OBJECTIVE:To provide reference for ration use of TCM injection. METHODS:The utilization of TCM injections in 39 hospitals from Chongqing area during 2012-2014 was analyzed statistically in respects of consumption sum,DDDs,DDC and B/A. RESULTS:The total consumption sum of TCM injections increased slowly in 39 hospitals from Chongqing area during 2012-2014,increasing from 767 581 thousand yuan to 911 759 thousand yuan,with annual growth rate of 8.98%. Total sum of consumption sum of top 10 drugs was 1 326 019.7 thousand yuan,accounting for 51.11% of total. The consumption sum of Hong-hua injection and Shenxiong glucose injection always took up the first 2 places in those years. DDDs of Xuesaitong injection, Shenxiong glucose injection glucose,Honghua injection and Shuxuetong injection always took up the first 4 places in those years. DDC of Xuebijing injection and Kanglaite injection always took up the first and second places in those years. Among top 10 TCM injection in the list of consumption sum,most of B/A was lower than 1.00;B/A of Shuxuetong injection,Xingnaojing injection, Shenqiong glucose injection and Xueshuantong injection were close or equal to 1.00. Xuesaitong injection was the one that B/A>1.00 from beginning to end. CONCLUSIONS:Total use of TCM injection increased steadily and drug use relatively concentrated in 39 hospitals from Chongqing area during 2012-2014,and rationality of drug use by physicians had been improved gradually.

Objective To explore the relevance between lymphatic metastasis and CT findings in colorectal cancer,and to estab-lish the logistic regression model to realize CT prediction for N staging in colorectal cancer.Methods Take 53 patients with complete data and colorectal cancer confirmed by pathology,and conduct correlation and regression analysis on pathological results based on the size,shape,density,edge and distribution characteristics of the regional lymph nodes that were expressed on CT images.Results It was predicted that patients with colorectal cancer showed lymph node metastasis,a number of lymph nodes with the minor axis≥ 8 mm and the irregular margin were selected in Logistic stepwise regression,the sensitivity of probabilistic model was predicted to be 85.7 %,specificity was 91.7 % and accuracy was 88.9 %;predict whether it had N2 stage,a number of lymph nodes with the heterogeneous density and the fuzzy margin were selected in Logistic stepwise regression,the sensitivity of probabilistic model was predicted to be 60.0 %,specificity 94.3 % and accuracy 86.7 %.Conclusion Lymph nodes with minor axis ≥ 8 mm,irregular margin,and heterogeneous density were the most important indicators for N staging in colorectal cancer,the combination and weigh-ting of these indicators can improve the accuracy of N staging in colorectal cancer.

OBJECTIVE:To provide reference for rational use of anti-tumor essential medicine in the clinic. METHODS:The application of anti-tumor essential medicine in 39 hospitals from Chongqing area during 2012-2014 was analyzed statistically in re-spects of consumption sum,DDDs,DDC and B/A. RESULTS:The total consumption sum of anti-tumor essential medicine in 39 hospitals from Chongqing area during 2012-2014 increased from 10 083.65 ten thousand yuan to 15 186.65 ten thousand yuan,with annual increase rate of 22.72%. 3-year total consumption sum was 37 952.45 ten thousand yuan,and the sum of consumption sum of top 10 medicines was 36 742.24 ten thousand yuan,accounting for 96.81%;top 3 medicines were paclitaxel,oxaliplatin and flu-orouracil. During 2012-2014,DDDs had changed to certain extent,and the front medicines contained tegafur,paclitaxel and cyclo-phosphamide,etc;the most increment medicine was paclitaxel (oral),whose annual growth rate was 59.63%;that of tamoxifen decreased year by year,with annual decrease rate of 5.14%. DDC of paclitaxel,oxaliplatin and etoposide were the higher others. Annual B/A of oxaliplatin,fluorouracil and cytosine arabinoside were all lower than 1.00. CONCLUSIONS:The lonsumption sum and DDDs of anti-tumor essential medicine had increased reasonably in 39 hospitals from Chongqing area during 2012-2014,while their DDC had kept stable. Main medicines used in the clinic are suitable for numerous indications,and are expensive.

[ ABSTRACT] AIM:To observe the effect of high glucose on the protein expression of calreticulin ( CRT) and its association with cell apoptosis and mitochondrial dysfunction in the cardiomyocytes.METHODS: AC-16 cardiomyocytes were randomly divided into normal glucose group, high glucose group, high glucose+CRT siRNA group and isotonic con-trol group.The cell apoptotic rate, reactive oxygen species (ROS), mitochondrial membrane potential level, respiratory enzyme activity, and protein expression of CRT were observed.RESULTS: Compared with the cardiomyocytes in normal glucose group, the apoptotic rate and ROS production of cardiomyocytes increased in high glucose group, accompanying with the decreases in the mitochondrial membrane potential level and enzyme activitiy of the respiratory chain.The protein expression of CRT was significantly increased in high glucose group.However, compared with high glucose group, high glucose+CRT siRNA decreased the expression of CRT and attenuated the damage of mitochondria, but CRT siRNA did not reduce the ROS level in cardiomyocytes.CONCLUSION:High glucose brings about CRT over-expression to induce mito-chondrial injury, thus increasing myocardial apoptosis.

Objective To explore the changes of cardiac structure and function in streptozotocin (STZ)-induced diabetic cardiomyopathy (DCM)rats so as to detect the level of angiotensinⅡ (AngⅡ)in blood and the myocardium and illuminate the role of AngⅡ in DCM.Methods We randomly divided 30 SD rats into control group and DCM group (which received a single injection of streptozotocin,65 mg/kg).The changes of cardiac structure and function were observed by ultrasonic cardiogram at the end of 16 weeks after injection.Then the changes in the myocardium were also analyzed by using hemotoxylin and eosin staining and Sirius red staining.The level of AngⅡ in blood was tested by radioimmunoassay.The expression of AngⅡ in the myocardium was detected by immunofluorescence. Results Compared with those of the controls,the hearts were dilated in DCM rats accompanied with cardiac dysfunction.There were significant increases in LVEDd,LVESd,LVEDv,and LVESv but decrease in LVEF (P <0.05).There were arrangement disorder and hypertrophic cardiomyocytes in DCM.Then the fibrosis area of DCM was significantly increased compared with that of the controls.The level of AngⅡ in blood and myocardium was significantly higher in DCM than in controls.At the same time,Pearson analysis revealed that the level of AngⅡ in blood was positively related to the collagen content of myocardium (r =0.907,P <0.05).Conclusion Our study provides experimental evidence that AngⅡ plays an important role in myocardial fibrosis of DCM.

BACKGROUND: Thoracolumbar burst fracture Dennis type B does not have significant damage in the intervertebral discs of the inferior vertebral body. To reduce fusion segment and remain normal intercalated disc, single discectomy (damaged vertebral body and supervisor vertebral body) is proposed, but because of the damage to the vertebral body, implanted screw is easy to loose following excising partial vertebral body, even cannot be fixed. However, it is still unknown whether implanted screw in the inferior vertebral body of the damaged vertebral body was stabilized using two segment discectomy with fixation.OBJECTIVE: To analyze the feasibility of single segmental spinal interbody fusion with bisegment fixation for thoracolumbar burst fracture type B.DESIGN, TIME AND SETTING: The randomized controlled in vitro study was conducted at the Laboratory of Biomechanics, Southern Medical University from June 2007 to June 2008.MATERIALS: A total of 20 fresh freezing 7-9 months pig samples (T_(13)?L_3 segment) were used, comprising 10 integral samples and 10 L_1 type B thoracolumbar burst fracture samples prepared by pre-injury and weight dropping technique.METHODS: Pig fresh thoracolumbar specimens from T_(13)?L_3 were collected to create models of type B thoracolumbar burst fracture. There were 4 groups in this study. Ten of them were selected as intact group (n=10) (fresh pig T_(13)?L_3 segment). T_1 vertebral endplate pre-injury and weight dropping technique and incremental trauma approach were used. Denis' type B burst fracture was produced, and ten of them were selected as unstable group (n=10). Firstly, unstable group was decompressed by discectomy and semivertebraectomy in upper half of the vertebral body, single level was fused with iliac and U-FRONT anterior thoracolumbar system were placed between T_(14) and L_2, as single discectomy with fixation group (n=10). Then lower disc of injury vertebra discectomy and vertebraectomy, fused with iliac U-FRONT anterior thoracolumbar system were placed between T_(14) and L_2, as two segment discectomy with fixation group (n=10). The bone graft was longer 1 mm than the bone graft region.MAIN OUTCOME MEASURES: The flexion, extension, right/left lateral bending, and right/left axial rotation range of motion (ROM) of T_(14)?L_2 were measured in each group on the spinal three-motional test machine at 10 N穖.RESULTS: The flexion, extension, right/left lateral bending, and right/left axial rotation were not stable in the unstable group.ROM was significantly increased in the unstable group compared with the intact group (P< 0.01). The primary stability was significantly elevated in the single discectomy with fixation and two segment discectomy with fixation groups. The flexion, extension, right/left lateral bending, and right/left axial rotation ROM were significantly reduced in the single discectomy with fixation and two segment discectomy with fixation groups compared with the unstable group (P < 0.05). The flexion, extension, right/left lateral bending ROM was significantly decreased in the two groups compared with the intact group, but axial rotation ROM was significantly increased (P< 0.05). Axial rotation ROM was smaller in the single discectomy with fixation group compared with the two segment discectomy with fixation group (P < 0.05).CONCLUSION: Single segmental spinal interbody fusion with bisegment fixation for thoracolumbar burst fracture type B had a good immediate stability in flexion, extension, lateral bending motion. Compared with traditional partial corpectomy L_1 between the caudal and cranial endplate of the adjacent vertebrae with bisegmental fixation, it had a better immediate stability in axial rotation.

Objective To investigate the clinical applications of 64-MSCTA for the follow-up of endovascular stent-graft exclusion (EVE). Methods Between Oct 2006 and Feb 2008, forty-four 64-MSCTA examinations were performed in 30 patients with aortic dissection (AD) and 5 patients with abdominal aortic aneurysm (AAA) who underwent EVE. Imaging reconstruction including MPR, MIP and VR were finished on workstation. The outcomes and complications after EVE of aortic dissection and aortic aneurysm were evaluated. Results (1) Of 30 patients with aortic dissection, large thrombosis in false lumen was observed in 28 cases and small thrombosis in 2 cases. The cavity of aortic aneurysm outside the stent was thrombosed completely in 5 patients with AAA. (2) Thrombosis in the innominate artery on follow-up CTA after EVE was found in 1 AD patient with the innominate artery involved, Thrombosis in the superior mesenteric artery was observed on 15 days follow-up CTA but thrombolysis on 3 months after EVE in 1 case, lntimal tear in right common iliac artery was found in 1 case. Of 5 patients with AAA, occlusion of right inner iliac artery was observed in 1 case, and instent thrombosis in distal right common iliac artery was found in 1 case. (3) Endoleak was found in 14 patients with AD, including 8 with type Ⅰ and 6 with type Ⅲ endoleaks, one type Ⅲ endoleak was disappeared on follow-up CTA after 3 months. Conclusions 64-MSCTA with fast, non-invasive and effective merits, combining multiple reconstructive methods, has become one of preferred imaging methods in post-operative evaluation of EVE.

Objective To investigate the pathotypes,epidemiological characteristics and antimicrobial resistance of diarrheagenic Escherichia coli (DEC) in children with acute bacterial diarrhea in Shanghai.Methods A total of 2 071 outpatient children with probable acute bacterial diarrhea referred to the enteric clinic of Children's Hospital of Fudan University during June 2012 to June 2014 were enrolled in our study.The stool samples were processed for routine microbiologic and biochemistry tests to identify enteric bacteria,including enteropathogenic Escherichia coli (EPEC),enterotoxigenic Escherichia coli (ETEC),enteroinvasive Escherichia coli (EIEC) and enterohemorrhagic Escherichia coli (EHEC).Kirby-Bauer method was used to identify the antibiotic sensitivity.Difference of means between groups was compared by chi-square test.Results Of 2 071 enrolled children,DEC were identified in 145 (7.0 ％)cases.148 strains were isolated with three of mix infection strains.All DEC isolates in this study included 106 (71.6％) EPEC,24 (16.2％) ETEC,16(10.8％) EIEC and 2(1.4％) EHEC.The median ages of diarrheal children with DEC infections were 14 months (range:3 months to 13 years) and 62.8％ of them were ＜2 years.Among 125 DEC isolates tested for antimicrobial susceptibility,the rates of resistance to ampicillin,trimethoprim-sulfamethoxazole,cefotaxime,cefepime,gentamicin,ceftazidime,amoxicillinclavulanate,ciprofloxacin,and ofloxacin in a descending order were 55.2％,35.2％,28.0％,27.2％,23.2％,8.8％,5.6％,4.0％ and 4.0％,respectively.Resistance rates of EIEC to cefotaxime,cefepime and ceftazidime were 50.0％,43.8％ and 25.0％,respectively,which were higher than those of EPEC,ETEC and EHEC.Conclusion DEC is the important enteric bacteria that causes bacterial diarrhea in children in this study.

Objective:To observe the effect of enriched rehabilitation training on cognitive function, plasma mir-146a-5p microRNA precursor levels and inflammatory factors in persons with post-stroke cognitive impairment (PSCI).Methods:Fifty-eight persons with PSCI were randomly divided into an observation group and a control group, each of 29. The observation group was given enriched rehabilitation training, while the control group was provided with conventional cognitive rehabilitation training. The Montreal Cognitive Assessment Scale (MoCA), the Digit Span Test (DST), parts A and B of the Trail Making Test (TMT A-B) and the Modified Barthel Index (MBI) were used to assess the subjects′ cognitive functioning and their ability in the activities of daily living (ADL). Plasma levels of mir-146a-5p, IL-6 and TNF-α were detected before and after the treatment.Results:After treatment, the average MOCA, DST and MBI scores, as well as the average TMT A-B times had improved significantly for both groups. However, the observation group′s averages were significantly better than those of the control group on all three tests. After the treatment, the average plasma expression of miR-146a-5p had increased significantly in both groups, but the increase in the observation group was significantly greater. Plasma IL-6 and TNF-α levels were significantly lower than before the treatment, with the average TNF-α level in the observation group significantly lower than that of the control group.Conclusions:Enriched rehabilitation training can improve the cognition of stroke survivors more effectively than conventional cognitive rehabilitation training. That may be related to the up-regulation of plasma miR-146a-5p and reducing inflammation.

This article describes a novel Multifunctional and Transparent Urinary System Model (MTUSM), which can be applied to anatomy teaching, operational training of clinical skills as well as simulated experiments in vitro. This model covers kidneys, ureters, bladder, prostate, male and female urethra, bracket and pedestal, etc. Based on human anatomy structure and parameters, MTUSM consists of two transparent layers i. e. transparent organic glass external layer, which constraints the internal layer and maintains shape of the model, and transparent silica gel internal layer, which possesses perfect elasticity and deformability. It is obvious that this model is preferable in simulating the structure of human urinary system by applying hierarchical fabrication. Meanwhile, the transparent design, which makes the inner structure, internal operations and experiments visual, facilitates teaching instruction and understanding. With the advantages of simple making, high-findelity, unique structure and multiple functions, this model will have a broad application prospect and great practical value.
Female ; Humans ; Kidney ; Male ; Models, Anatomic ; Models, Biological ; Prostate ; Ureter ; Urethra ; Urinary Bladder ; Urogenital System ; anatomy & histology