OBJECTIVE:To evaluate the effect of comprehensive intervention management mode on the use of proton pump inhibitors(PPIs)injection in oncology department of hospital. METHODS:Simple random sampling method was conducted to col-lect 1 457 discharged medical records used PPIs injection in oncology department of our hospital from Jan. 2012 to Dec. 2013(be-fore intervention)and 793 records from Jan. to Dec. 2014(after intervention). The utilization of PPIs injection before and after ad-ministrative intervention,technical intervention and information management was compared. RESULTS:After comprehensive inter-vention,the utilization rate of PPIs injection in oncology department of our hospital decreased from 62.59%(before intervention) to 60.70%,without significant difference(P>0.05). There were significant differences in the proportion of PPIs injection’s con-sumption amount in total medical costs and per capita consumption amount before and after intervention(P<0.05);the utilization rate of Lansoprazole for injection increased from 19.70%(before intervention) to 34.68%,and the Omeprazole for injection de-creased from 34.45%(before intervention)to 25.60%,with significant differences(P<0.05),while there were no significant dif-ferences in the utilization rate of Pantoprazole for injection and Esomeprazole for injection(P>0.05). The proportion of irrational use of PPIs injection decreased from 73.99%(before intervention)to 55.86%,among which,the proportions of no indications of medication,repeated administration and too long duration decreased from 40.01%,17.09% and 26.90%(before intervention)to 32.41%,9.08% and 18.03%,with significant differences(P<0.05),while there was no significant difference in the proportion of inappropriate dose selection before and after intervention (P>0.05). CONCLUSIONS:Comprehensive intervention manage-ment mode can improve the clinical utilization of PPIs injection in oncology department of our hospital to some extent,but the irra-tional use of PPIs injection in our hospital is still not optimistic,which needs further improve intervention to promote its clinical rational use.

A fructosamine (DMF) method for the estimation of Serum glycosylated LDL (GLDL) is reported. The glycosylated rate of LDL (K value) is equal to GLDL/LDL. It is concluded that fructosamine method for the estimation of GLDL and K value is more convenient, fast, and has a high specificity, and is not interfered by glutathione, other reducing substances with low melecular weight, and the variation of serum proteins. GLDL and K value are thus suggested to be a better indicator for the diagnosis and evaluation of treatment in diabetes mellitus than the glycosylated serum total proteins.

Objective To observe the effects of Fuzheng Huayu Capsule on the expressions of the main roles, Rock1 and Rock2, in RhoA/Rock signal transduction pathway in rats with myocardial infarction (MI);To explore the possible mechanism of Fuzheng Huayu Capsule to improve ventricular remodeling in myocardial fibrosis. Methods The MI model was induced by ligation of the left coronary artery. Rats with MI were randomly divided into the model group, Fuzheng Huayu group and Fasudil hydrochloride group. A sham-operation group threading without ligation was setting as a control group, with eight rats in each group. The rats were treated with corresponding medicine for 4 weeks from the second day after modeling. The expression of Rock1, Rock2 and its mRNA were detected by immunohistochemical and real-time PCR method. Results The protein expression of Rock1 and Rock2 in model group were significantly higher than those in the sham-operation group (P<0.05). The protein expression of Rock1 and Rock2 in the Fuzheng Huayu group and Fasudil hydrochloride group were lower than those in the model group. The mRNA expression of Rock2 was significantly higher in the model group than that in the sham-operation group (P<0.05). The mRNA expression of Rock1 in the Fasudil hydrochloride group was lower than that in the model group (P<0.05). The mRNA expression of Rock2 in the Fuzheng Huayu group and Fasudil hydrochloride group was lower than that in the model group (P<0.05). Conclusion Fuzheng Huayu Capsule can decrease the expression of Rock1, Rock2 and Rock2 in the marginal zone of myocardial infarction in rats with MI. The anti ventricular remodeling mechanism of Fuzheng Huayu Capsule maybe related with this.

Objective:To evaluate the role of nuclear factor NF-E2-related factor 2 (Nrf2)/heme oxygenase-1 (HO-1) signaling pathway in atorvastatin-induced reduction of intestinal ischemia-reperfusion (I/R) injury in mice.Methods:Twenty-four healthy male C57BL/6 mice, aged 6-8 weeks, weighing 18-22 g, were divide into 4 groups ( n=6 each) using a random number table method: sham operation group (S group), intestinal I/R group (I/R group), atorvastatin group (ATV group) and atorvastatin+ Nrf2 inhibitor ML385 group (AM group). Intestinal I/R was produced by occlusion of superior mesenteric artery for 45 min followed by reperfusion.In ATV and AM groups, atorvastatin 10 mg/kg was given by gavage for 3 consecutive days daily at 3 day before establishment of the model, while the equal volume of normal saline was given by gavage in S and I/R groups.Nrf2 inhibitor ML385 30 mg/kg was intraperitoneally injected at 1 h before establishment of the model in group AM.The mice were sacrificed at 2 h of reperfusion, and intestine tissues were obtained for examination of the pathological changes of intestinal tissues (with a light microscope) which were scored according to Chiu, for determination of wet/dry weight ratio (W/D ratio), for detection of the activity of superoxide dismutase (SOD) and content of malondialdehyde (MDA) (by xanthine oxidase method and thiobarbituric acid condensation method) and for determination of the expression of Nrf2 and HO-1 (by Western blot). Results:Compared with S group, the Chiu score, W/D ratio and MDA content were significantly increased, the activity of SOD was decreased, and the expression of Nrf2 and HO-1 was up-regulated in the other 3 groups ( P<0.05). Compared with the group I/R, the Chiu score, W/D ratio and MDA content were significantly decreased, the SOD activity was increased, and the expression of Nrf2 and HO-1 was up-regulated ( P<0.05), and the pathological changes were significantly attenuated in group ATV, and no significant change was found in the parameters mentioned above in AM group ( P>0.05). Compared with the group ATV, the Chiu score, W/D ratio and MDA content were significantly increased, the SOD activity was decreased, the expression of Nrf2 and HO-1 was decreased ( P<0.05), and the pathological changes were significantly aggravated in group AM. Conclusion:The mechanism by which atorvastatin reduces intestinal I/R injury is related to activating Nrf2/HO-1 signaling pathway in mice.

Objective:To evaluate the role of peroxidase proliferator-activated receptor γ (PPARγ)/nuclear factor kappa B (NF-κB) signaling pathway in sodium butyrate-induced reduction of intestinal ischemia-reperfusion (I/R) injury in mice.Methods:Thirty-two SPF-grade healthy adult male C57BL/6J mice, aged 7-9 weeks, weighing 20-25 g, were divided into 4 groups ( n=8 each) using a random number table method: sham operation group (Sham group), intestinal I/R group (IIR group), sodium butyrate group (NaB group) and PPARγ inhibitor GW9662 group (GW9662 group). The model of intestinal I/R was established by occlusion of superior mesenteric artery for 45 min followed by 2-h reperfusion in anesthetized animals.GW9662 2 mg/kg was intraperitoneally injected at 1 h before ischemia in GW9662 group, and sodium butyrate 500 mg/kg was intraperitoneally injected at 30 min before ischemia in NaB and GW9662 groups.Blood samples were obtained via cardiac puncture at 2 h of reperfusion, and the animals were then sacrificed.The intestinal tissues were removed for determination of diamine oxidase (DAO), tumor necrosis factorα (TNF-α) and interleukins 6 (IL-6) concentrations in serum (by enzyme-linked immunosorbent assay) and the expression of PPAR and NF-κB p65 (by Western blot). The damage to intestinal mucous membrane was assessed and scored according to Chiu. Results:Compared with group Sham, the Chiu′s score was significantly increased, levels of DAO, TNF-α and IL-6 in serum and intestinal tissues were increased, expression of PPARγ was down-regulated, and expression of NF-κB p65 was up-regulated in group IIR ( P<0.05). Compared with group IIR, the Chiu′s score, levels of DAO, TNF-α and IL-6 in serum and intestinal tissues were decreased, and expression of PPARγ was up-regulated in group NaB, and expression of NF-κB p65 was up-regulated in NaB and GW9662 groups ( P<0.05). Compared with group NaB, the Chiu′s score, levels of DAO, TNF-α and IL-6 in serum and intestinal tissues were increased, and expression of PPARγ was down-regulated, and expression of NF-κB p65 was up-regulated in group GW9662 ( P<0.05). Conclusion:The mechanism by which sodium butyrate reduces intestinal I/R injury may be related to activating PPARγ/NF-κB signaling pathway and inhibiting inflammatory responses in mice.

Objective:To investigate the effect of atorvastatin preconditioning on intestinal ischemia-reperfusion (I/R) injury in mice and the relationship with phosphatidylinositol 3-kinase (PI3K)/serine-threonine kinase (Akt) signaling pathway.Methods:Twenty-four healthy male C57BL/6 mice, aged 6-8 weeks, weighing 18-22 g, were divided into 4 groups ( n=6 each) using a random number table method: sham operation group (S group), I/R group, atorvastatin preconditioning group (A group), atorvastatin plus PI3K inhibitor LY294002 group (AL group). Atorvastatin 10 mg/kg was given by intragastric gavage for 3 consecutive days in A and AL groups, and in addition LY294002 0.3 mg/kg was intraperitoneally injected at 30 min before the last administration of atorvastatin in AL group.Intestinal I/R was produced by occlusion of superior mesenteric artery (SMA) for 45 min followed by 2 h reperfusion in anesthetized mice.The superior mesenteric artery was only isolated but not clamped in S group.The mice were sacrificed at the end of reperfusion, and small intestinal tissues were taken for determination of the pathological changes with a light microscope after HE staining and for determination of wet to dry weight ratio(W/D ratio) and expression of PI3K, phosphorylated Akt (p-Akt), autophagy-related proteins Beclin-1, microtubule-associated protein 1 light chain 3Ⅰ (LC3Ⅰ) and LC3Ⅱ.The intestinal damage was assessed and scored according to Chiu.The ratio of LC3Ⅱ expression to LC3Ⅰ expression (LC3Ⅱ/LC3Ⅰ) was calculated. Results:Compared with S group, Chiu′s scores and W/D ratio were significantly increased, the expression of PI3K and p-Akt was down-regulated, the expression of Beclin-1 was up-regulated, and LC3Ⅱ/LC3Ⅰ ratio was increased in I/R, A and AL groups ( P<0.05). Compared with I/R group, Chiu′s scores and W/D ratio were significantly decreased, the expression of PI3K and p-Akt was up-regulated, the expression of Beclin-1 was down-regulated, and LC3Ⅱ/LC3Ⅰ ratio was decreased in A group ( P<0.05). Compared with A group, Chiu′s scores and W/D ratio were significantly increased, the expression of PI3K and p-Akt was down-regulated, the expression of Beclin-1 was up-regulated, and LC3Ⅱ/LC3Ⅰ ratio was increased in AL group ( P<0.05). Conclusion:Atorvastatin preconditioning can mitigate intestinal I/R injury in mice, and the mechanism is related to activating PI3K/Akt signaling pathway and inhibiting the level of autophagy.

Objective To investigate the relationship between neonatal umbilical cord blood cytokine interferon-γ (IFN-γ),interleukin-4 (IL-4),interleukin-12 (IL-12),interleukin-18 (IL-18) and hepatitis B virus (HBV) intrauterine infection.Methods Seventy-five newborns delivered by HBsAg-positive pregnant women in the First Hospital of Hebei Medical University and the Fifth Hospital of Shijiazhuang from December 2017 to June 2018 were selected as observation group.According to the results of five items of hepatitis B and HBV DNA test in cord blood of newborns,17 of them were positive as intrauterine infection group,and 58 of them were negative as uninfection intrauterine group.Forty-three newborns delivered by healthy pregnant women with negative HBsAg were taken as control group.The levels of cytokines IFN-γ,IL-4,IL-12 and IL-18 in cord blood of neonates were detected by ELISA,Results The levels of IFN-γ,IL-4,IL-12 and IL-18 in the newborns of intrauterine infection group were (409.51 ±51.77),630.51(612.49,647.33),85.60(56.11,133.99),32.41 (23.04,87.53) ng/L.The levels in the uninfected intrauterine Group were (523.87 ± 38.45),573.33 (531.95,598.38),186.53 (77.77,302.66),125.99(63.32,202.73) ng/L.The levels in the control group were (509.39±73.02),565.83 (443.40,620.82),199.89 (128.92,289.30),152.98 (86.76,188.57) ng/L.There were significant differences in IFN-γ,IL-4,IL-12,IL-18 between the intrauterine infection group and the uninfected intrauterine group and the control group (all P＜0.01).There was no significant difference between the uninfected group and the control group (all P＞0.05).Conclusion The decrease of IFN-γ,IL-12,IL-18 and the increase of IL-4 in cord blood of neonates result in the decrease of viral clearance ability and the failure of HBV clearance,which leads to intrauterine infection of neonates with HBV.

Objective To study the curative effect of enhanced external counterpulsation(EECP) on the ischemic symptoms,heart function and heart failure markers in the patients with ischemic heart failure.Methods One hundred and eithty patients with ischemic heart failure were divided into the external counterpulsation group and the control group.The treatment group received the EECP therapy.The angina curative effect and heart function(ultrasonic echocardiography,noninvasive hemodynamic monitoring,NYHA heart function grade) as well as heart failure markers changes after treatment were observed in the two groups.Results The effective rate of angina treatment in the counterpulsation group was higher than that in the control group,the difference was statistically significant (P＜0.01).The cardiac output (CO) and cardiac index (CI) in the counterpulsation group were significantly higher than those in the control group,the difference was statistically significant (P＜0.01);the stroke volume (SV),stroke volume index (SI),acceleration index (ACI) and velocity index (Ⅵ) in the counterpulsation group were higher than those in the control group,the difference was statistically significant (P＜0.05);the systemic circulation peripheral vascular resistance (SVR),systemic circulation peripheral vascular resistance index (SVRI) and systolic time rate (STR) in the counterpulsation group were lower than those in the control group,the difference was statistically significant (P＜0.05).There were no statistical difference between the two groups in left ventricular ejection fraction(EF),left ventricular end diastolic diameter(LVEDd) and thoracic cavity fluid volume(TFC) (P＞0.05);there was no statistical difference in NYHA heart function grade between the two groups before treatment.The NYHA heart function grade after treatment in the counterpulsation group was improved compared with that in the control group (P＜0.05).There was no statistical difference in NT-proBNP before treatment between the two groups.The NT-proBNP level after treatment in the counterpulsation group was significantly lower than that in the control group,the difference was statistically sinificant(P＜0.01).Conclusion External counterpulsation can be used for the treatment in the patients with ischemic heart failure,can alleviate the angina symptoms,improves the heart function and heart failure markers.

Objective:To evaluate the effect of lycopene preconditioning on Toll-like receptors (TLRs)/nuclear factor kappa B (NF-κB) signaling pathway during hypoxia-reoxygenation (H/R) injury to rat cardiomyocytes.Methods:The rat H9C2 cardiomyocytes were cultured in vitro, inoculated in a petri dish at a density of 8×10 4 cells/ml and divided into 3 groups( n=30 each) using a random number table method: control group (C group), H/R group and lycopene preconditioning group (LP group). The H9C2 cardiomyocytes were reoxygenated for 6 h after hypoxia to establish a model of H/R injury in H/R group and LP group.The cells were preconditioned with lycopene 20 μmol/L at 12 h before establishing the model in LP group.The cell viability was detected by CCK-8 assay.The cell apoptosis rate was detected by flow cytometry (Annexin V and PI double staining). The levels of lactic dehydrogenase (LDH), superoxide dismutase (SOD) and malondialdehyde (MDA) and reactive oxygen species (ROS) were detected by microplate method.The expression of TLR2, TLR3 and NF-κB was detected by Western blot. Results:Compared with group C, the cell viability and SOD level were significantly decreased, the apoptosis rate and levels of LDH, MDA and ROS were increased, and the expression of TLR2, TLR3 and NF-κB was up-regulated in H/R and LP groups ( P<0.05). Compared with group H/R, the cell viability and SOD level were significantly increased, the apoptosis rate and levels of LDH, MDA and ROS were decreased, and the expression of TLR2, TLR3 and NF-κB was down-regulated in group LP ( P<0.05). Conclusion:The mechanism by which lycopene preconditioning attenuates H/R injury may be related to inhibiting activation of TLRs/NF-κB signaling pathway and inhibiting oxidative stress response in rat cardiomyocytes.

Objective To explore the relationship between heart rate variability (HRV),heart rate turbulence (HRT) and blood pressure (BP) control in hypertensive patients.Methods Hypertensive patients with controlled BP group (n =50) and uncontrolled BP group (n =40) and control group non-hypertensive patients (n =52)were enrolled in this study in our hospital during June 2015 to June 2016.HRV and HRT as well as clinical characteristic of the three groups were analyzed.Results (1) Body mass index was significantly higher in the controlled BP group than in the control group.There was no statistical difference in proportions and categories of antihypertensive medication between the uncontrolled and controlled BP groups (P ＞ 0.05).(2) VLF,LF and TS were significantly lower in the uncontrolled BP group than the control group,and HF was significantly lower in the uncontrolled BP group than in the controlled BP group (P ＜ 0.05).(3) Results of muhiple logistic regression analysis showed that lower rMSSD,pNN50,VLF,LF,HF and TS were risk factors for BP control after adjusting for gender,age,EF value,creatinine,blood lipids,Beta-blockers and history of smoking,coronary heart disease and diabetes mellitus.(4) Spearman correlation analysis of the hypertensive patients showed that LF was negatively correlated with TO,and SDNN,SDANN,rMSSD,pNN50,VLF,LF,HF were positively correlated with TS.Conclusion The present results demonstrate that uncontrolled BP is associated with abnormal HRV and HRT,which suggested autonomous nervous imbalance was existed in uncontrolled hypertensive patients.