OBJECTIVE:To provide reference for clinical rational use and management of anti-HIV drugs,and to provide ref-erence basis for occupational exposure to develop free drug policy. METHODS:Using retrospective study method,according to DDD calculation method recommended by WHO,consumption sum,DDDs,DDC and B/A of anti-HIV drugs in our center during 2011-2014 were analyzed and evaluated. RESULTS:The consumption sum of anti-HIV drugs increased firstly and decreased later, increasing from 512112 yuan in 2011 to 650854 yuan in 2012,decreasing to 496473 yuan in 2014. DDDs of anti-HIV drugs in our center during 2011-2014 decreased from 35932 in 2011,to 16363 in 2014,showing decreasing tendency. The consumption sum of nucleotide reverse transcriptase inhibitors during 2012-2014 took up the first place,and DDDs of nucleotide reverse tran-scriptase inhibitors took up the first place in 2011,2013,2014. DDDs of Zidovudine tablets took up the first place in 2013,2014, and that of Tangcao tablets took up top 3 places during 2011-2014. DDC of Tenofour disoproxil fumarate tablets,Zidovudine and la-mivudine tablets,Emtricitabine and tenofovir tablets,Lopinavir and ritonavir tablets were in high level,being more than 46 yuan. DDC of Zidovudine tablets,Stavadine tablets and Nevirapine tablets were in low level,being lower than 6 yuan. B/A of Tenofovir disoproxil fumarate tablets,Stavudine tablets and Efavirenz tablets ranged 0.5-1.5 in 4 years and B/A of Tangcao tablets was equal to 1,showing good synchronism of social and economical benefits. CONCLUSIONS:Clinical application of anti-HIV drugs in our center is rational basically,and the use of drug is basically consistent with the occupational exposure prevention. The use of TCM preparation is basically in line with the requirements of drug use in the clinic.

Objective To analyze the changes of bone mineral density (BMD) and glucose metabolism in patients with type 2 diabetes mellitus (T2DM) complicated with osteoporosis.Methods Eighty-six patients with T2DM were selected.The patients were divided into T2DM complicated with osteoporosis group and simple T2DM group according to the BMD value.The fasting blood glucose (FBG),fasting insulin (FINS),glycosylated hemoglobin (HbA1c) and course of disease were compared between the 2 groups,and the correlation was analyzed between the indexes and BMD.Ninety-three health examination people were selected as health control group.Results The rate of osteoporosis in health examination people was significantly lower than that in T2DM patients [28.0％(26/93) vs.59.3％(51/86)],there was statistical difference (P ＜ 0.05).There were statistical differences in HbA1c,FINS,BMD,course of disease between T2DM complicated with osteoporosis group (51 cases) and simple T2DM group (35 cases) [(8.57 ± 2.59)％vs.(7.26 ±1.68)％,(13.21 ±4.73) μU/L vs.(17.54 ±5.91) μU/L,(0.764 ±0.130) g/cm2 vs.(0.993 ± 0.123) g/cm2,(11.4 ± 6.4) years vs.(8.6 ± 4.7) years,P ＜ 0.05].The BMD in patients with T2DM was negatively correlated with course of disease,HbA1c,FINS (r =-0.306,-0.185,-0.269; P ＜ 0.05 or ＜0.01),there was no correlation between BMD with FBG (P ＞ 0.05).Conclusion The poor long-term blood glucose control,low insulin level,long course of disease are the risk factors for T2DM complicated with osteoporosis.

Objective:To compare the performance of chemiluminescent microparticle immunoassay ( CMIA) and enzyme-linked immunosorbent assay ( ELISA) for the determination of Anti-PR3 and Anti-MPO.Methods:Concentration of Anti-PR3 and Anti-MPO in serum samples from 166 patients with autoimmune diseases and 50 healthy donors were determined by using CMIA (Method A) and ELISA(Method B),respectively.The results from both assays were analyzed and compared by statistical methods .Results:Method A showed better intra-assay reproducibility and inter-assay reproducibility than Method B for the determination of high ,medium and low levels of control serum .Both methods met the accuracy requirement .The correlation coefficient of Anti-PR3 and Anti-MPO were 0.987 8 and 0.989 6 for Method A and Method B ,respectively.And the Kappa coefficients were 0.897 and 0.882 for Method A and Method B,respectively.Conclusion:The performance of Method A is superior to Method B for the deter-mination of Anti-PR3 and Anti-MPO, which makes Method A to be a potentially better choice for clinical application .

ObjectiveTo observe the clinical efficacy of acupoint application plus modified Yu Ping Feng decoction in treating cold due to weak constitution.MethodNinety-six patients with cold due to weak constitution were divided into two groups. The control group was intervened by regular Western medicine, while the treatment group was by acupointapplication plus modified Yu Ping Feng decoction.ResultThe total effective rate was 91.7% (44/48) in the treatment group, significantly higher than 79.2%(38/48) in the control group. A one-year follow-up study found that the disease duration and relapse frequency in the treatment group were markedly shorter and less than that in the control group (P<0.05).ConclusionAcupoint application plus modified Yu Ping Feng decoction can produce a significant efficacy in treating cold due to weak constitution.

We conducted a questionnaire survey among 36 community health care providers at Jingansi Health Center to learn their status quo.Our results showed that talented person aged less than 35 only accounted for 1/10.97%of the young physicians wished to have more continuous medical education and improved working environment.Proper working regulation,personnel resource management and payment system might help attract,train and retain more qualified persons,improve personnel quality,and achieve sustainable development of community health centers.

Objective To explore the effect of laparoscopic ovarian drilling technique in the treatment of polycystic ovarian syndrome.Methods 60 patients with polycystic ovarian syndrome were randomly devided into observation group( 30 cases) and the control group(30 cases).The effect of the two groups was observed.Results LH and T of all the patients were significantly improved after the treatments( t =27.2158,20.4752,9.7169,0.4551,all P ＜0.05);The ovulation rate and the pregnancy rate of observation group(86.7％ and 86.7％ ) was significantly higher than those of the control group( x2 =5.4545,9.3496,all P ＜ 0.05 ),and the OHSS rate of observation group was 0,significantly lower than that of the control group ( 16.7％ ) ( x2 =5.4545,P ＜ 0.05 ).Conclusion Laparoscopic ovarian drilling technique was effective and safe in treating polycystic ovarian syndrome.

Objective Human A20 is one of the endogenetic regulating proteins of inflammation in vivo and play important roles in preventing uncontrolled inflammatory response as well as endogenetic cellular protection.Our aim is to prepare a recombinant protein of human A20(rhA20) in Pichia pastoris and then research its roles in sepsis therapy.Methods rhA20 yeast expression vector yevCFP-hA20 was constructed by genetic engineering.Pichia pastoris with linearized yevCFP-hA20 was electroporated.The high copy clones were screened with MD/His~(-) medium and YPD/G418 gradient medium.The number of hA20 in yeast genome was detected by quantitative PCR.The rhA20 was expressed by methanol induction and identified by SDS-PAGE and Western blotting.The optimum conditions(including pH and ingredient of induced medium as well as the temperature of induced culture) were investigated.Results The molecular weight of rhA20 is about 93?10~3.After expression condition's optimization by decreasing the pH of BMMY medium,adding a low dosage of EDTA and the substrate of protease,as well as decreasing the induced temperature,the full expressing products was up to 11 times,rose to 18.24% in total protein and achieved to 254.1 024.52?g/ml.Conclusion we have successfully expressed rhA20 in Pichia pastoris GS115.The expression amount of full rhA20 increases clearly by progressing the ingredient and pH of BMMY and using a lower inducing temperature.This starts the biosynthesis of hA20 in vitro.A new solving regime is provided to other biologist when they meet product's degradation by using Pichia pastoris GS115.

Objective To analyze influencing factors of recurrence in patients with cervical intraepithelial neoplasia (CIN) after loop electrosurgical excision procedure (LEEP).Methods CIN patients who diagnosed by cervical cytology and cervical pathologic examination were treated with LEEP.Follow-up by cervical cytology and colposcope examination,patients with abnormal cytology were given colposcope pathologic examination.High risk human papilloma virus (HPV) was examined by hybrid capture HPV DNA method HC-2.Recurrent disease was defined when the same or higher level of lesion 6 months after LEEP were found.Results A total of 451 LEEP was performed during the study period,the age was 19-68 (39.0 ±7.4) years.Pathological grading:CIN Ⅰ was in 122 patients,CIN Ⅱ-Ⅲ was in 329 patients.Ninety-eight patients were recurrent,the rate of recurrence was 21.73％ (98/451),the rate of recurrence in CIN Ⅰ was 14.75％(18/122),in CIN Ⅱ-Ⅲ was 24.32％(80/329).Single factor analysis showed that high risk HPV infection,surgical margin,pathological grading,cervical cytology abnormal changes were the influencing factors of recurrence after LEEP (P＜0.01 or ＜0.05).Multi-factor analysis showed that the influencing factors of recurrence after LEEP were followed by high risk HPV infection,cervical cytology abnormal changes,surgical margin and pathological grading.Conclusions High risk HPV infection is an important influencing factor of recurrence after LEEP in patients with CIN,and cervical cytology abnormal changes,surgical margin and pathological grading are also influencing factor of recurrence after LEEP.

Objective To observe and analyze the clinical outcomes of levamisole in combination with vitamin B12 in the treatment of recurrent oral ulcer.Methods The prospective clinical study method was used,67 patients with recurrent oral ulcer who admitted to the dental were randomly divided into the combined treatment group,the levamisole group,and the vitamin B12 group.The combined treatment group was treated by levamisole combined with vitamin B12 .The levamisole group and the vitamin B12 group were treated with levamisole and vitamin B12 respectively. The cure rate,serum IL -6 and vitamin B12 levels were compared among the three groups.Results The cure rate of the combined treatment group was 90.90%,which was significantly higher than 77.72% of the levamisole group and 81.82% of the vitamin B12 group(P <0.05).The combined treatment group had significantly lower level of serum IL -6 than that of the levamisole group and the vitamin B12 group[(56.45 ±11.34)pg/mL vs.(102.35 ±10.23)pg/mL vs.(145.44 ±12.35)pg/mL,P <0.05].The combined treatment group had significantly higher level of vitamin B12 than that of the levamisole group[(523.34 ±13.45)μg/mL vs.(323.34 ±12.53)μg/mL,P <0.05].There was no difference between the combined treatment group and the vitamin B12 group regarding serum vitamin B12 level [(523.34 ±13.45 )μg/mL vs.(554.45 ±33.34)μg/mL,P >0.05 ].Conclusion Levamisole combined with vitamin B12 treatment can significantly decrease serum IL -6 and increase serum vitamin B12 and improve the cure rate for patients with recurrent oral ulcer.It has been proved to be the effective treatment for recurrent oral ulcer.

Bronchopulmonary dysplasia (BPD) is a severe complication of preterm birth,especially in those with very low birth weight or extremely low birth weight.The incidence of BPD increased with more survival of very preterm infants.Neonates with BPD are more oxygen-dependent and require prolonged mechanical ventilation.Respiratory and neurological outcomes in the childhood and even early adulthood,including pulmonary symptoms,re-admittance rate,pulmonary hypertension and dysfunction,will be adversely influenced.Meanwhile,BPD patients will develop more problems in cognition,education and behavior.