OBJECTIVE: To understand the current situation of off-indication drug use of folic acid in our hospital, to explore the rationality of the use of folic acid in combination with the latest guidelines, Meta-analysis and other data, to put forward suggestions for improvement and to provide reference for the rational use of folic acid in clinic. METHODSE: Retrospective study method was used to select all outpatient prescriptions of folic acid in our hospital from January 2019 to October 2019. According to the "drug instructions", relevant guidelines and consensus of experts, the data were processed and analyzed by Excel software. RESULTS: A total of 12 087 patients were included, including 11 226 patients using 5 mg folic acid and 861 patients using 0.4 mg folic acid. The results showed that there were 18 departments using 5 mg folic acid. The diagnosis of folic acid was found in nervous system, immune system and kidney system. Sixteen departments, including obstetrics, family planning, gynecology and respiratory medicine, used 0.4 mg folic acid, which were mainly diagnosed as pregnancy examination, infertility, menopause, postoperative lung cancer and so on. CONCLUSION: At present, there is a universal phenomenon of off-indication drug use of folic acid. In the current study, clinical pharmacists should strengthen the evaluation of rational use of folic acid in the aspects of over-indication.

Objective To compare three different internal fixations using dual plates in treatment of type C distal humerus fractures.Methods A total of 59 patients with type C distal humerus fractures fixed with dual plates between January 2004 and December 2008 were enrolled in the study,including 34 patients managed by perpendicular dual plate internal fixation (Group A),14 patients by dorsal dual plate internal fixation (Group B),and 11 patients by parallel dual plate internal fixation (Group C).Functional outcomes of injured elbow joints were assessed using Mayo elbow performance score (MEPS).Fisher' s exact probability,chi-square test and variance analysis were used to compare the perioperative variables among groups.Results The patients were followed up for average 28 months (range,12-55 months),which showed that all fractures were smoothly healed with satisfactory curative effects in each group.There were no significant differences with respect to functional outcomes among three groups.The patients with surgery difficulty in Group C were more than those in other two groups.Besides,an additional intercondylar screw was always required in Groups A and B,but rarely in Group C.Conclusions All internal fixations with three dual plates are effective in management of type C distal humeral fractures.The location of plates is determined by experiences of orthopedic surgeons and specific fracture type.

Objective：To set up a system for the culture of Dendrobium chrysotoxum in vitro. Method：Tissue culture，fire fly luminescence and phenol-H2SO4 method. Result：The embryo could germinate with or without light, the MS, 1/2MS, B5, N6 mediums are suitable to the growth and the differentiation of sprout with light, 0.5　mg*L－1NAA and 1　mg*L－16-BA, and ATP have regular changes, the content of polysaccharide was 2.833% in plant and 7.254% in sprout. Conclusion：The light has no effects on the embryo germination, but the phytohormone，nitrogen source and organized elements are important to the growth and differentiation of the sprout which should be transferred to the MS, 1/2MS, B5, N6 mediums in time supplemented with NAA与6-BA, ATP may be served as the dynamic indication of nourishment demand in the plant. The content of polysaccharide in the sprout is higher and can be utilized.

Objective To study the discrepancy influence of the sulbactam content on susceptibility testing results of cefoperazone/sulbactam combination disks.Methods Agar dilution method was used to determine MICs of cefoperazone,cefoperazone/sulbactam(2:1 and 1:1),and disk diffusion was used to detect the zone diameters of cefoperazone,cefoperazone/sulbactam(75/30 and 75/75μg/disk)disks against 534 clinical gram-negative isolates.The discrepancy within the results of MICs,zore diameters,the method of agar dilution and disk diffusion was analyzed.Results By standard agar dilution method,MIC_(50) of cefoperazone,cefoperazone/sulbactam(2:1 and 1:1)were 32,16,16μg/ml,and MIC_(90) of those were ≥256.128,64 μg/ml respectively.No statistic discrepancy was found for MICs between the ratios of 2:1 and 1:1 combination by Wilcoxon ranks test(Z=-0.248,P=0.804).Susceptibility rate,resistance rate,and intermediate rate with 75/30μg disk were 55.3%,24.5%and 20.2%respectively,which were similar to those determined by agar dilution method.Susceptibility rate,resistance rate,and intermediate rate(I%)with 75/75μg disk were 72.5%,12.4% and 15.1% respectively,compared with the susceptibility rate from 75/30μg disk was 17.2% higher.Statistic discrepancy were tested by paired t-test (t=21.613,P＜0.01)with two groups of whole strains' zone diameters from 75/30μg and 75/75μg disks,and resulting in the difference of susceptibility or resistance rates for ESBL-producing strains,Acinetobacter bauamnnii and Enterobacteriaceae without ESBL tested isolates.On the contrary,for Pseudomonas aeruginosa,Stenotrophomonas maltophilia and ESBL negative isolates,the zone diameters discrepancy was not statistically significant between the results from 75/30μg and 75/75μg disks.Conclusions There is no statistic discrepancy between the susceptibility results from cefoperazone/sulbactam(2:1 or 1:1 ratios)in dilution method and in diffusion method with 75/30μg disk.When the 75/75μg disk is used to be tested for ESBL-producing strains,Acinetobacter bauamnnii and other Enterobacteriaceae,the results should be shown with sulbactam content.

OBJECTIVE: To develop the visual uroflow scale (VUS), analyze the relationship of VUS score and index of free uroflowmetry, assess urination function preliminarily and improve the work efficiency in the clinic. METHODS: Male lower urinary tract symptoms (LUTS) patients, who attended the Department of Urology in Peking University People's Hospital from March 2016 to March 2017, were assessed for their urination function according to the Visual Uroflow Scale without help from clinicians before undertaking a free uroflowmetry test. And afterwards, a free uroflowmetry was undertaken, and variables including maximal flow rate (Qmax), the average flow rate (Qave) and voiding volume (VV) was obtained. During the study, 124 cases were collected and 53 cases met the inclusion and exclusion criteria and were included in the study cohort. The Spearman correlation analysis was used for analyzing the correlation of VUS scores with free uroflowmetry variables and age. The validity of VUS was evaluated. RESULTS: Most of the patients could choose the very figure matched with self-condition by first instinct without any help from the clinician. The data were analyzed by Spearman correlation analysis. In the present study, voiding time was positively correlated with the VUS score (correlation coefficient, 0.62, P < 0.05). In the present cohort, the patients chose the third and fourth figures to take longer time to urinate, implying worse LUTS situation. Flow time and VUS scores were positively correlated (correlation coefficient, 0.61, P < 0.05). The patients with higher VUS scores would spend more time on urinate, no matter how long urinary hesitation was. Both Qmax and Qave were negatively correlated with the VUS score (correlation coefficient －0.54, －0.62, P < 0.05). The study illustrated that the VUS score suggested that the Qmax basically and further reflected the urination function. And its relationship to age revealed the decreased urination function of aging male, which had reached a consensus. CONCLUSION Development of VUS has helped the clinician assess the urination function preliminarily at the first time. Patients are assessed for a VUS score before getting surgery or receiving the drug for treatment, and can be re-assessed after. The VUS score can provide an objective quantitative basis to evaluate the treatment efficacy. In addition, considering that it is convenient, timesaving and easy to understand, the VUS is available for follow-up.
Cohort Studies ; Humans ; Lower Urinary Tract Symptoms ; Male ; Urination ; Urodynamics

Objective To evaluate the clinical outcomes of periprosthetic femoral fractures (PFF) following hip arthroplasty utilizing locking compression plates (LCP) in regard to tips and tricks on the construction of LCP augmented with locking attachment plate (LAP) and titanium cables (TC).Methods A total of 41 cases of PFF follow hip arthroplasty (THA 3,Hemi-arthroplasty 2) between May 2008 to April 2016 have been retrospectively analyzed.There were 13 males and 28 females with an average age of 70.5±8.6 years,including 11 case of Unified Classification System (UCS) type Ⅳ.3B1.1,21 cases of B2.1 and 9 cases of type C.All were closed fractures caused by simple fall in terms of low-energy injury.Surgical options depended on individual configuration of the fractures with the combination of LCP and LAP or TC.In respect of reduction techniques,minimally invasive plate osteosynthesis (MIPO) was used in 5 cases for type B1.1 and 8 cases for type C,Mini-open in 6 cases for type B1.1 and 1 case for type C.Posterolateral approach with open reduction internal fixation were selected for type B2.1.The patients were followed up periodically.Harris score,Mukundan criteria and complications were recorded.Results Five cases died of the comorbidities (heart failure 3,pulmonary infection 1,multiple organs failure 1) within 1 year postoperatively.The follow-up rate was 78.0％ (32 out of 41 cases) and the average follow-up time was 41 months (ranging 11 to 71 months).No malunion,no reduction lost,no hardware failure,no hip dislocation and revision surgery following PFF care found.All cases showed the signs of fracture healing from 8 to 12 (average 10 weeks) postoperatively except 2 cases of delay union.The postoperative complications shown in 11 cases,including 2 cases of superficial infection of the wound,6 cases of deep vein thrombosis (popliteal vein 2,intramural gastrocnemius vein 4) and 3 cases of the prosthetic loosening.Harris score at the latest follow-up were 91.5±2.1 for group B1.1,77.5±4.2 for group B2.1 and 83.5±3.8 for group C.The LCP lengths were 248.9±24.3 mm,258.6±25.2 mm,280.4±24.0 mm for group B1.1,B2.1 and C respectively.The LCP length of group B1.1 was short than that of group C (P＜0.05).The screw numbers for the proximal fragments were 6.1±1.8,6.5±0.7 and 3.8±0.7 for group B1.1,B2.1 and C respectively.The number of screws used in B1.1 and B2.1 were more than that in C (P＜0.05).The screw numbers for the distal fragments were 3.5±0.5,3.9±0.5 and 5.1±0.8 for group B1.1,B2.1 and C respectively,indicating less screws used in B1.1 and B2.1 than that in C (P＜0.05).The cable numbers were 1.9±1.3,2.5±0.9 and 3.7±0.7 respectively for group B1.1,B2.1 and C (P＜0.05).The LAP used in 2,12 and 6 cases for type B 1.1,B2.1 and C respectively without significant difference statistically (P＞0.05).Conclusion Utilizing LCP for PFF following hip arthroplasty can achieve satisfactory short and mid-term clinical outcomes with the prerequisites of precise and individualized preoperative planning.LCP augmented by LAP and TC is a reliable option with low complication rate.However,type C PFF needs longer plate with more screws at distal fragment and more titanium cables.

OBJECTIVETo establish a solvent desorption Gas chromatographic method for detecting the isoflurane in air of workplaces.

METHODSThis method is based on "Standardization of methods for determination of toxic substances in workplace air".

RESULTSThis method presents the linear relation with the minimum detectable limit 1.0 µg/ml and the minimum detectable concentration 0.07 mg/m(3). The precision (RSD) was 0.5% ∼ 5.0%, the mean dsorption efficiencies were 96.7% ∼ 98.9%, the absorption efficiencies were 92.1% ∼ 100%, the breakthrough volume was 3.7 mg isoflurane/100 mg active carbon. Other volatile organic solvents (Sevoflurane, Enflurane and Ethyl Alcohol) did not interfere the detection. The sample could be stored in the active carbon tube at least for 10 days.

CONCLUSIONThis method is meet the requirement of GBZ/T 210.4-2008 "Guide for establishing occupational health standards-Part4: Determination methods of air chemicals in workplace" and is feasible for determining the isoflurane in the air of workplaces.

Objective To explore the relationship between self-reported chronic disease and smoking behavior among adult males in Jiangsu Province. Methods In 2007, 2010, and 2013 respectively, a multistage stratified cluster sampling method was used to select residents from 14 adult chronic diseases and their risk factor surveillance sites in Jiangsu Province to investigate the relationship between the prevalence of chronic diseases, smoking and smoking cessation behaviors among men aged 18 to 69 years. Results A total of 8 313 men aged 18 to 69 years had a self-reported prevalence of 1.5%, 1.1%, 1.5%, and 2.8% for cardiovascular and cerebrovascular diseases, malignancies, asthma, and chronic obstructive pulmonary disease (COPD), respectively.The self-reported prevalence of all four chronic diseases was higher in ex-smokers than in current smokers and non-smokers (all P<0.05).Multivariate analysis showed that the quit rate was of those suffering from cardiovascular and cerebrovascular diseases, malignancies, asthma, and COPD, respectively 3.356 times (95% CI: 1.966-5.728), 3.864 times (95% CI: 2.277-6.555), 2.103 times (95% CI: 1.321-3.345), and 2.586 times (95% CI: 1.872-3.573) higher, than those without. Conclusion Smoking cessation rates were significantly higher of those with chronic disease than those without, suggesting that illness would promote smoking cessation behaviors among smokers.

Objective To observe any curative effect of applying comprehensive pulmonary rehabilitation in moderate and severe cases of chronic obstructive pulmonary disease (COPD).Methods A total of 135 persons hospitalized with moderate or severe COPD were randomly divided into a rehabilitation group of 75 and acontrol group of 60.Both groups were given routine treatment,while the rehabilitation group was additionally provided with a comprehensive pulmonary rehabilitation regimen,including health education,exercise training,respiratory function training,respiratory muscle training,psychological support and nutritional intervention for six months.Before and after the treatment,both groups were evaluated using their walking distance within 6 minutes (6MWD),an anhelation index,a COPD assessment test (CAT),the Beck anxiety and depression scale,a nutritional assessment and indexes of pulmonary function and blood gases.Results After the intervention the average 6 MWD,anhelation index,CAT score,Beck anxiety and depression scores,forced expiratory volume,forced vital capacity and PaO2 of the rehabilitation group were all significantly better than before the treatment and better than those of the control group.Conclusion For moderate and severe COPD patients,comprehensive pulmonary rehabilitation effectively strengthens their moving ability,pulmonary function and arterial partial pressure of oxygen,while relieving anhelation,anxiety and depression.

Objective To find out the situation of seat belt wearing among drivers and passengers in Nanjing after the National Road Traffic Safety Law and its Ordinance had been issued for 3 years, in Jiangsu province. Methods Situation on seat belt wearing among drivers and front passengers on four types of vehicles including taxi, cars (below 8 seats), vans and pickups was studied during different time blocks at 4 sites in the city. Results A total number of 35 256 vehicles, their drivers and another 15 772 passengers sitting in the front, were observed. The prevalence rates of seat belt wearing, not wearing and pretend wearing among drivers were 49.9%, 44.1%, and 4.6% respectively while among front-seat passengers were 9.1% and 90.9% respectively. There were significantly declining trends in seat belt wearing among both drivers and front-seat passengers during the 3-years of observation, after adjustment by sex, types of vehicles and other factors (P<0.01). Risk of not wearing among front seat passengers was higher for those 'not-wearing' drivers (OR=8.10, P<0.01). Conclusion Neither the current law nor ordinance in Jiangsu province gives detailed regulations on seat belt wearing, which hampers the effective enforcement.