OBJECTIVE:To investigate the incidence,clinical features and influential factor of adverse drug events appeared in Zhuhai area.METHODS:246 cases with adverse drug events reported in our hospital from Jan.to Sep.in 2007 were analyzed statistically.RESULTS:Of the total drugs inducing adverse drug events(246 cases),anti-infectives took the lead(43.24%),which was related to its great variety,high application frequency and application range;78.05% were induced by intravenous infusion;41.12% were manifested as lesion of skin and its appendants;119(48.37%)failed to follow the direction of package inserts,of which,113 cases involved the use of anti-infectives.CONCLUSION:Medical workers should attach great importance to the acquisition of medication knowledge as well as the medication safety at each steps.

OBJECTIVE: To explore the characteristics and general pattern of adverse drug events(ADE) in Zhuhai area.METHODS: 311 ADE cases collected from Aug.2005 to Dec.2006 by Zhuhai workstation of Guangdong ARD Monitoring Center were statistically analyzed in respect of patients' age and sex,route of administration,category of drugs involved,ADR-involving organs/systems and clinical manifestations etc.RESULTS: The antiinfective drugs showed highest incidence rate of ADE,which caused ADE in 213 cases(68.49%).The most common clinical manifestations of the ADE were the damage of skin and adnexa,accounting for 51.45%(160 cases),all recovered after receiving corrsponding treatment.CONCLUSION: Allergic history of patients and their family members should be inquired in detail before the use of drugs and high alert should be given to pharmaceutical incompatibility,and the patients should be given fully attention after medication to reduce the incidence of ADE.

BACKGROUND: Abnormal changes of bone mineral density (BMD) easily occur in patients with non-insulin-dependent diabetes mellitus (NIDDM),however the mechanisms are still unclear.OBJECTIVE: To investigate the pathophysiological features of changes of BMD and metabolism in patients with NIDDM from the angle of traditional Chinese medicine (TCM) syndrome types.DESIGN: A case controlled and comparative observation.SETTING: Department of Endocrinology of Guangzhou General Hospital of Guangzhou Military Area Command of Chinese PLA PARTICIPANTS: Totally 103 cases (55 males and 48 females) of patients with NIDDM admitted in Department of Endocrine of Guangzhou General Hospital of Guangzhou Military Area Command of PLA from April 2003 to April 2004 were enrolled. They were, according to TCM syndrome types, divided into 3 groups: yin deficiency with heat excess (32 cases),deficiency of both qi and yin (36 cases), and deficiency of both yin and yang (35 cases) groups. The healthy persons of 30 staff, 16 males and 14 females, in the hospital were concurrently recruited as control group. Informed consent was obtained from all the subjects.METHODS: ①A dual-energy X-ray absorption meter was used to determine the bone mineral densities of orthophoric 1-4 lumber vertebrae, total hipbone and head of femur in left hip in each group. ② Radioimmunoassay was taken to measure the content of serum osteocacin (OC). ③Colorimetry was used to measure the level of serum tartrate resistant acid phosphatase (TRACP). ④ q-test and x2-test were respectively used for comparison of measurement and enumeration data.MAIN OUTCOME MEASURES: ①The BMD of the 1-4 lumber vertebrae, total hipbone and head of femur in left hip in each group. ②The morbidities of osteoporosis of subjects in each group. ③ The levels of OC and TRACP in each group.RESULTS:All 103 NIDDM patients and 30 healthy subjects entered the final result analysis. ① The BMD of the 1-4 lumber vertebrae, total hipbone and head of femur in left hip of subjects: The BMD in yin deftciency with heat excess, deficiency of both qi and yin and control groups were obviously higher than that in deficiency of both yin and yang group (P ＜ 0.05-0.01 ) ② The morbidity of osteoporosis: The morbidities of osteoporosis in yin deficiency with heat excess, deficiency of both qi and yin and control groups were obviously lower than that in deficiency of both yin and yang group[34%(ll/32),42% (15/36), 33% (10/30), 71% (25/35),P ＜ 0.01]. ③ The level of OC: The levels in yin deficiency with heat excess and deficiency of both qi and yin groups were obviously higher than that in deficiency of both yin and yang group (P ＜ 0.01 ), but lower than that in deficiency of both yin and yang group (P ＜ 0.05). ④ The level of TRACP: There was no significant difference among groups(P ＞ 0.05).CONCLUSION: ① The volume and formation of bone in NIDDM patients of deficiency of both yin and yang syndrome type were obviously lower than those in healthy persons and NIDDM patients of yin deficiency with heat excess and deficiency of both qi and yin syndrome types, and the osteoporosis morbidity in them was obviously higher than those in healthy persons and the other two syndrome-type patients. ② The quantity and formation of bone in NIDDM patients of deficiency of both yin and yang syndrome type were near to those in healthy persons.

ObjectiveTo investigate the relationship between KAI1/CD82 protein expression in human hepatocellular carcinoma (HCC) and invasion and metastasis.MethodsSpecimens from primary hepatocellular carcinoma (155 cases), tumorous emboli (22 cases), intrahepatic satellite metastases (4 cases), extrahepatic metastases (16 cases), and normal livers (5 cases) for which a tissue microarray was constructed and used for immunohistochemical detection of KAI1/CD82 protein expression. ResultsImmunohistochemical analysis of tissue microarrays demonstrated KAI1/CD82 protein expression in 61%(95/155)of the primary HCCs and only in 32%(7/22) of the tumorous emboli ( P

Objective To investigate the expression of Sonic hedgehog(SHH)and WNT/β-cate-nin in human pancreatic cancer and explore its clinical significance.Methods Reverse transcription-polymerase chain reaction (RT-PCR) and Western blot assay were used to determine the mRNA and protein expression of SHH and β-catenin in human pancreatic cancer tissue and normal tissues adjacent to cancer.Results The SHH mRNA and protein expression was detected in 81.6% and 79.6% of pancreatic cancer, respectively.The β-catenin protein expression was 71.4% in pancreatic cancer tis-sues.These were significantly different from those of normal tissue adjacent to cancer (P＜0.05).But the expression level of β-catenin mRNA was low in both pancreatic cancer tissues and normal tissues.There was no significant difference between them (P＞0.05).The expression of SHH and β-catenin protein in pancreatic cancer had no correlation with age, tumor size, pathological type and tumor site (P＞0.05), but had a relationship with lymph node metastasis and TNM stage (P＜0.05).The cor-relation between SHH and β-catenin protein was positive (r=0.352, P＜0.05).Conclusion The SHH and WNT/β-catenin signaling pathways were active in human pancreatic cancer.The crosstalk between these pathways may play an important role in the carcinogenesis and development of pancreat-ic carcinoma.

The therapeutic approaches for non-small cell lung cancer (NSCLC)patients with solitary bone metastases include surgery,radiotherapy,chemotherapy and so on.Recently,molecular targeted therapy such as the Denosumab has become a new option.Though there are so many options,the outcomes of the NSCLC with bone metastases are not so good.But for those with solitary bone metastases,radical treatment is necessary to improve the survival time and prognosis.

Objective To investigate the effect of costimulatory molecules 4-1BB/4-1BBL on T cell activation with systemic lupus erythematosus(SLE)patients.Methods The expression of NF-kB mRNA and p38 MAPK mRNA of T cells with 20 SLE patients and 20 normal controls before activation,after activation and blocked bv 4-1BB/4-1BBL were detected bv RT-PCR.The protein levels of p-p38 MAPK and NF-kB were detected by Western blot.Results The expression of NF-kB mRNA and p38 MAPK mRNA and the protein expression of NF-kB and p-p38 MAPK of T cell with SLE patients were higher than that of normal controls(P＜0.01).There were more expression of NF-kB mRNA,p38 MAPK mRNA,NF-kB protein and p-p38 MAPK protein of T cell with SLE patients stimulated by anti-CD3 monoantibody(P＜0.01).In anti-4-1BB monoantibody blockage group,there were decreased expression of p38 MAPK mRNA and p-p38 MAPK protein(P＜0.01).but not the decreased NF-kB mRNA and protein expression.Conclusion Costimulatory molecule 4-1BB plays a critical role in T cell activation of SLE by p38 MAPK signal pathway.

Objective To observe the changes of respiratory musc]e strength by traditional Chinese medicine combined with cholinesterase inhibitors in myasthenia gravis (MG) patients.Methods Thirty-four cholinesterase inhibitor-resistant patients,of them 14 were MG patients with stage Ⅰ ,and 20 were stage Ⅱ ,were treated with bromide dimethylcarbamate ( 360-480 mg/d ).Traditional Chinese potion were administered in those without effectiveness,and the dosages of bromide dimethylcarbamate decreased with Traditional Chinese potion lasting for 4-6 months.Vital capacity ( VC ),maximal voluntary ventilation ( MVV ),maximal inspiratory pressure ( PIM ),maximal expiratory pressure ( PEM ),respiratory centre driving pressure ( P0.1 ),residual volume ( RV )were measured before and after treatment.Results The amelioration of VC,MVV,PIM,PEM,P0.1 ,RV,respiratory muscle strength and other indicators of 34 MG patients were not obviously after treatment with cholinesterase inhibitor alone ( P ＞ 0.05 ).After treatment with traditional Chinese medicine combined with cholinesterase inhibitors,VC,MVV,PIM,PEM ( before treatment:76.66% ± 18.59%,68.03 % ± 10.45 %,43.25 % ± 18.16%,21.75 % ±14.44% ) increased significantly in all 34 MG patients( after treatment:86.91% ± 14.87% ,75.11% ± 11.17%,52.66% ±20.32% ,28.56% ± 10.06% ) ( P ＜ 0.05).RV decreased from 164.94% ± 67.97% to 143.16% ±79.21% (P ＜0.01 ),and respiratory muscle strength,endurance and other indicators significantly improved (P ＜0.01).PIM(65.80% ±28.03% to 52.66% ±20.32%),and PEM (37.03% ±20.57% to 28.56% ±10.06%)improved more significantly in group stage than in group stage (P ＜0.01 ).Respiratory muscle endurance in stage Ⅰpatients ( 108.71% ± 17.56% ) improved significantly than stage Ⅱ patients (96.01% ± 14.12% ,P ＜ 0.01 ).Conclusions Traditional Chinese medicine combined with cholinesterase inhibitors could effectively improve the lung function and respiratory muscle strength in patients with resistance of the cholinesterase inhibitors.The improvement of lung function,respiratory muscle strength were more obviously in stage Ⅰ patients than in stage Ⅱ patients.Respiratory muscle strength and endurance were improved greater in stage Ⅱ than in stage Ⅰ patients.

BACKGROUND: Caspase family is viewed as the executive factor of cell apoptosis. Neuronal apoptosis happens probably after spinal cord injury.OBJECTIVE: To observe the changes in caspase-3 expression after spinal cord injury in rats so as to probe into the relationship between it and neuronal apoptosis and provide the evidence on the prop e r time window of intervention on alleviating secondary spinal cord injury.DESIGN: Self-control and mutual-control were designed in animal experiment.SETTING: Department of Traumatic Surgery and Department of Orthopedics of Tongji Hospital Affiliated to Tongji Medical College of Huazhong University of Science and Technology.MATERIALS: The experiment was performed in Experiment Room of Tongji Hospital affiliated to Tongji Medical College of Huazhong University of Science and Technology from January to December 2001, in which, 54SD rats were employed, of either sex, mass weighted varied from 220 to 250 g and provided from Animal Experimental Center of Tongji Medical College of Huazhong University of Science and Technology.rats were divided into the control and injury group. Laminectomy was only done on Ts and T9 in the control and the injury group was subdivided into 9 subgroups, in which, the materials were collected on the 4th and 8th hours and on the 1st, 2rd, 3rd, 7th 14th and 21st days successively, 6 rats in each one. After abdominal anesthesia with 30 g/L pentobarbitol sodium,sternal cord on T8 andT9 segments were exposed with Nystrom method and 50 g weight compressed the front middle region of the spinal cord of such segments with arch smooth metal pad 2.2 mn×5.0 mm for 5 minutes. After injury, artificial bladder urination was done 3 times at 10:00, 16:00and 22:00 successively everyday till the bladder reflex was established.cord was collected at various time spots after spinal cord injury. 4 pieces of spinal cord tissue masses from each group, about 8mm in length, were embedded with paraffin and sectioned continuously. Afterwards, HE staining, immunohistocheistry and TUNEL (TdT-mediated dUTP-biotin nick end labeling) were performed successively. Two rats were sacrificed on ice in each group and central tissue of injured spinal cord was placed in expression was assayed with immunohistochemistry method, neuronal apoptosis was assayed with TUNEL method and linear correlation was used to analyze the correlativity between caspase-3 expression and neuronal apoptosis.pase-3 expression after spinal cord injury in rats of each group.RESULTS: Six rats were maintained in each group and included in result optic microscope: Extensive hemorrhage appeared in 1 hour in injured segment. In 4 to 8 hours, spinal structure began destructive and a large amount of neuronal death appeared. In 24 hours, the destruction of spinal cord became severe and in 7 to 21days, the range of injury was defined with immunohistochemistry in rats of each group: Very few caspase-3 expressions (2.1±0.5) presented in neurons of spinal cord in normal rat. In 8hoursafter spinal cord injury, caspase-3 expression of positive neurons was increased remarkably (89.2±10.5) and up to the peak (189.6±12.7) in 3 days. Caspase-3 expression of positive cell and apoptotic cell appeared alexpression assayed with transcription-polymerase chain reaction (RT-PCR)in rats of each group: Caspese-3 mRNA (0.442±0.024) began increased in 4h, was up to the peak (0.634±0.028) in 48 hours and was restored to be normal (0.351±0.013) in 7 days, which appeared early than apoptosis, indicating positive correlation with the level of neuronal apoptosis (r=0.622).In the control and 4 hours group, stained cell was seen occasionally and positive cell appeared 8 hours later, mainly localized in gray matter. Afterwards, positive cell was increased and up to the peak in 3 days. In 7 days,positive cell of apoptosis and staining was decreased gradually in gray matter, mainly around the white matter. Little amount positive cells appeared on the 14th day and 21st day.CONCLUSION: In normal spinal cord tissue, caspase-3 existed in form of zymogen with very low activity. Caspase-3 is enhanced in expression after spinal cord injury in rats, expresses in large amount in 8 hours and is up to the peak in 24 to 48 hours, which is overlapped in time with positive apoptotic cell assayed with TUNEL and concerning to the localization, it is in conformity with positive apoptotic cell of spinal cord injury compared with positive cell of caspase-3. It is indicated that caspase-3 is involved in regulation of cell apoptosis after spinal cord injury. It is seen in this experiment that the time from spinal cord injury to the activation of caspase-3 is the time window of treatment for cell apoptosis intervened by spinal cord and alleviating secondary spinal cord injury. It is suggested that genetic intervention or specific caspase-3 inhibitor should be applied in 48 hours.

Objective To investigate the effect of T lymphocyte proliferation,Th1 and Th2 cytokines on T cells from systemic lupus erythematosus (SLE)patients by blocking 4-1BB/4-1BBL.Methods The proliferation of T cells from 30 SLE patients and 20 normal controls was detected by MTT and the levels of patients stimulated with anti-CD3 McAb were significantly higher than those of T cells without stimulation(P＜IFN-γand IL-4 in SLE were significantly higher than those of normal controls(P＜0.01).There were more ex-pression of IFN-γ and IL-4 in supernatant of T cells from SLE after stimulated with anti-CD3 McAb(P＜0.01).However,the production of IFN-γ and IL-4 was inhibited by anti-4-1BB McAb(P＜O.05),and especially the level of IL-4 was markedly decreased.Conclusion Blocking 4-1BB/4-IBBL can significantlv inhibit the abnormal activation of T cells and the secretion of Thl and Th2 cytokines of SLE.