OBJECTIVE:To investigate the form, advantage, limitation, influence factor and effect of spontaneous reporting system of ADR monitoring. METHODS: Based on domestic and foreign literatures and information, the importance of spontaneous reporting system of ADR monitoring was evaluated with the method of literature analysis according to the condition of China. RESULTS&CONCLUSION: Spontaneous reporting system of ADR monitoring is the foundation of drug risk management and is the most rapid, powerful and economic administration method of early warning for drug safety monitoring.

OBJECTIVE:To explore the general rules and characteristics of ADR/ADE induced by Glycerol fructose injection and provide reference for clinical ration drug use. METHODS:284 cases of ADR/ADE induced by Glycerol fructose injection from Jan. 2004 to Oct. 2014 in Drug ADR Monitoring Center of Henan Province were statistically analyzed and comparatively analyzed with the drug instructions in 11 domestic drug manufacturing enterprises. RESULTS:ADR/ADE induced by Glycerol fructose injec-tion was related to gender,mainly adult male,and ADR/ADE might occurred within 30 min;main clinical manifestations were skin and its appendages damages,medication site damage and systemic damage. There were larger differences among the notes de-scription in the package inserts from 11 drug manufact urers. CONCLUSIONS:The clinic should strengthen the monitoring of ADR/ADE induced by Glycerol fructose injection,try to avoid or reduce the incidence of ADR,improve the drug instructions and ensure medication safety.

Objective To investigate the relationship between essential hypertension and serum C-reactive protein and plasma lipids.Methods Detecting fasting serum CRP and plasma lipid in each group of hypertensive patients to investigate the relationship between hypertension and fasting serum CRP and plasma lipids.Results CRP,TC,TG,HDL-C and LDL-C level of A,B and C group had significant differences with that of D group(t =4.03, 4.23, 4.61, 3.12, 3.41, 2.76,2.98,2.56,2.64,2.57,3.05,3.68,2.54,3.16,4.28,all P＜0.05).CRP,TC,TG,HDL-C and LDL-C levels between A,B and C group had significant differences(F = 4.68,4.05,3.29,3.59,4.11,all P＜0.05).There was significant correlation between serum CRP level and TC,TG,HDL-C,LDL-C level in 186 hypertension patients(r =0.274,0.356,0.327,0.302,all P＜0.05).Conclusion CRP,TC,TG and LDL-C levels showed significant linear correlation in patients with hypertension.

BACKGROUND: Bone marrow mesenchymal stem cells (BMSCs) as a genetic carrier are beneficial to keep a genetic stability of exogenous gene. BMSCs can transfer human vascular endothelial growth factor (hVEGF) gene into the myocardial infarcted area. It is possible to obtain a cooperation of gene and cell therapy. OBJECTIVE: To investigate the angiogenesis at myocardial infarcted area of rats undergoing the transplantation of BMSCs transfected with hVEGF gene and in vivo expression of VEGF gene. DESIGN, TIME AND SETTING: A randomized control experiment was performed at the Institute of Paediatrics of Hunan Children's Hospital and Central Laboratory of Xiangya Second Hospital of Central South University from 2004 to 2007. MATERIALS: Male clean inbred strain Wistar rats were selected in the study. Rat models of myocardial infarction were established by ligation of coronary artery. METHODS: BMSCs were harvested from rats by density gradient centrifugation and adherent culture. Plasmid PeDNA3. 1-hVEGF 165 were transfected at 80%-90% cell confluence. Rat models of myocardial infarction, constructed by ligation of the left anterior descending coronary artery, were randomly divided into 4 groups. 2 weeks after the ligation,BMSCs transfected with hVEGF gene were injected into rat models in the combination group at the myocardial infarction zone. BMSCs were injected into cell group. Liposome-pcDNA3.1-VEGF165 DNA compound was injected into gene group. Culture medium was injected into control group. MAIN OUTCOME MEASURES: Capillary density and VEGF gene expression in the myocardial infarcted area of rats in each group four weeks after injection. RESULTS: Capillary density was the highest at rat myocardial infarcted area in the combination and gene groups, followed by the cell group (P=0.001, 0.029) and the control group (P=0.028).Reverse transcriptase-polymerase chain reaction (RT-PCR) showed that the hVEGF165 gene was expressed in the combination, gene, cell and control groups from higher level to lower level in order. CONCLUSION: BMSCs as the vector of VEGF gene are beneficial to its stable expression.Transplantation of BMSCs transfected with hVEGF gene is helpful for angiogenesis at myocardial infarcted area of rats. Its outcome is better than gene or cell therapy alone.

OBJECTIVE:To investigate the regularity and characteristics of ADR induced by Mailuoning injection,and to provide reference for rational use of drugs.METHODS:In retrospective study,ADR/ADE cases of Mailuoning injection reported in Henan province from 2004 to 2009 were analyzed statistically.RESULTS:Main clinical manifestations were lesion of skin and its appendents(24.95%),respiratory system injury(23.81%) and nervous system injury(15.38%).The clinical manifestations of serious ADR/ADE were allergic shock,dyspnea and choking etc.CONCLUSION:Clinical rational use of drugs should be improved to avoid serious ADR and guarantee the safety of drug use.

Abstract: Objective To analyze the correlation between the thromboelastography (TEG) indexes and the indexes related to liver injury in patients with heat stroke, and explore the diagnostic value of TEG indexes for liver injury in patients with heat stroke. Methods A total of 95 patients with exertional heat stroke (EHS) admitted to 924 Hospital of the Joint Service Support Force of the People's Liberation Army of China from August 2020 to July 22 were selected, and divided into a non-liver injury group (55 cases) and a liver injury group (40 cases) according to whether there was liver injury. TEG instrument was used for the detection of thromboelastography to record the TEG parameters, including reaction time (R), agglutination time (K), α angle, maximum amplitude (MA value), and coagulation complex index (CI). The levels of glutamic transaminase (AST), alanine aminotransferase (ALT), total bilirubin (TBil), albumin (ALB) were detected by automatic biochemical analyzer. Pearson's method was applied to analyze the correlation between thromboelastography indexes R, K, α angle, CI and liver function indexes AST, ALT, TBil, ALB in patients with heat stroke after liver injury. Receiver operating characteristic curve (ROC) was applied to analyze the predictive value of thromboelastography indexes R, K, α angle, CI and combined detection for liver injury in patients with heat stroke. Results Compared with the non-liver injury group, the AST, ALT and TBil levels in patients with heat stroke in the liver injury group were higher (t=26.174, 16.923, 18.414, P<0.05), while the ALB level was lower (t=24.596, P<0.05); compared with the non-liver injury group, the R and K of patients with heat stroke in the liver injury group were higher (t=58.014, 52.862, P<0.05), and the α angle and CI were lower (t=46.853, 60.717, P<0.05); R was positively correlated with AST and ALT (r=0.532, 0.610, P<0.001), and negatively correlated with ALB (r=-0.551, P<0.001) in patients with heat stroke complicated with liver injury; K was positively correlated with AST, ALT and TBil (r=0.661, 0.531, 0.504, P<0.001); α angle was negatively correlated with AST and ALT (r=-0.473, -0.448, P<0.01), and positively correlated with ALB (r=0.539, P<0.001); CI was negatively correlated with AST, ALT and TBil (r=-0.458, -0.505, -0.549, P<0.001); the area under the curve (AUC) of thromboelastography indexes R, K, α angle and CI in predicting liver injury in patients with heat stroke was 0.807 (sensitivity of 70.0%, specificity of 81.6%), 0.831 (sensitivity of 77.5%, specificity of 85.5%), 0.747 (sensitivity of 67.5%, specificity of 74.5%), and 0.788 (sensitivity of 77.5%, specificity of 83.6%), respectively. The AUC of combined detection to predict liver injury in patients with heat stroke was 0.967 (sensitivity of 92.5%, specificity of 91.9%). Conclusions The thromboelastography indexes are correlated with the indexes related to liver injury in patients with heat stroke, and the thromboelastography indexes are helpful to diagnose liver injury in patients with heat stroke.

Objective To characterize the CT features of primary mediastinal seninoma. Methods CT scans of 10 cases with pathologically proved primary mediastinal seminoma were retrospectively reviewed.Results 9 of the 10 cases with the maximal dimension of 6. 5 ～ 18.2 cm( mean = 12. 3 cm) were located in the anterior mediastinum and 1 tumor was located in the middle mediastinum. All of the 10 tumors were solid masses and none of cavity, loculus, fat, calcification or fluid was detected. Areas of low density in the center of tumors were seen in 9 cases. Tumors encircling macrovascular or pericardium were seen in 7 cases. Chest wall invasion was detected in 2 cases. Enlarged lymph nodes in supraclavicular or mediastinum were identified in 4 cases. Lung diseases were found in 5 cases. Bilateral pulmonary metastasis was seen in 1 case. Pleural effusions were detected in 4 cases. Pericardial effusions were evident in 5 cases. Conclusion Most of the primary mediastinal seminomas are solid and large mass without calcification or fat. The tumors are usually located in the anterior mediastinum and areas of low density are usually seen in the center of tumors. Some tumors involve in adjacent structures. Seminoma has some features on CT.

Objective To assess the clinical value of multi-slice helical CT perfusion on the post-operative follow-up of glioma.Methods CT perfusion image was applied to 32 patients with glioma after operation.Various perfusion parameters,include cerebral blood volume(CBV),permeability surface(PS),relative cerebral blood volume(rCBV)and relative permeability surface(rPS)were measured on recurrent area,nonrecurrent area and normal cerebral area respectively.SPSS 12.0 statistical software was used.Independent t test was used to compare the differences.Results In the recurrent group(16 cases),the value of CBV in creased in 12 cases and was normal in the other 4 cases.The value of PS increased in all the cases of recurrent group.The value of rCBV exceeded 2.6 in 10 cases,among which the biggest value of rCBV was 4.01.The mean value of rCBV was 2.67 and the mean value of rPS was 6.32;In the non-recurrent group(16 cases),the value of CBV was nearly normal in 7 cases,increased in 2 cases and decreased in the remaining 7 cases.The value of PS was nearly normal in 11 case,decreased in 3 cases and increased in the remaining 2 cases.The values of rCBV were all less than 2.6 and the biggest value of rCBV was 2.14.The mean value of rCBV was 0.99 and the mean value of rPS was 1.42.The statistic significance was obtained for all the parameters when compared the recurrent group with the non-recurrent group(P＜0.01)and with the normal cerebral area(P＜0.01).When compared the non-recurrent group with the normal cerebral area,none of the parameters had statistic significance(P＞0.05);The statistic significance was obtained for rCBV and rPS when compared the recurrent group with the non-recurrent group(P＜0.01).Conclusion CT perfusion image is valuable in determining glioma recurrence after operation.

Objective To observe the effect of postoperative analgesia for cesarean section with a new approach to transversus abdominis plane block.Methods 40 ASA physical status Ⅰ to Ⅱ patients undergoing cesarean section firstly were rucruited.All the patients were randomly divided into the two groups,20 cases in each group.A standard subarachnoid block was used.Group A:TAP block was performed at the end of surgery by piercing the transversus abdominis muscle from inside the abdominal wall at the midaxillary line at the level of the umbilicus with a 22-gauge blunt needle.The patients were assigned to receive 20mL of 0.298％ ropivacaine on each side of the abdominal wall.Group B:the patients were also assigned to receive normal saline.Sufentanil was used for postoperative analgesia by PICA.Each patient was assessed at 2,4,8,24 hours postoperatively using a visual analog scale,the dosage of analgesic drug and the adverse reactions.Results Compared with group B,group A had significantly lower pain scores at 2,4 hours using a visual analog scale (P ＜ 0.05) and there were no significant differernces in 8,24 hours(P ＞ 0.05).The cumulative sufentanil requirement of group A was also significantly lower at all time points (P ＜ 0.01).The incidence of sedation of the two groups were also significant differernces,eg.nausea and vomiting (15％/25％),itchy skin(5％/20％),dizziness(0/10％) (P ＜ 0.05).Conclusion This new approach to transversus abdominis plane block provides effective postoperative analgesia after cesarean section.

Objective To analyze the correlation of vertebral osteophyte and lumbar disc degeneration in the elderly people and explore the possible mechanism of osteophyte formation. Methods X-ray and MRI data of 120 elderly people with backache or leg pain were retrospectively analyzed. Osteophyte was classified into four grades by X-ray according to the method proposed by Nathan. Discs with osteophyte were defined as occurring when osteophyte of grade II or greater were present. Lumbar disc degeneration was classified into five grades by MRI according to the method proposed by Pfirrmann. The obtained parameters were statistically treated and analyzed. Results Osteophyte and age were positively correlated at every lumbar disc level (P < 0.05). The proportion of osteophyte in L3/4 (76.7%) and L4/5 (70.08%) were more severe than that in L1/2 (31.7%) and L2/3 (46.7%). Osteophyte and lumbar disc degeneration were positively correlated at every lumbar disc level (P < 0.01). Conclusion Osteophyte becomes more severe with the increasing of lumbar disc degeneration. The vertebral stress after lumbar disc degeneration may be the main cause of osteophyte.