OBJECTIVE:To provide reference for the rational use of TCM injections. METHODS:487 medical records using TCM injection in our hospital from Jul. to Dec. 2014 were selected as control group,another 500 from Jan. to Jun. 2015 were inter-vention group. Utilization,rationality and adverse reactions of TCM injection between 2 groups were compared. RESULTS:Accord-ing to the intervention by clinical pharmacists,the sales amount and utilization rate of top 10 TCM injection in our hospital were lower significantly. The irrational utilization rate of 5 types (totally 26 varieties) in intervention group decreased (21.60% vs. 43.33%),incidences of adverse reactions reduced(3.00% vs. 7.39%),compared with control group,the differences were statisti-cally significant (P<0.05). Treatment cost per capita [(217.17 ± 22.64) yuan vs. (480.77 ± 21.35) yuan] and hospitalization time [(6.50 ± 1.99)d vs. (10.02 ± 3.25)d] in intervention group were significantly lower or shorter than control group,the differences were statistically significant (P<0.05). CONCLUSIONS:Implementing pharmaceutical interventions can strengthen the sense of clinicians’rational use of TCM injection,raise the level of rational use of drugs and reduce adverse reactions and medical errors.

Objective To evaluate the role of ERK1/2 signal transduction pathway in sevoflurane postconditioning-induced reduction of oxygen-glucose deprivation(OGD)injury in rat hippocampal slices.Methods Male adult SD rats weighing 80-100 g were anesthetized with ether and decapitated.The hippocampi were removed and sagittally sliced(400μm thick)and placed in artificial cerebrospinal fluid(aCSF)aerated with 95％ O2-5％CO2.Fifty hippoeampal slices were randomly divided into 5 groups(t =10 each):OGD group; 4％ sevoflurane postconditioning group(group Sevo); PD98059(specific inhibitor of ERK)group(group PD); dimethyl sulfoxide (DMSO)group; 4％ sevoflurane postconditioning + PD98059 group(group SPD).OGD was induced by incubating the slices in glucose-free aCSF aerated with 95％ N2-5％ CO2 for 15 min in group OGD.The hippocampal slices were perfused with aCSF saturated with 4％ sevoflurane for 30 min after OGD was induced in group Sevo.The hippocampal slices were perfused with aCSF containing PD98059 50 μmol/L for 10 min after OGD was induced in group PD.The hippocampal slices were perfused with aCSF containing DMSO 1 mol/L for 10 min after OGD was induced in group DMSO.The hippocampal slices were perfused with aCSF containing PD98059 50 μmol/L and aerated with 4％ sevoflurane for 30 min after OGD was induced in group SPD.The hippocampal slices were then perfused with plain aCSF for 1 h again in all the groups.The electrophysiological technique was used 1o record the amplitude of orthodromic population spike(OPS)in the stralum pyramidale of the CAI region.TTC staining was used to determine the degree of tissue injury.Results Compared with group OGD,the recovery amplitude and rate of OPS were significantly increased,and the degree of tissue injury was significantly decreased in group Sevo(P ＜0.01),while no significant change was found in each parameter in the other three groups(P ＞ 0.05).Compared with group Sevo,the recovery amplitude and tale of OPS were significandy decreased,and the degree of tissue injury was significantly increased in groups PD,DMSO and SPD(P ＜ 0.01).Conclusion ERK1/2 signal transduction pathway is involved in sevoflurane postcondilioning-induced reduction of OGD injury in tat hippocampal slices.

ObjectiveTo investigate the effects of diazoxide pretreatment on expression of phosphatidylinositol 3-kinase(PI3K) mRNA and protein serine/threonine kinase(Akt) mRNA in rat myocardial microvascular endothelial cells exposed to hypoxia-reoxygenation (H/R).MethodsThe SD rat myocardial microvascular endothelial cells were cultured.The cells were seeded in 96-well plates ( 100μd/hole) or in 6 cm diameter dishes (2 ml/dish) with the density of 1 × 106/ml and randomly divided into 4 groups ( n =25 each):normal control group (group C),H/R group,diazoxide pretreatment group (group DZ) and diazoxide pretreatment + 5-hydroxydecanoate (5-HD,a mitochondrial ATP-sensitive potassium channel blocker) group (group DZ + 5-HD).The cells were exposed to 2 h hypoxia followed by 2 h reoxygenation.Diazoxide 100 μmol/L and diazoxide 100 μmol/L + 5-HD 100 μmol/L were added to the culture medium 2 h before hypoxia in groups DZ and DZ + 5-HD respectively.The cell viability,apoptotic rate and expression of PI3K mRNA and Akt mRNA were detected at the end of reoxygenation.ResultsCompared with group C,the cell viability was significantly decreased,while the apoptotic rate increased and expression of PI3K mRNA and Akt mRNA up-regulated in group H/R (P ＜0.05 or 0.01).Compared with group H/R,the cell viability was significantly increased,while the apoptotic rate decreased and expression of PI3K mRNA and Akt mRNA up-regulated in group DZ (P ＜ 0.05 or 0.01).5-HD could inhibit diazoxide pretreatment-induced changes mentioned above (P ＜ 0.05 or 0.01 ).ConclusionDiazoxide pretreatment can reduce H/R injury by promoting PI3K gene and Akt gene transcription through activation of mitochondrial ATP-sensitive potassium channels in rat myocardial microvascular endothelial cells.

Objective To investigate the effects of diazoxide pretreatment on the expression of NF-κB mRNA and fractalkine (FKN) mRNA in rat myocardial microvascular endothelial cells exposed to hypoxia-reoxygenation (H/R). Methods The SD rat myocardial microvascular endothelial cells were cultured. The cells were seeded in 96-well plates (100μl/hole) or in 6 cm diameter dishes (2 ml/dish) with the density of 1 × 106/ml and randomly divided into4 groups (n = 24 each): Ⅰ normal control group (group C), Ⅱ H/R group, Ⅲ diazoxide pretreatment group (group DZ), Ⅳ diazoxide pretreatment + mitochondrial ATP-sensitive potassium channel blocker 5-hydroxydecanoate (5-HD) group (group DZ + 5-HD). The cells were exposed to 2 h hypoxia followed by 2 h reoxygenation. Diazoxide 100 μmol/L and diazoxide 100 μmol/L + 5-HD 100μmol/L were added to the cultured medium 2 h before hypoxia in group DZ and DZ + 5-HD respectively. The cell vitality, apoptotic rate and expression of NF-κB mRNA and FKN mRNA were detected at end of reoxygenation. Results Compared with group C, the cell vitality was significantly decreased, apoptotic rate increased and the expression of NF-κB mRNA and FKN mRNA up-regulated in H/R group. Compared with group H/R, the cell vitality was significantly increased,apoptotic rate decreased and the expression of NF-κB mRNA and FKN mRNA down-regulated in group DZ. 5-HD could inhibit diazoxide pretreatment-induced changes mentioned above. Conclusion Diazoxide pretreatment can reduce H/R injury in rat myocardial microvascular endothelial cells through down-regulating the expression of NFκB and FKN, and the mechanism is related to activation of mitochondrial ATP-sensitive potassium channels.

ObjectiveTo identify the risk factors related to the mortality of severe acute pancreatitis.Methods Clinical data of 57 cases of severe acute pancreatitis in our hospital from August 1997 to February 2004 were collected and analyzed retrospectively. There were 32 males and 25 females. The median age was 51 years. Cases were divided into death group and survival group according to their outcome. The characteristics, severity and surgical therapy were analyzed. ResultsEleven patients died, the mortality was 19.3%。 Thirty cases underwent surgery, 8 died, the mortality was 26.3%.Factors which were of significant differences between the two groups by univariate analysis were age, Ranson score, APACHEⅡscore, ascites, MODS, ARDS, heart failure and renal failure. Multivariate logistic regression showed that independent risk factors included age, ascites, MODS. ConclusionsIn case of severe acute pancreatitis,the independent risk factors related to mortality were age, ascites and MODS.

Object To establish the method for quality control of Fushengkang Capsule. Methods Semen Livistonae Chinensis, Fructus Camptothecae Acuminatae and Rhizoma Curcumae in this capsule were identified by TLC. The content of camptothecine was determined by HPLC. Condition of HPLC was: Dikma Diamonsil C 18 column (250 mm? 4 6 mm, 5 ?m) the mobile phase was a mixture of methanol water (55∶45), the flow rate was 0 8 mL/min, and detection wavelength at 254 nm. Results The spots of TLC were clear and concentrative. There was a good linear relationship for camptothecine within the range of 0 050 6 - 0 253 0 ?g. The average recovery was 96 90%, RSD=1 74% (n=6). Conclusion This method is sensitive, accurate, reproducible and exclusive. It can be used for quality control of Fushengkang Capsule

Objective To observe the effect of knee isometric training on mild to moderate lower limb muscle spasticity in stroke patients.Methods A total of 130 stroke hemiplegia patients were prospectively included in this study.They were admitted to Xiangcheng People's Hospital of Suzhou City between August 2021 and December 2023 and numbered according to the order of collection.The patients were then randomly assigned to either the control group or the isokinetic group using a random number table.Each group consisted of 65 cases.Both groups underwent conventional rehabilitation training(5 days a week,40 minutes per day),with the isokinetic group receiving additional isokinetic muscle training(5 days a week,20 minutes per day)on top of the conventional rehabilitation training.The treatment period lasted for 6 weeks.The surface electromyographic signals of the rectus femoris muscle on the affected side were analyzed for their root-mean-square(RMS),integral electromyographic(iEMG)values,the modified Ashworth scale(MAS)scores,knee flexors and extensors peak torque and its ratio,the Fugl-Meyer assessment scale-lower extremity(FMA-LE)scores,and the 10 m walk test were used before and after the treatments to compare the surface electromyography of rectus femoris,the degree of muscle spasticity and exercise capacity of the lower extremities of the two groups.Results Prior to treatment,there were no statistically significant differences between the two groups in terms of the RMS of the rectus femoris muscle,iEMG values,MAS scores,peak torque of the flexor and extensor muscles and their ratio,FMA-LE score,and step speed(all P＞0.05).RMS of the rectus femoris muscle,iEMG values,MAS scores,peak torque of the knee flexors and extensors and their ratios,FMA-LE scores,and step speed improved in control group after treatment compared to before treatment([12.3±2.2]μV vs.[15.5± 2.9]μV,[24.8±2.3]μV·s vs.[29.2±3.1]μV·s,[1.34±0.15]points vs.[1.56± 0.25]points,[20.8±3.4]N·m vs.[12.3±2.5]N·m,[34.5±2.3]N·m vs.[26.3±3.6]N·m,0.60±0.16 vs.0.47±0.14,[26.1±2.9]points vs.[21.3±2.4]points,[0.61±0.14]m/s vs.[0.46±0.15]m/s;all P＜0.05).Rectus femoris muscle RMS,iEMG values,MAS scores,peak torque of the flexor and extensor muscles and their ratio,FMA-LE scores and step speed after treatment in the isokinetic group were(10.9±1.8)μV,(22.4±2.1)μV·s,(1.25±0.18)points,(28.7±3.0)N·m,(41.5±2.8)N·m,0.69±0.18,(29.0±2.3)points,(0.69±0.18)m/s,compared with pretreatment(respectively[15.4±2.2]μV,[29.6±3.0]μV·s,[1.58±0.34]points,[12.6± 2.3]N·m,[26.1±3.1]N·m,0.48±0.17,[21.5±2.1]points,[0.48±0.17]m/s)and control group after treatment,the differences were statistically significant(all P＜0.05).Before treatment,the differences in rectus femoris muscle RMS and iEMG values between patients with mild spasticity and patients with moderate spasticity in the isokinetic group and the corresponding patients with mild spasticity and moderate spasticity within the control group were not statistically significant(all P＞0.05).After treatment,the rectus femoris muscle RMS and iEMG values in patients with mild spasticity within the isokinetic group([10.2±1.0]μV and[20.2±2.0]μV·s,respectively)were statistically different from those before treatment([14.1±2.3]μV and[28.1±3.2]μV·s,respectively)and those after treatment in patients with mild spasticity within the control group([11.4±1.7]μV and[23.6±2.5]μV·s respectively;all P＜0.05);the rectus femoris muscle RMS and iEMG values in patients with moderate spasticity within the isokinetic group improved compared with the pre-treatment period([11.8±1.5]μV vs.[16.9±2.6)μV,and[24.9±2.2]μV·s vs.[31.3±3.8]μV·s,respectively;both P＜0.05),and with the control group after treatment(RMS and iEMG values of[13.2±2.5]μV and[26.1± 2.7]μV·s,respectively),the difference in RMS was statistically significant(P＜0.01),and the difference in iEMG values was not statistically significant(P＞0.05).Conclusion Isokinetic muscle training has a positive effect on improving mild-to-moderate muscle spasticity of the lower limb knee extension,and the effect is more significant the lighter the degree of spasticity.

Objective:To investigate the effect of paper towel combined with 360° horizontal turning over method on the field of vision, operation time and detection of small lesions before gastroscopy, so as to improve the detection rate of early gastrointestinal cancer.Methods:The outpatients and inpatients who voluntarily accepted gastroscopy in the First Affiliated Hospital of Shandong First Medical University from May to October 2020 were enrolled. A prospective randomized controlled study was used. They were divided into the experimental group (paper towel group combined with 360° horizontal turning over) and the control group (routine) according to the random number table. Finally, a total of 948 patients were included, including 487 cases in the experimental group and 461 cases in the control group. The visual field clarity, operation time, rinse times, detection of micro lesions and detection of early cancer of the two groups were compared.Results:The scores of gastric mucosa clarity (fundus, body, antrum and whole stomach) in experimental group were (1.61 ± 0.79), (1.18 ± 0.56), (1.01 ± 0.36), (3.20 ± 0.51) points, which were significantly lower than (2.56 ± 0.82), (2.01 ± 0.65), (1.98 ± 1.10), (5.05 ± 0.89) points in control group. The difference was statistically significant ( t values were 0.02-0.07, all P<0.05). The operation time of the experimental group was (5.91 ± 0.41) min, which was significantly shorter than (6.80 ± 0.72) min of the control group, and the difference was statistically significant ( t=-7.46, P<0.05). The number of flushing in the experimental group was 67 times, accounting for 13.8%, which was significantly lower than 144 times in the control group, accounting for 31.2%, and the difference was statistically significant ( χ2=54.78, P<0.05). The number of microlesions in the experimental group was 398 cases, which was higher than 245 cases in the control group. The difference was statistically significant ( χ2=8.43, P<0.05). For biopsy pathology, the detection of precancerous lesions or early carcinomas in the experimental group (56 cases) was significantly higher than that in the control group (24 cases), and the difference was statistically significant ( χ2=6.45, P<0.05). Conclusions:The application of paper towel combined with 360° horizontal turning over method before gastroscopy can significantly improve the clarity of gastroscope field of vision, shorten the operation time, increase the detection rate of small lesions, and effectively improve the detection rate of early gastrointestinal cancer, which is a simple and practical preoperative preparation method.

Objective To explore the regulatory effect of Mertk expression level on NF-κb pathway in rat Schwann cells and its possible mechanism.Methods Rat Schwann cells were cultured in vitro,and the expression of Mertk in Schwann cells exposed to high glucose was detected by Western blot.Co-immunoprecipitation was used to detect the interaction between endogenous Mertk and Ikbkb.Western blot was used to detect the expression levels of Ikbkb,P65 and tumor necrosis factor-α in Schwann cells after Mertk silencing.The protein expressions of Mertk,Ikbkb and P65 after silencing Mertk were detected by immunofluorescence.Results Mertk was expressed in Schwann cells,and the expression level increased with the increase of glucose concentration.Co-immunoprecipitation assay showed that Mertk interacted with Ikbkb in rat Schwann cells.Compared with the control group,the expression level of Mertk was significantly decreased(P<0.05),while Ikbkb,P65 and TNF-α were significantly increased(P<0.05)after knock down expression of Mertk in Schwann cells.Immunofluorescence experiments showed that the fluorescence of Mertk was decreased,and the fluorescence of Ikbkb and P65 was increased in the silenced Schwann cells.Conclusion After the expression of Mertk is decreased,it can mediate the regulation of NF-κb pathway in Schwann cells through interaction with Ikbkb,and up-regulate the expression of P65 and inflammatory factor TNF-α.