OBJECTIVE:To review drug use in the pediatric outpatient department of our hospital.METHODS:1000pediatric prescriptions during Aug.1to Aug.20,2004and another1000during Aug.1to Aug.20,2005were collected from the pediatric outpatient department of our hospital,and which were subjected to statistical analysis using international indicators of rational drug use and DDDs.RESULTS:The usage of injection accounted for12.3%in2004and11.4%in2005.The usage of anti-infectives stood at84.20%in2005,accounting for46.11%of total drug consumption sum.Azithromycin and cefaclor respectively dominated the first place on the lists of consumption sum and DDDs.CONCLUSION:The practice of Prescription Management Rules(trial)helps improving the use of injections in the pediatric outpatient department of our hospital.However,there are still many problems,which needs to be tackled in the application of anti-infectives and further intervention measures needs to be taken.

Objective To gain the best cosmetic result and to avoid the manifest postoperative scar, bleeding and injury of the sensory nerves in the nipple and areola. Methods The gynecomastia was corrected under the endoscope through a small incision (2~3.5 cm) around the areola combined with the tumescent liposuction of the breast to individuals whose breast hyperplasia was mainly because of the fat tissue hyperplasia and the incised tissues were sent for pathological examinations. Results Since March 2000, 16 young men with normal men genitals appearance had undergone this operation, in which 4 cases were breast gland tissue hyperplasia, 3 cases of fat tissue hyperplasia and 9 cases of mixed fat and gland tissue hyperplasia. The results were satisfactory with normal men breast appearance and small areola incisions. No complications happened such as hematoma, abnormal feeling and necrosis in nipple and the breast. The incised tissue of the unilateral breast was 100~320g with average of 130g. The sunction lipectomy volume of the unilateral breast was 20~130ml with average of 68ml. The pathological examination revealed that the incised tissue were fat tissue and breast gland tissue. During 5 months to 3 years following up, no breast hyperplasia recurred. Conclusions The endoscopic operative technique is an ideal option to correct the gynecomastia because it minimizes the areolar incision and avoids the injury of the nipple and areola. It is also helpful to the distal part incision and remoulding of the breast.

Objective To observe the inhibition of asON phosphorothioate to the TIMP-1 gene and protein expression in the liver tissue of immune- induced hepatic fibrosis rats. Methods According to the analysis of modulator, structure protein, encoding sequence of TIMP-1 genome, we designed four different groups of asONs. These asONs were injected into the hepatic fibrosis rat models through coccygeal vein. The results were observed by RT-PCR, immunohistochemistry and in situ hybridization with collagen Ⅰ、Ⅲ, special staining of collagen fiber, electron microscope. Results The asON phosphorothioate of TIMP-1 could be expressed in vivo, and could block the TIMP-1 gene and protein expression in the liver of immune- induced hepatic fibrosis rats on the level of mRNA, which could promote the degradation of collagen Ⅰ、Ⅲ(P

Objective To investigate the clinical efficiency,safety,adverse reactions and healthrelated life quality of transdermal fentanyl patches for pain management in terminal cancer patients with hepatic and renal dysfunction and ascites.Methods 98 terminal cancer patients with moderate to serve pain combined with abnormal hepatic and renal dysfunction were randomly divided into two groups.Group Ⅰ (n=56)received transdermal fentany patches.Group Ⅱ,the control group (n=42),received morphine controlledrelease tablets.Terms of pain intensity,function of renal and liver,adverse reactions and heath-related quality of life were assessed before and after treatment.Results Patients were satisfied with their pain management in both groups,and no significant difference in pain release was observed between the groups (x2 =0.01,0.07,0.01,0.04,P ＞ 0.05).The incidences of constipation and dysuresia were significantly less in the group Ⅰ compared with that of the group Ⅱ (x2 =7.32,3.96,P ＜ 0.05).The incidences of hypersomnia,dizzy,nausea and vomiting were similar betwecn the two groups (x2 =0.12,0.54,0.54,0.02,P ＞ 0.05).Most of the adverse reactions would relieve or disappear after symptomatic treatment.Values of BUN,CR,ALT,AST were similar before and after treatment in group Ⅰ (t =1.43,1.67,0.91,0.11,P＞ 0.05).However,in group Ⅱ,these values were significantly increased after treatment (t =17.59,49.17,42.12,36.23,P ＜ 0.05).The heathrelated life quality (appetite,spirit,somnus,fatigue,daily life and countenance) were significantly improved after treatment in both groups (the group Ⅰ t =3.37,4.40,2.07,5.66,4.48,P ＜ 0.05; the group Ⅱ t =2.03,2.27,3.59,4.16,2.79,P ＜ 0.05),the spirit group Ⅰ improved more obviously compared with group Ⅱ (t =2.93,P ＜ 0.05).Conclusion Transdermal fentanyl patches provides equal pain relief compared with Morphine controlled-release tablets in the terminal cancer patients with abnormal hepatic and renal function and ascites.Transdermal fentanyl patches significantly improve health-related quality with less hepatic and renal function influence and low incidence of adverse reaction.It should be recommended in the treatment terminal cancer patients with moderate to serve pain combined with abnormal hepatic and renal function and ascites.

An experimental immunity hepatic fibrosis rat model was prepared by means of immunologic assault with human serum albumin, and normal rats served as a control group. The immunohistochemistry methods and in situ hybridization were respectively used to detect TIMP 2 mRNA and related antigens in the liver,and to investigate the localization and expression of TIMP 2 in the liver of both normal and experimental hepatic fibrosis rats. The results showed that TIMP 2 mRNA and related antigens in the livers of experimental group were expressed in myofibroblasts and fibroblasts, especially in the portal area and fibrous septum. The positive signal was located in the cytoplasm, but not in the nucleus. On the other hand, there was a high level of expression of TIMP 2 in the liver of the experimental group.It is suggested that in the process of hepatic fibrosis, fibroblasts and myofibroblasts are the major cells expressing TIMP 2. The severer the hepatic fibrosis in the injured liver is, the higher the levels of TIMP 2 related antigens and gene expression are.

Objective To analyse the relationship between T lymphocyte subsets and NK cells expression and dynamic changes in lung cancer patients 'peripheral blood and the occurrence and development of cancer,and investigate their clinical significances.Methods Flow cytometry was applied to detect 66 patients with lung cancer,60 patients with pulmonary tuberculosis and 60 healthy persons peripheral blood CD+3,CD+3CD+8,CD+3CD+4,Th/Ts,CD+16CD+56 expression.Lung cancer group peripheral blood CD+3,CD+3CD+8,CD+3CD+4,Th/Ts,CD+16CD+56 expression were also detected on 3rd,7th and 20th day before and after chemotherapy.Results Lung cancer group CD+3,CD+3CD+4,Th/Ts,CD+16CD+56 expression decreased significantly [(54.23±10.37)％,(34.23±8.03)％,1.35±0.20,(25.18±4.34)％] and had significant differences compared with pulmonary tuberculosis group [(63.09±9.19)％,(39.46±12.74)％,1.51±0.41,(26.45±3.96)％] and healthy group [(69.68±8.31)％,(42.31±13.29)％,1.89±0.48,(29.44±2.51)％](P ＜ 0.05),but CD+3CD+8 expression showed no significant difference(P ＞ 0.05).In chemotherapy group,comparing with before chemotherapy,remission group CD+3,CD+3CD+4,Th/Ts and CD+16CD+56 expression decreased significantly (P ＜ 0.01)on 3rd day after chemotherapy,while CD+3CD+8expression increased significantly(P ＜ 0.01).On 7th day,each index recovered to the level of before chemotherapy basically.On 20th day,CD+3,CD+3CD+4,Th/Ts and CD+16CD+56 expression increased significantly(P ＜ 0.05)compared with before chemotherapy,while CD+3CD+8 expression significantly decreased(P ＜ 0.05).Chemotherapy unease group had no significant difference (P ＞ 0.05).Lung cancer of stage Ⅲ A and Ⅲ B compared with stage Ⅰ A,and lymph node metastasis in N3 group compared with N0 group,CD+3,CD+3CD+4,CD+3CD+8,Th/Ts and CD+16CD+56 expression had significant differences (P ＜ 0.05).Compared with their pathological types,each index had no significant difference(P ＞ 0.05).Conclusion Monitoring the peripheral blood T lymphocyte subsets and NK cells dynamic of lung cancer patients can guide the clinical diagnosis and treatment,and contribute to the assessment of immune function.

This study aimed at investigating the effects of Chinese herbal compound Qi Kui granules on urine protein and inflammatory markers in patients with type 2 diabetic nephropathy (DN) based on the treatment of regular western medication.A randomized,parallel controlled method was involved in the present trial,and patients diagnosed with type 2 DN were randomly divided into the Chinese herb group and the control group.Regular treatment of angiotensin Ⅱ receptor blocker (ARB) in western medicine was administered in the two groups with the additional treatment of Qi Kui granules for the Chinese herb group.All the patients revisited the doctor every 4 weeks during the observation period within a 12-week course of the observation.Urinary albumin to creatinine ratio (UACR),urinary albumin excretion rate (UAER) and inflammatory cytokines in the two groups were determined.As a result,seventy-two patients in aggregate were included in the study,while 32 patients of the control group and 31 patients of the Chinese herb group effectively accomplished the observation.After the 12-week treatments,UACR and UAER were significantly decreased in the two groups (P ＜ 0.01),while the efficacy of the Chinese herb group was better than that of the control group (P ＜ 0.05).Compared with the control group,the levels of serum IL-6,tumor necrosis factor α (TNF-α),transforming growth factor f1 (TGF-f1) and urinary monocyte chemoattractant protein (MCP-1) / Cr significantly decreased after the 12-week treatment (P ＜ 0.01).It was concluded that the Chinese herbal compound Qi Kui granules successfully mitigated proteinuria in DN patients.The improvement of glomerular inflammation for renoprotection should be the mechanism behind this.

A method of direct injection and liquid chromatography coupled with tandem mass spectrometric (LC-MS / MS) was developed for simultaneous determination of 5 aniline compounds including aniline, 3-nitroaniline, 4-nitroaniline, 2,6-dichloro-4-nitroaniline and hexanitrodiphenylamine in drinking water and source water. The samples were filtered using a 0. 22-μm polyethersulfone membrane prior to HPLC analysis. Five target compounds were chromatographically separated on an HSS T3 column with gradient elution. Chromatographic data were acquired by tandem mass spectrometric detection in multiple reaction monitoring (MRM) mode, and thus favorable resolutions of all target compounds were achieved within 4 min. Under the optimal analytical conditions, the peak area of each analyte and its concentration had a good correlation within the linear range (R≥0. 995). The limit of detection (LOD) and limit of quantification (LOQ) of the method were 0. 773-1. 88 μg / L (S / N=3) and 2. 58-6. 27 μg / L (S / N=10), respectively. The intra- and inter-day relative standard deviations ( RSDs) of the mix standard solution were 0. 8% -1. 9% and 3. 3% -4. 9% , respectively. The spiked recoveries of the analytes were 84. 1% -105% and the RSDs of the spiked samples were 1. 0% -3. 1% . This proposed method was applied in the analysis of 35 samples from drinking water, source water and surface water, which indicated that the novel LC-MS / MS method could detect 5 aniline compounds in water without any complicated sample pretreatment in an accurate, sensitive and rapid way, and it also could provide technique support for evaluation of the contamination caused by aniline compounds.

Objective To definite the status of tone of autonomic nervous system during water immersion process by analyzing the nonlinear characteristic of ECG signals;To explore the relation of approximate entropy(ApEn),scaling exponent(?) changes and modulation function status of autonomic nervous system.Methods The ECG signals of rats during the process of restraint stress(RS),water-immersion restraint stress(WRS) and Vagotomy and Water-immersion restraint stress(vagotomy-WRS) were recorded.The ApEn and ? of RR intervals were calculated.Results After the stress,the differences of the value of ApEn and ? of RR intervals between RS and vagotomy-WRS groups and between different periods in vagotomy-WRS group were not significant.The value of ApEn increased in WRS group and decreased in RS group significantly.Compared with pre-stress,? showed decreased trend,all of the values smaller than 0.5 in WRS group and increased obviously,most values larger than 0.5 in RS group.Conclusion The increased ApEn and decreased ? indicates a higher intensity of parasympathetic activity.The parasympathetic activity is the predominant response of autonomic nervous system during water immersion process.

Objective Hypoalbuminemia is a typical symptom of nephrotic syndrome ( NS) , which may result from the loss of much protein with urine.Hyperbilirubinemia is also a common symptom in patients with NS.This study is intended to reveal the relationship between hypoalbuminemia and hyperbilirubinemia in patients with NS by investigating urine bilirubin, albumin( ALB ) and 24-hour urine protein in the NS group, chronic glomerulonephritis ( CGN ) group and postoperative gastroparesis syndrome ( PGS) group ( ALB<35 g/L) .Methods Totally 187 patients with NS, 70 patients with CGN and 64 patients with PGS ( ALB <35 g/L ) were recruited before ALB, urinary protein ( UPR ) , urinary microalbuminuria/creatinine(Umalb/cr) and total bilirubin(TBIL) were detected.SPSS 17.0 Software was used to analyze the difference between the three groups and to reveal the correlations between TBIL and UPR, ALB.Results TBIL, ALB, UPR and Umalb/Cr levels were significantly different between NS, CGN and PGS groups ( one-way ANOVA test, P <0.05), and TBIL was positively correlated with ALB but negatively correlated UPR and Umalb/Cr in both NS and CGN groups (Spearman′s rho test,P<0.05);but no correlation was found between these items in PGS group (Spearman′s rho test,P>0.05) .Conclusion Serum bilirubin of patients with NS is at a low level and shows significant correlations with serum albumin and urinary protein levels.No similar association is found with the other two groups.The results in this study show that the causes of low serum bilirubin in patients with NS may related to the large amount of protein lost in urine.