OBJECTIVE:To investigate the utilization of antineoplastic drugs in our hospital. METHODS:A retrospective analysis was conducted on antineoplastics used during 2005-2007 in our hospital in respect of the consumption sum,DDDs and average daily cost etc. RESULTS:Over the 3 years,the proportion of antineoplastics showed a year-on-year increase in consumption sum,with the antitumor plant amedica topping the consumption sum list and Tamoxifen topping the DDDs list for three years. Domestic drugs,injections and drugs on the RDL (reimbursable drugs list for basic medical insurance) showed high DDDs in our hospital. CONCLUSION:The consumption of antineoplastics is basically rational in our hospital,yet its management remains to be further tightened.

Objective To explore the clinical features and prognosis of arrhythmia in newborn infants.Methods Eighty children with arrhythmia were diagnosed by physical examination and electrocardiogram monitoring in author's hospital from Jan.2004 to Dec.2006.Their clinical features and 24-hour dynamic electrocardiogram were analyzed at the acute stage and followed up.Results Out of 80 cases of arrhythimics,52 cases were boys and 28 cases were girls,with an average age of 4 days on diagnosis of arrhythmias.Forty-five neonates presented with supraventricular arrhythmia,accounting for 56.3%.Their clinical presentations were atypical,and the hypoxia,infection,electrolyte disturbances and metabolic disorders were the main causes of the arrhythmias.After supportive and anti-arrhythmia treatment,18 cases of arrhythmias disappeared of 25 children with premature atrial beats;10 cases of 21 children with premature ventricular beats were cured,2 cases of 4 children with ventricular tachycardia,1 case died;2 cases of 3 children with supraventricular tachycardia didn't occure;3 cases of 5 with atrio-ventricular block were cured.The prognosis was better in supraventricular arrhythmias than that in ventricular and other arrhythmias at discharge.At the follow-up of(1.2?0.7)years,there were no differences in rates of recovery between supraventricular arrhythmias and ventricular arrhythmias.Conclusions Supraventricular arrhythmia was the most common type of arrhythmias in neonates.Most of the arrhythmia in neonates might be functional and could recover without treatment.Supraventricular arrhythmia usually had better prognosis in acute period.Only a few neonates with severe arrhythmia need anti-arrhythmias treatment.

rs of glucose and lipid metabolism in adolescents with abdominal obesity. Determimation of serum A-FABP concentration might be useful in diagnosis and prevention of metabolic syndrome and abdominal obesity in adolescent.

Objective:To investigate the feasibility of dynamic turbidity method for the detection of bacterial endotoxin content in influenza split vaccine. Methods: According to the bacterial endotoxin detection method described in general rule 1143 in Chinese Pharmacopoeia (2015 edition), the reliability test for standard curves of influenza split vaccine, the interference initial screening test, the interference verification test and the endotoxin content were performed or determined, and the results were compared with those by the gel method for the same batches of vaccine. Results:The results of reliability test for standard curves were accordance with the reg-ulations. In the interference initial screening test, vaccine was diluted by 160 times, 320 times and 640 times, and the recovery was between 50% and 200%, which showed no interference. The results of the interference verification test further proved that vaccine with 640 times dilution had no interference effect on test. The bacterial endotoxin contents of 10 batches of influenza split vaccine deter-mined by the turbidity method were less than the limit value of 20 EU·ml-1 , and the results were the same as those determined by the gel method. Conclusion:It is feasible to detect the content of bacterial endotoxin in influenza split vaccine by the dynamic turbidity method, which is worthy of promoted application.

Objective To explore the clinical characteristics of nosocomial infection in children with acute leukemia and the strategy of prevention and treatment.Methods One hundred and thirty-three cases of nosocomial infection in children with acute leukemia were analyzed by retrospective study.The relationship between nosocomial infection and stage of leukemia,hospitalization duration,and the rate of infection were investigated.Results Nosocomial infection rate was 53.4%(71/133 cases),significant difference of infection rate between acute lymphoblastic leukemia and nonlymphoblastic leukemia group was found(P0.05).The main pathogens of septicaemia were gram negative bacilli,and they were generally sensitive to Amicacin and Pi-peracillin/tazobactam.Conclusions Children with acute leukemia have high nosocomial infection rate.The occurrence of nosocomial infection was related to the type and stage of leukemia and hospitalization duration but not to the prognosis.The main pathogens of septicaemia were gram negative bacilli.

Objective To approach the effect of protective mechanical ventilation on acute lung injury after orthotopic liver transplantation, by observing changes of plasma markers of lung injury and inflammatory mediators.Methods Sixty patients scheduled for liver transplantation under general anesthesia, 42 males and 18 females, aged 21-62 years, weighing 43-80 kg, ASA physical status Ⅱ-Ⅳ, were randomly divided into 2 groups: protective mechanical ventilation group (group P) and unprotective mechanical ventilation group (group U).Pulmonary artery blood for plasma markers of lung injury and inflammatory mediators were collected at the following time points: before operation (T1), 3 hours after mechanical ventilation (T2), 2 hours (T3) and 4 hours in neohepatic stage (T4).These mediators included clara cell secretory protein (CC16), surfactant proteins (SP-D), soluble receptor for advanced glycation end-products (sRAGE), TNF-α, IL-6 and IL-8.Moreover, blood gas results were recorded at these 7 time points: T1-T4, 2 hours after operation (T5), before tracheal extubation (T6) and 2 days after operation (T7).The postoperative awakening time, tracheal extubation time, ICU stay time and the incidence of ALI were recorded.Results Compared with T1, plasma level of CC16 in the two groups increased at T2 and T3 (P<0.05 or P<0.01), however, plasma level of SP-D, sRAGE, TNF-α, IL-6 and IL-8 did not increase until T3 (P<0.01).Moreover, plasma level of sRAGE, TNF-α, IL-6 and IL-8 at T4 were higher than those at T1 (P<0.05 or P<0.01).Compared with T1, OIs in the two groups increased at T2, T5 and T6 (P<0.05 or P<0.01), while decreased at T4 in group P (P<0.01) and at T3 and T4 in group U (P<0.01).In group P, patients showed a lower plasma level of CC16 at T2 and T3 (P<0.05 or P<0.01), a higher OI at T3 (P<0.05) and an earlier tracheal extubation after operation [(8.9±3.2) h vs (9.3±2.8) h, P<0.05] compared with group U.There was no significant difference of acute lung injury incidence between the two groups after operation, which was 5(16.6%) and 7 (23.3%), respectively.Conclusion Protective mechanical ventilation may promote oxygenation index, and shorten tracheal extubation time, thus protect lung function of patients in liver transplantation to some extend.

Objective To evaluate the effects of lung-protective ventilation on acute lung injury after liver transplantation.Methods Sixty patients of both sexes,aged 21-64 yr,with body mass index of 18-28 kg/m2,of American Society of Anesthesiologists physical status Ⅱ-Ⅳ,scheduled for elective orthotopic liver transplantation,were divided into 2 groups (n =30 each) using a random number table:conventional mechanical ventilation group (group CMV) and lung-protective ventilation group (group LPV).In group LPV,the patients were mechanically ventilated (tidal volume 6-8 ml/kg,respiratory rate 10-15 breaths/min,positive end-expiratory pressure 3-10 cmH2 O),and lung recruitment mnaneuver was pertormed every 2 h.Before skin incision (T1),at 3 h of preanhepatic phase (T2),at 30 min of anhepatic phase (T3) and at 2 and 4 h of neohepatic phase (T4.5),bronchoalveolar lavage fluid (BALF) was collected and blood samples from the radial artery were simultaneously collected for determination of tumor necrosis factor-alpha and interleukin-8 concentrations in BALF and serum by enzyme-linked immunosorbent assay.At 2 h after operation (T6),before tracheal extubation (T7) and at 2 days after operation (T8),blood samples from the radial artery were collected for blood gas analysis,and oxygenation index was calculated.The concentrations of serum Clara cell secretory protein 16,surfactant protein D and soluble receptor for advanced glycation end-products were determined at T1-T8 using enzyme-linked immunosorbent assay.The postoperative emergence time,extubation time,duration of intensive care unit stay and development of acute lung injury were recorded.Results Compared with group CMV,the cxtubation time was significantly shortened,serum concentrations of Clara cell secretory protein 16 at T2,T3,T6 and T7,serum surfactant protein D concentrations at T5 and serum concentrations of soluable receptor for advanced glycation endproducts at T5 and T6 were decreased (P＜0.05),and no significant change was found in tunor necrosis factor-alpha and interleukin-8 concentrations in serum and BALF at each time point or postoperative incidence of acute lung injury,oxygenation index,emergence time and duration of intensive care unit stay in group LPV (P＞0.05).Conclusion Although lung-protective ventilation dose not decrease the development of acute lung injury after liver transplantation,it attenuates lung tissue injury to some extent.

Anti-Bacterial Agents ; therapeutic use ; Child ; Child, Preschool ; Drug Resistance, Bacterial ; Humans ; Mycoplasma pneumoniae ; drug effects ; pathogenicity ; Pneumonia ; drug therapy ; microbiology

OBJECTIVETo examine the expressions of HLA class I antigen and CD8 in various cervical diseases and investigate their association with cervical cancer.

METHODSThe expressions of HLA class I antigen and CD8 in cervical tissues sampled from patients with cervical cancer, cervical intraepithelial neoplasia (CIN), and chronic cervicitis were detected using SP immunohistochemistry. The association of the expressions of HLA class I antigen and CD8 with the clinicopathologic indices of the patients was analyzed.

RESULTSThe positive expression rates of HLA class I antigen in cervical cancer, CIN, and chronic cervicitis were 22.6%, 100.0%, and 100.0%, and the positive expression rates of CD8 were 22.6%, 95.5%, and 100.0%, respectively. The positive rates of HLA class I antigen and CD8 were significantly lower in patients with cervical cancer (P<0.01). Patients with stage I cervical cancer had significantly higher positive rates of HLA class I antigen and CD8 than those with stage II cervical cancer (46.7% vs 0.0%, 46.7% vs 0.0%, both P<0.01). The expressions of HLA class I antigen and CD8 decreased with the progression of the clinicopathological stages, and may even become undetectable. The expressions of HLA class I antigen and CD8 were not related to the differentiation degree of the tumor or lymph node metastasis (P>0.05). A positive correlation was found between HLA class I antigen expression and CD8 expression.

CONCLUSIONThe expressions of HLA class I antigen and CD8 are down-regulated or deleted in CIN and cervical cancer, and they may play important roles in the development and progression of CIN and cervical cancer.

Adult ; Aged ; CD8 Antigens ; immunology ; metabolism ; Cervical Intraepithelial Neoplasia ; immunology ; pathology ; Down-Regulation ; Female ; Histocompatibility Antigens Class I ; immunology ; metabolism ; Humans ; Middle Aged ; Uterine Cervical Neoplasms ; immunology ; pathology

OBJECTIVETo study the clinical features and etiological spectrum of pancytopenia in children.

METHODSThe clinical data of 174 children with pancytopenia between September 2003 and January 2010 were retrospectively reviewed.

RESULTSPale face was the most common clinical manifestation (147 cases, 84.5%), followed by bleeding (87 cases, 50.0%) and fever (41 cases, 23.6%). Mild to moderate anemia, severe thrombocytopenia and mild leucopenia were common in complete blood count. Of the 174 children, pancytopenia was attributed to hematopoietic system diseases in 155 cases (89.1%) and non-hematopoietic system diseases (virus infections, systemic lupus erythematosus, hypersplenism and neuroblastoma) in 6 cases (3.4%). Aplastic anemia (91 cases, 52.3%) was the most common cause of pancytopenia, followed by myelodysplastic syndrome (37 cases, 21.3%), acute leukemia and other hematological tumours (11 cases, 6.3%) and hemophagocytic syndrome (6 cases, 3.4%). The cause of pancytopenia was not identified in 13 cases (7.5%).

CONCLUSIONSAnemia, bleeding and fever are the main clinical manifestations of pancytopenia in children. Pancytopenia is mostly caused by aplastic anemia in children. Myelodysplastic syndrome, hematological tumours and hemophagocytic syndrome are also the common causes.

Adolescent ; Child ; Child, Preschool ; Female ; Humans ; Infant ; Male ; Pancytopenia ; blood ; diagnosis ; etiology