OBJECTIVE:To build the off-label drug use control system,and to realize automatic prompt for off-label drug use by system when physicians prescribed drugs. METHODS:The module and flow chart of off-label drug use control system were de-signed based on B/S structure. The drugs of the prescriptions were verified one by one in terms of drug indication,drug dosage, age and gender of patient,route of administration,etc. The system prompted automatically off-label drug use when drug use didn’t agree with preset value;at the same time,the management effect of the system was evaluated by taken the amount of attention about antibiotics medical orders as an example. RESULTS:At present,265 kinds of drugs were involved in the system designed by our hospital. Since the system was applied,the system had prompted more than 50 thousand items of off-label drug use prescrip-tions/medical orders,accounting for 0.3% of total. Among the types of off-label drug use,the most number of medical orders were over single dose(745 items),followed by extra-indication(706 items)and over daily dose(671 items). Within 3 months after sys-tem used,the attention numbers of antibiotics medical orders of over daily dose decreased month by month. CONCLUSIONS:Es-tablished off-label drug use control system of our hospital has a stable running and convenient manipulation,and contains powerful practicability. It can monitor off-label drug use of some drugs.

Objective To investigate the association of serum 25-hydroxyvitamin D (25OHD),parathyroid hormone (PTH),blood glucose,blood lipid,uric acid,obesity,insulin etc with blood pressure.Methods A total of 1 403 residents aged (45.3 ± 14.4) years were enrolled from Guiyang residents during a health survey in 2009.The standard questionnaire survey and physical examination were performed in all subjects.The fasting plasma glucose,postprandial 2 h plasma glucose (2hPG),triglyceride,high density lipoprotein-cholesterol,serum calcium,phosphorus,creatinine,and uric acid were determined by automatic biochemical analyzer,serum insulin by chemiluminescence method,and serum 25OHD and PTH by radioimmunoassay.Results Path analysis showed that age,gender,body mass index (BMI),insulin,25OHD,PTH,2hPG,and triglyceride affected systolic blood pressure,with the repective path coefficients of 0.453,0.294,0.120,-0.106,-0.049,0.047,0.030,and 0.030.BMI,age,gender,insulin,2hPG,triglyceride affected diastolic blood pressure,with the path coefficients 0.348,0.217,-0.146,0.134,0.035,and 0.035 respectively.Insulin,triglyceride,2hPG indirectly influenced blood pressure through BMI.BMI,PTH,and 25OHD had a significant and direct effect on blood pressure.Gender and age directly and indirectly influenced blood pressure through BMI.Conclusion The most significant influential factors on blood pressure are age,serum insulin,triglyceride,and 2hPG in the population of Guiyang.Serum 25OHD is negatively associated with systolic blood pressure while PTH level is positively associated with systolic blood pressure.

Objective With Pregnant women weight correction for serum marker Multiple of Median (MoM) of First trimester and second-trimester,integrated screen-ing for Down's syndrome (DS),can reduce the false positive rate.Methods The same pregnant woman were taken venous blood vessels with sterile vacuum during the first trimester (11-13 W(+ 6) d) and the second trimester (15-20 W(+ 6) d),Alpha-fetoprotein (AFP),serum free beta-human chorionic gonadotrophin (Free beta hCG) and pregnancyassociated protein-A (PAPP-A) of three kinds of serum marker screening indicators were assayed by Using Time-resolved fluoroimmunoassay (TRFIA).Screening for risk assessment software was used to calculate serum marker Multiple of Median,To assess the risks of 7 997 cases of local pregnant women DS,To construct the weight equation of local population using nonlinear weighted regression method,With maternal weight correction for serum marker Multiple of Median (MoM) of local pregnant women,Comparing the changes of screening index MoM before and after correction,chi square test to compare the detection rate and false positive rate.Results MoM values of three kinds of serum markers (al-pha-fetoprotein,free beta subunit of human chorionic gonadotropin,pregnan-cy-associated plasma protein A) decreased with the weight increasing,Screening index MoM after correction weight equation,the screening of false positives for crowd from 4.12％ down to 3.86％ (x2 =0.021,P ＞ 0.05).Setting threshold (cut-off) at 1/270,and no change detection rates were 71.4％ the local population before and after correction weight equation.Conclusion Maternal weight may affect the results of Down's syn-drome sereening.When screening proposal to set up,it is worth making weight cor-rections for serum maker multiple of median in order to get accurate risk calculation results.

Objective To explore the variation trends of interleukin-1β( IL-1β) and intercellular adhesion molecule-1 (ICAM-1) in both normal and affected sides of brain tissues in rats with ischemia-reperfusion injury and the therapeutic action of electroacupuncture.Methods The cerebral ischemia-reperfusion model was established with suture embolization in the right middle cerebral artery.The rats were randomly divided into control group, model group and electroacupunture group.Each group was then divided into six subgroups by the time after operation (12 h,24 h,48 h,72 h,96 h,144 h), ten rats in each subgroup. Frozen sections of brain tissues were prepared and the expression of IL-1βand ICAM-1 in brain tissues of both sides were detec-ted by immunohistochemistry.Results The expressions of IL-1βand ICAM-1 showed typical bimodal pattern in both affected is-chemic region and contralateral normal region.In the model group, the peaks of IL-1βin the cerebral ischemic region were at 12 h and 48 h, while in the contralateral normal region the peaks were at 12 h and 144 h, the expression of IL-1βin the ischemic region was significantly higher than that in the contralateral normal region at 48 h (P<0.05), and lower at 96 h and 144 h (P <0.05).In the electroacupuncture group, the expressions of IL-1βin the ipsilateral region were significantly lower than that in the contralateral region at 24 h, 48 h and 144 h (P<0.05).In the model group, the peaks of ICAM-1 in the cerebral ischemic regions were at 24 h and 72 h, while in the contralateral normal regions the peaks were at 24 h and 144 h.In the electroacupunc-ture group, the expressions of ICAM-1 in the ischemic regions were significantly lower than that in the contralateral normal re-gions at all the 12 h, 24 h, 48 h, 72 h and 144 h (P<0.05).Conclusions Our findings suggest that electroacupuncture may inhibit the inflammation of ischemia/reperfusion brain tissue through reducing the expression of IL-1βand ICAM-1 to relieve the cerebral ischemia-reperfusion injury.

Objective To explore the expressions of growth factor receptor binding protein 2 -associated bin-ding protein -1 (Gab -1 )and glioma -associated oncogene homologue -1 (Gli -1 )in pediatric medulloblastoma,and to analyze their correlation between clinical and pathological characteristics and prognosis in pediatric medulloblastoma. Methods Elivision immunohistochemistry was used to detect the expressions of Gab -1 and Gli -1 protein in tissue microarray of 40 paraffin embedded pediatric medulloblastoma specimens.Chi -square test or Fisher exact test was used to analyze the correlation between Gab -1 and Gli -1 protein expressions with gender,age,tumor location and pathological subtypes.Follow -up data were handled by using Kaplan -Meier survival analysis and Cox regression anal-ysis.Results Positive expression ratios of Gab -1 and Gli -1 protein in 40 pediatric medulloblastoma were 35.0%and 55.0%,respectively.The positive expression rate of Gab -1 in medulloblastoma tissues had no statistical signifi-cance between different genders[male:30.4%(7 /23 cases)vs.female:41 .2%(7 /17 cases)],age[<3 years old:40.0%(6 /15 cases)vs.≥3 years old:32.0%(8 /25 cases)],tumor location[cerebellum:25.0%(5 /20 cases)vs. the fourth ventricle:45.0%(9 /20 cases)]and pathological subtype[classical type:40.7%(11 /27 cases)vs.desmo-plastic /nodular type:50.0%(5 /10 cases)vs.anaplastic /large cell type:66.7%(2 /3 cases)](χ2 =0.496,0.264, 1 .758,3.289,all P >0.05).There were statistical differences of positive expression rate of Gli -1 protein in different age groups[<3 years old:80.0%(12 /15 cases)vs.≥3 years old 40.0%(10 /25 cases)],different pathological sub-types[classical type:40.7%(11 /27 cases)vs.desmoplastic /nodular type:90.0%(9 /10 cases)vs.anaplastic /large cell type:66.7%(2 /3 cases)](χ2 =6.061 ,7.333,all P <0.05 ).There was no statistical difference in positive expression rate of Gli -1 protein between different gender[male:60.9%(14 /23 cases)vs.female:47.1 %(8 /17 cases)]and different tumor location [cerebellum:55.0% (11 /20 cases)vs.the fourth ventricle:55.0% (11 /20 cases)](χ2 =0.753,0.000,all P >0.05).Kaplan -Meier survival analysis showed that the age,the expressions of Gab -1 and Gli -1 protein were correlated with prognosis of pediatric medulloblastoma(all P <0.05).Cox regression indicated that the age,pathological subtypes and the expression of Gli -1 protein were independent prognostic indicators in pediatric medulloblastoma(all P <0.05).Conclusion Expression of Gab -1 and Gli -1 protein is significantly correlated with the prognosis of medulloblastoma,and the positive expression is a marker of unfavorable prognosis.

Objective To investigate the relationship between changes of ankle brachial index (ABI) and adverse cardiovascular events. Methods Baseline survey was conducted in 4 160 forty-year-old or older citizens living in Yunyan District of Guiyang City from May to August of 2011, which was in the way of cluster sampling to obtain their ABI and to collect information related to physical and blood biochemical examination and disease history. These citizens were conducted a follow-up survey for (39.29±1.47) months from July to December of 2014. Based on the change of ABI (ΔABI) from initial survey to follow-up survey, participants were subsequently divided into three groups: ΔABI>0.15 group,-0.15≤ΔABI≤0.15 group and ΔABI<-0.15 group. The adverse cardiovascular events during follow-up survey were compared between three groups. The risk factors affecting the adverse cardiovascular events were analyzed. Results Follow-up surveys were completed in 3 220 citizens in 3 years. The follow-up rate was 77.4%. Eighty-two new cases (2.5%) of adverse cardiovascular events were found in 3 220 cases in follow-up. The incidence rates of adverse cardiovascular events were higher inΔABI<-0.15 group compared with those of-0.15≤ΔABI≤0.15 group (8.3%vs. 2.4%, P<0.016 7). Logistic regression analysis indicated that age, hypertension history, and ΔABI<-0.15 were risk factors for adverse cardiovascular events. Exercise was the protective factor for adverse cardiovascular events. Conclusion Subjects withΔABI<-0.15 are at high risk for adverse cardiovascular events. The ΔABI can be used as a means of monitoring of adverse cardiovascular event, which provides certain forecast value for determining the possibility of adverse cardiovascular event.

Objective To investigate the relationship between brachial ankle pulse wave velocity and the incidence of cardio-cerebral events in people aged over 40. Methods Cluster sampling method was used to prospectively study 4 380 residents aged over 40 in Guiyang City District from May to August in 2011. Data of ba-PWV were collected. The follow-up examination was conducted from July to November of 2014. According to ba-PWV values, participants were divided into three groups:<14 m/s (control, n=1 039) group, 14-17.9 m/s group (n=1 393) and≥18 m/s group (n=809). Multi-factor Logistic regression model was used to analyze the relationship between ba-PWV values and risk factors of cardio-cerebral events. Results After three-year follow-up, a total of 3 241 participants were included in the final analysis. The cardio-cerebral events were identified in 63 (2.0%) cases, which were 0.6%, 2.2%and 3.2%in control group, 14-17.9 m/s group and≥18 m/s group. The value of ba-PWV increased significantly in those two groups compared with that of normal group. Logistic regression analysis showed that the incidence rates of cardiovascular and cerebralvascular events in 14-17.9 m/s group and≥18 m/s group were 2.777 (1.123-6.864) and 2.786 (1.032-7.526) times of control group after adjusting age, gender, systolic blood pressure, risk factors of diabetes, hypertension and blood lipids. Conclusion There is higher incidence rate of cardio-cerebral events in people aged over 40 in higher ba-PWV group. The value of Ba-PWV can be used to predict the occurrence of cardio-cerebral events.

Objective To determine chromosomal localization of the primary gout susceptibility gene in a pedigree.Methods The clinical data and the peripheral blood samples were collected in the pedigree members and the genomic DNA was extracted from peripheral blood.A genome-wide screening was performed using 400 micro-satellite DNA markers in this family,and linkage analysis was used to determine the chromosomal location of the primary gout susceptibility gene.Results Linkage analysis showed that the maximum LOD score reached 1.50 at marker D4S1572 (at recombination fraction?=0.00).Conclusion Since D4S1572 is localized at 4q25,the primary gout susceptibility gene of this pedigree is localized at 4q25.

Objective To explore the sensitivity of using NT,combined with serum biochemical markers (Free-βhCG,PAPP-A) for Down's Syndrome screening in early stage of pregnancy.Methods Collect pregnant women aged 17-45 years old voluntary antenatal screening in our hospital from March 2009to October 2010,a total of 11882 cases.Serum Free-βhCG and PAPP-A were measured NT value was determined by ultrasound at 11-13w+64 of gestation.Calculating combined screening (NT,Free-βhCG,PAPP-A),and serum integrated screening (Free-beta hCG,PAPP-A) risk,respectively,using the risk calculation software for the same person.Results Early pregnancy screening was performed in 11 882patients,18 had a fetus with Down's syndrome,a rate of 0.15％.The detection rates of Down's syndrome in combined screening and serum integrated screening were 83.3％ and 72.2％ respectively.The specificities were 98.4％ and 97.3％ and detection efficiency were 7.18％,3.90％ respectively.Areas under the curve (AUCs) of fhst-trimester combined screening and serum integrated screening were 0.975 (95％ CI:0.943,1.007),0.901 (95％ CI:0.789,1.013) respectively.Conclusion In early stage of pregnancy,combined screening for Down's syndrome has higher sensitivity and specificity than serological screening,has higher detection rate in the same false-positive rate case,which can effectively reduce the pregnant women to receive invasive puncture.

This paper reports some histochemical,scanning and transmission electron mic-roscopical features of thymic nurse cell(TNC)of human fetuses.The results showedthat TNCs were all negative for ANAE,AcP,AlP,ATPase,5'-Nase and PAS.TNCcontained various numbers of lymphocytes.Some intracytoplasmic lymphocytes werepositive for ANAE,AcP,AlP and ATPase.Their ANAE positive percentage deter-mined were 26.8%.However,ANAE positive percentage of extracytoplasmic lym-phocytes of TNC were 51.3%.Our data demonstrated that there was significant dif-ference between these two ANAE positive percentages,P