OBJECTIVE: To survey the habits of public drug use in China and its reasons and to put forward countermeasures so as to provide reference for government and decision-making department. METHODS: From Nov. 2008 to Feb. 2009, questionnaire survey was adopted in 31 provincial administrative regions except for Hong Kong, Macao and Taiwan. 26 000 questionnaires were collected and 1 100 physicians were interviewed. SPSS17.0 software was used to analyze 11 796 valid questionnaires statistically. The frequency of words used by physicians was counted. RESULTS: The residents don’t have enough knowledge to support them to use medicine rationally. And they are not compliant with prescription but take medicine by arbitrariness. 44.88% of residents don’t buy medicines according to prescriptions and 74.39% don’t take medicine following treatment course, stop taking medicine once symptom relieve or change the category of drugs frequently. CONCLUSION: The improvement of pharmaceutical market environment, enhancement of medication guide and popularization of medication knowledge can promote rational use of drug.

BACKGROUND:Chondrocytes co-cultured with bone marrow stromal stem cells on the scaffold of platelet-rich plasma are found to proliferate, and besides proliferative growth, bone marrow stromal cells exhibit a tendency of differentiating into chondrocytes. OBJECTIVE:To study the effect of platelet-rich plasma and human umbilical cord mesenchymal stem cells (hUCMSCs) on cartilage repair. METHODS:Forty healthy New Zealand white rabbits were selected to establish models of cartilage defects, and then randomly divided into normal saline group, platelet-rich plasma group, hUCMSCs group and combination group. Platelet-rich plasma was prepared by using double centrifugations to prepare passage 3 hUCMSCs. After modeling, intra-articular injection of normal saline (0.5 mL), 12.5%platelet-rich plasma (0.5 mL), 1×107 hUCMSCs (0.5 mL), 12.5%platelet-rich plasma+1×107 hUCMSCs (total y 0.5 mL) was done in corresponding groups, respectively. After 12 weeks of modeling, the injured cartilage was grossly observed, and hematoxylin-eosin staining was used to observe cartilage repair under light microscope;according to the O'Driscol histologic standard, histological examination was performed. RESULTS AND CONCLUSION:The repair effect in the normal saline group was significantly better that in the platelet-rich plasma group, hUCMSCs group, combination group (P<0.05), while the platelet-rich plasma group and combination group also exhibit better outcomes than the hUCMSCs group (P<0.05). These findings indicate that both platelet-rich plasma and hUCMSCs can promote cartilage repair;moreover, platelet-rich plasma with or without hUCMSCs is superior to hUCMSCs alone in the cartilage repair.

Objective To investigate the predictive values of matrix metalloproteinase-9 (MMP-9) and serum ferritin (SF) for hemorrhagic transformation (HT) after acute ischemic stroke.Methods The patients with fist-ever acute ischemic stroke within 24 h of onset were selected.The demographic and clinical data were collected.The MMP-9 and SF levels were detected.The demographic and clinical data and laboratory results were compared between a HT group and a non-HT group.Multivariable logistic regression analysis was used to determine the independent risk factor for HT.The receiver operating characteristic (ROC) curve was used to identify the predictive values of MMP-9 and SF for HT.Results A total of 150 patients were enrolled,their mean age was 67.01 ± 9.11 years,including 65 males (43.33％).There were 32 patients (21.33％) in the HT group and 118 (78.67％) in the non-HT group.Univariate analysis showed that MMP-9 (161.19 ±36.86 μg/L vs.100.18 ±36.70 μg/L;t =8.333,P＜0.001) and SF (195.50 [188.25-201.00] μg/L vs.175.00[165.00-189.25] μg/L;Z =4.891,P ＜0.001) in the HT group were significantly higher than those in the non-HT group.Multivariable logistic regression analysis showed that diabetes (odds ratio [OR] 2.273,95％ confidence interval [CI] 1.019-5.070;P =0.047),atrial fibrillation (OR 4.846,95％ CI 1.934-12.146;P=0.001),MMP-9 (OR 3.176,95％ CI 1.842-5.479;P＜ 0.001),hypersensitivity C reactive protein (OR 2.243,95％ CI 1.015-4.954;P =0.045),and SF (OR 2.722,95％ CI 1.586-4.672;P ＜ 0.001) were the independent risk factors for HT.The ROC curve analysis showed that MMP-9 (area under curve 0.904,95％ CI 0.851-0.957) and SF (area under curve 0.776,95％ CI 0.684-0.869) had significant predictive values for HT.When the cut-off value of MMP-9 was 133 μg/L,the sensitivity and specificity were 84.4％ and 15.3％,respectively.When the cut-off value of SF was 187.5 μg/L,the sensitivity and specificity were 78.1％ and 27.1％,respectively.Conclusions The MMP-9 and SF levels were significantly increased in acute ischemic stroke patients with HT.Early detection of serum MMP-9 and SF levels help to predict the risk of HT.

Objective:To investigate the risk factors of acute Stanford type B aortic dissection (TBAD) complicated with pleural effusion (PE) and the short-term and long-term outcomes of thoracic endovascular aortic repair (TEVAR).Methods:A case-control study. The clinical and imaging data of 1 083 patients with acute TBAD admitted to the General Hospital of Northern Theater Command from April 2002 to December 2020 were retrospectively analyzed, including 211 cases with pleural effusion and 872 cases without pleural effusion. The baseline analysis of the two groups of patients was performed. The risk factors associated with pleural effusion were analyzed by binary logistic regression, and the results were expressed as odds ratio ( OR) and 95% confidence interval ( CI). According to the quantity of pleural effusion, they were simultaneously divided into small pleural effusion group and medium large pleural effusion group, to compare the short-term and long-term effects of TEVAR patients with different amounts of pleural effusion. Results:The incidence of pericardial effusion (17.5% vs. 3.8%, P<0.001), anemia (21.3% vs. 12.5%, P=0.001), aortic spiral tear (49.8% vs. 37.8%, P=0.002), dissection tear over diaphragm (57.8% vs. 48.1%, P=0.011), serum creatinine [85 (69, 111) vs. 81 (67, 100) μmol/L, P=0.011] and white blood cell levels[(11.3±4.2)×10 9/L vs. (10.3±4.2)×10 9/L, P=0.002] in acute TBAD pleural effusion group were significantly higher than those in non-pleural effusion group, and the hemoglobin level was significantly lower than that in non-pleural effusion group [(128±20) vs. (133±17) g/L, P<0.05]. Logistic stepwise regression analysis showed that pericardial effusion ( OR=5.038,95% CI 2.962-8.568, P<0.001), anemia ( OR=2.047,95% CI 1.361-3.079, P=0.001), spiral tear ( OR=1.551,95% CI 1.030-2.336 , P=0.002) and elevated white blood cell ( OR=1.059,95% CI 1.011-1.102, P=0.005) were independent risk factors for TBAD complicated with pleural effusion. The incidences of all-cause death (4/19 vs. 1.5% vs. 0.9%, P<0.001), aortogenic death (4/19 vs. 0.7% vs. 0.7%, P<0.001) and aortic related adverse events (4/19 vs. 1.5% vs. 1.1%, P<0.001) in patients with large pleural effusion during TEVAR operation were significantly higher than those in patients with small pleural effusion and those without pleural effusion, and the differences were statistically significant. At 1 month follow-up after TEVAR, the incidence of all-cause death (4/16 vs. 3.3% vs. 1.6%, P<0.001), aortogenic death (4/16 vs. 0.8% vs.0.7%, P<0.001), aorta related adverse events (4/16 vs. 4.1% vs. 4.7%, P=0.013) and overall clinical adverse events (4/16 vs.9.8% vs. 6.7%, P=0.014) in the medium and large thoracic group were significantly higher than those in the small pleural effusion group and no pleural effusion group, and the differences were statistically significant. At 1 year follow-up after TEVAR, the incidence of all-cause death (4/15 vs. 4.9% vs. 3.9%, P=0.004), aortogenic death (4/15 vs.2.5% vs. 2.1%, P<0.001), aorta related adverse events (5/15 vs. 11.5% vs. 9.4%, P=0.012) and overall clinical adverse events (5/15 vs. 18.9% vs. 13.1%, P=0.029) in the medium and large thoracic group were significantly higher than those in the small pleural effusion group and no pleural effusion group, and the differences were statistically significant. Conclusions:Single center data showed that pericardial effusion, anemia, spiral tear and elevated white blood cell were independent risk factors for acute TBAD complicated with pleural effusion; the early (1 month) and long-term (1 year) rates of all-cause death, aortic mortality, aortic adverse events and overall clinical adverse events were significantly higher in TBAD patients with moderate pleural effusion after TEVAR, and moderate and large pleural effusion was an independent risk factor for near and long-term aortic related adverse events after TEVAR surgery.

Objective: To explore the influences of comprehensive nursing intervention on the caregivers of severely burned children. Methods: Eighty severely burned children, admitted to our department from November 2016 to November 2017 and conforming to the study criteria, were included in this study. They were divided into comprehensive group and control group according to the random number table, with 40 children in each group. One caregiver for each child was included in the same group. Children and caregivers in control group had routine nursing care while children and caregivers in comprehensive group had comprehensive nursing care on the base of routine nursing care, including comprehensive psychological nursing of children and caregivers, guidance of rehabilitation for caregivers throughout the entire recovery process, individualized propaganda and education for caregivers on account of disease of children, perfecting social support system, sustained attention of children during follow-up. Anxiety self-rating scale and social support rating scale were used to assess the levels of anxiety and social support of caregivers of children in the two groups at the time of admission (before intervention) and the second month after discharge (the third time follow-up, after intervention). On the day of discharge, the nursing service satisfaction questionnaire of our department was used to evaluate the nursing service satisfaction of caregivers of children. Data were processed with chi-square test and independent sample t test. Results: (1) Before intervention, the anxiety and social support scores of caregivers of children in control group were respectively (64.5±3.8) and (40.4±2.5) points, similar to (63.5±4.9) and (40.5±2.6) points in comprehensive group (t=0.988, 0.177, P>0.05). After intervention, the anxiety score [(47.2±1.9) points] of caregivers of children in comprehensive group was significantly lower than that of control group [(57.6±4.3) points, t=13.917, P<0.01], and the social support score [(45.3±1.9) points] was significantly higher than (35.9±2.1) points in control group (t=-21.282, P<0.01). After intervention, scores of objective support, subjective support, and social support utilization in the social support evaluation rating of caregivers of children in comprehensive group were significantly higher than those in control group (t=12.678, -11.079, -10.031, P<0.01). (2) At the time of discharge, scores of clinical care, propaganda and education content and form in the nursing service satisfaction questionnaire of caregivers of children in comprehensive group were significantly higher than those of control group (t=-14.757, -15.627, -33.221, P<0.01). Conclusions Comprehensive nursing intervention method can effectively reduce the anxiety of the caregivers of severely burned children, help them to make better use of social support system, and improve the satisfaction of caregivers in nursing services.