OBJECTIVE:To provide references for rational clinical application of human serum albumin. METHODS:By adopting retrospective analysis,medical records of 256 tumor inpatients administered with human serum albumin in the affiliated cancer hospital of zhengzhou university during Jan. and Jun. 2014 were randomly selected to statistically analyze the drug consump-tion amount per capita,average course of treatment and the concentration of serum albumin in the patient before administration. RE-SULTS:In our hospital,human serum albumin was used in 15 clinical departments,mainly in non-surgical departments. The pa-tients received drugs at a single dose ranging from 10 to 20 g. Postoperative patients with hypoalbuminemia topped the list in terms of daily consumption amount of human serum albumin(15.82 g/d)and patients with hypoalbuminemia accompanied by ascites and pleural effusion experienced the longest average course of treatment(6.93 d). Human serum albumin was mainly used for hypopro-teinemia. CONCLUSIONS:The use of human serum albumin in our hospital conformed to the dispensatory and the regulations on the medical insurance organizations of Henan Province. However,it is not in compliance with the regulations on the medical insur-ance organizations of Beijing and the guidelines of the hospital associations of American universities. Therefore,the indication of human serum albumin needs to be further defined,and priority should be given to nutrition supply for the inpatient with hypoalbu-minemia caused by malnutrition.

OBJECTIVE:To provide reference for improving the breast cancer patients’medication compliance. METHODS:280 inpatients with advanced breast cancer who had received endocrine therapy in a hospital ward of chemotherapy of breast from Sept. to Nov. 2015 were selected,questionnaires was combined with on-site interview to investigate and analyze the medication com-pliance,influential factors and adverse reactions induced by endocrine drugs. RESULTS:Among the 280 patients,161 (57.5%) showed good medication compliance,64(22.9%)were general and 55(19.6%)were poor;its medication compliance were mainly affected by“wrong understanding on disease control (27.2%)”“adverse drug reactions (22.4%)”“forgetting taking medicines (21.1%)”;the common adverse reactions of endocrine therapy included hot flashes,mood disorders and joint pain. CONCLU-SIONS:Clinical pharmacists,especially the specialists should give full play to their own professional advantage,strengthen patient medication education,actively participate ward round and follow-up,improve breast cancer patients’compliance on endocrine therapy.

Objective To evaluate the clinical value of arterial chemotherapy and embolization in the treatment of advanced uterine carcinoma.Methods In this study,52 cases of uterine carcinoma(including 43 carcinoma of cervix and 9 cases carcinoma of endonetrium)were treated interventional therapy.In these cases,after one or two times interventional therapy and after 10-14 days,45 cases followed by uterectomy and pelvic lymphadenectomy. 7 cases that can't operated continue followed by interventional therapy. Results Curative effect was obvious,the clinical symptoms were alleviated,the bleed in operation was decreased and the tumor was divided easily.In 45 cases followed by operation,the one-year and three-year survival rate are 100% and 92%.In 7 cases treated by interventional therapy alone,the one-year and three-year survival rate are 100% and 85%.Conlusion The interventional therapy preoperation can reduce the clinical stage and metastasis of lymph,improve the ectomy by operation and survival rate of patients obviously,so it can be used as a routine treatment in uterine carcinoma.

OBJECTIVE:To provide reference for clinical rational drug use in advanced breast cancer patients with grade Ⅳmyelosupression induced by chemotherapy. METHODS:108 advanced breast cancer patients with grade Ⅳ myelosupression in-duced by chemotherapy in our hospital from July 2014 to June 2015 were retrospectively analyzed on the characteristics of myelosu-pression and the reasonability of chemotherapy reguneb and adjuvant drug for myelosupression. RESULTS:The incidence of gradeⅣ myelosupression induced by chemotherapy in advanced breast cancer patients was 8.3%,chiefly manifesting as grade Ⅳ neutro-penia(94.4%). The chemotherapy regimens which induced grade Ⅳ myelosupression were mainly docetaxel+epirubicin,docetaxel, vinorelbine+lobaplatin;irrational chemotherapy plan mainly shows irrational pretreatment of chemotherapy drug (32 cases, 91.4%);irrational therapy of myelosupression mainly manifested as rophylactic use of antimicrobials without indication,unsuitable choice of antibiotics(29 cases for each,36.2% for each). CONCLUSIONS:The use of drugs used in advanced breast cancer pa-tients with grade Ⅳ myelosupression induced by chemotherapy is basically rational,yet it is far from perfect in pretreatment of che-motherapy drug and therapy for gradeⅣmyelosupression,which should be further improved.

Clinical data of 129 young pafienm with lung cancer were analyzed retrospectively.Adenocarcinoma was the main pathologic type of lung cancer(n=62,48.1%),followed by undifferentiated small cell carcinoma(n=35,27.1%),squamous carcinoma(n=20,15.5%).Forty four cases were misdiagnosed at first consultation with a misdiagnosis rate of 34.1%.To avoid misdiagnosis seems to be the key issue for improvement of prognosis in young patients with lung cancer.

Total hip replacement is a very effective method to cure many kinds of hip joint illnesses. About a century ago, it was first used in clinic. Since then, total hip replacement has been well developed. Hip joints sustain the most load of body, so people pay great attention to the hip prothesis' mechanics property. Especially after the finite element analysis was widely used in biomechanics investigation, the stress distribution of different designs can be easily compared with each other, and the relatively better parameters of the design could be decided. The stress distribution of different materials with the same design also can be valued. However, studies have indicated that total hip joint replacement still has some disadvantages. Loosening of the hip prothesis is still the most likely cause of the failure of surgery, and generally this is believed to stem from either mechanical failure of the fixation in response to over high density stresses, or osteolysis of the surrounding bone stock responsing to particular wear debris. Many researchers on computational studies have considered the potential for the former one, but only a few have attempted to tackle the latter. The process of osteolysis of the bone is not yet completely known. Nowadays, in order to solve the problems of loosening, investigators are trying to find different methods. Some of them are working on improving the geometry parameters and the shape of the hip prothesises, some are trying to find new suitable biomaterials, and, at the same time, the fixation methods are under deliberation.
Arthroplasty, Replacement, Hip ; adverse effects ; Computer-Aided Design ; Finite Element Analysis ; Humans ; Prosthesis Design ; Prosthesis Failure ; Stress, Mechanical ; Weight-Bearing

Objective To identify uropathogens responsible for urinary tract infection in children less than 5 years of age and determine the antibiograms.Methods The data of 523 children(2 months to 5 years old) admitted at the Shengjing Hospital of China Medical University from January 2008 to December 2013 were studied retrospectively.Results Out of 523 children suffering from urinary tract infection,54 (10.3％) were complicated urinary tract infection,including 24 vesicoureteral reflux,8 ureter-pelvic junction stenosis,5 hydronephrosis,4 double kidneys,2 renal dysplasia,2 bladder diverticula,2 bladder ear,2 neurogenic bladder,1 urethral vaginal fistula,1 congenital megaureter,1 horseshoe kidney,and 1 Ureteral cyst and stone.A total of 487 cases underwent urine culture,207 (42.5 ％) had positive bacterial growth,the gramnegative bacteria accounted for 94.69％,gram-positive bacteria 5.31％.E coli was the most common uropathogens in gram-negative bacteria (79.23 ％),the second was Klebsiella (5.31％),the third was Proteus mirabilis(2.90％).Gram-positive bacteria was almost Enterococcus (4.35％).Twenty one strains were extended-spectrum beta-lactamase enzyme positive(ESBLs +),and they were sensitive to imipenem,amikacin and piperacillin/tazobactam.Conclusion The clinical features were atypical in children with urinary tract infection,we should investigate the underlying causes such as urinary anomalies or stones.E coli was still the most common uropathogens in children with urinary tract infection,the empirical therapy should according to the patient's conditions while awaiting the culture and sensitivity results.

Objective To examine the clinical features and long - term outcome of pediatric IgA nephropathy and to explore the clinical effect of Mycophenolate Mofetil(MMF)and Cyclophosphomide(CTX)in children with IgA nephropathy with nephrotic syndrome(NS). Methods A single - centre,retrospective,observational study of 115 chil-dren with IgA nephropathy from 2004 to 2013 in Pediatric Nephrology of Shengjing Hospital of China Medical University was conducted. Demographic and clinical data were reviewed retrospectively for age,sex,medical history,presenting symptoms,medications,follow - up duration and the responsiveness to treatment. Results In all children,NS occurred in 20(17. 4% ). There were 35 patients(30. 4% )with non - NS and 60 patients(52. 2% )with isolated hematuria. No special treatment in patients with IgA nephropathy with isolated hematuria. Among patients with proteinuria less than 20 mg/(kg·d),12 patients were treated with angiotensin - converting - enzyme - inhibitor(ACEI),8 patients were trea-ted with ACEI and corticosteroid. At all time points,mean proteinuria was significantly decreased in ACEI and cortico-steroid group compared with ACEI group(P ﹤ 0. 001). Patients with 20 - 49 mg/(kg·d)proteinuria were treated with ACEI and corticosteroid. At all time points,mean proteinuria was significantly decreased compared with the prior time point. Patients with NS were treated with MMF and corticosteroid or CTX and corticosteroid. Eleven patients were trea-ted with MMF,9 patients were treated with CTX. A significantly difference was seen after 3 months in proteinuria greater decrease from pretreatment in CTX group than those in MMF group(P ﹤ 0. 001). No significant difference in proteinuria was observed at other time point. No significant change in white blood cell count was observed in MMF group and CTX group. No serious complication developed in any patient during treatment. During the median follow - up of 35. 2 months (range 4. 0 - 124. 6 months),no patient progressed to end stage renal disease. Conclusions IgA nephropathy patients with isolated hematuria should be long - term followed up. Children with non - nephrotic - range proteinuria should be treated with ACEI or corticosteroid. Patients with NS should be treated with corticosteroid and MMF or CTX. The long -term prognosis within 3 - 5 years should be good if proteinuria within normal range in pediatric IgA nephropathy pa-tients.

Objective To compare the treatment response of plasma exchange and immunoadsorption for children suffering from severe systemic lupus erythematosus (SLE),and then find the more advantageous treatment method.Methods Between March 2007 and March 2013,27 children with severe SLE were collected from the Department of Pediatric Nephrology and Rheumatology of Shengjing Hospital of China Medical University.Part of them about 11 children accepted plasma exchange treatment (plasma exchang group) and the others accepted immunoadsorption(immunoadsorption group).The clinical features,ANA,IgG,serum ions,the cost of treatment and the hospitalization time were reviewed,and the comparative analysis were performed in two groups.Results There were comparabilities between plasma exchange group and immunoadsorption group in age,gender,couse of disease and systemic lupus erythematosus disease activity index(SLEDAI) score before treatment.(1)In plasma exchang group,11 children were conducted 26 times treatment.The SLEDAI score significantly decreased after plasma exchange (19.00 ± 3.77 vs 5.34 ± 4.35,P ＜0.05),and the ANA and IgG significantly decreased as well[2 439.58 ± 1 430.56 vs 303.54 ± 169.32; (8.35 ± 5.67) g/L vs (4.04 ± 2.23) g/L,P ＜ 0.05].(2) There were 16 children in immunoadsorption group,they accepted immunoadsorption treatment about 44 times.The SLEDAI score after immunoadsorption significantly decreased (18.25 ± 4.62 vs 4.25 ± 2.23,P ＜ 0.05),and the ANA and IgG significantly decreased as well [2 560.39 ± 1 563.78 vs 289.62 ± 137.62 ; (9.98 ± 6.03) g/L vs (3.23 ± 1.37) g/L,P ＜0.05].(3) There were no statistical differences in the value of SLEDAI score,ANA and IgG after the treatment between two groups.(4) The concentrations of serum potassium,sodium and chlorine and calcium in the children treated by plasma exchange or immunoadsorption were consistent with the original.(5) The hospitalization expense in plasma exchange group was distinctly higher than that of immunoadsorption group (P ＜ 0.05).(6) There was no significant difference in the length of hospitalization between two groups [(33.6 ± 8.60) d vs (31.9 ± 14.6) d,P ＞ 0.05].Conclusion The treatment both plasma exchange and immunoadsorption were effective methods for the children with severe SLE.However,the cost of plasma exchange was much higher and had a great influence on the concentration of antihypertensive drugs.

Objective To observe the effects of Baishile Capsules on the hippocampal PI3K signaling pathway in chronic mild unpredictable stress (CUMS) rats; To discuss its mechanism of action for anti-depression. Methods SD rats were randomly divided into 6 groups, control group, model group, fluoxetine group, Baishile Capsules high-, medium- and low-dose groups, with 10 rats in each group. The cums depression model was established, and gavage for medication was conducted at the same time for 21 days in a row. The behavioral changes of rats in each group were detected by the novel feeding experiment and Open-field experiment; monoamine neurotransmitter in serum were detected by ELISA; the expressions of PI3K, AKT and SGK1 in rat hippocampus were detected by immunofluorescence and Western blot test. Results Compared with the control group, feeding latency of rats in model group was significantly prolonged (P<0.01), horizontal and vertical activities were significantly reduced (P<0.01); the content of serum monoamine neurotransmitter decreased (P<0.01); the expressions of PI3K and AKT in hippocampus decreased, while the expression of SGK1 increased (P<0.01, P<0.05). Compared with the model group, Baishile Capsule high- and medium-dose groups can significantly shorten the incubation period of feeding rats (P<0.05), and increase the number of horizontal and vertical activities (P<0.01); the 5-HT and NE levels in serum were significantly elevated (P<0.05, P<0.01); the expressions of PI3K, AKT in hippocampal increased; the expression of SGK1 decreased (P<0.05, P<0.01). Conclusion Baishile Capsules can alleviate the depression like behavior in rat models, and regulate key factors of hippocampal PI3K signaling pathway, so as to exert antidepressant effects.