BACKGROUND: Attention deficit and hyperkinetic disorder (ADHD) isfrequently treated with psychostimulant medications, which had beenshown to improve both cognitive and behavioral outcomes for most chil dren. OBJECTIVE: To compare the efficacy and adverse effects of olanzapinevs methylphenidate treatment in childhood hyperkinetic syndrome.DESIGN: Clinical comparative study. SETTING: Department of Psychiatry, Beijing Huilongguan Hospital; De partment of Mental Psychiatry, Shangdong Mouping People's Hospital. PARTICIPANT S: Sixty children with hyperkinetic syndrome from theclinics of the Department of Psychiatry,Beijing Huilongguan Hospital andthe Department of Mental Psychiatry of Shandong Mouping People's Hos pital between March 2002 and April 2004 were enrolled into this prospec tive study after obtaining the consents from their guardians.The patientswere randomly divided into 2 group: the olanzapine group (n=30) and themethylphenidate group (n=30). METHODS: In the olanzapine group olanzapine 2.5-7.5 mg per day wasgiven as a single dose in every evening.In the methylphenidate groupmethylphenidate 5-15 mg per day was given in divided dose in everymorning and evening.The dosage ofolanzapine and methylphenidatewere adjusted according to age, body mass and patient's clinical condi tions. And the period of treatment for either drug was 12 weeks. Conners teachers scale was used before and at the end of the 12 weektreatment(①hyperkinetic index consisted of 10 items②hyperkinetic behavior factorconsisted of 7 items. Each item was rated “none=0, a little=1, quite alot=2, and very much=3 ). Side effect scale was used to evaluate the hy perkinetic symptom and adverse reactions which consisted of behavior toxicity, abnormal laboratory tests , symptoms of the nervous system, au tonomic nervous system, cardiovascular system and skin etc with. 0=none; 1 =suspicious or very mild, 2=mild, 3 =moderate, 4=severe. The highestscore was 22,and the lowest was 0 with a score over 2 being positivefinding). MAIN OUTCOME MEASURES:Hyperkinetic syndrom score and ad verse reaction score at the end of the 12 weeks treatment. RESULTS:All 60 children completed the study and their results wereentered into the data analysis① At the end of the 12th week treat ment, the total hyperkinetic index score and total behavior score in boththe olanzapine group and the methylphenidategroup were significantly lower than those before the treatment as shown in Table 1 (t=8.16-15.26, P ＜ 0.05-0.01 )]; The total hyperkinetic behavior score in the olanzap inegroup was significantly lower than that in the methylphenidategroup (t=2.69, P ＜ 0.05 ). ② The adverse reaction score of patients inthe olanzapine group and the methylphenidategroup was 10.3±4.5and 10.9±3.8 respectively ,with no significant difference(P ＞ 0.05)between the two groups. CONCLUSION: Olanzapine produced similar effect as methylphenidatein the treatment of the hyperkinetic symptoms and attention deficits with a better efficacy in treating the behavior disorder than methylphenidate.

Objective To study radiation -induced lung damage after lung ionizing radiation and the temporal and spatial release of pro -inflammatory cytokines of interleukin -6(IL-6),interleukin-8(IL-8) and interleukin-10(IL-10)in the irradiated lung tissue.Methods BALB/C male mice weighted around 25 g were randomly divided into two groups:radiation group ( R) and control group ( C) ,with 30 mice in R group and10 mice in C group.The thorax of mice was irradiated by 6 MV X-ray with 25 Gy in 5 fractions.The mice were sac-rificed at 12 weeks post irradiation.Lung tissues were collected and embedded in paraffin .After HE staining,lung histopathological changes were detected by immunohistochemistry to detect IL -6,IL-8 and IL-10 expression in lung tissue.Results Immunohistochemistry results showed that the expressions of IL -6,IL-8 and IL-10 were mainly expressed in macrophages and inflammatory cells .The results showed that the expressions of IL -6 and IL-8 in R group were significantly higher than that in C group .IL-10 expression level was lower than C group.Conclusion After 12 weeks exposing to radiation ,cytokines of IL-6,IL-8 and IL-10 in lung tissue are associated with radiation -induced lung injury .

Objective To use the DNA-pool technology to sequence patients with essential hypertension(EH) for exploring the single nucleotide polymorphism(SNP) mutation situation in Chinese patients with EH.Methods One hundred EH outpatients in the Shenzhen Sun Yat-sen Cardiovascular Hospital from March to June 2014 were continuously collected.The genomic DNA was performed the fragmentation process to 400-800 bp for conducting the database creation and sequencing.The sequencing results were compared with hg19 in the human gene bank(National Center of Biotechnology Information).Results A total of 120.8 Gb original sequence data were generated.The sequencing depth was 36.13 times,the coverage rate reached 99.88%.A total of 4 305 668 SNP loci were detected by the bioinformatic analysis,in which the C:G→T:A motation types were miximal,reaching 12 314 variation sites.Conclusion This study verifies that the data obtained by using the DNA-pool whole genome resequencing method replenishes the Chinese gene database of EH and provides some help for EH gene reasearch in the future.

OBJECTIVE:To evaluate the feasibility and effectiveness of Hazard analysis and critical control point (HACCP) system in the process of production of Loratadine tablets. METHODS:Taking wet granulation and tableting technology of Lorata-dine tablets as an example,and through the introduction of the concept of HACCP,the basic theory and method of HACCP were applied for hazard analysis on each production link to find critical control points and set critical limits for production quality man-agement. RESULTS:By HACCP analysis,three links namely drying,granules fitting and mixing,internal and external packaging were finally determined as the critical control points in the process of production of Loratadine tablets,thereby critical control lim-its were set for monitoring. After effective control over the risks in the process was ensured,HACCP work plan was made and veri-fied,and the results showed that HACCP system could effectively control and reduce the risks in the process of production and en-sure quality safety. CONCLUSIONS:Application of HACCP system to wet granulation and tableting technology of Loratadine tab-lets can fully embody its feasibility and effectiveness.

OBJECTIVE:To study the classification of deviation in drug production. METHODS:From the perspective of dom-inant and hidden deviation,combining with the theory of risk management,risk of deviation was evaluated with different risk man-agement tools to define the severity of the deviation,and it was handled by different methods. RESULTS & CONCLUSIONS:Ac-cording to the identifiability of deviation in actual management,the deviation was divided into dominance and hidden deviation. The dominant deviation can be divided into deep and shallow level. Whether the causes of deviation could be cleared and the conse-quences could be estimates were judged after the shallow level classification,and the deviation was further divided into simple and complex deviation. As for deviation complex,it could be evaluated with the tools of risk management to define the deviation severi-ty. As for hidden deviation,it needed beforehand preventing with the tools of risk management directly to define deviation levels and provide reference for preventive measures. In the process of deviation management,key point is to relay on the scientific meth-od to identify and classify deviation,and divide the influence levels. Combining the theory of risk management to select and use risk tools is the effective way to solve the problem.

Objective To investigate the clinical value of continuously detecting serum and pelvic drainage fluid C-reactive protein (CRP) and drainage fluid matrix metalloproteinase-9 (MMP-9) in the early diagnosis of anastomotic leakage after anterior resection of low rectal cancer.Methods The levels of CRP and MMP-9 in serum and pelvic drainage fluid were measured on postoperative 1,3,5,7 d in 158 patients with low rectal cancer anterior resection.The patients were divided into the anastomotic group (n=9) and non-anastomotic leakage group (n=149).The differences in the detection values between the two groups were compared and analyzed statistically.Results Among 158 cases,anastomotic leakage occurred in 9 cases.The correlation analysis of serum and drainage fluid CRP detection value and postoperative days (POD) in the two groups showed the POD 3,POD 5 and POD 7 difference was statistically significant (P＜0.05).The ROC curve analysis showed that the accuracy of the serum and drainage fluid CRP continuous detection for diagnosing the anastomotic leakage on postoperative 3 d was middle,which on postoperative 5,7 d was higher.The patients with CRP detection value ＞ 128.23 mg/L and drainage fluid CRP ＞89.93 mg/L on postoperative 5 d and those with CRP detection value＞113.71 mg/L and drainage fluid CRP＞81.75 mg/L on postoperative 7 d developed the anastomotic leakage.The drainage fluid MMP-9 detection value had no statistical difference between the anastomotic leakage group and the non-anastomotic leakage group (P＞0.05).Conclusion Continuous detection of serum and drainage fluid CRP level can be used for early diagnosing postoperative anastomotic leakage in low rectal cancer anterior resection.The drainage fluid MMP-9 continuous detection has no relation with early diagnosis of anastomotic leakage after low rectal cancer anterior resection.

Objective To investigate the related factors of the prognosis of arterial embolectomy of acute cardiogenic cerebral embolism caused by atrial fibrillation.Methods The clinical data of using vein thrombolysis bridging artery embolectomy or arterial embolectomy alone for the treatment of patients with acute cardiogenic cerebral embolism of cerebral large artery occlusion due to atrial fibrillation were analyzed retrospectively.From January 2015 to December 2016,22 consecutive inpatients with cardioembolic cerebral embolism caused by paroxysmal or persistent atrial fibrillation were enrolled,including 10 patients with the 90-day modified Rankin Scale (mRS) score 0-2 (good recovery group) and 12 patients with mRS scores 3-6 (poor recovery group).The clinical features,imaging data,and treatment of the patients in both groups were compared.The factors such as age,gender,preoperative international standardization ratio (INR),embolism position,whether bridging vein thrombolysis before thrombectomy,National Institutes of Health Stroke Scale (NIHSS) score at the onset,time of onset to reperfusion (TOR),whether using tirofiban,times of thrombectomy,modified Thrombolysis In Cerebral Infarction (mTICI) blood flow grade,and postoperative intracranial symptomatic intracerebral hemorrhage were analyzed.Results There were no significant differences in age,gender,preoperative INR,embolism position,the number of intravenous thrombolysis before thrombectomy,the number of using tirofiban in surgery,the proportion of the above mTICI 2b grade,and the proportion of symptomatic cerebral hemorrhage after surgery of the patients between the two groups (P>0.05).The NIHSS score 15.2±2.0 at the onset in the good recovery group was lower than 22.9±8.4 in the poor recovery group.There was significant difference between the two groups (P<0.05).The TOR time (307±86 min) in the good recovery group was less than that of the poor recovery group (426±145 min).There was significant difference between the two groups (P<0.05).Embolectomy was performed 1.5 (0.5,3.0) times in the good recovery group,which was less than the poor recovery group (4.0 [2.0,7.0] times).There was significant difference between the two groups (P<0.05).Conclusions Shortening the time of reperfusion and reducing the number of embolectomy during operation are the important factors for improving the prognosis of patients when atrial fibrillation causes arterial embolectomy in patients with acute cerebral embolism.However,a study of larger sample is needed for further exploration.

Objective To evaluate angiogenesis of the benign and malignant solid thyroid nodules with color Doppler ultrasound and immunohistochemistry staining. Methods Fifty-six solid thyroid nodules in 55 patients (28 papillary thyroid cancer, 23 goiter, 4 adenoma, 1 Hashimoto' s disease) were observed before surgery with color Doppler ultrasound. Pathological specimens of paraffin-embedded were immunohistochemically stained with CD34 and VEGF antibody. Results There were significant differences between the benign and malignant thyroid nodules in vascular morphology and regional rich blood flow. The irregular or less irregular vessels were found in 75 % of the malignant nodules. Regional rich blood flow or suspicious regional rich blood flow were found in 64. 3% of malignant nodules. The regular vessels were found in 89. 3% of the benign nodules, non-regional rich blood flow was found in 71.4% of the benign nodules. The number of CD34 in malignant lesions [(37.31 ± 11.55)/HP] was significantly higher than benign lesions [(29. 02 ± 8.32)/HP, P = 0.04]. There was a significantly difference of VEGF expression between the benign and malignant nodules which was higher in malignant nodules than in benign nodules(P ＜ 0.01). Conclusions Compared with the benign nodules, the vessles in malignant thyroid nodules were irregular,the distribution of vessles was asymmetry and angiogenesis was active.

Objective To investigate the clinical distribution and antimicrobial resistance of common gram-positive cocci in author's hospital.Methods Identification of these bacteria were done with API analysis system,disc diffusion tests were employed to study the antimicrobial resistance.Results A total of 25 052 clinical isolates were collected in 8 years,of gram-positive cocci accounted for 7907(31.9%).Staphylococcus aureus(3549 strains,44.9%),enterococcus(1760 strains,22.3%)and coagulase-negative staphylococcus(1558 strains,19.7%)were the most common isolates.The prevalence of MRSA increased from 59.6% in 2001 to 76.3% in 2008,and MRSCoN increased from 64.2% to 77.0%.The resistant rate of MRSA to gentamicin,clindamycin,erythromycin and levofloxacin were over 90%,to trimethoprim/sulfamethoxazole and chloramphenicol were less than 20%.The resistant rate of MSSA to gentamicin,levofloxacin,trimethoprim/sulfamethoxazole and chloramphenicol were low 20%,and to beta-lactamase antibacterial agents except penicillin were 0.The resistant rates of MRSCoN to all antimicrobial agents were lower than MRSA,but to trimethoprim/sulfamethoxazole(71.2%)was higher than MRSA(21.2%).No staphylococcus strains were resistant to vancomycin,teicoplanin and linezolid.2.1% enterococcus feacium and 4.4% other enterococcus were resistant to vancomycin.No strains of enterococcus were found resistant to teicoplanin and linezolid.Conclusion The resistant rate of gram-positive cocci were increasing obviously,the prevalence of MRS was high.Vancomycin,teicoplanin and linezolid were the most active agents against severe infection induced by multidrug-resistant gram-positive cocci.

Objective:To understand the etiology and clinical characteristics of hospitalized severe community-acquired pneumonia(SCAP) in Changchun, and provide scientific basis for its etiology diagnosis and targeted treatment.Methods:The study subjects included 618 children with clinical diagnosis of SCAP who were hospitalized from January 2016 to December 2019.We collected pharyngeal swabs and alveolar lavage fluid from children.Virus isolation, bacterial culture, time-of-flight mass spectrometry, PCR/RT-PCR, colloidal gold method and Optochin test were used to detect the antigen, nucleic acid and protein profiles in the specimen.Results:There were more boys than girls in hospitalized children with SCAP.The peak age of onset was 7 to 12 months.Most cases occurred in winter and spring.The highest detection rate of SCAP virus was 56.15%(347/618); 73.49%(255/347) were positive for one virus, among which the top five were respiratory syncytial virus (27.8%), influenza A virus (23.9%), influenza B virus (16.1%), rhinovirus (12.2%) and metapneumovirus (10.2%). Two viruses were positive for 19.88%(69/347); three viruses were positive for 4.32%(15/347); four viruses were positive for 2.31%(8/347). Atypical microbial infections were 29.77%(184/618), of which Mycoplasma pneumoniae accounted for 95.65%(176/184). Bacterial infections were 17.31%(107/618), mainly Streptococcus pneumoniae(39.25%, 42/107) and Staphylococcus aureus(24.30%, 26/107). The mixed infection of multiple pathogens was 7.61%(47/618), among which the mixed infection rates of Mycoplasma pneumonia with Streptococcus pneumoniae, virus were 40.43% and 34.04%, respectively.High fever, faster breathing, and perioral cyanosis were risk factors for SCAP, with OR and 95% CI of 7.71 and 4.56-13.04, 2.43 and 2.02-2.93, 3.53 and 2.56-4.86, respectively.Viral co-infection occurred in 36.96%(34/92) of complications such as heart failure, toxic encephalopathy, and myocardial damage; Mycoplasma pneumoniae and other pathogens co-infected 35.29% of children with pleural effusion. Conclusion:The pathogens of SCAP in Changchun are mainly viruses notably, respiratory syncytial virus is the dominant pathogen, followed by Mycoplasma pneumoniae.The bacterial pathogen is mainly Streptococcus pneumoniae.High fever, faster breathing, and cyanosis around the mouth are risk factors for severe pneumonia.Multi-pathogen mixed infection is prone to serious complications.