OBJECTIVE:To probe into the condition of the occurrence of the adverse drug reactions(ADRs) induced by Chinese materia medica.METHODS:A total of 933 ADR cases induced by Chinese materia medica published in 100 different kinds of journals during 2000～2008 were studied retrospectively.RESULTS:A total of 156 kinds of Chinese materia medica were involved in these ADRs,which were administered by 5 routes,with intravenous administration showing the highest incidence at 78.46%. Among all the ADRs,the systemic reactions represented 57.77%.CONCLUSION:It is necessary to popularize the knowledge on safe medication of Chinese materia medica,standardize clinical rational use of Chinese materia medica and its preparations and tighten control and monitoring on the ADRs induced by Chinese materia medica.

Objective To study the current incidence of Keshan disease in Yunnan Province,and provide scientific basis for Keshan disease(KD) prevention and control. Methods Based on the Scheme of KD Surveillance, 16 villages in 11 counties were chosen as surveillance sites by the historical data. An survey was made to the residents in the 16 surveillance sites by filling in the questionnaire, inquiry medical history, clinical examination, electrocardiogram and 2 meters post-anterior chest X-ray for suspected cases. KD cases were diagnosed according to the Diagnostic Criteria for Keshan Disease(GB 17021-1997). The prevalence data of KD in the whole province were collected from the KD case report in 2007 and the trace surveys. Results There were 6877 residents in 16 surveillance sites of 11 surveillance counties and totally 39 KD cases were diagnosed with a detection ratio of 0.57% (39/6877). The detection ratio of latent and chronic KD were 0.41%(28/6877) and 0.16%(11/6877), respectively and no acute or subacute cases were found. The cases aged 5 to 14 years old accounting for 66.67% (26/39). Electrocardiogram examination of 6877 residents were made and 5.25% (361/6877) abnormal electrocardiograms were detected in the 16 surveillance sites. Fifty-five people were checked by chest X-ray and there were 31 cases with heart-chest ratio ≤0.50, 16 cases with heart-chest ratio from 0.51 to 0.55 and 8 cases with heart-chest ratio from 0.56 to 0.60. The prevalence rate and incidence rate of chronic KD were 4.24 per 100 000 and 0.50 per 100 000 in Yunnan. No acute or subacute cases were found and the latent cases were listed. The prevalence rate and incidence rate were 7.76 per 100 000 and 1.18 per 100 000 in the 16 surveillance sites. Conclusions The incidence of KD is low incidence in Yunnan Province. Higher ineidence of chronic KD was detected in the some areas and the corresponding control measures need to be adopted.

Objective In order to master the current situation of Keshan disease in Yunnan province and to provide scientific basis for Keshan disease control and prevention. Methods Eighteen villages were selected as the investigation sites in 6 counties across all the Keshan disease wards in Yunnan province,where the residents were investigated. Then,the villages census data was collected,clinical examination aiming mainly on cardiovascular system was carried out,including electrocardiography and X-ray to the suspected patients. Correct diagnose of Keshan disease was made by the Diagnostic Standard of Keshan Disease(GB 17021-1997). At the same time,10 food samples and 10 hair samples for detecting selenium content in every investigation site. Results There were 9818 residents investigated in the 18 investigation sites in 6 counties,and 34 eases of Keshan disease were found,the total incidence rate was 0.35%(34/9818). Among the 34 Keshan disease eases,32 cases were latent Keshan disease,the incidence rate was 0.33%(32/9818); 2 cases were chronic Keshan disease,the incidence rate was 0.02%(2/9818). There was no any acute and sub acute cases be found. Most Keshan disease cases aged from 5 to 14,67.65% (23/34). Abnormal ECG rate was 6.90% (677/9818). Among 56 X-ray films,47 cases had a cardiothoracic ratio less than or equal to 0.50,83.93%(47/56),5 cases from 0.51 to 0.55,8.93%(5/56),4 cases from 0.56 to 0.60,7.14%(4/56). Selenium content was detected in 180 food samples and 180 hair samples. The average food selenium content (mg/kg) was 0.013±0.010,the lowest content in Yongsheng county (0.006± 0.001),the highest content in Tonghai county(0.027±0.009). The average hair selenium eontentwas(0.252± 0.078)mg/kg,with the lowest(0.145±0.043)mg/kg in Yoagsbeng county,the highest (0.297±0.062)mg/kg in Tonghai county. Conclusions The detected ratio of Keshan disease is low in Yunnan province. Most of Keshan disease patients age from 5 to 14. It was presented that the Keshan disease infectious agents were still strong and active. The foodstuffs and hair Selenium content is low in food and hair sample,and varies in different investigation site. It is necessary to supply selenium for prevent Keshan disease in the severe areas.

Objective To investigate the effect of propofol combined with remifentanil or sufentanil on cognitive function in patients undergoing awake craniotomy. Methods Sixty ASA Ⅰ or Ⅱ neurosurgical patients undergoing resection of glioma in cerebral cortical functional area were divided into 2 groups by random digits table: propofol + remifentanil (group RF, 30 cases) and propofol + sufentanil (group SF, 30 cases). Scalp nerve block and local infiltration of incision and dura mater were performed in both groups with 0.5% ropivacaine. Propofol, remifentanil and sufentanil were administered by target controlled infusion. The target plasma concentration of remifentanil was set at 1-2 ng/ml and that of sufentanil at 0.1-0.2 ng/ml,propofol was set at 3-6 μg/ml at open skull stage. The patients were inserted laryngeal mask and mechanically ventilated. Bispectral index (BIS) was monitored as the depth of anesthesia. Mini-mental scale examination (MMSE) was investigated at the time of preoperative,intraoperative wake-up after the patients had been targeted capacity. Results Blood concentration of propofol in group RF was (1.10 ± 0.06)μg/ml, group SF was (0.98 ± 0.05)μ g/ml in patients during intraoperative wake-up. BIS in group RF changed from 46.4 ± 2.5 to 90.8 ± 3.2 during wake-up, group SF from 44.8 ± 2.1 to 89.9 ± 3.2. The cognitive function score was not significantly different at the time of preoperative and intraoperative assessment. Conclusion Propofol combined with remifentanil or sufentanil has no effect on cognitive function for the patients undergoing awake craniotomy.

Background and purpose:This study aimed to investigate the relationship between lymph node metastatic rate (LR) and response to radioiodine therapy in patients with papillary thyroid carcinoma (PTC).Methods:A total number of 143 PTC patients after radioiodine therapy were included and classified into 4 groups [Ⅰ(0%-10%),Ⅱ(>10%-25%),Ⅲ(>25%-50%),Ⅳ(>50%)] according to the lymph node metastatic rate, and the responses to initial radioiodine therapy after a median follow-up period of 20.7 months were evaluated. They were classiifed into 4 groups [excellent response (ER), indeterminate response (IDR), biochemical incomplete response (BIR), and struc-tural incomplete response (SIR)] according to the guideline proposed by 2015 American Thyroid Association. One-Way analysis of variance,χ2 test and Kruskal-Wallis test were used to evaluate the differences in basic clinicopathological features and clinical responses among the 4 groups. The ROC curve was analyzed to evaluate the clinical value of lymph node metastatic rate for predicting ER and optimal cut-off point.Results:There were no signiifcant differences in gender and T-stage among 4 groups (P>0.05). However,Ⅰ group was signiifcantly older than the other 3 groups (P=0.001). With the increase of lymph node metastatic rate, the number of ER cases decreased, while cases of BIR and SIR generally increased. Compared with the other 3 groups, less cases of ER (27.8%), while more BIR (27.8%) or SIR (11.1%) were observed in groupⅣ (H=18.816,P=0.000). Cut-off value of lymph node involved rate was 52.27%, with a better speciifcity of predicting ER. Area under the ROC curve was 0.668.Conclusion:The higher lymph node metastatic rate in patients with PTC, the worse clinical outcome it could be. A cut-off value of lymph node metastatic rate 52.27% is a speciifc independent predictor for the clinical outcome in PTC patients treated with radioiodine therapy.

Objective To choose a best cultivar by comparing the content of total flavonoid and naringin between different cultivars of Citrus grandis 'tomentosa'.Methods The content of total flavonoids was determined by spetral photometric analysis.The content of naringin was determined by HPLC.Results The content of total flavonoid was 19.24 % and 18.06 %,and naringin content was 11.72 % and 12.38 % in the cultivars from Dachaling and Fengwei respectively,which were much higher than the other cultivars.Conclusion The contents of total flavonoid and naringin were different in different cultivars of Citrus grandis 'tomentosa'.The cultivars of Citrus grandis 'tomentosa' from Dachaling and Fengwei have the best quality.

Objective To investigate the relationship between the initial change of Tg and clinical outcome in DTC patients with pulmonary metastases after 131I treatment.Methods A total of 47 DTC patients (13 males,34 females;average age (41.6±16.3) years) with pulmonary metastases from January 2008 to June 2014 were retrospectively analyzed.Patients were divided into 3 groups according to the variation of Tg: G1 with a declined (more than 50％) Tg;G2 with a declined (less than 50％) Tg or an increased (less than 10％) Tg;G3 with an increased (more than 10％) Tg.The median follow-up time was 1 501 d.Clinical outcomes were divided into remission,stable disease and progressive disease according to the serum test and imaging results.Data analysis was performed by χ2 test and Fisher exact test.Results The percentage of G1,G2,G3 patients was 44.7％(21/47),40.4％(19/47),and 14.9％(7/47) respectively.Results of follow-up showed 19.0％(4/21) patients achieved remission and 81.0％(17/21) with stable disease in G1.There were 2/19 with remission,12/19 with stable disease and 5/19 with progression disease in G2.All patients (7/7) had progressive disease in G3.The clinical outcome was related to the variation of Tg after 131I treatment (Fisher exact test,P<0.01).Conclusions Initial Tg after 131I treatment could be a predictor to the outcome of patients.The increased Tg level indicates a high possibility of 131I refractory disease.

Objective To investigate the clinical effects differences of three-port and single-port invasively combination laparoscopic cholecystectomy and appendectomy in the treatment of acute appendicitis complicated with gallbladder stone. Methods 110 patients with acute appendicitis complicated with gallbladder stones from August 2012 to August 2015 were randomly divided into control group (55 patients) with three-port laparoscopic operation and observation group (55 patients) with single-port laparoscopic operation;and the clinical indexes for operation related, operation overall satisfaction score of Brown, the VAS score of depression and anxiety before and after operation and postoperative complications of both groups were compared. Results The incision length of observation group was significantly shorter than control group (P< 0.05). The operative time of observation group was significantly longer than control group (P < 0.05). The operation overall satisfaction of Brown of observation group was significantly higher than control group (P < 0.05). The VAS score of depression and anxiety after operation of observation group was significantly better than control group and before operation (P<0.05). There was no signiifcant difference in the incidence of postoperative complications between 2 groups (P < 0.05). Conclusion Compared with three-port laparoscopic operation, single-port invasively combination laparoscopic cholecystectomy and appendectomy in the treatment of acute appendicitis complicated with gallbladder stone can efifciently decrease the incision length, improve the aesthetic degree and postoperative negative emotions and not lead to increased risk of postoperative complications.

0.05);while great significances were found between group C and group B and A(P

Background and purpose: Neck lymph node metastasis, most of which presents in central neck compartment, is common in patients with papillary thyroid carcinoma (PTC). The objective of this study was to investigate the relationship between the number of dissected central neck lymph nodes and clinical outcome after radioactive iodine (RAI) ablation in pN1a PTC with no more than 5 lymph nodes involvement. Methods: A total of 167 PTC patients who had 1-5 proven metastatic lymph nodes according to postoperative pathological diagnosis were retrospectively analyzed, all of whom underwent total or near total thyroidectomy and central lymph node dissection. After a median follow-up period of 26 months, the clinical outcome of each patient was evaluated as excellent response (ER), indeterminate response (IDR), bio-chemical incomplete response (BIR), or structural incomplete response (SIR) according to the new American Thyroid As-sociation guidelines. The accumulative ER rate (ERn) was calculated in patients with different numbers of dissected lymph nodes (ERn was defined as the proportion of patients who achieved ER with the dissected lymph node number of ≤n). The relationship between the number of dissected central neck lymph nodes and ERn were investigated. Results: As the increase in the number of dissected central neck lymph nodes,there was also an overall increase in ERn, especially when n rose from 1 to 10. The values of ER1, ER5, ER10 and ER30 were 25.0%, 66.7%, 74.7% and 79.1%, respectively. Besides, the proportion of patients who achieved ER was higher in those with 10 or more dissected lymph nodes than in those with less than 10 (85.7% vs 73.3%, P=0.05). In the multivariate logistic regression analysis, both the dissected central lymph node number of ≥10 (OR=2.720, 95%CI: 1.052-7.033, P=0.039) and the level of preablation stimulated thyroglobulin (OR=0.955, 95%CI: 0.926-0.984, P=0.003) were shown to contribute independently to ER. Conclusion: As the increas-ing number of dissected central neck lymph nodes, the percentage of pN1a PTC patients that achieved ER after RAI ablation generally rises. In pN1a PTC patients with no more than 5 lymph nodes involvement, a central compartment dissection with 10 or more lymph nodes might help them achieve ER after RAI ablation.