OBJECTIVE: To investigate the features of adverse drug reactions(ADR) occurred in out hospital.METHODS: A total of 311 ADR cases collected in our hospital from Jan 1,2006 to Nov 20,2008 were analyzed statistically in respect of the number of case reports,source of reports,drug categories,routes of administration,distribution of western and Chinese medicines organs and systems involved and the clinical manifestations etc.RESULTS: 78.8% of the total 311 cases were reported by physicians and 18.0% by pharmacists;Of all the drugs involved in ADR,anti-infective drugs accounted for 36.90%,and 64.9% of the western medicines and 64.8% of the Chinese medicines were administered via intravenous drip.Lesions of skin and the appendants represented 30.53% of the total ADR.CONCLULSION: ADR monitoring and medication intervention should be further strengthened in our hospital to promote rational drug use.

Objective To explore the value of urine C polysaccharide antigens for the diagnosis of Streptococcus pneumonia in‐fection .Methods 372 cases of patients with community‐acquired pneumonia were selected ,and their urine C polysaccharide antigens were tested by using BinaxNOW kit .Results The sensitivity and specificity of urine C polysaccharide antigens were 63 .0% and 85 .3% ,respectively .The positive rate of urine C polysaccharide antigens in patients diagnosed with Streptococcus pneumonia infec‐tion was 84 .0% ,and that in patients suspected with Streptococcus pneumonia infection was 57 .4% .Conclusion The test of urine C polysaccharide antigens can be a diagnostic adjunct for Streptococcus pneumonia infection .

Objective To investigate the correlation between apolipoprotein E gene polymorphism and car-dio-cerebrovascular diseases. Methods Gene chip method was used to determine ApoE genotypes in 1427 pa-tients with cardiovascular disease and 450 health controls. Levels of serum lipid were compared. Results The highest genotype frequency of ApoE was ε3/3 in the patient group and control group. The allele frequency of ApoE from high to low wasε3,ε2 andε4. The genotype ofε3/3 in patient group was significantly lower than that in con-trol group(χ2 = 12.562,P < 0.01),whileε3/4 was significantly higher than that in control group(χ2 = 36.112, P < 0.01). No significant differences were found between patient groups in genotype or allele frequency of ApoE. The level of TCH,TG,LDL-c and sdLDL in the patient group were significantly higher than those in the control group,and HDL-c was significantly lower than those in the control group(P>0.05). The level of TCH and LDL-c significantly decreased in patients with E2 genotype,and increased in patients with genotype E4(P < 0.05). No significant differences were found in other indexes(P>0.05). Positive relationship was found between ApoE geno-type and phenotype of ApoE and LDL-c. Conclusions ApoE gene polymorphism plays an important role in the oc-currence and development of cardio-cerebrovascular diseases.

Objective To compare and evaluate the performance and applications of three assays in preliminary screening of dengue infections.Methods This study was designed as a retrospective study.Clinical data were obtained from 2 137 borderline cases from September to October in 2014 and 2015.Markers of dengue infections of serum samples were detected by NS1 antigen captured ELISA, dengue NS1 detect rapid test and dengue IgM detect rapid test, respectively.Chi square test was used to compare the preliminary screening value of these 3 methods.Forty-eight diagnosed patients were also examined in the 1st-3rd day, 4th-5th day, 6th-7th days and 14th day after infection to access the sensitivities and specificities of three assays.Results Nine hundred and fifty-seven ( 57.2%) cases in 2014 and 48 ( 10.4%) cases in 2015 were diagnosed to be Dengue fever of 2 137 borderline cases.The overall sensitivity of NS1-ELISA was superior to NS1 and IgM rapid detect test (χ2 =40.865,P<0.001;χ2 =151.383,P<0.001).No significant differences were found in specificity between three assays(χ2 =0.661,P=0.416;χ2 =0.548,P=0.459; χ2 =2.397,P=0.122).The NS1 detecting assays were sensitive in 7 days after infection, but the sensitivity of IgM detecting assay increased over time.Conclusions NS1 detecting assays had good sensitivities and specificities, which can be used as an important method in preliminary screening of dengue infection.ELISA or rapid test can be selected according to epidemic situation.

Objective To explore the expression difference of cytokines related to nuclear factor kappa B (NF-κB) signaling pathway among different traditional Chinese medicine (TCM) syndromes in the patients with diabetic nephropathy (DN).Methods Serum tumor necrosis factor-α (TNF-α),interleukin-1 (IL-1),interleukin-6 (IL-6) and interleukin-8 (IL-8) in 146 patients with DN and 62 individuals undergoing healthy physical examination in the control group were measured.Results The levels of serum TNF-α,IL-1,IL-6 and IL-8 in various DN groups were significantly higher than those in the control group (P＜0.05).The levels of serum TNF-α,IL-1,IL-6 and IL-8 were significantly different among groups of different TCM syndromes (P＜0.05).With the progression of DN,all cytokines levels showed a gradually increasing trend,moreover the increased extents and time were different in different TCM syndrome types of DN.Conclusion The levels of serum TNF-α,IL-1,IL-6 and IL-8 related to NF-κB signaling pathway are correlated with different TCM syndromes types and may play a role in the occurrence and progression of different TCM syndrome types of DN.

Objective To evaluate the impacts of the two different gastrectomy methods on the quality of life,complication and prognosis in proximal gastric cancer.Methods One hundred and two cases of proxi-mal gastric cancer in Tung Wah Hospital were collected for retrospective analysis.They were divided into proxi-mal gastrectomy/gastroesophagostomy (PG)group (n =50)and total gastrectomy/esophagojejunostomy (TG) group (n =52),according to the methods of gastrectomy and reconstruction.The postoperative complications, nutritional status and prognosis of the two groups were compared.Results The incidence of reflux esophagitis was obviously higher in PG group than that in TG group (38.0% vs 1 9.2%,χ2 =4.464,P =0.035).No sig-nificant differences were found between the two groups in the incidences of postoperative infection,bleeding and anastomotic leakage (χ2 =0.063,P =1 .000;χ2 =0.001 ,P =0.978;χ2 =0.31 1 ,P =0.577).There were no significant differences between PG and TG group in total plasma protein [(65.26 ±4.1 0)g/L vs (65.33 ± 3.75)g/L,t =-0.402,P =0.688],albumin [(39.76 ±2.1 7)g/L vs (39.59 ±2.04)g/L,t =1 .778,P =0.076],hemoglobin [(1 07.33 ±1 1 .1 0)g/L vs (1 08.09 ±1 1 .1 7)g/L,t =-1 .502,P =0.1 33]and weight loss [1 .00 ~8.00 kg vs 0.50 ~8.20 kg,t =-1 .622,P =0.1 05]in one year postoperatively.All cases were followed-up for 7 months to 1 0 years.No significant differences were found between PG and TG group in the incidences of anastomotic tumor recurrence (4.0% vs 5.8%,χ2 =0.1 71 ,P =0.679),metastasis (24.0% vs 28.8%,χ2 =0.308,P =0.579)and median survival time (53.6 months vs 49.8 months,χ2 =2.564,P =0.1 09).Conclusion Compared with PG group,the incidence of postoperative reflux esophagitis is effectively reduced,and the incidences of malnutrition,tumor recurrence and metastasis and death are not increased in TG group.Hence,TG should be a safe and effective surgery strategy.

Objective To detect serum IgG4 and IgE levels in children with allergic asthma and rhinallergosis to provide an im-portant laboratory evidence for its diagnosis ,treatment and prevention.Methods The serum IgG4 and IgE levels were detected in 118 children patients with allergic asthma ,167 children patients with rhinallergosis and 150 healthy children(control group) under-going physical examination in the same period.Results The levels of serum IgG4 and IgE in the allergic asthma group and rhinal-lergosis group were significantly higher than those in the control group ,the difference was statistically significant (P<0.05).In the intra-group comparison of the allergic asthma group and rhinallergosis group ,the positive rate of serum IgG4 was higher than that of serum IgE ,the difference was statistically significant (P<0.05).The positive rate of joint detection of serum IgG4 and IgE in these two groups was higher than that of single index detection ,the difference was statistically significant (P<0.05).The positive rate of serum IgG4 in the allergic asthma group was lower than that in the rhinallergosis group ,the difference was statistically sig-nificant(P<0.05).The positive rate of serum IgE in the allergic asthma group was lower than that in the rhinallergosis group ,but the difference was not statistically significant (P>0.05).Conclusion Serum IgG4 and IgE have a certain clinical significance in the occurrence ,treatment and surveillance of allergic asthma and rhinallergosis in children.

Objective To determine the clinical significance of pulmonary function test(PFT)in evaluating the features and severity of lung impairments associated with connective tissue diseases(CTD)by comparing the differences of pulmonary function test parameters among groups of CTD associated pulmonary disorders.Methods Cases of CTD associated pulmonary disorders were prospectively enrolled and assigned into 3 groups according to their lung impairments:CTD associated pulmonary arterial hypertension group (CTD-PAH,n=29),CTD associated interstitial lung disease group(CTD-ILD,n=35),CTD associated PAH plus ILD group(CTD-PAH+ILD,n=16)and CTD control group(n=34).Pulmonary function test parameters,including total lung capacity(TLC % predicted),forced vital capacity(FVC % predicted),forced expiratory volume in the first second(FEV_(1.0)% predicted),FE_(1.0)%/FVC and diffusing capacity of the lung for carbon monoxide(DLco,% predicted)were measured and compared among the four groups.Results One hundred and forteen eases were included and predominantly female with average onset age of 35～39 years old.CTDs that were predisposed to lung diseases were mixed connective disease(MCTD),systemic sclerosis(SSc),systemic lupus erythematosus(SLE)and primary Sj(o)ren syndrome(pSS),in order.There were 10,29 and 46 percent of patients presented with decreased TLC% in CTD-PAH,CTD-ILD and CTD-PAH+ILD group respectively,50,36 and 71 percent of patients with decreased FVC% respectively,54,47 and 71 percent of patients with decreased FEV_(1.0)% respectively,and 100,82 and 100 percent with decreased DLco% respectively.ANOVA analysis demonstrated that TLC%,FVC%,FEV_(1.0)%,DLco% had significant differences between CTD control group and each of the CTD associated lung disease group(P＜0.05),although none of them was lack of difference between the PAH and ILD groups.TLC% was significantly higher in CTD-PAH group than CTD-PAH+ILD group[(89±15)% vs(79±12)%,P＜0.05],while FVC% was significantly lower in CTDPAH+ILD group either than CTD-PAH group or than CTD-ILD group[(81±13)%,(80±16)% vs(65±22)%,P＜0.05].ConclusionPulmonary function test may be valuable in early screening for CTD associated lung disorders than distinguishing CTD-PAH from ILD,which usually reveal restrictive ventilation dysfunction and/or diffusing capacity dysfunction.

Objective To discuss the application and significance of homocysteine (Hcy),renal function and serum lipid levels in renal transplantation,by testing those from patients after renal transplantation.Methods Hcy,creatinine (Cr),urea nitrogen (BUN),uric acid (UA),total cholesterol (TC),triglyceride (TG),low density lipoprotein cholesterol (LDL-C) and high density lipoprotein cholesterol (HDL-C) were detected in transplantation group(n=63) and control group(n=60).Serum Hcy,Cr and BUN of transplantation group were continuously monitored before and 1,3,7,14 days after operation,and the relationship between Hcy and renal function before and after renal transplantation were compared.Results Compared with control group,Hcy,Cr and BUN in transplantation group all increased and the difference between two groups was statistically significant (P<0.05).Hcy,Cr and BUN in transplantation group all decreased after renal transplantation and the differences between two groups had statistical significance (P<0.05).Compared with that before surgery,Hcy,Cr and BUN in transplantation group gradually reduced 1,3,7 and 14 days after surgery,and the differences were statistically significant (P<0.05).Cr and BUN were positively correlated with Hcy (r=0.627,P<0.05).TC and LDL-C in transplantation group were higher than that in control group and the differences had statistical significance (P<0.05) while the difference of TG and HDL-C didn′t have statistical significance (P>0.05).Conclusion Hcy,Cr and BUN can be used as monitoring indicators of efficacy after renal transplantation,also which can be used to observe the incidence and severity of hyperlipidemia.

Aiming at evidence-based medicine course of graduate students, foreign medical colleges and universities usually took in the teaching philosophy that emphasized stages (focusing on knowledge ac-cumulation) and practicality (focusing on ability training). And they put forward a lot of teaching methods which implemented the conception, such as problem-based learning, journal club, blended learning approach, online learning platform, concept mapping etc. In order to provide a useful reference for the domestic teaching reform and development, this paper introduced the teaching philosophy and related teaching meth-ods mentioned above.