Objective To investigate the abnormality of parameters of thyroid function and incidence of autoimmune diseases in children with vitiligo.Methods A total of 363 children with vitiligo,including 198 males and 165 females were recruited into this study together with 93 normal human controls(55 males and 38 females).The serum levels of free tetraiodothyronine,free triiodothyronine,thyroid stimulating hormone,antithyroperoxidase antibody and thyroglobulin antibody were determined by chemiluminescent immunoassay in these subiects.Results The abnormality of parameters of thyroid function was observed in 43 out of 363(11.8%)patients affected by vitiligo and in 4 out of 93(4.3%)normal human controls;a significant difference was observed between the two groups (P＜0.05).Of the 43 patients wim abnormality of parameters of thyroid function,39 were diagnosed as vitiligo vulgaris,4 as segmental vitiligo.A significant increase Was observed in the incidence of abnormality of parameters of thyroid function in patients with vitiligo vulgaris compared with those with segmental vitiligo(P＜0.05).Conclusion There is an increase in tbe abnormality of parameters of thyroid function in children with vitiligo.

Objective To investigate the trend in incidence, causative drugs, clinical types and treatment of drug eruption. Methods Clinical data were collected from 922 inpatients with drug eruption in Huashan Hospital, Fudan University from January 2009 to December 2013, and analyzed retrospectively. Results From 2009 to 2013, the percentage of inpatients with drug eruption among all inpatients in the Department of Dermatology in a given year varied from 9.45% to 10.01%, and the percentage of inpatients with severe drug eruption among inpatients with drug eruption from 17.45% to 28.24%. Of the 922 cases, 371 (40.2%)were caused by single drugs, and 551 (59.8%)by multiple drugs. Among the 371 cases of drug eruption caused by single drugs, the top five causative drugs were traditional Chinese medicine(72 cases), cephalosporins(38 cases), amoxicillin(27 cases), antipyretic analgesics(26 cases)and tetanus antitoxin (24 cases)in 278 cases of non-severe drug eruption, antiepileptic agents (33 cases), allopurinol (28 cases), antipyretic analgesics (7 cases), cephalosporins (6 cases)and traditional Chinese medicine (6 cases)in 93 cases of severe drug eruption. Of the 922 patients, 422 (45.8%)presented with maculopapular eruption, 259 (28.1%)with urticaria, 135(14.6%)with Stevens-Johnson syndrome, 49(5.3%)with toxic epidermal necrolysis, 33(3.6%)with drug reaction with eosinophilia and systemic symptoms (DRESS), and 7 (0.8%)with acute generalized exanthematous pustulosis (AGEP). A total of 791 (85.8%)patients with drug eruption received glucocorticoid treatment. The dose of glucocorticoids was(47.61 ± 12.07)mg prednisone equivalent per day in 550 patients with non-severe drug eruption, and (73.10 ± 18.23)mg prednisone equivalent per day in 221 patients with severe drug eruption. Totally, 110 (11.0%) patients with drug eruption were treated with combined intravenous immunoglobulin (IVIG)because of poor response to glucocorticoids alone. Of 224 patients with severe drug eruption, only 2 (0.9%)died. Conclusions Carbamazepine and allopurinol are the main causative drugs for severe drug eruption, while traditional Chinese medicine is the first causative drug for non-severe drug eruption. From 2009 to 2013, the annual mortality of severe drug eruption decreased considerably.

Objective To investigate the effect of stellate ganglion block combined with morphine sustainedrelease tablets for controlling pain of advanced lung cancer.Methods 90 cases with advanced lung cancer were randomly divided into the observation group and control group with 45 cases in each group.The control group was givenmorphine sustained-release tablets,the observation group received combination therapy with stellate ganglion block and morphine sustained-release tablets.The analgesic effects,quality of life scores and adverse reactions of two groups were compared.Results The effective rate of observation group was 93.33 ％ (42/45),which was significantly higher than that of control group 77.78％ (35/45),the difference was statistically significant (x2 =4.54,P ＜ 0.05).The morphine consumption of observation group was significantly less than that of control group(t =9.11,P ＜ 0.05),duration of analgesia was significantly longer than that of control group (t =6.72,P ＜ 0.05).Quality of life score in the observation group was significantly higher than that in the control group,the difference was statistically significant(Z =3.61,P ＜ 0.05).The incidence rate of adverse reactions was 17.78％ (8/45),which was significantly lower than that of the control group 46.67％ (21/45),the difference was statistically significant (x2 =4.54,P ＜ 0.05).Conclusion Stellate ganglion block combined with morphine sustained-release tablets for controlling pain of advanced lung cancer can significantly improve analgesia,reduce morphine consumption and adverse reactions,is worthy of clinical application.

Objective:To analyze the hospitalization expenses in inguinal hernia inpatients under the single-disease payment standard of medical insurance.Method:A retrospective study was performed to analyze the data of inguinal hernia patients who received inguinal herniorrhaphy in 2006.According to the regulations worked out by the Beijing Medical Insurance Affairs Administration,32 cases were selected and their medical costs were characterized.Result:The average hospitalization expense in inguinal hernia patients was 5722.37?2967.66 yuan,including surgery cost(45.6%) and drug cost(26.7%).The surgery cost level depended on the selection of various hernia prosthetic mesh and the drug cost depended on the selection of various anti-infective drugs.The hospitaliztion expenditures were lower in 18 cases than the payment permission in the medical insurance standard but higher in the other 14 cases.The sex composition,surgery cost, drug cost and laboratory cost showed a significant difference between the two groups(P

Public Key Infrastructure (PKI) can provides a series of security services for computer-based patient record information system. This paper discusses the application of PKI to the security of computer-based patient record information system.

OBJECTIVE To analyze the antimicrobial therapeutic schemes in appendectomy inpatients so as to(evaluate) the economic impact factors of each project.METHODS Totally 286 medical cases of appendectomy inpatients were chosen and analyzed from 2003 to 2005.The antimicrobial agent costs of each scheme were evaluated by(using) cost minimization analysis of pharmacoeconomic method.RESULTS There were 24 kinds of antimicrobial therapeutic schemes used by 286 cases.The commonest schemes were nitrodazoles + ?-lactams and nitrodazoles + ?-lactams + aminoglycosides(or clindamycin). The drug costs were 1671.46 and 1977.13 yuan(RMB)(individually) in combination of two or three kinds of antimicrobial agents.Choosing metronidazole instead of ornidazole could reduce drug fee significantly,which was also observed in choosing ceftazidime instead of other ?-lactams.CONCLUSIONS The antimicrobial drug utilization in our hospital is rational as a whole.Considering of economic factors,using metronidazole and ceftazidime(administering clindamycin if necessary) may be better than other schemes for prventing wound infection.

OBJECTIVE:To evaluate the role and function of hospital preparations.METHODS:A retrospective analysis was conducted on the utilization of hospital preparations in our hospital from July 1,2005 to June 30,2006.RESULTS:A total of 158 kinds of hospital preparations were used in our hospital,with their sales value totaling RMB 10.025 3 million,representing 1.13% of total drug sales.The top 10 selling hospital preparations accounted for 72.2% of all hospital preparations in sales value.A difference was seen in use of hospital preparations by outpatient and inpatient departments.CONCLUSIONS:Hospital preparations are indispensable for routine diagnosis and medication despite their small proportion in sales value of total drugs.

Objective To analyze the diagnosis and therapy of pemphigus and pemphigoid.Methods Clinical data were retrospectively analysed for 648 patients with pemphigus or pemphigoid admitted in Huashan Hospital,Fudan University from 2003 to 2007.Results The mean age of onset of pemphigus was younger than that of pemphigoid(47.0±16.9 years vs 65.1±13.9 years.P＜0.001).Of 175 patients with pemphigus confirmed by direct immunoflorescence(DIF),100%were positive for IgG,and 92.0%for C3,while out of 223 patients with pemphigoid,51.12%were positive for IgG,99.1%for C3.For pemphigus,the consistency reached 68.8%among clinical diagnosis.pathological diagnosis and immunological(DIF)diagnosis,80.7%between pathological and immunological diagnosis.In the case of pemphigoid,the consistency was 62.8%among clinical,pathological and immunological diagnosis,and 78.1%between pathological and immunological diagnosis.Corticosteroids were primary treatment strategy for both pemphigus and pemphigoid.and prednisone of 0.5-1.5 mg per kilogram bodyweight per day could control the condition of most patients.Conclusions DIF could be used as an important diagnostic means for patients with pemphigus or pemphigoid which can not be confirmed by clinical manifestation or pathology.In primary hospitals,IgG and C3 are recommended for DIF testing when pemphigus is suspected,and C3 is recommended for suspected pemphigoid.

Objective To explore the relationship between the HLA-G 14 bp insertion/deletion polymorphism and the infection of Epstein-Barr virus(EBV) for children.Methods The study genotyped HLA-G 14 bp insertion/deletion polymorphism of 102 infectious mononucleosis children and 165 normal controls by PCR-PAGE,detected the plasma sHLA-G level of 51 infectious mononucleosis children and 146 normal controls by ELISA.Results A significant difference was observed for the frequencies of the HLA-G 14 bp genotype between the two groups( x2 =6.742,P=0.034 ),and a significant difference was also observed for the 14 bp allele frequencies between the two groups( x2 =6.672,P=0.01 ).The plasma sHLA-G levels in the infectious mononucleosis children were dramatically higher than that in normal controls,and a significant difference was observed between the two groups( Z=-9.472,P＜0.01 ).Among the infectious mononucleosis children,levels of sHLA-G was find a significant difference between the three genotypes of HLA-G 14 bp insertion/deletion polymorphism( H=6.09,P =0.048 ),and the level of s HLA-G with 14 bp+/+ genotype was markedly lower than that of the two other genotypes (Z=-2.376,P=0.01 8).Conclusion There was a relationship between the HLA-G 14 bp insertion/deletion polymorphism and the susceptibility to the infectious mononucleosis for children.Children who carried the 14 bp-/- genotype or deleted the 14 bp allele may have a significantly increased risk of the infection of EBV.The plasma sHLA-G might be considered as an index for auxiliary diagnosis infectious mononucleosis.

Objective To probe the Th cytokine pattern in pemphigus,so as to clarify the pathogenesis of pemphigus and draw up new therapy.Methods Reverse transcription-polymerase chain reaction(RT-PCR)was used to examine the interferon gamma(IFN-?)and interleukin10(IL-10)mRNA expression on peripheral blood mononuclear cells(PBMCs)of20cases of pemphigus in acute stage,20cases in stable stage,and20normal controls.Results The IFN-?mRNA expression in20cases of pemphigus in acute stage was higher than that of controls(P