Objective To investigate the changes of cardiac structure and function in type 2 diabetes mellitus (T2DM), analyze the related risk factors of heart failure, and improve the awareness of the effect of diabetes on the heart. Methods Randomly selected 170 cases of T2DM patients As the object of study, 170 cases of non diabetic patients as con-trol group, according to whether complicated with heart failure were divided into heart failure patients and non heart failure patients.Comparison of each group left ventricular posterior wall thickness, left ventricular end diastolic diameter, left ven-tricular end systolic diameter, left ventricular ejection fraction, E/A ratio Differences, analysis of the related risk factors of heart failure by logistic regressive.Results T2DM group left ventricular posterior wall thickness, left ventricular end diastolic diameter and left ventricular end systolic diameter increased , Left ventricular ejection fraction decreased, E/A ratio de-creased, were statistically significant difference compared with the control group (p <0.05).These differences are mainly come from non heart failure patients.Logistic regression showed that factors in patients with diabetes duration, HbA1c, com-pliance and complications of hypertension, coronary heart disease, is a risk factor for heart failure complicated with T2DM (all p<0.01).These may be the risk factor for diabetic patients with heart failure.Conclusion Diabetes can cause cardiac remodeling, systolic and diastolic dysfunction maybe some T2DM patients.They did not show symptoms of heart failure in the clinical, but their Cardiac structure and function are abnormal.We should pay attention to the cardiac function examination and early evaluation, prevention of risk factors, to avoid the occurrence of heart failure.

Objective To investigate the clinical significance of serum sialic acid (SA) in the diagnosis and treatment of IgA type multiple myeloma (MM). Methods The level of serum SA in 50 healthy subjects and 70 patients with MM were determined. Results In MM group, there were 25 cases of IgA type, 51 cases of other than IgA type (40 cases of IgG type, 7 cases of light chain type MM, 4 cases of non-secreting type MM). In healthy subjects, patients with IgA, IgG, light chain, non-secreting types and other than IgA type, the serum SA levels were (570.33 ± 67.72) mg/ L, (1289.24 ± 325.42) mg/ L, (585.88 ± 159.12) mg/L, (600.77 ± 126.90) mg/L, (590.50 ± 100.86) mg/L, and (588.39 ± 150.90) mg/L. The serum SA level of IgA type patients was higher than those of healthy subjects and other types (all P<0.01), and there was no significant difference among the other groups (all P> 0.05). The serum SA level of IgA type patients had positive correlations with serum IgA, globulin, bone marrow smear myeloma cell population and ESR (r values were 0.699, 0.753, 0.504, and 0.732, all P< 0.05); the serum SA level of IgA type patients had negative correlations with serum albumin, IgG, hemoglobin and platelet (r values were -0.712, -0.505, -0.629, and -0.596, all P< 0.05). The serum SA level of IgA type patients had no correlation with leukocyte, serum creatinine, serum IgM, lactic dehydrogenase, serum calcium, C-reactive protein and β2-microglobulin (all P>0.05). The level of serum SA in IgA type patients decreased with the improvement of the condition, and increased with the severity of the disease. Conclusions In MM patients, serum SA level in IgA type is high. The serum SA is an index for reflecting the tumor load capacity, and can evaluate the therapeutic efficiency of IgA type MM patients.

Objective To observe the effects of target-controlled infusion ofpropofol on hemodynamics during anesthesia induction in intracranial aneurysms interventional treatment.Methods Ninety patients in intracranial aneurysms interventional treatment were divided into three groups by random digits table method with 30 cases each:control group (group C),plasma drug concentration in target controlled infusion group (group P) and effect of chamber drug concentration in target controlled infusion group (group E).The induction of anesthesia:patients in group C were single intravenous injected with propofol of 2 mg/kg; patients in group P were set target plasma concentration of propofol with 4 μ g/ml.Patients in group E were set the effect target concentration of propofol with 4 μ g/ml.Three groups were set the concentration of remifentanil 4 ng/ml with plasma controlled infusion,and cisatracurium was injected with 0.2 mg/kg.Electrocardiogram,mean arterial pressure (MAP),heart rate (HR),end-tidal pressure of carbon dioxide,bispectral index,pulse oxygen saturation were continuously monitored.Before the time of induction (T0),immediately before intubation (T1),after intubation 1 min (T2),3 min (T3),5 min (T4),10 min (T5),arterial pressure and HR were recorded and the number of using vasoactive drugs were recorded.Results The level of MAP and HR among three groups at T0 had no significant difference (P ＞ 0.05).The level ofMAP and HR in three groups at T1 was significantly lower than that at T0.(P ＜ 0.05).The level of MAP and HR in group P was lower than that in group E and group C,and there was significant difference (P ＜ 0.05).The incidence of using vasoactive agen in group P was significantly lower than that in group C [6.7％(2/30) vs.40.0％ (12/30)],and there was significant difference (P ＜0.01).Conclusion Hemodynamics is relatively stable during anesthesia induction using plasma target controlled infusion with propofol in patients undergoing interventional therapy for intracranial aneurysm.

Objective To explore the surgical methods and clinical applications of single operation hole for thorascopic surgery in treatment of encapsulated effusion with atelectasis after thoracic injury.Methods From October 2011 to October 2013,using single operation hole for thorascopic surgery treating encapsulated effusion with atelectasis in 56 cases after thoracic injury,35 males and 21 females,aged 21-68,mean 34 years old.The left encapsulated effusion with atelectasis in 31 cases,the right of encapsulated effusion with atelectasis in 25 cases,atelectasis in 43 cases,partial atelectasis in 9 cases,total atelectasis in 4 cases.Before thorascopic surgery,routine thoracentesis or (and) closed thoracic drainage were performed,but ineffective.Surgical approach for anesthesia with the thorascopic surgery encapsulated effusion dissection + suction drum lung surgery.Thorascopic surgery were completed in single operation hole,postoperative chest tube into the hole from observation.Results The operation time was 55-120 min,average 75 min; blood loss was 25-150 ml,average 65 ml.All patients underwent in single operation hole.The postoperative hospital stay was 7-19 d,average 11.2 d.There were no perioperative mortality and major complications.Conclusions The single operation hole for thorascopic surgery in treatment of encapsulated effusion with atelectasis after thoracic injury is exactly effective and simple.It can be used as an effective treatment.

OBJECTIVE:To investigate the problems commonly occurred in outpatient prescriptions and to evaluate pharmacists’ role in the checking and intervention of prescriptions.METHODS:Questionable prescriptions recorded by outpatient pharmacists in their routine prescription checking from June,2004 to October, 2004 were classified and statistically analyzed. RESULTS:On average,the questionable prescriptions accounted for 0.35% of all the prescriptions dispensed by pharmacists. Of the questionable prescriptions,usage problems accounted for 43.0%,dosage accounted for 39.4%,volume dose accounted for 9.7%,frequency accounted for 2.7%.The results in prescribed frequency were significantly different before and after pharmacists intervention(P

Objective To clarify the advantages and disadvantages of domestic precision radiotherapy equipment by comparing the clinical efficacies of domestic and imported precision radiotherapy equipments in the treatment of lymphoma. Methods We investigated the treatments of lymphoma in hospitals of different levels using domestic and imported medical linear accelerators and divided them into domestic and imported groups. The data of patients in the two groups were retrospectively analyzed, and the radiotherapy equipment brand, short-term efficacy, acute toxicity, dosimetric parameters of organs at risk and the costs of radiation therapy were compared between the two groups. Results A total of 101 cases receiving radiation therapy for lymphoma in 10 hospitals were collected, including 77 cases in the imported group and 24 cases in the domestic group. The overall response rates were high in both groups, being 88.3% (68/77) in the imported group and 87.5% (21/24) in the domestic group, with no significant difference (P=1.00). The incidences of hematological toxicity (>grade 2) were low in both groups, being 1.3% (1/77) vs 8.3% (2/24), with no significant difference (P=0.14). Subgroup analysis was performed on the dosimetric parameters of organs at risk and acute toxicity of the two groups for extranodal nasal type NK/T cell lymphoma, and there were no significant differences in the maximal dose (Dmax) of the lens, Dmaxof the optic nerve, or mean dose (Dmean) of the parotid gland between the two groups (all P>0.05). However, there was an increasing trend in the domestic group compared with the imported group for Dmeanof bilateral parotid gland (left: [2 306.53±1 119.66] cGy vs[ 1 279.44±1 026.95] cGy, P=0.16; right:[ 2 328.35±1 009.76] cGy vs[ 1 303.79±1 116.79] cGy, P=0.17). The incidence of grade 2 xerostomia in the domestic group was higher than that in the imported group, but the difference was not statistically significant (50.0%[ 2/4] vs 14.3%[ 1/7], P>0.05). The domestic group had significantly lower radiotherapy cost [( 26 743.9±8 061.2] yuan vs[ 42 428.7±14 744.7] yuan) and total hospitalization cost [( 36 702.1± 12 225.8] yuan vs[ 50 192.7±15 494.4] yuan) than the imported group (both P<0.01). Conclusion There is no significant difference in the short-term efficacy of lymphoma treatment between the domestic radiotherapy equipment and the imported radiotherapy equipment, while the treatment cost of the domestic radiotherapy equipment is relatively low. However, the dosimetric parameters of organs at risk of imported radiotherapy equipment is lower and the acute toxicity is less..

OBJECTIVE:To investigate the role of clinical pharmacist in pulmonary infection therapy for a patient with hyper-sensitivity to several kinds of antibiotics. METHODS:Through admission evaluation,clinical pharmacists participated in the formu-lation of pulmonary infection therapy regimen for a patient with hypersensitivity to several kinds of antibiotics. According to clinical efficacy and disease condition,clinical pharmacists adjusted therapy plan and provided individual pharmaceutical care. RESULTS:Physician adopted clinical pharmacist’s suggestions,and then the patient transferred to community hospital after pulmonary infec-tion had been controlled. CONCLUSIONS:Clinical pharmacists adopt admission assessment and classification management,posi-tion high risk patient,provide whole-course pharmaceutical care,and help physician to optimize and promote therapy plan,in or-der to guarantee the safety of drug use.

Objective To analyze the correlation between the resistance of Acinetobacter baumannii and the utilization of antimicrobial agents in the hospitalized patients of Beijng Chuiyangliu Hospital,and provide the basis for clinical rational use antimicrobial agents.Methods A retrospective analysis was conducted for the drug resistance rate and specimen source of the 2 194 strains of Acinetobacter baumannii from 2010 to 2014 in the hospital and DDDs/DUI of antimicrobial agents was analyzed by Pearson correlation.Results The resistance rate of Acinetobacter baumannii was positively correlated with the DDDs and DUI of imipenem/cilastatin(r=0.991,0.994,all P<0.01), and was positively correlated with the DDDs of cefepime(r=0.934,P=0.020).The resistance rate of Acinetobacter baumannii to amikacin was positively correlated with the DDDs of etimicin(r=0.931,P=0.022).The resistance rate of Acinetobacter baumannii was negatively correlated with the DUI of levofloxacin(r =-0.986,P =0.002). Conclusion The resistance rate of Acinetobacter baumannii was high and there was correlation between the drug resistance and the utilization of some antimicrobial agents.

Objective To analyze the behavior of patients with serious adverse drug reactions and look for risk factors leading to serious adverse drug reactions .Methods Patient medication behavior evaluation method was established,which was used in cases of serious adverse reaction caused by stains in recent three years in Beijing Chuiyangliu Hospital .Clinical pharmacists participated in field survey .Medication behavior of patients was analyzed from three aspects of knowledge ,attitude and ability .Results Three patients had serious adverse reactions occurred in recent 3 years,drugs were suspected of simvastatin and atorvastatin .The score of medication knowledge was lower than 20%.The score of health attitude was lower than 20%.The score of taking ability was lower than 20%. Conclusion In the investigation of serious adverse reaction ,pharmacists found the risk behavior of patients with daily medication is an important cause of patients with serious adverse reaction .Pharmacists should strengthen the drug education and publicity ,especially in patients with risk factors of medication behavior such as knowledge ,attitude and ability in their daily work .

Objective To investigate the survival rate of patients with chronic severe hepatitis B (CSH) after lamivudine treatment. Method A matched retrospective cohort study using data on patients derived from a prospectively collected chronic severe hepatitis B database was conducted. The database included patients who received or did not receive lamivudine treatment from October, 1999 to December, 2003. The match was conducted according with 3 variables: sex, age and duration of disease. The match ratio was 1∶1. Cases were patients who received lamivudine treatment (n=103).Controls were patients who did not receive lamivudine treatment (n=103). All the patients were followed up and their median survival time and survival rate were compared and evaluated. Results The median survival time in lamivudine treatment group and control group were 85 and 35 d respectively. The survival rate for 3 years in treatment group and control group were 42.7% and 23.4% respectively. There was significance difference in survival rate between the 2 groups (P