Objective To analyze the application situation of the anti HBV drugs, and provide reference for clinical rational use of drugs and improve the therapeutic effect of liver disease.MethodsBy using the method of hospital management system, the application situation from 2012 to 2016 in our hospital of various types of anti liver disease drugs, including drug name, dosage forms.The specifications, the number of drug, drug cost, drug use quantity, the amount of medication, medication frequency (DDDs), daily drug cost (DDDc) and other indicators were sorted and analyzed.ResultsThe total amount and drug therapy of anti liver disease drug in our hospital showed increasing trend,the annual growth rate of the amount of medication was also showing a rising trend, the 2015 annual growth in the amount of medication for the highest rate, 41.56%.The annual hepatoprotective drugs in various anti proportion are the first in liver disease drug, liver drugs accounted for the largest amount of drugs and the reduced glutathione, the amount of drugs and antiviral drugs in the largest proportion of entecavir.ConclusionThe application of Anti Sense drugs showing a growth trend year by year, the amount of medication of the annual growth rate is higher, suggesting that the incidence rate of liver disease in our province had a rising trend.At the same time, hepatoprotective drugs accounted for relatively large of the existence medicine The phenomenon of substance abuse, clinicians should pay attention to.In the promotion of rational use of anti hepatitis drugs, clinicians and pharmacists should jointly do a good job of drug evaluation, has achieved the effective, reasonable application of drug safety and economic purposes.

Objective To use in our hospital during 2012 to 2016 anti diabetic drugs were investigated in the analysis, and provide the basis for clinical treatment.MethodsThe drug collected in our hospital during 2012 to 2016 anti diabetic drug name, manufacturer, specifications, quantity, amount, amount, using Excel 2007 for data processing, calculation of DDDs (DDDs) and daily cost (DDC).ResultsFrom 2012 to 2016, the antidiabetic drugs in our hospital the total expenses increased from 12 million 311 thousand and 500 yuan to 19 million 467 thousand and 800 yuan, up 58.13% The amount of consumption.The top three anti diabetic drugs for insulin, sulfonylurea, biguanides;DDDs three for insulin, sulfonylureas, alpha glucosidase inhibitors;DDC three drugs was the highest in Epalrestat Tablets, Insulin Glargine Injection, Insulin Aspart 30 Injection.ConclusionThe treatment of diabetes in our hospital during 2012 to 2016 drug use is more reasonable, the insulin dosage, some new oral proportion is increasing.

Objective To ivaluate the effect of low dose spironolactone combined with febuxostat on the treatment of early diabetic nephropathy complicated with hyperuricemia, in order to provide guidance for clinical.Methods206 cases with early diabetic nephropathy complicated with hyperuricemia in Zhongshan hospital affiliated to Fudan University from June 2013 to June 2014, were randomly divided into the control group and the experimental group, 103 cases in each group.The 2 groups were treated with oral hypoglycemic drugs or insulin to control blood sugar, low salt, low fat and low protein diet.At this basis, the control group were treated with low dose of spironolactone, the experimental group were given low dose spironolactone combined with febuxostat, 24 weeks for a course of treatment.The disease related indexes in the two groups were compared before and after treatment.ResultsAfter treatment, the HbAlc, SUA, TC, TG, UAER and the whole blood viscosity were significantly decreased in the experimental group (P<0.05).There was no significant difference among the indexes in the control group before and after treatment.UAER and SUA in the experiment were lower than those in the control group after treatment (P< 0.05), and the differences of HbAlc, TC, TG, HDL-C, LDL-C and hemorheology index in the two groups were not statistically significant.ConclusionBased on the control of blood glucose and diet therapy, it can correct hyperuricemia, regulate blood sugar and blood lipid disorders, correct the hemorheological indexes, which low doses of spironolactone combined with febuxostat in treating early diabetic nephropathy complicated with hyperuricemia, it can protect renal function well, and it is worthy of attention and promotion.

Objective To explore the influence of middle cerebral artery blood flow on mechanical ventilation in very low birth weight premature after using Budesonide(BUD) mixed with pulmonary surfactant(PS),and to explore the protection mechanism of cerebral injury.Methods Forty premature infants (gestational age ＜ 34 weeks,birth weight ＜ 1 500 g) with respiratory distress syndrome(RDS) were randomly assigned into study group and control group in Nanjing Maternal and Child Health Hospital from Aug.2010 to Mar.2012.PS and BUD mixture was used in study group (Per 70 mg PS adding BUD 0.25 mg),PS dose of 70 mg/kg,BUD dose of 0.25 mg/kg.Control group was only administered with PS,dose 70 mg/kg.It was administered intratracheally after 30 to 60 minutes of birth in both groups.The index of blood flow rate and blood vessel elasticity of arteria cerebri media [including systolic velocity (Vs),diastolic velocity (Vd),mean velocity (Vm),resistant index (RI) and elasticity index (PI)] were monitored by using transcranial Doppler.Results The Vs increased steadily in study group,but instability in control group,and there were of statistical differences on the 4 d,5 d,6 d and 7 d (t =3.21,2.95,3.12,3.43,all P ＜ 0.05).The Vd increased steadily in study group,but unsteadily in control group,and there were statistical differences on the 4 d,5 d,6 d and 7 d (t =4.21,3.10,3.98,4.56,all P ＜0.05).The Vm of study group was higher than that in the PS group,and there were statistical differences on the 4 d,5 d,6 d and 7 d (t =2.68,2.98,3.98,3.57,all P ＜ 0.05).The RI of study group was higher than that in the control group,and there were statistical differences in the 5 d,6 d and 7 d(t =3.10,3.98,4.06,all P ＜ 0.05).PI steadily in study group,but instability in control group,and there were statistical differences in the 5 d,6 d and 7 d (t =4.18,3.23,3.02,all P ＜ 0.05).The overall incidence of periventricular/intraventricular hemorrhage showed no significant difference,but severe periventricular/intraventricular hemorrhage (grade Ⅲ,Ⅳ) of study group was less than that in the control group (x2 =4.80,P ＜ 0.05).The incidence of periventricular leukomalacia was reduced in the study group compared with that in the control group (x2 =3.31,P ＜ 0.05).Conclusion The very low birth weight infants treated with mechanical ventilation show steady cerebral blood flow and lower incidence of brain injury after using BUD mixed with pulmonary surfactant.

Objective To observe the usage of antiasthmatic drugs and seek problems of following the guidelines of asthma and COPD prevention & treatment in community hospitals.Methods The prescribed quantity in 2013 of antiasthmatic drugs was recorded for 5 community hospitals in a district of Shanghai.Basing on the defined daily dose (DDD),the dosing frequency of drugs (DDDs) and the percentages of each category of drugs were calculated.Then comparisons were made with the data of a grade Ⅱ hospital and a grade Ⅲ hospital in the same district.Results Among three level hospitals,no significant difference existed in the percentages of oral antiasthmatic drugs.But the major category of oral drugs at grades Ⅱ-Ⅲ hospitals was leukotriene receptor antagonist whereas only oral theophylline and oral β2-receptor agonists were available at community hospitals.Among inhaled drugs,inhaled corticosteroids (ICS) dominated at grades Ⅱ-Ⅲ hospitals.But at community hospitals,inhaled short-acting beta-agonists (SABA) predominated.Among inhalants,dry powder inhaler (DPI) dominated at grades Ⅱ-Ⅲ hospitals and metered dose inhaler (MDI) at community hospitals.Conclusions The usage of antiasthmatics at community hospitals is not consistent with the guidelines.Optimizing drug purchasing at hospitals,strengthening continued medical education,modifying the medication concept of patients and boosting the production of domestic inhalants should be urgently undertaken.

Objective To investigate the application of U100plus laser in treating incarcerated in gallbladder stones. Methods The clinical data of 52 patients accepted U100plus laser lithotripsy of gallbladder neck incarcerated were retrospective analyzed. Results All 52 patients were successful treated by surgery. Twelve patients with gallbladder wall edema, drainage tubes were used to prevent bile leakage after gallbladder surgery. After 2~4 d, the ultrasound examination showed that no abnormal drainage, and tube was removed. The mean operative time was 40 min. The mean intraoperative bleeding was 2 mL. Patients were able to get out of bed 1 day after surgery. The average length of hospital stay was 4 d. Pa-tients were followed up for 6 to 30 months, and no special discomfort, The ultrasonography showed no stone recurrence. Conclusion U100plus laser lithotripsy is a safe and effective method for treating incarcerated gallbladder stones.

Objective To understand the clinical features of hepatitis B virus(HBV)/hepatitis C virus(HCV)coinfected patients with different virological profiles.Methods The clinical data of 186 patients with HBV/HCV coinfection from May 1999 to May 2010 in the Third Affiliated Hospital of Sun Yat-Sen University were analyzed retrospectively.The demographic data,epidemiological data,laboratory results and pathological index were analyzed.The statistical analysis was done using t test and chi square test.Results A total of 186 patients were divided into 4 groups:66(35.5%)in HBV DNA(-)/HCV RNA(-)group,8(4.3%)in HBV DNA(+)/HCV RNA(+)group,68(36.6%)in HBV DNA(+)/HCV RNA(-)group and 44(23.7%)in HBV DNA(-)/HCV RNA(+) group.The gender composition,complication incidence,transmission among drug users,alanine aminotransferase(ALT)level,total bilirubin(TBil)level,prothrombin activity(PTA)and hapatitis B e antigen(HBeAg)negative rate were all significantly different among four groups(F or x2=11.578,8.451,11.738,2.669,5.102,4.254 and 18.413,respectively;all P<0.05).In groups of HCV RNA(-)and HCV RNA(+),the proportions of patients infected through drug abuse were 49.3%and 23.1%,respectively(x2=9.987,P:0.002)and blood transfusion transmission were 29.9%and 46.2%,respectively(x2=4.412,P=0.036).When HBV DNA was negative,the median ALT levels in HCV RNA(-)and HCV RNA(+)patients were 177 U/L and 62 U/L,respectively(t=2.200,P<0.05),median TBil levels were 133 μmol/L and 20μmol/L,respectively (t=3.608,P<0.05)and PTA were 70.6%±27.7%and 83.3%±27.8%,respectively(t=-1.982,P<0.05).The HBeAg negative rate was not affected by HCV RNA levels(t=0.707,P>0.05).The HBeAg negative rate in HBV DNA(-)patients was 85.5%,which was higher than that in HBV DNA(+)patients(59.2%)(x2=16.393,P<0.05).Conclusions HBV DNA(+/-)/HCV RNA(-)profile were major components in HBV/HCV confection.HBV DNA level is related to disease progression and prognosis,but not relate to disease severity.Liver function damage and disease severity are aggravated with HCV RNA level decreases.HBV DNA level is related to HBeAg negative rate,while HCV RNA level is not related to HBeAg seroconversion rate.

Objective To investigate the level of serum macrophage migration inhibitory factor (MIF) and its correlation with serum precollagen Ⅲ peptide (PⅢP) and tissue inhibitor of metalloproteinase (TIMP)-1 in patients with chronic hepatitis B (CHB) and hepatitis B virus (HBV)-related cirrhosis. Methods Forty-four CHB patients (hepatitis B group), 44 patients with HBV-related cirrhosis (cirrhosis group) and 30 healthy controls (control group) were enrolled in this study. The venous blood was collected and MIF level was detected by enzyme-linked immunosorbent assay (ELISA). Correlations between MIF and PⅢP, TIMP-1 were analyzed in observed groups. Comparison between groups was done using t test. The correlations between MIF level and alanine aminotransferase (ALT), aspartate aminotransferase (AST), total bilirubin (TBil), plasma thromboplastin antecedent (PTA), PⅢP and TIMP-1 were analyzed by rectilinear correlation. Results The levels of serum MIF, PⅢP and TIMP-1 in CHB group and cirrhosis group were all significantly higher than those in control group (t=12.87,5.28, 10.98,t=11.22,14.84,11.17;all P<0.05), while there were no significant differences between CHB group and cirrhosis group (t= -1.05,1.52,--2.07;all P>0.05). There was no correlation between MIF level and ALT, AST, TBil and PTA. MIF level in CHB patients with hepatitis B e antigen (HBeAg) positive and high viral load were both higher than that in patients with HBeAg negative and low viral load. MIF level was both positively correlated with PⅢP level in CHB group and cirrhosis group (r=0. 603, P<0.05 and r=0. 415, P<0. 05, respectively). MIF level was also positively correlated with TIMP-1 level in CHB group (r=0. 458, P<0.05), while not correlated in cirrhosis group (r=0. 210, P>0.05). Levels of PⅢP and T1MP-1 were both correlated in CHB group and cirrhosis group (r=0. 849, P< 0.05 and r=0. 424, P<0.05, respectively). Conclusions The levels of serum MIF are significantly increased both in patients with CHB and cirrhosis. The early production of MIF might be related with viral replication, but not with liver function. MIF participates in formations of hepatitis, liver fibrosis and cirrhosis, which could reflect the degree of liver cirrhosis.

OBJECTIVE: To explore the clinical effect of ultrasound guided microwave ablation in the treatment 01 recurrent thyroid nodules. METHOD: Seventy-five cases of recurrent thyroid nodules were treated with ultrasound guided microwave ablation(MWA) under local anesthesia. All the patients underwent biopsy puncture, then the microwave ablation needle puncted in the center site of nodule with energy of 25-35 W, and the center tempera- ture could reach to 70-95 °C. RESULT: MWA were successfully performed in all the patients without significant com- plications. Temporary hoarseness occurred in 5 cases and dispeared after 1-3 weeks, choking water occurred in 2 patients and recovered 3-5 days later. Ultrasound examination showed that the bloodstream of thyroid nodules disappeared in all the patients, and the nodules diminuted with varying degrees at 3-month and at 6-month follow- up Serum FT4 and TSH did not change significantly. CONCLUSION Ultrasound guided MWA could be effective in the treatment of recurrent thyroid nodule with minimal invasive technology.
Anesthesia, Local ; Catheter Ablation ; Humans ; Microwaves ; Recurrence ; Thyroid Nodule ; surgery ; Treatment Outcome ; Ultrasonics

Objective To explore the relationship between folic acid levels of cord blood and birth weight, hyaline membrane disease in newborns. Methods Eighty-seven newborns were divided into premature infant group(42 cases) and term infant group(45 cases),intrauterine growth retardation group( 28cases) and control group (59 cases), hyaline membrane disease of premature infant group ( 13 cases) and premature infant control group(15 cases) according to the gestational age, birth weight, clinical manifestation and chest X-ray, respectively. Folic acid levels of cord blood were measured. Results The folic acid level of cord blood in premature infant group was lower than that in term infant group [(10.87 ±4.31) nmol/L vs.( 13.56 ± 5.07) nmol/L,P ＜0.05 ]. The folic acid level of cord blood in intrauterine growth retardation group was lower than that in control group [(11.01±4.29)nmol/L vs.( 14.87 ± 5.14)nmol/L,P＜0.05]. The folic acid level of cord blood in hyaline membrane disease of premature infant group was lower than that in premature infant control group [(9.15 ±4.02) nmol/L vs.(12.91±4.51) nmol/L,P＜0.05]. The positively correlation was found between the folic acid level of cord blood and birth weight in newborns (r =0.1825).Conclusion The folic acid level of cord blood is correlated with the occurrence of premature infants,intrauterine growth retardation and hyaline membrane disease in newborns.