Objective To understand the clinical characteristics of primary small vessel vasculitis with involvement of lungs in children and analyze the causes of misdiagnosis.Methods Clinical data from 16 patients with primary small vessel vasculitis were collected and their pathological,antineutrophil cytoplasmic antibody(ANCA),pulmonary lesion manifestations,image and misdiagnosis were further analyzed.Results Among 16 cases,9 cases were microscopic polyarateritis(MPA) and 4 cases were Wegeners granulomatosis(WG) and 3 cases were Churg-Strause syndrome(CSS).The ages of onset were from 3 to 14 years old with average age of 7.5 years old.Seventy-five percent(12/16) were ANCA positive.The patients with lung involvement had cough,chest pain,dyspnea,hemoptasis and asthma.Findings on lung X-ray films were variable.Some showed multiple patch shadows,others showed single or multiple masses or nodular shadows with or without cavity formation.After the treatments with corticosteroid and cyclophosphamide,10 cases turned better;including 8 cases with normal on lung X-ray films.Three cases given up;3 cases died.Conclusion It is very difficult to make diagnosis of primary small vessel vasculitis with involvement of lungs and should be paid more attentions to this issue.

The Logminer utility has been provided by the latest Oracle 8i version.It can analyze archived log files and online log files.This paper introduces how to install and use this utility,especially how to make the use of the auditing function on key users and key data tables,as well as recover the hostility operation without the shutdown of database.

Objective:To observe the clinical efficacy of Jianpiqinghua Particles and Wentong Powder on early stage of diabetic feet adding to basal treatment,and to establish a standardized clinical diabetic foot prevention program of integrated traditional Chinese medicine.Methods:Take a randomized blind placebo-controlled add-on trial:The treatment group of 20 was given with Jianpiqinghua Particle(oral),Wentong Powder(foot washing),the control group of 20 was given placebo by same methods.The course in both groups was16 weeks.The change of total effect body and foot feeling(VAS scale),electro-neurophysiological examination and ankle/brachial ratio were evaluated.Results:The TCM group was superior to the control group in improving the body and feet clinical symptoms,nerve conduction velocity,evoked potential amplitude and the ABI index(P

Objective To explore the relationship between methylenetetrahydrofolate reductase (MTHFR) 677C ＞ T and unexplained recurrent pregnancy loss (URPL).Methods All patients were recruited from the outpatient department of Obstetrics/Gynaecology & Genetics of Hangzhou First People's Hospital from January 2013 to May 2014.A case-control study was performed.According to the stochastic indicator method,there were 125 subjects with a history of ≥2 times URPL as the case group,and 905 healthy parous women with no history of URPL as the control group.Polymerase chain reaction-restriction fragment length polymorphism (PCR-RFLP) was used to detect the distributions of the polymorphisms of MTHFR 677C ＞ T,and the results were validated using oligo-chip and direct sequencing.Results The allele and genotype frequencies of MTHFR were 60.0％ for C,40.0％ for T,32.0％ for CC,56.0％ for CT,and 12.0％ for TT in the case group and 67.4％ for C,32.6％ for T,41.4％ for CC,52.0％ for CT,and 6.6％ for TT in the control group,respectively.The prevalence of allele T was significantly higher in the case group than in the control group (OR =1.379,95％ CI =1.051-1.808,P =0.020),the frequency of genotype TT was also significantly higher in the case group than in the control group (OR =2.344,95％ CI =1.220-4.503,P =0.009).Conclusion The fertile women with MTHFR 677T allele and 677TT genotype may be susceptibility to URPL in a Chinese Han population from the Hangzhou area.

ObjectiveTo observe the therapeutic effects of calcium dobesilate combined with irbesartan in treating early diabetic nephropathy ( DN ).Methods65 patients with early DN were randomly divided into two groups,experiment group( irbesartan plus calcium dobesilate,n =34) and control group( irbesartan,n =31 ).After 24 week treatment,the urinary albumin excretion rate(UAER),fasting blood glucose ( FBG ),postprandial blood glucose (PBG) and glycosylated hemoglobin(HbA1c) were detected and compared between two groups before and after treat ment.ResultsUAER after treatment was significantly reduced in both 2 groups(t =8.074,12.89,all P＜0.01),and the decrement in the experiment group was more obvious than that in the control group with statistical significance ( t =3.965,P ＜ 0.05).ConclusionCalcium dobesilate combined with irbesartan has good effects in the treatment of early DN.

It is the foundation of HIS that the database system runs well.Therefore,the database administrator is required to recover it rapidly when the system is broken down.This paper introduces how to backup and recover database by using RMAN which ORACLE corporation recommends.It is more rapid and more reliable than traditional cool backup and online backup.

Objective To gather laboratory results automatically.Methods An interface software was developed with Mscomm32 control and PowerBuilder.Result The results of laboratory instruments were input into LIS database automatically.Conclusion Hospital engineer can realize the connection of laboratory instruments with Mscomm32 control and PowerBuilder.

Objective To investigate the changes of anti-cyclic citrullinated peptide antibody ,rheumatoid factor (RF) ,erythrocyte sedimentation rate(ESR) and C reactive protein(CRP) levels in the patients with early rheumatoid arthritis (RA) and their applica-tion value in the diagnosis and treatment.Methods A total of 210 cases of early RA in sixth affiliated hospital of Guangzhou Medi-cal University from December 2015 to June 2016 were selected as the RA group ,including 28 males and 182 females ,at the same time 115 cases of other rheumatism were selected as the non-RA group ,male ,including 38 males and 77 females.85 persons under-going the healthy physical examination were taken as the health group ,including 46 males and 39 females.The latex enhanced im-mune turbidimetry was adopted to quantitatively detect anti-cyclic citrullinated peptide antibody.The RF and CRP levels were quan-titatively detected by using the immune turbidimetry.The Westergren method was used to test the ESR ,their content changes in RA ,non-RA arthritis and other autoimmune diseases were detected.Results The sensitivity ,specificity ,positive predictive value , negative predictive value and Youden index of anti-cyclic citrullinated peptide antibody in the RA group were 60.95% ,97.64% , 98.46% ,50.30% and 0.59 respectively ,which of RF test were 52.38% ,95.29% ,96.49% ,44.75% and 0.48 respectively ,which of CRP test were 30.48% ,89.41% ,87.67% ,87.67% ,34.23% and 0.20 respectively ,which of ESR test were 49.52% ,87.06% , 90.43% ,41.11% and 0.37 respectively.Anti-cyclic citrullinated peptide antibody detection in the RA group was obviously higher than that of the RF test ,their test results were obviously higher than those of the non-RA group and healthy group ,the differences were statistically significant (P<0.05).CRP and ESR detection had no statistical difference between the RA group and non-RA group (P>0.05).Conclusion Anti-cyclic citrullinated peptide antibody level is higher in the patients with RA ,which is signifi-cantly superior to the RF test ,and anti-cyclic citrullinated peptide antibody detection has higher value for early diagnosis of RA.

Objective:To explore the personnel arrangement in the outpatient pharmacy by calculating working hour to provide ref-erence for the rational staffing in hospital. Methods:The daily work content and working hour of 18 pharmacists in the outpatient phar-macy of a large general hospital from January to March in 2013 were following-up observed and recorded using the working hour meas-urement. The data were input the EXcellsoftware to establish the database, and the workload in various positions was collected and sorted. The obtained relative parameters were used to calculate the needed worker number on the basis of manpower planning model. Results:The research confirmed the mean operation time for 9 work programs in the outpatient pharmacy, and the time for drug dispen-sing and distributing was detailed. The needed number of pharmacists was 13. 29 according to the calculation, plus the officer-in-charge and sanitation workers, the total number was 15. 29(approx. 16). Conclusion:The working hour measurement can scientifically de-termine the time for each job, and the workload should be used as the foundation for configuring personnel qualification and the number in outpatient pharmacy.

Objective:To study the effect of invigorating the kidney and spleen complex prescription on deltamethrin intoxicated pregnant rats. Methods:Pregnant rats were divided into 5 groups. Except the blank group,other groups were orally fed 1/20LD50(6.93mg/kg)DM daily from day 1 to 15 when proved pregrancy. 4 Hours later,rats in model group were given physiological saline,other 3 groups were given high/ median /low dose of Zhuyun Formula. Half pregnant rats were killed on D15. The rest was kept until labour. The abortion rate,survival rate,delivery condition,the level of estradiol,progestogen were observed. Results:With respect to abortion rate,model group showed statistical signifi cance when compared with other groups. Model group also showed low progesterone level. With the treatment Zhuyun Ⅲ,it had desirable effect in decreasing abortion rate,and increasing the level of progesterone. The labour time of all groups was within the normal range. Conclusion:DM had toxicity on reproduction,it could lead to abortion which was related to endocrine function of pregnant rats. Zhuyun Ⅲ could regulate the above condition and relief DM toxicity.