OBJECTIVE:To probe into the situation of drug use that goes beyond the scope of package inserts in pediatrics of our hospital and to promote clinical rational drug use.METHODS:A total of 3 142 prescriptions between Mar.and Apr.2006 collected from the pediatric out-patient department of our hospital were analyzed in accordance with the contents of the related drug package inserts.RESULTS:Of the total 3 142 prescriptions,345(11.0%) involved drug use that goes beyond the scope of package inserts,leading the list were prescriptions of infants,accounting for 71.3% of the total.The problems such as age(52.2%) and indication(36.5%) were the main type;respiration system drugs(48.4%) and the antibiotics(40.6%) were the main drug kinds involved.CONCLUSIONS:It's widespread for drug use that goes beyond the package inserts in the pe-diatrics,which conforms to evidence-based medicine and the spirit of philosophy and ethics,but against the principle of law,which thus should be given fully attention in the clinic.

Objective To investigate the clinical features of divergence paralysis improve the diagnostic and therapeutic ability,and evaluate the effect of surgical and non-surgical treatment.Methods It was a retrospective case series study.11 cases with complete data,diagnosed and treated as divergence paralysis in Tianjin Eye Hospital from September 2014 to January 2016,were summarized.The observation items included general date,neurologica consultation,comprehensive eye examination,and the eye position and movement,deviation degree,binocular vision,AC / A,diplopia examination of pre-treatment and post-treatment.The patients were followed up from 3 months to 1.5 yeas,averaged 6.9 months.Results In our study,1 patient was MillerFisher syndrome,3 cases had a history of hypertension,and 1 case had the history of intaking sleeping pills for about 3 months.The rest of the patients denied the nervous system disease,cardiovascular disease and other medical history.All patients complained about uncrossed diplopia only at distance.All of the 11 patients had a sudden onset of their symptoms.Each patient was examined by same neurologist,meanwhile MRI or CT were performed.All the results showed normal.All patients had refractive error.The angle of esotropia for distance of 5 meters was from + 25 △ to + 55 △ and was from + 8 △ to + 40△ for near(33 cm)before treatment while changed into-4△ ～ + 12△ for distance (5m) and to-8△ ～ +8△ for near (33 cm) after treatment.The ratio of AC / A ranged from 1.3 to 4.0,with an average of 2.6.Conclusion The clinical characteristics of divergence paralysis are a greater angle of esotropia and ipsilateral diplopia.Lateral rectns resection and non-surgical treatment have better effects on the improvement of diplopia and esotropia.

Objective Determination of polysaccharide content in dried peel seeding watermelon, and its mechanism of lowering blood glucose.Methods The content of polysaccharides in dried peel of seeding watermelon was determined by the method of phenol-sulfuric acid.Mice were given starch and sucrose load,and the mouse blood glucose was examined.The inhibitory activities of seeding watermelon against α-glucosidase were tested by the colorimetry of pNPG.Results The calibration of polysaccharide was A=0.066 4 C+0.022 6, R2=0.999 5, the content of polysaccharide in dried peel of seeding watermelon was 4.45% (n=10,RSD=1.80%);50,100 and 150 mg·kg-1 of polysaccharide could significantly reduce the starch load in mice blood glucose(P<0.01);100 and 150 mg·kg-1 of polysaccharide significantly reduced sucrose load blood glucose(P<0.01);polysaccharide concentration in 18 mg·mL-1 could significantly inhibit the activity of α-glucosidase as the inhibitory rate was (73.19±3.45)% (n=10).Conclusion Seeding watermelon polysaccharide has effect on lowering blood glucose in starch and sucrose load mice, and inhibits α-glucosidase significantly.

Objective Under the guidance of graduate education evaluation theory,to establish the comprehensive quality evaluation standard of medical graduate students and apply it in the research of the scholarship evaluation.Methods Byusing literature study,brainstorming,expert advice and other research methods,we established comprehensive quality assessment scale.In the work of graduate scholarship,the scale was used to carry out the evaluation work,and the application of the scale,the use value and the effect of moral evaluation were studied.Results A comprehensive quality assessment scale for medical graduate students,which included 4 dimensions of moral education,training process,scientific research and social activities was established so that the students' daily performance was quantified and evaluated,which,to a certain extent,eliminated the influence of the subjective judgment to the evaluation work,and had good guidance and practicality.Conclusion Establishing comprehensive quality quantitative evaluation mechanism of the graduate students and conducting the dynamic evaluation to graduates' moral education,their academic and social activities are conducive to stimulating the development of postgraduates' comprehensive quality and improving the quality of training.

Objective To study the application of negative pressure drainage on nasal septum reconstructomy by endoscopy.Methods Totally 80 patientswith nasal septum deviation in our hospital from May 2014 to March 2015 were randomly divided into the observation group and the control group.All patients were given nasal septum reconstructomy by endoscopy,and patients of the observation group were given negative pressure drainage after surgery while the patients in control group were given traditional nasal cavity filling postoperatively.Observed the subjective symptoms,degree of disease and complications of patients 12 hours and 24 hours after surgery.And the clinical curative effect of the two groups were compared and analyzed 1 week after the surgery.Results The subjective symptoms of the observation group was obvi-ously better than the control group 24 hours after the surgery with statistically significant difference (P <0.05).And the degree of disease in observation group had significantly improved,and the nasal mucosa edema ratio of level 0 was 40%,which was significantly higher than 10% in the control group (P <0.05).The total effective rate was 97.50% in the observation group 1 week after surgery and it was 80% in the control group,and there were significant difference between the two groups (P <0.05).The incidence of complications in the observation group was 2.50%,which was significantly less than 20% in the control group (P <0.05).Conclusion The application of negative pres-sure drainage on nasal septum reconstructomy by endoscopy could effectively relieve the pain of patients and reduce complications,and its prognosis effect is better.

Objective To investigate the clinical and endoscopical features of patients suffered from Henoch-Schonlein purpura (HSP). Methods Retrospective analysis of the clinical manifestation in 197 purpura patients, of which 81 cases were HSP, and described the endoscopic features of 19 cases who underwent gastroscopy and/or colonoscopy. The specimens from 15 cases were evaluated histopathologically. Results Eighty-one patients were diagnosed as HSP, 51 (63. 0% ) of them had a history of upper respiratory tract infection 1 -3 weeks before, taking antibiotics or animal protein prior to the onset of the illness. In 21 patients, abdominal symptoms presented firstly, which occurred 1 -40 days prior to the appearance of skin rashes. Seventy- four (91. 4% ) patients experienced abdominal pain, 37(45. 7% ) patients had digestive tract bleeding. Endoscopic features included diffused congestive edema of gastrointestinal mucosa, widespread hemorrhagic spots, erythema, erosion and ulceration. Lesions were relatively severer in small intestine than those in large intestine. Histological manifestations showed massive neutrophilic infiltration in mucosa and submucosa, fibrotic necrosis of small vessels, focal bleeding, erosion and ulceration. There was prominent accordance in the extents of endoscopic and pathologic manifestation with the severity of gastrointestinal symptoms. Conclusions Forty one percent of purpura patients presented as HSP, of them 26% had the abdominal symptoms firstly. Small bowel lesions were severer than those of stomach or colon. The typical features of the illness and endoscopic findings are very helpful to the early diagnosis of HSP.

Objective To investigate the status of self-care ability and cognition among disabled elderly,and to analyze the relationship between self-care ability and cognition,then analyze their influencing factors.Methods A total of 813 disabled elderly accepted long-term care at community or facility were recruited by stratified sampling method and investigated by socio-demographic questionnaire,activities of daily living and short portable mental status questionnaire.Results The total scores of self-care ability of the long-term care disabled was 32.01±11.59,and the total points of cognition was 3.77±3.24.Disabled elderly with severe disorders of self-care ability had a higher obstacle rate in every cognition ability than those with mild disabilities (P＜0.001).There were differences in orientation and memory function with different persistent disabled time (x2 =11.875,14.758,P＜0.01).Disabled elderly with cognition obstacles have a higher obstacle rate in every self-care aspect than those with normal cognition (P＜0.01).The multiple regression analysis showed that the educational level (β=-0.067),arital status (β=-0.071),disabled persistence time (β=0.121),orientation ability (β=0.403),the amount of cognition obstacles (β=0.443) were the influence factors of Basic Activities of Daily Living(BADL) among disabled elderly ; and disabled persistence time (β=0.116),orientation ability (β=0.417),recalled ability (β=0.275),memorial ability (β=0.189),calculative ability (β=0.257),the amount of cognition obstacles (β=0.358) were the important factors influence Instrumental Activities of Daily Living(IADL).Conclusion The self-care ability and cognition of the long-term care elderly were declining sharply,and influencing each other.It is advisable to offer them direct long-term care service combined with the laws and characteristics of cognition and self-care ability.

Objective:To investigate the role of TSLP and NF-κB in the pathogenesis of adenomyosis.Methods:Immunohisto-chemistry was employed to detect the expression of TSLP and NF-κB p65 in the endometrial glandular cell and stromal cell of 35 adeno-myosis patients and 20 hysteromyoma patients as control , and analyze the correlation of the two proteins.The concentration of TSLP was measured by specific ELISA in the serum of healthy subjects besides of the patients with adenomyosis and hysteromyoma .Results:TSLP and NF-κB p65 were both positively expressd in the glandular cells and stromal cells of ectopic and eutopic endometrium of patients with adenomyosis , their expression was significantly higher than that of the control group ( P<0.01 ) , and the expression of TSLP and NF-κB p65 in ectopic endometrium was significantly higher than that in eutopic endometrium ( P<0.01 ).There was positive correlation between TSLP and NF-κB p65 in ectopic endometrium.The concentration of TSLP was higher in the serum of patients with adenomyosis.Conclusion:The TSLP is highly expressed in endometrial glandular and stromal cells of patients with adenomyosis , and there is higher level of TSLP in serum , and there is correlation between the expression of TSLP and NF-κB in ectopic endometrium.

0.05).Conclusion:The abnormal expression of HLA-G protein in eutopic and ectopic endometrium tissues may play a key role in the pathogenesis of adenomyosis.

Objective:To observe the flap complications after LASIK and analyze their clinical characters and treatment. Methods:The flap complications after LASIK in 35 eyes of 27 patients was reviewed.Visual acuity were measured at 3,7,15,30,60 days after the operation,at the same time, the eyes were examined with slit lamp. Results:After the therapy,diffuse lamellar keratitis of 10 eyes were recovered in 1 to 2 months,the visual acuity were 0.8 to 1.5.Flap slippage of 9 eyes were treated with replacement and the visual acuity were 1.0 to 1.2.One eye with trauma induced flap lose underwent allogeneic keratomileusis and the visual actity was 0.5 to 0.6.One eye with interface infection was treated by removing the infected flap and PTK.The corneal surface was healed but remained with little haze.The visual acuity were 0.8 to 1.0 after the therapy in three eyes with epithelial ingrowth.Three eyes with fiap breaking in the procedure were reoperated half a year later,and the visual acuity were 1.0 to 1.2. Conclusion:Flap complications after LASIK occurred at various period and are related with surgical technic,patient~(,)s eyes conditions and the treatment after the surgery.Early detection and therapy can obtain an comparatively excellent recovery.