Objective: To investigate the effect of irrational use of traditional Chinese patent medicines (CPM) on medication safety.Methods: The adverse drug reaction (ADR) reports on traditional CPM (including traditional Chinese medicine for injection) in our hospital during January 2013 to October 2016 were collected and analyzed retrospectively.After finding the corresponding prescriptions, the situation of irrational drug use in the reports including indications, usage and dosage, combination of traditional CPM, combination of Chinese and western medicines and course were analyzed, and the rate of irrational drug use was calculated.Results: A total of 217 reports were collected including 217 patients.The primary diseases ranked top three were cardio-cerebral vascular system diseases, digestive system diseases and respiratory system diseases.The cases involved 81 kinds of drugs, and among them, 37 cases were induced by Shenmai injection.The rate of irrational drug use associated with indications, usage and dosage, combination of traditional Chinese patent medicines, combination of Chinese and western medicines and course was 6.45% , 5.99% , 2.76% , 0.92% and 1.84% , respectively, and the total rate was 17.97% (39/217).Conclusion: The irrational drug use maybe one of the important factors related to ADR of CPM.According to syndrome differentiation, CPM should be used rationally, and pharmaceutical care should be strengthened to reduce the incidence of ADR.

Objective To observe the therapeutic effect of acupuncture combined with rehabilitation on dysphagia after stroke at differentstage. Methods According to the randomized trial principle, 155 cases were divided into two groups: control group (n=80) and observationgroup (n=75). The control group was treated with rehabilitation training, and the observation group was treated with acupuncture and rehabilitationtraining, 5 times every week for 4 weeks. The two groups were assessed by TCM swallowing assessment scores and Kubota testbefore and after treatment. Results According to Kubota test, the total rate was 66.67% in the control group and 89.33% in the observationgroup with a significant difference between the groups (P<0.001). In the observation group, the total rate was 90.48% at acute stage and88.89% at the convalescence stage with a significant difference (P<0.01). According to TCM swallowing assessment, the total rate was64.00% in the control group and 74.67% in the observation group with no significant difference between the groups (P<0.05). In the observationgroup, the total rate was 90.48% at acute stage and 68.52% at the convalescence stage with a significant difference (P<0.001). ConclusionAcupuncture combined with rehabilitation facilitates to improve the swallowing function in stroke patients following dysphagia especiallyat acute stage.

Objectives To compare endovascular aortic repair (EVR) and medical therapy for acute type B aortic dissection (AD) in terms of treatment results.Methods From January 2004 to October 2010 116 cases were collected and were divided into two groups,with treatment of EVR (n =60)and medical therapy (n ＝ 56).Treatment outcomes were assessed.Results Clinical manifestations of AD are complex and variable,with the most common symptom being pain on chest and back (74.1％).CTA is the most valuable method in confirming the diagnosis of aortic dissection.In conservative group of 56 patients admitted to hospital,30-day mortality rate was 16.1％.In EVR group of 60 patients with grafts successfully released,the 30-day mortality was 1.7％.There is significant difference between the two groups on mortality rate during 30-day(P ＜0.05).Follow-up rate in conservative group and the EVR group was 71.4％ and 86.7％,with average follow-up time of (38 ± 16) months and (35 ± 14) months.The 5-year survival rates were 87.5％ and 88.5％ respectively in conservative group and EVR group (P ＞ 0.05).Conclusions EVR is considered to be the first choice for acute Stanford type B dissection.EVR can improve patients' 30-day survival,though long term result is comparable with that of conservative treatment.

Objective: To assess the anti-inflammatory and immunomodulatory activities of schisandrin B in mice. Methods: Kun-ming mice were randomly divided into 6 groups: the blank control group, the model control group, the positive control group( dexam-ethasone hydrochloride 5 mg·kg-1,levamisole hydrochloride 30 mg·kg-1), schisandrin B low (100 mg·kg-1), medium (200 mg ·kg-1) and high (400 mg·kg-1) dose groups. The inflammatory mice were induced by xylene and the immunosuppressed mice were induced by cyclophosphamide. The ear edema experiment, carbon clearance experiment and serum hemolysin experiment were per-formed with the swelling rate, swelling inhibition rate, carbon clearance index, phagocytic index, half hemolytic value, spleen index and thymus index as the investigation factors. Results: High dose and medium dose schisandrin B groups had significant inhibitory effect on mice ear edema when compared with the model control group(P<0. 05);There were significant differences between the high dose group and the positive group and there were significant differences in clearance index and phayxyitc index between high dose group and low dose group(P<0. 05), and high dose schisandrin B group had increased clearance index and phagocytic index in low immune function mice when compared with the model control group (P<0.05). Schisandrin B significantly increased HC50in low immune function mice when compared with the model control group (P<0. 01). Schisandrin B significantly increased the spleen index and thy-mus index in low immune function mice when compared with the model control group ( P<0. 01,and in a dose-dependent manner. Conclusion: Schisandrin B has significant anti-inflammatory and immune function enhancing effects.

BACKGROUND:The rabbit model of osteonecrosis of the femoral head (ONFH) has been successfully established by glucocorticoid combined with lipopolysaccharide.OBJECTIVE:To observe the dynamic changes of bone mass in the early steroid-induced ON FH.METHODS:Twenty-four adult New Zealand white rabbits were randomly divided into experimental and control groups (n=12 per group).Rabbits in the experimental group were injected with lipopolysaccharide and glucocorticoid to establish the model of ONFH,while those in the control group given the same volume of normal saline.The changes in the femoral head structure,morphology and distribution of the trabecular bone at 5,1 0,15 and 20 days after modeling were observed through multi-slice spiral CT,micro-CT and hematoxylin-eosin staining;the bone mineral density and rate of empty lacunae were detected.RESULTS AND CONCLUSION:The imaging examinations showed that the rabbit femoral head was intact and smooth in both groups;on days 15 and 20,in the experimental group,the cortical bone became thinner,the trabecular bone became sparse and discontinuous,and the bone mineral density,tissue mineral density and bone volume/total volume were significantly lower than those in the control group (P ＜ 0.01).The histological observation indicated that there were more empty lacunae and adipocytes,as well as less osteocytes and hematopoietic cells in the experimental group;the rate of empty lacunae in the experimental group was significantly higher than that in the control group on days 15 and 20 (P ＜ 0.01).These findings suggest that in the early stage of ONFH,necrotic osteocytes increase in number,accompanied by trabecular micro-fractures,which leads to a decrease in bone mineral density,eventually resulting in bone remodeling disturbance.

OBJECTIVETo evaluate the feasibility and safety of CO2 laser supraglottoplasty for severe laryngomalacia in infants.

METHODSFrom January 2009 to December 2011, 32 infants with severe laryngomalacia were confirmed by electronic laryngoscope and clinical assessment in Shenzhen Children's Hospital. According to the choice made by the parents, 16 children accepted CO2 laser supraglottoplasty (group 1), the others were treated conservatively (group 2). The beginning observation point T0 was defined as the age on the first medicine taking day or the age of surgery. T1, T3, T6 were defined as 1, 3, 6 months following T0. Clinical symptoms included stridor, dyspnea, aspiration, and respiratory infections. The body weight, PSG reports, laryngoscope findings, cure rates of the two groups were compared.

RESULTSThe anatomical abnormalities were corrected surgically, and the symptoms ,such as stridor, dyspnea, and aspiration improved rapidly after the operation. The cure rates was higher in group 1 than in group 2 on T1, T3, T6 stage. There were statistically significant differences(χ(2) were 13.9, 28.1, 24.6 respectively; all P < 0.01). Children in group 1 gained weight better than in group 2. There was a statistically significant difference in Z scores median on T1, T3, T6 stage (z score were -0.848, -2.940, -4.110; P < 0.05, or P < 0.01 respectively). The lowest oxygen saturation in group 1 improved one month after the surgery (from average 0.686 ± 0.106 to 0.901 ± 0.041). There was a statistically significant difference (t = -7.876, P = 0.001). Complications included adhesion (1 case) and temporary new-onset aspiration (1 case).

CONCLUSIONSThe CO2 laser supraglottoplasty can resolve severe laryngomalacia symptoms including stridor, dyspnea and aspiration. It can reduce the frequency of respiratory infections, and contribute to weight gaining. The CO2 laser supraglottoplasty is effective, of high security and with rare complications.

Carbon Dioxide ; Glottis ; Humans ; Infant ; Infant, Newborn ; Laryngomalacia ; radiotherapy ; Laryngoscopes ; Lasers, Gas ; therapeutic use ; Low-Level Light Therapy ; Retrospective Studies

OBJECTIVETo locate motor functional area of patients who undergone modified anatomical hemispherectomy in order to analysis the plasticity of upper limbs motor.

METHODSThe patients who undergone modified anatomical hemispherectomy were performed BOLD sequences, to locate functional cortical areas in their residual brain.

RESULTS6 patients have performed examination of BOLD sequences by 3.0-T MRI.5 of them obtained contralateral upper limb motor areas in their residual brain, and 3 of them obtained ipsilateral and contralateral upper limb motor area map in cortex. The ipsilateral upper limb motor areas in the M1, SMA and posterior parietal cortex.

CONCLUSIONSThe patients who undergone modified anatomical hemispherectomy is an excellent model to investigate mechanism of plasticity in the developing brain. Functional magnetic resonance (fMRI) provided fine spatial detail of brain responses, would describe the motor functional area of cortical maps. These patients exist ipsilateral motor areas in their residual mono hemisphere. The study indicated there maybe have somewhat extent of correlation between the surgical procedure and the outcome of neuroplasticity.

Cerebral Cortex ; physiopathology ; Epilepsy ; physiopathology ; surgery ; Female ; Hemispherectomy ; Humans ; Magnetic Resonance Imaging ; methods ; Male ; Neuronal Plasticity ; physiology ; Postoperative Period ; Upper Extremity ; innervation ; physiopathology

Objective To investigate the clinical features,treatment regimen and prognosis of acute lymphoblastie leukemia (ALL) complicating central nervous system leukemia (CNSL).Methods The clinical data,results of laboratory detection and imageological examination in the patients with ALL complicating CNSL in this hospital from January 2005 to January 2015 were retrospectively analyzed.Results A total of 83 cases were collected,including 52 male cases(62.65％) and 31 female cases (37.35％) with a median age of 27 (15-72) years old.Among them,19 cases were T cells ALL(T-ALL),54 eases were B cell ALL(B-ALL),3 cases were Burkitt lymphoma/leukemia,2 cases were ALL (T/B lymphocyte) and 5 cases were undefined type.The median follow-up time was 10(1-52) months.The univariate analysis results showed that the patients with high WBC count (WBC≥100× 109) at initial diagnosis or unreach complete remission (CR) after 1 treatment course had relatively poor prognosis.Receiving the radiotherapy could improve the patients' survival rate(P＜0.05).In the multivariate analysis,high WBC count at initial diagnosis was an independent prognostic factor affecting the patients' overall survival(OS) (P=0.007).Conclusion The clinical features in the patients' with ALL complicating CNSL have poor specificity,high WBC level and unreaching CR by 1 treatment course are the poor prognosis factors,and local radiotherapy has a certain significance for prolonging the patients' survival period.

OBJECTIVESTo detect the levels of reactive oxygen species (ROS), superoxide dismutase(SOD) and interleukin 8(IL-8) in seminal plasma of infertile patients, and evaluate the possible relationship between those levels.

METHODSSemen was collected from normal donors (15 cases), infertile men without infection (16 cases), and infertile men with infection (leukocytospermia, 11 cases). The routine analysis of semen was accomplished, and then the levels of IL-8, malondialdehyde (MDA), SOD, and white blood cell (WBC) were examined. The correlative analysis between the level of ROS and other parameters in these populations was made.

RESULTSIn leukocytospermic group, the levels of MDA, WBC, and IL-8 were higher than those in the other two groups (P < 0.001). Significantly positive correlation was observed between IL-8 and MDA (r = 0.852, P < 0.001) and between the levels of IL-8 and WBC.

CONCLUSIONSThese findings suggest that increased oxidative stress in patients with leukocytospermia may cause the increase of IL-8(r = 0.818, P < 0.01). The increased oxidative stress may be due to defect in ROS scavenging system.

Adult ; Cytokines ; blood ; Humans ; Infertility, Male ; blood ; complications ; Male ; Male Urogenital Diseases ; blood ; complications ; Reactive Oxygen Species ; blood ; Semen

Objective:To investigate the current application of colonoscopy at hospitals in China.Methods:From November 2019 to January 2020, an online questionnaire survey was conducted among gastroenterologists and colonoscopists in hospitals of different levels. The contents of questionnaire survey included basic information of colonoscopy at the respondent′s hospital, protocols and patient education of bowel preparation, implementation of colonoscopy quality control, and colonoscopists′ understanding of polypectomy techniques and post-polypectomy follow-up.Results:A total of 236 valid questionnaires were collected, involving 187 hospitals, and 143 (76.5%) had an annual operation capacity of more than 5 000 cases. In terms of bowel preparation, split-dosed polyethylene glycol electrolyte powder (PEG) was the most commonly used (60.4%, 113/187) and the most common volume of PEG was 3 L (67.4%, 126/187). Verbal (90.9%, 170/187) and written (79.7%, 149/187) instructions were given more often than other methods for patient education of bowel preparation. Antifoaming agent was routinely used in 124 (66.3%) hospitals. In terms of quality control, only 11.5% (20/174) hospitals implemented all four measures. In terms of polypectomy techniques, 98.1% (203/207) colonoscopists chose hot snare polypectomy or endoscopic mucosal resection for lesions of diameter>1 cm, while options varied for lesions of diameter<1 cm. The interval of follow-up after polypectomy recommended by colonoscopists was shorter than that by guidelines.Conclusion:Several problems are found in the survey in the application of colonoscopy in China, i. e., patient education of bowel preparation is not diversified; quality control of colonoscopy still needs to be strengthened; polypectomy techniques and follow-up after polypectomy need to be further standardized.