OBJECTIVE:To probe into the utilization of sedative hypnotics in outpatient prescriptions of our hospital. METHODS: In Mar. 2008, 1 317 prescriptions of sedative-hypnotics randomly selected from total 49 791 outpatient prescriptions were analyzed regarding the rationality of the utilization of top 5 drugs on the list of DDDs. RESULTS: The top 5 sedative hypnotics on the DDDs list were Alprazolam tablets, Estazolam tablets, Lorazepam, Zolpidem tablets (Stilnox) and Clonazepam tablets, and their DUIs were 0.54, 0.73, 0.19, 0.81 and 0.53, respectively. CONCLUSION: The dosages of sedative hypnotics in our hospital were basically reasonable and in conformity with the indications listed in package inserts.

Objective:Based on the unreasonable structure,fragmentization and insufficient resources of medical and health service system in China,the literature review was conducted on the analysis of integrated medical and health service system.Methods:It sorted out and analyzed the existing related literature in the academic field.Results:The integrated health system was developed by their elements and methods,which lacked the evaluation and analysis on the responsibility among different stake holders and effects after the integration.Conclusion:Further research should be developed into the implementation of dual referral based on integrated health system;the responsibility relationship among different stakeholders in the integration progress,the integration and optimization of medical and health service system under the background of Internet+,etc.

Objective To explore the clinical manifestation and laboratory examination of chronic diarrhea in children with acquired immunodeficiency syndrome(AIDS) and analyze the reasons that causes the chronic diarrhea in children.Methods Clinical data of 7 patients (male 4 cases,famale 3 cases)with AIDS with manifestation of chronic diarrhea among the 17 cases were diagnosed as AIDS in Beijing children′s hospital from Jan.1999 to Dec.2006.The time of diarrhea,degree of dinrrhea,characteristic of stool,accompaniment symptom,laboratory examination were retrospectively analyzed.Results The average onset age was 6 years old(from 2-9 years old).The average time of diarrhea was 6 months(from 1-16 months).Four cases main complained with chronic diarrhea,3 cases came to the hospital because of fever,cough and wasting;6 cases with diarrhea,7 cases with malnutrition and anemia,5 cases accompanied hypokalemia and metabolic acidosis,6 cases had delay in growth and development,2 cases with abnormal stool routine exam,1 case with positive stool culture of fungi.All patients were with lower CD4,5 cases with lower CD4/CD8.Conclusions Chronic diarrhea is a common symptom in children with AIDS,and usually accompanied by obvious delay in growth and development,malnutrition and anemia,the reasons that causes the chronic diarrhea are consi-dered to be related with both the opportunistic infection and HIV infection.

Hodgkin lymphoma (HL) is a highly curable malignancy for most patients. Frontline treatment is generally ABVD alone or combination with other chemotherapy regimens or radiation. However, the treatment of relapsed refractory HL (RR HL) remains a major challenge for clinicians. High dose chemotherapy followed by autologous stem cell transplantation is the preferred treatment for chemoresistant patients. In addition, the combination of brentuximab vedotin (BV) with programmed cell death receptor 1 monoclonal antibody nivolumab, BV combined with ICE (ifosfamide, carboplatin, etoposide), panobinotast in combination with ICE and many other new drugs are in clinical trials and research. The latest progress in treatment of HL is reported in depth in the 58th American Society of Hematology Annual Meeting.

Objective To assess the possibility of using arterial pressure waveform or pulse oximetry plethysmographic waveform variation to estimate the pulmonary arterial wedge pressure (PAWP) Methods Fourteen ASA Ⅰ Ⅱ patients aged 33 69 years and weighing (62 0?9 5)kg scheduled for elective abdominal tumor surgery were studied Their Hb exceeded 120g/L and Hct 35% Anesthesia was induced with midazolam 0 04mg/kg atropine 8?g/kg,fentanyl 2?g/kg,propofol 2mg/kg and vecuronium 0 1mg/kg and maintained with isoflurane The patients were intubated and mechanically ventilated and P ET CO 2 was maintained at 4 67 5 33 kPa Radial artery was connulated for arterial pressure waveform monitoring and Swan Ganz catheter was inserted via right internal jugular vein and connected to continuous cardiac output monitor (VGS2,Baxter,USA) for hemodynamic monitoring Hypervolumic hemodilution was performed after induction of anesthesia and intubation with crystalloid and colloid (1:1) infused at a rate of 0 7ml?kg -1 ?min -1 PAWP, systolic pressure variation (SPV), delta down (dDown), SPV plet and dDown plet and other hemodynamic parameters were measured and recorded when total fluid volume (crystalloid and colloid) infused reached 10ml/kg and 20 ml/kg and at the end of operation, CVP was maintained at 10 12mm/kg during operation Systolic blood pressure at the end of Valsalva maneuver (airway pressure was kept at 30 cmH 2O) and the systolic pressure before the Valsalva maneuver during apnea were used to calculate arterial pressure ratio (APR) Results APR,SPV,dDown,SPV plet and dDown plet all correlated well with PAWP (r=o 7174,-0 6951,-0 680-0 5216 and 0 6237 respectively P

Objective To observe the characteristics of fundus fluorescein angiography (FFA) and optical coherence tomography (OCT) in juvenile retinoschisis. Methods The photochromes of the ocular fudus of 7 cases (14 eyes) who were diagnosed as juvenile retinoschisis were taken, among whom, 5 (10 eyes) were examined by FFA, and 6 (12 eyes) by OCT. Results In 8 eyes with cystiform stellate maculopathy under ophtalmoscope, the result of FFA showed granular fluorescence in different density and shape without exact connection of the configuration between these granules and the cystlike maculopathy. In 2 eyes with pigment disorder in the macula under ophthalmoscope, blocky fluorescence was found in FFA. In 3 eyes with peripheral schisis, FFA discovered distorted and dilated retinal capillaries with different extent, and flecks of non-perfusion area. OCT images revealed thickening of the macular neuroepithelium with laminal seperation, and cystic low-reflect areas in the inner layer. Conclusions In juvenile retinoschisis, pigment proliferation and degeneration in the macular area could be found. Granular fluorescence and cystic low-reflect areas could be seen in FFA and OCT, respectively.

OBJECTIVE: To observe the clinical efficacy of Shenmai injection in treating congestive heart failure (CHF). METHODS: 120 cases with CHF were randomly assigned to receive conventional therapy(control group) or conventional therapy plus Shenmai injection(treatment group). The therapeutic efficacy and adverse reactions were compared between the two groups. RESULTS: There were significant differences between 2 groups in the total effective rate(86.7% in treatment group vs. 75.0% in control group;P

Objective To summarize the peri operative therapeutic experience from 67 severe traumatic head injuried patients with a score of 3 8 on Glasgow coma scale (GCS). Methods 67 severe head injuried patients with a score of 3 8 on GCS admitted to our department from Feb. 1992 to Oct.1998 were analyzed. Results Forty five (67 2%) out of 67 patients survived and 22 died. Among the surviving patients 34 (50 7%) achieved a good recovery or moderate disability and left other 11 patients severe deficits(16 5%). Conclusions The prognosis of severe head injuried patients could be improved by correct management before hospitalization, early evacuation of intracranial hematoma with large decompressive craniotomies, intracranial pressure monitoring, moderate hypothermia therapy and other effective prevention and treatment of cerebral vasospasm and complications.

Objective To study the feasibility and surgical techniques of C57BL/6 mice intracarotid injected Lewis lung cancer cell line 3LL to establish a kind lung cancer brain metastasis animal model .Methods Green fluorescent protein(GFP) positive 3LL cells were intracarotid injected into C57BL/6 mice to establish lung cancer brain metastases animal models ,then tumor growth and survival time were analyzed .Results The intracarotid injection animal model could establish brain metastases animal model success-fully .Conclusion The intracarotid injection is an effective method to establish cancer brain metastatic animal model .

Objectives A rare case of juvenile dermatomyositis (JDM) complicated by myelodysplastic syndrome (MDS) was reported in order to improve the understanding of the disease in its clinical signs, differential diagnosis and treatment. Meth-ods The course of the disease, clinical characteristics and the process of diagnosis and treatment were analyzed. Specimens of bone marrow, lymph nodes, muscles were examined by histopathological or immunohistopathological means and lfow cytometry. Results The diagnosis of JDM complicated by MDS was made based on the clinical manifestations, related laboratory results and the accompanying changes in hematological and bone marrow examinations. Conclusions JDM complicated by MDS is very special and rarely seen in China and its pathological mechanism and strategy of diagnosis and treatment should be further explored.