OBJECTIVE:To discuss the characteristics and regular patterns of adverse drug reactions (ADRs) induced by Qingkailing injection for references of clinical rational drug use. METHODS:ADR cases induced by Qingkailing injection reported in Chinese pharmaceutical journals from 2003 to 2005 were retrieved and analyzed statistically. RESULTS:The ADRs induced by Qingkailing injection were more often seen in men than in women, with children and young adults showing higher percentages. Allergic reactions were the main type of adverse drug reactions. Of the total ADR cases induced by Qingkailing injection, 22 cases(33.33%) were anaphylactic shock,15(22.73%) were allergic reactions,10(15.15%) were allergy of circulation system. CONCLUSION:The ADRs induced by Qingkailing injection may be resulted form many factors, which should be given fully attention in the clinic. ADRs monitoring should be stressed when this drug being used by western medicine physicians to make sure rational use of which and to reduce incidences of ADRs.

OBJECTIVE:To investigate the situation and characteristics of serious adverse drug reactions (ADR) occurred in our hospital in order to promote rational clinical drug use. METHODS: 25 severe ADR cases collected in our hospital from Jun. 2004 to Dec. 2006 were analyzed statistically and evaluated based on the ADR causality judgment criteria. RESULTS: The 25 severe ADR were associated with 21 kinds of drugs, with anti-infectives (12 kinds) making up the highest proportion, followed by traditional Chinese medicine preparations. The main systems involved in he ADR were skin and its appendages and nervous system. 3 new and severe ADR cases were found to have no report in package inserts or literature. CONCLUSION: Severe ADR may be induced by many factors, therefore, it is necessary to strengthen the awareness of rational drug use to guard against severe ADR and ensure safe and effective medication.

Objective: To investigate the mechanisms of chlorogenic acid (CGA) on regulating carbohydrate metabolism in skeletal muscle of SD rats fed on high-fat diet. Methods: Forty male SD rats were randomly divided into five groups: normal control (NC), high-fat diet (HFD), HFD with low-dose-CGA (20 mg/kg, HFD-LC), HFD with high-dose-CGA (90 mg/kg, HFD-HC), and Rosiglitazone (HFD-ROS) groups. NC rats were fed with normal chow diet, while the other rats were fed with HFD. The rats were killed after 12 weeks, and the real-time PCR method was used to measure the expression levels of GLUT-4, PKA, Akt, AMPKα2, IRS-1, PI3K, and PPARs mRNA in skeletal muscle. Results: The expression levels of GLUT-4, AMPKα2, and PPARβ in HFD group were more dramatically decreased than those in the NC group (P<0.05); Compared with the HFD group, CGA increased genes involved in carbohydrate metabolism, particularly Akt, PI3K, IRS-1, GLUT-4, PKA, AMPKα2, PPARα, and PPARβ in HFD-HC group (P<0.05). Conclusion: High-dose CGA could significantly slow the weight gain induced by HFD, as well as improve carbohydrate metabolism in skeletal muscle through regulating PI3K/Akt and AMPK signaling pathways, and insulin sensitivity.

Adult ; Aged ; Aged, 80 and over ; Cerebrovascular Circulation ; Cervical Vertebrae ; pathology ; Female ; Humans ; Male ; Manipulation, Spinal ; Middle Aged ; Spinal Osteophytosis ; diagnostic imaging ; therapy ; Tomography, Spiral Computed ; Vertebral Artery ; diagnostic imaging ; pathology ; Vertebrobasilar Insufficiency ; diagnostic imaging ; therapy

Objective To assess the causes of sildenafil failure and the feasibility of successfully rechallenging non-responding patients. Methods A total of 126 consecutive erectile dysfunction (ED) patients from Jan 2009 to Dec 2009 who claimed poor response to sildenafil (sildenafil 100 mg on demand, at lease 4 epiodes) were enrolled into the study. All patients received sexual reeducation and were treated with sildenafil, taken on a daily dose of 50 mg for 4 weeks. The International Index of Erectile Function-5 (IIEF-5), Rigiscan, serum testosterone or penile Doppler were used to evaluate ED and the cause of on-demand sildenafil failure. End point efficacy of rechallenging was evaluated using the IIEF-5 and the sexual encounter profile (SEP) 'Were you able to insert your penis into your partner's vagina?' and 'Did your erection last long enough to achieve successful intercourse?'. Results The recruited patients comprised of 41 cases with psychological ED, 39 cases with hypogonadism ED, 28 cases with diabetes mellitus ED and 18 cases with vascular ED. Compared with pretreatment and on-demand sildenafil baseline, daily administration of sildenafil significantly enhanced all efficacy outcome variables. The IIEF-5 was significantly improved after daily sildenafil (12.3 ± 2.9 vs18. 8±4.4, P＜0.01), 78 patients responded to daily sildenafil. The overall salvage rate was 61.9%(78/126). Conclusions Sexual reeducation and daily administration of sildenafil may be able to salvage many patients with ED who were sildenafil non-responders.

Objective To estabalish a new conception, Erectile Dysfunction-no sexual life (ED-NS), so as create an evaluating questionnaire, Self-estimation Index of erectile function-No sexual life (SIEF-NS) so as to investigate its clinical reliability. Methods The conception of ED-NS was identified and the SIEF-NS questionnaire was established. Patients who complained of ED-NS and normal controls were enrolled into the research and assessed the erectile function was assessed with SIEF-NS.The SIEF-NS includes 12 questions, such as sexual libido, general erectile function, nocturnal penile erection, erectile function during foreplay, erectile function during audio-video sexual stimulation,confidence, depression, etc and each question has 5 point scales. Results Sixty-one ED-NS patients and 57 controls were enrolled into the study and assessed erectile function with SIEF-NS. The mean score of each question and integral score of SIEF-NS in ED-NS patients were significantly different from normal controls (P＜0. 05). When the integral score was 35 points according to the ROC curve of integral score, the sensitivity of SIEF-NS was 88.5% and specificity was 96. 5%. Conclusions ED-NS is a new conception to define patients who have erectile dysfunction without sexual life. SIEFNS is suggested to be a useful method for the evaluation of ED-NS patients.

BACKGROUND:Recently,with the rapid development of material science and bioscience,the technology of dental implant has made great progress,especially the immediate implant technology.But the size and shape of implant are usually not fit for tooth extraction wound,so it is an important factor that leads to failure when implant and tooth extraction wound can not form close tangency.Guided bone regeneration or bone grafting materials are usually used to solve this problem.OBJECTIVE:To study the effects of nano-hydroxyapatite/collogen (nHAC) with recombinant human bone morphogenetic protein-2(rhBMP-2) and titanium (Ti) membrane on repairing peripheral bone defects of instant implant.DESIGN,TIME AND SETTING:A randomized,controlled animal study was performed at the Central Laboratory,the Fourth Military Medical University of Chinese PLA between January 2005 and January 2006.MATERIALS:Ti screw implants (diameter 2 mm,length 10 mm,and pitch 0.4 mm) without the part that went through gum were offered by Nonferrous Metal Academy in Baoji,China.The nonabsorbable Ti membranes (2 cm×2 cm) were offered by Zhongbang Biomaterial Limited Company in Xi'an,China.The nHAC materials were gifted by professor Cui Fu-zhai from Material Science and Engineering Department of Tsinghua University and fabricated into 0.5 mm×0.5 mm×0.5 mm small blocks.rhBMP-2 was offered by the Academy of Military Medical Sciences in Beijing,China.rhBMP-2 was dissolved with hydrochloric carbamidine and then nHAC was immersed in it.Vacuumization,freeze-drying,and Ekibon degermation were followed.Each gram of nHAC compounds required approximately 1 mg rhBMP-2.METHODS:Four healthy purebred male dogs were included in this study.According to the methods to repair bone defects rhBMP-2+Ti membrane,nHAC composited with rhBMP-2 was implanted,covering Ti membrane.Six defects were made on the mandible on each side.MAIN OUTCOME MEASURES:At 6 and 12 weeks after implantation,new bone formation and the correlation of new bone to Ti implant were investigated by radiography,bone density measurement and histological examinations.RESULTS:All the bone wounds were full of new bone at 12 weeks,the Ti implants were steady and the osseointegration was good.In the nHAC+rhBMP-2 and nHAC+rhBMP-2+Ti membrane groups,new bone formed and maturated earlier.In the nHAC +Ti membrane,blank control,and nHAC + rhBMP-2 +Ti membrane groups,new bone formed well below Ti membrane and the alveolar crest was plump.In the nHAC + rhBMP-2 +Ti membrane group,new bone formed earliest with the most quantity and the alveolar crest was the plumpest.By 12 weeks,the bone density had achieved the same level as the autologous cancellous bone transplantation,but the alveolar crest was plumper compared to the positive control group.In addition,bone mass was much more.Bone formed slowest in the blank control group and fastest in the positive control group with the crest of ridge being slightly absorbed.CONCLUSION:nHAC is a new good bone graft material in repairing peripheral bone defects of instant implant,especially compositing with rhBMP-2 and/or Ti membrane.A round method to repair the surrounding bone defect of instant implant should be selected according to the specific situation in the clinic.

Objective To explore the CT findings of mucoepidermoid carcinoma (MEC) of the tracheobronchial tree and improve the diagnostic accuracy. Methods The CT images, histopathological and clinical data in 24 patients with pathologically proved MEC of the tracheobroncbial tree were retrospectively analyzed. Results The clinical symptoms included cough, sputum, fever, wheezing, chest pain and hemoptysis. The patient was proved to be low-grade (n=19) and high-grade (n=5) MEC histopathologically. One lesion was located in trachea, 6 in main bronchus, 12 in lobar bronchus and 5 in segmental, subsegmental and distal bronchus. The tumor presented as no-invasive endotracheobronchial well-defined round-like nodule (n=13, locating in lobar and higher bronchus) and columnar sharp (n=3, locating in main bronchus), or intra-and-extraluminal well-defined round-like nodule or mass (n=6, locating in lobar and lower bronchus) and irregular mass with invasive pattern (n=2, high-grade type). The density of lesion was similar to the muscule and the calcification within lesion was showed in 4 patients on non-enhanced CT. The lesion had marked enhancement in 17 patients on enhanced CT. Obstructive changes were found in 20 patients. Conclusion MEC of the tracheobronchial tree is usually low-grade malignancy and locates in main and lobar bronchus with no-invasive well-defined airway mass, marked enhancement and calcification on CT.

Objective To review the clinical manifestation,pathological characteristics,treat ment and prognosis of malignant mesothelioma of the tuniea vaginalis testis.Methods A case of ma lignant mesothelioma of the tunica vaginalis testis was reported and relative literature was reviewed.A34 year old man was admitted to hospital with a history of aggravated hydroeele for 5 years.A hardtumor was palpated above the right testis,which was smooth and slight tenderness.The level of β-hCG and AFP was normal.Ultrasonography revealed a 2.05 cm× 1.97 cm,well demarcated,mixedecho tumor.Results An operation was performed to incise the tumor and tunica vaginalis undersubarachnoid space block anesthesia.The tumor was histologically diagnosed as low potential malig nant mesothelioma of the tunica vaginalis testis.Microscopic examination showed that the tumor wasmalignant with a biphasic pattern composed of epithelial and stromal components.The former compo nent was dominant.The epithelial cells proliferated obviously with atypia and mitosis.Immunohisto chemical staining showed cytokeratin and vimentin were strongly positive.The capillary,lymph ves sel,spermatic cord and testis were not infiltrated.Right radical orchiectomy and right scrotectomywas performed one month after the first operation.There was no evidence of relapse during 38 monthfollow up after operation.Conclusions The major symptom of patients with malignant mesotheliomais hydrocele,malignant mesothelioma is diagnosed by histopathology.Due to the invasive potential ofthis disease and the risk of tumor recurrence,radical orchiectomy and close follow up are strongly rec ommended.

Objective To investigate the angiographic manifestation of the proper esophageal artery (PEA),the hish risk factom for the presence of the anomalous PEA in hemoptysis and to evaluate the safety of transcatheter aaefial embolization(TAE) of the PEA using gelatin sponge(GS).Methods Selective esophageal arteriography WSS performed in forty-three patients with hemoptysis,including 15 cases of pulmonary tuberculosis,18 cases of bmnchiectasis,7 cases of posttuberculous bronchiectasis and three cases of lung cancer. One case experienced failure of bronchial arterial embolization. The angiographic manifestation of the PEAs Was studied.The complications of the procedure and clinical results were observed in the patients who underwent TAE using GS.Results Thirty-nine PEAs were catheterized selectively in 37 patients(86.0%).Eighteen anomalous PEAs(46.2%)were catheterized selectively in 17 patients (45.9%).The anomalous PEAs showed tortuosity,dilatation,hyperplasia,shunting with pulmonary artery and anastomosis with the bronchial artery.All lesions involved basal segment of inferior pulmonary lobar. Bronchiectasis Was the most frequent disease for PEA abnormality. No complications occurred and satisfactory curative effect Was achieved with TAE of the anomalous PEAs.Conclusions It is necessary to perform selective proper esophageal arteriography when the lesion involves basal segment of inferior pulmonary lobar in hemoptysis.Supplemental TAE of the anomalous PEA using GS is safe and valuable in the management of hemoptysis.