OBJECTIVE:To investigate outpatients' cognition(including knowledge,attitude and behavior)on adverse drug reactions(ADR),and to analyze the influential factors of ADR cognition.METHODS:An on-the-spot questionnaire survey was conducted in which a total of 488 outpatients sampled from our hospital from May to December in 2007 were investigated and the data analyzed statistically.RESULTS:The correct rate was 36.6% for the questions related to cognition on ADR.70.5% of the patients investigated had a poor cognition on ADR.The factors influencing patients' cognition on ADR included educational background,ADR experience,pharmacists' guidance on medication,source of medicine knowledge,occupation,doctors' guidance on medication,community ADR lecture,and gender.CONCLUSION:The outpatients have a poor cognition on ADR.Both doctors and pharmacists should offer guidance on medication and give lecture in community to inform patients the knowledge about rational administration and ADR.

There is a long history of Toad venom in the treatment of cancer in China.Bufalin,extracted from Toad venom,is one of the biologically active compounds of anticancer.We elaborate the molecular mechanism of bufalin on anticancer activity from several aspects such as inducing cell apoptosis and differentiation,inhibitting cell proliferation and angiogenesis,enhancing the sensitivity of chemotherapeutics,which can provide the basis for in-depth study of Toad venom and its development and clinical medication.

Objective To compare the manipulation of two different methods of percutaneous dilatational tracheostomy (PDT),the guidewire dilating forceps (Portex method) and the modified onestep dilation technique (Ciaglia Blue Rhino method,CBR method).Methods From March 2013 to February 2014,48 patients eligible to meet the criteria of tracheostomy in ICU were collected and were divided into two groups at random.The length of time consumed for operation,amount of blood lost during operation and the operation complications were compared between two groups.The participant surgeons were asked which method they preferred,Portex or CBR.Results Of them,the mean age was 76.7 ± 11.6 years old,and 25 patients (52.1％) were male.The reasons for tracheotomy were the length of time needed for mechanical ventilation support expected to be longer than 2 weeks (n =30),severe disturbance of consciousness (n =17),and upper airway obstruction (n =1).The patients enrolled in the study were randomly divided into Portex and CBR groups.There were no significant differences in age,gender,APACHE Ⅱ score,the reason of tracheotomy,the length of time for mechanical ventilation support before tracheotomy,and the preoperative coagulation function between two groups.CBR method can easily be done with less operation time required than Portex [(5.9 ±4.3) min vs.(9.9 ± 1.5) min,P ＜0.01],and had obviously fewer operation complications and less amount of blood lost than Portex method (P ＜ 0.05).The male surgeons with a slew of surgical practice were in preference to Portex,whereas female doctors with less work experience and without surgical practice preferred CBR.Conclusions The CBR method can easier be done and was better than the Portex method in minimizing operative trauma and reducing the complications,especially it can easily be accepted by female doctors with less work experience and without surgical practice and it is worth using widely in clinic.

Since the laparoscopic thyroidectomy carried out in China for ten years,this technique has become more and more mature,indications gradually broadened,and playing a vital role in the field of thyroid surgery.This article will explain this technique in the aspects of approaches,the establishment and maintenance of the surgical space,indications,antiindications and complications.

ObjectiveTo study the protective effects of Qiqiong(QQJN) on focal cerebral ischemia/reperfusion injury and its mechanism. MethodsMiddle cerebral artery occlusion(MCAO) was used to make focal cerebral ischemia/reperfusion model by intravascular nylon filament occlusion. The protective effects of QQJN were evaluated by investigating neurological function score, percentage of cerebral infarction, pathomorphology of brain, the activity of SOD and the content of MDA in hrain tissue,thrombogenesis and platelet aggregation in vitro. ResultsCompared with model group, QQJN(4.4、8.8g/kg)could decrease the neurological score in 8 and 22h after reperfusion, reduce the percentage of cerebral infauction,improve pathomorphology of brain, decrease the length, wet weight and dry weight of thromb and inhibit platelet aggregation. ConclusionQQJN had protective effects on focal cerebral ischemia/reperfusion injury. The role of anti-injury of free radicals,inhibit thrombogenesis and platelet aggregation should contribute to its neuroprotective effects.

The clinical data of 76 children with EFE admitted from June, 1998 to December, 2009 was retrospectively analyzed. Tachypnea、 cough and cyanosis were common and all presented with heart failure. Electrocardiogram revealed sinus tachycardia 、left ventricular hyperthrophy and ST-T alterations. On chest radiograph 54 cases (54/76) had a cardiothoracic ratio ＞ 0. 65 and 33 with pneumonia.Echocardiopraphy revealed lowered left ventricular systolic function in all cases and decreased left ventricular diastolic function in 21 (21/76). 63 cases (63/76) presented with thickened and enhanced left ventricular endocardium and 11 (11/76) with thickened interventricular septals. All were treated with digitalis. 58children were improved and discharged, 10 gave up therapy and 8 died during hospitalization. 41 out of 58 improved cases were followed for 1 - 4 years, with 2. 6 years on average. Among them 28 were clinically cured, 7 deteriorated and 6 died of heart failure. Echocardiography is of diagnostic value for ERE. Systolic and diastolic function of the heart can be used to predict the outcome. Pulmonary infection is a major risk factor associated with deterioration. Long-term treatment is imperative to improve the prognosis.

Objective Tracking of the vaginal microflora recovery and the expression of immune factors from untreated and treated patients with bacterial vaginosis (BV) by using different administration regimens and studying the relationship of treatment results and regimen selections. Methods 25 healthy females were selected as a control group and 100 BV patients were randomly divided into 4 groups (n=25/group). Group A: Intravaginal administration of metronidazole (× 7 d), Group B:Continuous intravaginal administration of metronidazole (× 7 d) and then live Lactobacillus Capsule (× 7 d) , Group C: Intravaginal administration of nifuratel (× 7 d), Group D: Continuous intravaginal administration of nifuratel (× 7 d) and then live Lactobacillus Capsule (×7 d). The microecological assessment system and EILSA were used to compare the clinical efficacy, vaginal microflora recovery and the changes in IL-8, TLR2 and TNF-αof the vaginal lavage fluid in healthy women or patients with bacterial vaginosis before and after treatments by four treatment strategies. Results ① The vaginal microflora imbalance, flora disturbance, pH value increased were presented in BV group compared with the control group.②Compared to the median of IL-8, TLR2 and TNF-α in vaginal lavage fluids of control group, there was no significant difference in IL-8 level but both TLR2 and TNF-αwere significantly increased (P<0.05) in BV group. The immune factors had no significantly difference in all BV groups.③The therapeutic effect in each BV groups was compared after stopping treatment for 7 days. The cure rate and the vaginal microflora recovery rate were significant higher in group B and D than group A and C (P<0.05). ④ After treatment there was no significant change in IL-8 level but there was an obviouslydecrease in TLR2 and TNF-α(P<0.05). The decreased levels are more significant in groups B and D than groups A and C (P<0.05). Conclusion By combining with the microecological assessment system to evaluate the therapeutic effect of BV, our research suggests that the sequence schemes of nifuratel plus live Lactobacillus Capsule is more effective in therapy effect, restoring normal vaginal micro-ecological environment and vaginal local immunity than metronidazole used alone.

OBJECTIVE:To explore the antidepressant effects of bioactive compounds from paecilomyces tenuipes(BCPT)on expression of hippocampus and cortex mineralocorticoid receptor(MR),glucocorticoid receptor(GR)mRNA in CUS(chronic unpredictable stress)rats.METHODS:The depression model rat was produced by CUS,the therapy effect of BCPT was observed in CUS rats.It detected expression of hippocampus and cortex MR,GR mRNA with RT-PCR in CUS rats.RESULTS:BCPT could enhance the expression of hippocampus and cortex MR,GR mRNA or decrease the ratio of MR/GR mRNA in CUS rats.CONCLUSION:BCPT could obviously enhance the expression of hippocampus and cortex MR,GR mRNA or decrease the ratio of MR/GR mRNA in CUS rats,the result of this study suggested that BCPT possess certain antidepressant effect.

Problem-based Learning (PBL) is a teaching model originating from the construc-tivism theory, which stressed the meaning construction in problem situation by collaborative learning, conversation and completing knowledge. Based on the times background, development of learning theory, teaching situation, cognitive strategies, ideological connotation about constructivism, PBL's practical significance, its teaching forms, teaching resources, internal motivation, and the teaching evaluation were analyzed deeply, which was beneficial to carrying out PBL normatively in medical education, so as to provide the theoretical support for further exploration and innovation of PBL.

Objective:To investigate lesion size caused by channel radiofrequency volumetric reduction of por-cine tongue base in vitro using the technique of three-dimensional reconstruction. And to evaluate safety about channel radiofrequency volumetric reduction of tongue base. Method: Eighteen fresh porcine tongues were randomly separated into six groups,and each group had three ones. The tongue bases were designed six points according to description of Powell. Tongues base were acted on 10 s and 6 level by Coblation radiofrequency system and were cut into serial freezing histological sections. These segments were sectioned at 20 μm on the injury lesion and stained with H & E. Collected 2D digital imagine of order histological sections, drawn and cut apart part of the le-sion of these sections. Images were procesed IPS and were taken three-dimensional reconstruction and statistics an-alyzes with SPSS10. 0. Result: The mean value of tongue base lesion volumes among points was (359. 5± 5. 6)mm~3 ,(364. 3±7. 0)mm~3 ,(363. 7±7. 2)mm~3, (354. 1±11. 8)mm~3, (349. 4±17. 2)mm~3 ,(353. 5±7. 9)mm~3 separately. Statistic analysis by one-way ANOVA showed that there was a insignificant difference between the groups(P>0. 05). Conclusion:These results demonstrated no significant effect lesion size in channel radiofrequency volumetric reduction in the different points of the tongue base. These data also indicated that coblation radiofre-quency system is a safe method for obstructive sleep apnea hypopnea syndrome.