OBJECTIVE:To investigate the "drug use for pregnant women" in drug package inserts and to provide reference in standarding the drug package inserts.METHODS:375 package inserts of common drugs collected in our hospital were analyzed statistically in terms of the item of "drug use for pregnant women".RESULTS:Among the 375 drug package insert,134 stated "forbidden or contraindicated for pregnant women";51 stated "to be used with caution for pregnant women",40 had indefinite explanation about the drug use for pregnant women,and 23 had no explanation for drug use for pregnant women.CONCLUSIONS:It is advisable for the related department in our country tighten control on the safety of drug package inserts by organizing experts to conduct a regular post-marketing reevaluation on the drugs,urging drug manufactures to timely update the drug package inserts,setting and improving the standard format of drug package inserts to ensure the safety of clinical drug use.

Objective To investigate the clinical significance of γ-interferon release test (IGRA) in the diagnosis of entry-exit people with tuberculosis.Methods A total of 64 patients with tuberculosis and 46 healthy people were detected by IGRA,tuberculin skin test (TST),LAM,38× 103 and 16 × 103.The results of different methods were compared and analyzed.Results The sensitivity of IGRA detection method (88.9 ％) and specificity (95.8 ％) were both higher,while the sensitivity (92.7 ％) of the TST method was higher and the specificity (76.7 ％) was lower.Conclusion The sensitivity and specificity of IGRA in the detection of tuberculosis are higher,and it has important clinical application value.

Objective To investigate the clinical outcomes of three kinds oi internal fixations via posterior approach for treating adjacent two-segment thoracic and lumbar vertebral fractures.Methods A retrospective analysis was done on data of 34 patients with adjacent two-segment thoracic and lumbar vertebral fractures treated between 2003 and 2010.The treatments included three different pedicle screw fixations via posterior approach,ie,fixation with four verlebrae and four screws (Group Ⅰ,n ＝ 14),fixation with four vertebrae and six screws ( Group Ⅱ,n ＝ 11 ),fixation with four vertebrae and eight screws ( Group Ⅲ,n ＝ 9).The changes of spinal Cobb' s angle before and after operation and at the last final follow-up were statistically analyzed.Oswestry disability index (ODI) score,Denis pain scale and Denis work scale at the final follow-up were evaluated.Also,the recovery of neurological function was observed.Results The duration of follow-up was average 24 months (range,10-48 months).The neurological function of all the patients recovered to some degree.Two patients had pedicle screw breakage and one had spontaneous fusion of the collaprsed vertebra in Group Ⅰ.The Cobb' s angles of the three groups were decreased immediately after operation,but all obtained some degree of enhancement at the final follow-up.In Group Ⅰ,the mean Cobb's angle was (7.5 ±3.0)° postoperatively and then improved to ( 13.7 ±5.1 )°at the final follow-up,with correction loss of (6.2 ±2.1)°.In Group Ⅱ,the average Cobb's angle was( 1.4 ± 1.5) ° postoperatively and later increased to (4.5 ± 2.4)° at the final follow-up,with correction loss of (3.1 ± 1.1 )°.In Group Ⅲ,the mean Cobb' s angle was ( 0.0 ± 1.1 )° postoperatively but was increased to ( 1.3 ± 1.2 )° at the last follow -up,with correction loss of ( 1.3 ± 0.0 1 )°.The three groups showed statistical difference regarding the correction loss of Cobb' s angle ( P ＜ 0.05 ).Group Ⅱ and Group Ⅲ showed no significant differences in aspects of ODI score and Denis work and pain scale at the final follow-up,but the differences were significant when Group Ⅰ was compared with Group Ⅱ and Group Ⅲ (P ＜ 0.05 ).Conclusions The posterior transvertebral pedicle screw fixation with 4 vertebrae and 8 screws for adjacent two-segment thoracic and lumbar vertebral fractures is beneficial to gaining well reduction and fixation,maintaining deformity correction,preserving motion segment and releasing pain.The operation,a simple and convenient technique,has the prospect of clinical application.

Objective To compare the result differences of different dynamic nerves transferring to different segments of the radial nerve. Methods From 1997 to 2000, different ways of intercostal nerves or contralataral C 7 transfering to different segments of the radial nerves were carried out in 36 cases with total avulsed brachial plexus injuries that were followed up for average 42.39 months. Four-fold table was selected to statistically calculate the effective rate of muscle strength recovery. Results The total effective rate was 56% (20/36). The effective rate of the functional rehabilitation of elbow extension was 5/8 in the group with neurotization to radial nerve trunk and 4/4 in the group with neurotization to branches innervating the triceps brachii muscle of radial nerve. The highest effective rate up to 75% (9/12) of the functional rehabilitation of wrist and digit extension belonged to the group with contralateral C 7 transferring to the radial nerve segment in the humeral spiral groove where branches innervating the triceps brachii muscle had already diverged. Conclusions The way of neurotization to radial nerve trunk and to branches innervating the triceps brachii muscle of the radial nerve can win good functional rehabilitation of elbow extension. Contralataral C 7 transfering to the radial nerve segment in the humeral spiral groove ranks the best way for function recovery of the wrist extension. Age below 30 years and operation interval less than 12 months are helpful for functional rehabilitation of the radial nerve.

Objective To study and compare the effects of Fentanyl transdermal pain patches and Pethidine in postoperative analgesia of malignant tumor and its nursing methods.Methods 100 patients with malignant tumor in our hospital from January 2008 to November 2010 were selected as research object,all the patients were randomly divided into group A (Fentanyl transdermal pain patches group) and group B (Pethidine group)with 50 cases in each group,then the VAS score 2,4,8,24 and 48h after the surgery,incidence of adverse reactions,satisfaction rate and serum catecholamine,cortisol,blood glucose before and after the surgery were analyzed and compared,and all the patients were given corresponding nursing measures.Results The VAS score of group A at 2,4,8,24 and 48h after the surgery were all better than those of group B,incidence of adverse reactions was lower than that of group B,satisfaction rate was higher than that of group B,serum catecholamine,cortisol,blood glucose after the surgery were all lower than those of group B,there were significant differences.Conclusions The effects of Fentanyl transdermal pain patches in postoperative analgesia of malignant tumor is stable,and it gets good reputation from the patients,the effects is obvious combined with nursing.

Objective To explore the correlation between illness conception, health seeking behavior and mental health status in recruits. Methods 865 recruits were evaluated by Symptom Checklist 90 (SCL-90), Self-Rating Anxiety Scale (SAS), Self-Rating Depression Scale (SDS) and Self-Rating Scale of Illness Conception and Health Seeking Behavior (SSICHSB) . Results (1) Except interpersonal sensitivity, depression and hostility, there were significantly differences in other factors of SCL-90 between recruit and the national norm. Somatization and anxiety scres were significantly higher ghan the military norm. The scores of SAS and SDS were significantly higher for recruits compared to national norm. (2) There was negative correlation between the total score, each factor score of SCL-90, the total score of SDS, the total score of SAS and SSICHSB; (3) Stepwise lines regression found three factors including anxiety, the total score of SAS and obsessiveness statistically significant, when the dependent variable was the total score of SSICHSB. Conclusion There are obvious somatization,anxiety and depression in recruits. The more obvious the symptoms are, the more passive the illness conception and health seeking behavior are.

Objective To analyze the causes for the failures after posterior pedicle screw instrumentation for thoracolumbar fractures.Methods From June 2003 to December 2014,182 patients with thoracolumbar fracture were treated by fixation through the posterior approach using pedicle screws and fully followed up in our institute.We analyzed the cases of postoperative infection,recovery of neural symptoms,breakage and loosening of pedicle screws and connecting rod,non-union of the fractured vertebra,and correction loss of kyphosis in associations with the AO classification and Loading Sharing Classification of Spine Fracture (LSCSF) system,osteoporosis,intervertebral disc injury and methods of internal fixation.Results In this series,altogether 27 cases failed(14.8％).The rate of postoperative infection was 1.1％ (2/182).The rate of breakage of pedicle screw or connecting rod was 7.7％ (14/182).The implant breakage rates for fractures of AO types A1,A2 and A3.1 were significantly lower than for other types (P ＜ 0.05).The implant breakage rate for the patients with ≤6 LSCSF points was significantly lower than for those with ≥7 LSCSF points (P ＜ 0.05).The implant breakage occurred in 3 cases of those who underwent fixation of one normal vertebra respectively below and above the two contiguous segments but not in those who underwent additional fixation of the injured vertebrae.The rate of screw loosening was 2.2％ (4/182).The non-union rate of the injured vertebra was 2.7％ (5/182).The rate of kyphosis recurrence was 1.1％ (2/182).Conclusions To prevent the failure of posterior pedicle screw fixation,surgeons should pay more attention to the following key points before operation:the type and evaluation of spinal fractures,a proper approach and method of internal fixation,and the weight bearing capability of the anterior column.

Objective:To compare the therapeutic and adverse effects of chemotherapeutic regimen based on three drugs (taxol+carboplatin/cisplatin+etoposide) and two drugs (carboplatin/cisplatin+etoposide) on the combined small cell lung cancer (CSCLC). Methods:A retrospective study was conducted based on the data of 62 CSCLC patients who were admitted to and treated at Tianjin Medical University Cancer Institute and Hospital between July 2000 and April 2013. Of the 62 patients, 19 received the three-drug regi-men and 43 received the two-drug regimen. All patients received at least two cycles of chemotherapy and completed follow-up proce-dures. For each patient, the therapeutic efficacy was evaluated every two cycles, and toxicity was evaluated every cycle. Results:The response rates between the three-drug and two-drug groups were statistically significant (90%vs. 53%, P=0.033). However, no statisti-cal differences were observed in the disease control rate between the two groups (100% vs. 86%, P=0.212). The three-drug regimen could induce a better median progression-free survival compared with the two-drug regimen, but with no statistical significance (10.5%vs. 9.8%, P=0.484). Similarly, no statistical differences were noted in the median overall survival between the three-drug and two-drug groups (24.0%vs. 17.5%, P=0.457). The incidence rates of grade IV bone marrow depression and the termination of the original regi-men owing to severe adverse reactions were both significantly higher in the three-drug group than in the two-drug group (26.3% vs. 7.0%, P=0.036;31.6%vs. 14.7%, P=0.004). Conclusion:The two-drug regimen had almost the same survival rate and lower toxicity compared with the three-drug regimen. When using the TEP/TCE regimen, a close attention should be focused on its adverse reactions. The findings of this work showed that the two-agent regimen should be one of the standard treatments for CSCLC.

Objective To study the role of total flavonoids of hippophae rhamnoides in improving contactile function of stretched cardiac myocyte.Method Flavonoids were given to stretched myocytes which were proved their contractile function decline and then myocyte contractile mechanics characteristics and calcium transfer were measured.Result Flavonoids increased myocyte contractility,as indicated by myocyte shortening,velocity of shortening,peak+dL/dt and peak-dL/dt during shortening,in a concentration-dependent manner (r>0.9,P<0.001),and with no relation to the intracellular calcium transfer in the myocytes.Conclusion Flavonoids of the traditional Chinese drug hippophae rhamnoids is effective in improving the contractile function of stretched cardiac myocyte in low dosage.

Objective To investigate the effects of L-glutamine-supplemented parenteral nutritional sup- port on nutritional status, immunity, and inflammatory response in patients with lung cancer following radical opera- tion. Methods Forty-two malnourished patients with lung malignancies who had undergone radical operations were randomly divided into PN plus group (n =22) and PN group (n = 20). From day 1 to day 5 after operations, parenteral nutrients with the non-proteinic calorfic value of 90 kJ · kg-1 d-1 and nitrogen 0.25 g · kg-1 d-1 were given. From day 2, liquid diets were provided to both groups, and L-glutamine particles (30 g) were provided to PN plus group. Peripheral blood specimens were collected before operation, on day 1, and on day 7 after the oper- ations to determine the serum levels of albumin, prealbumin, transferrin, T lymphocyte subgroup 3 (CD3), CD4, CD8, CD4/CD8, immunoglobulin A (IgA), IgG, IgM, and C-reactive protein. Results The levels of the serum transferrin [(2.29±0.34) vs. (2.15±0.42) g/L], prealbumin [ (0. 27±0.76) vs. (0.23±0. 84) g/L], CD4 (30.9%±2.2% vs. 28.9%±2. 3% ), CD4/CD8 (1.17±0.19 vs. 1.10±0. 81), IgG [(12. 94 2.08) vs. (11. 19±1. 95) g/L] were all significantly higher in the PN plus group than those in PN group on day 7 (P <0. 05) . The level of serum C-reactive protein was significantly lower in PN plus group than that in PN group on day 7 [(31.6±16.7) vs. (36.5±13.3) mg/L, P<0.05]. Conclusion Postoperative L-glutamine-supplemented parenteral nutrition support can improve the nutritional status and immune function and reduce the acute inflammatory response in patients with lung cancer.