Drug induced liver injury(DILI) is one of the most common factors causing liver damage and liver failure in children.And in most cases,patients' manifestations lack characteristic features.Thus,patients will develop gastrointestinal symptoms such as jaundice,nausea,vomiting and abdominal abstention until serious hepatic dysfunction.Futhermore,some patients are likely to develop acute liver failure,even death,without drug discontinuation and timely intervening measures.Early diagnosis and effective therapies considerably make sense.This review aims to illustrate the mechanism,manifestations,diagnosis and treatment of DILI in children,in order to promote the early treatment of the disease,reduce the serious complications and improve survival rate in clinical work.

Objective To assess the effect of resident training in clinical skills on SARS prevention and treatment. Methods A survey was conducted by means of questionnaires on 101 residents of the authors' hospital who were at the forefront of the fight against SARS. Results Training in clinical skills assisted the residents to various degrees in SARS prevention and treatment. 100% of the residents surveyed held that the training was helpful, beneficial and assisted them in solving problems. Conclusion Training in clinical skills, which rendered the residents proficient in basic skills and more capable of clinical application of the skills, also enhanced their ability to handle emergent events in SARS prevention and treatment.

AIM To study the effects of cyclophosphamide (CTX) on the pharmacokinetics of buthionine sulfoximine (BSO)in Walker 256 tumor bearing rats. METHODS Walker 256 tumor bearing rats were treated ip for 4 days with saline or CTX in saline (20 mg?kg -1 ), then received iv BSO 200 mg?kg -1 . BSO concentration in rat plasma was determined by a reverse phase HPLC with fluorescence detection after precolumn derivatization with o phthaldialdehyde. Compartment model and pharmacokinetic parameters were determined by 3P87 software processed on a computer. RESULTS A single intravenous dose of BSO 200 mg?kg -1 was eliminated from plasma in a two compartment manner in tumor bearing rats. The pharmacokinetic parameters of BSO were as follows: In tumor bearing control rats, T 1/2? =(11 1?2 4) min, T 1/2? =(65?14) min, CLs=(12 8?1 3) ml?min -1 ?kg -1 , AUC=(262?26) mg?L -1 ?h; in tumor bearing CTX treated rats, T 1/2? =(8 2?1 8) min, T 1/2? =(42?3) min, CLs=(13 4?1 9) ml?min -1 ?kg -1 ,AUC=(252?35) mg ?L -1 ?h. CONCLUSION There is no significant difference between the parameters of tumor bearing control and CTX treated rats except T 1/2? .

Only in recent years, attentions have been drawn to the significance of expressing killer cell inhibitory receptors (KIR) in T cells KIRs specifically bind to the corresponding region of the MHC class I molecules and transmit negative signals to prevent cytotoxity of T cells. When the ligands of KIRs are missing, the lysis of the target cells can't be avoided. Perhaps the existence of KIRs is the main mechanism for preventing T cells from attacking autologous tissues. The recognition mechanism of the interaction between the KIR + donor T cells and the recipient's MHC class I molecule expressing tissue cells might shed light on the establishment of the immunotolerance for the prevention of allo-graft rejection and graft-versus-host disease.

Objective The study analyzes the inadequacies of the research integrity educational practice for the medical postgraduate students in the present stage of China.Furthermore,the paper puts forward improvement suggestions and clears the direction for further efforts.Methods From the perspective of the educational law about cognition,emotion,will and behavior,the comparative analysis method is used,based on the rich experience in the United States.Results There are inadequacies of the research integrity educational practice for the medical postgraduate students in China,including that students lack knowledge learning motivation,and the pattern of education is simple.There are not enough emotional experience channels and the participation of students.Students lack honesty will training,and the intensity of supervision and punishment is not strong.The honesty recognition mechanism is weak,and cannot be used to guide practice.Conclusions In order to improve the level of the research integrity for the medical postgraduate students in China,we should optimize the system,follow the law of education,strengthen the transmission of knowledge,put the academic honesty education into normal work,enhance the emotional experience,build a participatory mechanism,highlight the positive guide,and increase the intensity of punishment.

Objective To investigate the value of Kugel patch for elderly patients with recurrent inguinal hernia.Methods From February 2004 to February 2007,37 elderly patients with recurrent inguinal hernia received surgical treatment in our hospital.The patients were divided into two groups according to the surgical methods.Twenty-one patients,including 17 cases of unilateral indirect inguinal hernia,1 bilateral indirect hernia,1 direct hernia,1 indirect hernia complicated with femoral hernia,and 1 indirect hernia complicated with direct hernia,received hernia repair with Kugel patch via the posterior approach.The other 16 patients,including 15 cases of unilateral indirect hernia and 1 case of direct hernia,were treated with TAPP.Results The operation time in the Kugel group was significantly shorter than that in the TAPP group [(23.2?5.8) min vs(40.5?5.2) min,t=-9.392,P=0.000].In the TAPP group,2 patients complained of surgical-site pain or tension,while no patient in the Kugel group had the symptoms(?2=0.869,P=0.351).The mean hospital stay in the Kugel group was shorter than that in the TAPP group [(5.7?0.7)d vs(6.3?0.8) d;t=-2.429,P=0.020].The patients were followed up for 3-36 months,none of them had recurrence.Conclusions As an new,non-tension,safe,and minimally invasive method,hernia repair using Kugel patch through the posterior approach is of great advantage to elderly patients.The method is worth being used widely.

OBJECTIVE:To observe therapeutic efficacies and safety of diltiazem combined with ciclosporine in the treatment of nephrotic syndrome complicated with acute renal injury. METHODS:A total of 66 patients with nephrotic syndrome and cute kid-ney injury were randomly divided into control group(30 cases)and observation group(36 cases). Control group was given routine treatment;observation group was additionally given Diltiazem hydrochloride tablet 5 mg orally,twice a day,and Ciclosporin soft capsules 1.5 mg/(kg·d)orally,twice a day. Treatment course of 2 groups lasted for 20 d. Clinical efficacies of 2 groups were ob-served. The serum creatinine and kidney injury molecule 1(KIM-1),24 h urine volume,24 h urine protein levels,AKI classifica-tion,follow-up and recurrence were observed before and after treatment as well as the occurrence of ADR. RESULTS:The remis-sion rate of observation group was significantly higher than that of control group,and recurrence rate was significantly lower than control group,with statistical significance(P<0.05). Before treatment,there was no statistical significance in the serum creatinine levels,KIM-1,24 h urine pratein,24 h urine and AKI classification between 2 groups (P>0.05). After 2 weeks and 1 month of treatment of observatiom groups,and after 1 month of treatment of control group,serum creatinine levels,KIM-1 and 24 h urine protein of observation group were significantly lower than before treatment,and the observation group was significantly lower than the control group;24 h urine and the ratio of gradeⅠby AKI classification were significantly more than before treatment,and the observation group was significantly more than the control group,with statistical significance(P<0.05). Follow-up rate in 2 groups were 100%,and there was no statistical significance in the incidence of ADR between 2 groups(P>0.05). CONCLUSIONS:Based on routine treatment,diltiazem combined with ciclosporin shows significant therapeutic efficacy in the treatment of nephrotic syn-drome and acute renal injury with good safety.

OBJECTIVE:To establish an HPLC method for the determination of gastrodin in Choudongning capsule. METHODS:The sample was determined on Elite C18 column(250 mm?4.6 mm,5 ?m);the mobile phase consisted of methanol -water(3∶97) at a flow rate of 1.0 mL?min-1;the detection wavelength was set at 221 nm. RESULTS:The linear range of gastrodin was from 0.051 ?g to 0.357 ?g(r=0.999 9) and its average recovery was 98.99%(RSD=1.91%,n=6).CONCL-USION:The method is convenient,accurate and reproducible,and it is applicable for the quality control of Choudongning capsule.

OBJECTIVE:To improve the quality of drug consultation.METHODS:The drug consultation records of a total of 1 663 cases in our hospital from July 2004 to July 2007 were analyzed statistically by a retrospective method.RESULTS:Of the drug consultation records of a total of 1 663 cases,the chief questions consulted were adverse drug reactions and long-term medication safety(25.2%),dosage and administration(21.1%),medication for special populations(9.7%),drug interactions(8.1%),pharmacological action and indications(7.1%),and generic name and composition of drugs(5.2%).CONCLUSION:The drug consultation service in our hospital achieved a remarkable efficacy in guiding physicians and pharmacists on rational drug use;however,it has its problems and remains to be improved further.

OBJECTIVE:To establish an HPLC method for the determination of the contents of cinobufagin and resibufogenin in Yigankang capsule.METHODS:The samples were separated on Spherigel ODS C18(150 mm?4.6 mm,5 ?m)chromatographic column with 0.5% KH2PO4-acetonitrile(50∶50,pH was adjusted to 3.2 by phosphoric acid)used as a mobile phase at a flow rate of 1.0 mL?min-1.The detection wavelength was set at 296 nm and the column temperature was kept at 40 ℃.RESULTS:The linear ranges of cinobufagin and resibufogenin were 0.22～1.09 ?g(r=0.999 8)and 0.26～1.30 ?g(r=0.999 9),respectively,and the average recoveries of cinobufagin and resibufogenin were 99.4%(RSD=1.9%,n=9)and 98.7%(RSD=1.4%,n=9),respectively.CONCLUSION:This method is proved to be sensitive,simple,accurate and specific,and it is applicable for the quality control of Yigankang capsule.