OBJECTIVE: To discuss the characteristics and regular pattern of the adverse drug reactions(ADR) in our hospital.METHODS: A total of 314 ADR case reports collected by ADR monitoring center in our hospital during 2007 were analyzed statistically.RESULTS: 13 categories(178 kinds) of drugs and 338 cases were involved in the total 314 ADR case reports,mainly anti-infective agents(128 cases,38 kinds) and Chinese drugs preparation(51 cases,20 kinds).The ADR were manifested chiefly as lesions of skin and its appendants(134 cases) followed by gastro-intestinal lesion(56 cases).The patients showed a favorable turn and the death occurred in only 1 case.CONCLUSION: More attention should be paid to the monitoring of rational drug use to avoid or reduce the incidence of ADR.

Objective To investigate the effect of nalmefene on sufentanil and propofol anesthesia for abortion and its impact on BIS. Methods One hundred and twenty patients undergoing abortion patients were randomly divided into group A, B, C, and D (n = 30 each). Patients in group A and B received 0.2 μg/kg or 0.3 μg/kg sufentanil, respectively, followed with 1.5 mg/kg propofol for induction of anesthesia post-pretreatment with 0.2 μg/kg nalmefene. Patients in group C and D received induction of anesthesia as patients in group A and B. According to the BIS and fluctuation of hemodynamic , the amount of propofol was adjusted. If necessary, additional single intravenous injection of 0.5 mg/kg propofol. The mean arterial pressure (MAP), heart rate (HR), pulse oxygen saturation (SpO2) and respiratory rate (RR) in patient before injection (T1), the eyelash reflex (T2), dilatation (T3), curettage (T4) and surgery awake (T5) were detected. The additional amount of propofol , operation time , recovery time of surgery , the steward score of orientation recovery after 1min of surgery , body movement reaction , cough , respiratory depression , postoperative visual analog digital score (VAS) 15 min later were also recorded in each group. Results Compared with group A, propofol could reduce the intraoperative body movement reaction rate , with lower postoperative VAS in group B and group D (P <0.05, respectively), with no significant difference between group C and group A (P > 0.05). The rapid recovery, surgery within 1 min orientation recovery were higher in group B, C, D compared with group A (P <0.05). However, orientation recovery score in group D was higher than that in group B (P < 0.05); The respiratory depression and choking were higher in group A and B than those in group C , D (P < 0.05, respectively). Conclusion The doses of 0.2 μg/kg nalmefene can effectively antagonize the respiratory depression , delay recovery and other adverse reactions in painless which induced by sufentanil , and the dose of nalmefene in this study failed to enhance the effect of analgesic and change the BIS values.

Objective To investigate the safety and efficacy of photoselective green laser vaporization of bladder tumor (PVBT). Methods A total of 522 patients with bladder tumor were enrolled in present study from January 2010 to May 2015, including 405 cases of non muscle-invasive bladder cancer (NMIBC) and 117 cases of muscle-invasive bladder cancer (MIBC). All of patients were treated with PVBT and intravesical instillation of epirubicin. Patients with MIBC received intravenous chemotherapy (kisi-hama and cisplatin). Results The hospitalization time was (7.32±1.28) days, the operation time was (27.08±5.36) min, and the indwelling urinary catheter was (2.42±0.34) days for patients in NMIBC group. During the follow-up period (12-60 months), 38 cases (9.4％) relapsed, of which 3 cases underwent radical cystectomy, and other 35 cases underwent PVBT again. All 405 patients were alive at the end of follow-ups. The hospitalization time was(26.18 ± 1.92) days, the operation time was (38.32 ± 6.54) min, and the time of indwelling urinary catheter was (2.72 ± 0.85) days for patients of MIBC group. During the follow-up period (12-60 months), 19 cases (16.2％) relapsed. Among them, 4 patients underwent radical cystectomy, and other 15 cases underwent PVBT. Six patients died from distant organ metastasis (including 2 cases of pulmonary metastasis and 4 cases of bone metastasis), and other 111 patients survived. Conclusion PVBT is safe and effective in the clinical application, especially for NMIBC and MIBC patients who are unable or unwilling to undergo radical cystectomy.

Objective To investigate the effects of CD24 on CCl4-induced murine liver fibrosis and to analyze the possible molecular mechanism.Methods Wild type (WT) and CD24 knockout (CD24-/-) C57BL/6 mice were treated with CCl4 through intraperitoneal injection.Levels of ALT in serum samples were detected and liver tissues were stained with hematoxylin and eosin (HE) to assess liver tissue injury.Sirius Red staining was used to observe liver fibrosis.Real-time PCR was performed to detect the expression of α-SMA (α-smooth muscle actin), Col1a1 (Collagen, typeⅠ, alpha 1), TGF-β1 (transforming growth factor-β1) and CD24 at mRNA level in liver tissues.Western blot was performed to analyze the expression of α-SMA and Col1a1 at protein level.Flow cytometry analysis was used to detect the macrophages in liver tissues.ELISA was used to detect the expression of TGF-β1 in the culture supernatants of M1 and M2 macrophages.Results The expression of CD24 at both mRNA and protein levels were up-regulated in mice with CCl4-induced liver fibrosis.HE staining showed that liver inflammation in CD24-/-mice was more severe than that in WT mice after treated with CCl4.Sirius Red staining of paraffin-embadded liver sections revealed that compared with WT mice, CD24-/-mice presented with more severe liver fibrosis.Moreover, α-SMA and Col1a1, indicators of liver fibrosis, in CD24-/-mice were significantly higher than those in WT mice.Flow cytometry analysis showed that murine hepatic macrophages significantly increased in CD24-/-mice than in WT mice following CCl4 treatment.Real-time PCR analysis also confirmed that significantly enhanced expression of TGF-β1 at mRNA level in liver tissues was observed in CD24-/-mice than in WT mice.TGF-β1 secreted in the culture supernatant of M2 macrophages derived from CD24-/-mice group was more than that of the WT mice group.No significant difference in TGF-β1 secretion in culture supernatant of M1 macrophages was observed between the two groups.Conclusion Taken together, these data suggest that CD24 plays an important role in attenuating CCl4-induced chronic inflammation and hepatic fibrosis in mice.The mechanism of CD24 in alleviating liver fibrosis might be through regulating intrahepatic macrophages, inhibiting the secretion of TGF-β1 by M2 macrophages and suppressing the activation of hepatic stellate cells.

Autoimmune encephalitis is a type of autoimmune disease affecting the central nervous system, which is mediated or associated with anti-neural antibodies. The pathogenesis and etiology are complex. Acute or subacute psycho-behavioral abnormalities, seizures, and cognitive impairment are the main clinical manifestations. Early diagnosis and aggressive immunotherapy are helpful for prognosis. This article reviews the progress in the pathogenesis, etiology, diagnosis and treatment of autoimmune encephalitis.

Objective:To explore the effect and mechanism of different processing motivation on college students' intergroup interaction willingness by technology of eye movement.Methods:Sixty college students conforming to the study conditions were selected from Northwest Normal University and randomly divided into ingroup motivation group ( n=30) and outgroup motivation group ( n=30) according to the random number table method. Subjects of the two groups first participated in the eye movement task, and then participated in the partner selection task.In the eye movement task, the percentage of time that subjects looked at faces of different groups was recorded.And in the partner selection task, the number of selections that subjects selected faces from different groups was recorded.SPSS 20.0 software was used for repeated measurement analysis of variance. Results:(1) In the eye movement task, there was a significant interaction of group and face group type ( F=13.37, P<0.001), but the main effects of group( F=3.23, P=0.077), and face group type ( F=0.09, P>0.05) were not significant. Further simple effect analysis showed that the percentage of time that the ingroup motors looked at the yellow race((16.00±0.06)%) was significantly higher than that of the outgroup motors ((12.00±0.04)%), and the percentage of time that the outgroup motors looked at the white race((17.00±0.06)%) was significantly higher than that of the ingroup motors ((9.00±0.04)%). (2) In the task of partner selection, there was a significant interaction among group, face group type and face old and new types( F=4.38, P=0.041), and the main effect of face group type was significant( F=14.87, P<0.001). The main effect of old and new types of face was significant( F=8.88, P=0.004), but the main effect of group was not significant ( P>0.05). Further simple effect analysis showed that the two groups of college students had statistically significant differences in the selection times of familiar faces from different groups( F=11.51, P=0.001). The number of times that the ingroup generator (5.51±1.14) selected the familiar yellow race as its partner was significantly greater than that of the outgroup generator (2.30±0.65). The number of times that the outgroup generator (5.40±1.00) selected the familiar white race as its partner was significantly greater than that of the ingroup generator (3.47±0.94). (3)Preferential attention to the ingroup members was a mediator between processing motivation and intergroup interaction willingness (mediating effect=0.20, 95% CI=0.02-0.31). Conclusion:Ingroup processing motivation has a threatening effect on college students' intergroup interaction willingness, outgroup processing motivation has a promoting effect on college students' intergroup interaction willingness, and processing motivation affects intergroup interaction willingness through ingroup bias.

Objective To investigate the effect of adjuvant therapy of Shenfu Injection on NOD-like receptor protein 3 (NLRP3)/cysteine-aspartic acid-specific protease 1 (Caspase-1) mediated pyroptosis signaling pathway and inflammatory factor levels in rats with acute myocardial infarction (AMI). Methods A total of 40 rats were randomly divided into sham operation group, model group, betaloc group (0.9 mg/kg), and combination group (0.9 mg/kg betaloc combined with 6 mL/kg Shenfu Injection), with 10 rats in each group. The rats were treated by gavage continuously for 3 weeks. The levels of serum troponin I (cTnI), creatine kinase-MB (CK-MB), interleukin (IL)-6, IL-1β, and tumor necrosis factor-α (TNF-α) in rats were detected before modeling, after modeling, and at 3 weeks of treatment. Echocardiographic parameters such as left ventricular ejection fraction (LVEF), left ventricular end-systolic diameter(LVESD), left ventricular end-diastolic diameter (LVEDD), and myocardial infarction area were compared among groups after modeling and at 3 weeks of treatment. Real-time fluorescence quantitative polymerase chain reaction (qRT-PCR) and Western blot were used to detect the mRNA and protein expression levels of NLRP3 and Caspase-1 in the myocardium. Results Compared with the sham operation group, the levels of cTnI, CK-MB, IL-6, IL-1β, TNF-α, myocardial infarction area, and the expressions of NLRP3 mRNA and Caspase-1 mRNA in the model group were significantly increased after modeling and at 3 weeks of treatment (P < 0.05); compared with the model group, the levels of cTnI, CK-MB, IL-6, IL-1β, TNF-α, myocardial infarction area, and the expressions of NLRP3 mRNA and Caspase-1 mRNA in the betaloc group and the combination group were significantly decreased at 3 weeks of treatment, and the above indicators in the combination group were significantly lower than those in the betaloc group (P < 0.05). Conclusion Adjuvant therapy of Shenfu Injection for AMI can further alleviate myocardial cell injury, shorten infarction size, and inhibit inflammatory response and pyroptosis activity.

Objective:To screen the serum exosomal microRNAs differentially expressed in early pancreatic cancer patients and evaluate the diagnostic value of exosomal hsa-let-7f-5p.Methods:From January 2019 to January 2020, 19 patients with early pancreatic cancer (early pancreatic cancer group) and 16 patients with chronic mass-forming pancreatitis (pancreatitis group) were selected from Affiliated Hospital of Nanjing University of Chinese Medicine who underwent surgery and were confirmed by pathology. Serum samples of the two groups of patients were collected. At the same time, serum samples of 19 healthy volunteers were selected as the normal control group. The exoEasy Maxi Kit was used to isolate serum exosomes. The structural characteristics of exosomes were observed by transmission electron microscopy (TEM). The particle size of exosomes was observd by nanoparticle tracking analysis. CD 63 and CD 81, the specific protein marker on the surface of exosomes, were identified by western blotting. The total RNA of exosomes was extracted by the miRNeasy Serum/Plasma Kit, and a small RNA library was constructed after quality inspection. With reference to the small RNA database, the differentially expressed exosomal microRNAs in early pancreatic cancer group, pancreatitis group and normal control group were filtered out. The miRNA candidates were validated by quantitative polymerase chain reaction (qPCR) and different expressions of them were analyzed. The role of target genes and metabolic pathways of candidate miRNAs in the occurrence and development of early pancreatic cancer were analyzed by gene ontology (GO) and Kyoto Encyclopeda of Genes and Genomes(KEGG) enrichment pathway. Results:The isolated serum exosomes can be seen to have cup-like vesicle with the double lipid layer by TEM. The main peak of the particle size of target exosomes was about 150 nm. The expression of exosome specific protein markers CD 63 and CD 81 was positive. Comparing the expression of miRNAs among early pancreatic cancer group, pancreatitis group and normal control group, the specific tumor marker exosomal hsa-let-7f-5p was screened out in this study, and its expression in early pancreatic cancer group was significantly higher than that in pancreatitis group and normal control group (both P values <0.05). Receiver operating characteristic curve analysis (ROC) showed that the area under curve (AUC) of exosomal hsa-let-7f-5p to distinguish pancreatic cancer from pancreatitis was 0.843 (95% CI 0.640-1.000). The sensitivity and specificity were 100% and 81.82% respectively. The AUC for distinguishing pancreatic cancer from normal controls was 1.000 (95% CI 1.000-1.000), and both sensitivity and specificity were 100%. The diagnostic efficiency of exosomal hsa-let-7f-5p was equivalent to that of CA19-9 ( P>0.05). The GO analysis results showed that target genes of exosomal hsa-let-7f-5p were mainly involved in complement activation lectin pathway in biological processes, and the proteins expressed by target genes were mainly distributed in cilium, and molecules mostly functioned by combining with nitric-oxide synthase. The KEGG pathway enrichment analysis showed that the target genes were closely related to MAPK signaling pathway. Conclusions:Serum exosomal hsa-let-7f-5p has the potential to be a diagnostic biomarker for early pancreatic cancer.

ObjectiveTo explore the possible action mechanism of Qingshi Anti-itch Ointment （青石止痒软膏， QAO） in the treatment of psoriasis. MethodsForty mice were randomly divided into four groups， blank group， model group， calcipotriol group and QAO group， with 10 mice in each group. Except for the blank group， psoriasis was induced by applying imiquimod cream to the dorsal skin. After modeling for 6 hours daily， the calcipotriol group and QAO group were treated with 0.5 g of calcipotriol ointment or 0.5 g of QAO， respectively， applied to the treated dorsal skin. The blank group and the model group received no treatment. The skin lesions were observed， and the psoriasis area and severity index （PASI） score was assessed every other day. After 7 days， Hematoxylin and Eosin （HE） staining was performed on dorsal skin tissue to observe pathological changes. The levels of interleukin 1β （IL-1β） and interleukin 18 （IL-18） were determined by enzym-linked immunosorbent assay （ELISA）. The protein levels of Caspase-1，Pro-Caspase-1， gasdermin D （GSDMD） and gasdermin-D-N （GSDMD-N） were detected by Western Blot （WB）. The protein levels of GSDMD were observed by immunohistochemistry. ResultsCompared with the blank group， the model group mice showed redness， erythema， and white scales on their skin， with histological observations indicating epidermal thickening， elongated spines， and infiltration of inflammatory cells. The PASI scores of the skin tissue on days 1， 3， 5， and 7 were elevated； the IOD and AOD values of GSDMD protein increased； the protein levels of Caspase-1， Pro-Caspase-1，GSDMD， GSDMD-N， and IL-1β and IL-18 were significantly elevated （P＜0.05 or P＜0.01）. Compared with the model group， the QAO group and calcipotriol group showed lighter skin lesions； the PASI scores on day 5 and day 7 in the QAO group， and on day 3， 5， and 7 in the calcipotriol group， were reduced； the IOD and AOD values of GSDMD protein， and the protein level of Caspase-1， GSDMD， and GSDMD-N， as well as level of IL-18 and IL-1β decreased in both groups； in the calcipotriol group， Pro-Caspase-1 protein level also decreased （P＜0.05 or P＜0.01）. Compared with the calcipotriol group， the QAO group showed slightly redder skin， more obvious thickening of the stratum corneum， and less capillary dilation； the PASI scores on day 3 and day 7 increased， while the score on day 5 was reduced； the protein level of Pro-Caspase-1， GSDMD， GSDMD-N， and the level of IL-18 and IL-1β were increased in the QAO group （P＜0.05）. ConclusionQAO can effectively relieve psoriasis dermatitis in mice. Its potential mechanism may be related to the regulation of the Caspase-1/GSDMD protein pathway， down-regulation of IL-18 and IL-1β levels， and alleviation of pyroptosis.

Diarrhea caused by chemotherapy is called chemotherapy-related diarrhea （CRD）. CRD can lead to reduced treatment effectiveness and compliance， affect the long-term outcome of tumor patients， and can be life-threatening in severe cases. In addition to conventional chemotherapy drugs， many molecularly targeted drugs are also associated with CRD， including small molecule epidermal growth factor receptor （EGFR） inhibitors， anti-EGFR monoclonal antibodies， phosphoinositide 3-kinase inhibitors， small molecule inhibitors of vascular endothelial growth factor receptor， BCR-ABL1 and KIT inhibitors， human epidermal growth factor receptor 2 target inhibitors， cyclin-dependent protein kinase inhibitors， antibody-drug conjugates and other molecularly targeted drugs. The occurrence mechanism may be related to the intestinal mucosal injury or enteritis caused by molecularly targeted drugs. The clinical manifestations are increased stool frequency and/or loose imposition， and patients are often associated with excess hyperproduction and/or colic. The incidence of CRD varies with different drugs. Great importance should be attached to collecting medical history and differential diagnosis， actively intervening and conducting dynamic evaluation， strengthening patient education， and timely detecting and preventing the occurrence of intestinal toxicity.