OBJECTIVE:To probe into the general regularity and characteristics of ADR in our hospital. METHODS:117 ADR reports were analyzed retrospectively in respect of the patient’s gender,age,dosage form,route of medication,medication combination,category of drugs,involved organs and system and clinical manifestation,ect. RESULTS:Of total 117 cases of ADR,female cases of 69 accounted for 58.97% while 48 male cases 41.03%. ADR cases were mainly found in the group aged from 41 to 50(23.93%). ADR was predominantly caused by intravenous drip infusion(86.32%). 46 kinds of drugs in 10 categories were involved,in which antimicrobial drug took dominate place including 20 kinds in 10 categories(58.97%). The most common clinical symptom represented as lesion of skin and its appendants(54.70%). 117 cases were cured and improved without death case. CONCLUSION:Great importance should be attached to rational use of drug and safety of drug use of special population.

Objective To explore the relationships of serum levels of leptin,TNF-?,FFA and resistin with IR and between themselves. Methods 48 T2DM patients and 47 non-diabetic controls were selected.Levels of leptin,TNF-?,FFA and resistin were measured.FPG,insulin,blood lipid,blood pressure,BMI and WHR were measured.Results The levels of leptin,TNF-?,FFA and resistin were correlated positively with HOMA-IR(P

Objective To seek the evidence-based medicine (EBM) evidences of curative effects of intravitreous injection with triamcinolone acetonide (TA) for macular edema. Methods All articles of intravitreous injection TA for macular edema published in English or Chinese were picked up from databases of MEDLINE and CNKI and then evaluated according to EBM standard. The data in accord with research standard were selected by using excluding and including criteria, and classified according to the appraisal standard of clinical therapeutic documents. Results In the selected papers, none in gradeⅠevidence; 1 in gradeⅡevidence; 7 in grade Ⅲ evidence; 24 in grade Ⅳ evidence; and 19 in gradeⅤevidence. Forty-two papers reported that intravitreous injection with TA had significant effect for macular edema within 3 months, and the improvement of visual acuity was recorded in these papers. Regression of macular edema was recorded in 23 papers. Among 20 papers, side-effect was found in 93 eyes (31.41%) and the serious side-effect in 4 eyes (1.35%). Conclusions Intravitreous injection with TA has some curative effects for macular edema in short term, but the quality of current study has not been encouraging. There are no grade I document and lack of the study of validity in long term and essentiality and validity of retreatment. The special attention should be payed on the increasing persistency of efficacy and preventing the serious side-effects in the future investigation.

This paper discusses the problems, clinical application and limitations of argon-helium cryosurgical scalpel and liquid nitrogen cryosurgical scalpel. The feasibility of self-absorption liquid-CO2 cryosurgical scalpel is analyzed. The result shows that self-absorption liquid-CO2 cryosurgical scalpel can be applied to cryosurgery.

Objective To explore histopathological features in the nigrostriatal tissues of Parkinson’s disease (PD)and Parkisonism plus syndrome. Methods The substantia nigra and the striatum of 5 PD cases, 3 progressive supralnuclear palsy (PSP) cases and 3 multiple system atrophy (MSA) cases, and 5 normal aging control cases were examined by routine neuropathological methods and Gallyas-Braak staining and tau, ubiquitin and ?-synuclein immunohistochemistry. Pigmented neurons in the substantia nigra of PD, PSP, MSA cases and normal aging control cases were counted. The neuronal and glial cytoplasmic inclusions in the nigrostriatal tissues were observed. Components of the abnormal proteins were identified. Results Nerve cells in the substantia nigra of PD,PSP and MSA groups showed severe loss in number,especially the ventrolateral zone and the ventromedial zone. Compared with those in the normal aging control group,numbers of nerve cells in the ventrolateral zone of PD, PSP and MSA groups decreased to 37.5%, 24.2%, 33.8% in the right side, and 48.0%, 25.8%, 33.9% in the left side respectively. There were ?-synuclein and ubiquitin-positive Lewy bodies in the substantia nigra of PD. A lot of tau-positive, argyrophilic globous neurofibrinary tangles, tuft-shaped astrocytes and coiled bodies in the substantia nigra and the striatum of PSP were observed.Severe loss of neurons and gliosis in the caudate nucleus and putamen of MSA were found. In addition, ?-synuclein and ubiquitin-positive glial cytoplasmic inclusions were found in the substantia nigra and striatal region of MSA. Conclusions Lewy bodies in PD and glial cytoplasmic inclusions in MSA are related to abnormal depositions of ?-synuclein and ubiquitin.Neuronal and glial cytoplasmic inclusions in PSP are related to abnormal aggregation of tau.

Objective To compare the effect of treating hyperglycemia on insulin pump therapy in newly diagnosed type 2 diabetes mellitus(T2DM) and the patients with failure to oral antidiabetic therapy. Methods Selecting 32 patients with newly diagnosed T2DM(NDM group)and 64 T2DM patients with failure to oral antidiabetic therapy(ODM group),which were treated by insulin pump,having no significant difference of the level of blood glucose,body mass index(BMI),age,proportion of sex between NDM group and ODM group. Results (1)The mean time and the maximal dosage of insulin for blood glucose to be targeted in NDM group were all lower than those in ODM group(P all

Objective To evaluate the value of intravascular interventional embolization in the emergency treatment of patients with hemodynamically unstable pelvic fracture.Methods The retrospective analysis was made on the medical records of 45 cases treated from October 2012 to December 2014.There were 27 male and 18 females(39.2-± 10.3) years (range,28-54 years).Time from injury to admission was within 3 h.Injury severity score (ISS) was (25.3 ± 8.1) points.The pelvic fracture included 32 cases of Type B and 13 Type C according to Tile classification system.After admission,anti-shock treatment and pelvic immobilization with the belt or external fixator were performed,and emergent intravascular interventional embolization was used to stanch bleeding after the bleeding of other organs was excluded.Vascular intervention,post-treatment vitazl signs and prognosis were evaluated.Results Time from admission to interventional therapy was 1.2-2.7 h [(1.9 ± 0.8) h].Time of interventional treatment was 1.6-3.2 h [(2.3-± 0.6) h].Of the 45 cases,contrast extravasation was seen in 38 cases,abnormal vascular morphology in 5 cases,no obvious bleeding in 1 case,and contrast extravasation in the angiographic venous phase in 1 case.Among the 38 cases of contrast extravasation,the offending vessels involved were internal pudenda artery (26 cases),obturator artery (16 cases),superior gluteal artery (4 cases),inferior gluteal artery (4 cases),inferior epigastric artery (1 case) and external iliac artery (1 case),but 8 cases were noted to have two offending vessels and 1 case had delayed bleeding.Of the 45 cases,the hemostatic effect was good in the early stage.After the interventional embolization therapy,the heart rate was (105.2 ± 14.8) beats/min,arterial pressure was (79.0 ± 10.6) mmHg,central venous pressure was (5.1 ± 0.8) cmH2O,and shock index was 1.1 ±-0.5,showing improved vital signs postoperatively (P ＜ 0.05).Four cases died mainly due to the multiple organ failure.One case had abdominal distention aggravated 3 days after operation,which were confirmed to be bleeding in the branch of external iliac artery,and the symptom was alleviated after embolization therapy.Forty-one cases survived with ICU length of stay of (14.5 ± 5.4) d,hospitalization time of (35.2 ± 12.8) d and medical expense of (96,755.3-± 20,568.1) CNY.Conclusion In the emergency treatment of patients with hemodynamically unstable pelvic fracture,the intravascular interventional embolization has become an important measure of comprehensive treatment that allows fast and mini-invasive procedure hemostasis,and deserves clinical promoting.

Objective To evaluate hepatic segment vascular occlusion technology in precise resection of liver segment.Methods Sixty-seven cases of liver cancer patients who underwent precision liver segment resection from August 2007 to May 2012 in Qilu Hospital were analyszed retrospectively.There were 51 male patients and 16 female patients,age ranging from 45 to 66 yrs.Results All operations were performed successfully.All cases were with single tumor,the diameter ranged from 2 cm to 6 cm.Resection of segment Ⅲ was performed in 22 cases,segment Ⅳ in 10 cases and segment Ⅵ in 35 cases.Operation time was 50-120 minutes,and the average time was 73 minutes.Blood loss was 50-200 ml,averaging 86 ml.No patient needed blood transfusion.Postoperative incisional liquefaction was found in 6 cases which were cured with interference in time.There was no bile leakage,hemorrhage,celiac infection and complications such as liver failure.The average hospital stay was 7.8 days.No rccurrence was found during 3 months follow-up.Conclusions Hepatic segment vascular occlusion technology was safe and feasible in precise resection of liver segment in liver cancer patients.It effectively controlled blood loss and reduced liver damage.

Objective To evaluate systematically whether administration of hypertonic saline transfusion affects clinical outcomes with compared to standard fluid in the early stage of resuscitation for traumatic shock patients.Methods Seven English and Chinese routine biology and medicine databases were searched for randomized controlled trials (RCTs) published from January 2002 to August 2012,and established inclusion and exclusion criteria to evaluate these RCTs.The quality assessment was based on the Cochrane Handbook for Systematic Reviews of Interventions Version 5.0.1 and Jadad' s score scale.RevMan 5.0 statistical software was used for meta-analysis.Results After evaluated 211 related literatures,five RCTs met all the inclusion criteria and were enrolled for meta-analysis.The meta-a nalysis demonstrated that early hypertonic transfusion did not decrease short-term (first 48 hours after admission) mortality (RR =1.04,P =0.74); nor did it decrease later-term (7day to 3month after injury) mortality (RR =0.97,P =0.72).It also did not decrease the total volume of fluid and blood transfusion required during the first day (P =0.38).Similarly,it did not affect the incidents of infections (RR =1.04,P =0.70),the length of stay in ICU (P =0.2) and total length of stay in the hospital.Conclusions Compared to standard fluid,there was no advantage on mortality and hospital infection by using hypertonic supplement transfusion in the early stage of resuscitation for traumatic shock patients.Hypertonic transfusion did not have any significant effect on the volume of total fluid and blood transfusion required the first day,and no trend of reduction for the length of ICU and hospital stay.Further well-designed randomized controlled trials are needed to demonstrate the cost effectiveness of hypertonic transfusion to traumatic shock patients while in ICU.

BACKGROUND: Synaptic density, a key index of structure and function of brain tissues, is related to cognitive function. Synaptic loss occurs during human brain aging and in Alzheimer disease (AD), inducing the changes of synaptic density.OBJECTIVE: To observe quantitative synaptic alterations in human brain and changes of synaptic density in different parts during normal aging so as to compare them with those of AD patients.DESIGN: Sampling survey.SETTING: Senile Neurological Department of General Hospital of Chinese PLA.PARTICIPANTS: Pathological data were selected from General Hospital of Chinese PLA from June 1996 to December 2002. Inclusion criteria: had no major nervous system diseases and neuropathological changes. Brain tissues of 28 corpses in normal aging group, 23 males and 5 females aged 23-100 years with an average of (65±22.8) years, were obtained at autopsy.All corpses were divided into three groups according to their age, namely,adult group (23-55 years old, n=9), senile group (64-72 years old, n=7),and ＞75 group (76-100 years old, n=12). Cerebral hippocampal samples of other six corpses diagnosed with AD were selected from clinic. The corpses included 5 men and 1 woman aged 76-94 years with an average of (83±7.7) years.METHODS: Response intensity of synaptophysin immunochemistry remained stable after 4-8 hours of death, so brains were obtained at autopsy after 8-72 hours of death and fixed with 4% formalin for at least 6 weeks.In normal aging group, tissues were taken from left superior frontal gyrus,striatal area of left occipital lobe, left putamen (striatum section, including head of caudate nucleus), and left hippocampus (from lateral geniculate body section to medial occipitotemporal gyrus). In AD cases, tissues were taken from left hippocampus of 4 corpses and right hippocampus of other 2. All sections were stained with hematoxylin eosin (HE), toluidine blue and synaptophysin immunostaining (rabbit anti-human synaptophysin polyclonal antibody from Beijing Zhongshan Biotechnology Co., Ltd.). Morphology and distribution of positive objects in synapse immunologic reaction were observed under the light microscope. Relation between absorbance in each region and age was determined with Pearson's coefficient. Differences among groups were analyzed with nonparametric test, and the differences in hippocampal CA3 area between ＞ 75 group and AD group were analyzed with the same test.MAIN OUTCOME MEASURES:① Absorbency of synaptophysin at various sites of normal aging group and correlation with age; ② absorbance value in CA3 area between AD patients and advanced aged normal subjects (＞75 years) was compared.RESULTS:All the 34 cerebral samples entered the final analysis.①Synaptophysin-positive granules of various size were scattered through neocortex, putamen and hippocampus, neuronal somata, neuroglia, vessels and white matter. Density was particularly strong over layers Ⅱ and Ⅲ in frontal lobe, and layer ⅣV in occipital lobe. ② Synaptophysin density was negatively correlated with age, which was -0.688 in frontal lobe, -0.592 in occipital lobe, -0.458 in putamen and -0.619 in hippocampal CA2 area,respectively (P = 0.000, 0.001, 0.014, and 0.000). ③ Significant difference in synaptic density in CA3 area was found between AD patients (0.031 3±0.003 0)and normal subjects over the age of 75 (0.040 7±0.005 3) (Z=-2.997, P=0.001)in nonparametric test.CONCLUSION:① Synaptic density was found to decrease in frontal lobe, occipital lobe, CA3 area of hippocampus and putamen with age; the changes had significant correlation with age.② Synaptic density of AD patients was lower than that of normal subjects, and their cognitive hypofunction was related to synaptic loss. ③ All tissues were obtained after 8-72 hours of death and fixed over 6 weeks, which to the greatest extent reduced the effects of tissue autolysis and formalin fixation on the results.