OBJECTIVE:To strengthen the clinical rational use of drug and to ensure safety of drug use.METHODS:The irrational medication orders of PIVAS in our hospital from Mar.to Aug.in 2009 were analyzed statistically.RESULTS:Of total 859 339 medication orders,771 irrational medication orders accounted for 0.94‰,including excessive dosage,irrational compatibility and improper solvent selection,etc.CONCLUSIONS:Pharmacists can correct irrational medication order to improve rational use of drug by PIVAS.Moreover,PIVAS plays an important role in training clinical pharmacists.

Objective To investigate the influence of perioperative continuing aspirin therapy on tooth extraction surgery in elderly patients with coronary heart disease.Methods A total of 926 patients with coronary heart disease who required tooth extraction were enrolled in this study.Among them,241 patients discontinued aspirin therapy before tooth extraction,685 patients continued aspirin therapy before tooth extraction.The entering rate of operation was evaluated.100 patients continuing aspirin and 100 patients discontinuing aspirin were randomly selected.Systemic pressure,diastolic pressure and heart rate before and after tooth extraction were detected.100 matched healthy elderly patients were selected as normal control group.Multivariate logistic regression analysis was used to estimate the risk for tooth extraction.Results The entering rate of operation was 67.9％ (131 cases) in 193 patients with angina pectoris discontinuing aspirin therapy and 82.1 ％ (312 cases) in 380 patients with angina pectoris continuing aspirin therapy (x2 =14.77,P＜0.01).The entering rate of operation was 41.7％ (20 cases) in 48 patients undergoing coronary revascularization and discontinuing aspirin therapy,and 80.7％ (312 cases) in 305 patients undergoing coronary revascularization and continuing aspirin therapy (x2=33.95,P＜0.01).The changes in systolic blood pressure before versus after dental extraction had a significant difference between the discontinuing aspirin group and control group [(15.9±5.5) mmHg vs.(12.2±4.7)mmHg,P＜0.05,1 mmHg=0.133 kPa],while had no significant difference between the continuing aspirin group and control group [(13.6±4.5) mmHg vs.(12.2±4.7) mmHg,P＞0.05].There were no significant differences in changes in diastolic blood pressure and heart rate in the intraoperative period between the patients and controls (P＞0.05).The bleeding rate in patients continuing aspirin therapy was not significantly different as compared with control group (P＞ 0.05).Multivariate logistic regression analysis revealed that perioperative discontinuing aspirin therapy remained the second significant risk factor for tooth extraction.Conclusions Preoperative administration of aspirin should be continued in dental extraction surgery in elderly patients with coronary heart disease.

Objective: To explore the value of implanted intensity-modulated bmchytherapy for recurred cervical carcinoma. Metheds: A total of 25 cases of recurred cervical carcinoma were enrolled into the trial group which were treated with pelvic implanted aftedoading intensity-modulated brachytherapy. The other 25 patients with recurred cervical carcinoma treated with routine brachytherapy during the same pedod were en-rolled into the control group. Results: There were 20 cases with CR and 5 cases with PR in the trial group, and 10 cases with CR, 7 cases with PR, 4 cases with SD and 4 cases with PD in the control group, with a signifi-cant difference between the two groups (P<0.05). In the trial group, there were 5 cases with vaginal-rectal fis-tula and 1 case with grade 3 enteritis. In the control group, there were 3 cases with vaginal-rectal fistula. Con-dusion: Pelvic implanted intensity-modulated brachytherapy for recurred cervical carcinoma is satisfactory with better short-term efficacy than that of the routine brachytherapy and tolerable side effects.

Amifostine ; pharmacology ; Anemia, Aplastic ; chemically induced ; pathology ; prevention & control ; Animals ; Benzene ; toxicity ; Dose-Response Relationship, Drug ; Male ; Mice

Objective To compare the reliability and effectiveness of anterolateral thigh flap with double vein anastomosis or one vein anastomosis for reconstruction of head and neck defects.Methods Two hundred and sixty four cases of anterolateral thigh flap transfers for head and neck reconstruction from January,2013 to September,2013 in the Second Xiangya Hospital of Central South University were reviewed.260 patients were randomly divided into 2 groups.In the experimental group,there were 138 patients 140 cases of anterolateral thigh flap with one vein one artery anastomosis.In the control group,there were 122 patients 124 cases of anterolateral thigh flap with double vein one artery anastomosis.Results Among 264 anterolateral thigh flaps,the overall success rate of free flap was 98.1％ (259/264),5 free flaps were lost.In the experimental group,there were 6 free flaps occurred venous thrombosis,two of them were lost.In the control group,there were 5 cases occurred venous thrombosis,three of them were lost.No arterial thrombosis occurred in both groups.The time of micromanipulation was 18 to 101 min,with the average of 47 min in the experimental group.In the control group,the time was 45 to 133 min,with the average of 71 min.(P =0.0003).Conclusion Anterolateral thigh flap with one vein one artery anastomosis for head and neck reconstruction did not affect the survival rate but it can absolutely reduce the operation time.

Objective To observe the characteristics and treatment of malignant peripheral nerve sheath tumor originated from neurofibromatosis and the outcome of the patients. Methods A case was reported and the related literatures were reviewed. Results and Conclusion Malignant peripheral nerve sheath tumor is a rare soft tissue malignancy, which is with highly invasion. There are some difficulties with the diagnosis and treatment, and the outcome is poor. Early diagnosis is very important for treatment.

Objective To investigate the clinical characteristics of postoperative spondylodiscitis after lumbar intervertebral disc herniation.Methods 9 cases with spondylodiscitis were reviewed,about their clinical symptoms,laboratory tests,bacteria culture,CT and MRI finging,etc.Results and Conclusion The clinical symptoms occurred 8~24 d after operation.Laboratory test and MRI were helpful for the early diagnosis.The outcome of both surgical and non-surgical treatment was satisfactory.

Objective To investigate the value of intra-cavitary contrast enhanced ultrasound(CEUS)in the location of drainage tubes which were unclear in conventional ultrasonography. Methods The locations of 32 drainage tubes in 26 patients were unclear in conventional ultrasonography. The diluted ultrasound contrast agent (SonoVue) was injected through the tubes. CEUS was used to evaluate the visualizations of the inner tubular portions and the distal ends. Whether the drainage tubes were in situ or not was also judged. The time-consumption of detection was counted. Results The percentages of the visualization of inner tubular portions and the distal ends in conventional ultrasonography were 52.25%(18/32) and 0,respectively. However,the percentages of visualization in CEUS were 100% and 93.75%(30/32), respectively. The difference were significant when compared conventional ultrasonography with CEUS ( P＜0.001 ). CEUS detected that three drainage tubes weren't in situ. And the median of timeconsumption of CEUS was just 4. 5 seconds (range: 1-77 seconds). Conclusions Intra-cavitary CEUS is a sensitive and high efficient technique in the visualization of drainage tube which may complement the insufficiency of conventional ultrasonography. It could be used as the first choice in the location of drainage tube.

Objective To discuss the use of contrast enhanced intraoperative uhrasound(CE-IOUS) in evaluating hepatic radiofrequency ablation(RFA)lesions.Methods Fifteen RFA lesions in twelve dogs were examined by IOUS and CE-IOUS 15 min and 30 min after RFA.IOUS and CE-IOUS images were compared with RFA specimen stained by TTC.Results Satisfactory images could be achieved bv CE-IOUS at 15 rain after RFA.Compared with IOUS,CE IOUS could depict the border of RFA lesions more clearly (P＜0.01).In CE-IOUS,93.3%(12/13)of RFA lesion images were consistent with that of TTC in shape,while in IOUS,only 13.3%(2/15)of the images were consistent with that of TTC in shape.The average areas of RFA lesions cross-section measured by IOUS,CE-IOUS and TTC were(4.82±1.49)cm2,(3.48±1.25)cm2 and(2.93±0.87)cm2.Statistical significance was found between the areas shown by IOUS and TTC staining(P=0.000),as well as between CE-IOUS and TTC staining(P=0.027).The areas shown by IOUS and TTC were not linear correlated(r=0.28,P=0.316),but the areas shown bv CE IOUS and TTC were wetl correlated(r=0.75,P=0.002). Conclusions CE-IOUS is a promising method for evaluating intraoperative RFA lesions and worthy of further clinical research.

efore graft harvesting in living donor liver transplantation.