OBJECTIVE:To evaluate the current situation and the trend of development of quinolones used in156hospitals of6cities in the Yangtze valley.METHODS:Quinolones used in156hospitals of6cities in the Yangtze valley were analyzed statistically in respect of the kind,consumption amount and DDDs etc..RESULTS:During the period of2000～2003,the annual increasing rate for consumption sum,DDDs and the defined daily cost of Quinolones used in156hospitals were22.08%,2.16%and19.50%respectively,with that of the higher defined daily cost increased faster,of which the annual increase rates in consumption sum and DDDs were up to33.22%and33.59%respectively,while the increasing percentage of oral quinolones was8.57%and-0.88%.Levofloxacin,which ranked the first in consumption,accounted for48.22%of total consumption and25.66%in DDDs.CONCLUSION:The marketing of quinolones will be further expanded.

OBJECTIVE:To investigate the current situation and developing trend of the use of antidepressants in hospitals of Shanghai.METHODS:Using DDD as index,the data of antidepressants used in47hospitals in Shanghai during the period2000～2002were analyzed.RESULTS:The average annual increase rate of sum of money for antidepressants was15.33%.The sum of money for selective serotonin reuptake inhibitors(SSRIs)accounted for92.17%,and that of fluoxetine accounted for60.02%of the total antidepressants used.CONCLUSION:SSRIs occupied the antidepressants marketing predominance.

AIM:To explore whether miR-21 low expression enhances the effect of matrine ( MAT) on the ap-optosis of hepatocellular carcinoma cells .METHODS:Real-time fluorescence quantitative PCR ( RT-qPCR) was used to detect the expression of miR-21 in the HepG2 cells treated with different concentrations of MAT .The effect of miR-21 on MAT-induced HepG2 cell apoptosis was analyzed by flow cytometry .The mRNA and protein expression of Bcl-2 and Bax in the HepG2 cells treated with MAT was determined by RT-qPCR and Western blot .RESULTS:The expression of miR-21 increased with the increasing concentration of MAT .Low expression of miR-21 promoted MAT-induced apoptosis , and en-hanced the expression of Bax at mRNA and protein levels ( P<0.05 ) , while inhibited the expression of Bcl-2 at mRNA and protein levels (P<0.05).CONCLUSION:Low expression of miR-21 enhances MAT-induced HepG2 cell apoptosis by inhibiting the expression of Bcl-2 and promoting Bax expression .

Objective To investigate the effect and mechanism of dibenzazepines ( DBZ ) injection on pulmonary hypertension in rat. Methods Rat models of pulmonary hypertension were established, and 30 male rats were randomly divided into 3 groups: normal control group with saline injection, pulmonary hypertension model control group with hypoxia treatment and saline injection, DBZ group with hypoxia treatment and DBZ injection. The right ventricular pressure was determined by ultrasound cardiogram.Pulmonary arterial remodeling was detected by HE staining.Proliferation cell nuclear antigen and CCK-8 in pulmonary arterial smooth muscle cells were detected by Western blotting. Results The right ventricular pressure of pulmonary hypertension group was significantly increased compared with normal control group [(4.60±0.16) kPa vs. (3.37±0.18) kPa(P<0.01)].After hypoxia treatment, pulmonary arterial remodeling and proliferation of pulmonary arterial smooth muscle cells of the rats of pulmonary hypertension group were augmented remarkably. Rats from DBZ group showed reductions in right ventricular pressure, amelioration in pulmonary arterial remodeling and suppression in proliferation of pulmonary arterial smooth muscle cells. The proliferation of rat pulmonary artery smooth muscle cells decreased significantly in DBZ treated group [(2.073±0.064) vs.(4.392±0.013)] compared with model control group (P<0.05). Conclusion Notch pathway takes part in the process of pulmonary hypertension, and DBZ injection can significantly suppress the proliferation of pulmonary artery smooth muscle cells with a protective effect on pulmonary hypertension.

Objective To investigate the role of microRNA-21(miR-21) on cardiac fibroblast proliferation and dif-ferentiation in the mouse model of myocardial infarction. Methods The mouse model of myocardial infarction (MI) was es-tablished by ligation of the left coronary artery in male C57BL/6 mice(MI group). The echocardiographic assessment and his-tological evaluation were performed after ligation. The expression levels of miR-21 were measured by quantitative real-time PCR in the various myocardial tissues. The cardiac fibroblasts transfected with miR-21 mimic were over-expressed miR-21. The proliferation was assessed by immunostaining for 5-ethynyl-2’-deoxyuridine (EdU). Western blot assay was used to detect the expression ofα-SMA and Smad7 in the cardiac fibroblasts,and compared with control group and blank group. Results The expression of miR-21 was significantly increased in border area in MI group than that of sham group [(6.043 ± 0.231)×10-4 vs(1.620±0.451)×10-4,P<0.01]. There was a higher expression of miR-21 in miR-21 mimic group than that of control group and blank group [(4.839±0.705)×10-4 vs(1.143±0.064)×10-4 vs(1.017±0.201)×10-4,P<0.01]. The EdU positive rate was significantly higher in miR-21 mimic group than that of control group and blank group[(27.892±1.645)%vs(12.553 ± 1.227)% vs(13.946 ± 1.550)%,P<0.01]. The expression of α-SMA was significantly increased in miR-21 mimic group, while the expression of Smad7, a target gene of miR-21, was significantly decreased. Conclusion The over-expression of miR-21 in cardiac fibroblasts disrupts TGF-βsignaling pathway by reducing the expression of Smad7, which promotes the proliferation and differentiation of cardiac fibroblast, and finally regulates cardiac remodeling after myocardial infarction.

Pelvic inflammatory disease sequela (chronic pelvic inflammation) is one of the diseases that affect women's health conditions, and leads to large economic burden. Chinese Material Medica (CMM) plays an impor-tant role in treating pelvic inflammatory disease sequela (chronic pelvic inflammatory). However, due to the lack of Evidence-based Pharmacoeconomic Evaluation Technical Essentials of CMM in Treatment of Pelvic Inflamma-tory Disease Sequela (Chronic Pelvic Inflammatory), non-standard phenomenon often appears in the research liter-ature, such as the selection of research methods, viewpoint of research, determination of cost, effect and utility. Thus, the publish of Evidence-based Pharmacoeconomic Evaluation Technical Essentials of CMM in Treatment of Pelvic Inflammatory Disease Sequela (Chronic Pelvic Inflammatory) is essential for the pharmacoeconomic evalua-tion of CMM in treating pelvic inflammatory disease sequela (chronic pelvic inflammatory).

Objective To evaluate early results of Endurant stent-graft in the treatment of abdominal aortic aneurysms (AAAs).Methods From July 2010 to June 2011,68 patients (57 men,11 women; mean age 74.3 years) were treated with Endurant stent-graft at our center.26 cases had hostile proximal neck in the anatomy.According to ASA classification,15 cases were class Ⅱ ; 32 cases were class Ⅲ and 21 cases were class Ⅳ.Results Intraoperative immediate technical success was achieved in all cases.At completion angiography,a type Ⅱ endoleak was detected in 18 (26％) of the 68 patients.The mean operation time was (96 ± 29) min,the mean blood loss was (99 ± 68 ) ml,and the mean contrast usage was (122 ± 65) ml.No intraoperative conversion to open surgery,stent migration,types Ⅰ/Ⅲ endoleak,other major complications,or death was encountered.49 patients (72％) had a postimplantation syndrome with fever,leukocytosis,and increase of C-reactive protein levels,which completely resolved within two weeks.The mean follow-up time was (8 ± 5) months.Conclusions Endurant stent-graft seems to be safe and effective in endovascular aneurysm repair,even in patients with hostile aortoiliac anatomy.

Objective To probe into the reasons for and results of remedial surgical therapy in thoracic aortic dissection patients after first endovascalar repair.Methods From July 2000 to December 2012,12 cases received second interventional surgery.The average time from second therapy to first surgery was ( 14 ± 11 ) months.Main reasons for second endovascular therapy were sustained type Ⅰ endoleak at proximal landing zone and type A dissection caused by retrograde tear.Therapies included hybrid operations in 8 cases and absnlute endovascular therapy in 4 cases.Results The 30 day mortality after the second intervention was 5.6％ ( 1/12),total mortality rate was 16.7％ (2/12).In 7 cases with endoleak,small endoleak remained after remedial therapy (57.1％ ) in 4 cases.Among 4 cases with secondary type A aortic dissection,successful staged hybrid operation with mid-sternal thoracotomy was adopted in 3 cases,one died of pulmonary emtbolism during follow-up period,1 case with Bebcet disease still had proximal type Ⅰ endoleak after second hybrid operation,and died from tear of aorta.Conclusions Endoleak and secondary type A aortic dissection are the main cause necessitating second intervention after primary endovascular therapy for thoracic aortic dissection.Hybrid operation remains the best choice to treat postoperative complications after endovascular therapy for thoracic aortic dissection.

Objective To determine the influence of hostile neck anatomy on type Ⅰ a endoleak development after endovascular aortic aneurysm repair (EVAR) for infrarenal abdominal aortic aneurysmal disease.Methods From July 2008 to July 2011,195 consecutive patients with non-ruptured abdominal aortic aneurysms (AAA) were treated with EVAR.There were 150 males and 45 females,aging from 52 to 95 years with a mean of 69 years.Forty-three patients were with hostile neck anatomy ( HNA ).High-resolution computed tomography was abtained in all patients,with detailed measurement of proximal neck parameters.Univariate and multivariate analyses were used to compare Ⅰ a endoleak and HNA.Follow-up protocol consisted of computed tomography (CT) angiograms or ultrasound at 3,6,and 12 months,and annually thereafter.Results Twenty-three patients had intraoperative type Ⅰ a endoleaks.The adjunctive measures,such as repeated balloon angioplasty,cuff extension,Palmaz stent placement and chimney technique were used for treating type Ⅰ a endoleak.Small endoleak remained in only one patient.The technical success rate was 98.5％ (192/195).The association between type Ⅰ a endoleak development and magnitude of the infrarenal angle was statistically significant.The mean follow-up time was ( 18 ± 3 )months.The survival rates at 1- and 3-year were 97.4％ and 89.2％ respectively.Conclusions The proximal neck angle is related to intraoperative type Ⅰ a endoleak occurrence,but other factors often thought to be indicative of adverse neck anatomy are not significant predictors.Most type Ⅰ a endoleaks in this study were uccessfully eliminated intraoperatively with a satisfactory mid to long term results.

Background Conjunctivochalasis is an age-related inflammatory ocular surface disease manifesting redundant,loose conjunctiva folds.Studies showed that conjunctivochalasis often accompanies with inflammatory response,indicating that a variety of inflammatory cytokines are involved in pathogenesis of conjunctivochalasis.Objective This study attempted to investigate the expressions of pentraxin-3 (PTX-3) and tumor necrosis factor-α stimulated gene-6 (TSG-6) proteins in fibroblasts of conjunctivochalasis.Methods The protocol was approved by Ethic Committee of Putuo Hospital affiliated Shanghai University of Traditional Chinese Medicine.Thirteen eyes of 13 patients with conjunctivochalasis,16 eyes of 16 patients with age-related cataract and 16 eyes of 15 patients with pterygium were included in Putuo Hospital Affiliated to Shanghai University of Traditional Medicine from January,2011 to June,2012.The samples of conjunctival tissue were collected in the patients during surgery under the informed consent,and fibroblasts were cultured and passaged by explant culture method.Content of PTX-3 and TSG-6 proteins in cell supernatant was detected by ELISA.Results Translucent poor,dark black area was around the cell overflow.Cultured cells of third generation showed long shuttle type,uniform size,radiated out in all directions,and oval nuclei was sited in the cytoplasm,surrounded by varying the length of cross-linking of cell processes.The concentrations of PTX-3 protein in cell supernatant were (2 182.33 ± 738.68) pg/ml in the conjunctivochalasis group,which were higher than (738.32±335.00) pg/ml in the age-related cataract group and (981.37±416.04)pg/ml in the pterygium group,showing a significant difference among the three groups (F =6.474,P=0.032).The contents of TSG-6 proteins in cell supernatant were (59.10±6.52) pg/ml,(53.99± 11.16) pg/ml and (35.01±5.33)pg/ml in the conjunctivochalasis group,pterygium group and age-related cataract group,with a significant difference among the three groups (F =7.421,P =0.024),and contents of TSG-6 proteins in the agerelated cataract group was lowest,however,no significant difference was found in the TSG-6 contents between the conjunctivochalasis group and the pterygium group (P＞0.05).Conclusions Inflammatory reaction participates in the pathogenesis and development of conjunctivochalasis,up-regulation of PTX-3 and TSG-6 expression in fibroblasts might partakes in the pathogenesis of conjunctivochalasis.