OBJECTIVE:To discuss the general regularity and the characteristics of the adverse reaction resulted from Levofloxacin so as to provide references for the rational use of drugs in the clinic.METHODS:89cases of adverse reaction resulted from Levofloxacin covered by the medical and pharmaceutical periodical of recent10years were statistically classified and analyzed.RESULTS:The adverse reaction were mainly manifested as allergic reactions and symptoms in neural system,digestive system and respiratory system,and the adverse reaction were more likely to occur in the senile patients.CONCLU-SION:Great attention should be paid to the anti-bacteria effect of Levofloxacin and the danger posed by its adverse reaction in the clinic.

Objective To investigate the incidence and risk factors of acute kidney injury (AKI) in patients with multiple soft tissue contusion.Methods A total of 513 patients diagnosed as multiple soft tissue contusion in the First Affiliated Hospital of Xinjiang Medical University from January 1,2008 to January 1,2013 were retrospectively analyzed.Demographics,clinical data and laboratory examinations before and after AKI were collected and analyzed.Results The age of all subjects was 31.30 (12-78) years old with the male to female ratio of 2.1∶ 1.AKI occurred in 74 cases with an incidence rate of 14.4％.No AKI was observed in patients with assault injuries,while AKI was found in 27 cases (36.5％) with car accident injuries and 4 cases (5.4％) with other injuries.AKI showed in 1 case(1.4％) with damaged area under 1％,in 4 cases(5.4％) with damaged area ranged from 1％ to ＜ 3％,10 cases (13.5％) with damaged area ranged from 3％ to 5％ and 19 cases (25.7％) with damaged area over 5％ with significant difference among the groups (P ＜ 0.01).Incidence rate of AKI was significantly higher in patients with chronic kidney disease (CKD) than those without CKD (54.5％ vs 20.3％,P ＜ 0.01).Two of the AKI cases died,with a mortality rate of 2.7％.Multivariate logistic regression analysis showed that the followings were the independent risk factors for the occurrence of AKI in patients with multiple soft tissue injuries:age (OR =1.996),basic serum creatinine (OR =0.976),basic evaluated GFR (eGFR) (OR =0.964),serum potassium (OR =2.117),myoglobin (OR =0.950) and damaged area (OR =1.811).Conclusions Incidence rate of AKI is quite high in multiple soft tissue contusion.Age,basic serum creatinine,basic eGFR,serum potassium,myoglobin and damaged area are the independent risk factors for the occurrence of AKI in patients with multiple soft tissue injury.

Objective To explore the effect of hospital-community-based collaborative management on elderly out-patients with chronic heart failure (CHF).Methods A total of 228 out-patients with CHF were randomly assigned to the community-based health management group (n =106 ) and the hospitalcommunity-based collaborative health management group (n =122).In community-based health management group,the patients only received community-based health management,while in hospital-community-based collaborative health management group the patients accepted comprehensive health management.One year later,medication compliance,readmission rate,mortality,average length of hospitalization,medical costs and Minnesota living with heart failure questionnaire (LiHFe) were compared between the two groups.Results No statistically significant differences in clinical data were found between the two groups at baseline.After one year,medication compliance was significantly improved in hospital-community-based collaborative health management group when compared to community-based health management group ( x2 =8.97,P ＜ 0.05 ).Readmission rate,averagelengthof hospitalizationandmedicalcostsof hospital-community-based collaborative health management group were lower than community-based health management group (x2 =9.91 ; t =3.78,3.61 ; all P ＜ 0.05 ).One year ago,the items of LiHFe including physical dimension,emotion,symptom and social dimension and total score showed no significant between the two group (t =0.42,0.81,0.66,0.44,0.41 ; all P ＞ 0.05 ).While one year later,all the scores of hospital-communitybased collaborative health management group were significantly declined( t =6.37,11.81,6.16,9.64,9.13;P ＜ 0.05 ).Mortality showed no significant difference between the two groups ( x2 =0.247,P ＞ 0.05 ).Conclusion Hospital-community-based collaborative management for health care may be a practical and valuable strategy for decreasing readmission rate and medical burden and improving quality of life of elderly patients with CHF.

Objective To analyze the constitution of in-patient death causes in Sharxi Cancer Hospital from 2005 to 2010. Method Statistical analysis of 1277 hospitalized cases from 2005 to 2010 in Shanxi Cancer Hospital was retrospectively conducted. Results The overall case fatality rate of hospitalized patients from 2005 to 2010 was 0.86 ％ (1277/146820),the rates were 1.16 ％,1.05 ％,0.99 ％,0.85 ％,0.84 ％, 0.64 ％, respectively, with a declining trend, and the differences among them was statistically significance (x2 =45.763,P ＜0.001).Total mortality rate of male hospitalized patients (1.26％) was higher than that of women (0.53％),and the difference was statistically significant (x2=215.367,P＜ 0.001).Analysis of cancer death cause revealed that lung cancer possessed the leading cause of cancer death with the ratio of 36.4％(456/1253). The analysis of top 10 death causes showed that the majority of the population in cancer death causes were men,cadres of staff and workers,secondary school education level people,and people over the age of 60. Conclusion The consitution of in-patient deaths in Shanxi Cancer Hospital is defined, which could provide a scientific basis for disease prevention and control.

Objective To explore the regulation of ROS level and ROS-triggered downstream events on SK-N-MC Ewing sarcoma cells upon apoptasis induction by 2-Methoxyestradiol (2-ME). Methods To detect the reversibility of apoptosis and the alternation of activity of respiratory chain, mitechondria transmembrane potential (△ψm), and cellular ROS level and to explore their association with flow cytometry, clark oxygen electronic node analysis, drug-removal design, and permeability transition (PT) pore stablizing agent. Results SK-N-MC cells were induced to ROS-dependent apoptosis. Apoptosis occured irreversibly after2-ME treatment for 3 h. Upon 2-ME treatment, the activity of respiratory chain was inhibited and the ROS generation was accelerated; the △ψm underwent the increasing within 3h but decreasing after 3h which could be reversed by PT pore stablizing; the ROS level underwent the continuous increasing and PT pore stablizing had no obvious effect on it. Conclusion 2-ME causes the acceleration of ROS generation via inhibiting the activity of respiratory chain and elevating the level of △ψm. ROS plays a signaling role and when total ROS accumulate to a threshold, the PT pore opening and the collapse of △ψm could be induced irreversibly and cell is eventually introduced to death.

Objective Streptococcus pneumoniae can form biofilms .The aim of this study was to investigate the biofilm forma-tion of Streptococcus pneumoniae and the relationship with antibiotic resistance of penicillin etc . Methods A total of 147 clinical iso-lates of Streptococcus pneumoniae were collected from 7 teaching hospitals in Nanjing from 2010 to 2012.Minimal inhibitory concentration (MIC) of penicillin, erythromycin, cefuroxime and ceftriaxone were determined by agar dilution method .Streptococcus pneumoniae with various penicillin MIC was selected randomly as follow:MIC≤0.065μg/mL, 0.5μg/mL, 2μg/mL and≥4μg/mL, which was incuba-ted to form biofilms in 96-well plates and 24-well plates for 24 hours.The A values at 570 nm was measured and the biofilm was observed through confocal laser scanning microscope ( CLSM) . Results The biofilm semi-quantitative detection and CLSM both displayed that all strains formed biofilms.The A value of the group which penicillin MIC was ≤0.065μg/mL (0.228 ±0.063) was higher than the 0.5μg/mL group (0.200 ±0.061) and the≥4μg/mL group (0.186 ±0.050) (P<0.05) , and there was no difference among the groups which penicillin MIC were 0.5μg/mL, 2μg/mL and≥4μg/mL, respectively (P>0.05).The A value of the group which erythromycin MIC was ≤0.5μg/mL (0.211 ±0.068) was higher than the ≥4μg/mL group (0.201 ±0.052) (P>0.05).The A value of the group sensitive to cefuroxime (0.216 ±0.062) was higher than the group resistant to cefuroxime (0.196 ±0.054) (P<0.05). Conclusion Streptococcus pneumoniae can form biofilms .Streptococcus pneumoniae with high antibiotics MIC has a trend of weakened biofilm formation .

Objective To analyze the prognostic factors of patients with leukemia treated with single fraction total body irradiation (SFTBI) followed by hernatopoietic stem cell transplantation (HSCT).Methods From January 2001 to September 2008, 102 patients received HSCT. The differences of the survival rate, relapse rate and incidence of interstitial pneumonia (IP) between groups regarding different genders, ages, pathological types, transplantation methods and TBI parameters were compared and the factors related with the survival rate, relapse rate and incidence of IP were analyzed. Results The followup time ranged from 15 to 1482 days (median, 406 days). The follow-up rate was 95.1%. 86 and 55patients were followed up more than one year and three years. The 1-and 3-year survival rates were 59.0%and 44.0%. In univariate analysis, the 3-year survival rate was signifcantly different between the groups with and without relapse before transplantation (20% vs. 55%, χ2 = 6.33, P = 0. 012), allogeneictranplantation versus autologous tranplantation (39% vs. 68%, χ2 = 8.06, P = 0.005), grade 3 or more acute graft versus host disease (aGVHD) and grade 0 -2 aGVHD (0% vs. 54%, χ2 = 7.52, P = 0.006),with and without relapse after transplantation (19% vs. 58%, χ2 = 10.13, P =0.001), with and without IP (23% vs. 58%, χ2 =8.35, P=0.004). Multivariate analysis showed that grade 3 or more aGVHD was the only statistically significant prognostic factors (χ2 = 12. 74 ,P =0. 000). The l-and 3-year relapse rateswere 30. 0% and 50. 0%. The incidence of relapse was obviously higher in the group with relapse before transplantation than that without (47% vs. 16%, χ2 =7. 32, P=0. 007). Multivariate analysis showed thatrelapse before transplantation was a significant factor predicting relapse after transplantation (χ2 = 9. 39,P =0. 020). The cumulative incidence of IP was 35.0%. The incidence of IP was different between groups with dose homogeneity > 3% and ≤ 3% (27% vs. 4%, χ2 = 5. 21, P = 0. 023), with and without acute parotitis (34% vs. 3%, χ2 = 14. 15, P= 0.000), allogeneic transplantation group and autologous transplantation group (31% vs. 8%, χ2= 7.70, P= 0.006). Multivariate analysis showed that transplantation methods, acute parotitis and dose homogeneity were statistically significant factors in predictingIP (χ2 = 10. 08 , 10. 08 and 7.69 , P = 0. 002 , 0. 002 and 0. 010 , respectively) . Conclusions Patients who develop grade 3 or higher aGVHD have poor prognosis. Dose homogeneity influences the incidence of IP. Patients undergoing allogeneic transplantation are apt to have IP. Acute parotitis is related with IP and might be a predictor.

【Objective】 To explore the significance of electrocard iogram monitoring during the effective application of radiofrequency energy to s low atrioventricular (AV) nodal pathway ablation. 【Methods】 Slow AV nodal pathway ablation was performed in 58 patients with slownfast AV nodal ree-trant tachyca rdi a (AVNRT). The changes of electrocardiogram were monitored during the effective application of low radiofrequency RF energy (15～25 W). A faster rate of junctio nal ectopy (>150 min-1), ventriculoatrial (VA) block in association with j unctional ectopy, and l ong P-R interval during sinus beat were considered as harbingers of atrioventri cular (AV) block. RF energy deliveries were discontinued as soon as the harbinge rs of AV block occurred. Otherwise, RF energy continued until junctional ectopie s were decreased or vanished. If junctionnal ectopies were not decreased, RF ene rgy continued lasted for 90～120 s. 【Results】 Slow AV nodal pathway ablation w as successful in all patients who had junctional ectopy during the effective del ivery of RF energy. The effective ablation time was (128±26) s. 54 patients exp erienced one time successful ablation, and 4 patients experienced two times abla tion. Unsustained AV block occurred in 6 patinets after RF energy deliveries whi ch were immediately terminated because of VA block in association with junctiona l ectopy in 4 patinets and long P-R interval during sinus beats in 2 patients. No patients developed permanent AV block. Recurrent AVNRT requiring second ablat ion occurred in 2 of 58 successfully ablated slow pathway during (18±16) months of follow-up. 【Conclusion】 RF energy deliveries could be instructed b y intracardiac electrocardiogram monitoring during AVNRT ablation, which could e nhance the successful rate of slow pathway ablation, reduce recurrence and avoide permanent AV block.

Objective To investigate the effects of salmeterol/fluticasone (seretide) combined with community intervention on lung function and quality of life of chronic obstruetive pulmonary disease (COPD) patients in the stable period.Methods 96 cases with COPD in the stable period were divided into two groups randomly:Group A was treated only by seretide for six months,group B was treated by seretide combined with community intervention (health education,psychological intervention,exercise training,and nutritional guidance).6 months later,the lung function was determined and the quality of life was assessed by SGRQ.Results The lung function and the score of the quality of life in two groups after treatment [Group A:(1.78 ±0.16)L,(65 ±9)％ and 40 ± 18,36 ± 16,125 ±40;group B:(2.05 ±0.28)L,(73 ±9)％ and 21 ± 10,20 ± 11,58 ± 28,respectively] were improved than those before treatment [Group A:(1.59 ±0.15),(58 ±7) and 63 ±22,50 ±24,167 ±68;group B:(1.61 ±0.14)L,(58 ± 8)％ and 62 ±22,48 ± 22,163 ± 67,respectively] (P ＜ 0.05 );The lung function and the score of the quality of life in B group were improved than those in A group after treatment ( P ＜ 0.05 ).Conclusions Using community intervention combined with seretide in treatment of COPD patients has better effect than the single use of seretide therapy,it improves lung function and quality of life.It is a safe treatment method and worthy to spread widely.

AIM:To evaluate complement activation in patients with all forms of acute coronary syndromes(ACS)and to examine the relationship between the degree of complement activation and myocardial injury.METHODS:The subjects were divided into 2 groups:110 ACS patients(group ACS)and 18 healthy persons(group control).One hundred and ten patients with ACS were divided into 3 sub-group:51 patients with ST-segment elevated myocardial infarction(STEMI),28 patients with non-ST-segment elevated myocardial infarction(NSTEMI)and 31 patients with unstable angina(UA).Complement 3(C3),complement 4(C4),troponin T(TnT)as well as creatine kinase MB(CK-MB)were evaluated.RESULTS:Plasma C3 and C4 peak levels were significantly higher in patients with STEMI [(1 525?302)mg/L and(423?123)mg/L] and NSTEMI [(1 516?289)mg/L and(396?68)mg/L] than those in patients with UA [(1 275?172)mg/L and(356?91)mg/L] and the control subjects [(1 072?196)mg/L and(182?73)mg/L](P