Objective:To analyze the adverse drug reactions(ADR)and clinical application of thalidomide to provide useful reference for rational medication in clinics. Methods:The case reports and literatures from foreign countries on the clinical medication of thalidomide were analyzed and summarized. Results:The ADR of thalidomide included gastrointestinal reaction, hematotoxicity,cadiovascular toxicity,neurotoxicity,skin lesion,pulmonary embolism and so on. Its new medication methods were widely used in clinics. Conclusion:Clinicians and pharmacists should pay more attention to the medication risks and rational use of thalidomide in order to assure the safety and effectiveness of clinical drug use.

Objective To compare the cerebral oxygenation in the patients undergoing gynecological laparoscopic surgery under sevoflurane-versus propofol-based anesthesia.Methods Fifty adult patients,aged 18-56 yr,weighing 55-72 kg,of American Society of Anesthesiologists physical status Ⅰ or Ⅱ,with hemoglobin≥ 110 g/L,undergoing elective gynecological laparoscopic surgery under general anesthesia,were equally and randomly divided into sevoflurane group (group S) and propofol group (group P) using a random number table.Anesthesia was induced with iv midazolam 0.04 mg/kg,sufentanil 1.5-2.0 μg/kg,rocuronium 0.9 mg/kg,and propofol 1.5-2.0 mg/kg.Anesthesia was maintained with inhalation of sevoflurane (2.0％-2.6％) in group S,or with target-controlled infusion of propofol (plasma concentration 2.5-4.0 μg/ml) in group P.The concentrations of sevoflurane and propofol were adjusted to maintain bispectral index value at 40-50.In both groups,remifentanil was given by targetcontrolled infusion (target plasma concentration 2 ng/ml),and vecuronium 0.06-0.08 mg/kg was injected intermittently to maintain muscle relaxation.The regional cerebral oxygen saturation (rSO2) was recorded after induction and at 10 min before pneumoperitoneum (T1),at 10 min of pneumoperitoneum in the Trendelenburg position (T2),and at 10 min after the end of pneumoperitoneum (T3).The occurrence of cerebral oxygen desaturation was recorded during surgery.Results The rSO2 was significantly higher at T2,3 in group S than in group P (P＜0.05).Compared with the value at T1,no significant change was found in rSO2 at T2,3 in group S (P＞0.05),and the rSO2 was significantly decreased at T2,3 in group P (P＜0.05).The incidence of cerebral oxygen desaturation was 12％ in group P,and cerebral oxygen desaturation was not detected in group S.Conclusion Sevoflurane-based anesthesia produces no effect on rSO2,however,propofol-based anesthesia can decrease rSO2 in the patients undergoing gynecological laparoscopic surgery,and sevoflurane-based anesthesia is more suitable for gynecological laparoscopic surgery.

OBJECTIVE:To explore how to establish good procedure,system and mode of drug management,dispensing and application,in order to provide reference for risk management and rational use of rabies vaccine. METHODS:The use of rabies vaccine and storage temperature monitoring in our hospital during 2013-2014 were analyzed statistically,and risk management and use of rabies vaccine in our hospital were analyzed,and management measures and attentions were put forward. RESULTS:The amount of vaccinum rabiel (Vero cell) and human rabies immunoglobulin in our hospital were increased in 2014,compared to 2013. The position labeled with #1 in storehouse and that of labeled with #1 and #2 in dispensing store could meet the storage condi-tion of rabies vaccine. Risk management could be carried out in fields of drug requisition,cold chain management,drug manage-ment and drug dispensing. ADR should be paid attention. CONCLUSIONS:It is of significance to develop risk management and ra-tional medication guidance of rabies vaccine.

This paper was aimed to study the method of rapid determination of total flavonoids in Chrysanthemum of different processing methods by near infrared spectroscopy (NIRS). The Chrysanthemum was dried by three different processes. The three methods were directly drying, drying after steamed and drying after fry, respectively. The determination of total flavonoids in Chrysanthemum by different processing methods was produced by using UV-Vis spectrophotometry. Collecting the NIRS spectra of Chrysanthemum, the quantitative analysis model of total flavonoids content in Chrysanthemum of different processing methods was established by partial least square (PLS) and the model was validated. The correlation coefficient (R2), the root-mean-square error of calibration (RMSEC) and the root-mean-square error of prediction (RMSEP) were 0.996 19, 0.104 and 0.168, respectively. The correlation coefficient of predication (r) was 0.979 3 which state that the prediction was accurate. The method of NIRS had the advantage of fast determination, simple operation and high accuracy of prediction, and could be used for rapid determination of total flavonoids content in Chrysanthemum of different processing methods.

Objective To evaluated the prevalence of EGFR mutations in Hubei region,to provide reliable experimental basis for reasonable screening TKI beneficiaries in clinic.Methods EGFR mutation of 253 patients diagnosed with NSCLC in Hu-bei region during 2010 to 2015 was detected by PCR-sanger sequencing and ARMS assay,to investigate the sensitivity of dif-ferent methods,to explore the frequency and clinical significance of EGFR mutation in different gender,in different histologi-cal type and different exons.Results 93 of 253 NSCLC patients harbored EGFR mutation,mainly occurred in exon 19 and 21,accounting for 53.76% and 35.38% of the total EGFR mutation rate,respectively.ADx-ARMS method showed higher sensitivity (P=0.001).The mutation detection rate of female NSCLC was significantly higher than that of male NSCLC (P=0.001).The observed incidence of EGFR mutations in patients with adenocarcinomas (38.01%)was the highest in differ-ent histological type,followed by glandular squamous cell carcinoma (30.77%),large cell carcinoma (20%)and squamous cell carcinoma (4.55%).Nonsmoking patients had a higher EGFR mutation frequency (51.6%,81/157)than those with a history of smoking (24%,12/50).Conclusion ARMS assay was more sensitive and more convenient detection method for clinical screening for EGFR-TKI treatment subpopulation.The mutation rate of female NSCLC was significantly higher than that of male NSCLC in Hubei Province.Speculated that the sexual differences in NSCLC with EGFR mutation frequencies were related to hormone levels and smoking status.

Objective To study the influence of herbal decoction Shuxin Yin(SXY)on platelet activation of rats and mice with a- cute myocardial ischemia in order to explain its possible mechanism for treating coronary heart disease.Methods The rat model with acute myocardial ischemia and the mice model with acute myocardial ischemia and reperfusion were established.The male SD rats and ICR mice,51 each,were randomized into 5 groups respectively:sham operation group,model group,low dose SXY group,high dose SXY group,ticlopidine groap.Made models and collected blood Sample after 30 days gastric infusion in succession.The flow cytome- try technique and the monoclonal antibody examination were adopted to test the mice platelet glycoprotein CD_(62)P;the radioim- munoassay was used to test rat platelet aggregation rate(PAR),fibrinogen(Fg),thromboxane B_2(TXB_2)and 6-keto-PGF_(1?) and their ratio.Results Shuxin Yin can,inhibit the high expression of CD_(62)P of mice with acute myocardial ischemia and reperfusion,and de- crease PAR,Fg and TXB_2/6-keto-PGF_(1?) of rats with acute myocardial isehemia.Compared with the effect of ticlopidine,the differ- ence was not significant.Conclusion Shuxin Yin could effectively inhibiting platelet activation in rats anel mice with acute myocardial ischemia,and its effect in preventing and treating coronary heart disease might be related to the inhibition of platelet activation.

Objective To observe the application effect of ISO9001 Quality Management System combined with level 3 general hospital evaluation standard (2011 version) in nursing management. Methods ISO9001 Quality Management System combined with nursing part of level 3 general hospital evaluation standard applied in nursing management; and data of nursing goals were collected before and after the implementation of nursing management system from 2011 to 2014. Results Nursing management system got more perfect, safety of blood transfusion, adverse event reports and so on were included. Both nursing quality target completion and satisfaction rate of hospitalized patients on nursing work increased year by year from 2011 to 2014. Satisfaction rate of doctors and nurses with high quality nursing service were both above 96%. Conclusions Nursing management system can promote can promote quality of nursing care, and provide comprehensive development guarantee to the whole hospital quality system, and offer reference for other hospital′s nursing management.

Objective The aim of this study was to evaluate the prognosis of resection followed by chemotherapy compared with chemoradiotherapy for limited-stage small cell lung cancer .Methods The clinical data of 230 limited-stage small cell lung cancer patients with curative treatment between January 2006 and December 2011 were retrospectively analyzed .All patients divided to two group: the resection plus chemotherapy ( S +C ) and chemoradiotherapy ( R +C ) .And the prognostic factors were further analyzed with limited stage small cell lung cancer .The Kaplan-Meier method was used for the survival analysis.Results The overall survival rates of 1-year, 3-year and 5-year were 87.0%, 38.9%, 25.4%, respectively and the media survival time ( MST) 26.0 months.When patients were stratified by clinical stageⅠ+Ⅱ, the 1-year , 3-year and 5-year overall survival rates of S +C group and R +C group were 92.6%, 63.2%, 47.3%and 76.2%, 42.9%, 30.6%, respectively (χ2 =7.851, P<0.05), while those were 88.5%, 26.9%, 10.6% and 86.0%, 25.1%, 25.1%, respectively in stage ⅢA with no significant difference ( P >0.05).In univariate analysis, tumor location, tumor stage, lymph node metastasis, TNM stage, the cycle of chemotherapy , treatment modalities were significantly associated with survival ( RR=1.735, P<0.05).The multivariate analysis only showed TNM stage were independent factors of prognosis .Conclusions The results suggested that resection plus chemotherapy could improve the prognosis of early-stage(stageⅠ+Ⅱ) small cell lung cancer, but patients in ⅢA stage should received the definitive chemoradiotherapy .The TNM stage was still the independent factor of prognosis .

Objective To investigate the safety and effectiveness of Solitaire FR stent mechanical thrombectomy combined with 5F Navien catheter aspiration technique for the treatment of acute middle cerebral artery occlusion.Methods From February 2016 to May 2016,the case data of 11 consecutive patients with acute middle cerebral artery occlusion treated with Solitaire FR stent mechanical thrombectomy combined with 5F Navien catheter aspiration technique at the Department of Neurosurgery,Xuanwu Hospital,Capital Medical University were enrolled retrospectively.The age,gender,National Institutes of Health Stroke Scale (NIHSS) score on admission,thrombolysis in cerebral infarction (TICI) grade,operation-related complications,NIHSS score at 24 h after operation,and modified Rankin Scale (mRS) score at day 90 after operation were documented.The relevant data differences before and after treatment were analyzed with the SPSS software.Results Among the 11 patients with acute middle cerebral artery occlusion,7 were men and 4 were women,the age ranged from 44 to 78 years,and the mean age was 66 ± 11 years.The preoperative and postoperative NIHSS scores were 18 ± 3 and 8 ±4 respectively.There was significant difference before and after treatment (t =5.327,P ＜ 0.01).The recanalization of occluded middle cerebral artery achieved successfully.The follow-up at day 90 after operation,the good prognosis of the patients (mRS 0-2) was in 7 cases.No complications associated with severe M1 segment catheter operation occurred.Conclusion The preliminary experience showed,Solitaire FR stent mechanical thrombectomy combined with 5F Navien catheter aspiration technique for the treatment of acute middle cerebral artery occlusion was a safe and effective endovascular mechanical thrombectomy method.

Objective To analyze the efficacy of chemoradiotherapy in the treatment of esophageal carcinoma and its influencing factors,and to provide an optimal combination mode of chemoradiotherapy for treating esophageal carcinoma. Methods A retrospective analysis was performed on clinical data from 232 patients with esophageal carcinoma who were admitted to our hospital from January 2006 to December 2012 and received radical chemoradiotherapy. All patients received three?dimensional conformal radiotherapy or intensity?modulated radiotherapy as well as platinum?based chemotherapy. The overall survival ( OS ) and local control ( LC) rates were calculated using the Kaplan?Meier method and analyzed using the Logrank test. Univariate and multivariate prognostic analyses were made by the log?rank test and the Cox proportional hazard model,respectively. Results In all patients,the 1?,3?,and 5?year LC rates were 66?1%,42?2%, and 38?5%,respectively;the median LC time was 24?4 months;the 1?,3?,and 5?year OS rates were 73?3%, 37?2%,and 19?5%,respectively;the median OS time was 21 months. The univariate analysis revealed that T stage,N stage,clinical stage,irradiation range,and no less than 3 cycles of chemotherapy were influencing factors for OS ( P=0?000,0?000,0?000,0?030,0?001) and LC ( P=0?112,0?031,0?009,0?074,0?218) . The multivariate analysis revealed that N stage,clinical stage,and no less than 3 cycles of chemotherapy were independent prognostic factors for OS ( P=0?006,0?000,0?001) . Conclusions The LC and long?term OS rates in patients with early?stage esophageal carcinoma can be substantially improved by radical chemoradiotherapy. The irradiation range and no less than 3 cycles of chemotherapy improve the long?term survival in patients.