Objective:To survey the status quo of ADR occurred in our hospital. Methods:Totally 277 ADR reports were collect-ed and analyzed statistically in our hospital from January 2010 to June 2013. Results:Among the ADR cases,the ratio of male to fe-male was 1∶1. 565, and 59. 93% of ADR occurred in the people over 50 years old. Totally 240 ADR cases (86. 64%) were induced by intravenous administration and 32 ADR cases (11. 87%) were induced by oral administration. Totally 167 ADR cases were caused by antibiotics (60. 29%), among them, 54 cases wero by cephalosporins (32. 34%), 47 cases by quinolones (28. 14%) and 32 ca-ses by cephamycins (19. 16%). Totally 42 ADR cases were caused by traditional Chinese medicine injections (15. 16%), and 18 ca-ses were caused by cardiovascular system drugs (6. 5%). The main clinical manifestations were lesion of skin and its appendant organr and digestive system injury with 162 cases (58. 48%) and 62 cases (22. 38%), respectively. Conclusion: It is necessary to strengthen clinical ADR monitoring, rationally use antibiotics and emphasize the importance of safe medication of traditional Chinese medicine injections.

Objective To investigate the effect of electron transfer system on the hyphal formation of Candida albicans. Methods Candida albicans was cultured in RPMI 1640 supplemented with 10% new-born calf serum in 5% CO2 at 37 ℃ with or without the presence of inhibitors or activators of electron transfer system. Growth curve, morphology and percent of filamentation were observed for Candida albicans. MTT assay was used to assess the viability of Candida albicans. Results The solvents (chloroform and dimethyl sulfoxide) had no significant effect on the growth of and filamentation in Candida albicans. After incubation with thenoyltrifluoroacetone (TTFA) or benzhydroxamic acid for 24 hours, yeast cells of Candida albicans predominated in the culture. The growth of Candida albicans was significantly inhibited in log phase by the incubation with classic respiratory chain inhibitors such as rotenone, antimycin A, oligomycin, sodium azide, TTFA and sodium malonate, compared with the controls (all P < 0.01). Benzhydroxamic acid, an inhibitor of alternative oxidative pathway, also significantly inhibited the growth of Candida albicans in log phase (t = 10.92, P < 0.01). After incubation with rotenone, antimycin A, oligomycin, sodium azide, TTFA, sodium malonate, benzhydroxamic acid and disodium gnanylate, the percentage of filamentation in Candida albicans at 12 hours was 87.49 ± 0.52, 48.75 ± 4.44, 50.33 ± 8.50, 99.00 ± 1.00, 1.60 ± 0.53, 94.01 ± 0.99, 0.00 ± 0.00 and 92.33 ± 2.08, respectively, and the growth of Candida albicans at 7 hours was inhibited by (1.34 ± 0.15)%, (70.61 ± 1.02)%, (50.63 ± 5.38)%, (17.80 ± 7.89)%, (45.17 ± 1.27)%, (10.75 ± 3.62)%, (72.46 ± 1.14)% and -(5.96 ± 4.07)%, respectively. Conclusions Hyphal formation of Candida albicans could be suppressed by inhibitors of classic respiratory chain or alternative oxidative pathway, and is mainly regulated by alternative oxidative pathway.

Objective To evaluate the early change of left ventricular (LV) systolic function in patients with type 2 diabetes mellitus(T2DM) by ultrasound speckle tracking imaging. Methods Ninety-five subjects were included:40 T2DM with normal LV ejection fraction (LVEF≥50% ,group A),20 T2DM with abnormal LVEF (LVEF<550 %) (group B), and 35 normal controls. Two-dimensional strain images were acquired from LV short-axis view. LV peak systolic global and segmental radial strain and circumferential strain at the levels of mitral annulus, papillary muscle and apex, and LV systolic global and segmental rotation at the levels of mitral annulus and apex and LV peak systolic global twist were assessed. Results In group A, compared with control group, LV peak systolic radial strain parameters were not significant difference (P >0.05), peak systolic circumferential strain of part segments, average peak strain of each plane and global strain were reduced (P <50.05～0.001) ,and LV peak systolic rotation of all apical segments, peak systolic global rotation at the levels of mitral annulus and apex,and peak systolic global twist were significantly increased (P <0.05～0.001). Compared with control group and group A,all LV systolic radial strain and circumferential strain parameters, LV systolic global and segmental rotation and peak systolic global twist in group B were significantly reduced (P <0.05 ～ 0.001). Conclusions Speckle tracking imaging could be used to evaluate the early change of LV torsional deformation and LV systolic function in T2DM.

Objective To investigate the genotype of Trichophyton rubrum isolated from children and adults with dermatophytosis,and to explore the relationship between the genotype and location of lesions as well as drug susceptability of T.rubrum.Methods Dermatophytes were isolated from 67 children and 88 adults who had been diagnosed with dermatophytosis by microscopy and fongal culture.DNA was extracted from the clinical isolates of T. mbrum and random amplification of polymorphic DNA(RAPD)assay was performed with two random primers.i.e.,OPA11 5'ACCCGACCTC3'and OPD18 5'GAGAGCC AAC3',respectively.PCR products were subjected to electrophoresis to identify the genotypes of clinical isolates.Broth microdilution method was applied to assess the in vitro susceptibility of T. rubrum isolates to eight antifungal agents:fluconazole,itraconazole,terbinafine,ketoconazole,liranaflate,butenafine,econazole and bifonazole.Results T. rubrum was isolated from 47 children and 62 adults with dermatophytosis.RAPD assay yielded clear and stable DNA band profile.With primer OPA 11,these T.rubrum isolates were classified into 4 genotypes,i.e.,Ⅰ a,Ⅱ a,Ⅲa and Ⅳa.Both type Ⅰ a and Ⅲa represented 41.94%of the T. rubrmn isolates from adults,while type Ⅰa 65.96%of those from children;there was a significant difference in the genotype distribution between the two groups(P＜0.05).Also,the genotype distilbution was statistically different for tinea corporis and tinea pedis(P＜0.01,＜0.05 respectively)between adults and children,however,no significant difierence was observed for onychomycosis and tinea cruris(both P＞0.05).In vitro susceptibility test showed that all antifungal agents were effective against these T. rubrum isolates.Among these antifungals,terbinafine had the highest efficacy,and fluconazole exhibited the lowest effect against these isolates.Moreover,a higher efficacy was observed for ketoconazole and fluconazole against T. rubrum of type Ⅰ a than against other types of T. rubrum,and for bifonazole against T. rubrum isolates of type Ⅱ a than against other types.while the efficacy of itraconazole was lower against T. rubmm isolates of type Ⅲ a than against other types.Conclusions T. rubrum is the main pathogenic microorganism in adults and children with dermatophytosis.In adults,Ⅰ a and Ⅲ a are the predominate types of T. rubrum associated with dermatophytosis,while Ⅰ a is the common type in children.All the 8 antifungals tested have a good efficacy for various genotypes of T. rubrum,whereas the efficacy of fluconazole,itraconazole,kctoconazole,terbinafine and bifonazole varies with the genotypes of T. rubrum.

Objective To explore left ventricular remodeling index(LVRI),systolic function and their correlation by real-time three-dimensional echocardiography(RT-3DE)in patients with coronary artery disease(CAD).Methods According to coronary artery angiography,one main vessel stenosis no less than 50% was defined as positive standard,RT-3DE data of 24 patients with left circumflex coronary artery or/and right coronary artery stenosis(LCA/RCA group),21 patients with left anterior descending coronary artery stenosis(LAD group),27 patients with double or triplex coronary arteries stenosis which must included LAD(vessels group)and 22 normal controls(NC group)were acquired.Left ventricular end-diastolic volume(EDV),left ventricular end-diastolic epicardial volume(EDVepi),left ventricular ejection fraction(EF)were automatically measured by RT-3DE analysis software;left ventricular mass[1.05×(EDVepi-EDV)],LVRI(left ventricular mass/EDV)were calculated.The inter-group differences of LVRI,EF and intra-group correlations between LVRI and EF were analyzed.Results LVRI and EF significantly decreased in order(P＜0.05 or P＜0.01);and their correlation coefficents were r=0.10(P＞0.05),0.86(P＜0.01),0.83(P＜0.01)and 0.77(P＜0.01)in NC group,LCA/RCA group,LAD group,vessels group,respectively.Conclusions LVRI measured by RT-3DE can assess left ventricular remodeling,and reflect left ventricular systolic function in different CAD,which can be as a new approach for evaluating left ventricular remodeling in clinic.

Objective To explore the role of echocardiography in the therapeutic evaluation after surgical repair of anomalous origin of the left coronary artery from the pulmonary artery(ALCAPA). Methods Six patients with ALCAPA underwent surgery from 2000 to 2007 ,including 3 intrapulmonary tunnel procedures and 3 left coronary artery bypass graft procedures. Post-operative echocardiography was given in every case and the characteristics were compared with the pre-operative results. Results In all cases, the mainly coronary haemodynamics recovered rapidly with decreased severity of mitral regurgitation and excellent cardiac function. Five patients had smooth rebuilded vessels but 1 patient had mild anastomotic block and slight intrapulmonary tunnel leakage. Conclusions Transthoracic echocardiography can evaluate the rebuilded coronary artery, possible complication, cardiac morphous and function and the severity of mitral regurgitation accurately.

Objective To determine the extracellular enzymatic activity of common pathogens for onychomycosis, in the hope of finding virulence factors associated with the pathogenesis of onychomycosis. Methods Strains tested in this study included standard strains of common dermatophyte and non-dermatophyte fungi as well as clinical isolates of Trichophyton rubrum from patients with onychomycosis. All the tested strains were cultured in medium containing nail fragments at 25 ℃ for 10 to 21 days followed by the determination of the nail fragment-containing medium, a significant increase was observed in the activities of esterase, esterase lipase, N-acetyl-β-glucosaminidase and α-mannosidase in dermatophytes compared with non-dermatophytes (all P ＜ 0.05 ), as well as in the activity of N-acetyl-β-glucosaminidase in Trichophyton rubrum compared with the other tested species of fungi (all P ＜ 0.05). No significant difference was noted in the activity of extracellular enzymes, except for that of naphthol-AS-BI-phosphohydrolase, between the isolates of Trichophyton rubrum from patients with different ranges of scoring clinical index for onychomycosis (SCIO). Conclusions In specific conditions, the extracellular enzymatic activity of fungi isolated from patients with onychomycosis is associated with fungal species, and may have a certain influence on the manifestations of anychomycosis.

A 19-year-old man was admitted to the hospital for erythema and nodules on the face and postauricular region for 6 years. Microscopic examination of lesion scrapings revealed brown septate hyphae. A restricted, velvety and black colony grew on Sabouraud's dextrose agar. Slide culture on potato dextrose agar plate showed flask-shaped phialides at the apex of or around the hyphae with clear collarettes and flaring apex,mucilage-encapsuled, round to oval, semi-endogenous phialosporae accumulating at the apex of the phialides,giving a flower-like appearance. Anti-fungal susceptibility test showed that the fungus was sensitive to itraconazole, terbinafine and amphotericin B, but resistant to fluconazole. Sequence analysis of the ITS1-ITS4 region revealed a 98% consistency with the reference sequence of ITS1-ITS4 of Phialophora verrucosa. On the basis of above findings, the patient was diagnosed with cutaneous phaeohyphomycosis. Clinical improvement was seen after treatment with oral itraconazole (400 mg/d).

Objective To explore the value of echocardiography in the diagnosis of the criss-cross heart. Methods The echocardiographic results of 6 patients with the criss-cross heart were reviewed retrospectively. The echocardiographic characteristics were analyzed and compared with the surgery results in 4 operated cases. Results The 6 cases were interpreted as representing a criss-cross heart with solitus atria,D-loop ventricles and concordant atrioventricular connections. The ventriculo-arterial alignments of 5 cases were abnormal including double outlet right ventricle with anterior aorta in 2 and transposition of the great arteries in 3 while 1 patient had concordant connection. The following principal characteristics were tilting the transducer from posterior to anterior could demonstrate the connection of the left-sided left atrium and the right-sided left ventricle through mitral valve at first. The more anterior angulation of the transducer then showed the right-sided right atrium was connected to the left-sided right ventricle through tricuspid imaging displayed the two atrial outflows crossed each other without mixing at atrioventricular valve level.right ventricle often occured. The echocardiographic diagnosis of the criss-cross heart and its associated cardiac abnormalities were confirmed by surgery in 4 cases except 1 persistent left superior vena cava was missed. Conclusions The invisibility of a standard 4-chamber view in any cut was very characteristic in the echocardiographic diagnosis of the criss-cross heart. The definitive appearance was the separate display of the two ventricular inlets and the crossed atrioventricular connections with each atrium emptying into the contralateral ventricle by continuous subxiphoid or apical scanning. The transthoracic echocardiography can diagnose this rare heart disease and associated cardiac abnormalities accurately.

Objective To explore the value of two-dimensional strain echocardiography for quantitative assessing the change of regional left ventricular myocardial function in rats following acute myocardial infarction. Methods Sixty Wistar rats were randomly divided into two groups. The study group consisted of 50 rats with occlusion of LAD for 30-45 minutes and the sham-operated group consisted of 10 rats without occlusion of LAD. Echocardiography were performed before operation, which was defined as baseline, and 1 week, 4 weeks and 8 weeks after operation. Left ventricular internal diameter at diastole ( LVIDd) and systole < LVIDs), fractional shortening( FS), ejection fraction (EF) and left ventricular mass(LVM) were measured by anatomical M-model echocardiography. High frame rate two-dimensional images were recorded in the left ventricular short-axis views at the papillary muscle level. Peak systolic radial strain(PRS) and circumferential strain(PCS) of each segment were measured using 2-dimensional strain software. The rats were sacrificed and the infarcted size of each segment was measured using triphenyl tetrazolium chloride (TTC) after echocardiography was performed. Fibrosis of left ventricular myocardium was displayed using Van Gieson stain in 1 weeks after infarction. Results Based on the TTC findings,the left ventricle of the study group was divided into three regions:infarcted,peri-infarct and remote myocardial regions. Van Gieson stain showed fibrosis existed in all the three regions. Compared with baseline and sham-operated group, PRS and PCS of infarcted, peri-infarct and remote myocardial regions of the study group significantly decreased within 1 week after operation ( P <0. 01) and persisted for 8 weeks. PCS and PRS of infarcted, peri-infarct and remote myocardial regions of the study group in 4 weeks and 8 weeks after operation showed no significant difference when compared with those in 1 week after operation ( P >0. 01). Compared with baseline and sham-operated group,LVIDd,LVIDs and LVM of study group all increased significantly ( P <0. 05) in 4 weeks and 8 weeks after operation,and FS and EF reduced significantly ( P <0. 05). Two-dimensional strain obtained in interobserver and intraobserver both showed high agreement. Conclusions Two-dimensional strain echocardiography can assess regional function of myocardium with different perfusion in rats following acute myocardial infarction, and provides a sensitive and reliable method to follow up the process of left ventricular remodeling after myocardial infarction.