OBJECTIVE: To study the status quo and features of serious ADR case in our hospital in order to improve the rational use of drug. METHODS: A total of 215 cases of serious ADR collected in our hospital in 2008 were evaluated and analyzed statistically, according to causality of ADR criteria. RESULTS: Sex and age have nothing to do with serious ADR. The ADR were predominantly induced by antimicrobial drugs accounting for 28.21% (n=101), followed by antipyretic,analgesics and anti-inflammatory drugs and antirheumatic 12.85% (n=46) and TCM preparation 11.73% (n=42). Organs and systems involved in ADR were characterized by the damage of skin and its appendants (33.49%, n=73), followed by liver lesion in 70 cases (32.11%). 160 improved cases, 54 cured cases and 1 sequela cases were include in 215 cases of serious ADR reports. CONCLUSION: Several factors result in serious ADR,so rational use of drug should be enhanced to reduce and avoid occurrence of ADR and guarantee the safety and effectiveness of drug therapy.

Mucosa-associated lymphoid tissue (MALT} lymphoma is a low grade B-cell lymphoma arising from MALT of extra-nodal. A link of Helicobacter pylori (HP) infection with gastric MALT lymphoma was confirmed in the early years. Currently, growing evidence indicates that development of non-gastric MALT lymphoma is also associated with infections by microbial pathogens. t(l1;18)(q21;q21)、t(l;14)(p22;q32) and t (14;18)(q32;q21) are specifically associated with MALT lymphoma, which occur at variable incidences in MALT lymphoma of different sites. The oncogenic activity of these three chromosome translocations is linked by antigen receptor-mediated NF-κB activation.In addition, a number of novel genetic abnormalities have been recently identified in MALT lymphoma. The findings of these microbial pathogens and molecular genetics would be helpful in better understanding the pathogenesis of MALT lymphoma and also useful for the diagnosis at early stage and proper treatments of MALT lymphoma.

Five compounds, huyouyisu (1), vomifoliol (2), isoferulic acid (3), 1,2,3-trihydroxy-phenol (4) and p-hydroxy-phenol (5), were isolated from the peels of Citrus changshan-huyou Y.B.Chang for the first time by utilizing repeated column chromatography on silica gel. Among them, huyouyisu (1) is a new compound. The structure was elucidated by using 1D and 2D spectra.

Objective:To study the chemical constituents of the peels collected from Citrus changshan-huyou Y.B.Chang,and further screen the bioactive components as the lead structures.Methods: These compounds were isolated by repeated flash column chromatography on silica gel and Sephadex LH-20.The structures of isolated compounds were elucidated by using IR,EIMS,and NMR analyses.Results: One novel compound along with nine known compounds were obtained and identified as huyoujiasu(Ⅰ),3-hydroxy-4-methoxybenzoic acid(Ⅱ),3,4-dihydroxybenzoic acid(Ⅲ),fatty acid(Ⅳ),gly-ceride(Ⅴ),6,7-dimethoxycoumarin(Ⅵ),6′,7′-dihydroxybergamottin(Ⅶ),daucossterol A(Ⅷ),daucossterol B(Ⅸ) and huyou-triterpenoid(Ⅹ).Conclusion: One new compound,Huyoujiasu,was obtained from these peels by repeated column chromatography,and the other known compounds were isolated from this fruit for the first time as well.

Objective To study the causes of conversion to open surgery in patients receiving gynecological laparoscopic operations. Methods From January 2002 to December 2007,totally 2630 patients received gynecological laparoscopy in our hospital; 45 of them were converted to open surgery. The data of the 45 cases were analyzed. Results The causes of conversion to open surgery included uterus myoma located at specific locations (25 cases,55.6%),severe pelvic-abdominal adhesion (10 cases,22.2%),uterine horn pregnancy (3 cases,6.7%),ovarian tumors (3 cases,6.7%),surgical injury (3 cases,6.7%) ,and adenomyoma with requirement for uterus conservation (1 case,2.2%). Conclusions Peculiar locations of uterine myoma and severe pelvic-abdominal adhesion are the main causes of conversion to open surgery during gynecological laparoscopy. Detailed preoperative evaluation can decrease the rate of the conversion rate. Right timing of the conversion may reduce complication rate.

Objective To further study on the chemical constituents in the peels of Citrus changshan-huyou.Methods The chemical constituents were separated by repeated silica gel column chromatography,the structures were determined by spectral analyses.Results Ten compounds were obtained and identified as huyoujiasu(2'-hydroxy-malonyl-3,4-dihydroxybenzoic acid,Ⅰ),3'-hydroxy-4',5,6,7,8-pentamethoxyflavone(Ⅱ),eriodictyol(Ⅲ),tetracosanoic acid(Ⅳ),glyceryl dodecanoate(Ⅴ),neoeriocitrin(Ⅵ),naringin(Ⅶ),neohesperidin(Ⅷ),4-methoxy-3-hydroxybenzoic acid(Ⅸ),and 3,4-dihydroxybenzoic acid(Ⅹ).Conclusion 2'-hydroxy-malonyl-3,4-dihydroxybenzoic acid is a new compound and the above ten compounds are obtained from this plant for the first time.

Objective To investigate haemodynamic change during hemodialysis and analyze effects of cardiac index (CI) on hemodynamic parameters and associated influencing factors in maintenance hemodialysis (MHD) patients.Methods Seventy-five patients bearing an arteriovenous fistula (AVF) entered the study.Cardiac output (CO),cardiac index (CI),central blood volume (CBV) and peripheral vascular resistance (PR) were determined by ultrasound dilution technique at the end of 1 hour,2 hours and 3 hours of dialysis.AVF blood flow (Qa) was also measured with the same device before haemodynamic parameters investigation.Results Mean age of patients was (55.84 ±12.39) years old (range 21-81 years) and 43 patients (57.3％) were female.Systolic arterial pressure,SV,CO,CI and CBV were significantly declined and no significant change for diastolic arterial pressure and heart rates at the end of 2 hour and 3 hour hemodialysis,whereas PR was increased gradually during hemodialysis.Patients were divided into there groups with CI less than 2.5 L·min 1·(m2)-1,2.5-4.2 L·min-1·(m2)-1 and more than 4.2 L·min-1 ·(m2)-1 at the end of 1 hour dialysis.Statistically significant decreasing SV,CO and increasing PR were detected in patients with CI＜2.5 L·min-1· (m2)-1 and 2.5-4.2 L· min-1· (m2)-1,compared with CI＞4.2 L·min-1· (m2)-1 group (P＜0.01).The hemodynamic change was the most obvious in the group of CI less than 2.5 L· min-1· (m2) 1,and no significant changes happened in CI＞4.2 L·min-1 ·(m2)-1 group.Some factors were found to be associated to CI values.Qa and systolic arterial pressure had positive relationship with CI,while age and diabetes had negative relationship with CI.Conclusions Systolic arterial pressure,CO,CI and CBV decrease and PR increases during hemodialysis.Obvious change occurs when CI is less than 2.5 L·min-1· (m2)-1.CI is associated with Qa,systolic arterial pressure,age and diabetes.

Objective To analysis the clinical and pathological features, results of laboratory tests and prognosis of nephrotic syndrome (NS) in patients with non-heamatological maligancy. Methods The data were collected from 25 patients who presented with NS around the diagnosis of non-heamatological malignancy. Results Twenty-five cases were investigated (age: (56.6±17.7) years; male/female ratio: 20/5). Malignancy and NS occurred within one year in 92% patients. There was a wide distribution of malignancy with involvement of 36% in digestive system and 20% in respiratory system. Ten patients (40%) presented with NS as their initial manifestation. Heamaturia appeared in 67% patients and acute renal insufficiency was complicated in 12% cases before treatments. Some other non-specific laboratory tests were found including elevated serum gamma-globulin in 50% and anemia not related with renal failure in 28% cases. Membranous nephropathy was the most common pathological changes in 67% cases. Although NS still continued for several weeks in 8 of 9 cases after surgery and/or chemical therapy, glucocorticoids was helpful to achieve the remission in these patients. However, no remission was achieved in patients without the treatment for malignancy. Conclusion Malignancy may present with NS as its initial manifestation. It should be inspected routinely and regularly in elder patients with NS, especially in those with membranous nephropathy, as well as gamma-globulinemia and anemia.

Objective To evaluate the diagnostic efficacy of MRS in prostate cancer based on sextant localization. Methods There were 110 patients, 54 patients with pathologically confirmed prostate cancer and 56 patients confirmed non-prostate cancer proved by ultrasound guided systemic biopsy. The (choline + creatine)/citrate (CC/C) value in each voxel and ratio of positive voxel (PVR) in sextant localization were measured. The ROC analysis was used to evaluate the diagnostic efficacy of CC/C in single voxel and PVR in sextant localization. Results There are 1673 and 2426 voxel in prostate cancer and non-prostate cancer respectively. The median of CC/C in cancer sextants was 2. 137; the median of CC/C in noncancer sextants was 0. 600. The difference of these two groups was statistically significant (Z = -41.7, P < 0. 01 ). The diagnostic sensitivity was 81.4% ( 1362/1673 ), the specificity was 83.1% (2018/2426), and the accuracy was 82.4% [ (1362+2018)/4099] for prostatic cancer with the cutoff point 0. 911 of the CC/C value. The median of PVR in cancer sextants and noncancer sextants were 1 and 0 respectively, the difference of PVR was statistically significant (Z = -11.7,P < 0.01 ). The diagnostic sensitivity was 77. 5% (148/191), the specificity was 76. 9% (247/321), and the accuracy was 77. 1% [ ( 148 + 247 )/ 512] for prostatic cancer with the cutoff point 0. 519 of the PVR. Conclusion Detecting the cutoff point of the CC/C value in single voxel and the PVR in sextant localization may be valuable in the diagnosis of prostate cancer.

Objective In order to provide information for the health administration and the price authorities to establish the reasonable price,the practical cost of special nursing of the chronic wound be analyzed,and be compared with the present charge,and the deviation be studied.Methods The cost of nursing care for all items was measured,recorded and collected,then calculating the special nursing cost for chronic wound using the method of ladder sharing the project cost.Rusults The true cost on a single special care for chronic wound was (29.42±9.29)yuan,and it reached 2.5 times of present charge ( 12 yuan).Conclusions The present charge on the special care for chronic wound was seriously deviated from the practical cost,and the labor value of special care of nurses could not be embodied.