Antithyroid drugs(ATD)is the main treatment for hyperthyroidism and its adverse reactions have been much concerned by physicians. Methimazole(MMI)and propylthiouracil(PTU)are the two common antitithyroid drugs used currently. Generally, the ATD are safe and effective, though their clinical adverse reactions are also relatively common. The toxic effects include liver damage and leukocytopenia, antineutrophil cytoplasmic antibody-associated pulmonary small-vessel vasculitis, hypoglycemia, allergic reactions, muscle impairment,and so on. They are usually reversible and disappear spontaneously when the drug is discontinued. However,the serious rare side effects can also occur and there may have potentially deadly threatening effects which need to be cautious for the clinicians. MMI is usually preferred over PTU because it has significantly fewer side effects. And unlike the dose-dependent side effects of MMI, there has no significant correlation between adverse reaction and drug dosage in using PTU. Moreover, PTU has more severe hepatotoxity than MMI, even fatal liver impairment and liver failure. The risk of liver damage from PTU is an important concern, particularly in children. For this reason, MMI is the first choice for treating children with hyperthyroidism.

Parathyroid carcinoma is a rare endocrine tumor.Clinical manifestations are varied with multiple organs involved,mainly due to hypercalcemia.So far the etiology and pathogenesis of parathyroid carcinoma are still unclear and preoperatively diagnosis is difficult.Technetium-99 m sestamibi scan and ultrasound can help to find the early lesions.Complete surgical resection with suspicious involved lymph nodes is the recommended treatment.Parathyroid carcinoma is insensitive to chemotherapy and radiotherapy.New immune therapy yields unsure efficacy.Therapeutic effect and prognosis mainly depend on primary surgical resection of the tumor.The disease recurs in more than 50％ of patients with poor prognosis.

Objective:To improve the work of drug quality sampling and testing. Methods:The regulation of testing related work in Drug Quality Sampling and Testing Regulation was analyzed and discussed. Results and Conclusion: Some suggestions were pro-vided in order to improve the regulation of testing work in Drug Quality Sampling and Testing Regulation.

Humans ; Medical Staff ; Occupational Exposure ; prevention & control ; Occupational Health

Health Promotion ; Humans ; Occupational Health ; Prospective Studies ; Workplace

Objective To analyze the clinical significance of aberrant hepatic artery which originated from superior mesenteric artery in liver cancer and gastric cancer operations.Method Four hundred liver cancer patients who underwent digital subtraction angiography (DSA) and multislice spiral computed tomography angiography (MSCTA) and 86 gastric cancer patients who underwent MSCTA between June 2008 and June 2010 and operated at the First Affiliated Hospital of Guangxi Medical University were included in this study.Preoperatively,the origins of the aberrant hepatic arteries from superior mesenteric arteries were detected by medical imaging.Postoperatively,immunohistochemistry of lymphoid tissues around the aberrant hepatic arteries of the gastric cancer patients were performed using recombinant human cytokeratin 20 (CK20) and carcino-embryonic antigen (CEA) to determine the incidence of lymph node metastases around the aberrant arteries.Results Among 486 patients,49 patients with liver cancer and 14 patients with gastric cancer had an aberrant hepatic artery which originated from the superior mesenteric artery.The rate was 12.96％ (63/486).The hepatic artery ran in front of the pancreas in 2 patients (3.17％) and behind the pancreas in 61 patients (96.83％).Immunohistochemical analyses of CK20 and CEA were negative which revealed no metastases in the lymphoid tissues surrounding the aberrant arteries.Conclusions Aberrant hepatic artery originated from the superior mesenteric artery can be classified into the pre-pancreas type and postpancreas type.The majority of aberrant hepatic artery belonged to the post-pancreas type.The clinical significance of aberrant hepatic artery is that the hepatic hilar lymph nodes should be dissected in liver cancer and gastric cancer operations.

The identification and classification of Thermus to Thermales is revie wed. Up to now, the order Thermales is consist of only one family Thermaceae, w h ich includes 4 genera with 14 valid species about 50 strains, and with 4 unvalid spcecies and more than 50 strains unidentified. The morphology, physiology, G+ C mol%, DND hybridization, fatty acid components, 16S rRNA alignment and secondar y structure analyses have been tools for the taxonomy of Thermales.

Objective: To explore the therapeutic efficacy and mechanism of transcutaneous electrical acupoint stimulation (TEAS) for menopausal insomnia. Methods: A total of 80 patients with menopausal insomnia were randomly divided into a control group and an observation group, with 40 cases in each group. The patients in the control group received conventional Western medication treatment, and the patients in the observation group received TEAS on the basis of conventional Western medication treatment. The treatment for both groups lasted for 4 weeks. Before and after treatment, Pittsburgh sleep quality index (PSQI) and modified Kupperman scale were evaluated, and the serum levels of estradiol (E2) and follicular stimulating hormone (FSH) were measured. The therapeutic efficacy was evaluated after treatment. Results: After treatment, the total effective rate of the observation group was significantly higher than that of the control group (P<0.05); in the control group, the improvement of PSQI score was significant (P<0.05), while the change of modified Kupperman score was insignificant (P>0.05); the PSQI and Kupperman scores in the observation group were significantly improved after treatment (both P<0.05), and there were significant differences between the observation group and the control group in PSQI and Kupperman scores (both P<0.05). After treatment, the serum E2 and FSH levels in the control group were not statistically different from those before treatment (both P>0.05); the serum E2 level was significantly increased (P<0.05), and the FSH level was decreased (P<0.05) in the observation group after treatment, and the between- group differences in serum levels of E2 and FSH were significant (both P<0.05).Conclusion: TEAS plus conventional Western medication in treating menopausal insomnia is effective, and can significantly improve the symptoms of insomnia and menopause, which may be related to the regulation of serum E2 and FSH levels.

Objective To reduce the incidence rate of sepsis caused by multidrug-resistant acinetobacter baumanni and provide the basis for clinical antibiotics use.Methods It is one retrospective case-controled study.Thirty-six patients with multidrug-resistant acinetobacter baumanni infection(case group) and 42 patients with non-multidrug-resistant acinetobacter baumanni infection(control group) admitted in PICU during 2009 to 2013 were enrolled in the study.Seven high risk factors including the irrational antibiotics use,the length of hospital stay,tracheal intubation,the length of mechanical ventilation,the basic diseases (hematologic malignancies,congenital heart disease,inherited metabolic diseases),use of central venous catheters and the length of using central venous catheters were analyzed.The drug sensitivity of multidrug resistant acinetobacter baumanni was detected.Results There were significantly differences in 7 high risk factors between case group and control group,including irrational antibiotics using (29 cases vs.18 cases),the length of hospital stay ＞7 d(35 cases vs.12 cases),tracheal intubation(22 cases vs.8 cases),mechanical ventilation ＞ 7 d (19 cases vs.2 cases),basic diseases (9 cases vs.3 cases),using of central venous catheters (18 cases vs.2 cases) and central venous catheters using ＞ 7 d(9 cases vs.1 cases) ;multidrug resistant acinetobacter baumanni had high resistance against penicillins,cephalosporins,aminoglycesides,quinolones,sulfonamides (94.87％,74.36％,76.92％,65.38％ and 56.41％),but had high sensitivity to carbapenems and tetracyclines (55.56％ and 77.78 ％).Sixteen cases infected with pandrug resistant acinetobacter baumanni infection (44.44％),4 cases infected with whole drugresistant acinetobacter baumanni (11.11％).Conclusion The irrational antibiotics use,the length of hospital stay,tracheal intubation,the length of mechanical ventilation,the basic diseases,central venous catheters and the length of using central venous catheters are the high risk factors of spesis caused by multidrug resistant acinetobacter baumanni; only carbapenems and tetracyclines can keep high sensitivity rate to multidrug resistant acinetobacter baumanni among clinical antibiotics.

Objective To explore the change of serum procalcitonin (PCT)in infectious diseases and the relationship between PCT and the severity of illness in children.Methods This was a single-center prospective study of serum procalcitonin concentration in children with infectious diseases.Ninty-five children with infectious diseases (mycoplasma infection 30 cases,viral infection 30 cases,bacterial infection 35 cases),hospitalized in PICU of Shengjing Hospital from April 2011 to April 2013,were divided into three groups:non-serious group(64 cases),serious group(20 cases)and very serious group(11 cases)according to pediatric critical illness score(PCIS).Bacterial infectious patients were divided into two groups:gram positive bacterial group(20cases),gram negative bacterial group(15 cases).Twenty children of non-infectious diseases during the same period were selected as the control group.Serum PCT levels were detected by using VIDAS BRAHMS PCT detection system(rapid semi-quantitative PCT test).Laboratory detection was conducted in Department of Laboratory Medicine,Shengjing Hospital of China Medical University.Results The serum PCT levels of the control,the bacterial infection,virus infection,and mycoplasma infection group were (0.41 ± 0.34) μg/L,(2.56 ± 0.38)μg/L,(0.52 ±0.44) μg/L and(0.21 ±0.10) μg/L.The serun PCT levels higher than or equal to 0.5 μg/L were defirned as positive.There was significant difference in PCT positive rate between bacterial infection group and the control grouP(x2 =28.05,P ＜0.05).The serum PCT levels of children with infectious diseases were higher than those of non-infection group,mycoplasma infection group and virus infection group(P ＜ 0.05).Besides,the PCT value of gram negative bacillus infection group was also obvious higher than gram positive infection group.There was no significant difference among the non-infection group,mycoplasma infection group and virus infection group(P ＞ 0.05).There was significant negative correlation between the serum PCT concentration and the PCIS score in children with infectious diseases (r =-0.579 ～-0.793,P ＜ 0.05).The higher concentration of PCT in children with the infectious diseases indicated higher severity illness scores,more complications,and longer length of hospital stay.Conclusions PCT may provide an informative and sensitive molecular marker for pathogen identification (bacterial infection,pneumonia mycoplasma infection or viral infection).In the early diagnosis of infectious disease,PCT assay can help predict the severity of the disease.