitals participating in the survey in 2021, and 94.1% of the hospital had the habit of routine follow-up after TIPS. Most hospitals believed that the main indications of TIPS were the control of acute bleeding (42.6%) and the prevention of rebleeding (40.7%). 48.1% of the teams carried out early or priority TIPS, 53.0% of the teams carried out TIPS for the cavernous transformation of the portal vein, and 81.0% chose routine embolization of collateral circulation during operation. Most of them used coils and biological glue as embolic materials, and 78.5% of the team routinely performed intraoperative portal pressure gradient measurements. In selecting TIPS stents, 57.1% of the hospitals woulel choose Viator-specific stents, 57.2% woulel choose conventional anticoagulation after TIPS, and the duration of anticoagulation was between 3-6 months (55.4%). The limitation of TIPS surgery was mainly due to cost (72.3%) and insufficient understanding of doctors in related departments (77.4%). Most teams accepted the domestic instruments used in TIPS (92.7%).Conclusions:This survey shows that TIPS treatment is an essential part of treating portal hypertension in China. The total number of TIPS cases is far from that of patients with portal hypertension. In the future, it is still necessary to popularize TIPS technology and further standardize surgical indications, routine operations, and instrument application.