OBJECTIVE:To provide reference for promoting the rational use of national essential medicines in antibiotics. METHODS:The use of national essential drugs in antibiotics in 3 second-level general hospitals from Chongming area of Shanghai from 2011 to 2013 were statistically analyzed. RESULTS:The sales amount of antibiotics was in an increasing trend,with an aver-age growth rate of 28.16%;while the proportion of sales amount accounted for the total sales amount of drugs were still relatively low,with an average growth rate of 2.16%. The proportion of total sales amount of top 3 antibiotics from 2011 to 2013 accounted for the total sales amount of drugs were respectively 87.92%,93.60% and 95.54%,with an increasing trend;while compared with 2011,the DDDs of national essential medicines in antibiotics was decreased a little during 2012-2013;the top 2 DDDs were Cefuroxime axetil tablets and Amoxicillin capsules,the top 1 sales amount was Cefuroxime sodium for injection. Varieties with the sales amount/ DDDs close to 1 were relatively less,indicating that the sales amount of drugs and the number of drug use was not synchronous. CONCLUSIONS:There are still some problems in the utilization of national essential medicines in antibiotics. It needs to be continuously improved in the related work to further improve medication rationality and economy,and progressively re-alize the institutionalized and normalized antibiotics in clinical use management.

OBJECTIVE:To investigate the pharmacoeconomic efficacy of four chemotherapeutic schemes for advanced non-small cell lung cancer in elderly patients.METHODS:92 elderly patients with advanced non-small cell lung cancer were randomly divided into four groups:GP,NP,PC,and TP groups.The pharmacoeconomic efficacy of the four groups was analyzed and evaluated retrospectively using the cost-minimization analysis in pharmacoeconomics.RESULTS:The costs of GP,NP,PC,and TP schemes were 10 820.69 yuan,5 864.54 yuan,7 595.57 yuan,and 7 774.64 yuan,respectively(P0.05),respectively.The adverse drug reactions were characterized by different degree of myelosuppression and gastrointestinal reactions,all were cured on symptomatic treatment.CONCLUSION:The cost-minimization analysis showed that NP scheme is the optimal one of the four schemes.

Esophageal carcinoma is one of the top frequently occur malignant cancers, especially in Chinese.Studies on esophageal carcinoma have suggested that genetic predisposition, dietary or environmental factors, such as nitrosamine, tobacco smoking, malnutrition, trace element deficieny and fungus toxin could be important in the carcinogenesis of this cancer.

Objective To evaluate of the clinical efficacy and side-effect of 595nm tunable pulsed dye laser in treatment of children heamangioma of skin. Methods A retrospective study was conducted according to 76 children patients with heamangioma of skin (including 53 cases of nevus flammenus, 20 strawberry hemangioma and 3 cavernous hemangioma) treated with 595nm tunable pulsed dye laser. We evaluated the efficacy and side-effect of the treatment. Results The effectiveness rates were 83.2% and 86.63%, respectively, in nevus flammenus and strawberry hemangioma, but there were disappointed efficacy obtained in patients with cavernous hemangioma treated with 595nm tunable pulsed dye laser. There was 7.9% of the side-effect rate in the children with heamangioma of skin treated by 595 nm tunable pulsed dye laser. Conclusion There is satisfactory clinical efficacy and lower side-effect for children hemangioma treated by 595nm tunable pulsed dye laser.

Objective To investigate the value of procalcitonin (PCT) for urosepsis secondary to ureteral calculus.Methods Samples of 68 ureteral calculi patients who were suspected of urosepsis were obtained for PCT level,C-reactive protein (CRP) level,blood routine examination,urinary sediment,blood culture and urine culture.Sixty-eighy patients were divided into urosepsis group and non-urosepsis group based on the urosepsis diagnostic standard.The age sex,stone location,stone size,blood WBC count,CRP level,PCT level and urine WBC count were compared between the 2 groups.PCT levels before and after treatment were also compared.Results The age,stone size in urosepsis group were significantly higher than those in non-urosepsis group.The PCT levels of patients in urosepsis group and non-urosepsis group were 19.09±25.15 μg/L and 2.09± 1.85 μg/L respectively before treatment,and there was a significant difference between the 2 groups (P＜0.05).The blood WBC counts (× 109/L) of patients in urosepsis group and non-urosepsis group were 11.00± 3.47 and 10.27±2.32 respectively before treatment (P＞0.05).The CRP levels of patients in urosepsis group and non-urosepsis group were 17.41±15.24 mg/L and 15.02±4.94 mg/L respectively before treatment (P＞0.05).The median urine WBC counts (per HPF) of patients in urosepsis group and non-urosepsis group were 54 and 47 respectively before treatment (P＞0.05).The PCT levels of patients in urosepsis group before and after treatment were 19.09 ± 25.15 μg/L and 1.06 ± 0.56 μg/L,and there was a significant difference (P＜0.05).Conclusion PCT has a definite value for early diagnosis of urosepsis,condition assessment and treatment guideline.

Objective To analyze the relationship between the measured diameters of pituitary gland on MRI and peak-stimulated growth hormone(GH) in children with growth hormone deficiency (GHD).Methods A total of 46 children with GHD were included in this study, and 30 healthy children who were admitted to the hospital for health check-up were acted as the control group during the same period.The measured diameters of pituitary gland on MRI were compared between the two groups and the correlation between the diameters of pituitary gland on MRI and peak-stimulated GH were analyzed.Results ① The coronary and sagittal heights of pituitary gland on MRI were greater in children aged 7-10 years old and older than 10 years in control group and in children older than 10 years in observation group than those in children younger than 6 years (P<0.05).The anteroposterior diameter of pituitary gland on sagittal MRI in the control group was increased (P<0.05).The coronal height, sagittal anteroposterior diameter and sagittal height were lower in the observation group compared with age-and gender-matched controls(P<0.05).②The peak-stimulated growth hormone levels were higher in children aged 7-10 years old and older than 10 years in both groups compared with children younger than 6 years old (P<0.05).The peak-stimulated GH were lower in observation group compared with age-and gender-matched controls(P<0.05).③ The heights of pituitary gland on coronary and sagittal MRI in children with GHD were positively related to the peak-stimulated GH, and coronary height had the highest correlation(P<0.05).Conclusion The heights of pituitary gland on coronary and sagittal MRI in children with GHD are positively related to the peak-stimulated GH.The growth and development of children can be predicted by monitoring the changes of GH levels.

Objective To survey age of menarehe in Pudong district in Shanghai. Methods Data in this study were derived from 56 924 women at age of 20 -81 years in screening for cervical cancer between January 2007 and July 2008 in Pudong district. The age of menarche were recorded in a questionnaire. To investigate the trends in age at menarehe in different socioeconomic status, the subjects were divided into 12 groups in 5-year birth cohorts. The mean menarche age in each group was analyzed by analysis of variance(ANOVA). The percentage of menarche age at 10- 12 years and more than 18 years was analyzed by χ2 method. Results (1 ) The minimum age of menarcbe recorded is 10 years old, and the maximum is 28 years old, with average age of menarche at 15.7 years. In all groups, the smallest average age of menarcbe is 14. 6 years in 26 - 30 years old age group, while the biggest average age of menarche age is 16. 5 years in ＞ 75 years old group; The difference showed statistical significance (P ＜ 0. 01 ). (2) The percentages for participants with early menarehe age (10 - 12 years old) or late menarehe age (＞ 18-year-old menarche) were 1.82% (1034/56 924 ) and 5.20 % (2959/56 924 ) respectively. However, the maximum percentage for early menarche was recorded in 31 -35 years old group (4. 45% ,197/4431 ), only 0. 84% (10/1191 ) of participants in ＞75 years old group was classified as early menarebe. Meanwhile, the lowest percentage for late menarehe was 0. 38% (17/4431 ) in 31 - 35 years old group, and the highest percentage was 14. 70% (91/619) in ＞ 75 years old group. The changes in the percentages for early menarche or late menarche are significantly associated with age differences (P ＜ 0. 01 ). Conclusion The study suggested that the average of onset age of menarche in Pudong district has declined over the past decades in an age-based way, accompanied with the increase of the percentage for early menarche and the decrease of percentage for late menarehe.

Objective To analyze the clinic features and hereditary characteristics of three subtypes of porokeratosis, namely disseminated superficial actinic porokeratosis (DSAP), porokeratosis palmaris et plantaris disseminata(PPPD) and porokeratosis of Mibelli (PM) in five pedigrees with porokeratosis. Meth-ods After clinical and pathological diagnosis, every living family member of the five pedigrees with poro-kerotosis was undergoing medical examination and genetics analysis. These five pedigrees consisted of three DSAP pedigrees (totally 266 family members including 100 patients), and one PPPD pedigree (composing of 90 members including 26 patients), one PM pedigree (cornposing of 34 members including 17 patients). Results While diagnosed as porokeratosis, the five pedigrees included three distinctive variants, each with its own clinic characteristics. The lesions was initiated on the face in DSAP subtype, on palms and the flex-ion side of fingers in PPPD subtype; or involving sun-covered areas in PM subtype. Of the three subtypes of porokeratosis, the onset age in DSAP subtype was earliest, usually about 8-20 years old, about 14-20 years old in PPPD subtype, but PM subtype about 20-30 years old. Conclusions As a group of autosomal dominant genodermatosis, porokeratosis presented various clinic variants with different genetic basis. And, different subtype could be seen in a same patient or same pedigree.

Objective To explore the prognosis and management of atrial fibrillation (AF) in patients with atrial septal defect(ASD) accompanied by AF after transcatheter closure of ASD. Methods During the period from July 2010 to May 2013, a total of 24 patients with ASD accompanied by AF were admitted to authors’ hospital to receive transcatheter closure of ASD. Electrocardiogram (ECG), chest X-ray film and transthoracic echocardiography (TTE) were performed before and one day after the operation. Follow-up information was obtained through telephone or at out-patient clinic interview. Results Successful occlusion of ASD was obtained in all patients, and in no patient the AF rhythm turned to sinus rhythm after the procedure. In one patient preoperative AF turned to postoperative atrial flutter, and AF recurred in one case who had received transcatheter ablation of AF before the procedure. One female patient developed gastric bleeding during the course of orally taking warfarin, and she died of cerebral infarction at three days after ceasing the use of warfarin. Of the 24 patients, no anticoagulant drug was used in 5 (20.8%), oral administration of aspirin was given in 7 (29.2%), and oral medication of warfarin was employed only in 11 (45.8%). Conclusion The spontaneous conversion rate of AF is very low in patients with ASD complicated by AF after transcatheter closure of ASD. Postoperative medication of anticoagulation should be strictly standardized and carefully managed.

Objective To study the clinical significance of serum hs-CRP level in smokers with carotid atherosclerosis (CA) and analyze its difference in subtypes of CA.Methods Two hundred and ninety-eight smokers with CA served as a smoker group and 120 non-smokers with CA served as a non-smoker group,50 healthy smokers without CA served as control group 1 and 50 healthy non-smokers served as control group 2.Their serum hs-CRP level was measured by colloid-enhanced immunoturbidimetry.Smokers were divided into stable plaque group and unstable plaque group.Effect of smoking on serum hs-CRP level in CA patients was analyzed.Results The serum hs-CRP level was significantly higher in smoker group and control group 1 than in non-smoker group and control group 2 (7.26±4.24 mg/L vs 3.56±2.28 mg/L,4.34±2.74 mg/L vs 3.17± 1.68 mg/L,P＜0.05).The smoking index was positively related with the serum hs-CRP level (r=0.395,P＜0.01).The number of daily smoked cigarettes was significantly greater in unstable plaque group than in stable plaque group (P＜0.05).The recurrence rate of ischemic stroke was significantly higher in smokers with a high serum hs-CRP level than in those with a low serum hs-CRP level (11.36％ vs 2.00％,P＜0.01).Conclusion Smoking can increase the serum hs-CRP level in CA patients,which is closely related with the stability of plaques and the recurrence of ischemic stroke.