OBJECTIVE:To investigate the characteristics and regularity of adverse drug reaction (ADR) in a third grade class A hospital,and to provide reference for rational drug use in clinic. METHODS:A total of 813 cases of ADR reported to Na-tional ADR Monitoring by the hospital during 2013-2015 were summarized and analyzed retrospectively in terms of age,gender,route of administration,drug type,organs or systems involved in ADR,clinical manifestation and outcome. RESULTS:Among 813 cases of ADR,there were 391 male (48.09%) and 422 female (51.91%). Patients aged more than 60 were with high inci-dence of ADR,involving 347 cases(42.68%). Among routes of administration,most ADR cases were caused by intravenous ad-ministration,involving 747 cases (91.88%). Among all drug types,the number of ADR cases caused by anti-infective drugs was the most,involving 382 cases(46.99%);cephalosporins took up the highest proportion,being 38.22%(146 cases). Organs or sys-tems involved in ADR were mainly skin and its appendants,involving 434 cases (53.38%). CONCLUSIONS:ADR monitoring should be strengthened for elderly patients receiving anti-infective drugs intravenously so as to reduce the occurrence of ADR and guarantee medication safety.

OBJECTIVE:To analyze the situation of the minimum sales package unit,and to provide reference for standardiz-ing package. METHODS:According to related regulations of New Edited Materia Medica(17th edition)and package inserts,373 kinds of oral drugs,57 kinds of oral drugs for lowering blood glucose,blood lipid and blood pressure,6 kinds of second kind psy-chotropic oral drugs were analyzed statistically in respect of minimum sales package unit and medication duration. RESULTS:There were 30 kinds of minimum sale package unit for 373 oral drugs,among which common capacity were 20,10,100 grain/tab-let/pill,accounting for 14.21%,14.21%,12.33% respectively,and 57.11% were used within 7 d. There were 13 kinds of mini-mum sale package unit for 57 oral drugs for lowering blood glucose,blood lipid and blood pressure,among which the common ca-pacity were 7,30,14,10 grain/tablet/pill,accounting for 33.34%,14.04%,14.04%,14.04% respectively,and 85.97% were used within 14 d,indicating sales package unit often based on weekly dosage. Among 6 kinds of type Ⅱ psychotropic oral drugs, minimum sales package unit capacity of 3 kinds were all 20 grain/tablet/pill,and those of other 3 kinds were 10,7,6 grain/tablet/pill;one of them were used more than 7 d. CONCLUSIONS:Minimum sales package unit is confirmed discretionarily. It is sug-gested that minimum sale package unit of oral drugs for lowering blood glucose,blood lipid and blood pressure should be packaged according to the dosage of 2 weeks to one nonth;the capacity of type Ⅱ psychotropic oral drugs is lower than the dosage of 7 days,and daily dose package is the best.

AIM: To investigate the clinicopathological features of orbit primary liposarcoma. METHODS: By means of histological, ultrastructural and immunohistochemical studies, the clinical and pathological features of two cases of orbit primary liposarcoma were analyzed and compared with 6 cases of primary retroperitoneum liposarcoma. RESULTS: Two cases of orbit primary liposarcoma were young persons. The majority of cases of primary retroperitoneum liposarcoma were aged over 40 years. The tumors were located at the retrobulbar region, and involved the wall of eyeball and optic nerve. The tumor cells of case 1 were round, with abundant eosinophilic granules in the cytoplasm, and there were lipoblasts in the tumor cells of two cases. Local recurrence following excision occurred in case 2.Immunohistochemical expression of S100 protein was positive in all cases, and CK (AE1/AE3), desmin, MyoD1, melanoma were negative. Ultrastructure observation showed lipid drops in the tumor cells in case 2 of orbit primary liposarcoma. CONCLUSION: Primary liposarcoma of the orbit may recur.The diagnosis was based on histological,ultrastruc-tural observation and immunohistochemical staining.

Background As a main suppressing neurotransmitter in visual system,gamma-aminobutyric acid (GABA) participates in the transmission and regulation of visual information.GABA and dopamine (DA) coexist in the visual cortex,and their mutual effects should be clarified.Objective This study was to investigate the effect of DA on GABA-activated current in vitro in cultured visual cortical neurons of rats.Methods Neutrons from visual cortex of clean neonatal rats were isolated and cultured by explant culture method.The neutrons cultured for 11 -to 14- days were collected for the record of whole cell currents of GABA-A (IGABA) channels in vitro using patch clamp technique.The DA solution (100mmol/L),SKF38393 (10mmol/L) solution and quinpirole solution(10mmol/L) were prepared with double distilled water and then the extracellular fluid was added to different concentrations.The IGABA changing rate under the action of SKF38393+SCH23390,SKF38393+Quinpirole for different time was recorded respectively and compared with that of action of DA,SKF38393,SCH23390,Quinpirole.The IGABA activated by extracellular fluid along served as control.Results The IGABA was significantly attenuated after activated by ≥10μmol/L of DA or SKF38393 separately in comparison to that of extracellular fluid action (P＜0.05).In various time of action,there were obviously differences in IGABA between DA or SKF38393 action and extracellular fluid (P＜0.05,P＜0.01).No evident change in IGABA changing rate was found after only SCH23390 action in comparison with extracellular cells (P＜0.05).However,after combination of SCH23390 and SKF38393,IGABA changing rate reduced by 19.49%.No significant differences were found in the changing rates of IGABA among different concentrations of quinpirole action groups compared with extracellular fluid group (P＞0.05);while when quinpirole was combined with SKF38393,the IGABA was elevated in comparison with only SKF38393 action group (P＜0.05).Conclusion Dopamine participates in the transfer and regulation of visual information through suppressing GABA-activated currents from neutrons of visual cortex at time-dependent manner in vitro.

Objective To explore the effect of recombinant human tumor necrosis factor-α receptor Ⅱ:IgG Fc fusion protein injection (rhTNFR:FC) on the expression of cartilage oligomeric matrix protein (COMP) in the synovial fluid and peripheral blood of juvenile idiopathic arthritis (JIA); and to explore the clinical significance of COMP for JIA and the relationship between rhTNFR:FC and COMP in JIA.Methods Thirty-five patients with JIA (JIA group),30 patients with traumatic arthritis (trauma group) and 30 patients with indirect inguinal hernia hernioplasty (normal group) were included.Peripheral blood from all enrolled patients and synovial fluid from 15 JIA and 10 trauma arthritis were obtained for COMP detection before the treatment.Fifteen JIA (group A) patients were treated with combined rhTNFR:FC,diseasemodifying antirheumatic drugs (DMARDs) and non-steroid anti-inflammatory drugs (NSAIDs),20 JIA (group B) were treated with combined DMARDs and NSAIDs.After three to six months' treatment and when the disease were in remission,peripheral blood from group A and B were drawn for COMP detection.In group A,the synovial fluid from 5 patients were obtained for COMP detection after treatment.At the same time,such as tender joint count (TJC),swollen joint count (SJC),time for morning stiffness,blood routine,erythrocyte sedimentation rate (ESR),and C-reactive protein (CRP) and other parameters before and after treatment were measured.The level of COMP was tested by double antibody sandwich enzyme-linked immunosorbent assay.The measurement data were tested for variance and independent sample t-test; and the enumeration data were tested by chi-squared or Fisher's exact test.Pearson's correlation analysis was adopted to analyze the association among the variables.Results ① The blood COMP level before treatment was (0.77±0.29) ng/ml in the JIA group,(1.00±0.28) ng/ml in the traumatic arthritis group,and (1.33±0.37) ng/ml in the normal control group.The level in the former two groups was obviously lower than that in the normal control group.The variation was statistically significant (F=25.345,P＜0.05).The comparison between any two groups was statistically significant (P＜0.05).② The COMP level in the synovial fluid before treatment were (14.8±1.6) ng/ml in the JIA group,(15.1±1.0) ng/ml in the traumatic arthritis group.The variation was not stati-stically significant (t=0.523,P=0.606).③ The serum COMP level of the systemic JIA group was obviously lower than that of the oligoarticular JIA patients,and patients with enthesitis-related arthritis and polyarticular JIA (0.26± 0.03 vs.0.87±0.17,0.89±0.22 and 0.70±0.35 ng/ml,respectively; F=9.244,P＜0.05).④ The serum COMP level of JIA at the acute phase was negatively correlated with white blood cells count (WBC),CRP and ESR (r=-0.556,-0.582 and-0.684,respectively; P all＜0.05).By contrast,no correlation was detected between the serum COMP level and joint tenderness index,joint swelling index,morning stiffness duration,hemoglobin level and platelet count(r=0.06,-0.206,-0.107,0.15 and-0.185,respectively; P all ＞0.05).⑤ The serum COMP level was obviously lower in the JIA with joint destruction than that without joint destruction (0.52±0.22 vs.0.92±0.22 ng/ml; t=5.207,P＜0.05).⑥After treatment,the blood COMP level in group A was (1.33±0.21) ng/ml and (0.96±0.22) ng/ml in group B,which was obviously higher than that in the JIA group before treatment (0.77±0.29) ng/ml.In addition,the level in group A was higher than that in group B.The variation was statistically significant (F=24.681,P＜0.05).⑦ After treatment,the COMP level in the synovial fluid (18.4± 1.1) ng/ml (n=5) was higher than that before the treatment was (14.8± 1.6) ng/ml (n =15).The variation was of statistical significant (t=4.565,P＜0.05).Conclusion The COMP level in blood and synovial fluid declines before treatment and increases after treatment.The increase is more obvious after combined with rhTNFR:FC treatment.The serum COMP level is remarkably decreased in JIA at the acute phase,systemic JIA,and the JIA with destruction of joint,and showes a negative correlation with WBC,CRP and ESR.Serum COMP may be a useful marker of active disease,destruction of joint and growth inhibition for patients with JIA.rhTNFR:FC treatment for JIA can facilitate the recovery of COMP.

Objective The CYP19 gene product enzyme aromatase mediates the conversion of the androgen testosterone to es -tradiol.The aim of this study is to investigate whether the CYP19A1 gene single nucleotide polymorphism (SNP) is associated with the susceptibility to polycystic ovary syndrome (PCOS) and serum hormone levels. Methods We conducted a case-controlled study, which included 373 PCOS patients and 313 healthy controls.We genotyped SNP rs2899470 in the subjects using the polymerase chain re-action-restriction fragment length polymorphism ( PCR-RFLP) method and analyzed the frequencies of genotypes and alleles as well as the association of different genotypes with age , menarchal age, body mass index (BMI), and serum levels of hormones. Results The gen-otypic distributions of rs2899470 GG, TG, and TT in the PCOS women were 44.5%, 49.6%, and 5.9%, respectively, significantly dif-ferent from 39.3%, 48.6%, and 12.1%in the healthy controls (P=0.013).The frequency of the G allele was 69.3%in the former, remarkably higher than 63.6%in the latter (P=0.025).The rs2899470 genotypic frequencies were associated with the serum E 2/T lev-els in the PCOS patients. Conclusion SNP rs2899470 in the CYP19A1 gene is associated with the susceptibility to PCOS , and so is the genotype of rs2899470 with serum E2/T levels, which may be attributed mainly to the reduced activity of aromatase .

Objective:To study the moxibustion at Guanyuan(CV 4)and Tianshu(ST 25)on intestinal dvsbacteriosis in rats.Methods:Fifty Wistar rats,clearing grade,were randomly divided into 5 groups,a normal group,a model group,a medical group,and a Guanyuan(CV 4)group and a Tianshu(ST 25)group,with 10 rats in each group.The rats were treated with Lincomycin Hydrochloride via intragastric administration for developing models.The model rats were treated with medicine and moxibustion respectively.0.1 g fresh rat feces in each group were cultured on the selective culture medium of bifidobacterium species(BS),lactobacillus(LBS),enterobactefiaceae(EB)and enterococcus(EC).The growth and quantity of the bacterial colony were tested by biochemical identification tubes and turbidimetry.Results:Moxibustion at Guanyuan(CV 4)increased BS and LBS while moxibustion at Tianshu(ST 25)improved EB and EC.Conclusion:Moxibustion at Front-Mu points Of different body parts selectively regulated advantaged probiotics for treating intestinal dysbactenosis.

Objective To investigate the condition and causes of needle-stick injuries among health care workers(HCWs), and explore effective strategies for preventing needle-stick injuries.Methods Needle-stick injuries recorded by healthcare-associated infection management department in a hospital between January 2013 and December 2015 were surveyed retrospectively.Results 164 HCWs suffered needle-stick injuries, including 71 (43.29%) doctors, 81 (49.39%) nurses, and 12 (7.32%) other HCWs.The number of injuries in 2013, 2014, and 2015 were 47(28.66%), 54(32.93%),and 63(38.41%)respectively.152(92.68%), 9(5.49%),and 3(1.83%)injuries were caused by contaminated medical instruments, uncertain-contaminated medical instruments, and non-contaminated medical instruments.Among 164 cases of needle-stick injuries, 67(40.85%) occurred in operating rooms, 141 (85.98%) were finger injuries;the main causes of needle stick injuries were carelessness, busy work and nonstandard manipulation(n=115, 70.12%), most doctors suffered needle stick injuries due to the lack of experience (52.11%), most nurses suffered needle stick injuries due to carelessness, busy work and nonstandard manipulation(93.83%).Conclusion Needle stick injuries among HCWs increased year by year, strategies should be implemented to reduce the occurrence of needle injuries, including strengthening occupational protection consciousness among HCWs, strengthening construction of healthcare-associated infection management system, and improving medical environment.

Objective:To understand the medication safety events about cephalosporin in our hospital in order to provide evidence for the better medication safety of cephalosporin. Methods:Adverse drug reaction ( ADR) reports, medication error ( ME) reports and drug quality problem records about cephalosporin in our hospital were collected and the critical indicators in the reports were analyzed. Re-sults:The ADR reports selected in our hospital were mainly reported by pharmacists. More males were involved in the related patients, and young adults were in the majority. Second and third-generation cephalosporin were the major drugs used in the reports. The damages in skin and its appendages were the major damages in organs. The ME reports selected in our hospital were totally reported by pharma-cists. Errors in frequency and dose of drug administration were the most common, and the main causes were lack of knowledge and train-ing. No serious quality problem in cephalosporin was found in our hospital, and the inner and outer packaging in damaged conditions was the most common problems in our records. Conclusion:Cephalosporin as one widely used antibacterial agent is considered safe and effec-tive. Because of its large amount of application, cephalosporin should be paid more attention by health care professionals. MEs should be avoided as far as possible. ADRs should be treated timely and properly in order to decrease medical disputes. More attention should be paid to ensure security of drug use for patients.

Objective To investigate skin manifestations and comorbidities of chronic arsenicosis due to conta?minated drinking water, and to explore their possible risk factors. Methods Data about demographic characteristics, skin manifestations and comorbidities were collected from 95 patients with chronic arsenicosis due to contaminated drinking water in Inner Mongolia, and retrospectively analyzed. A logistic regression model was established to analyze associations of skin manifestations and comorbidities with patients′ gender, age, age at onset of drinking of arsenic?contaminated water, arsenic concentrations in water and duration of arsenic exposure. Results Among the 95 patients, 77 had hyperpigmentation, 75 hypopigmentation, 93 palmoplantar keratoderma, 27 skin cancer, and 8 multiple skin cancer. Five patients were complicated by tuberculosis, 15 by hypertension, 2 by rheumatoid arthritis, 4 by cerebral infarction, 7 by coronary heart diseases, 3 by internal malignancy, 6 by hepatic cirrhosis and 2 by anemia. Logistic regression analysis revealed a significant correlation between hyperpigmentation and arsenic concentrations in water(OR=0.32, 95%CI=0.10-0.98;ORadjusted=0.27, 95%CI=0.08-0.90), between occurrence of hepatic cirrhosis and arsenic concentrations in water (OR=24.67, 95%CI=2.69-226.57;ORadjusted=22.51, 95%CI=2.38-213.11), and between occurrence of coronary heart diseases and duration of arsenic exposure(OR=6.41, 95%CI=1.09-37.88;ORadjusted=8.55, 95%CI=1.21-60.41). Conclusions There is a high incidence of aberrant pigment metabolism, palmoplantar keratoderma and skin cancer in patients with chronic arsenicosis due to contaminated drinking water. Different arsenic concentrations in water and duration of arsenic exposure seem to have different influences on the human body.