OBJECTIVE:To understand the drug use of sample hospitals,and to provide reference for drug production,man-agement and service department. METHODS:Statistical analysis was conducted in the data of drug use in national 1 248 sample hos-pitals during 4th quarter of 2012-3rd quarter of 2013. RESULTS&CONCLUSIONS:Anti-infection medicine,Chinese patent medi-cine,nervous system drugs has being ranked the top 3 in the list of consumption sum,and that of various drugs is in an upward trend. Top 20 drugs in the list of consumption sum mainly are biological products,drugs for the nervous system,digestive system drugs;that of human albumin and deproteinized calf serum have increased greatly. Top 10 imported pharmaceutical enterprises or joint ventures in the list of consumption sum mainly are multinational enterprises,and they are stable in ranking. The development of pharmaceutical enterprises should focus on brand,quality,price and service,etc.,so that their competitiveness can be improved.

Objective To observe the therapeutic efficacy and safety of recombinant tissue plasminogen activator (rt-PA) for treatment of patients with acute cerebral infarction and investigate the prognostic factors of thrombolysis. Methods The clinical data of 60 patients with acute cerebral infarction from January 2009 to November 2013 in Department of Emergency, Hangzhou Traditional Chinese Medicine Hospital were retrospectively analyzed;of them, 30 cases received intravenous rt-PA thrombolytic treatment, being in the thrombolytic group, 0.9 mg/kg rt-PA was given to the patient within 4.5 hours after the disease onset, the total dosage could not exceed 90 mg, in which 10%was intravenously injected and the rest 90%was intravenously dripped slowly within 60 minutes. That another 30 cases did not undergo thrombolytic therapy was assigned as the control group, and they took aspirin, etc anti-platelet aggregation routine treatment. Before and after thrombolytic treatment for 1 hour, 24 hours and 14 days, the National Institutes of Health Stroke Scale (NIHSS) score was evaluated in the two groups;before and after thrombolytic therapy for 0.5, 1.0, and 1.5 hours, the patient's scores of Barthel index (BI) were observed in the two groups. In thrombolytic group, the situations of hemorrhage transformation, symptomatic hemorrhage and modified Rankin scale (mRS) score in 3 months of the patients with different ages, complications and NIHSS scores were observed. Results Before treatment, no statistically significant differences were found in the NIHSS score (15.2±3.6 vs. 15.5±3.3) and BI score (45.0±8.8 vs. 44.1±7.6) between the control group and thrombolytic group (both P>0.05);after treatment with the extension of time, the NIHSS score was gradually reduced, reaching the lowest level on the 14th day after thrombolytic treatment, while the BI score was gradually increased, reaching its peak at 1.5 hours after thrombolytic treatment, the changes being more prominent in thrombolytic group (NIHSS score:9.7±2.6 vs. 12.8±4.2, BI score:82.6±7.8 vs. 69.6±9.8, both P<0.05). In thrombolytic group, there were cerebral hemorrhage transformation 2 cases, gum bleeding 3 cases, skin bleeding 1 case, urethral bleeding 1 case, gastrointestinal bleeding and black stool 1 case. In control group, cerebral hemorrhage transformation was seen in 1 case. There was no obvious systemic hemorrhage in the two groups. In the 30 cases in thrombolytic group, the baseline NIHSS score of patients>80 years old was higher than that in cases≤80 years old (15 vs. 12); the age (years: 71.0±4.1 vs. 61.5±2.6), baseline NIHSS score (14 vs. 11) and bleeding conversion rate [37.50% (3/8) vs. 18.18% (4/22)] of cases with atrial fibrillation were higher than those not complicated with atrial fibrillation; the NIHSS score of cases with elevated international normalized ratio (INR) was lower than those without elevated INR (11 vs. 14);The bleeding conversion rate [16.67%(1/6) vs. 29.17%(7/24)] with NIHSS score≤4 were lower than those with NIHSS score>4;the mRS score in 3 months (4 vs. 2), and percentage of 3-month mRS score≤2 [11.1%(1/9) vs. 52.38%(11/21)] in cases with NIHSS score≥20 was higher than that in cases with NIHSS score<20 (all P<0.05). The fatality rate of two groups was 3.33%. Conclusions The intravenous rt-PA thrombolytic treatment can significantly promote the early recovery of neurologic impairment for patients with acute cerebral infarction. The therapy can improve the prognosis and its safety is relatively good. Meanwhile it is similarly effective for cases over 80, with complications such as atrial fibrillation, raised INR, and with different degrees of severity.

Objective To investigate the mRNA expression of secondary lymphoid tissue chemokine (SLC) in human gastric carcinoma. Method The study was designed to investigate semi-quantitatively the expression of SLC mRNA in gastric carcinoma and metastatic lymph nodes by reverse transcription-polymerase chain reaction.Result The expression of SLC mRNA in the gastric cancer tissues was markedly reduced compared with that in adjacent noncancer tissues. The average tumor/normal (T/N) ratio determined by RT-PCR was 0.43?0.08 in 29 patients.Metastatic lymph node/normal ratio was 0.63?0.07.Negative lymph node/normal ratio was 1.19?0.11. As a control,the mean G3PDH T/N ratio was 1.16?0.06,there was no correlation between SLC mRNA expression and clinicopathological characteristics in gastric cancer.ConclusionSLC mRNA expression is suppressed in the gastric tumours. SLC may play an important role in the early stage of carcinogenesis.

Objective To explore the clinical efficacy and safety of closed negative pressure drainage(VSD) in the treatment of elderly patients with abdominal trauma and infection.Methods 82 elderly patients with abdominal trauma and infection were selected into clinical research,they were divided into two groups according to the treatment time number.41 cases of odd numbers were in the control group,they were given conventional dressing change and antibiotic therapy.41 cases of double numbers were in the observation group,they were given VSD therapy and antibiotic therapy.The clinical efficacy and safety after treatment was evaluated.Results The daily volume of the observation group [(48.67 ± 3.87) mL] was significantly increased compared with the control group,the dressing times [(8.59 ±1.04) times],hospitalization time [(18.33 ± 1.50) d] were significantly reduced compared with the control group,the differences were statistically significant(t =8.56,7.88,6.74,all P ＜ 0.05).The VAS score after treatment of the observation group was (3.38 ± 0.51)points,which was significantly lower than those before treatment and of the control group,the difference was statistically significant (t =8.06,7.56,all P ＜ 0.05).The infection control rate of the observation group was 92.68％,which was higher than that of control group,and the incidence of adverse reactions of the observation group was 4.88％,which was lower than that of the control group,the differences were statistically significant(x2 =6.87,7.69,all P ＜ 0.05).Conclusion The effect of vacuum sealing drainage technique in the treatment of elderly abdominal trauma and wound infection is significantly,it can effectively control the infection,reduce the number of dressing,relieve the pain of patients,and has the advantages of simple operation,high safety,which is suitable for promotion and application.

Objective To investigate the effect of transabdominal gastroesophageal stapling in management of variceal bleeding in portal hypertension with Hassabi operation and sum up our clinical experience.Methods Retrospective analysis of 48 cases with portal hypertension operated by transabdominal gastroesophageal stapling between May,1998 and Oct.2005.The elimination of oesophagus venous、the rebleeding rate、the operation mortality、the stricture and the fistula rate and the index that influences the liver function were maily observed.Results No case suffered rebleeding and hepatal encephalopathy during the hospitaligation of the patients.Esophageal varices disappeared or reduced in all cases.One case resulted from stricture and one case died of multiple organ failure.Conclusions Transabdominal extensive oesophagogastric devascularization combined with gastrooesophageal stapling is an effective and safe procedure for control of acute variceal haemorrhage with satisfactory short-term control,but the long-term effect needs to be long follow-up for the patients.

0 05). Conclusions Serum ? hCG could reflect the degree of functional imbalance of the placental trophoblasts on PIH and it may be used as a clinical detecting index of PIH. On the other hand, HPL is not such a useful factor.

Objective To compare the clinicopathological characteristics and prognosis of primary Waldeyer's ring non-Hodgkin lymphoma.Methods From Jan 2008 to Dcc 2013, 50 patients with primary Waldeyer's ring non-Hodgkin lymphoma were retrospectively analyzed.Kaplan-Meier method was used for survival analysis.Log-rank method was used for univariate analysis.Results Waldeyer's ring diffuse large B-cell lymphoma (DLBCL) and extranodal nasal-type NK/T-cell lymphoma (ENKTCL) were the common pathological types of primary Waldeyer's ring non-Hodgkin lymphoma accounting for 56 ％ (28/50) DLBCL and 34 ％ (17/50) ENKTCL, respectively.The age at onset of ENKTCL patients was younger than that of DLBCL patients.Two groups had different primary sites, including 50.0 ％ (14/28) of DLBCL with tonsillar disease and 88.2 ％ (15/17) of ENKTCL with nasopharynx disease.The short phase effect of DLBCL group was higher than that of ENKTCL group.The overall survival (OS) and progression-free survival (PFS) rates had significant differences between DLBCL and ENKTCL (x2 =4.45, P =0.035;x2=6.47, P =0.011).Conclusion DLBCL and ENKTCL are different in clinical characteristics.The short phase effect and prognosis of DLBCL are obviously better than those of the ENKTCL.

Objective To compare the clinical safety and efficacy of simultaneous bilateral total knee arthroplasty (TKA) and staged bilateral TKA in treatment of both knee osteoarthritis.Methods A total of 119 patients (14 males,105 females) with both knee osteoarthritis who underwent TKA from March 2005 to March 2012 were retrospectively analyzed.Their ages ranged from 30 to 81 years with the average age of 65.23±6.33 years.The patients were divided into three groups according to different treaments:simultaneous bilateral TKA group,staged bilateral TKA group during the same hospitalization period and staged bilateral TKA group in two separate hospitalization periods.All the procedures were performed by the same surgeons and the same type of prostheses (LPS-Flex,Zimmer,US) were implanted.Differences of preoperative factors (age,height,body mass in dex and complications),treatment factors (preoperative hemoglobin,operation time,drainage volume,blood transfusion volume,total hospitalization time and total hospitalization costs) and postoperative curative effects (HSS scores,WOMAC scores and ROM)among three groups were compared.The analysis of viariace,LSD-t test and x2 test were used for data analysis.Results The differences of gender composition,body mass index,preoperative hemoglobin were not statistically significant among three groups (P＞0.05).The patientsin simultaneous bilateral TKA group were younger,and havelower incidence ofpreoperative complications (P＜0.05).The differences of post-operative HSS scores,WOMAC scores and ROM were not statistically significant among the three groups (P＞0.05).Although the total hospitalization time,operation time were shorter,and the hospitalization costs were significant ly lower in simultaneous bilateral TKA group,the total drainage volume,the total blood transfusion volume and incidence of postoperative complication rate were higher in this group than those of the other two grops (P＜0.05).Conclusion Due to great impact on patients' physiological conditions,more postoperative complication occurrence and high risk of periprosthetic infection,the decision of simultaneous bilateral TKA should be made cautiously.

Objective To evaluate the effects of fasudil on DCD hearts .Methods Sixteen domestic ,mixed‐breed male porcine [mean body weight (28 ± 3)kg] were randomly divide into experiment group and control group (n= 8 in each) .Experiment group :animals were sedated ,anesthetized and paralyzed .Mechanical ventilation with room air was provided .After thoroctomy ,cardiac arrest was established by bloodletting ,and then keeps at room temperature for additional 25 minutes (warm ischemia) .Hearts were perfused via the aortic root with fasudil (0 .1 mg/kg) enriched cold Stanford solution for coronary artery flushing ,rapidly excised and the aorta was cannulated .Hearts were subjected to isolated Langendorff perfusion (retrograde perfused with warm oxygenated autologous blood) afterwards ,and then underwent 20 minutes of equilibrium ,immersed in fasudil (0 .5 mg/kg) enriched cold Stan‐ford solution for 2 hours in situ cold preservation .Finally ,all the hearts were resuscitated with the warm oxygenated autologous blood perfusion .Control group :hearts from the animals experienced the same except for fasudil supplement .Left ventricular per‐formances were evaluated .Coronary blood flow ,myocardial infarction volume ,myocardial water content ,and myocardial enzyme were measured .Myocardial electron microscopic examinations were carried out as well .Results All the hearts from both groups were successfully resuscitated ,fasudil significantly decreased water content ,enzyme leakage (P< 0 .01 each versus control group) , and increased coronary blood flow (P< 0 .01 versus control group) .Left ventricular function were better preserved (P< 0 .01 each versus control group) .All hearts lacked severe necrosis as determined by tetrazolium staining ,myocardial infarction volume were decresed in experiment group (P< 0 .01 each versus control group) .Intracellular components retained various types of organelle in both group ,but still ultrastructural alterations in control group were more distinctive than in experiment group .Conclusion (1) Donor heart arrested by exsanguinations and plus 25 minutes warm ischemia ,could still be resuscitated with satisfactory result ;(2) The addition of fasudil to Stanford solution (before excise of graft ,during the cold preservation) ,might alleviate DCD heart I‐R in‐jury ,improving the effect of DCD heart preservation ,and hopefully ,might be a novel arsenal in clinical DCD heart transplantation in the future .

OBJECTIVE:To promote rational drug use and improve medical quality.METHODS:A comprehensive analysis was performed on the contents of drug counseling problems presented by 483 patients and medical staff.RESULTS:The use of cardio-cerebral-vascular drugs,anti-bacterial drugs and digestive system drugs were the most common drugs inquired by patients,and their questions focused on the action and clinical use,adverse reactions,administration and dosage etc of drugs.However,anti-bacterial drugs were the leading drugs inquired by medical staff,and their questions focused on drugs available for choice and combined use of drugs etc.CONCLUSIONS:Drug counseling can help promote rational drug use,improve medical quality and patients' awareness toward medical care,besides,it is conducive to the publicity for hospital pharmacists.