OBJECTIVE:To investigate the characteristics and regulations of antibacterials-induced adverse drug reactions (ADR) in our hospital,and to provide reference for promoting rational drug use. METHODS:233 patients with antibacterials-in-duced ADR in our hospital from Oct. 2013 to Jun. 2015 were selected and analyzed statistically according to patient's age and gen-der,route of administration,the type of antibacterials,occurrence time,organs/systems involved in ADR,etc. RESULTS:There were a large number of ADR in patients age ≤18 and ≥70 years,accounting for 19.3% and 18.5%;the male was more than the female;the incidence of ADR induced by intravenous route was the highest,accounting for 94.0%. Most of ADR was caused by cephalosporins,accounting for 33.9%;ADR often occurred within 1 d after medication,accounting for 63.9%;lesion of skin and its appendants injury was main ADR,accounting for 39.3%. CONCLUSIONS:Adhere to theclear indications,a detailed inqui-ry about allergy history before drug use,right dose,suitable route of administration and course,and timely ADR disposal can re-duce the damage caused by ADR.

Objective To study the application value of T lymphocyte subsets and inflammatory factors in evaluating severity andprognosisofaplasticanemia.Methods 40patientswithaplasticanemiainthehospitalwereenrolledinthestudyasAAgroup, which was further divided into acute aplastic anemia(AAA) subgroup and chronic aplastic anemia(CAA) subgroup .In addition to that ,40 healthy people who received physical examination in the hospital during the same period were enrolled in the study as con‐trol group .Then blood routine tests were performed ,T lymphocyte subsets content in peripheral blood and serum inflammatory fac‐tor content were detected and the results were compared .Results Th1 ,Th17 contents and Th1/Th2 ,Th17/Treg ratio in AA group were higher than those in control group(P<0 .05) ,while Th2 ,Treg contents were lower(P<0 .05);Th1 ,Th17 contents and Th1/Th2 ,Th17/Treg ratio in AAA group were higher than those in CAA group(P<0 .05) ,while Th2 ,Treg cells contents were lower . Serum IL‐2 ,IFN‐γ ,IL‐17 contents in AA group were higher than those in control group(P<0 .05) ,while IL‐4 ,IL‐6 ,IL‐10 contents were lower(P<0 .05);serum IL‐2 ,IFN‐γ,IL‐17 contents in AAA group were higher than those of CAA group ,while IL‐4 ,IL‐6 , IL‐10 contents were lower .Hb ,PTL contents were negatively correlated with Th1 ,Th17 contents and serum IL‐2 ,IFN‐γ ,IL‐17 contents ,while positively correlated with Th2 ,Treg cells contents and serum IL‐4 ,IL‐6 ,IL‐10 contents .Conclusion Peripheral blood T lymphocyte subsets and serum inflammatory factors contents in aplastic anemia are abnormal and are correlated with the severity and prognosis related indicators .

Objective: To examine the expression of glucocorticoid receptor in human colon cancinoma tis-sues and call lines and to explore the survival of colon cancer cell lines treated with dexamethasone alone or in combination with 5-Fu and L-OHP in a way of dexamethasone pretreatment or co-administration in vitro.Methods: The expression of glucocorticoid receptor was detected in 61 cases of colon cancer tissue samples and 4 types of colon cancer cell lines by immunohistochemistry. Apoptosis was detected by Hoechst33342 staining and flow cytometry. MTT assay was employed to detect the chemosensitivity of colon carcinoma cells to L-OHP and 5-Fu with dexamethasone pretreatment for 24 hours or co-administretion. Results: Positive GR expression was found in 57.3% colon cancer tissue samples and in Lovo and HCT-116 cell lines, not in HT-29 and SW-480. Apoptosis was detected in GR-expressed Lovo and HCT-116 cells at 72 hours after 1×10~(-4)mol/L Dex treatment, and the rates of apoptosis were higher than those in the control groups without Dex (P<0.01),GR-negative cells, HT-29 and SW-480 even treated with 1 × 10~(-4)mol/L Dex for 72 hours. Pretreatment and co-administration for Lovo cells with 1×10~(-4)mol/L Dex could decrease the IC50 of L-OHP from 13.7±1:1.3μg/mL to 5.9±0.6μg/mL and 4.8±0.7μg/mL, respectively. IC50 of 5-Fu was decreased from 72.2±8.1 μg/mL to 21.1±4.1μg/mL and 18.6±4.0μg/mL, respectively. Conclusion: There is expression of glucocorticoid receptor in part of colon carcinoma tissue samples and cell lines. Apoptosis does occur in GR-expressed Lovo and HCT-116 cells induced by dexamethasone in vitro. Pretreatment for 24h and co-administration with Dex can increase the chemosensitivity of Lovo cells to L-OHP and 5-Fu.

Objective To study the characteristics of patients with low body mass index (BMI) chronic obstructive pulmonary disease(COPD). Methods A total of 38 clinically stable patients with moderate-to-severe COPD were enrolled. They were divided into two groups: underweight (UW) group (n=16,BMI<20);normal weight(NW) group(n=22, 20≤BMI<26). Body height and weight, smoking indexs, and six minutes walk distance (6MWD) were assayed. The British Medical Research Council (MRC) dyspnea scale was used to assess the degree of dyspnea. St. George's Respiratory Questionnaire (SGRQ) and Short Form 36 item Questionnaire (SF-36) were used for health-related quality of life (HRQoL) evaluation. The serum concentrations of leptin and ghrelin were detected by enzyme-linked immunosorbent assay (ELISA). Results Compared with the NW group, the inspiratory eapacity(IC), forced expiratory volume in one second (FEV), vital capacity (VC) ,most ventilate volume (MVV) and peak expiratory flow(PEF) were lower(P<0. 05) in the UW group. Residual volume-to-total lung capacity ratio (RV/TLC), smoking indexs and MRC score were higher (all P<0. 05) and 6MWD was significantly lower (P<0. 05) in the UW group than in NW group. Activity scores,impact scores and total scores of SGRQ showed significant deterioration in the UW group (P<0. 05). SF-36 also showed significantly worse scores for the parameters of the emotional and social functioning (P < 0. 05 ). Serum leptin was significantly lower ( P< 0.01 ) and ghrelin was higher in UW group than in NW group (P<0. 05). Stepwise multiple regression analyse showed that lC,mental health(MH) and physical function (PF) of SF-36, leptin,6MWD and smoking indexs were independently correlated with BMI. Conchtsions The pulmonary function, nutritional status, PF and life quality of COPD patients with low BMI were more deteriorative. The most significant influencing factor for BMI in COPD patients was IC. M H,exercise capacity,leptin level and smoking indexs were independently correlated with BMI in COPD patients. It is important to retrieve low BMI in the management of COPD patients.

Objective To explore early endoscopic diagnosis and treatment of the clinical value of biliarypancreatitis. Methods From January 2007 to December 2009 completed 93 cases acute pancreatitis of endoscopic treatment,routining for endoscopic incision nipple,observed remission of symptoms and recurrence after treatment. Results In these cases acute biliarypancreatitis was 62.4% (58/93),occult biliarypancreatitis diagnosed by endoscopy was 27.6% (16/58),remission rate was 93.8% (15/16),no surgical operation and recurrence. Conclusion Occult biliarypancreatitis occupies a certain proportion of acute pancreatitis,also easily missed diagnosis and recurred,endoscopy is currently the most effective method.

Objective Evaluate the effects of venous-arterial modified ultrafiltration on hemodynamics compared to arterial-venous in children undergoing cardiopulmonary bypass (CPB) for repair of congenital heart defects. Methods Forty patients underwent MUF randomly divided into two groups,group V-A MUF (n =20) and group A-V MUF (n =20) for 10 min after CPB. They were studied before CPB, after CPB, 10 min after CPB, and 30 min after CPB. Haemodynamic data including heart rate, blood pressure, central venous pressure and hematocrit were recorded. Transoesophaegeal echocardiography determined left ventricular posterior wall thickness in end-systole ( LVPWs) and end-diastole (LVPWd) , end diastolic volume (EDV) , end systolic volume (ESV) and ejection fraction (EF) were measured and compared in two groups. Results Patients in V-A MUF maintained better systolic arterial blood pressure at 10 min and 30 min compared with 0 min values after CPB. A significant decrease in EF were observed in both groups immediately after CPB ( P < 0.05 ). Significant increase in EF was observed at 10 min (60% ) and 30 min (46% ) after CPB compared with 0 min value after bypass in V-A MUF (P <0.001 ). In A-V MUF, no such increase in EF was observed. EF were significantly higher at 10 min and 30 min in V-A MUF as compared with A-V MUF (P < 0. 001). There was also significant improvement in posterior wall thickness in V-A MUF (P <0.05). Haematocrit values were not different in duration of postoperative between two groups. Conclusion Veno-arterial modified ultrafiltration is a safe and effective method of improving hemodynamics in children following cardiac surgery.

Objective To determine the long term outcomes of laryngomalacia infants with anomalies and to determine the clinical practice guideline for these infants.Methods The charts of infants with moderate to severe laryngomalacia,who were admitted to our hospital between January 2013 and December 2015,were retrospectively reviewed.These infants were divided into two groups,anomaly(A) group(n=37) and non-anomaly (NA) group(n=19).Results Fifty-six cases were enrolled.Infants in A group were older at symptom relief than those in NA group[(10.00±3.56) months vs.(7.89±3.03) months,P＜0.05],and the weight percentiles of infants in A group were lower at 3,6 and 12 months than those in NA group(P＜0.05).There was no statistically significant difference between the two groups on the weights percentiles in infants at 24 months after diagnosis.Five of 37 cases in A group and 3 of 19 cases in NA group had supraglottoplasty.One infant in A group had tracheotomy.Conclusion Both breathing difficulty and development retardations of infants with moderate or severe laryngomalacia could gradually improved with age.There is not enough evidence to support the aggressive supraglottoplasty for infants with anomalies and laryngomalacia.

OBJECTIVETo explore the effect of 5-HT2A-receptors coupled with superoxide anion (O2-) on respiratory regulation signal transductionin passageway in the medial area of nucleus retrofacialis (mNRF).

METHODSmNRF island was prepared from medullary slices of neonatal SD rats according to Johnson's method and transferred separately into 24-well culture plates with reagents according to protocol, followed by incubation for 60 min at 37 degrees C in a humidified incubator with 5% CO2. Absorbance of 100 microl supernatant was measured by spectrophotometry at 550 nm and the effect of 5-HT and 2,5-dimethoxy-4-iodoamphetamine hydrochloride (DOI, agonist of 5-HT2A-receptors) on O2- generation in the mNRF was observed, along with the inhibition of this effect by ketanserin (antagonist of 5-HT2A-receptors) and alpha-lipoic acid (alpha-LA, a antioxidant).

RESULTS5-HT concentration-response curve demonstrated that absorbance peak occurred at 1 micromol/L without further increment with higher concentration. DOI concentration-response curve showed the absorbance peak at 20 micromol/L without further increment. 5-HT and DOI significantly increased the absorbance with comparable effects. Ketanserin and alpha-LA significantly decreased the absorbance generated by 5-HT and DOI.

CONCLUSIONActivation of 5-HT2A receptors results in obvious O2- production in mNRF, suggesting that 5-HT2A receptors regulate respiratory function in association with O2-.

Animals ; Animals, Newborn ; Medulla Oblongata ; metabolism ; physiology ; Rats ; Rats, Sprague-Dawley ; Receptor, Serotonin, 5-HT2A ; metabolism ; physiology ; Respiratory Center ; metabolism ; physiology ; Superoxides ; metabolism

Objective To investigate the time for spontaneous closure of the ductus arteriosus and the trends of cardiac index(CI),peripheral vascular resistance index(SVRI)and blood pressure of neonates with different gesta-tional ages(GA). Methods A prospective observational study about 95 newborns,including 20 full - term and 75 pre-term infants were divided into 4 groups according to their GA as GA ﹤ 32 weeks(n = 27),32 weeks≤GA ﹤ 34 weeks (n = 25),34 weeks≤GA ﹤ 37 weeks(n = 23),GA≥37 weeks(n = 20). Patent ductus arteriosus was diagnosed by echocardiography(ECHO)at the time of 24 h,48 h,72 h,7 d and 14 d. CI,SVRI and blood pressure were measured with ultrasonic cardiac output monitor(USCOM). Results The cumulative spontaneous closure rate of arterious ductus of 32 weeks≤GA ﹤34 weeks,34 weeks≤GA ﹤37 weeks group and GA≥37 weeks group at 24 h after birth was 44. 0% , 61. 0% and 90. 0% respectively. However the rate was only 59. 1% at 72 h with the GA less than 32 weeks,of which 9 cases needed ibuprofen and 1 patient was conducted ductus arteriosus ligation. The differences in cumulative closure rate among 4 groups based on GA at 5 time points were statistically significant(χ2 =6. 756,4. 735,18. 890,11. 366,28. 159,all P ﹤0. 05). There was significant increase of systolic blood pressure,diastolic blood pressure and SVRI with ductus arte-riosus closure(t = -32. 561,-19. 913,-31. 791,4. 760,all P ﹤0. 000 1;t = - 25. 091,- 23. 400,- 21. 147,2. 240,all P ﹤0. 05;t = -10. 931,-9. 975,-9. 629,2. 350,all P ﹤ 0. 05). Whereas CI significantly decreased in groups of GA ﹤32 weeks,32 weeks ≤GA ﹤34 weeks,34 weeks ≤GA ﹤37 weeks(t =9. 224,6. 515,5. 996,all P ﹤ 0. 001)and no sig-nificant changes in GA≥37 weeks(t =0. 940,P ﹥0. 05). Conclusions With the increase of gestational age,the rate of naturally early arterial catheter closure is higher. Whereas there still are nearly one - third infants requiring medical or surgical intervention in the group of GA ﹤32 weeks. Ductus arteriosus has great influence on hemodynamics. For preterm, especially very low birth weight preterm,the use of ECHO and USCOM can early detect and treat patent ductus arteriosus.

Abstract: In the United States, it is estimated that 1% to 4% of pregnant women are infected with hepatitis C virus （HCV）, which carries approximately a 5% risk of transmission from mother to infant. Hepatitis C virus can be transmitted to the infant in utero or during the peripartum period, and infection during pregnancy is associated with an increased risk of adverse fetal outcomes, including fetal growth restriction and low birthweight. The purpose of an excerpt of Society for Maternal-Fetal Medicine Consult Series #56: Hepatitis C in pregnancy—updated guidelines: Replaces Consult Number 43, November 2017 is to discuss the current evidence, provide updated recommendations regarding screening, review treatment, and address management of hepatitis C virus during pregnancy.