OBJECTIVE:To investigate outpatients' cognition(including knowledge,attitude and behavior)on adverse drug reactions(ADR),and to analyze the influential factors of ADR cognition.METHODS:An on-the-spot questionnaire survey was conducted in which a total of 488 outpatients sampled from our hospital from May to December in 2007 were investigated and the data analyzed statistically.RESULTS:The correct rate was 36.6% for the questions related to cognition on ADR.70.5% of the patients investigated had a poor cognition on ADR.The factors influencing patients' cognition on ADR included educational background,ADR experience,pharmacists' guidance on medication,source of medicine knowledge,occupation,doctors' guidance on medication,community ADR lecture,and gender.CONCLUSION:The outpatients have a poor cognition on ADR.Both doctors and pharmacists should offer guidance on medication and give lecture in community to inform patients the knowledge about rational administration and ADR.

Since the laparoscopic thyroidectomy carried out in China for ten years,this technique has become more and more mature,indications gradually broadened,and playing a vital role in the field of thyroid surgery.This article will explain this technique in the aspects of approaches,the establishment and maintenance of the surgical space,indications,antiindications and complications.

Objective To compare the manipulation of two different methods of percutaneous dilatational tracheostomy (PDT),the guidewire dilating forceps (Portex method) and the modified onestep dilation technique (Ciaglia Blue Rhino method,CBR method).Methods From March 2013 to February 2014,48 patients eligible to meet the criteria of tracheostomy in ICU were collected and were divided into two groups at random.The length of time consumed for operation,amount of blood lost during operation and the operation complications were compared between two groups.The participant surgeons were asked which method they preferred,Portex or CBR.Results Of them,the mean age was 76.7 ± 11.6 years old,and 25 patients (52.1％) were male.The reasons for tracheotomy were the length of time needed for mechanical ventilation support expected to be longer than 2 weeks (n =30),severe disturbance of consciousness (n =17),and upper airway obstruction (n =1).The patients enrolled in the study were randomly divided into Portex and CBR groups.There were no significant differences in age,gender,APACHE Ⅱ score,the reason of tracheotomy,the length of time for mechanical ventilation support before tracheotomy,and the preoperative coagulation function between two groups.CBR method can easily be done with less operation time required than Portex [(5.9 ±4.3) min vs.(9.9 ± 1.5) min,P ＜0.01],and had obviously fewer operation complications and less amount of blood lost than Portex method (P ＜ 0.05).The male surgeons with a slew of surgical practice were in preference to Portex,whereas female doctors with less work experience and without surgical practice preferred CBR.Conclusions The CBR method can easier be done and was better than the Portex method in minimizing operative trauma and reducing the complications,especially it can easily be accepted by female doctors with less work experience and without surgical practice and it is worth using widely in clinic.

There is a long history of Toad venom in the treatment of cancer in China.Bufalin,extracted from Toad venom,is one of the biologically active compounds of anticancer.We elaborate the molecular mechanism of bufalin on anticancer activity from several aspects such as inducing cell apoptosis and differentiation,inhibitting cell proliferation and angiogenesis,enhancing the sensitivity of chemotherapeutics,which can provide the basis for in-depth study of Toad venom and its development and clinical medication.

To express feruloyl esterase A from Aspergillus oryzae in Pichia pastoris expression system and study its hydrolysis function, explore the conditions and effects of purification for ferulic acid extracts by macroporos resin. Using the total RNA from A. oryzae CICC 40186 as the template, we amplified coding sequence AorfaeA encoding a mature feruloyl esterase A (AorFaeA) by RT-PCR technique. Then, the coding sequence AorfaeA was successfully expressed in Pichia pastoris GS115 mediated by an expression plasmid pPIC9K. The purified recombinant AorFaeA (reAorFaeA) showed one single band on SDS-PAGE with an apparent molecular weight of 39.0 kDa. The maximum activity of reAorFaeA to methyl ferulate, measured by high-performance liquid chromatography (HPLC), was 58.35 U/mg. Then, reAorFaeA was used to release ferulic acid from de-starched wheat bran in the presence of xylanase. The purification tests for ferulic acid from the enzymatic hydrolysate were carried out with preselected macroporous resins. The results showed that macroporous resin HPD-300 had much higher adsorption and desorption capacities. Ferulic acid could be quantitatively recovered by 50% of the eluent concentration at a flow speed of 1 mL/min. Under the purification condition, the recovery ratio of ferulic acid was 92%, and the content of ferulic acid was increased from 0.13% in the raw material to 10.55%. This work exploits the breakdown of ferulic acid by recombinant enzymeand provids a good strategy to its "green production".
Aspergillus oryzae ; enzymology ; Carboxylic Ester Hydrolases ; biosynthesis ; genetics ; Cloning, Molecular ; Coumaric Acids ; chemistry ; Electrophoresis, Polyacrylamide Gel ; Hydrolysis ; Molecular Weight ; Pichia ; genetics ; metabolism

Objective:To investigate lesion size caused by channel radiofrequency volumetric reduction of por-cine tongue base in vitro using the technique of three-dimensional reconstruction. And to evaluate safety about channel radiofrequency volumetric reduction of tongue base. Method: Eighteen fresh porcine tongues were randomly separated into six groups,and each group had three ones. The tongue bases were designed six points according to description of Powell. Tongues base were acted on 10 s and 6 level by Coblation radiofrequency system and were cut into serial freezing histological sections. These segments were sectioned at 20 μm on the injury lesion and stained with H & E. Collected 2D digital imagine of order histological sections, drawn and cut apart part of the le-sion of these sections. Images were procesed IPS and were taken three-dimensional reconstruction and statistics an-alyzes with SPSS10. 0. Result: The mean value of tongue base lesion volumes among points was (359. 5± 5. 6)mm~3 ,(364. 3±7. 0)mm~3 ,(363. 7±7. 2)mm~3, (354. 1±11. 8)mm~3, (349. 4±17. 2)mm~3 ,(353. 5±7. 9)mm~3 separately. Statistic analysis by one-way ANOVA showed that there was a insignificant difference between the groups(P>0. 05). Conclusion:These results demonstrated no significant effect lesion size in channel radiofrequency volumetric reduction in the different points of the tongue base. These data also indicated that coblation radiofre-quency system is a safe method for obstructive sleep apnea hypopnea syndrome.

Problem-based Learning (PBL) is a teaching model originating from the construc-tivism theory, which stressed the meaning construction in problem situation by collaborative learning, conversation and completing knowledge. Based on the times background, development of learning theory, teaching situation, cognitive strategies, ideological connotation about constructivism, PBL's practical significance, its teaching forms, teaching resources, internal motivation, and the teaching evaluation were analyzed deeply, which was beneficial to carrying out PBL normatively in medical education, so as to provide the theoretical support for further exploration and innovation of PBL.

ObjectiveTo study the protective effects of Qiqiong(QQJN) on focal cerebral ischemia/reperfusion injury and its mechanism. MethodsMiddle cerebral artery occlusion(MCAO) was used to make focal cerebral ischemia/reperfusion model by intravascular nylon filament occlusion. The protective effects of QQJN were evaluated by investigating neurological function score, percentage of cerebral infarction, pathomorphology of brain, the activity of SOD and the content of MDA in hrain tissue,thrombogenesis and platelet aggregation in vitro. ResultsCompared with model group, QQJN(4.4、8.8g/kg)could decrease the neurological score in 8 and 22h after reperfusion, reduce the percentage of cerebral infauction,improve pathomorphology of brain, decrease the length, wet weight and dry weight of thromb and inhibit platelet aggregation. ConclusionQQJN had protective effects on focal cerebral ischemia/reperfusion injury. The role of anti-injury of free radicals,inhibit thrombogenesis and platelet aggregation should contribute to its neuroprotective effects.

Objective:To evaluate the difference of vestibular compensation between triple semicircular canal occlusion(TCO) and labyrinthectomy(LE)in guinea pigs.Material and Methods:TCO was performed on 8 guinea pigs,while LE was did on 7 guinea pigs.Behavior and ENG were recorded in detail preoperatively and repeatedly up to one month postoperatively according to the experiment design.Results:There was spontaneous nystagmus towards the nonoperated side on the first postoperative day and nystagmus absence during sinusoidal angular acceleration stimuli on the operated side was observed in all the animals.All the animals displayed head tilt towards the operated side (right)and an unsteady gait towards the right along the vertical axis after surgery,while the animals performed LE rolled towards the operated side.On the 3rd postoperative day,faint nystagmus appeared on the operated side,but the left and right nystagmus was significantly asymmetrical.The left and right nystagmus still remained asymmetrical on the 5th and 10th day postoperatively.From the 15th postoperative day,left and right nystagmus returned symmetrical in the animals performed TCO,while left and right nystagmus returned symmetrical only at the pendular amplitude of 120°,150°,180°,in the animals performed LE up to 30th postoperative day.There was a significant reduction of nystagmus to the operated side at the Pendular amplitude of 60°and 90° one month after the LE and there was 3 animals still displayed head tilt towards the operated side.Conclusion: the animals compensated faster and more completely after TCO than LE.

The clinical data of 76 children with EFE admitted from June, 1998 to December, 2009 was retrospectively analyzed. Tachypnea、 cough and cyanosis were common and all presented with heart failure. Electrocardiogram revealed sinus tachycardia 、left ventricular hyperthrophy and ST-T alterations. On chest radiograph 54 cases (54/76) had a cardiothoracic ratio ＞ 0. 65 and 33 with pneumonia.Echocardiopraphy revealed lowered left ventricular systolic function in all cases and decreased left ventricular diastolic function in 21 (21/76). 63 cases (63/76) presented with thickened and enhanced left ventricular endocardium and 11 (11/76) with thickened interventricular septals. All were treated with digitalis. 58children were improved and discharged, 10 gave up therapy and 8 died during hospitalization. 41 out of 58 improved cases were followed for 1 - 4 years, with 2. 6 years on average. Among them 28 were clinically cured, 7 deteriorated and 6 died of heart failure. Echocardiography is of diagnostic value for ERE. Systolic and diastolic function of the heart can be used to predict the outcome. Pulmonary infection is a major risk factor associated with deterioration. Long-term treatment is imperative to improve the prognosis.