OBJECTIVE: To study the regular pattern and characteristics of adverse drug reactions(ADR) in our hospital.METHDOS: 93 ADR cases collected from Jan.1,2006 to Dec.31,2006 in our hospital were analyzed statistically in respect of drug categories,Sex and age distribution,routes of administration,organs and systems involved and clinical manifestations etc.RESULTS: Of the 93 ADR cases,the patients aged above 60 showed the highest proportion(47.3%);31.2% were induced by anti-infective drugs;69.9% were induced through intravenous way;and damages of skin and its appendants were the most common manifestations(35.5%).CONCLUSION: Anti-infective drugs should be used rationally to avoid or reduce the occurrence of ADR.

Objective:To investigate the correlation between anterior cruciate ligament injury and the bone contusion in the posterior of tibial plateau and the risk factors of it.Methods:Data of patients with knee trauma who came to our hospital from Oct. 2017 to Nov. 2019 were retrospectively analyzed. There are 100 males and 55 females with an average age of 40.0±10.6 years (range, 18-60). Bone contusion in the posterior tibial plateauand anterior cruciate ligament, posterior cruciate ligament, medial collateral ligament, lateral collateral ligament and fibula injury were evaluated through imaging data, and injury mechanism, age, sex and the side of injury were collected from medical records. The effect of events on bone contusion in the posterior of tibial plateau was analyzed.Results:Bone contusion occurred in 92 of the 155 patients (56 males and 36 females), with an average age of 39.6±10.5 years (range, 19-55 years). There were 45 cases on right knee and 47 cases on the left side. ACL injury: ACL was completely ruptured in 42 cases, partially ruptured in 34 cases, and had no injury in 16 cases. There were 18 cases with PCL injury, and 74 cases without any injury. There were 57 cases of non-contact injury, and 35 cases of contact injury. There were 57 cases with fibular head injury, and 35 cases without. There were 44 cases with MCL injury, and 48 cases without. There were 13 cases with LCL injury, and 79 cases without. ACL injury degree ( χ2=18.345, P<0.05) and the head of fibula ( χ2=5.495, P<0.05) injury were significantly different between the two groups. There was no significant difference in male ratio ( χ2=1.315, P>0.05), knee side ( χ2=0.880, P>0.05), injury mechanism ( χ2=3.467, P>0.05), age ( t=0.664, P>0.05), LCL ( χ2=0.010, P>0.05)、MCL ( χ2=0.029, P>0.05) and PCL ( χ2=0.161, P>0.05). ACL injury was an independent risk factor for bone contusion in the posterior of tibial plateau ( P<0.05) and the injury of fibula head was an independent risk factor for the formation of bone contusion in the posterior of tibial plateau ( P<0.05) according to logistic analysis. The possibility of bone contusion on the posterior tibial plateau in ACL complete injury was significantly greater than that of ACL partial injury ( OR=2.695, P=0.021). Conclusion:The injury of ACL and fibula head are independent risk factors for the bone contusion in posterior of tibial plateau; ACL complete injury is more likely to be associated with posterior tibial plateau bone contusion than ACL partial injury.

Objective Carotid body tumor is closely related to carotid artery .How to deal with carotid artery is the guaranty of successful surgery .The aim of this study was to summary the experience of keeping carotid artery continuity in the treatment of 15 carotid body tumor cases . Methods Clinical data of 15 cases with 17 carotid body tumors , in which 2 patients had bilateral tumors , were collected.The 17 carotid body tumors were classified as Shamblin I (6 cases),Ⅱ(6 cases) andⅢ(5 cases).Fifteen tumors were dissected simplely.Among these 15 tumors, three of Shamblin Ⅱand two of Shamblin Ⅲunderwent repair of the break of carotid artery.The rest two of Shamblin Ⅲunderwent tumor and external carotid artery excision and internal carotid artery repairment .Matas pressing test of carotid artery or carotid artery balloon occlusion test was not performed in any patient . Results All 17 tumors were successfully excised .None of the 17 tumors underwent anastomosis or reconstruction of internal carotid artery or arteria carotis com -mun.The continuity of carotid artery or internal carotid artery was kept in all the patients after tumor excision .Hoarseness and bucking induced by the injury of vagus nerve occurred in 13 cases, and bucking recovery in all the cases after 2 years follow up, and only one case remained mild hoarseness .Hypoglossal nerve injury occurred in 4 cases with tongue deviation , and the symptom recovery after 6 months follow up.No one had recurrent by the follow-up period ranging from 1 to 9 years. Conclusion Most carotid body tumors could be completely resected by tumor dissection method with the accurate treatment , thereby the continuity of carotid artery could be kept.The Matas pressing test of carotid artery or carotid artery balloon occlusion test is not necessarily to every patient .

OBJECTIVE: To explore the genetic basis for a rare case of acute B-lymphocytic leukemia (B-ALL) with double Philadelphia chromosomes (Ph) and double derivative chromosome 9s [der(9)]. METHODS: A patient with double Ph and double der(9) B-ALL who presented at Shanghai Zhaxin Intergrated Traditional Chinese and Western Medicine Hospital in June 2020 was selected as the subject. Bone marrow morphology, flow cytometry, G-banding karyotyping, fluorescence in situ hybridization (FISH), genetic testing and chromosomal microarray analysis (CMA) were used to analyze bone marrow samples from the patient at various stages. RESULTS: At initial diagnosis, the patient's bone marrow morphology and flow immunotyping have both supported the diagnosis of B-ALL. G-banded karyotyping of the patient indicated double Ph, in addition with hyperdiploid chromosomes involving translocations between chromosomes 9 and 22. BCR-ABL1 fusion gene was positive. Genetic testing at the time of recurrence revealed presence of a heterozyous c.944C>T variant in the kinase region of the ABL1 gene. FISH showed a signal for ABL1-BCR fusion on both chromosome 9s. CMA showed that the mosaicism homozygosity ratio of chromosome 9 was about 40%, and the mosaicism duplication ratio of chromosome 22 was about 43%. CONCLUSION Since both der(9) homologs were seen in 40% of cells, the possible mechanism for the double der(9) in this patient may be similar to that of double Ph, which might have resulted from non-disjunction during mitosis in the Ph chromosome-positive cell clone.
Humans ; Philadelphia Chromosome ; In Situ Hybridization, Fluorescence/methods* ; China ; Chromosome Aberrations ; Precursor Cell Lymphoblastic Leukemia-Lymphoma/genetics* ; Translocation, Genetic ; Fusion Proteins, bcr-abl/genetics* ; Chromosomes, Human, Pair 9/genetics*

OBJECTIVE：To overview and analyze the current evidence of systematic reviews of drug treatment for children with tic disorder （TD），and to provide evidence-based reference for clinical practice. METHODS ：Retrieved from Medline ，Embase， CBM，CNKI，VIP and Wanfang database ，and so on ，systematic reviews about the efficacy and safety of drug treatment for TD were collected. AMSTAR- 2 tools were used to evaluate the quality of included studies ；the intervention measures ，diagnosis standard，outcome index ，the types of included studies ，main conclusion ，control measures ，effect sizes of different drug treatment were also extracted and analyzed descriptively. RESULTS ：A total of 27 systematic reviews were included ，of which 5 were medium-quality，8 low-quality and 14 very-low-quality. Meta-analysis showed that although typical psychiatric drugs could control tic symptoms ，ADR were prominent and the safety was not good ；risperidone and aripiprazole as atypical psychiatric drugs had good efficacy and safety ，and the research evidence was relatively sufficient. Clonidine as α2 adrenergic agonist could effectively control tic symptoms with fewer ADR ，especially for patients with affention deficit and hyperactivity disorder （ADHD），and research evidence was sufficient. Tiapride could effectively improve tic symptoms ，and the overall tolerance was better. Tomoxetine and methylphenidate could significantly improve the tic symptoms of tic patients with ADHD. CONCLUSIONS ：In the clinical treatment of TD in children ，ADR induced by typical antipsychotics are prominent and the safety is not good ；risperidone， aripiprazole，clonidine and tiapride have good efficacy and safety. Clonidine ，tomoxetine and methylphenidate could significantly improve tic symptoms of TD patients with ADHD. But the quality of systematic review methodology for tomoxetine and methylp- henidate is not good and further improvement is needed.