Objective To protect patients and employees from being polluted and the inferiors,and to build a prototype to enhance the supply chain security of medical consumables according to JCI.Method According to the supply chain security model,adopting corresponding measures of the design of the supply chain management of medical consumables.Result The supply chain security capabilities are enhanced and the risk is reduced in accordance with the quality requirements of JCI.Conclusion The security model applied in the supply chain management of medical consumables can effectively strengthen the security of the supply chain.

Background The clinical efficacy and safety of mouse nerve growth factor(NGF) for injection have been evaluated by Ⅰ,Ⅱ,Ⅲ stage of clinical trials.But as a clinical drug,its adverse effects for special population should been further studied.Objective This clinical trial was to observe and assess the safety and tolerability of mouse NGF for injection during the application in juvenile and elder patients with optic nerve damage.Methods A multicenter non-randomized controlled trial for the safety evaluation of mouse NGF injection solution was performed in 100 eye centers in China.This study protocol was approved by the Ethic Committee of each drug research center,and written informed consent was obtained from the subject,legal mandatary and guardian prior to this study.Total 2046 patients who met the included criteria of optical nerve damage were enrolled.The patients were divided into the juvenile group(90 cases,＜ 18 years),youth-middle-age group (1868 cases,1 8-75 years) and older group(88 cases,＞75 years).Mouse NGF(30 μg)was intranuscularly injected once per day for 21 days in all the patients.Systolic and diastolic blood pressure,heart rate,intraocular pressure (lOP),laboratory examinations of blood and urine,blood biochemical indexes were recorded before and after injection.All adverse events were evaluated after administration of drug.Results There were 189 (189/2046,9.23％)dropped out cases,including 184 lost cases after 3 weeks of treatment and 5 withdrew cases from adverse responses of drug,with a shedding rate ＜10％ in each group.Total 1857 individuals finished this trial.No significant differences were found in the IOP,heart rate and blood pressure between before and after admninistration of grug in the juvenile group,youth-middle-age group and older group (P＞0.05).The incidence rate of the adverse response in the juvenile group,youth-middle-age group and older group was 57.78％,68.18％,60.01％ respectively,and the primary local adverse events were pain(48.89％),redness and swelling(59.09％),duration(54.49％),without significant difference in the rate of local adverse events among the three groups(X2 =2.302,P =0.324).The abnormal rates of laboratory results of blood and urine were not significantly different among the three groups(all at P＞0.05).The percentage of impaired fasting glucose was 7.46％,23.73％and 7.79％ in the juvenile group,youth-middle-age group and older group,respectively,and the percentage in the older group was higher than that in the juvenile group and the youth-middle-age group (x2 =8.685,P =0.005 ;x2 =27.720,P =0.000).Conclusions Injection of mouse NGF is well tolerated in juvenile and elder patients over the age of 75 years.

Objective To evaluate the consistency of fetal brain ultrasound screening and neurosonogram (NSG) with magnetic resonance imaging (MRI),and the clinical values of ultrasound and NSG in the diagnosis of fetal nervous system abnormalities,and the values of NSG in the diagnosis of fetal brain malformations.Methods A retrospective study was conducted on 221 gravidas who were diagnosed with fetal brain development abnormality by ultrasound screening or NSG in Peking University First Hospital between January 2012 and July 2015 and received fetal brain MRI within one week after ultrasound examination.According to the saved images,the 221 cases were divided into two groups:fetal brain ultrasound basic screening group (111 cases) which had three basic transverse planes and NSG group (110 cases) which had ten basic transverse planes.There were four conditions according to the diagnostic results of ultrasonography and MRI:ultrasonography and MRI suggesting the same diseases (A);ultrasonography and MRI suggesting the same diseases,but MRI providing more information for diagnosis (B);ultrasonography and MRI suggesting different diseases (C);ultrasonography suggesting abnormal,but MRI suggesting normal (D).Diagnostic results of ultrasonography and MRI were respectively comparatively analyzed in the two groups.T-test and Chi-test were used for statistical analysis.Results The diagnostic results for NSG group and fetal brain ultrasound basic screening group were listed as follows:A:70.9％(78/110) and 44.1％(49/111);B:7.3％ (8/110) and 8.1％ (9/111);C:3.6％ (4/110) and 21.6％ (24/111);D:18.2％ (20/110) and 26.1％ (29/111).The consistency with MRI results was higher in NSG group than that of fetal brain ultrasound basic screening group (x2=18.985,P＜0.001).Conclusions Compared with fetal brain ultrasound basic screening,NSG provides more consistent results with MRI,suggesting its great clinical value in the diagnosis of fetal nervous system malformations.

Objective To observe the clinical efficacy and safety of immediate-effect moxibustion combined with massage for the treatment of knee stiffness after knee ligament reconstruction surgery.Methods A total of 138 patients after knee ligament reconstruction surgery were randomly divided into control group and observation group,69 cases in each group.The control group received joint rehabilitation therapy,which included TDP light radiation,joint exercise by continuous passive motion apparatus,contraction and relaxation of quadriceps femoris muscle and ankle pump.The treatment group was given immediate-effect moxibustion combined with massage based on the treatment for the control group.The treatment lasted from postoperative day 3 to 14.Before and after treatment,Lysholm knee joint scores,joint activity scores and activities of daily living(ADL) scores of the two groups were observed.Results After treatment,the Lysholm knee joint scores,joint activity scores and ADL scores of the two group were obviously increased (P ＜ 0.05 or P ＜ 0.01 compared with those before treatment),and the increase in the observation groups was superior to that in the control group,the differences of the alove indexes except for joint activity scores being statistically significant between the two groups (P ＜ 0.05 or P ＜ 0.01).Conclusion Immediate-effect moxibustion combined with massage is effective on preventing knee from postoperative ankylosis after knee ligament reconstruction surgery.

Background Retinal hypoxia is one of primary causes of retinal neovascularization,and its mechanism is research hot topic.Studies showed that hypoxia stimulates the activation of many trancripation factors and vascular endothelial cells,which leads to angiogenesis.Besides to the vascular endothelial growth factor,the effect of adenosine on angiogenesis is increasingly concerned.Objective This study was to invastigate the relationship of biological behaviour of human microvascular endothelial cells (HMEC-1) under the hypoxia and adenosine,and to explore the effect of adenosine on angiogenesis under hypoxia.Methods HMEC-1 cell line was cultured in vitro,and the cells were divided into normoxia group and hypoxia group.The cells in the normoxia group were cultured under the 5％ CO2 environment,and those in the hypoxia group were cultured under the 1％ O2,94％ N2 and 5％ CO2 environment.The proliferation ability and percentage of the cells were assayed by cell counting kit-8 (CCK8) and EDU.The migration number and invasive number of the cells were detected by transwell chamber.The expressions of CD39 and CD73 proteins in the cells were tested by Western blot and immunofluorescence technique,and the level of adenosine was measured by high performance liquid chromatography (HPLC).Results The proliferation values (absobancy) were 0.715-±0.067 and 0.821 ±0.056 in the normoxia group and the hypoxia group in 12 hours after culture,and those in 24 hours were 0.946±0.028 and 0.998±0.028,showing significant increase in the hypoxia group compared with the normoxia group (t12h =3.805,t24h =3.222,all at P ＜ 0.01).The precentage of the proliferation in the hypoxia group was evidently higher than that in the normoxia group (t =-6.868,P＜0.01).The number of the cell migration and invasion in 24 hours after culture was 185.3 ± 10.594 and 74.2± 10.741 respectively in the normoxia group,and that in the hypoxia group was 300.7±22.853 and 107.5±7.007,with significant differences between the two groups (t=-12.124,-6.367,both at P＜0.01).The expression levels of CD39 and CD73 proteins in the hypoxia group were significantly higher than those in the normoxia group in bothl2 hours and 24 hours after culture(all at P＜0.05),and the adenosine content in the cells is gradually increased in 2,6,12,24 and 36 hours after culture,with the highest content in 36 hours.The adenosine content was significantly higher in the hypoxia group than in the normoxia group at various time points (t2h =2.469,P =0.017;t6h =5.442,P＜0.001;t12h =3.841,P＜0.001;t24h =4.458,P＜0.001;t36h =2.757,P =0.008;t48h =3.319,P =0.002).Conclusions Compared with the normoxia group,the proliferation,migration and invasion abilities of HMEC-1 are stronger,meanwhile,the expression of CD39 and CD73 as well as the adenosine level in the cells are all increased under the hypoxic condition.It is suggested that the activation of human microvascular endothelial cells might be significantly related to the level of adenosine and its key enzymes.

Objective To investigate the relation between anormalities of fetal abdominal great vessels and heterotaxy, the clinical significance of screening fetal heterotaxy by the abnormalities of fetal abdominal great vessels. Methods 6532 fetuses from our hospital were scanned and the fetuses with abdominal great vessels abnormalities were included. Parameters of fetal growth, abdominal great vessels and anatomical survey were detected. Results Forty-five cases (0.7%) of fetal abdominal great vessels abnormalities were detected prenatally. Forty-two cases were confirmed postnatally, including 35 cases of heterotaxy syndrome and 7 cases of situs inversus totalis and 3 cases missed. The incidences of the abnormal fetus,heterotaxy syndrome and situs inversus totalis of the fetuses with abnormal abdominal great vessels were higher than that of the fetuses with normal abdominal great vessels, the differences were statistically significant( P＜ 0.001). The incidence of both type Ⅰ and type Ⅱ of the heterotaxy syndrome were significantly higher than that of type Ⅳ (P＜0.001). There was a high incidence of left isomerism in abnormal type Ⅰ and of right isomerism in abnormal type Ⅱ , the differences were statistically significant (P＜ 0.001). Conclusions Abnormal great vessels abnormalities have strong relations to heterotaxy and situs inversus which can be used as effective and simple indicator in screening heterotaxy syndrome.

Adult ; Diagnosis, Differential ; Dyspepsia ; blood ; Female ; Humans ; Male ; Medicine, Chinese Traditional ; Middle Aged ; Motilin ; blood

Objective To analyze the quality of life (QOL) of mothers of children with cerebral palsy and it's influencing factors.Methods The QOL of 123 children with cerebral palsy and their mothers was assessed a 36-item short form health survey (SF-36) and basic questionnaires combined with interviews.The factors influencing QOL were analyzed with t-tests and one way analysis of variance,and multiple regression analysis was used to determine the main influencing factors.Results Scores on all of the SF-36 items were much lower for mothers of children with cerebral palsy than for mothers of normal children.Average scores in the domains of emotional health,general health and vitality were the lowest (55.28,60.49 and 65.26 respectively).Correlation analysis showed that general health,physical function and role emotions were positively correlated with the child's age.All domains except pain were negatively correlated with the child's condition.Social functioning was positively correlated with the mother's age.The general health,role emotional,social function,and mental health scores were all negatively correlated with the mother's education level.Univariate analysis showed that the child's age and condition,the mother's education level and occupation,and the father's occupation all significantly predicted the mother's QOL.Multivariate regression analysis confirmed that the child's age and the father's occupation had significant predictive power.Conclusions The QOL of the mother of a child with cerebral palsy is mainly influenced by the child's age and condition,the mother's education level and occupation,and the father's occupation.Comprehensive and effective measures should be taken to improve the QOL of mothers of children with cerebral palsy and to improve the efficacy of rehabilitation for children with cerebral palsy.

Objective To investigate the clinical application of statins for secondary prevention and its efficacy in patients with ischemic stroke.Methods A total of 300 patients with ischemic stroke were divided into statins group (n=91) and control group (n=209) according to whether statins was received or not.Serum lipid parameters,liver and kidney function,carotid artery intimamedia thickness (IMT) and plaque area were compared between the two groups.Results In 209 patients not taking statins,68 cases (32.5％) were not advised by clinic doctor; 55 cases (27.8％)were reluctant to take statins in fear of adverse reactions; 77 cases (36.8％) discontinued stains when serum lipids were normal; 3 cases (1.4％) developed skin allergic reaction and the skin rash that disappeared after stains discontinuance; 3 cases (1.4％) had elevated liver enzyme levels and the enzyme levels were declined to normal after stains discontinuance.The levels of total cholesterol (TC),triglyceride (TG) and low density lipoprotein cholesterol (LDL-C) were significantly lower in statin group than in control group [(4.93±0.45) mmol/L vs.(5.87±0.38) mmol/L,(1.68±0.61)mmol/L vs.(2.01±0.58) mmol/L,(2.49±0.57) mmol/L vs.(3.76±0.44) mmol/L,t=18.60,4.46,20.94,P=0.000,0.007,0.000,respectively].High density lipoprotein (HDL-C) level was significantly higher in stain group than in control group [(1.36±0.31) mmol/L vs.(1.03±0.25)mmol/L,t=9.75,P=0.001].There were no significant differences in liver and kidney function parameters such as alanine aminotransferase,aspartate aminotransferase,alkaline phosphatase,serum total bilirubin,direct bilirubin,indirect bilirubin,glutamyl transferase,blood urea nitrogen and serum creatinine between the two groups (all P＞0.05).The carotid IMT and carotid atherosclerotic plaque area were significantly lower in stain group than in control group [(1.62 ± 0.23) mm vs.(1.74±0.31) mm,(0.57±0.12) cm2 vs.(0.65±0.18) cm2,t=3.32,3.88,P=0.008,0.002,respectively].Conclusions Most patients with ischemic stroke are still not taking statin for secondary prevention.Statins can improve the blood lipid levels and carotid arteriosclerosis status,and no obvious adverse reactions are observed.

Objective To evaluate the role of δ receptor in reduction of hypoxia-reoxygenation (H/R) injury to cardiomyocytes by morphine preconditioning in rats with chronic heart failure.Methods Adult male Sprauge-Dawley rats weighing 220-250 g were used in the study.Chronic heart failure was induced by injection of adriamycin 2 mg/kg via the tail vein once a week for 6 weeks.Their hearts were removed 2 weeks after the last injection and the cardiomyocytes were isolated and cultured.The cells were randomly divided into 5 groups ( n =8 each):control group (group C); H/R group; morphine preconditioning group (group MPC); morphine preconditioning + naloxone (opioid receptor antagonist ) group (group MPC + Naloxone) ; morphine preconditioning + naltrindole ( δ receptor antagonist) group ( MPC + Naltrindole group).The cells were cultured in normal culture atmosphere in group C and were exposed in hypoxic air for 3 h followed by 1 h reoxygenation in the other groups.Morphine preconditioning was performed immediately before hypoxia in group MPC.Naloxone and naltrindole were added before morphine preconditioning in groups MPC + Naloxone and MPC + Natrindole respectively.At 1 h of reoxygenation,the cell viability ( by MTT assay),activities of lactate dehydrogenase ( LDH ) and creatine kinase (CK),and cell apoptosis were detected.The apoptotic rate was calculated.Results The cell viability was significantly lower,and the activities of LDH and CK and apoptotic rate were significantly higher in groups H/R,MPC + Naloxone and MPC + Natrindole than in group C (P ＜ 0.05).The cell viability was significantly higher,and the activities of LDH and CK and apoptotic rate were significantly lower in group MPC than in group H/R ( P ＜ 0.05).Conclusion Morphine preconditioning reduces H/R injury to cardiomyocytes through activating δ receptor in rats with chronic heart failure.