OBJECTIVE:To investigate the effect of evaluation method on management of prescription. METHODS:A total of 24 000 prescriptions of 12 months were evaluated with both method 1 devised by our hospital and method 2 specified in ordinance of Management of prescription. The administration department intervened physicians’ prescription behaviors according to the evaluation results. The change of data in method 1 was compared with that in method 2. RESULTS: In method 1,the problems of usage and dosage increased a little while other irrational problems lessened largely. In method 2,the average amount of drug categories reduced a little while the other data increased a little. CONCLUSION: The effect of evaluation and intervention in method 1 are superior to those in method 2.

[Objective] To observe the effect of different acupoint application therapies :a summer treatment for the winter disease on allergic rhinitis ,and compare the relationship between the different acupoints and therapeutic effect. [Methods ] The 81 cases of allergic rhinitis who met inclusion criteria were divided into 12 acupoint group and 6 acupoint group. The time of application was in first ten-day period of the hot season. The duration of application was 2h. The days later, namely in the second ten-day period of the hot season, and twenty days later, in the third ten-day period of the hot season, the application was repeated respectively. Before treatment and half year after the treatment, the score of quality of life, symptoms of allergic rhinitis were observed to compare the relationship between the different acupoints and therapeutic effect. [Results] The effective rate was higher in 12 acupoints group than 6 acupoints group. After treatment, the score of quality of life, symptoms of allergic rhinitis were significantly improved( P<0.05 or P<0.01). And the comparison of the therapeutic effect of two groups showed significant difference in statistics( P<0.01). [Conclusion] The acupoint application therapy is effective for allergic rhinitis, and the comprehensive combination of acupoint is influential on the effect.

OBJECTIVE: To compare the results of skin prick test with allergens of Allergopharma company or ALK company in Shanghai area. METHOD: The study included 9 233 patients diagnosed as allergic rhinitis. The patients were divided in to two groups (Allergopharma group and Alutard-SQ group) SPT was given from June, 2005 to Feb, 2013. The results of the positive rate using two reagents were analyzed and compared. RESULT: There were no significant differences between the two groups in age and gender (P > 0.05). The total positive rate in Allergopharma group was 62.90%, and 59.68% in Alutard-SQ group. The positive rate in Allergopharma group was significantly higher than that in Alutard-SQ group (P < 0.01). Dermatophagoides farinae (Der f) and Dermatophagoides pteronyssinus (Der p) were identified as the mostly responsible allergens. The positive rate of Der f in Allergopharma group and Alutard-SQ group was 55.23% and 45.57% respectively. The same rate were 54.83% and 47.89% of Der p. There were significant differences of the positive rate of two allergens in both groups (P < 0.01). CONCLUSION The total positive rate was different using different allergens for SPT among the patients diagnosed as allergic rhinitis of the same area. Dust mites were identified as main allergens. The positive rate was different when using different reagents, which needed more attention to make the decision of specific immune therapy.
Adolescent ; Adult ; Aged ; Aged, 80 and over ; Allergens ; immunology ; Antigens, Dermatophagoides ; immunology ; Child ; Child, Preschool ; China ; Female ; Humans ; Indicators and Reagents ; Male ; Middle Aged ; Rhinitis, Allergic ; diagnosis ; Skin Tests ; Young Adult

ObjectiveTo investigate the effects of aliskiren on blood nitric oxide(NO) and bradykinin (BK) through analyzing the changes of NO, BK and non-dominant arm blood pressure before and after treatment of aliskiren and ramipril. MethodsThe chnical trial was conducted in 67 patients with essential hypertension. After a single-blind period of taking placebo orally once a day for 2 weeks, the patients were divided into different group in accordance with random table, and all patients were consecutively treated with drugs for 8 weeks. The trial uncovered showed that 17 patients were treated with ramipril (5 mg) in control group. Patients in trial group were given aliskiren and were assigned to three subgroups, 300 mg group (300 mg aliskiren, 16 cases), 150 mg group(150 mg aliskiren, 17 cases) and 75 mg group(75 mg aliskiren, 17 cases). The blood NO and BK before and after treatment in two groups were measured by enzyme linked immunosorbent assay and radioimmunoassay method. Non-dominant arm blood pressure was measured by calibration qualified mercury blood pressure instrument before and after treatment. Results The blood NO after treatment of aliskiren 8 weeks in trial group increased significantly than those before treatment [before treatment, the blood NO in 300 mg group, 150 mg group,75 mg group were (44.414 ±5.841 ), (43.496 ± 5.576), (41.037 ± 5.312) μ mol/L, after treatment they were(60.381 ± 6.756), (56.480 ±6.959), (53.766 ±7.276) μmol/L] (P <0.05). After treatment, non-dominant arm blood pressure decreased significantly in trial group (P < 0.05 ), but the blood BK had no significant defference before and after treatment (P >0.05). The blood NO and BK after treatment of ramipril 8 weeks in control group increased significantly than those before treatment [(57.286 ±6.431) μmol/L vs.(39.935 ±6.388)μ mol/L, (7.120 ± 1.015) μg/L vs.(5.232 ± 1.288) μg/L], and meanwhile non-dominant arm blood pressure decreased significantly(P <0.05). ConclusionsAliskiren and ramipril could increase the concentration of NO remarkably. Ramipril has strong effect in increasing the concentration of BK, but aliskiren hasn't effect on BK.

Objective · To observe the changes of cerebral gray matter pre- and post-treatment with short term drugs in patients with schizophrenia. Methods · T1-weighted brain MRIs were obtained on a 3T scanner in 21 controls and 27 subjects with schizophrenia who were not given antipsychotic medication. The controls and 21 schizophrenia patients received the second scan after 8 weeks of antipsychotic treatment. Voxel-based morphometry (VBM) were used to investigate the differences in gray matter (GM), mainly about the regional GM volumes. Results · GM volumes were significantly smaller in the patient group than those of healthy controls in left cerebellum posterior lobe , left and right parahippocampalgyrus, left middle temporal gyrus(P=0.000, voxels>50). GM volumes extensively decreased after 8 weeks of antipsychotic-treatment compared with pre-treatment in the superior, middle, and inferior temporal gyri, superior,middle and inferior frontal gyri, parahippocampa gyri, cingulate gyri, right supramarginal gyrus, right cerebellum posterior lobe, and right lingual gyrus(P=0.000, voxels>50). Conclusion · Short term antipsychotic treatment (8 weeks) may have adverse effects on the gray matter of patients with acute schizophrenia by reducing the volume of gray matter.

Objective This retrospective study is to analysis the special medical conditions that most Chinese secondary hospitals are facing with,and to review the safeguards and pitfalls for arterial switch operations,in order to probe intothe feasibility of this procedure for Chinese secondary hospitals and provide our experiences to help other surgeons to avoid pitfalls on complex procedures.Methods Between January 2006 and December 2011,totally 21 newborns and infants with TGA/VSD and TGA/IVS underwent arterial switch operation.There were 15 males and 6 females.In the TGA/VSD group,there were 16 cases,ranging from 30 days to 1 year at surgeries,and weight from 3.4-8.5 kg with average of (5.33 ± 1.42) kg.In the TGA/IVS group,there were 5 cases,ranging from 13 days to 1 month at surgeries,and weight from 3.1-5.5 kg with average of (3.75 ± 1.17)kg.All patients underwent one stage of arterial switch operation.Routine follow-up checking points are set at discharging,3 months,half year and every year after operation.Results The early death rate is 9.5％ (2/21),and the reexploration rate is 9.5％ (2/21).In the TGA/VSD group,average cardiopulmonary bypass time is (151 ± 33) minuntes with the aortic crossclamp time is (1 19 ± 26) minutes.Ventilator support time is 24-159 hours,and the length of ICU stay is 3-17 days.1 case has residual VSD with the diameter less than 2 mm.The pulmonary flow velocity in 2 cases increase mildly to 2.0 m/s and 2.2 m/s,and another 2 cases increase severely to 3.1 m/s and 3.7 m/s.The aortic flow velocity in 3 cases increase to 2.0m/s.ECG instructs no case has myoinfarction signs.In the TGA/IVS group,average cardiopulmonary bypass time is (170 ± 52) minuntes with the aortic crossclamp time is (137 ± 48) minutes.Ventilator support time is 51-144 hours,and the length of ICU stay is 4-14 days;The pulmonary flow velocity in 2 cases increase mildly to 2.0 m/s.The aortic flow velocity in 1 cases increase to 2.0 m/s.ECG instructs no case has myoinfarction signs.Conclusion Unbalanced medical resources distribution causes significant differences between heart centers and the secondary hospitals in China,especially on the complex congenital heart diseases procedures.However,with relatively solid background on correction of the simple congenital heart diseases,the Chinese secondary hospitals can still perform arterial switch operation with satisfactory mortality and morbidity,and provide more prompt medical services for more population.

Objective To explore the mechanism of the catdioprotection of isoflurane delayed preconditioning on myocardial ischemia reperfusion injury in rabbits.Method Thirty male New Zealand white rabbits,weighing 2.0 to 2.5 kg,were randomly divided into three groups(ten for each group):Control group(group C),I/R group(I/R group) ,2.0% isoflurane group(group S) .Group S was exposed to 2.0% isoflurane-100% oxygen for2 h.Group C and I/R group were exposed 2 h to 100% oxygen served as untreated controls.Twenty-four hours later I/R group and group S underwent 40 rain of coronary occlusion followed by 2 h of reperfusion.Blood samples were taken from arterial line at 20 min before occlusion(T1) ,20 rain after occlusion(T2) ,40 rain after occlusion(T3) ,1 h after reperfusion(T4) and 2 h after reperfusion(TS) for determination of plasma IL-10 levels and TNF-alevels by ELISA.At the end of the reperfusion,infarct size and area at risk were defined by Evans and TTC staining.The heart was harvested and levels of the nuclear factor kappa β(NF-κB)activity were determined by Western Blot,and ultrastructures were observed by electron microscopy.The data was expressed as,and were analyzed by using oneway ANOVA test with SPSS 13.0.P value less than 0.05 indicated statistical significance.Results The NF-κB activity of group S was significantly lower than that of group I/R(P<0.05).Group S significantly(P<0.05)reduced infarct size(19.7%±2.8% in group S) of the left ventricular area at risk as compared with control (37.8 %±1.7 % in I/R group).The injury of I/R group was worse than that of group S from the changes of the cellular structure under light microscope.Group S had a lower levels of TNF-α and also had a higher level of IL-10.Conclusions Isoflurane can inhibit NF-κB activity during myocardial ischemia reperfusion and modulate the cytokine expression,which may be one of molecular mechanisms of Isoflurane delayed preconditioning on cardioprotection.

Objective To investigate the role of opioid receptors in the protective effects of isoflurane-induced delayed preconditioning against myocardial ischemia-reperfusion (I/R) injury in rabbits. Methods Forty male New Zealand white rabbits weighing 2.0-2.5 kg were randomly assigned into 4 groups ( n = 10 each) : group I sham operation (S); group II I/R; group Ⅲ isoflurane + I/R (Iso) and group IV Iso + naloxone + I/R (Nal). Myocardial I/R was induced by 40 min occlusion of left anterior descending branch (LAD) of coronary artery followed by 120 min reperfusion. In group Ⅲ (Iso) 2% isoflurane in 100% O2 was inhaled for 2 h and I/R was produced 24 h later. In group IV (Nal) naloxone 6 mg/kg was given iv 10 min before 2 h of 2% isoflurane inhalation and I/R was produced 24 h later. At the end of 120 min reperfusion, infarct size (IS) and area at risk (AAR) were determined by Evan's blue and TTC staining. Myocardial ultrastructure was examined by electron microscopy. The phosphorylated p38MAPK protein expression in myocardium was determined by Western blot. Results The IS was significantly smaller in group Iso ( Ⅲ ) ( 19.7% ± 2.8%) than in I/R group ( II ) (37.8% ±1.7%) (P<0.05). The phosphorylated p38MAPK protein expression in myocardium was significantly lower in group Iso than in group I/R. Microscopic examination showed less myocardial damage in Iso group than in group I/R. The protective effects of delayed preconditioning by isoflurane was prevented by naloxone pretreatment. ConclusionOpioid receptors may be involved in the protective effects of delayed preconditioning by isoflurane against myocardial I/R injury.

Objective To investigate the effects of isoflurane delayed preconditioning(IDP) on myocardial proteomin rabbits with myocardial ischemia-reperfuaion(I/R).mjury.Methods Eight New Zealand white rabbits of both sexes weighing 2.0-2.5 kg were randomly divided into 2 groups(n=4 each):I/R group and IDP group.Myocardial I/R Wgg induced by occlusion of left anterior descending artery for 40 min followed by 120 min repednsion.In group IDP.the animals inhaled 2%isoflurane for 2 h,undergoing I/R 24 h later.At the end of 120 min reperfusion,the myocardium of left ventricle anterior wall was removed for two-dimensional gel electrophorvsis.The different protein spots were analyzed by means of mass chromatography.Results There were 13 different protein spots between group I/R and IDP.Of the 13 proteins,the expression of 10 spots Was up-regulated and 3 spots down-regulated in quantity.Eleven protein spots of all spots were identified by means of MALDI-TOF-MS.Conclusion IDP can aNenuate myocardial I/R injury in rabbits and it may be related to the alteration in proteome of myocardium.

Cerebrospinal Fluid Leak ; surgery ; Endoscopy ; Humans ; Iatrogenic Disease ; Male ; Meningocele ; surgery ; Middle Aged ; Nose ; surgery