To promote the understanding and practice of evidence-based medicine (EBM) in coronary artery bypass grafting (CABG). The transition of CABG graft materials from saphenous vein to arterial conduits were perceived using the principles of EBM. The arterial conduits were increasingly performed based on the principles and practice of EBM, therefore the postoperatively long-term graft patency rate, survival rate, and free cardiac event rate were significantly improved. CABG outcomes can be significantly improved by using arterial conduits based on principles of EBM.

Objective To investigate the expressions of insulin-like growth factor receptor-1 (IGF-1R) and insulin-like growth factor binding protein-3 (1GFBP-3) and their correlations with clinicopathological parameters in the primary colon cancer,as well as their roles in lymph node metastasis of colon cancer.Methods The expressions of IGF-1R and IGFBP-3 in 78 cases of colon cancer tissues and 78 cases of normal colon mucosa tissues were detected by SP immunohistochemical technology and the correlations between the expressions and the clinical pathological parameters of colon cancer were analyzed.Results The positive rate of IGF-1R in colon cancer (66.7％,52/78) was significantly higher than that in control group (24.4％,19/78),x2 =28.150,P =0.000.The positive rate of IGFBP-3 in colon cancer (73.1％,57/78) was significantly lower than that in control group (89.7％,70/78),x2 =7.158,P =0.007.IGF-1R expression in colon cancer was significantly correlated with the invasion (x2 =5.804,P =0.016),TNM stage (x2 =5.246,P =0.022) and lymph node metastasis (x2 =12.955,P =0.000).IGFBP-3 expression in colon cancer was signi-ficantly correlated with the TNM stage (x2 =7.096,P=0.008),lymph node metastasis (x2 =5.893,P =0.015) and distant metastasis (P =0.003).Both with other factors had no significant correlation (P ＞ 0.05).1GF-1R expression and IGFBP-3 expression showed a negative correlation (r =-0.245,P =0.03).Conclusion The over expression of IGF-1R and low expression of IGFBP-3 are associated with TNM stage and lymph node metastasis in colon cancer.IGF-1R and IGFBP-3 may become new targets of the treatment of colon cancer.

Objective:To explore the importance of preventive maintenance (PM) of the medical equipment operation and maintenance management system in hospital quality control module. Methods:By introducing the quality control module of maintenance management system into medical equipment operation, the test data was analysed and medical equipment PM plan was developed. Results:Medical equipment PM plan can effectively reduce the failure rate of equipment, thus guaranteeing the normal operation of the equipment. Conclusion:The application of hospital medical equipment operation and quality control module of maintenance management system, can make more accurate statistics for failure cycle and failure rate of hospital equipment, implement the new PM plan, effectively reduce the failure rate and operation cost of hospital equipment, and improve equipment utilization.

Objective To summarize the clinical experience of endovascular intervention for intra-cranial aneurysms, especially in the respect of the technique and management of intra-operative complications. Method The clinical data of 60 patients with intra-cranial aneurysms treated with endovascular intervention in the past 3 years were analyzed. The relevant literature especially with regard to the practical technique described was reviewed so as to potentiall minimize and properly manage the intra-operative complications. Results A total of 69 sacciform aneurysms and one dissecting aneurysm located at left vertebral artery (VA) were detected by using digital subtraction angiography (DSA) in 60 patients. There were 65 saccular aneurysms obliterated with constructive approach, and five of them treated with stent-assisted technique and four of them treated with ballon-assisted technique. The VA dissecting aneurysm was obliterated with coils by deconstructive approach with complete occlusion of its parent vessel. There were a total of 53 complete occlusions of aneurysms accounted for 76.81% of 69 sacciform aneurysms in 51 patients ( 85 % ) and eight subtotal occlusion of aneurysms (95 % ～ 99 % occlusion) accounted for 13.56% of total sacciform aneurysms in five patients (8.47%) and four incomplete occlusion of aneurysms ( ＜ 95% occlusion) accounted for 6.78% of total sacciform aneurysms in three patients (5.08%), and one was failure in operation. The rupture of aneurysms occurred during operation in4 patients (6.78%). Two senile patients suffered from intra-opeartive symptomatic thromboembolisn. One patient had stent shifting and spring coil dislocated and moved into the M3 segment of the ipsilateral MCA. Vasospasm occurred in 15 patients during operation, and most of them received endovascular intervention 3 days after the initial ictus. The rate of good recovery was 93.3% at discharge from hospital (the modified Rankin Scales, mRS＜ 2). There were 55 patients followed up for up 24 months after discharge, and excellent recovery rate was found in 51 patients ( mRS ＜ 2), and 3 died.During the follow-up period, no aneurismal recanalization or rupture was noticed in all patients. Conclusions The endovascular intervention is a safe and effective approach to the intra = cranial aneurysms. Advances in the skill of technique and proper management will decrease the complications during operation and improve the prognosis of patients.

OBJECTIVE:To prepare anti-tumor drug H6(lactone compound)polymeric micelles,and to investigate its in vitro anti-tumor effects. METHODS:Using mPEG2000-PCL4000 as carrier,H6/mPEG2000-PCL4000 micelles were prepared. Using particle size, PDI and 48 h whether to produce precipitation as indexes,feeding ratio,H6 concentration,volume ratio of organic solvent were screened. The encapsulation efficiency and drug-loading amount of micelle were all detected. MTT assay was used to detect the tox-icity of micelles and H6 solution to human non-small cell lung cancer cell A549 and human lung cancer cell H460. RESULTS:The screened formulation was as follows as feeding ratio of 1∶25,H6 concentration of 2 mg/mL,the ratio of ethanol to chloroform of 1∶1(V/V). The parameters of prepared H6/mPEG2000-PCL4000 micelles were as follows as particle size of(40.74±0.116 3)nm,PDI of(0.101±0.006),encapsulation efficiency of(94.87±0.016 3)%,drug-loading amount of(7.07±0.001 5)%(n=3). IC50 of mi-celles and H6 solution to A549 cell were 15.62 and 12.57 nmol/L;IC50 of micelles and H6 solution to H460 cell were 27.68 and 15.19 nmol/L. CONCLUSIONS:H6/mPEG2000-PCL4000 micelles are prepared successfully and show in vitro anti-tumor effects.

Objective To investigate the relationship of the activation of nuclear factor kappa B(NF-kB) with myocardial neutrophil infiltration and injury in human open heart surgery,and to observe the inhibiting effect on the activation of NF-kB and protecting effect on myocardium of the coenzyme Q10,a scavenger of oxygen free radicals.Methods Forty-seven adult patients undergoing open heart surgery were randomly divided into two groups,the control and the treatment.CoenzymeQ10 tablets were given to the treatment group 5 days before operation.Biopsy of right atrium for myocardial pathology,activated NF-kB detection and ultrastructure observation were done prior to cardiopulmonary bypass,45 minutes of ischemia and 45 minutes of reperfusion.The dynamic indexes,vasomotor drug dosage,and outcomes were observed postoperatively.Results Upon 45 minutes of ischemia and 45 minutes of reperfusion,in control group there were neutrophil accumulation and adhesion of vascular endothelium,ultrastructural damages,and positive expression of NF-kB both in nuclei and cytoplasm,in myocardium.In treatment group,there were only mild neutrophil infiltration and ultrastructural damages,and weak positive expression of NF-kB both in nuclei and cytoplasm.However,the dynamic indexes,vasomotor drug dosage,and outcomes of two groups were not significantly different.Conclusion NF-kB plays an important role in pathophysiological process of myocardial ischemia and reperfusion in open heart surgery.CoenzymeQ10 has obvious inhibiting effect on activation of NF-kB and protecting effect on myocardium.

OBJECTIVE: To discuss the development direction for hospital pharmacists in the medical reform and to promote rational use of drugs.METHODS: The status quo for the medical reform was analyzed based on the practicality of hospital and the author's perspectives on how to improve pharmaceutical care level was presented.RESULTS & CONCLUSIONS: Hospital pharmacists should change pharmaceutical care model to face up to the challenges in the medical reform by establishing clinical pharmacists' team and setting up pharmaceutical care center to improve pharmaceutical care level and adapt to the development of medical reform.

Objective: To analyze the trend in burden of rheumatoid arthritis (RA) in China from 1990 to 2021, so as to provide insights into reducing the RA burden in China. Methods: Data of Global Burden of Disease Study 2021 were collected, and the incidence, mortality and disability-adjusted life years (DALY) of RA in China from 1990 to 2021 were analyzed and compared with global and different Socio-demographic Index (SDI) regions. The trend in burden of RA was analyzed using average annual percent change (AAPC). Results: The crude incidence rates of RA in China increased from 10.87/105 in 1990 to 17.38/105 in 2021, the crude mortality rates increased from 0.41/105 to 0.72/105, and the crude DALY rates increased from 34.26/105 to 58.61/105, with the increases of 59.98%, 77.95% and 71.06%, respectively. From 1990 to 2021, the standardized incidence rates of RA in China showed an increasing trend (AAPC=0.545%, P<0.05), the standardized mortality rates showed a decreasing trend (AAPC=-0.783%, P<0.05), and the standardized DALY rates showed no significant trend (AAPC=-0.017%, P>0.05). In 2021, the standardized incidence rate, standardized mortality rate and standardized DALY rate of RA were higher in females than in males; from 1990 to 2021, the standardized DALY rates of RA showed a decreasing trend in females (AAPC=-0.200%, P<0.05) and an increasing trend in males (AAPC=0.316%, P<0.05). The crude incidence rates of RA first increased and then decreased with age in 2021, reaching the highest in the age group of 75-<80 years at 34.36/105. Both the crude mortality rates and the crude DALY rates increased with age, reaching the highest in the age group of 95 years and older at 26.72/105 and 285.67/105, respectively. The standardized incidence rates and standardized DALY rates of RA in China in 2021 were lower than those in high SDI regions, while the standardized mortality rate was lower than that in medium-low SDI regions. Conclusions The burden of RA in China from 1990 to 2021 showed an upward trend, and was at a high level compared to different SDI regions. Higher disease burden of RA was seen in females and the elderly.

Objective To assess the efficacy of combination of Jiehe pellet and the standardized anti-tuberculosis therapeutic regimen for pulmonary tuberculosis complicating cervical lymph node tuberculosis in the aged. Methods A total of 103 aged patients with pulmonary tuberculosis complicating cervical lymph node tuberculosis were enrolled and randomly allocated to either a standardized anti-tuberculosis therapeutic regimen group (control group with 51 patients) or a standardized anti-tuberculosis therapeutic regimen plus Jiehe pellet group (treatment group with 52 patients). The patients in the control group and the treatment group received the treatment with 2HRZE/4HR and 2HRZE/4HR plus Jiehe pellet for 6 months, respectively. The abscessed lymph nodes were treated by either total excision or incision and drainage after 4 weeks of medicine treatment in both groups. Sputum smear was examined for acid-fast bacilli. The CD8 cells expressing natural killer T cells receptors NKG2A, NKG2D in peripheral blood were detected by flow cytometry. The treatment outcome was measured at the end of treatment. Results The rates of lesion resolution (78.85%vs. 58.82%;χ2=4.439, P<0.05) and cavity closure (62.86% vs. 35.48%;χ2=3.893, P<0.05) in the treatment group were significantly higher than those in the control group. In the end of 2, 4 and 6 months of treatment, cumulative rates of sputum conversion from positive to negative in the treatment group were significantly higher than those in the control group (χ2 were 5.343, 5.067 and 4.118,all P<0.05). The CD8 cells expressing NKG2A after treatment in the treatment group were significantly lower than those before treatment in the treatment group (t=9.510, P<0.01) and after treatment in the control group (t=9.832, P<0.01);the CD8 cells expressing NKG2D after treatment in the treatment group were significantly higher than those before treatment in the treatment group (t=10.622, P<0.01) and after treatment in the control group (t=10.433, P<0.01). The serum levels of IL-6 and TNF-αafter treatment were significantly lower than those before treatment in both groups (t were 17.344 and 21.142 in the treatment group, 10.984 and 12.203 in the control group;all P<0.01 );the serum levels of IL-6 and TNF-α after treatment in the treatment group were significantly lower than those after treatment in the control group (t were 7.832 and 5.478,all P<0.01). The serum IL-10 levels after treatment were significantly higher than those before treatment in both groups (t were 12.454 in the treatment group, 7.934 in the control group; all P<0.01 ); and the serum IL-10 level after treatment in the treatment group was significantly higher than that after treatment in the control group (t=4.720, P<0.01). The effective rate for cervical lymph node tuberculosis in the treatment was significantly higher than that in the control group (88.5%vs. 64.7%;χ2=6.855, P<0.01). Conclusion Combination of Jiehe pellet and the standardized anti-tuberculosis therapeutic regimen may improve immune function, increase the rate of sputum conversion from positive to negative, and facilitate lesion resolution in aged patients with pulmonary tuberculosis complicating cervical lymph node tuberculosis.

t=2.331,P=0.022) T cell levels and CD4+/CD8+ ratio (1.1 ± 0.2vs. 0.9 ± 0.2;t=4.488,P<0.001) showed significant difference between post-treatment and pretreatment. CD3+, CD4+, CD8+ T cell levels and CD4+/CD8+ ratio after treatment showed significant different between the two groups (t values were 3.920, 11.966, 5.573, 10.700,P<0.01). After the treatment, the cure rate in treatment group was significantly higher than that in the control group (80%vs. 56%;χ2=5.561,P=0.018). The rates of sputum conversion from positive to negative (72.0%vs. 50.0%;χ2=5.086,P=0.024)and cavity closure (36.0%vs. 16.0%;χ2=5.198,P=0.023) 6 months after treatment in the treatment group were higher than those in the control group.ConclusionFeitai capsule combined with mycobacterium vaccae can significantly improve the immune function in elderly patients with pulmonary tuberculosis.