This paper reviews briefly the roles of these two ri sk factors in influenza epidemic, and the progress of the research on serologica l and molecular epidemiology of the influenza viruses antigenic mut ation.

Obstructive sleep apnea hypopnea syndrome(OSAHS)is a serious health hazard in children.It can cause damage to multiple systems, including cardiovascular, metabolic, endocrine and neurocognitive systems, especially for cognitive impairment.OSAHS may cause sleep fragmentation and intermittent ventilation abnormalities due to repeated partial or total upper airway obstruction, resulting in hypoxemia and hypercarbia, affect attention, intelligence, memory, language, executive function, etc.

OBJECTIVE:To gain a clear idea of difference of drug requirement and DDD between senile women and men patients,so as to provide a scientific basis for safely,effectively,economically and rationally preventing and treating diseases of senile patients and improving their quality of life METHODS:A 2-year(1998～1999)prescription database,which was set up by PRESCRIPTION ANALYSIS research group of 22 hospitals in Beijing,was used for this study Information of senile out-p_atients(≥60 years old)was collected and analysed Foxpro software was used for statistics and analysis RESULTS:The prescription rate for senile male patients was 11 6%,whereas that for senile female patients was 8 3% Proportion of injection for per hundred male out-patients was 17 0% and that for female patients was 20 4% The main kinds of drugs used for both male and female patients were cardiovascular drugs and vitamins,the DDDs of which were lower than those defined by WHO and drug directions,however,the DDDs for male patients were higher than those for female The rate of consultation for cardiovascular disease was high in both sexes Prostate diseases in senile male patients and diabetes in female should be given more concern The drugs used for both sexes accorded with National Essential Drugs List(men 85%;women 87 5%) CONCLUSIO_N:The rate of prescription and DDDs for senile male patients were higher than those for female,however,the proportion of injections for per hundred male patients was lower than that for female

Objective To clarify the features of malignant ovarian neoplasms arising from ovarian endometriosis Methods A total of 26 women with malignant ovarian neoplasms arising from ovarian endometriosis were analyzed retrospectively Results Dysmenorrhea and pelvic mass were the most common clinical features Among 18 cases who underwent B ultrasound or color doppler ultrasound examination, solid foci in the pelvic masses were found in 10 cases The main histologic types of ovarian malignancy were endometrioid adenocarcinoma and clear cell carcinoma Microscopically atypical endometriosis with the tumors were found in 15 cases International Federation of Gynecology and Obstetrics stage:stage Ⅰ 21(81%)cases,stage Ⅱ 3(12%)cases,stage Ⅲ 2 (8%)cases Conclusions Clinical diagnosis of malignant ovarian neoplasms arising from ovarian endometriosis in early stage is difficult, and B ultrasound examination is more valuable for diagnosis It is suggested that close serutiny of endometrial hyperplasia, cellular atypia and malignancy in ovarian endometriosis be essential to understand the origin and development of malignant neoplasms arising from ovarian endometriosis

Objective To investigate the microvessel density of stomach tumor and the relationship between the microvessel density and CT findings.Methods Conventional contrast-enhanced CT scans were performed in 64 patients with stomach tumor(OMNIPAQUE 100 ml,3.0 ml/s),the images at 45 s were gained.After operation,the specimens with partial normal stomach tissue were dealed with injecting the contrast medium through its feeding arteries(10 ml/100 g,within 30 min),then,the specimens underwent CT scan(delayed time 10 s and 20 s),the nets of blood vessel of the masses were reconstructed by post-processed.The density of masses was evaluated in comparison with the enhanced effect of masses before operation.The pathological examinations of specimens were done and the microvessel density of tumors were measured through immunohistochemical technique.The hemodynamic characteristics of tumors were analysed.Results In tumors,the highest density(D)increased with the tumor rank(beside dead band).The visive vessels of specimen were more than that on conventional contrast-enhanced CT,but the D/d(the highest density in the masses/the density in normal stomach tissue)was basically consistent.Conclusion For gastric carcinoma,the D/d ratio can reflect the microvessel density of the tumors on certainly and the hemodynamic characteristics of tumors.

Objective To study the efficacy of disodium pamidronate in the treatment of patients with primary hyperparathyroidism (PHPT) complicated by hypercalcemic crisis.Methods A total of 9 patients (12 cases) admitted into our hospital were diagnosed as PHPT complicated by hypercalcemic crisis.Of them,4 patients had parathyroid carcinoma,3 patients had parathyroid adenoma,2 patients had parathyroid hyperplasia.The intravenous disodium pamidronate was given for 12 times in all 9 patients.Serum calcium were monitored before and after treatment.Results Before the treatment,the serum calcium levels was 3.75 (3.66,3.99) mmol/L.On the second and third day after the treatment with disodium pamidronate,the serum calcium levels were 3.44 (2.95,3.78) mmol/L and 2.79 (2.50,3.14) mmol/L.The lowest level of serum calcium after treatment was 2.25 (2.00,2.55) mmoL/L.There were significant differences in the level of serum calcium of different days (P ＜ 0.05).On the second and third day,the change of serum calcium were 0.46 (0.10,0.88) mmol/L,0.60 (0.25,0.75) mmol/L,there were no differences.After intravenous disodium pamidronate,the serum calcium level decreased below 3.5 mmol/L in (2.27 ± 0.65) days,and were kept below 3.5mmol/L for 18.45 ± 12.30 days.Conclusions Disodium pamidronate can decrease serum calcium levels in hypercalcemic crisis caused by primary hyperparathyroidism effectively with mild adverse events.

Objective To investigate operation time on biliary duct stone with acute gallstone pancreatitis.Methods The clinical data of 44 patients with acute gallstone pancreatitis who were admitted to Department of General Surgery,Taicang First People's Hospital for surgical management from January 2011 to December 2013 were retrospectively analyzed.Patients were divided into early surgery group and delayed surgery group according to the timing.Early surgery group was defined as the patients whose symptoms of pancreatitis were basically disappeared after conservative treatment and surgery was performed within two weeks,while delayed surgery group was defined as the patients who underwent surgery after two weeks.Results Of the 44 acute gallstone pancreatitis cases,18 patients were males,and 26 were females,with median age of 54 years old (range 26-83 years old).Forty-two cases were mild acute pancreatitis and the other two cases were severe acute pancreatitis.Preoperative imaging indicated both cholecystolithiasis and choledocholithiasis in 5 patients,cholecystolithiasis alone in 39 patients.The 5 patients underwent cholecystectomy and choledocholithotomy with T-tube drainage.Among these 5 cases,one patient with concomitant acute suppurative cholangitis had an emergency surgery,two patients with Ranson score ≤3 had early surgery,and two patients with Ranson score ≥4 had delayed surgery,and all the patients were cured and discharged.Thirty-nine cases with cholecystolithiasis alone were treated with laparoscopic cholecystectomy.Among the 39 patients,25 patients underwent early laparoscopic cholecystectomy,and the other 14 patients underwent delayed surgery,and all the patients were cured and discharged.When compared with delayed group,the average age and Ranson score of early group were lower [(46 ± 12) yrs vs (64 ± 11) yrs and (1.0 ± 0.5) vs (1.5 ± 0.8)],and the median hospital length of stay and the cost were significantly less in the early group than those in the delayed group [(14.0 ± 2.8) d vs (18.1 ± 3.3) d and (17 899 ± 3461) Yuan vs (23 710 ± 3230) Yuan],and the difference between the two groups was statistically significant (P＜0.05).Nevertheless,there was no difference between the operation time and recovery time.There was no conversion to open surgery or post-operative complication in the two groups.Conclusions For severe acute pancreatitis,the delayed operation is recommended when the symptom of pancreatitis is completely improved after conservative management,while for mild acute pancreatitis,early surgery does not increase operation difficulty and complication,and it can decrease the length of hospital stays and costs.

Objective To find antitumor cOnstituents from Tripterygium hypoglaucum.Methods The chloroform extract of T.hypoglaucum was separated by silica gel column chromatography and preparative HPLC.The structures of compounds isolated were identified by spectral analysis and chemical evidence.Results Seven compounds were isolated and identified as rhein ethyl ester(1),chrysophenol(2),physcion(3),emodin(4),wilfordine(5),wilforgine(6),and wilforine(7).The cytotoxic activities of the compounds against cancer cell lines were assayed.Conclusion Compound 1 is a new natural compound with strong activities against human cancer cell lines (A2780 and OVCAR-3).Compounds 2-4 are isolated from this genus plants for the first time.The possible structure-activity relationship among compounds 1-4 shows that the methoxy group or oxyethyl moiety might be responsible for the cytotoxity.

Objective To evaluate the value of real time continuous blood glucose monitoring system (RT-CGMS) versus intermittent blood glucose monitoring (IGM) in the critically ill patients under intensive insulin therapy (IIT).Methods A systematic searching randomized and controlled trials (RCT) in databases was performed for meta-analysis by Review Manager 5.2 software.Outcomes were hypoglycemia episode,alteration of mean blood glucose level,the percentage of time at a blood glucose level within optimal target range,and the early mortalities.Results Six studies,totally 531 patients,were included in this meta-analysis.The pooled SMD of mean blood glucose level was =-0.21 (95％ SMD:-0.43-0.01,P=0.07).The pooled SMD of percentage of time at a blood glucose level within optimal target range was 0.20 (95％ SMD:-0.09-0.49,P =0.18).The pooled OR of hypoglycemia episode frequency was 0.20 (95％ CI:0.09-0.43,P ＜ 0.01).The pooled OR of early mortalities was 0.35 (95％ CI:0.14-0.89,P =O.03).Conclusions In critically ill patients under the intensive insulin therapy,RT-CGMS had obvious beneficial effect on reducing hypoglycemic events.RT-CGMS had no obvious beneficial effect on keeping blood glucose level within optimal target range.

OBJECTIVE:To provide reference for the establishment of prevention and control measures for medication errors. METHODS:Based on JCI standard,51 cases of medication error reported by ADE information platform of our hospital in 2012 were summarized,and analyzed in terms of error type,error time,working life of responsible person,etc. The prevention and con-trol strategies were introduced. RESULTS:Referring to related requirements of JCI standard,medication errors reduced significant-ly during 2013-2014 through personnel training and education,system improvement and process optimization. CONCLUSIONS:Medication errors surveillance and control is important for the promotion of rational use of drugs. JCI standard has played an impor-tant role in monitoring and preventing medication errors.