OBJECTIVE:To provide reference for the standardization of package insert of common drugs for elderly patients. METHODS:Outpatient prescriptions in our hospital from 2013 to 2014 were collected,and common drugs of elderly patients(≥60 years old)were ordered by consumption sum,and package inserts of top 100 drugs were statistically analyzed for absent items. RESULTS:The 100 common drugs for elderly patients included 28 Chinese traditional drugs and 72 chemical drugs. The Chinese traditional drug had more absent items,mostly were pharmacokinetics and drug overdose(92.9%),medication of elderly patients (85.7%),drug interactions(78.6%)and pharmacological actions(50.0%);the proportion of contraindications(16/28),adverse re-actions(15/28) and precaution(9/28) with uncertainty was relatively high. Items of chemicals package insert were better than Chi-nese traditional drug,absent items were pharmacokinetics and drug overdose(5.6%),medication of elderly patients and pharmaco-logical actions (2.8%) and drug interactions (1.4%);the proportion of medication of elderly patients (16/72),drug interaction and drug overdose(12/72)with uncertainty was relatively high. CONCLUSIONS:The common problem existing in the drug manu-al is characterized by absence of usage for elderly,drug descriptions is not clear,etc. Package inserts should be further improved to strengthen its standardization.

Objective:To evaluate 131I adjuvant therapy in B-Raf proto-oncogene, serine/threonine kinase (BRAF) V600E mutant patients with non-distant metastatic papillary thyroid cancer (PTC). Methods:From January 2008 to January 2019, a total of 181 PTC patients (65 males, 116 females, age: (38.9±11.8) years) with non-distant metastases from Peking Union Medical College Hospital were retrospectively enrolled. All patients received only one time 131I therapy with complete clinicopathological information, data of follow-up (median time: 63 months) and assessment of response to therapy. Patients were divided into mutant and wild type group in terms of BRAF V600E status or ablation group (1.1 GBq) and adjuvant therapy group (3.7-5.5 GBq) in terms of different 131I dosage. Clinicopathological features and the response to therapy were compared between different groups by using independent-sample t test, Mann-Whitney U test and χ2 test. Results:The levels of preablative stimulated thyroglobulin (ps-Tg) in the BRAF V600E mutant type group ( n=150) was significantly higher than that in the wild type group ( n=31; 6.32(0.90, 8.70) vs 3.92(0.40, 4.40) μg/L; z=-2.413, P=0.016), however, there were no significant differences in other clinicopathological characteristics (including age, sex, tumor size, multifocality, capsule invasion and N staging) between the two groups ( t=-0.663, z=-1.151, χ2 values: 0.003-1.491, all P>0.05) and the therapeutic response was also not different between the two groups( χ2=1.094, P=0.778). Of 81 patients who received 131I adjuvant therapy, the ps-Tg level of BRAF V600E mutant type group ( n=69) was higher than that of the wild type group( n=12; 8.70(1.30, 11.80) vs 3.40(0.30, 4.50) μg/L; z=-2.194, P=0.028), while the therapeutic response was not different between the two groups ( χ2=1.792, P=0.617). Compared with BRAF V600E mutant patients received 131I ablation ( n=81), BRAF V600E mutant patients received 131I adjuvant therapy ( n=69) had larger tumors (1.52(0.95, 2.00) vs 1.21(0.60, 1.50) cm; z=-2.728, P=0.006), more advanced N staging ( χ2=11.460, P=0.003) and higher ps-Tg level (8.70(1.30, 11.80) vs 4.34(0.50, 5.30) μg/L; z=-3.314, P=0.001), but the therapeutic response was not different between the two groups ( χ2=6.478, P=0.091). Conclusion:131I adjuvant therapy may improve the longer-term response to therapy in BRAF V600E mutant PTC patients with lager tumors, more advanced N staging and higher ps-Tg level.

Objective To investigate the short and long term therapeutic effects of prostaglandin E1 (PGEl) on diabetic nephropathy (DN). Methods Patients with DN in stage Ⅲ to Ⅴ according to Mogensen criteria were randomly assigned to four groups of PGE1, angiotensin-converting enzyme inhibitor (ACEI), PGE1 + ACEI and control drug. The levels of proteinuria and albuminuria were measured before and 15 days, 6 months and 18 months after treatment. Patients with DN in stage Ⅳ were subdivided into three groups according to proteinuria: early stage IV (protienuria was less than 1.5 g/d), middle stage Ⅳ (protienuria was between 1.5 g/d and 2.5 g/d) and late stage Ⅳ (protienuria was larger than 2.5 g/d). Results Fifteen days after treatment, the levels of proteinuria and albuminuria were significantly decreased compared with pre-treatment in PGE1 and PGE1 + ACEI groups (P<0. 01), and the therapeutic effect was better in PGE1 + ACE1 group than in ACEI group (P<0. 01). Six months after treatment, there were still significant differences in above parameters in patients with DN in stage Ⅲ and Ⅳ between PGE1 + ACEI and PGE1 groups. And for the patients in stage Ⅴ, statistic significance between pre-and post-treatment existed only in PGE1 + ACEI group (P<0. 05). but not in PGE1 and ACEI groups (both P>0. 05). Eighteen months atter treatment, the levels of proteinuria and albuminuria were significantly decreased in patients in stage HI and early stage IV in all treatment groups (P<0. 01). For patients in middle stage IV and late stage Ⅳ , the significant differences still occurred between pre-and post-treatment in PGE1 + ACEI group (P<0. 01 or P<0. 05), and were significantly better than in ACEI group (P<0. 01 or P<0. 05). However, the proteinuria of patients in late stage IV elevated in PGE1 group in post-treatment versus pre-treatment (P<0. 05). Conclusions The short term therapeutic effect of PGE1 is quick and good in patients with DN. The therapeutic effect is much better in patients in stage Ⅲ compared with stage Ⅴ. The combination of PGE1 and ACEI will get better best therapeutic effect than PGE1 or ACEI alone in long term.

Humans ; Mouth Diseases ; diagnosis ; etiology ; Palate ; pathology

Objective:To study the biocompatibility of porous Ti processed by laser solid forming(LSF)with osteoblasts.Methods:SD rat osteoblasts were seeded on porous Ti surface processed by LSF.Adhesion,proliferation and ALP activity of the osteoblasts were measured at different time,and all samples were observed under SEM.Dense sand-blasted Ti sheets were used as the controls.All data were statistically analyzed.Results:Adhered cells on porous Ti were more than those on nonporous Ti sheets after 2 and 3 hours of culture(P <0.05).At 4 and 7 days,cell proliferation and ALP activity were significantly higher on porous Ti than those on the controls(P <0.05).Conclusion:Porous Ti processed by LSF possesses good biocompatibility with osteoblasts.

OBJECTIVE:To evaluate the current status and future trend of antibacterials utilization in our hospital.MET-HODS:A retrospective analysis was conducted on the use of antibacterials in our hospital in 2003～2005,covering sales value and application density(AD).RESULTS:Antibacterials as used in our hospital had been high in AD for the three years.In ran-ked order,the top three subcategories were quinolones,macrolides and lincosamides,represented respectively by levofloxacin,azithromycin and clindamycin.CONCLUSIONS:Antibacterials as used in our hospital are high in AD.Administration of antibacterials use during the perioperative period should be specially strengthened to avoid irrational combination medication.

Micrometastasis may occur in the early stage of lung cancer and dissemination of lung cancer cells into blood circulation is pivotal for metastasis. Many approaches, such as polymerase chain reaction, magnetic activated cell sorting, flow cytometery, and rare event imaging system, have been developed rapidly. The detection of circulating tumor cells may renew the clinical stage and treatment of lung cancer.
Biomarkers, Tumor ; blood ; Carcinoma, Squamous Cell ; blood ; pathology ; Flow Cytometry ; Humans ; Lung Neoplasms ; blood ; pathology ; Neoplastic Cells, Circulating ; pathology ; Reverse Transcriptase Polymerase Chain Reaction ; Sensitivity and Specificity

Objective The aim of the present study was to evaluate the clinical application of 2 μm thulium laser in pulmonary nodules resection under VATS.Methods 61 patients,undergoing thoracoscopic resection of pulmonary nodules in thoracic department of Xuanwu Hospital,were identified between January and December of 2016.Of those,30 underwent 2μm thulium laser dissection and 31 were treated with standard technique by using staplers.In terms of clinical characteristics,including gender,age and smoking history,there is no significant difference between the laser group and the stapler group,but the lesion size was slightly larger in the stapler group compared with the laser group.The lesions of the two groups were almost evenly distributed on the five lobes.Results All the procedures were performed successfully under VATS.The intraoperative evaluation of air leaks demonstrated that less than or equal to 2 grade air leaks were observed in 28 cases in the laser group and in 30 cases in the stapler group.Grade 3 air leaks requiring a rescue treatment were observed in 2 cases in the laser group and in 1 case in the stapler group.There were no significant differences in the postoperative hospital stay and total hospital stay between two groups.Chest tube duration was lower in the laser group compared with the stapler group even if it was not statistically significant (2.71 vs 3.55 days).Hospitalization costs was significantly lower for the laser group.Conclusion The use of 2um thulium laser to prevent intra-and postoperative air leaks and bleeding is effective and makes patients recover quickly,which allows a minimally invasive,accurate and safe application during thoracoscopic resection of pulmonary nodules.

Abdomen ; Hernia ; Humans ; Prostheses and Implants ; Prosthesis Implantation ; Treatment Outcome

OBJECTIVETo investigate the therapeutic effect of prostaglandin E1 (PGEl) on diabetic nephropathy (DN) after a one-year treatment.

METHODSAccording to Mogensen DN diagnostic criteria, the patients were divided into DN stages III, IV and V groups. Patients in stage IV nephropathy were subdivided into three groups according to the proteinuria, namely early stage IV (protienuria less than 1.5 g/day), mid-stage IV (protienuria between 1.5 and 2.5 g/day) and late stage IV (protienuria above 2.5 g/day). The patients were randomly given PGEl, PGEl plus angiotensin-converting enzyme inhibitor (ACEI), ACEI mono-therapy or basal treatment (control group). Proteinuria and albuminuria were measured before and at 15 days and 1 year of the treatment.

RESULTSIn the patients in DN stages III and early stage IV, proteinuria and albuminuria decreased significantly after 15 days and 1 year of treatment with PGEl+ACEI and PGEl (P<0.01), and the decrements were greater than that in patients receiving ACEI only (P<0.01 or P<0.05). In the patients in mid- and late stage IV nephropathy, proteinuria and albuminuria decreased significantly in PGEl+ACEI group after 15 days and 1 year of treatment (P<0.01), showing greater decrement than in ACEI group (P<0.01 ). Proteinuria and albuminuria decreased significantly in PGEl group after 15 days of treatment (P<0.01), but remained higher than that in ACEI group at one year (P<0.05). In the patients with stage V nephropathy, significant proteinuria and albuminuria reduction occurred in PGEl+ACEI and PGEl groups at 15 days (P<0.01) with a greater decrement than that in ACEI group (P<0.01 or P<0.05). In PGEl+ACEI group, proteinuria and albuminuria showed no significant changes at one year but were lower than those in ACEI group (P<0.05). Proteinuria and albuminuria increased significantly in ACEI and PGEl group after the treatment but were comparable between the two groups (P<0.05).

CONCLUSIONSThe therapeutic effects are much better in patients with stage III nephropathy than in those in stage V. The combination of PGEl and ACEI produces stronger therapeutic effects than PGE1 or ACEI alone even at the one-year follow up.

Adult ; Aged ; Albuminuria ; urine ; Alprostadil ; therapeutic use ; Angiotensin-Converting Enzyme Inhibitors ; therapeutic use ; Diabetic Nephropathies ; drug therapy ; Drug Therapy, Combination ; Female ; Follow-Up Studies ; Humans ; Male ; Middle Aged