Objective To analyze the risk factors of mortality in hospitalized patients with peptic ulcer bleeding (PUB).Methods From January 2003 to December 2012,1 210 patients with PUB were collected.Among them,1 170 patients were cured (cured group) and 40 patients died (dead group).The general information and clinical data of patients were collected,which included gender,age,smoking history,non-steroidal anti-inflammatory drugs intake,haematemesis,shock,blood infusion and rebleeding.The information of patients combined with other diseases was also collected.The lab findings and gastroendoscopy findings were also collected,including hemoglobin,platelets,serum albumin,blood urea nitrogen,serum creatinine levels,coagulation,location of ulcer and Forrest classification.Chi-square test was performed for comparison between groups of count data.The t-test was used for comparison between groups of measurement data and normally distributed,and Mann-Whitney rank sum test was used for non-normal distribution.The risk factors of mortality of patients with PUB were analyzed by univariate and multivariate Logistic regression analysis.Results The rates of age over 65,combined with other diseases,shock,rebleeding,abnormal coagulation,Forrest classification above Ⅱ b,medicine spraying to stop bleeding under gastroendoscope,gastroendoscopic hemostasis with titanium clip and operation of dead group (57.5％,23/40; 27.5％,11/40; 25.0％,10/40; 42.5％,17/40; 25.0％,10/40; 35.0％,14/40; 15.0％,6/40; 12.5％,5/40 and 17.5％,7/40) were all higher than those of cured group (25.0％,293/1 170; 7.4％,86/1 170; 12.5％,146/1 170; 13.1％,153/1 170; 5.1％,60/1 170; 20.9％,244/1 170; 4.8％,56/1 170; 4.1％,48/1 170 and 6.5％,76/1 170).The differences were statistically significant (x2 =21.117,18.651,5.400,27.728,9.203,4.613,6.332,4.661 and 5.710,all P＜0.05).The serum albumin level of dead group ((28.71±7.13) g/L) was lower than that of cured group ((32.82±7.55) g/L) and the difference was statistically significant (t=2.215,P＜0.05).Between the groups,there were no significant differences in gender distribution,rate of patients smoking,rate of patients taking non-steroidal anti-inflammatory drugs,rate of patients with haematemesis,volume of blood infusion,location of ulcer,dosage of proton pump inhibitor (PPI),average hemoglobin level,blood urea nitrogen level,serum creatinine and platelet count (all P＞0.01).Age over 65,combined with other diseases and rebleeding were the independent risk factors of mortality of patients with PUB during hospitalization (OR=4.821,12.959 and9.627,all P＜0.01).Conclusion Age over 65,combined with other diseases and rebleeding are the independent risk factors of mortality of patients with PUB during hospitalization.

Along with recent advances in biological signal molecule and tissue engineering technology,periodontal regeneration has been gained more and more new opportunities,but also faces many challenges.This paper briefly reviewes the preclinical and clinical studies of periodontal tissue regeneration,highlighting the latest achievement and progress in the clinical study of biological signal molecules and stem cell therapy in the treatment of periodontal disease worldwide.

OBJECTIVE:To study the stability of Fuke zhidai capsule at accelerated testing and room temperature. METHODS:HPLC was conducted to determine the content of berberine hydrochloride in the preparation:the column was Diamonsil C18 with mobile phase of B methanol-0.7% triethylamine(pH adjusted to 3 by phosphate)(50:50,V/V)at a flow rate of 1 ml/min;detec-tion wavelength was 265 nm,with a column temperature at 45 ℃,and the injection volume was 5 μl;its moisture,disintegration time,accelerated stability and long-term stability were studied according to the 2015 edition of Chinese Pharmacopoeia. RE-SULTS:The linear range of berberine hydrochloride was 0.0217-0.1736 mg/ml(r=0.9999);RSDs of precision,stability and re-producibility tests were lower than 2%;recovery was 97.24%-101.73%(RSD=1.72%,n=6). CONCLUSIONS:The moisture,dis-integration time,accelerated stability and long-term stability were all in line with the quality standards.

Objective:To discuss the management norms for the rational use of potassium chloride injection in neurosurgery department of a hospital.Methods:A special review of the medical advice including potassium chloride injection from January to June in 2016 in neurosurgery department was carried out.Results:In the 2 596 prescriptions including potassium chloride injection,the irrational drug use rate was 17.87%,and among them,92.67% were irrational compatibility,which showed serious risk of drug use.Conclusion:Some defects still exist in the application management of potassium chloride injection in neurosurgery department of this hospital.In order to avoid the risk of clinical medication,it is necessary to establish standardized management norms for the use of potassium chloride injection in this hospital to further promote the management of high-risk drugs with intravenous administration commonly used in clinics.

OBJECTIVE:To study the effectiveness of the management measures on the enhancing of pharmacy services quality in our hospital.METHODS:The concerned data about the management measures such as rules that‘those who rece_ ived the prescriptions the first should be responsible for which’,activity that‘no error,no appealing for100days’,rules th_ at‘exchanging notebooks about working quality’,etc.,were analyzed by SPSS10.0software package.RESULTS:The ef?fective practice of management measures can increase patients'satisfaction and trust in the consultancy.CONCLUSION:The management measures are helpful in the enhancement of pharmacy services quality and the information communication between pharmacy department and the other concerned departments.

Objective To evaluate the role of phosphatidylinositol 3-kinase/protein kinase B (PI3K/Akt) signaling pathway in mild head hypothermia-induced reduction of global cerebral ischemiareperfusion (I/R) injury in rats.Methods Sixty male Sprague-Dawley rats,weighing 250-280 g,were randomly divided into 5 groups (n=12 each) using a random number table:sham operation group (group S),group I/R,mild hypothermia + I/R group (group H),mild hypothermia + I/R + solvent control group (group DM),and mild hypothermia + I/R + PI3K inhibitor LY294002 group (group LY).Global cerebral I/R was induced by modified four-vessel occlusion method described by Pulsinelli.In H group,when the hippocampal temperature was decreased to 33℃ using nasopharyngeal cooling,the bilateral common carotid arteries were occluded for 15 min followed by reperfusion,and hippocampal hypothermia was maintained at 32.5-33.5 ℃ for 1 h.In DM and LY groups,DMSO and LY294002 5 μl were injected into the left ventricle,respectively,and 20 min later the other procedures were similar to those previously described in group H.At 8 h of reperfusion,6 rats were sacrificed,and hippocampal specimens were obtained to detect the expression of pFoxO3a,Bcl-2 and Bax (by immuno-histochemistry).The expression of phosphor-Akt (p-Akt) was determined by Western blot.Results Compared with group S,the expression of p-Akt,pFoxO3a and Bcl-2 was significantly up-regulated in I/R,H and DM groups,the expression of Bcl-2 was down-regulated,and the ratio of Bcl-2/Bax was increased in H and DM groups,and the ratio of Bcl-2/Bax was decreased in I/R and LY groups.Compared with group I/R,the expression of p-Akt,pFoxO3a and Bcl-2 was significantly up-regulated,the expression of Bcl-2 was down-regulated,and the ratio of Bcl-2/ Bax was increased in H and DM groups.Compared with H and DM groups,the expression of p-Akt,pFoxO3a and Bcl-2 was down-regulated,the expression of Bax was up-regulated,and the ratio of Bcl-2/ Bax was decreased in group LY.Conclusion PI3K/Akt signaling pathway is involved in reduction of global cerebral I/R injury by mild head hypothermia in rats.

Objective To evaluate the effects of lung-protective ventilation on acute lung injury after liver transplantation.Methods Sixty patients of both sexes,aged 21-64 yr,with body mass index of 18-28 kg/m2,of American Society of Anesthesiologists physical status Ⅱ-Ⅳ,scheduled for elective orthotopic liver transplantation,were divided into 2 groups (n =30 each) using a random number table:conventional mechanical ventilation group (group CMV) and lung-protective ventilation group (group LPV).In group LPV,the patients were mechanically ventilated (tidal volume 6-8 ml/kg,respiratory rate 10-15 breaths/min,positive end-expiratory pressure 3-10 cmH2 O),and lung recruitment mnaneuver was pertormed every 2 h.Before skin incision (T1),at 3 h of preanhepatic phase (T2),at 30 min of anhepatic phase (T3) and at 2 and 4 h of neohepatic phase (T4.5),bronchoalveolar lavage fluid (BALF) was collected and blood samples from the radial artery were simultaneously collected for determination of tumor necrosis factor-alpha and interleukin-8 concentrations in BALF and serum by enzyme-linked immunosorbent assay.At 2 h after operation (T6),before tracheal extubation (T7) and at 2 days after operation (T8),blood samples from the radial artery were collected for blood gas analysis,and oxygenation index was calculated.The concentrations of serum Clara cell secretory protein 16,surfactant protein D and soluble receptor for advanced glycation end-products were determined at T1-T8 using enzyme-linked immunosorbent assay.The postoperative emergence time,extubation time,duration of intensive care unit stay and development of acute lung injury were recorded.Results Compared with group CMV,the cxtubation time was significantly shortened,serum concentrations of Clara cell secretory protein 16 at T2,T3,T6 and T7,serum surfactant protein D concentrations at T5 and serum concentrations of soluable receptor for advanced glycation endproducts at T5 and T6 were decreased (P＜0.05),and no significant change was found in tunor necrosis factor-alpha and interleukin-8 concentrations in serum and BALF at each time point or postoperative incidence of acute lung injury,oxygenation index,emergence time and duration of intensive care unit stay in group LPV (P＞0.05).Conclusion Although lung-protective ventilation dose not decrease the development of acute lung injury after liver transplantation,it attenuates lung tissue injury to some extent.

OBJECTIVETo research the regulation of transmembrane transport activity of paclitaxel influenced by fangchinoline in MDR1-MDCK II cells.

METHODPaclitaxel, one of the substrate of P-gp, was selected as the model drug. Verapamil hydrochloride was adopted as the active control to investigate the bilateral transport activity of paclitaxel regulated by fangchinoline in MDR1-MDCK II cells. RP-HPLC was applied to determine the concentration of paclitaxel in the transporting medium, which was used to calculate apparent permeability coefficient of paclitaxel across MDR1-MDCK I1 monolayer cells.

RESULTThe efflux rate of paclitaxel was faster than the absorption rates across the MDR1-MDCK II monolayer cells with highly expressed P-gp. The absorption rates of paclitaxel combinated with fangchinoline and verapamil hydrochloride respectively were remarkably increased and the efflux rate was decreased. The reversal effect of the fangchinoline was stronger than the verapamil hydrochloride with the same molar concention.

CONCLUSIONFangchinoline can apparently decrease the efflux of paclitaxel and inhibit the multidrug resistance of antitumor drug mediated by P-gp.

ATP Binding Cassette Transporter, Sub-Family B ; ATP-Binding Cassette, Sub-Family B, Member 1 ; genetics ; metabolism ; Animals ; Benzylisoquinolines ; pharmacology ; Biological Transport ; drug effects ; Cell Line ; Cell Membrane ; drug effects ; metabolism ; Cell Membrane Permeability ; drug effects ; Dogs ; Humans ; Models, Biological ; Paclitaxel ; pharmacokinetics ; Plant Extracts ; pharmacokinetics

Immunological checkpoint inhibitors include monoclonal antibodies of cytotoxic T lymphocyte antigen-4 (CTLA-4) and programmed cell death-1 (PD-1).Anti-CTLA-4 drug ezetimab (ipilimumab)and anti-PD-1 drug (pembrolizumab and nivolumab) are approved for the treatment of melanoma and non-small cell lung cancer.The effects of these drugs on renal cell carcinoma,bladder cancer,breast cancer,gastrointestinal cancer and other types of cancers are still in large-scale clinical trials.These drugs have good effects in the clinical application,but they inevitably lead to many adverse reactions.

Objective To investigate the risk factors for stroke in population with family history in rural areas of Zhengzhou. Methods A cluster random sampling method was used to collect 386 residents with family history of stroke from 5 villages of Zhengzhou. The participants were divided into stroke group and non-stroke group according to diagnosis. IBM SPSS STATISTICS 21.0 and SPSS Modeler 14.1 software were used to analyze the data.Results Hypertension, dyslipidemia, atrial fibrillation or arrhythmia, smoking and drinking in stroke group were significantly higher than those of the non-stroke group (P < 0.05). Logistic regression analysis indicated that hypertension (OR=35.705, 95％ CI9.045～140.950, P =0.000) and dyslipidemia (OR=2.669, 95％ CI 1.077～6.614, P = 0.034) were linked with stroke. Artificial neural network (ANN) model indicated the independent variables in predicting stroke were hypertension, dyslipidemia, smoking, drinking and atrial fibrillation or arrhythmia according significance, respectively. The accuracy of the model was 82.0％. Conclusion Among population with family history of stroke, those who had hypertension, dyslipidemia, atrial fibrillation or arrhythmia, smoking and drinking were more susceptible to develop this condition.