OBJECTIVE: To evaluate the current situation and trend of narcotic drug use in our hospital where the authors work in order to provide the reference for scientific management and rational use of these drugs. METHODS: The yearly amount of narcotic drugs administered in the whole hospital, the yearly amount in the separate departments, as well as drug expenditures and ratios between January 2002 and November 2005 were added up and analyzed statistically. RESULTS: The amount of bucinnazine use dominated in the first. The amount of morphine for oral use was increasing year by year. The amount of fentangl transdernal patch use was also bigger and increasing rapidly. However, the amount of pethidine and morphine for injection use was decreasing. CONCLUSION:Analgetics for oral and transdermal use will be the main categories of analgetics in the future.

Objective:To discuss the regularity of adverse drug reactions induced by statin.Method:82 cases from published articles were retrieved from 1998 to 2008.According to the given standard,the data were statistically analyzed. Result:77 articles carried 82 case reports concerning statins inducing ADRs in the period of 10 years.52 cases were caused by simvastatin.ADRs of statins could involve multiple organs and systems,mainly myopathys.Severe reaction could result in renal failure and even death.Conclusion:A rational use of statins should be strengthened in the clinical practice and strict monitoring in order to prevent and reduce the occurrence of serious adverse drug reactions.

Cytoskeletal Proteins ; biosynthesis ; genetics ; physiology ; Humans ; Neoplasm Metastasis ; Neoplasms ; pathology ; Signal Transduction

Objective To summarize the clinical application of parenteral nutrition (PN) in Fuwai Hospital. Methods The clinical applications of PN in 132 critically ill patients undergoing cardiac surgery in our hospital were retrospectively investigated and analyzed. Results The application of PN in Fuwai hospital was basically appropriate and standardized. Energy supply in PN formulation was reasonably low, but still met the energy needs of patients in the fasting period. The nutritional composition and energy/nitrogen ratio in the formulation were basically rational. However, problems including the lack of double energy in partial formulation, low proportion of glucose-supplied energy due to low glucose-lipid ratio, and insufficient supply of insulin still existed. One (0.76%)patient was discharged according to his own decision; 22 ( 16.67% ) patients died, which were not directly associated with PN; and the other 109 (82.58%) patients were cured and discharged. Conclusion Application of PN for critically ill patients undergoing cardiac surgery must strictly follow the operation indications and rationally select nutritional components and proportions to ensure its safety and effectiveness.

Child ; Child, Preschool ; Humans ; Leukemia ; immunology ; prevention & control ; Vaccination

Objective To explore relationship between Liver and Spleen of Tradicational Chinse Medicine in T cell activation. Methods The expression of IFN-r and IL-4 of T cells in asthenic spleen qi model and hepatic depression model was detected by RT-PCR. Results IFN-r level of T cells in asthenic spleen qi model significantly decreased, in hepatic depression model significantly increased, in asthenic spleen qi model treated with decoction of four mild drugs rose to normal range, and in hepatic depression model treated with powder of bupleuri dispersing stagnated hepatic qi fell to normal range. The IL-4 level of T cells in asthenic spleen qi model significantly increased, in hepatic depression model significantly decreased, in asthenic spleen qi model treated with decoction of four mild drugs fell to normal range, and in hepatic depression model treated with powder of bupleuri dispersing stagnated hepatic qi rose to normal range. Conclusion Liver and spleen are related to the regulation of THO cells functions.

Background Posterior capsular opacification (PCO) is a primary complication after extracapsular cataract extraction.The mechanism of PCO is associated with proliferation,migration and epithelialmesenchymal transition (EMT) of human lens epithelial cells (LECs).To explore the target treatment of PCO is very important.Objective This study was to investigate the biological effects of second mitochondria-derived activator of caspases (Smac) on the proliferation and apoptosis of LECs.Methods Human LECs line (HLE-B3) and Smac-overexpressed LECs line were cultured,and the cells were transfected using small interfering RNA (siRNA)-Smac3 plasmid with green fluorescent protein (GFP) for 24 hours.Different concentration of transforming growth factor-β2 (TGF-β2) (5,10,20 and 50 μg/ml) or 200 μmol/L H2O2 were added respectively into the culture medium to establish PCO model and oxidative stress model.Cell counting kit-8 (CCK-8) assay was used to compare the cell proliferative activity among PBS group,TGF-β2 group and Smac-hyperexpression +TGF-β2 group.Flow cytometry was used to evaluate the apoptotic rate of the PBS group,H2 O2 group and siRNA-Smac+H2 O2 group.The expressions of Smac,caspase-3 and proliferating cell nuclear antigen (PCNA) mRNA and their proteins in the cells were detected by real-time quantitative PCR (RT-PCR) and Western blot.Results The GFP+ cells were≥ 80％ 12 hours after siRNA-Smac3 transfection,with the optimal plasmid of siRNA-Smac3.GFP+ cell rate was (72.32 ± 2.31)％ in the siRNA-Smac3 transfection group,which was significantly higher than that in the blank plasmid group ([4.91 ±0.24] ％) (t=116.342,P＜0.001).The relevant expression levels of Smac was 35.21 ±4.11 in the Smachyperexpression group,and that in the blank plasmid group was 15.24±2.48,with a significant difference between them (t =215.47,P＜0.05).The cell viability of 20 ng/ml TGF-β2 affected PBS group,TGF-β2 group and Smachyperepression+TGF-β2 group was (98.4 ± 1.7) ％,(98.9 ± 0.1) ％ and (64.2 ± 3.1) ％,and the cell viability of Smac-hyperepression+TGF-β2 group was significantly lower in the Smac-hyperepression+TGF-β2 group than that in the TGF-β2 group (P＜0.05).The apoptotic rate in the PBS group,H2 O2 group and siRNA-Smac+H2 O2 group were (2.9 ± 1.2) ％,(45.1 ±4.5) ％ and (27.5 ± 1.8) ％,and the apoptotic rate was evidently lower in the siRNA-Smac +H2O2 group than that in the H2O2 group (P＜0.05).RT-PCR results showed that the expression levels of caspase-3 mRNA in PBS group,H2 O2 group and siRNA-Smac + H2 O2 group were 0.321 ± 0.103,0.715 ± 0.112 and 0.479 ±0.209,respectively.Compared with the H2 O2 group,the relative expression level of caspase-3 mRNA in siRNA-Smac+ H2O2 group was significantly decreased,the difference was statistically significant (P＜ 0.05).The PCNA mRNA expression levels in PBS group,TGF-β2 group and Smac-hyperepression+TGF-β2 group were 0.299±0.013,0.645± 0.102 and 0.490±0.209,respectively.Western blot results showed that the relative expression of caspase-3 protein in siRNA-Smac+H2O2 group and H2O2 group was 0.712±0.012 and 0.973±0.051,with significant difference between the two groups (t =132.52,P＜0.05).The relative expression of PCNA protein in Smac-hyperepression+TGF-β2 group was 0.782±0.212,which was lower than 1.126±0.251 in the TGF-β2 group (P＜0.05).Conclusions Smac may prevent and treat PCO by inhibiting the proliferation and promoting apoptosis of human LECs.

Objective To investigate the relationship between CT characteristics and histological differentiation of soft tissue sar-comas.Methods Forty-two cases with pathologically proved soft tissue sarcomas were collected.The tumor size,morphology,den-sity and relationship of the tumor to the adjacent structures on CT were analyzed retrospectively.The value of the CT signs in evalu-ating the histological differentiation of the tumor was explored.Results The maximal diameter of the tumor was over 5 cm in 36 ca-ses.Oval shape was seen in 29 cases and irregular shape was seen in 13 cases.Heterogeneous density was seen in 32 cases including intratumoral calcification in 3 cases and intratumoral necrosis in 22 cases.Adjacent structures were infiltrated in 25 cases.Compared to the pathological results,intratumoral necrosis and invasion of adjacent structures were related to the degree of histological differ-entiation (P <0.05),and the relation coefficients were 0.64 and 0.57,respectively (P <0.01).Conclusion Intratumoral necrosis and invasion of adjacent structures are correlated with the histological differentiation of the soft tissue sarcomas.They may reflect the biological behavior of low-differentiated or undifferentiated soft tissue sarcomas to some extent.

Objective:To investigate the clinical significance of thrombospondin-2 (THBS2) mRNA expression in gastric carcino-ma and its relationships with clinicopathologic features, microvessel density (MVD), and matrix metalloproteinase-2 (MMP-2). Meth-ods:THBS2 mRNA expression was detected in 82 cases of gastric carcinomas and adjacent tissues using real-time quantitative fluores-cence polymerase chain reaction. The correlation of this expression with clinicopathologic features was also analyzed. Cluster of differ-entiation 34 (CD34) and MMP-2 protein expression was examined using an immunohistochemical Elivision method. MVD was deter-mined based on CD34-positive tubular structures. Results:The THBS2 mRNA expression level was significantly higher in the gastric carcinomas than in paraneoplastic tissues (P=0.002). The expression was associated with the depth of tumor invasion, MVD, and MMP-2 (P=0.02, r=0.35, P<0.01, and P=0.004, respectively) but not with patient gender, patient age, tumor size, histological type, and lymph node metastasis (P=0.53, P=0.53, P=0.21, P=0.84, and P=0.96, respectively). Conclusions: THBS2 may be significantly in-volved in the occurrence and progression of gastric carcinoma. The effects of THBS2 on gastric tumor growth and metastasis can be monitored by controlling the MMP-2 expression in the carcinoma. However, the specific functions and underlying mechanisms of TH-BS2 require further investigation.

Objective To explore the clinical features of renal and urinary lesions in IgG4-related disease (IgG4-RD).Methods Clinical manifestation,laboratory profiles,iconography images,pathologic findings,treatment and prognosis of 6 IgG4-RD patients with renal and urinary system involvement from Peking Union Medical College Hospital during Aug 2010 to Dec 2011 were analyzed retrospectively.Results Six patients had renal and/or urinary lesions among IgG4-RD cases diagnosed in our hospital,including 4 males and 2 women,with median age of 59 years (36 to 72 years) and median disease course of 10.5 months.All the patients presented multiple organ involvement simultaneously.Urinary system lesion varied,including renal dysfunction,abdominal pain and edema.Hyperglobulinemia,elevated serum IgG (median 23.3 g/L) and IgG4 (median 4227.0 mg/L),tubular proteinuria were found in all the 6 patients,and elevated Scr (median 237 μmol/L) in 5 cases.Kidney CT image often showed renal swelling,hydronephrosis,multiple low density focus with attenuation and kidney atrophy.Renal pathology revealed interstitial inflammatory cells infiltration comprising predominantly plasma cells and lymphocytes,with a high prevalence of IgG4-positive cells often admixed with fibrosis,which fit the features of tubulointerstitial nephritis.Patients with IgG4-RD nephropathy presented good response to glucocorticoids.After therapy,the symptoms were improved and serum IgG,IgG4 and Scr decreased.Conclusions Renal and urinary lesions of IgG4-RD are heterogeneous in clinical manifestation,and are often complicated with various organ lesions.The feature of renal histopathology is tubulointerstitial nephritis infiltrated by plasma cells and lymphocytes with positive IgG4.Glucocorticoids treatment is effective for this disease.