OBJECTIVE:To study the adverse drug reactions induced by?-lactam antibiotics and to promote rational use of drugs in clinics.METHODS:442ADR cases induced by?-lactam antibiotics collected in our hospital during2001～2005were analyzed retrospectively.RESULTS:Among the total961ADR cases collected in5years,46%were induced by?-lactam antibiotics.The most common displays of ADR were the lesion of skin and the appendants,followed by the lesion of cardiovas-cular system and digestive system etc.CONCLUSION:It is advisable to promote rational use of?-lactam antibiotics and strengthen ADR monitoring so as to decrease or avoid the occurrence of ADR.

Echocardiography, Three-Dimensional ; Heart Defects, Congenital ; diagnostic imaging ; therapy ; Humans

Hypercholesterolemia and coronary heart disease caused by it have become the most important factors threatening human health. The lipid metabolism-related studies are increasingly receiving attention. Recent studies have demonstrated that proprotein convertase subtilisin/kexin type 9 (PCSK9), a family member of precursor protein-converting enzyme, plays an important role in the regulation of lipid metabolism. The expression and mutation of PCSK9 gene are closely correlated with the content of low-density lipoprotein receptor (LDLR). The excessive expression of PCSK9 promotes the degradation of LDLR, thereby increasing the levels of plasma LDL; whereas the inhibition of PCSK9 gene expression causes the decreased levels of plasma LDL. Therefore, it is promising to develop novel medications for treating hypercholesterolemia, controlling hyperlipermia and preventing coronary heart disease by studying the mechanism of PCSK9.

Objective To explore the potential associations of HLA-DQA1 and DQB1 alleles with systemic scleroderma (SSc) in Zhuang and Han nationalities in Guangxi Zhuang Autonomous Region. Methods Genomic DNA was extracted from the peripheral blood of SSc patients of Zhuang (n=50) and Han (n=50) nationality,normal controls of Zhuang (n=100) and Han (n=100) nationality in Guangxi Zhuang Autonomous Region.PCR with sequence-specific primers (PCR-SSP) was used to detect HLA-DQA1 and -DQB1 alleles in these subjects. Results There was a significant increase in the frequency of HLA-DQA1*0401, -DQBl*0501 and -DQB1*0601 alleles in the patients of Zhuang nationalty(RR=4.056,χ2=15.407,PC=0.001;RR=4.472,χ2=10.653,Pc=0.004;RR=3.473,χ2=10.06,Pc=0.008)compared with normal controls of Zhuang nationality,and in the frequency of HLA-DQA1*0401,DQA1*0601 and DQB1*0601 alhles in patients of Han nationality (RR=9.333,χ2=8.371,Pc=0.036;RR=8.071,χ2=20.130,Pc=0.000;RR=3.764,χ2=10.755,Pc=0.004)compared with normal control of Han nationality.However,the frequency of HLA-DQA1*0201 allele was statistically lower in the patients of Zhuang and Han nationality than in the controls of corresponding nafionality (χ2=13.583,Pc=0.002;χ2=12.209,Pc=0.004).Conclusions HLA-DQA1*0401 and-DQB1*0601may be susceptible genes for SSc in Zhuang and Han nationalities,HLA-DQB1*0501 for Sse in Zhuang nationality,and HLA-DQAl*060l for SSc in Han nationality in Guangxi Zhuang Autonomous Region.

Many clinical studies have demonstrated that raised morning blood pressure surge is closely related to path‐ogenesis and prognosis of cardiovascular diseases ,but there is still no unified understanding for its prevention until now ,and raised morning blood pressure surge phenomenon is not effectively controlled in most patients .The pres‐ent article made a brief review on raised morning blood pressure surge .

Objective To explore the clinical and MDCT features of pediatric irreducible intussusception. Methods 66 patients were divided into irreducible intussusception group (19 cases) and reducible intussusception group (47 cases). Age clinical courses, length of intussusception body (L), neck max diameter (D1), head max diameter (D2) andthe ratio (D2/D1) and MDCT imaging data were compared and analyzed. Results (1) The course time, L and D2/D1 values of irreducible intussusception group were significantly higher than those of reducible group, the D1 was lower than that ofreducible group, and the difference is statistically significant (P<0.05). Clinical course,L and D2/D1 value AUC values were more than 0.7, the threshold values were 33.0 h, 7.5 cm and 1.33. (2) The occurrence rate of non-ileum-colon intussusception, Meckel's diverticulum, appendicitis and intestinal necrotic for irreducible intussusception were 36.8%, 21.1%, 21.1%, 15.8%and 10.5%respectively. Conclusion Whenthe time of course>33.0 mo, D2/D1>1.33 and L>7.5 cm, the irreducible intussusceptioncould be considered, and Meckel??s diverticulum, intestinal necrosis, appendicitis and intestinal obstruction should be judged further.

Radiotherapy is the main treatment for nasopharyngeal carcinoma .The intensity modulated ra-diation therapy is one of the most ideal radiotherapy technology for nasopharyngeal carcinoma .Local recurrence and distant metastasis are still the main reasons responded to the radiation fails .Therefore,chemoradiotherapy has become the most recommended treatment for nasopharyngeal carcinoma ( NPC) ,and the synchronous chemoradio-therapy is a widely accepted joint model .Neoadjuvant chemotherapy shows significant advantages comparing to concurrent chemoradiotherapy in reducing the adverse reactions ,while it is uncertain whether the follow -up ma-intenance chemotherapy can improve total survival .The understanding of targeted drugs in chemoradiotherapy is still in early stage,but the result is worth looking forward to .In addition,novel treatments and concepts ,including immune therapy and biological chemotherapy ,are attracting more and more attention .

The development of renal transplantation from living relative donors relives the shortage of transplanted organs,and benefits patients with end-stage renal diseases.However,when seen from the aspect of donors,implementing a non-therapeutic invasive surgical treatment on a healthy person still violates the absolute sound principle of medical ethics.To reduce the harm to the minimum,a comprehensive assessment should be conducted before the transplantation,and long-term follow-up observations after transplantation should also be strengthened.

Objective To compare the efficiency of acute physiology and chronic health evaluation (APACHE)Ⅱ and Ⅳ in mortality risk prediction of severe acute pancreatitis (SAP).Methods From January 2013 to December 2014,SAP patients admitted to intensive care units (ICU) were retrospectively analyzed in single center.The clinical data of the first 24 hours since the patients admitted into ICU were collected.The modified Marshall score,APACHE Ⅱ and APACHE Ⅳ score were calculated.The mortality risk predictive value of each patient was calculated by APACHE Ⅱ and APACHE Ⅳ.According to the final clinical outcome of patients,Hosmer-Lemeshow was performed to compare real mortality rate with predictive mortality rate,and calibration of APACHE Ⅱ and APACHE Ⅳ in the mortality risk of each patients was evaluated.The resoluation of the two scoring systems was compared by the area under the receiver operator characteristic curve (AUC).Results In the end,192 patients (152(79.2％) survivors and 40(20.8％) dead) were enrolled.Modified Marshall score,APACHE Ⅱ score and APACHE Ⅳ score of patients in dead group was 6.30±0.36,21.3±8.0 and 88.1± 30.2,respectively;and those of survival group was 3.70 ± 0.20,12.3 ± 5.6 and 53.4 ± 19.0,respectively,and the differences between two groups were statistically significant (t-6.436、-6.683、-6.913,all P＜ 0.01).The results of Hosmer-Lemeshowin calibration of APACHE Ⅱ and APACHE Ⅳ indicated that both two systems could predict mortality risk of SAP patients well (P＞ 0.05).The AUC of APACHE Ⅱ score (cut-off ≥26) and APACHE Ⅳ score (cut off≥91) was 0.81(95％CI 0.74 to 0.89) and 0.83(95％CI 0.75 to 0.90),respectively,and the difference was not statistically significant (x2 =0.21,P=0.644),which indicated that there was no statistically significant difference in calibration.Conclusions APACHE Ⅳ scoring system is not better than APACHE Ⅱ scoring system in prognosis prediction of SAP patients.The prognosis of SAP patients could be accurately evaluated by APACHE Ⅱ.