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Objective To analyze the regularity and characteristics of 2621 cases of adverse drug reaction (ADR) occur-ring in our hospital during 2013-2016 ,and to explore the factors and causes of ADRs ,so as to provide evidence for the contin-uous improvement of rational use of drugs .Methods 2621 cases of ADR reports were retrospectively analyzed by monitoring software to extract ADR report source ,patient age and sex ,related pharmaceutical dosage forms ,routes of administration , clinical characterization ,organ involvement and other information .The Pareto method was used to identify the main drugs that caused ADR and ADR factorial analysis was performed with Fishbone diagram .Results ADR mainly reported by physicians (2573 cases ,98 .17％ ) and pharmacists reported at least (3 cases ,0 .11％ );population aged >70 years accounted for the lar-gest proportion (570 cases ,21 .74％ );ADR mainly caused by intravenous infusion (1680 cases ,64 .10％ ) .The clinical mani-festations were gastrointestinal system lesions (717 cases ,24 .17％ ) .Pareto analysis showed that the main drug factors in-volved anti-infective drugs ,anti-neoplastic drugs ,Chinese medicine injections and parenteral nutrition drugs .Fishbone analysis showed that elderly patients ,intravenous administration ,incomplete monitoring and related drugs were the determining factors associated with ARDs .Conclusion The close attention should be paid to monitoring and guidance of special populations ,espe-cially the elderly ;reducing intravenous forms ,monitoring the main factors of medicines ,carrying out the individualized medica-tion monitoring ,strengthening clinical pharmacy ,in order to promote clinical rational use drug and reduce the occurrence of drug-induced diseases .
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Objective To observe the effects of total glucosides of white paeony(GWP) on psychological ethology and neuroendocrine system of stress rats. Methods Ten male Sprague-Dawley rats were treated as normal control group,the others (n=40) were constructed by isolated custody and chronic unpredictable stimuli to build the model of stress rats.Stress rats were randomly divided into 4 groups:model control group,GWP high dose group and low dose(66,33 mg·kg-1) group,fluoxetine(5. 0 mg·kg-1) group,each group had 10 rats.The changes of rat behavior were monitored by locomotor activity system.The change of emotion was observed by tail suspension test.The pathology change of adrenal was observed by HE staining.The levels of CorT and ACTH in serum were measured by radioimmunoassay.The expression of CRH mRNA of hypothalamic were detected by RT-PCR. Results The activity of the level scoring and vertical scoring of GWP high dose group was obviously improved as compared to that in model control group,while static time was significantly shortened,Adrenal index of GWP groups were increased significantly(P<0.05),thymus index of the treatment group was declined(P<0.05),CorT and ACTH content were decreased (P<0.05) and hypothalamus CRH mRNA of GWP group was decreased(P<0.05). Conclusion The improvement of activity and related hormone anomalous changes were observed in rats treated with GWP.The mechanism of its actions might be involved adjusting the endocrine function,decreasing CorT and ACTH content and the expression of hypothalamic CRH mRNA of stress rats.
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Objective To investigate the value of conventional ultrasound and CEUS in diagnosis of thyroid nodules with Logistic regression models.Methods A total of 218 cases of thyroid nodules (74 cases of malignant,144 cases of benign nodules) confirmed by pathology were enrolled.The boundary,morphology,anteroposterior and transverse diameter ratio,microcalcification,internal echogenicity,blood distribution and enhanced pattern of nodules were observed and analyzed with univariate analysis.The Logistic regression model was established with parameters which were significantly different of those features,and the receiver operating characteristic curves (ROC) were constructed.Results Hypoechoic,irregular morphology,blurred boundary,anteroposterior and transverse diameter ratio≥ 1,microcalcifications,blood distribution (Ⅰ,Ⅱ),heterogeneous enhanced pattern and low enhanced were significantly prognostic factors (all P＜0.01).Irregular morphology,microcalcifications,heterogeneous enhanced and low enhanced were independent prognostic factors (all P＜0.05).The accuracy of Logistic regression model was 82.57％,and the area under ROC curve was 0.906.Conclusion The Logistic regression model of boundary,morphology,anteroposterior and transverse diameter ratio,microcalcifica tions,internal echogenicity,blood distribution and enhanced pattern can help to diagnose malignant thyroid nodules.
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AIM:In this study, the rat lung injury model was induced by ammonium chloride for studying the effect of imidapril on blood gas, serum TNF-α, IL-6 and MDA concentrations, and AngⅡand CD54 protein expression in rat lung tissue.METHODS:Male rats were randomly divided into 3 groups:control group, lung injury model group and drug group.The rats in control group were given saline (2 mL/kg), while the rats in lung injury model group were given 6% ammonium chloride (2 mL/kg).In drug group, imidapril (3 mg· kg-1· d-1) was given to the rats once daily for 1 week by intragastric gavage after given 6%ammonium chloride.On the 7th day, the rats were anesthetized with 2% so-dium pentobarbital.Abdominal aorta blood, venous blood and lung tissue were collected.The blood gas indexes and serum TNF-α, IL-6 and MDA concentrations were determined.The lung tissues were fixed and sliced, and the expression of AngⅡ and CD54 proteins was detected by immunohistochemistry.RESULTS: The PaCO2 increased in lung injury model group compared with control group and drug group (P<0.05).The expression of AngⅡand CD54, and the concentrations of TNF-α, IL-6 and MDA also increased significantly ( P<0.01) in model group.Pulmonary edema, inflammation, alveo-lus congestion, hemorrhage and hyperplasia in model group were obvious compared with control group and drug group. CONCLUSION:Imidapril improves blood gas indexes, and reduces lipid peroxidation and inflammatory responses in the rats with lung injury induced by ammonium chloride.
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Objective To investigate hospitalized children's nutritional risk and malnutrition occurrence,and to provide clinical basis for nutrition support.Methods Nutritional risk screening tool STRONGkids was applied to 651 cases of hospitalized children with nutritional risk screening,and through physical measurement to assess children' s nutritional status,at the same time during the patient's diagnosis,the length of time data for analysis was recorded.Results Of 651 cases of hospitalized children,7.07％ (46 cases) were of highly nutritional risk,80.95％ (527 cases) with moderate nutrition risk,and 11.98％ (78 cases) were of low nutrition risk.Malnutrition rate was 22.58％,moderate malnutrition in 111 cases (17.05％),severe malnutrition in 36 cases (5.53％).The first three high risk diseases were congenital heart disease,chronic liver disease and chronic kidney disease(x2 =21.43,P ＜0.01).According to the result of nutrition evaluation concluded with congenital heart disease,chronic kidney disease occurred with severe malnutrition was far higher than other diseases(x2 =16.53,P ＜ 0.05).Children with highly nutritional risk were more likely to have weight loss than the children with relatively low nutritional risk (P ＜ 0.05),and their length of hospital stay were obviously longer than the children with low or moderate nutritional risk (P ＜ 0.05).Conclusions The hospitalized children have high incidence of malnutrition,and different nutritional risks lead to different clinical outcomes.STRONGkids score method helps to evaluate nutritional risk in hospitalized children and detect malnutrition and potential deterioration,which is conducive to early comprehensive nutritional assessment and proper nutritional treatment,thus to improve their clinical outcomes.