OBJECTIVE:To study the adverse drug reactions induced by?-lactam antibiotics and to promote rational use of drugs in clinics.METHODS:442ADR cases induced by?-lactam antibiotics collected in our hospital during2001～2005were analyzed retrospectively.RESULTS:Among the total961ADR cases collected in5years,46%were induced by?-lactam antibiotics.The most common displays of ADR were the lesion of skin and the appendants,followed by the lesion of cardiovas-cular system and digestive system etc.CONCLUSION:It is advisable to promote rational use of?-lactam antibiotics and strengthen ADR monitoring so as to decrease or avoid the occurrence of ADR.

Echocardiography, Three-Dimensional ; Heart Defects, Congenital ; diagnostic imaging ; therapy ; Humans

Background The signal pathway of mammalian target of rapamycin (mTOR) plays an important role in the regulation of cell cycle.Rapamycin(RAPA) can inhibit the proliferation of cells by regulating of cell cycle.Objective This study was to investigate the effect of RAPA on the proliferation of Rhesus retinal vascular endothelial cells (RF/6A).Methods RF/6A cell strains were cultured in vitro,and PBS,10 μg/L RAPA or 5 μg/L RAPA was added into the medium respectively.The expression of cyclin D1 protein in the RF/6A cells (absorbancy) were detected by Western blot.The cell cycle distribution after RAPA action was analyzed by flow cytometry.Matrigel was used in endothelial-cell tube formation to evaluate the effect of RAPA on angiogenesis.Results Western blot assay showed that the expressions of cyclin D z protein were 0.92±0.04,0.58±0.02 and 0.73±0.02 in the PBS group,10 μg/L RAPA group and 5 μg/L RAPA group,showing a significant difference among the three groups (F =246.320,P =0.000),and the relative expressing level of cyclin D1 protein in the l0 μg/L RAPA group and 5 μg/L RAPA group was significantly lower than that of the PBS group (both at P＜0.05).The proportion of G0/G1 cells were (42.13±0.57)％,(65.15±0.64)％ and (54.09± 0.78)％ respectively in the PBS group,10 μg/L RAPA group and 5 μg/L RAPA group,which was significantly different among the three groups (F=887.815,P=0.000).The number of endothelial-cell tubes were (9.67 ± 1.53)/field,(4.33 ± 0.58)/field and (6.33 ±0.58)/field respectively in the PBS group,10 μg/L RAPA group and 5 μg/L RAPA group,and the number of endothelial-cell tubes in 10 μg/L RAPA group and 5 μg/L RAPA group was less than that in the PBS group,with a significant difference among the three groups (F =21.778,P =0.002).Conclusions RAPA can inhibit the proliferation of RF/6A cells in vitro by down-regulating the expression of cyclin D1.

Objective To explore the clinical and MDCT features of pediatric irreducible intussusception. Methods 66 patients were divided into irreducible intussusception group (19 cases) and reducible intussusception group (47 cases). Age clinical courses, length of intussusception body (L), neck max diameter (D1), head max diameter (D2) andthe ratio (D2/D1) and MDCT imaging data were compared and analyzed. Results (1) The course time, L and D2/D1 values of irreducible intussusception group were significantly higher than those of reducible group, the D1 was lower than that ofreducible group, and the difference is statistically significant (P<0.05). Clinical course,L and D2/D1 value AUC values were more than 0.7, the threshold values were 33.0 h, 7.5 cm and 1.33. (2) The occurrence rate of non-ileum-colon intussusception, Meckel's diverticulum, appendicitis and intestinal necrotic for irreducible intussusception were 36.8%, 21.1%, 21.1%, 15.8%and 10.5%respectively. Conclusion Whenthe time of course>33.0 mo, D2/D1>1.33 and L>7.5 cm, the irreducible intussusceptioncould be considered, and Meckel??s diverticulum, intestinal necrosis, appendicitis and intestinal obstruction should be judged further.

Objective To compare the efficiency of acute physiology and chronic health evaluation (APACHE)Ⅱ and Ⅳ in mortality risk prediction of severe acute pancreatitis (SAP).Methods From January 2013 to December 2014,SAP patients admitted to intensive care units (ICU) were retrospectively analyzed in single center.The clinical data of the first 24 hours since the patients admitted into ICU were collected.The modified Marshall score,APACHE Ⅱ and APACHE Ⅳ score were calculated.The mortality risk predictive value of each patient was calculated by APACHE Ⅱ and APACHE Ⅳ.According to the final clinical outcome of patients,Hosmer-Lemeshow was performed to compare real mortality rate with predictive mortality rate,and calibration of APACHE Ⅱ and APACHE Ⅳ in the mortality risk of each patients was evaluated.The resoluation of the two scoring systems was compared by the area under the receiver operator characteristic curve (AUC).Results In the end,192 patients (152(79.2％) survivors and 40(20.8％) dead) were enrolled.Modified Marshall score,APACHE Ⅱ score and APACHE Ⅳ score of patients in dead group was 6.30±0.36,21.3±8.0 and 88.1± 30.2,respectively;and those of survival group was 3.70 ± 0.20,12.3 ± 5.6 and 53.4 ± 19.0,respectively,and the differences between two groups were statistically significant (t-6.436、-6.683、-6.913,all P＜ 0.01).The results of Hosmer-Lemeshowin calibration of APACHE Ⅱ and APACHE Ⅳ indicated that both two systems could predict mortality risk of SAP patients well (P＞ 0.05).The AUC of APACHE Ⅱ score (cut-off ≥26) and APACHE Ⅳ score (cut off≥91) was 0.81(95％CI 0.74 to 0.89) and 0.83(95％CI 0.75 to 0.90),respectively,and the difference was not statistically significant (x2 =0.21,P=0.644),which indicated that there was no statistically significant difference in calibration.Conclusions APACHE Ⅳ scoring system is not better than APACHE Ⅱ scoring system in prognosis prediction of SAP patients.The prognosis of SAP patients could be accurately evaluated by APACHE Ⅱ.

Many clinical studies have demonstrated that raised morning blood pressure surge is closely related to path‐ogenesis and prognosis of cardiovascular diseases ,but there is still no unified understanding for its prevention until now ,and raised morning blood pressure surge phenomenon is not effectively controlled in most patients .The pres‐ent article made a brief review on raised morning blood pressure surge .

Objective To explore the potential associations of HLA-DQA1 and DQB1 alleles with systemic scleroderma (SSc) in Zhuang and Han nationalities in Guangxi Zhuang Autonomous Region. Methods Genomic DNA was extracted from the peripheral blood of SSc patients of Zhuang (n=50) and Han (n=50) nationality,normal controls of Zhuang (n=100) and Han (n=100) nationality in Guangxi Zhuang Autonomous Region.PCR with sequence-specific primers (PCR-SSP) was used to detect HLA-DQA1 and -DQB1 alleles in these subjects. Results There was a significant increase in the frequency of HLA-DQA1*0401, -DQBl*0501 and -DQB1*0601 alleles in the patients of Zhuang nationalty(RR=4.056,χ2=15.407,PC=0.001;RR=4.472,χ2=10.653,Pc=0.004;RR=3.473,χ2=10.06,Pc=0.008)compared with normal controls of Zhuang nationality,and in the frequency of HLA-DQA1*0401,DQA1*0601 and DQB1*0601 alhles in patients of Han nationality (RR=9.333,χ2=8.371,Pc=0.036;RR=8.071,χ2=20.130,Pc=0.000;RR=3.764,χ2=10.755,Pc=0.004)compared with normal control of Han nationality.However,the frequency of HLA-DQA1*0201 allele was statistically lower in the patients of Zhuang and Han nationality than in the controls of corresponding nafionality (χ2=13.583,Pc=0.002;χ2=12.209,Pc=0.004).Conclusions HLA-DQA1*0401 and-DQB1*0601may be susceptible genes for SSc in Zhuang and Han nationalities,HLA-DQB1*0501 for Sse in Zhuang nationality,and HLA-DQAl*060l for SSc in Han nationality in Guangxi Zhuang Autonomous Region.

The development of renal transplantation from living relative donors relives the shortage of transplanted organs,and benefits patients with end-stage renal diseases.However,when seen from the aspect of donors,implementing a non-therapeutic invasive surgical treatment on a healthy person still violates the absolute sound principle of medical ethics.To reduce the harm to the minimum,a comprehensive assessment should be conducted before the transplantation,and long-term follow-up observations after transplantation should also be strengthened.