0 05) The overall incidence of adverse effects was between 12 9% and 28 8% There were no significant differences between these two groups Rivastigmine had no influence on vital signs and laboratory indexes Conclusion Rivastigmine may significantly improve the symptoms of the patient with AD and have a good safety and tolerability,being an ideal choice in treating AD

OBJECTIVE:To discuss the application of rational drug use software system in drug dispensing in outpatient depart-ment of our hospital. METHODS:The application of rational drug use software system (included clinical decision support soft-ware,drug dispensing software and drug management software) in prescribing (warning in advance),dispensing (intervention in the event)and the prescription review(the post review)in outpatient department of our hospital were all introduced. Outpatient pre-scription checking and intervention were collected from our hospital after the application of rational drug use software system to evaluate the effect of the software system. RESULTS & CONCLUSIONS:Rational drug use software system is adopted to realize scientific,convenient and express monitoring and management of prescription drug use in advance,in the course and afterwards. A total of 721 507 outpatient prescriptions were checked in our hospital from Jan. to May in 2015;0.17‰prescriptions were intercept-ed by system warning;system pointed out and pharmacists had checked 23.25% prescriptions;the rate of qualified prescription was more than 99.96%. After pharmacists intervention,various types of irrational prescriptions decreased significantly (P<0.01). It is suggested that pharmacists should make full use of information system,at the same time,optimize and improve the system through active exploration so as to improve rational drug use.

ObjectiveTo explore the differences of patients with mild cognitive impairment (MCI) and normal elderly individuals in neuropsychology and ApoE genotype polymorphism.Methods23 patients with MCI and 28 normal controls were examined with the neuropsychological test and ApoE phenotypes. The neuropsychological test included mini-mental state examination (MMSE), activities of daily living scale (ADL), Preffer outpatient disability questionnair (POD), Fuld object memory evaluation (FOM), rapid verbal retrieve (RVR), digit span (DS), logical memory (LM), Geometry figures, clock drawing test (CDT), delayed recall, clinical dementia rating scale (CDR), global deterioration scale (GDS), Hachinski ischaemic scale (HIS) and center for epidemiological studies-depression scale (CES-D).ResultsMCI cases achieved significantly lower scores than healthy elderly in all cognitive function measures (P<0.05～0.001)except ADL,POD performance and naming, especially in logical memory and semantic memory, similar with the earlier period of AD. The ApoE genotype polymorphism examination showed that the rate of ApoE epsilon 4 allele carry in MCI patients was around 10 times to that in normal controls.ConclusionIndividuals with MCI appear to be at an increased risk of developing AD. Susceptible neuropsychological marker binding other biomarker, e.g. ApoE, can raise the sensibility and specificity in early diagnosis of AD.

Objective:To evaluate the effect of surgery on 47 patients with moyamoya disease by retrospective analysis.Methods:A total of 47 patients with moyamoya disease were enrolled from August,2010 to According to the improved treatment in August,2013,all cases were divided into two groups:a pre-improved group and a post-improved group.According to different surgical methods,they were divided into two subgroups:an indirect revascularization subgroup and a combined revascularization subgroup.Results:The cerebral ischemia in 77.4％ of patients was relieved after the surgery.There was significant difference in outcomes of patients between the pre-improved group and the post-improved group (P＜0.05),while there was no significant difference between the pre-improved indirect revascularization subgroup and the pre-improved combined revascularization subgroup.There was also no significant difference between the post-improved indirect revascularization subgroup and the post-improved combined revascularization subgroups (P＞0.05).Conclusion:Surgical treatment can improve the outcomes of patients with moyamoya disease,but there is no significant difference in surgical effects between indirect and combined revascularization.

Objective To explore the impact of early repetitive painful procedures on subsequent pain behaviors and physiological indicators in full-term infants.Methods Sixty-two full-term neonates were enrolled (male 36 cases,female 26 cases) from the medical center of neonatal care at Nanjing Children's Hospital Affiliated to Nanjing Medical University from March to May in 2009.The data of all painful procedures were performed on those neonates and their responses to them were collected by using digital video recording were collected.The Neonatal Facial Coding System C(NFCS) and Neonatal Infant Pain Scale(NIPS) were used prospectively to evaluate the pain response to painful procedures.Results The average experience of pain caused by operation on newborn at the hospital was 56.5 times (12-249 times),and the daily average was 5.9 times (4-26 times).After they were exposed to more than 10 repetitive pain procedures,the full-term neonates showed the declining pain response assessed by NFCS and NIPS during the subsequent painful procedures (NFCS:P10=0.012,P20=0.015,P30=0.041;NIPS:P10=0.006,P20=0.015,P30=0.049),and the temporarily enhanced pain response was observed in the preparation phase of the subsequent painful procedures (NFCS:P2＜0.001,P3＜0.001,P4=0.004,P5=0.009;NIPS:P2＜0.001,P3＜0.001,P4=0.045,P5 =0.031).Bnt there was no difference in preparation phase.There was no alternation in latency and crying time after repetitiing painful procedures,but the proportion of crying neonates in the preparation phase of the painful procedures was increased(P=0.032).Conclusions After exposed to repetitive pain,full-term neonates expressed hypoalgesia during subsequent painful procedures,but the temporary irritation was enhanced during the following phases exposed to stress.

Objective To evaluate the left ventricular(LV)global and segmental myocardial systolic function in patients with permanent DDD pacemaker implantation by speckle tracking imaging.Methods Myocardial imaging of LV apical long views and parasternal LV short axis views were performed in 9 patients with right ventricular(RV)septum pacing(RV septum group),15 patients with RV apex pacing(RV apex group)and 13 healthy subjects(control group).Peak systolic longitudinal strain(S_L),peak systolic radial strain(S_R)were measured,and the average of S_L and S_R among LV 18 segments were calculated respectively as corresponding GS_L and GS_R.Results The GS_L[-(18.29±2.67)%]of RV apex group showed significant decrease compared with RV septum group[-(20.54±2.29)%]and control group[-(21.07±2.08)%](P＜0.05),while no significant difference was found between RV septum and control group.The GS_R of the pacing groups were both lower than control group[(36.26±9.37)%in control group,(28.59±6.06)%in RV septum group,(26.85±7.73)%in RV apex group,P＜0.05],but RV apex group showed more decrease trend.The S_L and S_R of the LV myocardial segments close to the pacing sites in both pacing groups showed significant decrease compared with control group,but RV septum group preserved similar LV strain distribution with control group while RV apex group showed abnormal LV strain pattern.Conclusions Speckle tracking imaging is a useful modality to evaluate global and segmental myocardial systolic function of LV with pacing at different right ventricular sites.

Objective · To conduct a survey on the current status of professionalism and personal protection in Central Sterile Supply Department (CSSD) practitioners in Shanghai, analyze the existing problems and provide suggestions, in order to improve work quality and management level of CCSD. Methods · Cluster sampling was used to extract 23 different level hospitals with CSSDs among 4 districts in Shanghai including Jing'an, Jinshan,Qingpu and Jiading. A total of 147 participants consisted of 104 employees and 43 heads of CSSDs. Field investigation and questionnaire survey were applied into CSSD practitioners for investigating their essential information, professionalism and personal protection status. Results · Practitioners in different hospitals showed different professional knowledge, especially practitioners in private hospital performed worse than those in secondary and tertiary-level hospitals in this survey of professionalism. Daily protection measures were defective due to lacking of consciousness of personal protection.Conclusion · There was problem of personal professionalism and protection consciousness in CSSD practitioners. It is important to optimize the allocation of CSSD human resource, reinforce skill training and improve quality management.

Objective To clarify the position,figure and connections with adjacencies in the pallial thickening(Pth),and provide essential parameters for its function study. Methods The coronal serial sections of 60?m thickness in gekko gecko brain were made by cryo-microtome,and Nissl staining was used.Pictures were taken in each coronal section containing the Pth and the size of Pth in each section was measured.One of them was chosen for the three-dimensional reconstruction.3D MAX was used as the tool software to rebuild the nucleus. Results 1.The Pth was located in the rostral part of the telencephalon,the lateral part of anterior dorsal ventricular ridge,the medial part of the lateral cortex and the ventral part of the dorsal cortex.The length of Pth from the rostral to the caudal end was(912.67?110.96)?m(n=10),the cubage of Pth was about(0.1430?0.0414)?m~3(n=10).2.The Pth could be divided into four segments,the anterior,the middle,the posterior and the terminal segments from the rostral to the caudal end.In the posterior segment,its dorsoventral axis was the longest,and could be divided into two parts: the dorsal and the ventral parts.The boundary of the two parts was clear.Conclusion The Pth is a long,narrow and flat structure;its rostrocaudal axis is longer than its dorsoventral axis,and its dorsal edge is smoother than its ventral edge.In the Pth,its caudal region is larger than its rostral region,and the posterior segment in the caudal region is divided into the dorsal and the ventral cell populations.

Objective:To evaluate the effect of epigallocatechin-3-gallate (EGCG) and epigallocatechin-3-O-(3-O-methyl)-gallate (EGCG-3Me) on the anti-bacterial effect and the stability of intraradicular dentin-adhesive interface.Methods:EGCG and EGCG3Me with the concentration of 400 μg/ml were incorporated into Single Bond 2 (SB2) respectively to obtain 2 modified adhesives E-SB2 and E3-SB2.Confocal laser scanning microscopy(CLSM) and ultraviolet spectrophotometry were used to evaluate the anti-bacterial effect of the modified adhesives.Micro-Raman spectrum was used to test the degree of conversion (DC) of the adhesives.Push-out bond strength test was conducted to examine the immediate bond strength and the bond strength after themocycling.Results:E-SB2 and E3-SB2 both showed inhibiting effect on the proliferation of E.faecalis,while E3-SB2 performed stronger inhibiting effect.DC and the immediate push-out bond strength of SB2 were not decreased with the incorporation of EGCG or EGCG-3Me(P ＞ 0.05).E-SB2 and E3-SB2 showed significantly higher push-out bond strengths than that of SB2 (P ＜ 0.05) after themocycling.Conclusion:EGCG and EGCG-3Me modified adhesives have anti-bacterial effect and can enhance the stability of bonding between intraradicular dentin and adhesive,EGCG-3Me may have stronger anti-bacterial effect.

Objective To analyze the risk factors for neurodevelopmental impairment of infants with tetralogy of Fallot (TOF).Methods Neurodevelopment of infants aged 0-3 years and undergoiong tetralogy of Fallot surgic operations in NanJing Children Hospital between October 2010 and October 2011 were assessed with Bayley Scales of Infant Development test (BSID).On the basis of assessment results,infants with 90 piont or more were devided into the normal group,and the rest less than 90 point were devided into the abnormal group.Compare the difference of birh weight,age,weight transcutaneous oxygen saturation (SPO2),hematokrit (HCT),McGoon index and left ventricular end-diastolic capacity index(LVEDI) at surgery between the two groups with t-test.And to identify risk factors for neurodevelopmental impairment of infants with tetralogy of Fallot with multivariate linear regression analysis.P ＜ 0.05 was statistically significant.Results All of 83 infants with 55 males and 28 females were admitted into this prospective study.There was no statistical significance in mental development index (MDI) and psychological development index (PDI) between the sexes.For MDI:normal 67 (80.7％),abnormal 16 (18.3％).With t-test,McGoon index,left ventricular end-diastolic capacity index and birth weight had significant difference between the two groups (P ＜ 0.05).Multivariate linear regression analysis showed that McGoon index,left ventricular end-diastolic capacity index and age at surgry were risk factors for MDI decrease,beta was 21.41,0.59 and-0.31,respectively (P＜ 0.05).Age at surgry was connected with MDI nagetively,McGoon index affected mostly.For PDI:normal 61 (73.5％),abnormal 22(26.5％).With t-test,MaGoon index and left ventricular end-diastolic capacity index had statistical significance between the two groups(P ＜ 0.05).Multivariate linear regression analysis showed that McGoon index and left ventricular end-diastolic capacity index were risk factors for PDI decrease,beta was 23.88 and 0.49,respectively (P =0.000).McGoon index influenced greatly.Conclusion McGoon index,left ventricular end-diastolic capacity index and age at surgry are influence factors for MDI decrease.McGoon index,left ventricular end-diastolic capacity index are risk factors for PDI decrease.McGoon index affects neurodevelopment of infants with tetralogy of Fallot mostly.