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 investigate the relationship between tumor metastasis-related Rac1 mRNA expression levels and gastric carcinomas metastasis, and to investigate the significance of Rac1 as a tumor marker for the evaluation of gastric carcinomas metastasis and distinguish between benign and malignant lesions. Methods This experiment used fluorescence quantitative RT-PCR TaqMan probe technology, chose Rac1 target gene fragment, which was cloned into the pET-20b (+) vector, constructed recombinant plasmid, and established the Rac1 mRNA fluorescence quantitative RT-PCR standard curve. And then the Rac1 mRNA levels were detected in 52 cases of gastric carcinoma tissues,52 cases of para-carcinoma tissues and 12 cases of benign gastric disease tissues. Its association with the metastasis of gastric carcinomas was analyzed. Results The positive rates and levels (median, P25-P75) of Rac1 mRNA were 100. 0% ,7.41 ×105 (3. 50 × 105-4. 36 × 106) copies/μl in gastric carcinomas, 46. 2% ,0(0-1.73 × 104) copies/μl in parscarcinoma tissues, 33. 3%, 0(0-3.55 × 103) copies/μl in benign tissues. The positive rates and leves(x2 =43.16,x2Xk-w = 64. 19, P ＜0. 01)among the three groups were significantly different. When the critical value of Rac1 mRNA level was 1.73 × 104 copies/μl determined by ROC, the sensitivity and specificity were 88. 5% and 100% respectively. When the critical value of Rac1 level was 7.49 × 105 copies/μl, the sensitivity and specificity were 57.9% and 78. 6% respectively. ConclusionThe Rac1 mRNA level detected with fluorescence quantitative RT-PCR has reference value to distinguish between benign and malignant lesions and evaluate gastric carcinoma metastasis.

Objective To investigate the changes of electrolyte metabolism in patients undergoing moderate elective abdominal operation,and explore its relationship with postoperative complications.Methods The clinical data of 1117 inpatients (age ≥ 18 years) who had undergone moderate elective abdominal operation in the Department of General Surgery of Beijing Hospital from January 1,2011 to December 31,2011 were retrospectively analyzed.They received postoperative fasting for ≥ 3 days,and the preoperative liver function and renal function were normal.The perioperative electrolyte changes and clinical outcomes were recorded.For patients with normal preoperative electrolytes but abnormal postoperative electrolytes,its potential correlations with the postoperative infections and total complications were analyzed.Results The rates of abnormal postoperative electrolytes were as follows:potassium,24.1％ ; sodium,6.4％ ; chloride,27.6％ ; calcium,61.7％ ; magnesium,16.3％ ; and phosphorus,71％.The vast majority of ion levels were below the normal levels.The total complication rate was 19.7％ and the postoperative infection rate was 17.19％.Univariate logistic regression analysis showed that the postoperative total and infective complications were significantly associated with the increased (P =0.007) or decreased (P =0.007) serum potassium,the decreased serum sodium (P =0.016),the decreased serum phosphorus (P =0.004),and the decreased magnesium (P =0.049).Conclusions Electrolyte decrease is common after moderate elective abdominal operations.There is a certain correlation between postoperative electrolyte decrease and postoperative complications.Therefore,attention should be paid to maintain electrolyte balance during the perioperative period.

Objective To summarize the clinical outcomes after the optimization of nutrition support in elderly patients after hepatic carcinoma surgery.Methods The clinical data of 52 elderly patients with hepatic carcinoma in Beijing Hospital were collected and analyzed from 2007 to 2009(research group).Nutritional Risk Screening(NRS)2002 was applied for the nutrition risk screening at admission.NRS 2002 score≥3 was regarded as at nutritional risk.Enteral nutrition(EN)or EN combined with parentoral nutrition(EN+PN)supports were provided during the peri-operative stage.The control group included 30 patients from 2005-2007 under the same conditions with rescareh group but only received PN supports pest-operatively.Nutritional parameters,complications,lengh of hospital stay,and healthcare expenditures were analyzed.Results Body weight and plasma albumin were no significantly different in two groups(P>0.05)by the 7th post-operative day.The incidence of infection-relatod complications and length of hospital stay were significantly lower in research group than in control group (P<0.05).Conclusions Nutrition risk screening should be performed for the elderly patients with hepatic carcinoma after admission.Optimization of peri-operative nutrition support can reduce complications and improve the clinical outcomes.

Objective To evaluate the effect of omega-3 polyunsaturaed fatty acid on liver function, donor's T lymphocytes and acute rejection following orthotopic liver transplantation in rats. Methods Orthotopie liver transplantation from BN (RT1 n) to Lewis was performed. Normal saline (NS, n = 6), parenteral nutrition (PN, n = 6) or parenteral nutrition and Omega-3 fatty acid (OM, n = 6) was given through internal jugular vein catheter respectively beginning the first day for consecutive 6 days. At 7thday, the liver function and pathological changes of the transplant liver were observed. The percentage of CD4+ , CD8+, CD4+ CD25+ and CD8+ CD28- T lymphocytes were analyzed by flow-cytometry. Results In OM group the CD4+, CD8+ , CD4+ CD25+ and CD8+ CD28- T lymphocytes significantly decreased, compared with NS (t = 4.28, P < 0.01 ; t = 2.63, P < 0.05 ; t = 2.59, P < 0.05 ; t = 8.86, P <0.01)or PN group(t =8.06, P<0.01; t =3.57, P<0.01; t =5.35, P<0.01; t =7.98, P<0.01). The ratio of CD4+ to CD8+ significantly decreased in OM group compared with NS group and PN group(t = 6.25, P<0.01; t=4.92, P<0.01). RAI (rejection activity index) in NS group, PN group and OM group was 7.17 +0.98, 6.17±0.75 and 4.33±0.52, respectively. The rejection grade in OM group was siguificanfly alleviated than that in NS group and PN group(t =6.25, P <0.01;t =4.92, P <0.01). Conclusion Omega-3 fatty acid inhibits T lymphocytes, especially help T lymphocytes, alleviates acute rejection. The suppressor T cell and the regulatory T cell were not responsible for the alleviation of the rejection.

Objective To systematically evaluate the efficacy and safety of injected hemocoagulase Agkistrodon for intraoperative bleeding.Methods We electronically searched several Chinese database till May 2014 to identify randomized controlled trials (RCTs) about injected hemocoagulase Agkistrodon for operative hemorrhage.The methodological quality of included RCTs was assessed,and the data were extracted by two reviewers independently according to the Cochrane Handbook.The homogeneous RCTs were pooled using RevMan software (Version 5.1.0).Results 2 358 articles were searched initially,and 12 RCTs involving 1 031 patients met the inclusion criteria.The results of Meta-analyses showed that:in the study groups,the average haemostatic time of the wound is shorter [OR =-40.29,95％ CI(-71.13,-9.44),P =0.01],the hemorrhagic volume of the wound [OR =-1.38,95％ CI(-1.90,-0.87),P ＜ 0.000 01],hemorrhagic volume per unit area of the wound [OR =-0.05,95％ CI(-0.06,-0.03),P ＜ 0.00001],introperative hemorrhagic volume and drainage volume on POD1 [OR =-18.52,95％ CI (-25.50,-11.53),P ＜ 0.000 01] are lower than the placebo groups.In all studies,no difference was found in the variation of hemostatic function,liver and renal function and drug-induced adverse events.Conclusions The injection of hemocoagulase Agkistrodon can significantly reduce the average haemostatic time of the wound,the hemorrhagic volume of the wound,overall introperative hemorrhagic volume and drainage volume on POD1,and does not affect the hemostatic function,liver and renal function and not increase the incidence of adverse effects or postoperative complications.

Objective The purpose of this paper is to study the relationship between blood concentration and brain tissue drug concentration by different dose of TMX chemotherapy acute lymphoblastic leukemia in mice. Methods 4 weeks, health Kun Ming mice 80: establishment acute lymphoblastic leukemia mice model,20 mice were randomly selected to take the femur bone marrow biopsy bone marrow OK for model verification; the remaining 60 acute lymphoblastic leukemia mice were allocated randomly 6 groups of 10 mice in each group, respectively A, B, C, D, E, F groups. And collected blood 0.5 ml and brain tissue 0.4 g individually at 0.5 hour in every group. We used supernatant of centrifugation blood and brain homogenate to detected drug concentration by fluorescence polarization immunoassay. Results The mean blood concentration of MTX of six groups A, B, C, D, E, F are (39.08±5.18) μmol/L, (15.86±1.02)μmol/L, (8.67± 5.43)μmol/L, (68.29±5.19)μmol/L, (29.55±6.22)μmol/L, (13.98±1.12)μmol/L, respectively. Compared the mean blood concentration of MTX of each group there are statistical significance (P<0.05). The mean concentration of MTX of six groups in brain tissue are followed by A group (1.05±0.26)μmol/L, B group (0.61±0.25)μmol/L, C group (0.48±0.25)μmol/L, D group (2.07±0.35)μmol/L, E group (1.27±0.21)μmol/L, F group (0.59±0.69)μmol/L. Compared the mean concentration of MTX of each group in brain tissue there are statistical significance (P<0.05). MTX concentration in blood and in brain tissue of correlation coefficient followed by 0.82, 0.75, 0.19, 0.81, 0.55, 0.43. Conclusion The chemotherapy acute lymphoblastic leukemia mice of HDMTX scheme, the peak of blood concentration and brain tissue drug concentration is come after injected MTX 0.5 hour, MTX 5 g/m~2 is better permeation blood-brain barrier and more easy make brain tissue drug concentration to reach effectively therapeutic concentration than MTX 3 g/m~2.

Objective To explore the effect of horizontal beam on IMRT plan for lung cancer.Methods Totally 18 patients were enrolled,including 10 cases of left lung cancer and 8 cases of right lung cancer.Two intensity modulated radiation therapy (IMRT) plans were generated:one was the normal IMRT plan and another was the IMRT plan including a horizontal beam (H-IMRT).MUs,sub-field and the dose distribution of target and organs at risk (OARs) were compared.Results There were no statistically significant differences between two plans in D Dminand D of PTV,the V30 and D of the ipsilateral lung,V20 and V30 of the contralateral lung,and V30 of the total lung.When the horizontal beam was added,the PTV heterogeneity index (HI) and conformity index (CI) were significantly increased (t=-9.33,10.88,P＜0.05),the other dose index in lung was inferior (t =-1.55--7.58,P＜ 0.05),whleheart sparing were clearly better (t =1.84-3.99,P＜0.05),the number of MUs and segments were less(t =12.57,3.19,P ＜ 0.05).Conclusions IMRT in the treatment of lung cancer can further improve the PTV coverage when the horizontal beam is added.However,the increasing lung volume of low dose irradiation is not conducive to lung protection.

Objective To evaluate the effects of hypocaloric parenteral nutrition on metabolism and prognosis of aged post-traumatic patients. Methods The prospective randomized controlled study was designed. Twenty-four aged post-operative patients were divided into 2 groups: hypocaloric parenteral nutrition group (Caloric 15 kcal?kg -1?d -1/Nitrogen 0.1 g?kg -1?d -1 ) and traditional parenteral nutrition (Caloric 28 kcal?kg -1?d -1/Nitrogen 0. 2 g?kg -1?d -1), respectively. Serum glucose, protein, and lipid levels, infection-related complications, nutrition therapy hospital expenses, hospitalization duration after operation were analysed. Results During nutritious fluid transfusion at 1-5 days after operation, nutrition therapies, serum glucose level of hypocaloric group was obviously lower than that of the traditional group 〔(6.8?0.3) mmol L -1 vs (8.3?0.4) mmol?L -1 , P

N 6-methyladenosine (m 6A) is the most abundant RNA base modification in mammals, especially in eukaryotic messenger RNA (mRNA). N 6-methyladenosine modification can regulate RNA splicing, translocation, stability and ultimately affect protein synthesis. m 6A modification is catalyzed by RNA writers, reduced by erasers and also be recognized by readers. Abnormal changes ofm 6A levels are closely related to tumor occurrence and development, including proliferation, growth, invasion and metastasis. In the process of tumor radiotherapy, m 6A modification affects the efficacy of radiotherapy by affecting DNA damage, tumor stem cell generation and tumor cell radiation sensitivity. This article reviews the role of m 6A-modified epigenetic regulation in malignant tumors and the research progress of its mechanism in tumor radiotherapy, in order to provide new ideas for the development of clinical tumor molecular targeted therapies and radiosensitizers.