This paper reviews briefly the roles of these two ri sk factors in influenza epidemic, and the progress of the research on serologica l and molecular epidemiology of the influenza viruses antigenic mut ation.

OBJECTIVE:To gain a clear idea of difference of drug requirement and DDD between senile women and men patients,so as to provide a scientific basis for safely,effectively,economically and rationally preventing and treating diseases of senile patients and improving their quality of life METHODS:A 2-year(1998～1999)prescription database,which was set up by PRESCRIPTION ANALYSIS research group of 22 hospitals in Beijing,was used for this study Information of senile out-p_atients(≥60 years old)was collected and analysed Foxpro software was used for statistics and analysis RESULTS:The prescription rate for senile male patients was 11 6%,whereas that for senile female patients was 8 3% Proportion of injection for per hundred male out-patients was 17 0% and that for female patients was 20 4% The main kinds of drugs used for both male and female patients were cardiovascular drugs and vitamins,the DDDs of which were lower than those defined by WHO and drug directions,however,the DDDs for male patients were higher than those for female The rate of consultation for cardiovascular disease was high in both sexes Prostate diseases in senile male patients and diabetes in female should be given more concern The drugs used for both sexes accorded with National Essential Drugs List(men 85%;women 87 5%) CONCLUSIO_N:The rate of prescription and DDDs for senile male patients were higher than those for female,however,the proportion of injections for per hundred male patients was lower than that for female

Obstructive sleep apnea hypopnea syndrome(OSAHS)is a serious health hazard in children.It can cause damage to multiple systems, including cardiovascular, metabolic, endocrine and neurocognitive systems, especially for cognitive impairment.OSAHS may cause sleep fragmentation and intermittent ventilation abnormalities due to repeated partial or total upper airway obstruction, resulting in hypoxemia and hypercarbia, affect attention, intelligence, memory, language, executive function, etc.

Objective To study the efficacy of disodium pamidronate in the treatment of patients with primary hyperparathyroidism (PHPT) complicated by hypercalcemic crisis.Methods A total of 9 patients (12 cases) admitted into our hospital were diagnosed as PHPT complicated by hypercalcemic crisis.Of them,4 patients had parathyroid carcinoma,3 patients had parathyroid adenoma,2 patients had parathyroid hyperplasia.The intravenous disodium pamidronate was given for 12 times in all 9 patients.Serum calcium were monitored before and after treatment.Results Before the treatment,the serum calcium levels was 3.75 (3.66,3.99) mmol/L.On the second and third day after the treatment with disodium pamidronate,the serum calcium levels were 3.44 (2.95,3.78) mmol/L and 2.79 (2.50,3.14) mmol/L.The lowest level of serum calcium after treatment was 2.25 (2.00,2.55) mmoL/L.There were significant differences in the level of serum calcium of different days (P ＜ 0.05).On the second and third day,the change of serum calcium were 0.46 (0.10,0.88) mmol/L,0.60 (0.25,0.75) mmol/L,there were no differences.After intravenous disodium pamidronate,the serum calcium level decreased below 3.5 mmol/L in (2.27 ± 0.65) days,and were kept below 3.5mmol/L for 18.45 ± 12.30 days.Conclusions Disodium pamidronate can decrease serum calcium levels in hypercalcemic crisis caused by primary hyperparathyroidism effectively with mild adverse events.

Objective To investigate operation time on biliary duct stone with acute gallstone pancreatitis.Methods The clinical data of 44 patients with acute gallstone pancreatitis who were admitted to Department of General Surgery,Taicang First People's Hospital for surgical management from January 2011 to December 2013 were retrospectively analyzed.Patients were divided into early surgery group and delayed surgery group according to the timing.Early surgery group was defined as the patients whose symptoms of pancreatitis were basically disappeared after conservative treatment and surgery was performed within two weeks,while delayed surgery group was defined as the patients who underwent surgery after two weeks.Results Of the 44 acute gallstone pancreatitis cases,18 patients were males,and 26 were females,with median age of 54 years old (range 26-83 years old).Forty-two cases were mild acute pancreatitis and the other two cases were severe acute pancreatitis.Preoperative imaging indicated both cholecystolithiasis and choledocholithiasis in 5 patients,cholecystolithiasis alone in 39 patients.The 5 patients underwent cholecystectomy and choledocholithotomy with T-tube drainage.Among these 5 cases,one patient with concomitant acute suppurative cholangitis had an emergency surgery,two patients with Ranson score ≤3 had early surgery,and two patients with Ranson score ≥4 had delayed surgery,and all the patients were cured and discharged.Thirty-nine cases with cholecystolithiasis alone were treated with laparoscopic cholecystectomy.Among the 39 patients,25 patients underwent early laparoscopic cholecystectomy,and the other 14 patients underwent delayed surgery,and all the patients were cured and discharged.When compared with delayed group,the average age and Ranson score of early group were lower [(46 ± 12) yrs vs (64 ± 11) yrs and (1.0 ± 0.5) vs (1.5 ± 0.8)],and the median hospital length of stay and the cost were significantly less in the early group than those in the delayed group [(14.0 ± 2.8) d vs (18.1 ± 3.3) d and (17 899 ± 3461) Yuan vs (23 710 ± 3230) Yuan],and the difference between the two groups was statistically significant (P＜0.05).Nevertheless,there was no difference between the operation time and recovery time.There was no conversion to open surgery or post-operative complication in the two groups.Conclusions For severe acute pancreatitis,the delayed operation is recommended when the symptom of pancreatitis is completely improved after conservative management,while for mild acute pancreatitis,early surgery does not increase operation difficulty and complication,and it can decrease the length of hospital stays and costs.

Objective To evaluate the value of real time continuous blood glucose monitoring system (RT-CGMS) versus intermittent blood glucose monitoring (IGM) in the critically ill patients under intensive insulin therapy (IIT).Methods A systematic searching randomized and controlled trials (RCT) in databases was performed for meta-analysis by Review Manager 5.2 software.Outcomes were hypoglycemia episode,alteration of mean blood glucose level,the percentage of time at a blood glucose level within optimal target range,and the early mortalities.Results Six studies,totally 531 patients,were included in this meta-analysis.The pooled SMD of mean blood glucose level was =-0.21 (95％ SMD:-0.43-0.01,P=0.07).The pooled SMD of percentage of time at a blood glucose level within optimal target range was 0.20 (95％ SMD:-0.09-0.49,P =0.18).The pooled OR of hypoglycemia episode frequency was 0.20 (95％ CI:0.09-0.43,P ＜ 0.01).The pooled OR of early mortalities was 0.35 (95％ CI:0.14-0.89,P =O.03).Conclusions In critically ill patients under the intensive insulin therapy,RT-CGMS had obvious beneficial effect on reducing hypoglycemic events.RT-CGMS had no obvious beneficial effect on keeping blood glucose level within optimal target range.

BACKGROUND:For patients with osteoporosis, bone mineral density and other factors can lower the success rate of posterior lumbar interbody fusion. But there is no comprehensive report on the effects of different bone graft materials and osteoporosis on the posterior lumbar interbody fusion.
OBJECTIVE:To explore the influence of different bone graft materials and osteoporosis on the success rate of posterior lumbar interbody fusion.
METHODS:Clinical data of 227 patients undergoing posterior lumbar interbody fusion were retrospectively analyzed, and these patients were assigned into autogenous iliac bone group (n=121), fusion cage combined with autogenous cancelous bone group (combined group,n=65) and alograft group (n=41) according to different bone graft materials. There were 20, 22, 6 patients with osteoporosis in the three groups, respectively. Al the patients were folowed up for 24 months, and postoperative bone fusion, fusion time, intervertebral height and internal fixation failure and other adverse events were recorded and compared among three groups.
RESULTS AND CONCLUSION:The failure rate of internal fixation, fusion time and loss of intervertebral height were higher, but the fusion rate was lower in the alograft group than the other two groups (P < 0.05). In addition, there was no difference between the autogenous iliac bone group and combined group. For the osteoporosis patients, the failure rate of internal fixation and fusion time were higher, while the loss of intervertebral height and fusion ratewere lower in the alograft group than the other two groups (P < 0.05); compared with the autogenous iliac bone group, the combined group had longer fusion time and higher fusion rate (P < 0.05). These findings indicate that autogenous iliac bone graft combined with or without fusion cage can achieve higher fusion rate and less internal fixation failure in the posterior lumbar interbody fusion; however, for osteoporosis patient, the autogenous iliac bone graft can obtain better fusion effects.

Myelodysplastic syndromes ( MDS ) represent a heterogeneous group of clonal hematopoietic disorders with diverse clinical course .Because of the heterogeneity and the lack of molecular markers to monitor disease progression, clinical management of MDS patients is challenging .Recently, with the development of molecular analysis techniques , an increasing number of MDS related molecular biomarkers have been reported.In this review, we will discuss the clinical applications of the newly reported molecular makers in terms of diagnosis , prognosis and treatment.These markers may improve the diagnosis and prognostic assessment systems of MDS , which may potentially be used to guide decision making in the individual therapy.

OBJECTIVE:To optimize the formulation of Compound tripterygium hypoglaucum gel. METHODS:Using the comprehensive score(total score was 15.0)composed by forming property,glossiness,uniformity,viscosity,pH,spreadable prop-erty and stability as indexes,using the usage amount of carbomer 940,propylene glycol,triethanolamine and extracts in formula as study factors,orthogonal test was designed to optimized the formulation of Compound tripterygium hypoglaucum gel,and the verification test was conducted. RESULTS:The optimal matrix formulation was as follow as carbomer 9401.0 g,azone 2.0 g,so-dium bisulfite 0.4 g,extracts 50 mL,propylene glycol 10 g,triethanolamine 1.0 g,adding water to 100 g. The average comprehen-sive score of the gel in verification test was 14.8 (RSD=1.35%,n=3). CONCLUSIONS:The optimized formulation of Com-pound tripterygium hypoglaucum gel shows good forming property,the quality meets the requirements.