OBJECTIVE: To analyze the characteristics of adverse drug reaction (ADR) induced by Levofloxacin (LVFX) injection and to promote rational use of drugs in the clinic. METHODS: 137 LVFX injection-induced ADR cases reported in our hospital during 2006～2009 were collected and analyzed statistically with Excel in respect of age, gender, medication and clinical manifestation, etc. RESULTS: ADR cases occurred nearly in all ages of people, and 32.85% were appeared in people over 60 years. Main clinical manifestations were lesion of skin and its appedants (62.04%) and gastrointestinal injury (16.06%). Most of them were mild and medium ADR. CONCLUSION: Great importance should be attached to the rational use of LVFX injection and ADR monitoring to guarantee the safety of patients.

Objective To assess the role of dynamic contrast-enhanced MRI for diagnosis and differential diagnosis of prostatic cancer. Methods Six volunteers, 32 patients with benign prostatic hyperplasia and 13 patients with biopsy-proven prostatic cancer underwent MR imaging. Dynamic MR with Gd-DTPA (gadolinium-diethylene triamine pentaacetic acid) bolus enhancement was performed followed by post-contrast T 1-weighed imaging. The signal intensive value in dynamic MRI was measured and calculated to draw the time-signal intensity curve of normal peripheral zone, prostatic cancer and benign hyperplasia. Results In dynamic MRI, the normal peripheral zone were enhanced mildly and slowly. The lesion enhancement of benign prostatic hyperplasia in 32 patients were obvious in early phase (60 s) and strengthened gradually, and then went to decrease in late phase (240 s) after peak value. The lesions in 9 of 13 cases with prostate cancer were enhanced obviously in early phase (60 s) and washed out rapidly in late phase, and the peak value was located on early phase. Conclusions In dynamic MRI, the enhancement of normal peripheral zone, prostate cancer and benign hyperplasia were different significantly. Dynamic MRI was very useful in the diagnosis and differentiation of prostate cance.

Objective To investigate the effect of propofol on the learning and memory function in neonatal rats under hypoxic conditions. Methods Eighty-four 7-day-old SD rats were randomly divided into 6 groups (n = 14 each): propofol + 18% oxygen (propofol-hypoxia, group PH), propofol + air (group PA), propofol +100% oxygen (propofol-oxygen, group PO), 0.9% normal saline (NS) + 18% oxygen (group CH), NS + air (group CA), NS + 100% oxygen (group CO). The rats received injection of intraperitoneal propofol 50 mg/kg or NS 5.0 ml/kg once a day for 7 consecutive days and they were exposed to 18% oxygen, air or 100% oxygen at the end of each injection. SaO2 and respiratory rate (RR) were monitored and recorded after administration. The rats were returned to the cage after recovery of the righting reflex. Six rats in each group were sacrificed 24 h after the 7th injection, and the brain tissues were taken to observe the apoptosis in hippocampal neurons. Morris water maze test was used to test the learning and memory function 2 weeks after administration in the other rats. Results RR was significantly lower and the escape latency at T1.2 longer in group PO than in group CO (P ＜ 0.05). RR and SaO2 were significantly decreased, apoptotic index was increased, the escape latency was prolonged and the frequency of crossing the original platform was reduced in group PA compared with group CA, and in group PH compared with group CH (P ＜ 0.05). Compared with group PO, SaO2 was significantly decreased, apoptotic index was increased, the escape latency was prolonged and the frequency of crosing the original platform was reduced in group PA (P ＜ 0.05). Conclusion Propofol induces apoptosis in hippocampal neurons and decreases the learning and memory function in neonatal rats under hypoxic conditions.

Larotaxel, a new taxane compound prepared by partial synthesis from 10-deacetyl baccatin Ⅲ, is active against tumors. In this research, a selective LC–MS method was developed and validated for the study of degradation kinetics of larotaxel, which was carried out in aqueous solutions with different pH (1.5, 3.0, 5.0, 6.5, 7.4, 9.0, 10 and 11.0) and temperature (0, 25, 37 and 45 °C). The linear range was 0.5–25μg/mL, the intra-and inter-day precisions were less than 7.0%, and accuracy ranged from 97.4–104.5% for each analyte. The observed rate obtained by measuring the remaining intact larotaxel was shown to follow first-order kinetics. The activation energies for degradation were 126.7 and 87.01 kJ/mol at pH 1.5 and 11, respectively. Although larotaxel was stable in pH 5, 6.5 and 7.4 buffers at 37 °C for 24 h during our study, increasing or decreasing the pH of the solutions would decrease its stabilities. Moreover, three main degradation products in alkaline condition were separated by HPLC and identified by Q–TOF–MS. The three degradation products were confirmed as 10-deacetyl larotaxel, 7, 8-cyclopropyl baccatin Ⅲ and 10-deacetyl-7, 8-cyclopropyl baccatin Ⅲ.

Objective To investigate the changes of indications, degree of difficulty in procedure, complication and its severity in endoscopic retrograde cholangiopancreatography (ERCP) in Changhai hospital from 2001 to 2007. Methods The clinical data, including demographic data, indications, degree of difficulty in procedure, success rate, complication rate and severity of complication, of 2374 patients who underwent ERCP in 2001 and 2007 (966 in 2001 and 1408 in 2007), were retrospectively reviewed. Results Indications of ERCP changed at an interval of 5 years. Operations due to bile duct stone decreased (59.0% vs. 49.3%, P=0.000), while operations due to pancreas disease, especially chronic pancreatitis (6.6% vs. 18.5%, P=0.000) and recurrent pancreatitis (0.2% vs.1.6%, P=0.001), increased. Patients with biliary duct problems after liver transplantation appeared in 2007. The procedures of ERCP performed in 2007 were more difficult (P=0.000), with an increased percentage of Degree 5 procedure (7.3% vs. 33.3%, P=0.000). The number of diagnostic ERCP significantly decreased (Degree 1 + Degree 3, 30.5% +2.8% vs. 5.9% +3.1%, P=0.000). There was no significant difference in the success rate between the two years (P=0.084). The complication rate of ERCP in 2007 was significantly higher than that in 2001 (3.73% vs. 7.88%, P=0.000), but the severity of complication showed no significant difference (P=0.820). Conclusion Cases of diagnostic ERCP decreased in 2007. Indications of ERCP have changed, with a decrease in bile duct diseases and an increase in pancreatic diseases. The procedures are more complicated, but it does not lead to lower success rate. The increase in complication rate is possibly due to increase of therapeutic ERCP.

Objective To investigate the changes of mestruation patterns and adverse effects during the treatment of levonorgestrel-releasing intrauterine system (LNG-IUS) for symptomatic adenomyosis in a prospective cohort study. Methods From December, 2006 to December, 2014, patients of symptomatic adenomyosis diagnosed by transvaginal ultrasound in Peking Union Medical College Hospital were given LNG-IUS. Before and after placement of IUS, all patients′ parameters were recorded, including carrying status of IUS, symptoms and scores of dysmenorrhea, menstruation scores, biochemical indicators, physical parameters, menstruation patterns and adverse effects. Risk factors for changes of menstruation patterns and adverse effects, and their impact on treatment effects were analyzed. Results Totally 1 100 cases met inclusion criteria, with median age 36 years (range 20-44 years), median follow-up 35 months (range 1-108 months). During follow-up changes of menstruation patterns increased significantly with amenorrhea and shortened-menstruation being the most common manifestations. On 3, 6, 12, 24, 36, 48 and 60 months after the placement of LNG-IUS, 0, 5.8%(43/744), 6.9%(47/682), 10.1%(60/595), 17.3%(87/502), 27.2%(104/383) and 29.6%(82/277) patients achieved amenorrhea respectively (P<0.01). Total and subclassification of adverse effects decreased significantly (P<0.01). Within 12 months and >12 months after placement, abdominal pain and body weight increasing ≥5 kg/year were the most common adverse effects. Changes of menstruation patterns, total and subclassifications of adverse effects were neither dependent on patient parameters, treatment modes and treatment effects, nor could predict future LNG-IUS carrying status (all P>0.05). After taking out of LNG-IUS, most changes of menstruation and adverse effects disappeared. Conclusions During the treatment of LNG-IUS for symptomatic adenomyosis, changes of menstruation patterns increase gradually with amenorrhea and shortened-menstruation being the most common manifestations, while adverse effects decrease significantly. Changes of menstruation patterns or adverse effects neither have any risk factor nor have impact on treatment effects.

Objective To investigate treatment effects of levonorgestrel-releasing intrauterine system (LNG-IUS) for adenomyosis with severe dysmenorrhea in a prospective cohort study. Methods From December 2006 to December 2014, patients of symptomatic adenomyosis diagnosed by transvaginal ultrasound in outpatient or inpatient clinics of Peking Union Medical College Hospital were given the treatment of LNG-IUS. Before and after placement of LNG-IUS, all the patients′parameters were recorded prospectively, including symptoms and scores of dysmenorrhea, menstruation scores, biochemical indicators, physical parameters, carrying status of LNG-IUS, menstruation patterns and adverse effects. Changes of scores and patterns of pain during follow-up were analyzed. Results Totally 1 100 women meets inclusion criteria, among which 640 cases (58.18%, 640/1 100) had severe dysmeorrhea, with median follow-up period of 35 months (range 1-60 months), and accumulative carrying rate of 65% at 60 months follow-up. After placement of LNG-IUS, scores of pain and ratio of severe dysmenorrhea had decreased significantly compared with baselines (all P<0.01), the scroes of visual analog scale (VAS) were 8.1 ± 0.9, 5.5 ± 2.4, 4.6 ± 2.4, 3.3 ± 2.2, 2.2 ± 2.1, 2.2 ± 1.8, 1.4 ± 1.6 and 1.3 ± 1.3 at 0, 3, 6, 12, 24, 36, 48 and 60 months respectively. During 36 months after placement of LNG-IUS, scores of pain had improved significantly compared with preceding period (all P<0.01). We found no universal dependent factors predicting improvement of pain, which was neither relevant with simultaneous changes of menstruation patterns nor adverse effects (all P>0.05). Conclusion LNG-IUS is effective for adenomyosis of severe dysmenorrhea. Improvement of pain is independent on patients characters, menstruation patterns or adverse effects.

Objective To investigate treatment effects of levonorgestrel-releasing intrauterine system (LNG-IUS) for adenomyosis with menorrhea in a prospective study. Methods From December 2006 to December 2014, patients of symptomatic adenomyosis diagnosed by transvaginal ultrasound in outpatient or inpatient clinics of Peking Union Medical College Hospital were given the treatment of LNG-IUS. Before and after placement of LNG-IUS, all the patients′parameters were recorded prospectively, including scores of menstruation blood loss, carrying status of IUS, symptoms and scores of dysmenorrhea, biochemical indicators, physical parameters, menstruation patterns and adverse effects. Changes of pictorial chart scores of menstruation and distribution of anemia during follow-up were analyzed. Results Totally 1 100 women meets inclusion criteria, among which 618 cases (56.18%, 618/1 100) had severe menorrhea, with median follow-up period of 28 months (range 1-60 months), and accumulative carrying rate of 66% at 60 months follow-up. After placement of LNG-IUS, compared with baselines, pictorial chart scores and ratio of menorrhea had decreased significantly (all P<0.01), the scroes of menstruation were 157±34, 94±35, 70±33,67 ± 18, 67 ± 20, 65 ± 19, 66 ± 19, 65 ± 21 at 0, 3, 6, 12, 24, 36, 48 and 60 months respectively. During 24 months after placement of LNG-IUS, pictorial chart scores and distribution of anemia had improved significantly compared with preceding period (all P<0.01). We found no dependent factors predicting improvement of pictorial chart scores of menorrhea, which was neither relevant with simultaneous changes of menstruation patterns nor adverse effects (all P>0.05). Conclusions LNG-IUS is effective for adenomyosis of menorrhea. Improvement of menstruation blood loss is independent on patients characters, menstruation patterns or adverse effects.

Objective To explore the relationship of phospholipase A2 receptor (PLA2R) expression in renal tissue with clinical characteristics,prognosis of idiopathic membranous nephropathy (IMN) patients.Methods 134 patients diagnosed as nephropathy proven by biopsy was selected as subjects of this research,including 98 patients with IMN patients,10 patients with secondary membranous nephropathy and 26 patients with other renal glomerular diseases.The expression of PLA2R antigen in renal tissue was detected by immuno-fluorescence chemistry staining.Results The positive rate of renal PLA2R expression in IMN patients was higher than that in SMN patients (91.84％ vs 40.00％,P＜ 0.01),whereas there is no expression in other glomerular diseases.The PLA2R negative group were mainly stage Ⅰ membranous nephropathy,and positive group was mainly in stage Ⅱ.The distribution of pathological stage between the two groups was statistically significant (P ＜0.01).Compared with the positive group,the negative group was manifested with higher eGFR[(115.91± 23.32) ml· min-1 · (1.73 m2)-1 vs (94.06±27.38) ml· min-1 · (1.73 m2)-1,P=0.031],associated with the higher 12-month complete remission rate (87.50％ vs 44.07％,P=0.021).Conclusions The expression of PLA2R antigen in renal tissue plays an important role in the diagnosis,disease evaluation and prognosis of IMN.The negative PLA2R in kidney tissue of IMN may indicate a good clinical prognosis.

Objective Type 2 diabetes increases the risk of colorectal cancer and reduces the survival rate of the patients. Therefore, analyzing the characteristics of colorectal cancer in patients with type 2 diabetes may help to develop precise medical measures and to improve the prognosis of patients. Methods The pathological characteristics of 123 colorectal cancer cases with or without type 2 diabetes were analyzed. In addition, PCR and pyrosequencing method were used to test the common gene mutation status of colorectal cancer, including KRAS( codons 12, 13, 61, and 146) , BRAF( codon 600) , and PIK3CA ( exons 9 and 20) , in order to investigate the molecular characteristics of colorectal cancer in diabetic patients which may provide some clues to clinical decision. Results The mean age and body mass index of patients with diabetes were higher than those of patients without diabetes, but there was no difference in the location, the degree of cell differentiation and the grade of colorectal cancer between these 2 groups. The rate of PIK3CA mutation in patients with type 2 diabetes mellitus, especially in patients with long term type 2 diabetes was significantly higher than that in patients without diabetes (28.6％vs 10.3％, P<0.05). There was no significant difference between the two groups in common BRAF and KRAS mutation sites. Conclusion Diabetes does not alter the clinical pathological characteristics of colorectal cancer, but long course type 2 diabetes increases PIK3CA mutation rate. Therefore, using medicine targeting PIK3CA gene mutation may help to improve the prognosis of patients.