OBJECTIVE:To review drug use in the pediatric outpatient department of our hospital.METHODS:1000pediatric prescriptions during Aug.1to Aug.20,2004and another1000during Aug.1to Aug.20,2005were collected from the pediatric outpatient department of our hospital,and which were subjected to statistical analysis using international indicators of rational drug use and DDDs.RESULTS:The usage of injection accounted for12.3%in2004and11.4%in2005.The usage of anti-infectives stood at84.20%in2005,accounting for46.11%of total drug consumption sum.Azithromycin and cefaclor respectively dominated the first place on the lists of consumption sum and DDDs.CONCLUSION:The practice of Prescription Management Rules(trial)helps improving the use of injections in the pediatric outpatient department of our hospital.However,there are still many problems,which needs to be tackled in the application of anti-infectives and further intervention measures needs to be taken.

Purpose To explore the multislice spiral CT (MSCT) features of renal chromophobe carcinoma, and to improve the understanding and diagnosis of the disease. Materials and Methods MSCT features of 17 patients with renal chromophobe carcinoma confirmed by surgical pathology were retrospectively analyzed, plain MSCT and multi-phase dynamic contrast-enhanced scan were applied to these patients. Results Single substantive round or oval-shaped soft tissue mass was demonstrated in 17 cases. The lesions were all uniform density on plain MSCT, and mild to moderate homogeneous enhancement in 11 cases on enhanced MSCT, including 9 cases with significant enhancement above the renal medulla and below the renal cortex, and 2 cases with similar enhancement to renal medulla in corticomedullary phase. On nephrographic phase the lesion showed significant lower density than renal medulla. Heterogeneous enhancement presented in 6 cased, including 1 case with small necrosis and 1 case with stellate scar lesion in low-density. Conclusion Renal chromophobe carcinoma demonstrates a round solid mass of uniform density on plain MSCT, and mild to moderate homogeneous and heterogeneous, which can provide the reference value for preoperative diagnosis.

cholesterol 7α-hydroxylase gene ( CYP7A 1 ) plays a key role in the catabolism of cholesterol into bile acids. To investigate whether the A-204C polymorphism in CYP7A1 gene affects the gene expression,using luciferase as the reporter gene, four recombinants were constructed by inserting forward or reverse sequence with A or C allele at the polymorphism site into the promoter-less vector pGL3-basic. The constructs were then transfected into four cell lines and the luciferase activity of each expression vector was examined by dual luciferase reporter gene assay system. The results showed that activities of the forward sequence of both genotypes were higher than that of reverse sequence. Promoter activity of the recombinants with A allele was about one third lower than that with C allele. According to the analysis with TRANSFAC database, there may exist a Zic3 binding site when there is the C allele at -204. Our study indicates that the A-204 C polymorphism in CYP7A1 promoter region decreases its promoter activity and thus represses the gene expression, possibly due to the lack of a potential Zic3 binding site.

Objective To investigate imaging findings of lung injury after seawater drowning.Methods The imaging data in 12 cases with seawater drowning treated in our hospital in the past 8 years were analyzed retrospectively.Results After 2 to 12 hours of leaving the water,the initial chest X-ray examinations or CT scans were taken.The initial X-ray films displayed the lung markings increase,the small patch shadows or wide distribution patch shadows.CT showd large ground-glass density,diffuse patchy or flocculus shadows and different degress of emphysema in bilateral lung.Most of the foci were absorbed obviously in 1 to 3 days.In 1 case,the focus formed pulmonary abscess later.Conclusion X-ray and CT examinations can clearly show the severity and changes of lung damage in seawater submersion victims,and that can provide important informations for clinical diagnosis and treatment.

Small cell lung cancer is the most common primary neuroendocrine malignancy of the lung and is characterized by high malignant degree,rapid doubling time,easy metastasis in early stage and poor prognosis.Accurate staging of small cell lung cancer can formulate personalized therapeutic plans and improve the prognosis of patients.PET/CT can obtain metabolism and anatomical images of the whole body in one scan and improve the diagnostic accuracy and integrity.PET/CT has been widely applied to clinical practice now.PET/CT will play a more and more important role in diagnosis,staging,treatment and prognosis assessment of patients with small cell lung cancer.The value of PET/CT in staging and treatment of small cell lung cancer was reviewed in this article.

Objective To investigate the profiles of serum nerve grow factor profile (NGF),neurotrophin (NT)-3,as well as brain-derived neurotrophic factor (BDNF) in patients with dermatomyositis (DM) complicated with interstitial lung damage (ILD).Methods Forty-seven patients were divided into 2 groups:ILD group (30 patients) and non-ILD group (17 patients).Twenty healthy blood donors were used as controls.Serum levels of NGF,NT-3,as well as BDNF were measured serum by enzyme-linked immunosorbent assay (ELISA).ANOVA was used to compare serum level of NTs.When a significant difference was found,the exact P-values were calculated using the student's t-test or t-test followed by Bonferroni's correction.Pearson test was used for correlation analysis.Results The serum NGF levels in healthy control group,the non-ILD group and the ILD group were (182±43),(308±72),(480±96) pg/ml respectively.There was statistically significant difference between the three groups (F=90.3,P＜0.01),and the serum NGF levels were elevated significantly in ILD and non-ILD patient groups as compared with healthy controls (t=12.9 and t=6.5 respectively,both P＜0.01).The serum level of NGF was significantly higher in ILD group than that in the non-ILD group (t=6.4,P＜0.01).There was no significant difference in the serum levels of NT-3 among the two patient groups and healthy controls.On the contrary,BDNF levels were significantly decreased in both ILD [(792± 106) pg/ml] and non-ILD patients groups [(963±93) pg/ml] when compared with healthy controls [(1 281±107) pg/ml] (t=15.9 and t=9.6 respectively,both P＜0.01).The decrease was also significant in ILD group when compared with non-ILD group (t=5.6,P＜0.01).Moreover,NGF and BDNF both showed significant correlation with serum C-reactive protein (CRP) level in ILD group by applying Pearson correlation analysis (r=0.56,P＜0.01; r=-0.48,P＜0.05 respectively).Conclusion Neurotrophins may play an import role in the pathogenesis of DM.

Objective To investigate the incidence and risk factors of chronic post-surgical pain (CPSP) and its effects on the quality of life in a large sample prospective study.Methods A total of 1098 patients of either sex,aged 18-70 yr,of American Society of Anesthesiologists physical status Ⅰ or Ⅱ,undergoing elective surgery,were enrolled in the study.Data regarding patient age,gender,body mass index,educational level,marital status,living situations,occupation,pre-surgical pain in the site of surgery,complications,type of surgery,surgery time and anesthesia method were recorded.The highest numeric rating scale scores within 3 days after surgery were also recorded.The patients were followed up at 3,6 and 12 months after surgery to record the development of CPSP.The patients were divided into CPSP group and non-CPSP group according to whether or not CPSP developed.Multivariable logistic regression analysis was performed to identify the risk factors for CPSP,and the quality of life was scored.Results A total of 981 patients completed the 1 year follow-up after surgery,the incidence of CPSP was 35.7％,and the constituent ratio of the distribution of the course was as follows:3 months ≤ postsurgical course ＜ 6 months was 33.1％;6 months ≤ postsurgical course ＜ 12 months was 16.8％;postsurgical course ≥ 12 months was 50.1％.Female,no diabetes mellitus and pre-surgical pain in the site of surgery were the independent risk factors for CPSP (P＜ 0.05).Compared with non-CPSP group,the physiological function score,professional function score,body pain score,vitality score,social function score,mental health score and general health score were significantly decreased (P＜0.01),and no significant change was found in the emotional function score in CPSP group (P＞0.05).Conclusion The probability of development of CPSP is high and the course is long,and the quality of life score is decreased;female,no diabetes mellitus and pre-surgical pain in the site of surgery are the independent risk factors for CPSP.

Objective To investigate CT signs of peripheral small cell lung cancer (SCLC).Methods The CT signs of 78 patients with SCLC confirmed by pathology were retrospectively reviewed.According to the presence of mediastinal lymph node metastasis and its size, 78 cases of peripheral SCLC were divided into two types: typeⅠ(isolated lesion) and typeⅡ(lung lesion + lymph nodes).Type Ⅱwere divided into two subtypes:type Ⅱa (short diameter of lymph nodes of pulmonary hilar and mediastinum less than 10 mm) and type Ⅱ b (short diameter of lymph nodes of pulmonary hilar and mediastinum greater than or equal to 10 mm).Results Of the 78 SCLCs, typeⅠwas 7 cases, and typeⅡwas 71 cases,including 8 cases of typeⅡa and 63 cases of typeⅡb.All of the lesions were soild density.The shape were round or oval in 52 cases, vermicular or spindlein 9 cases, and other shapes in 17 cases.Among 71 cases performed CT enhancement, there were 9 cases with homogeneous enhancement, 58 cases with heterogeneous enhancement, 4 cases with non-enhancement large necrosis area.These cases showed the following CT signs: smooth edge in 65 cases, coarse edge in 12 cases, blurred edge in 1 case;air bronchogram in 3 cases, vacuole sign in 4 cases, calcification in 4 cases;lobulation sign in 46 cases, spiculated sign in 5 cases;thickening of the bronchovascular bundle in 41 cases, pleural indentation in 6 cases, marginal ground-glass opacity in 5 cases, vascular convergence sign in 1 case;emphysema in 42 cases;obstructive pneumonia in 4 cases;bronchus abruptly interruption on the edge of the nodules in 18 cases;enlargement of mediastinal lymph nodes in 63 cases, the diameter of mediastinal lymph nodes larger than the primary lesions in 42 cases;and a little pleural effusion in 9 cases.Conclusion Solid density, smooth margin with lobulation,and significantly enlarged mediastinal lymph nodes are common signs in peripheral SCLC.Thickening of the bronchovascular bundle indicates reletively advanced stage.

Objective: To understand the vaccination coverage and associated factors among children under 7 years old in rural areas of Ningxia in 2019, so as to provide a basis for better immunization plans and corresponding strategies in this region. Methods: A multi-stage stratified cluster random sampling method was adopted to select 1 144 children under 7 years old and their families in three rural counties of Ningxia. Demographic information, as well as primary and secondary immunization was investigated. Multivariate Logistic regression analysis was conducted on the relevant factors. Results: In Ningxia, the coverage rate of primary vaccines for children under 7 years of age for hepatitis B vaccine, BCG vaccine and dpt vaccine was above 95%, polio vaccine 83.7%, measles vaccine 38.6%, "five vaccines" 33.8%, and the coverage rate of secondary vaccines was only 4.9%. There were statistically significant differences in the total vaccination rates of "five seedlings" in different ages, per capita annual income of different families, and whether they had received a health examination in the past year (χ2=33.60,13.17,29.96,P<0.05). There were statistically significant differences in the vaccination rates of secondary vaccines among different age groups, different inoculation units and whether received a physical examination in the last year (χ2=18.58, 8.45, 60.04, P<0.05). Multivariate analysis showed that the age of children and whether received physical examination in the last year were the relevant factors affecting the total inoculation of five seedlings(P<0.05). Age of children and inoculation unit were the relevant influencing factors affecting the secondary immunization(P<0.05). Conclusion The primary vaccination rate for children under the age of 7 in rural areas of Ningxia is kept at a high level, but the secondary vaccination rate is relatively low. It is suggested to strengthen publicity and education and establish effective mechanisms to improve the vaccination rate and protect the health of children in rural areas.

Objective To investigate CT findings of abnormal bronchovascular bundle in patients with peripheral small cell lung cancer (SCLC).Methods The CT findings of abnormal bronchovascular bundle in 78 peripheral SCLC patients confirmed by pathology were retrospectively reviewed.Abnormal bronchovascular bundle of peripheral SCLC was divided into three types:type Ⅰ (thickening of the bronchovascular bundle),type Ⅱ (string beads of bronchovascular bundle) and type Ⅲ (bronchial cast with bronchus cut-off).Results 41 of 78 patients had abnormal bronchovascular bundle,in which 26 cases were in type Ⅰ,10 in type Ⅱ,5 in type Ⅲ.Except for 1 case with no mediastinal lymph node metastasis among 41 cases with abnormal bronchovascular bundle,all other 40 cases had mediastinal lymph node metastasis.Conclusion The abnormal bronchovascular bundle could reflect the biologic character of SCLC.Abnormal bronchovascular bundle is associated with advanced patients.