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 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 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 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.

Objective To compare anatomic resection (AR) and non-anatomic resection (NAR)for hepatocellular carcinoma (HCC) as a factor in preventing intra-hepatic recurrence and local recurrence after the initial surgical procedure.Methods A systematic review and Meta-analysis of nonrandomized trials comparing anatomic resection with non-anatomic resection for HCC published from 1990to 2010 in PubMed and Medline,Coehrane Library,Embase,and Science Citation Index were searched.Intra-hepatic recurrence,including early and late recurrence,and local recurrence were primary outcomes.5-year survival and 5-year disease-free survival were secondary outcomes.Pooled effect was calculated by utilizing either fixed effects model or random effects model.Result Eleven nonrandomized studies including 1576 patients were identified and analyzed.810 patients were in the AR group and 766 were in the NAR group.Patients in the AR group were characterized by lower prevalence of cirrhosis,more favorable hepatic function,and larger tumor size and higher prevalence of macrovascular invasion compared with patients in the NAR group.Anatomic resection significantly reduced the risks of local recurrence (OR,0.27; 95％ CI,-0.17～0.43; P＜0.001) and achieved a better 5-year disease-free survival (OR,2.10; 95％ CI,-1.41 ～3.12; P=0.001) in HCC patients.Also,anatomic resection was marginally effective in decreasing early intra-hepatic recurrence.However,anatomic resection was not advantageous in preventing late intra-hepatic recurrence.No significant differences were found between the AR and NAR groups with respect to postoperative morbidity,mortality,and length of hospitalization.Conclusion Anatomic resection was recommended to be superior to non-anatomic resection in reducing the risks of local recurrence,early intra-hepatic recurrence and achieving a better 5-year disease-free survival in HCC patients.

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 evaluate the incremental value of 131I SPECT/CT over 131I whole body scan (WBS) in the patients with DTC.Methods A total of 97 patients with DTC (31 males,66 females,mean age:44.1 years,age range:17 to 74 years) were retrospectively reviewed.All subjects underwent 131I WBS and SPECT/CT after 131I treatment.The images were interpreted by 2 experienced nuclear medicine physicians.The final diagnosis was based on the pathologic findings and clinical follow-up.The diagnostic accuracies between 131I WBS and 131I SPECT/CT were compared using x2 test with SPSS 13.0.Results 131I WBS detected 175 lesions (128 neck and 47 distant lesions),while 131I SPECT/CT found 176 lesions (128 neck and 48 distant lesions).Out of the 176 lesions,78 were confirmed as benign and 95 as malignant,including 51 lesions in thyroid bed,67 cervical lymph nodes or local residual lesions,7 lesions related to local physiological uptake,30 distant metastases and 18 distant foci due to physiological uptake.The other 3 lesions were still in follow-up.The sensitivity and specificity of 131 I WBS was 73.7％ (70/95) and 78.2％ (61/78),respectively.The accuracy of 131I WBS (106/173,61.3％) was lower than that of 131I SPECT/CT (171/173,98.8％; x2=72.3,P＜0.05).131I SPECT/CT corrected the diagnosis of 131I WBS in 67 lesions,including 37 local lesions (37/128,28.9％) and 30 (30/48,62.5％) distant metastases.The sources of error for the 67 lesions were due to wrong location (n =27) or wrong characterization (n =40).Compared with 131I WBS,131I SPECT/CT changed the location in 27 lesions,clinical staging in 8 cases and therapeutic strategy in 14 cases.Conclusions 131 I SPECT/CT could improve the differentiation of malignant local lesions from residual thyroid,of distant metastatic lymph node,lung or bone lesions from physiological uptake.Such incremental values would be valuable to the management of DTC patients compared with WBS.