OBJECTIVE:To investigate the status quo and causes of adverse drug reaction(ADR) caused by traditional Chinese medicine(TCM) in our hospital.METHODS:154 ADR cases reported in our hospital from Feb.2008 to Jun.2009 were analyzed statistically in respect of age and gender of patients,organs and systems involved in ADR and its clinical manifestation.RESULTS:Main clinical manifestations were lesion of skin and its appendents.Most of ADR cases were caused by TCM injections.CONCLUSION:Great importance should be attached to TCM injections and its monitoring to reduce the incidence of ADR.

Objective To evaluate the effects of external fixators combined with vascularized bone graft in treatment of talar neck fractures. Methods We retrospectively reviewed the records of seven patients who were treated for fractures of talar neck from January 2004 to March 2005 in our department. Of them, six were type Ⅱ and one was type Ⅲ according to the Hawkin s classification. One case was managed with closed reduction and six with open reduction and internal fixation with percutaneous cannulated screws. In addition, all the patients were treated with transarticular external fixators combined with vascularized bone graft. Bone healing, osteonecrosis and hindfoot functional recovery were documented. Results All the patients were followed up for 13 to 24 months (average, 17 months). All of them achieved bony union. According to the Maryland hindfoot scoring system, five cases were excellent and two were good. No avascular necrosis was found. One patient complicated with talar body fracture developed posttraumatic arthritis that was later managed by tibiotalar fusion. Conclusions External fixators combined with vascularized bone graft can effectively prevent avascular necrosis of the talus, but the long-term effects of this method need further observation.

OBJECTIVE:To improve the effectiveness of experimental teaching and independent hands-on ability of the students.METHODS:Combined with teaching characteristics of newly established universities,the characteristics of instrumental analytical experiment teaching and the characteristics of pharmaceutical students,flipped classroom and project modular design were applied to instrumental analytical experiment teaching together.The instrumental analytical experiment teaching was expounded and integrated in respects of curriculum content design,teaching implementation and curriculum assessment.RESULTS&CONCLUSIONS:The students achieve the knowledge learning after classroom,and complete the knowledge absorption and mastering in class with the help of video and audio information.It also improved independent learning ability of the students,strengthened the ability of interactive learning and cooperative leafing between teachers and students and among students.It is feasible to apply the flipped classroom and the experimental project modular design in the instrument analytical chemistry experiment teaching reform.This method also can provide some references for the reform of instrument analytical chemistry experiment teaching.

Objective To investigate the expression of hypoxia-inducible factor-1 alpha (HIF-1 α),vascular endothelial growth factor-A (VEGF-A) and vascular endothelial growth factor-D (VEGF-D)in hypoxic environment as well as the relationship between HIF-lα and VEGF-D.Methods Human esophageal cancer cell line EC9706 was cultured under hypoxia environment for 6,12 and 24 h,the cell radiosensitivity was evaluated by survival curve.HIF-1 α siRNA was constructed and transfected into human EC9706 cells.Protein expressions of HIF-1 α,VEGF-A and VEGF-D were analyzed by Western blot before and after RNA interference.Results EC9706 cells under hypoxia showed radioresistance with a SF2 of 0.62 higher than that of normoxic cells of 0.43.Moreover,the protein expressions of HIF-1α,VEGF-A and VEGF-D were all increased (F =205.24,227.88,130.55,P ＜0.05) due to hypoxia treatment.On the contrary,after HIF-1α siRNA transfer,the protein expressions of HIF-1α,VEGF-A and VEGF-D in EC9706 cells were not influenced by hypoxia treatment.Conclusions EC9706 cells in hypoxic environment was radioresistance,and the upexpressions of HIF1α,VEGF-A and VEGF-D may be involved.

Objective To evaluate the correlation of sub-foveal chomidal thickness (SFCT) variation in type 2 diabetic patients with clinically significant diabetic macular edema (CSME) and the related factors using enhanced depth imaging optical coherence tomography technique (EDI-OCT).Methods A total of 40 normal volunteers (group A), 49 type 2 diabetic patients without CSME(group B) and 37 type 2 diabetic patients with CSME (group C) were recruited, including 67 male and 59 female.All study subjects received EDI-OCT examination.The SFCT in A, B and C groups were compared using one-way ANOVA analysis.The correlations between SFCT and duration of diabetes, fasting blood glucose (FBG), glycoseylated hemoglobin HbAlc, low density lipopmtein (LDL), triglyceride (TG), total cholesterol (TC), high density lipopmtein (HDL), systolic blood pressure (SBP) and diastolic blood pressure (DBP) were analyzed using logistic regression analysis.Results Average SFCT in group A was (271.49±36.18) μm.Average SFCT in group B was (260.48±35.27) μm, and compared with group A, the difference was not statistically significant (P＞ 0.05).Average SFCT in group C was (227.90±34.73) μm, and compared with group A, the difference was statistically significant (P＜0.01).There was a significant difference of SFCT between groups B and C (P＜0.01).There was no statistically correlation between average SFCT and duration of diabetes, FBG, HbA1c, TG, TC, HDL, creatinine, SBP and DBP (P＞0.05), while a statistically correlation between SFCT and LDL or urinary albumin excretion rate (UAER) was observed in the study (r=-0.609,-0.681, P＜0.01).Conclusions Compared with groups A and B, SFCT in type 2 diabetic patients with CSME was significantly thinner.UAER and LDL levels in type 2 diabetic patients with CSME were negatively correlated with SFCT, that is to say, with the increasing of UAER and LDL levels, SFCT in type 2 diabetic patients with CSME decreased.

Objective To study the relationship between advanced liver fibrosis and peripheral neuropathy in patients with type 2 diabetes mellitus (DPN). Methods A total of 173 patients (89 men and 84 women) with type 2 diabetes who hos?pitalized in Tianjin Third Central Hospital within nearly three years (2013.02-2015.02) were divided into three groups ac?cording to non-alcoholic fatty liver disease (NAFLD) fibrosis score:group A (NFS≤-1.455), group B (-1.455

BACKGROUND: Independent urination and defection functions do not exist in patients with paraplegia above T12 because the injury disrupts the connection to the brain.OBJECTIVE: To reconstruct urination and defecation functions in patients with paraplegia with vascularized intercostal nerve transfer to sacral nerve roots with selected interfascicular anastomosis.DESIGN: Self-control observation.SETFING: Department of Orthopedics, Changhai Hospital of the Second Military Medical University of Chinese PLA.PARTICIPANTS: We recruited 30 patients with traumatic paraplegia at T9-L2 who received treatment in the Department of Orthopedics,Changhai Hospital of the Second Military Medical University of Chinese PLA, from January 1990 to December 2000. Paraplegia plane at T9-T11was found in 17 cases and paraplegia plane at T12-L2 in 13 cases. All the cases had undergone vertebral lamina decompression and internal fixation, 24 of whom had an additional operation to remove the internal fixation.METHODS: Two normal vascularized intercoastal nerves and artery and vein (intercostals nerves were generally at ribs 7 and 8 or 9 and10)above the spinal cord injury site were harvested by cutting in at their distal ends at the midclavicular line and separating the proximal ends from the levatores costarum. The nerves were then transferred to the vertebral canal through a submuscular tunnel. A sural nerve segment that had been harvested and sheared into two segments was sutured to the intercostal nerves by epiperineurial neurorrhaphy and then to the S2-4nerve roots by interfascicular neurorrhaphy. For patients with spinal injury plane below T11, intercostal nerve or subcostal nerve among the 10th and 11th ribs were harvested from the incision of abnormal wall. The nerves were transferred to the lumbar part through the channel of lateral abdominal wall. The transplanted sural nerve was conrected to S2-4 nerve root of partial nerve tract cut alternatively and exposed from S1,2 plane posterior. Defecation function of the patients was evaluated at postoperative 1, 3, 6, 12 and 24 months and follow-up; urodynamic examination was performed before and after operation.patients.RESULTS: A total of 30 patients were followed up for 5 years on average,tion and defecation functions of the patients: 26 (86.6%) had recovered defecation and urination sensation, 23 (76.7%)regained the micturition reflex and uriesthesis; 19 (63%) had recovered function of the detrusor The postoperative maximum urine flow ratio, surplus urine volume, and the maximum systolic pressure of detrusor muscle were obviously improved as compared with those before operation [(12.0±3.0) vs (2.0±0.3) mL/s,(80±12) vs (150±30) mL, (11.76±3.43) vs (5.88±1.47) kPa, P ＜ 0.05]. Postoperative low compliance was found in 9 cases, and detrusor areflexia in 7cases. The number was both significantly decreased as compared with that of preoperative cases (26 and 27 respectively).CONCLUSION: Transfer of vascularized intercostal nerve to S2-4 nerve roots with selected interfascicular anastomosis can reconstruct partial urination and defecation functions, and sensation in buttock, perineal region and cunnus region in paraplegia.

BACKGROUNDConventional cytology is valuable in diagnosing the cancer cells in pleural fluid of patients with lung cancer. However, the diagnostic value of detecting pleura micrometastasis is limited. The aim of this study is to investigate clinical significance of CK19 mRNA expression in pleural fluid of patients with lung cancer.

METHODSReverse transcriptase-polymerase chain reaction (RT-PCR) was used to detect CK19 mRNA in pleural fluid from 86 patients with lung cancer and 40 patients with benign lung diseases, and the results were compared with the results of conventional cytologic diagnosis.

RESULTSThe positive rates of CK19 mRNA in pleural fluid were 93.0%(80/86) from patients with lung cancer and 20.0% (8/40) from patients with benign lung diseases, which showed an obvious difference between two groups (Chi-square=65.69, P < 0.01). The positive rates of CK19 mRNA in pleural fluid of patients with lung cancer had no correlation with histopathology types (P > 0.05). The sensitivity and accuracy of CK19 mRNA were obviously higher than those of diagnosis of conventional cytology in pleural fluid of patients with lung cancer (P < 0.01).

CONCLUSIONSCK19 mRNA can be taken for a molecular marker to detect pleura micrometastasis, it may be helpful to diagnose the cancer cells in pleural fluid of patients with lung cancer and evaluate the clinical staging more correctly.

Objective To evaluate the clinical application value of multi-slice helical CT volumetric (VH) scanning in lumber spine. Methods One thousand of patients with back and leg pain who underwent CT examinations were selected as subjects. We simulated the traditional protocol of single-slice(SS) discrete scanning for L3/4, L4/5, and LS/S1 intervertebral discs. The VH scanning mode was performed with 120 kV, 210 mAs,pitch of 1.5 and coverage of 97. 5 mm. The simulated SS scanning mode was performed with 120 kV, 240 mAs and coverage of 45.0 mm. The diagnostic outcomes and the radiation doses were compared between the two scanning modes. Two groups doctors observed ten terms, including the osseous spinal stenosis,narrowed intervertebral space and so on in two scanning modes respectively. Then consistency analysis of the data was carried out. Results The VH scanning mode showed far more features than the SS mode. The detection rates of the VH mode in the osseous spinal stenosis, narrowed intervertebral space,herniated nucleus pulposus, narrowed lateral recess, vertebral lesion, hypertrophy of L5 transverse process,abnormal direction of facet, facet degeneration, lumbar spondyloschisis, and paraspinal soft tissue were 11.8% (n =118), 38. 5% (n =385), 9. 3% (n =93), 46. 8% (n =468), 31.4% (n =314), 5.7% (n =57), 25.4% (n = 254), 49. 7% (n = 497), 9.9% (n = 99), and 0. 6% (n = 6) respectively, while the detection rates of the SS mode in ten terms were 5.6% (n = 56), 0, 0. 6% (n = 6), 27. 9% (n = 279),22.4% (n =224), 1.2% (n = 12), 16.7% (n = 167), 37.2% (n =372), 0.5% (n =5), and 0.2%(n = 2) respectively. The difference between the two groups had statistically significance (average P <0.05), except the paraspinal soft tissue abnormal (P > 0.05). The detection rates of the VH mode were higher than the SS mode in the osseous spinal stenosis, narrowed intervertebral space, herniated nucleus pulposus, lumbar spondyloschisis, being 6.2% (n = 62) , 38. 5% (n = 385) , 8.7% (n = 87), and 9.4%(n =94), respectively. In addition, VH mode only partially showed the articular facets, narrowed lateral recess, hypertrophy of L.5 transverse process, and paraspinal soft tissue. We could not acquire the imaging slices paralleling to intervertebral discs in SS mode in 467 patients (46.7%) with lumbosacral angle greater than 35°. The radiation dose of VH mode (164.9 mGy/em) was slightly higher than SS mode (147.0 mGy/cm) Conclusion MSCT VH scanning mode can significantly improve the diagnostic rate of lumbar spine diseases compared with SS mode, and was not restricted by the lumbosacral angle with slightly increasing radiation dosage.