OBJECTIVE:To explore the general regulation and characteristics of adverse drug reactions(ADR)induced by ti-cagrelor,and provide reference for clinical rational drug use. METHODS:672 patients received ticagrelor in our hospital from Dec. 2013 to Jun. 2015 were followed-up,and the situation was analyzed and summarized after taking drug. RESULTS:In the 672 patients,78(11.6%)patients sutfered from 108 cases of ADR,the ratio of male to female was 5.5∶1,there was statistical signifi-cance (P<0.05);patients mostly aged 51-60 years (37.2%);the mainly involved organs/systems were respiratory system (41.7%),and skin and its appendages (38.0%),the main clinical manifestations were minor bleeding (78.7%),dyspnea (17.6%) and bradycardia (2.8%);no severe ADR was found. CONCLUSIONS:Ticagrelor had good safety and tolerability,but due to its shorter time to market in China and absense of evidence-based medicine for large-scale clinical trials in Asian population, clinic should strengthen medication monitoring to reduce the ADR and ensure drug safety.

OBJECTIVE To explore the risk factors of infection in patients with chemotherapy-induced neutropenia in order to offer scientific references for clinical treatment.METHODS With case-control study,two hundred and fifty-six cancer patients with chemotherapy-induced neutropenia were compared between the infection group and non-infection group.The data were analyzed on risk factors by univariate analysis(Chi-square test) and multivariate analysis(non-conditional Logistic regression models).RESULTS Multivariate analysis showed that early lymphopenia after chemotherapy(OR=3.347),the depth of the Absolute neutrophil count nadir(

Objective To investigate the correlation between adiponectin, CRP and homocysteine (Hcy) and evaluate its mechanism in acute cerebral infarction. Methods Serum adiponectin, hs-CRP,Hcy, blood lipid, FPG and blood pressure were measured in eighty patients with acute cerebral infarction ( cerebral infarction group) and eighty healthy persons ( control group). Results In cerebral infarction group, serum hs-CRP, Hcy, TG , and systolic pressure were significantly higher than in control group ( P ＜0. 05) , while serum adiponectin were significantly lower than in control group ( P ＜0. 05). Serum adiponectin levels were negatively correlated with Hcy( r = -0. 453) , hs-CRP ( r = -0. 397) ,TG( r = -0. 321) , FPG( r = -0. 318) and systolic pressure ( r = -0. 288). Conclusion There is correlation between adiponectin, Hcy, hs-CRP, glucose and lipid metabolism and blood pressure, which plays a role in occurrenc and development of acute cerebral infarction.

[Summary] As of 2014, an estimated 387 million people have diabetes mellitus ( DM) worldwide, which represents 8.3%of the adult population.China Noncommunicable Disease Surveillance in 2010 shows that the overall prevalence of DM is estimated to be 11.6%(approximately 113.9 million) in the Chinese adult population, with the prevalence among men of 12.1%and women of 11.0%, respectively.Control of blood glucose is fundamental to DM management.Despite the availability of several antihyperglycemic agents, only 53%of patients with DM achieve the recommended goals for DM care of HbA1C<7.0%.According to the National Health and Nutrition Examination Survey and the Behavioral Risk Factor Surveillance System Survey during the period of 10 years in the United States, 33.4%to 48.7%of persons with DM still have not met the targets for glycemic control, blood pressure or lipid level.In order to improve glycemic control, there is a need for new therapeutic options with innovative mechanisms of action and acceptable safety profiles.As a newly developed class of oral antidiabetic drugs, sodium-glucose co-transporter 2 inhibitors(SGLT2i) have recently been approved for the treatment of patients with type 2 diabetes mellitus, including canagliflozin, dapagliflozin, and empagliflozin.Evidence from clinical trials has suggested promising efficacy and safety of SGLT2i when used as monotherapy or in combination with other antihyperglycemic medications.SGLT2i significantly reduce HbA1C and fasting plasma glucose, and are well tolerated in general with a low intrinsic propensity to cause hypoglycemia, as well as rare severe renal or cardiovascular adverse events reported.

The PICC application in tumor chemotherapy patients has the advantages of simple operation, long time of implanting catheter, small pain and protect vein. They can ensure the chemotherapy smoothly, and further promotion in the clinical application, but when the patients took the tube back, the complications increased significantly. Health education is the mail channel for patient and family to get the major way to maintain PICC knowledge and skills. Through literature review of PICC health education at home and abroad, in our country, according to the present situation of PICC health education, the health education model, method and effect evaluation were summarized and looked for the problems in the present education of PICC health education. It can provide a basis for exploring new pattern of health education for improving the sevice life of the catheter and the patients’ life quality.

The glycemic variability is one component of unified glucose tetrad concept.The long-term glycemic fluctuation may enhance the oxidative stress reaction,which can promote the development of micro vascular complications.The relationship between the glycemic variability and the CVD deserves further investigation.CGMS is helpful to monitor the glucose fluctuation especially in those with fragile diabetes and no symptom hypoglycemia.The suitable regime is the key point to control glycemic variability,even after the desired HbA1c target is attained. Abstract:Summ ary:The glycem ic variab ility is one component of un ified glucose tetrad concept.The long-term glycem ic fluctuation m ay enhance the oxidative stress reaction,wh ich can promote the developm ent ofm icro vascu lar comp lications.The rela-tionsh ip between the glycem ic variab ility and the CVD deserves further investigation.CGMS is helpfu l to mon itor the glu-cose fluctuation espec ially in those w ith fragile d iabetes and no symptom hypoglycem ia.The su itab le regim e is the key point to control glycem ic variab ility,even after the desired HbA1c target is attained.

OBJECTIVE To evaluate the risk factors for postoperative nosocomial infection(NI) among inpatients with cervical carcinoma.METHODS A prospective and retrospective study was carried out to investigate the clinical data of patients with cervical carcinoma in department of gynecology during the period from Jan 1 to Dec 31,2003.RESULTS The incidence and case incidence of NI were 22.88% and 23.99%,urinary tract infection((52.3%)) was the most common infection,followed by vaginal margin infection and pelvic infection.NI was closely related with diabetes mellitus,the duration of catheter reservation,and different operators.CONCLUSIONS NI is high in postoperative patients with cervical carcinoma,which should be paid attention during the course of clinical treatment.

Objective A rare HLA phenotype carrying three HLA-A antigens, A2, A11.2 and A24, was identified in a potential bone marrow donor SZHD1. Methods To determine molecular basis of this phenotype the HLA-A gene fragments from this donor and his family members were cloned and sequenced. Results Sequencing analysis indicated that the donor carries an unusual HLA haplotype, A*1102, A*24020101; B*38; DRB1*15. Conclusions Other four family members were found to carry this haplotype, which as a Mendelian gene was segregated and stably transmitted through three generations. This is a first example of a family carrying triple HLA-A antigens to the best of our knowledge.

Objective To investigate the ingestion, metabolism and subcellular localization of indocyanine green (ICG) in human retinal epithelial (RPE) cells. Methods RPE cells were incubated with 0.25 mg/ml ICG under the condition of 37℃ in the camera. The ICG granule and ultrastructure of RPE cells were observed under the electron microscopy after 1-, 4-, and 24-hour incubation, and the ICG autofluorescence was detected by fluorescence microscopy after the incubation for 1, 2, 4, 8, 12, 24, and 48 hours, respectively. The absorbency (A value) of ICG solution was measured at 805 nm with ultraviolet/visible specrtrometer. The standard curve of concentration of ICG was drawn and the related equation of concentration of ICG and the A value was calculated. After being incubated for 1, 2, 4, 8, 12, 24, 48, and 72 hours, respectively, the A value of supernatant fluid was calculated according to the equation. After incubated with ICG for 24 hours, one sample was observed under electron microscope and fluorescence microscope per week to evaluate the metabolizable period of ICG. Results ICG granules were distributed evenly after entering the RPE cells. After incubated with 0.25 mg/ml ICG for 24 hours, no significant change of the ultrastructure of the RPE cells was found. ICG granules accumulated in the cells as the time goes by and reached the peak after 24 hours, and then they decreased because of the slowdown of the metabolism. Few ICG was still remained in the cells 1 week later. Conclusions RPE cells may take in ICG actively. ICG metabolizable period in RPE cells is long, which may be one of the mechanisms of the toxicity of ICG to the retina in the vitreous operation.

Objective To investigate the efficacy and safety of laparoscopic repair in children with congenital esophageal hiatal hernia. Methods From September 2001 to December 2008,seven children with congenital esophageal hiatal hernia,including 4 boys and 3 girls,were treated by laparoscopic repair and Nissen's fundoplication in our hospital. One of them received laparoscopic pyloroplasty in the meanwhile because of delayed gastric emptying (confirmed by preoperative gastrointestinal angiography); one child underwent laparoscopic high ligation due to right oblique inguinal hernia; spleneolus was found in one patient,no further treatment was carried out. Results The procedures were completed in all of the patients without conversion to open surgery. The mean operation time was 94.2 min (75-150 min) in this series,and the average blood loss was 5 ml (2-10 ml). No patient received blood transfusion after the surgery. The children began to intake milk or regular diet in 24-48 hours after the operation. They were discharged from hospital in a mean of 4.5 days (ranged from 3 to 7 days). Then,the children were followed up for 6 to 20 months (mean,12.6 months). One of the patients suffered from vomiting on the 10th day after the operation,1 patient showed recurrence in 1 year postoperation and then was cured by a second operation. The other five patients were healthy during the follow-up. Conclusions Laparoscopic repair of congenital esophageal hiatal hernia is a safe,effective,and minimally invasive procedure. It is feasible for patients complicated with other diseases. The indications for the surgery must be strictly selected.