OBJECTIVE:To discuss the characteristics and regularities of adverse drug reactions (ADR) in our hospital. METHODS:ADR reports of 618 cases collected via ADR network system and submitted to state ADR database from 2005 to 2006 were analyzed statistically in respect of patients' age and sex,rating of correlated factors and outcome,clinical manifestations,routes of administration,and the involved drugs etc. RESULTS:Anti-infective drugs dominated the first place on the list of ADR incidence rate,followed by antineoplastic agent and Chinese patent medicines. The main symptoms of ADR were drug eruption,allergic,athma,followed by gastrointestinal reaction. There were fewer incidences of serious ADR such as bone marrow depression,hypoleukemia and shock. CONCLUSION:The ADR monitoring in Fuzhou General Hospital is lack and should be strengthened,and knowledge of ADR must be publicized for guiding the rational,safe and effective drug use in clinic.

Objective]This article discussed Professor Xie Jianguo's survival with tumor experience on advanced lung cancer treatment in the last decade. [Methods]To observe Professor Xie Jianguo's survival with tumor experience of advanced lung cancer on the clinical treatment process, and organize related cases, which summarized the unique thoughts of treatment, commonly used empirical prescriptions and demonstrated with typical clinical cases. [Resluts] Professor Xie Jianguo's theoretical guidance on advanced lung cancer treatment, included tumor inhibition, anticancer effect, survival with tumor. Treatment methods, included recruitment of the vital qi, adjusting the internal environment, the phlegm, stasis toxin factors, with rigorous thinking, sophisticated medication. [Conclusion] Professor Xie Jianguo's survival with tumor experience on advanced lung cancer treatment has remarkable significance in guiding clinical treatment.

Objective To discuss the influence of weather process on the event of non-occupational carbon monoxide poisoning. Methods The weather data on the event of carbon monoxide occurred on February 18, 2001 (2.18 event) such as weather position, air stability, mixed layer depth, inversion layer, air temperature, air pressure, wind speed and observation of 255 meters meteorological tower were analyzed. Results The 2.18 event happened under the conditions including warm ridge in higher level, depression system, calm or breeze, air temperature increasing in the surface, inversion layer enhanced, mixed-layer depth lowering. Conclusion The weather factors such as the higher and low layer atmosphere circumfluence position, wind from surface, air temperature, pressure and mixed layer depth produce an integrated effect on the non-occupational carbon monoxide poisoning.

Objective To explore the effect of enteral nutrition combined with parenteral nutrition support on the prognosis of severe acute pancreatitis(SAP).Methods Sixty-one patients diagnosed with SAP in our hospital from July 2011 to June 2012 were chosen and randomly divided into EN and PN group(30 cases)and PN group(31 cases).At the early stage of treatment,the former group was provided parenteral nutrition(PN)alone while the latter group was given enteral nutrition together with parenter-al nutrition.Then we measured the patients′body mass index on the 1st,2nd,3rd,5th,7th,10th,14th day respectively after admis-sion,and recorded the following indexes:whether complications occurred or not,the time for the first passage of gas by anus and defecation,the total time and cost of hospitalization,the drug proportion and the time the serum and urine amylase returned to nor-mal.Results The two groups of patients′body mass index showed no significant differences in the first 3 days,but there were sig-nificant differences in statistics on the 5th,7th,10th and 14th day(P <0.05).In addition,the two groups of patients formed a sharp contrast in such aspects as the bowel sound recovery time,the anal exhaust time,the total cost of hospitalization and the incidence rate of the complications(P <0.05)whereas there were no remarkable differences in the serum and urine amylase recovery time and the total time of hospitalization(P >0.05).Conclusion Compared with PN,the combined therapy of EN and PN could improve the patients′nutrition,reduce the weight loss caused by consumption,promote intestinal peristalsis,effectively reduce infectious compli-cations caused by floraectopic and ease the patients financial burden.

BACKGROUND: Studies have demonstrated that intermittent high glucose can have a more severe impact on vascular endothelial function in comparison with persistent hyperglycemia.OBJECTIVE: To investigate the effect of intermittent high glucose on the proliferation and apoptosis of endothelial progenitor cells (EPCs) from human peripheral blood in vitro as well as the production of malondialdehyde (MDA) and antioxidant. METHODS: Total mononuclear cells were isolated from human peripheral blood by Ficoll density gradient centrifugation and then the cells were placed on fibronectin-coated culture dishes. After 7 days of culture, the adherent cells were identified as EPCs by laser scanning confocal microscope. The cells were synchronized and then stimulated with glucose 5.5 mmol/L (normal control group), 20 mmol/L (constant high glucose group), and 5.5/20 mmol/L (intermittent high glucose group, 5.5 and 20 mmol/L glucose culture solution was changed every 8 hours) for 72 hours. EPCs proliferation and apoptosis was measured by MTT assay and flow cytometry, respectively. The content of MDA and the activity of superoxide dismutase (SOD) in culture solution were detected with colorimetry.RESULTS AND CONCLUSION: After EPCs were exposed to constant high glucose (20 mmol/L) and intermittent high glucose (5.5/20 mmol/L) for 72 hours, proliferated cells were significantly reduced and the apoptosis rate was significantly increased compared with those exposed to normal glucose (P < 0.01). Furthermore, there was a significant increase in MDA contents as well as a significant reduce in SOD activities in the constant high glucose and intermittent high glucose group (P < 0.01), especially in the latter group. These findings indicated that both intermittent high glucose and constant glucose could inhibit the proliferation and promote the apoptosis of EPCs; however, intermittent high glucose appears to worsen the effects on EPCs. This is maybe due to the increased oxidative stress.

Objective To evaluate the clinical characteristics of epithelioid trophoblastic tumor (ETT).Methods Six cases of ETT treated in Women's Hospital,School of Medicine,Zhejiang University from 2005 to 2007 were retrospectively analyzed,together with a literature review.Results Six cases of ETT were diagnosed pathologically after surgery.The age of patients ranged from 27 to 46 years.The most common presentation was abnormal vaginal bleeding(5/6).The preceding gestational events were hydatidiform mole in 1 case,abortion in 2 cases,and term delivery in 3 cases.The interval between the preceding gestation and the diagnosis of ETT ranged from 15-48 months.The serum human chorionic gonadotropin(hCG)level was 46-121 147 IU/L.Four cases presented with metastasis,including lung metastasis in all of the 4 cases,liver metastasis in 1 case,and pancreas metastasis in another 1 case.The main therapies were surgery combined with chemotherapy.All of the 6 cases received total abdominal hysterectomy.and 1 case also had lung lobectomy.One ease had a recurrence but refused any treatment again,and was lost to follow up;the therapy of 1 case unfinished;another 4 cases were without evidence of disease 9 to 19 months after surgery.Condusions The confirmation of ETF diagnosis is difficult before surgery.Surgical management is mostly recommended in ETT. The role of chemotherapy in ETT is not clear yet.

Objective To detect the expression of vascular endotheilal growth factor (VEGF), stromal cell-derived factor-1α (SDF-1α), and its receptor CXCR-4 in the retinopathy of diabetic rats, and to explore the relationship between those factors and diabetic-retinopathy(DR). Methods Diabetes was induced in 40 rats with a single intraperitional injection of streptozotocin(STZ). Experimental rats were randomly divided into M1 (diabetic for 1 month), M3 (diabetic for 3 months), and M5 (diabetic for 5 months) groups, and another 10 rats served as a normal control group (NC). Retinal vascular status was observed by transmission electron microscope. After retinal stretched preparation, VEGF, SDF-1α and CXCR-4 immunohistochemistry were done. Retinal VEGF, SDF-1α, and CXCR-4 mRNA were detected by semi-quantitative RT-PCR. Protein expression was measured by Western blot. Results Under transmission electron microscope, change in vascular status was found in M1 to M5 groups, but not in the NC group. The changes became increasingly serious with the prolongation of the disease. By immunohistochemistry, we found the expression of VEGF, SDF-1α, and CXCR-4 on the retina increased gradually. It increased after injecting STZ for 1 month and increased significantly after 5 months.VEGF, SDF-1α, and CXCR-4 mRNA expression increased obviously after injecting STZ for 1 month and increased significantly after 5 months. Western blot showed that protein of VEGF, SDF-1α, and CXCR-4 had no change after injecting STZ for 1 month. It began to increase in the M3 group and increased most in the M5 group. Conclusion The expression of VEGF, SDF-1α, and CXCR-4 on the retina in retinopathy of diabetic rats increases gradually with the prolongation of the disease. It is an important factor for diabetic retinopathy.

Objective To investigate the expression of low molecular mass polypeptide-2 (LMP2)and protein phosphatase 1A (PPM1A) in gestational trophoblastic disease and elucidate their predictive value in malignant transformation of hydatidiform mole. Methods The expressions of LMP2 and PPM1A protein in 196 complete hydatidiform moles (in which 28 cases with malignant transformation) , 7 invasive moles, 5 choriocarcinomas and 20 normal chorionic villus were detected with the method of En Vision immunohistochemistry. Their clinicopathologic data were retrospectively analyzed. Results LMP2 and PPM1A protein expressed in cytotrophocytes, syncytiotrophoblast and extravillous trophoblast. The level of LMP2 expression in deteriorative hydatidiform mole was significantly higher than that in non-deteriorative hydatidiform mole or normal chorionic villus (6. 79 ±2. 38, 5.26 ±2.63 and 3. 10 ±1.65, all P <0. 01),while there were no difference compared with gestational trophoblastic neoplasms (6. 42 ±2. 68, P=0. 113).The level of PPM1A expression was highest in normal chorionic villus, and decreased gradually in hydatidiform mole (non-deteriorative and deteriorative) and gestational trophoblastic neoplasms (6. 30 ±2. 98, 4. 93 ± 2. 50, 4. 43 ± 2. 04 and 3. 33 ± 2. 06, all P < 0. 01); the level of PPM1A expression in deteriorative hydatidiform mole was significantly lower than that in non-deteriorative hydatidiform mole (P=0.001). The expression of LMP2 protein was correlated to theca lutein ovarian cyst, the expression of PPM1A protein was related with uterine size (P < 0. 05) . While, there was no correlation between the expressions of the two proteins (P >0. 05). Conclusions High expression of LMP2 and low expression of PPM1A might play an important role in the motility and invasiveness of trophohlast cells and malignant transformation of hydatidiform mole. Testing the expression of LMP2 and PPM1A in hydatidiform mole tissues of initial uterine evacuation might be have some reference significance in judging outcomes of hydatidiform mole.

We carried out a new unit-based method in the teaching process of epidemiology for improving undergraduate prevention-oriented medical students' comprehensive ability. The new method integrated heuristic teaching and case teaching, and focused reform on the system of teaching and assessment. The results showed new teaching method can significantly improve students' capacity of analysis and oral expression, and contributes to the comprehensive ability.