Hospital Restructuring ; Hospitals ; Occupational Health Services

Objective:To investigate the application of drug utilization evaluation( DUE) as a kind of clinical pharmacy work model in the antibacterial drug special rectification. Methods: Following the steps of DUE schedule,retrospective method was conducted to collect the data of the use of vancomycin in one institution and the model of clinical drug use was improved by the evaluation result. Re-sults:The rationality of vancomycin use was improved in the institution. The index of drug use reasons and key disease course indica-tors was improved significantly. The qualification rate of indications and drug indications was increased from 79. 5% to 95. 0%,and the qualification rate of antibacterial drugs classification management was increased from 63. 3% to 92. 7%. The qualification rate of dosing frequency was increased from 72. 5% to 96. 0%. Conclusion:As a program for continual improvement of new clinical pharmacy work mode and medical care quality,the mode plays an important role in the institution and improves the rational use of vancomycin.

Asingleparticle-inductivelycoupledplasmamassspectrometric(SP-ICP-MS)methodwas established to detect the size distribution and number concentrations of silver nanoparticle ( AgNPs) in dilute aqueous solution. The optimal dwell time was 3 ms to reduce possibility of two or more particles entering into detector simultaneously. An iterative algorithm was applied to distinguish AgNPs as outliers from baseline and dissolved metal ion signal if the measured intensity was beyond five time standard deviation of whole data. Size distribution and number concentration of three commercial silver nanoparticle dispersions ( nominal diameters of 30, 50, 100 nm) were determined using SP-ICP-MS. The result of SP-ICP-MS is accurately similar to the transmission electron microscopy ( TEM) , indicating that SP-ICP-MS is able to size silver nanoparticles. The particle size detection limit is 25 nm and the limit of number concentration is 8 × 104 particles/L in dilute solution. Tap water added with silver nanoparticle was tested to obtain a similar size distribution and number concentration. This method is simple, fast and highly sensitive, which can be used to investigate risk assessment of silver nanoparticle in aqueous environment and monitor silver nanoparticle in drinking water.

OBJECTIVETo assess the long-term clinical effectiveness of Chinese herbal medicines for benefiting qi and activating blood circulation (CHMBQABC) plus routine Western medical intervention in treating unstable angina (UA) patients of qi deficiency blood stasis syndrome (QDBSS) after percutaneous coronary intervention (PCI) based on Markov model.

METHODSA Markov model was established based on prognosis and sequelae of UA patients after PCI treated by CHMBQABC plus routine Western medical intervention or by routine Western medical intervention. According to the transition probabilities of 40 Markov cycles and quality-adjusted life years (QALYs) averagely gained, we assessed the therapeutic advantage of CHMBQABC plus routine Western medical intervention.

RESULTSBy the prediction of Markov model for 20 years, the transition probabilities of revascularization, non-fatal myocardial infarction, non-fatal stroke, and all-cause death in the CHMBQABC plus routine Western medical intervention group was 56.65%, 6.53%, 5.16%, and 31.66%, respectively, and the QALYs averagely gained was 12.95; while the transition probabilities of revascularization, non-fatal myocardial infarction, non-fatal stroke, and all-cause death in the Western medical intervention group was 55.31%, 6.87%, 5.25%, and 32.57%, respectively, and the QALYs averagely gained was 12.84. Compared with the Western medical intervention group, the QALYs averagely gained was 0.11 in the CHMBQABC plus routine Western medical intervention group.

CONCLUSIONBased on predicted results of the Markov model, CHMBQABC plus routine Western medical intervention got better efficacy in treating UA patients after PCI, indicating CHMBQABC plus routine Western medical intervention could improve the long-term clinical effectiveness for UA patients of QDBSS after PCI.

Aged ; Angina, Unstable ; drug therapy ; Drugs, Chinese Herbal ; therapeutic use ; Female ; Humans ; Male ; Markov Chains ; Middle Aged ; Models, Theoretical ; Phytotherapy ; Treatment Outcome

Twelve compounds were isolated from the rhizome of Paris mairei Lévl by silica gel, Sephadex LH-20 and ODS col-umn chromatographies. The structure elucidation was accomplished by ESI-MS and NMR methods. These compounds were identified as lupeol(1), lup-20(29) -ene-3β-yl octacosanoate(2), palmitic acid(3), glyceryl α-mono-palmitate(4), α-spinasterol(5), diosgenin (6), (25R) diosgenin-3-O-α-L-rhamnopyranosyl (1--> 4) -α-L-rhamnopyranosyl (1 --> 4) - [α-L-rhamnopyranosyl(1 --> 2)] -β-D-glucopyranoside(7), pennogenin(8), pennogenin-3-O-β-D-glucopyranosyl(1 -->3) - [α-L-rhamnopyranosyl(1 --> 2)] -β-D-glucopyranoside(9), flazin(10), calonysterone(11), and isorhamnetin-3-O-β-gentiobioside(12). Compounds 1-5,10-11 were isolated from the genus Paris for the first time, and all compounds were isolated from this plant for the first time.
Drugs, Chinese Herbal ; chemistry ; Liliaceae ; chemistry ; Molecular Structure ; Rhizome ; chemistry ; Spectrometry, Mass, Electrospray Ionization

Objective To determine the diagnostic value of anti-mutated citrullinated vimentin(anti- MCV)antibodies for rheumatoid arthritis(RA).Methods The anti-MCV were determined in 136 patients with RA,80 non-RA patients and 19 normal peoples.The diagnostic value of anti-MCV was assessed and compared with anti-CCP,AKA and RF.Results The sensitivity and specificity of anti-MCV in the 136 RA patients was 95.6% and 80.8% respectively,there was significanl difference between the test group and the control group(P

Objective To explore the effect of moderate hypothermia (MH) in liver ischemiareperfusion (IR) injury.Methods Male BALB/c mice (8 weeks old,n =15) were randomly divided into three groups:IR group:five mice subjected to 70％ hepatic IR (hepatic vascular triad above the bifurcation occlusion for 35 min before 24 h reperfusion) in normal temperature condition (37 ±0.5 ℃);MH + IR group:five mice were treated with MH (32 ±0.5 ℃) for 2 h before 70％ hepatic IR was performed;sham group:the other five mice were subjected to laparotomy and liver manipulations without vascular occlusion.AST and ALT in plasma were detected in all mice,and the morphological changes,cell apoptosis and the cold-inducible RNA-binding protein (CIRP) expression after MH in liver tissues were detected.Results Compared with IR group,the ALT and AST levels in MH + IR group were significantly decreased.In IR group,the liver morphology deteriorated with more severe hydropic degeneration and more cell apoptosis.In MH + IR group,the expression of CIRP began to increase after MH preconditioning.Conclusion MH preconditioning could protect against the liver ischemia-reperfusion injury.

ObjectiveTo evaluate the potential value of acoustic radiation force impulse (ARFI)elastography in the characterization of solid liver tumors.MethodsForty-three patients with 56 liver tumors were evaluated with ARFI,which included 21 patients with hepatocellular carcinoma (HCC),8 patients with metastase,5 patients with cholangiocarcinoma(CCC),and 9 patients with hemangioma.The shear wave velocity of the tumor and background liver parenchyma were calculated,and results were compared with 30 healthy subjects.Statistical analysis was performed on the shear wave velocity for differentiation of normal liver,background liver parenchyma,and tumors.ResultsHCC and CCC had greater stiffness than metastase (P ＜0.05),there were no statistical differences between HCC and CCC (P = 0.179).Malignant liver tumors had significantly greater stiffness than hemangioma and normal liver (P = 0.000).34.5% (9/26) HCC and 33.3% (4/12) hemangioma appeared softer than the background liver.With a cut-off value of 1.5 m/s for the shear wave velocity,the sensitivity,specificity,positive predictive value and negative predictive value for malignancies were 79.5%,83.3%,94.5% and 52.6%,respectively.ConclusionsARFI elastography quantification is a promising noninvasive technique for assessing solid liver tumors.Use of ARFI elastography quantification may lead to new quantitative tissue characterization parameters for differentiating hemangioma and malignant liver tumors.

Objective To investigate the clinical efficacy of body weight supported treadmill training (BWSTT) for the recovery of walking ability and comprehensive function after thoracolumbar spinal cord injury (SCI).Methods Sixty patients with SCIs in a thoracolumbar segment were assigned to a treatment group or a control group with 30 in each.Both groups received similar conventional rehabilitation training,but the patients in the treatment group were additionally treated with BWSTT (30 to 40 min,once daily,5 d/week,30 days for a course,a total 3 courses).The American Spinal Injury Association lower-extremity motor function assessment (ASIA),a functional comprehensive assessment (FCA),the walking ability assessment from the FCA (WA) and the modified Barthel index (MB1) were used in the assessment of the two groups before and after treatment.Results There were no significant differences in the two groups＇ average ASIA,FCA,WA or MBI results before treatment.After treatment ASIA,FCA,WA and MBI scores had all increased significantly in the treatment group compared with before treatment,and were significantly higher than in the control group.Conclusion As a supplement to conventional rehabilitation,BWSTT can improve walking ability and comprehensive function significantly after thoracolumbar spinal cord injury.

Objective To investigate the stress distribution in a cemented femoral component in elderly patients with a partial marrow type Ⅰ intertrochanteric fractures and to compare differences in the stress distribution after a long-and short-stem prosthetic replacement.Methods Spiral CT images of right femur of the volunteer were obtained and processed with Mimics software and modeling software to reconstruct a three-dimensional model of the femur.Based on this,a three-dimensional physical model for partial marrow type Ⅰ intertrochanteric fractures,long-and short-stem femoral prostheses,and cement mantle was established.Subsequently,a three-dimensional finite element model of long-and short-stem prosthetic replacement for intertrochanteric fractures was established using the finite element analysis software,and biomechanical analysis was implemented for the model.Results No significant changes in stress distribution of the femur occurred after long-or short-stem prosthetic replacement.Stress on the femur still presented a gradual increase from the proximal end to the distal end,peaked at the lower 1/3 of the medial and lateral junction and then decreased at the end.A stress concentration zone formed in the medial and lateral end of cement-stem interface in short-stem prosthetic replacement.Besides,the maximum value of stress in the lateral interface reached 15.3 MPa,but without surpassing the fatigue strength of the bone cement.Whereas,a stress concentration zone formed in the distal medial and lateral part of cement-stem interface and the medial middle part of the interface in long-stem prosthetic replacement and the maximum value was also lower than the fatigue strength of bone cement.No significant stress concentration zones were found in the femoral calcar reconstructed using bone cement.Conclusions Cemented long-or short-stem prosthetic replacement achieves no significant alteration in stress distribution of the femur.Loosening probability of the cemented long-or short-stem prosthesis is almost the same,but the latter has advantages of shorter surgery time,minor trauma,and fewer complications and may be more suitable for treatment of the elderly patients with a partial marrow type Ⅰ intertrochanteric fractures.