OBJECTIVE:To provide reference for clinical rational drug use.METHODS:Computer network system(CNS)of clinical rational drug use was constructed by using Hospital Information System(HIS),electronic medical records for both outpatients and inpatients and Prescription automatic screening system(PASS),which was then used for real time monitoring of clinical drug use.RESULTS & CONCLUSION:CNS has become an indispensable means for hospital management and clinical drug use in that it can provide support for the data analysis of clinical rational drug use,improve the level of clinical rational drug use,standardize the medical behavior and imrpove the treatment quality.

Targeted therapeutic strategy for cancer stem cells (CSCs) is the key to prevent tumor relapse and metastasis. The im-portant roles of epigenetic regulation on the development of stem cells and gene reprogram of somatic cells suggest that this process may remarkably affect the occurrence and development of CSCs. The epigenome, which comprises DNA methylation, histone modifica-tions, chromatin structures, and non-coding RNAs, controls gene expression patterns. In renal cell carcinoma (RCC), aberrant changes occur in the epigenome. To date, cells with CSC properties from RCC have been successfully isolated using different methods, such as sorting using the Hoechst 33342 side population, forming tumor spheroid, and sorting CD105 cell surface biomarker. According to the progress in genetic studies on RCC, in addition to DNA sequence, the abnormality in the regulatory mechanism has considerable func-tions in tumor progression. Epigenetic changes may be integral to the behavior of cancer progenitor cells and their progeny. Knowledge on epigenetics in renal tumorigenesis process is beneficial in the development of new therapeutic modalities and may deliver new prog-nostic and early diagnostic markers. This paper reviews the latest development in the study of RCC stem cells and the underlying mech-anisms of epigenetic regulation on the development of CSCs in RCC.

Objective　To evaluate the effectiveness of intratracheal tube suctioning by respiratory mechanics measurement.Methods　The indexes of respiratory mechanics,including respiratory rate,expiratory tidal volume,% leak around the tube,dynamic respiratory compliance and mean airway resistance were measured just before and 20 minutes after intraendotracheal tube suction in mechanical ventilated children with respiratory failure.Results　Fifty-two measurements was carried out in 11 patie nts.The mean values of respiratory risistance was (116.73±27.12)cmH2O/L.s before suctioning and (93.38±26.64)cmH2O/L.s after suctioning,with significant differrence(P＜0.01)；The mean values of % leak around the tacheal tube dereased from(18.12±4.12)% before suctioning to (8.71±3.76)% after suctioning (P＜0.05),The mean values of expiratory tidal valume was markedly increased from(7.31±2.12)ml/kg before suctioning to(5.72±1.2)ml/kg after suctioning(P＜0.01),The total respiraory rate markedly decreased after suctioning.Conclusion　The respiratory mechanics measurement is very useful to evaluate the airway patient.The removal of secretions is crucial in respiratory managemet.

Objective: To study diagnostic and predictive value of levels of high sensitive C reactive protein (hsCRP) and cystatin C (CysC) for acute coronary syndrome (ACS) in aged patients.Methods: A total of 60 ACS patients (ACS group) treated in our hospital and 60 healthy subjects (healthy control group) undergoing physical examination during Dec 2013 to Sep 2015 were randomly selected.Serum levels of hsCRP and CysC, and abnormal rates of hsCRP and CysC were measured and compared between two groups.Results: Compared with healthy control group, there were significant rise in serum levels of hsCRP[(3.02±1.13) mg/L vs.(7.95±2.38) mg/L]and CysC[(0.75±0.11) μg/ml vs.(1.35±0.43) μg/ml], and abnormal rates of hsCRP (0 vs.13.33%) and CysC (0 vs.11.67%) in ACS group, P<0.01 all.Conclusion: Serum hsCRP and CysC level measurements can effectively predict and assess occurrence, development and prognosis of disease in ACS patients, and provide clinical valid evidence for its diagnosis, prevention and treatment.

Objective To evaluate the effect of chlamydiaphage virus protein 2(Vp2) on the recombinant virus and virus screening research, and it clinical value thereof. Methods To compare the Vp2 protein sequences to get the conserva-tive region with COBALT. A phylogenetic tree was built with ProteinBlast of Distance tree. The amino acid sequence in the high conservative region was predicted by the methods of Gamier-Robson and Chou-Fasman, and its flexibe regions were predicted by Karplus method. The hydrophilicity plot was predicted by Kyte-Doolittle and Hopp-Woods method. The sur-face probability was analysed by Emini, and the antigenic index was analysed by Jameson-Wolf method. Results The six Chlamydiaphage Vp2 proteins were the highly conserved sequences. There were obvious differences between Chp1Vp2 and other 5 Vp2 proteins. There were the main structure-alpha helix and some cell epitopes in the high conserved region. Con-clusion Vp2 protein is the important component of chlamydia phage capsid with the conservative nature. Vp2 protein has complicated structures and high conservative region with strong immunogenicity, playing a practical value of research in vi-rus recombinantment and screening the wild strains of chlaymdia trachomatis phage.

Objective To evaluate the safety and efficacy of overlapping sirolimus-eluting stent (SES) for long lesions during primary percutanous coronary intervention(PCl) in elderly patients with ST-segment elevation myocardial infarction (STEMI).Methods Seven hundred and seventy-five elderly patients with STEMI who underwent primary PCI were enrolled and followed up. Patients with two or more SES implanted for long lesions during PCI were taken as long lesion group and patients with single stents implanted were regarded as control group. The safety endpoints were in-hospital and follow-up death and stem thrombosis, and the clinical endpoints were the incidence of restenosis and target vessel revascularization rate during in-hospital follow-up and 6 months" follow-up.Results Among 775 patients, 62 patients had 64 long lesions. The average number of stents was 2. 2, and the average lesion length and stent length implanted were (45.3±10. 4)mm and (52.2±11.0)mm, respectively. During the 6 months' follow-up, the incidence of angiographically documented stent thrombosis were 1.6% in long lesion group and 1.1% in control group, respectively. No death or myocardial infarction occurred in two groups. There was no significant difference in the incidence of restenosis and target vessel revascularization rate between long-lesion group and control group (8. 1 vs. 4.8%, 6.9% vs. 3. 7%, both P>0.05). Conclusions Overlapping implantation of homemade SES is safe and effective for STEMI patients with long lesions in short-term period.

Objective To explore the effect of prehospital 12-lead electrocardiogram (ECG) and transtelephonic notification on door-to-balloon time in patients with ST-segment elevation myocardial infarction (STEMI). Methods Four hundred and two patients with STEMI who underwent primary PCI from January 2006 to December 2007 in Beijng Anzhen Hospital were analyzed. They were divided into 3 groups: 137 patients without prehospital ECG (group A), 176 patients with prehospital ECG (group B) and 89 patients with prehospital ECG and early transtelephonie notification (group C). Door-to-balloon time and in-hospital mortality were compared among the groups. Results There were no significant differences in age, sex, past medical history and infarcted area among three groups. Compared with group A, patients in group B and group C had much shorter door-to-balloon time (96 minutes and 86 minutes vs. 113 minntes in group A, all P<0. 01). No difference was found in in-hospital mortality among three groups (2. 9% vs. 2.3% vs. 2. 2%, P> 0. 05). Conclusions Prehospital ECG and early transtelephonic notification can significantly shorten door-to-balloon time in patients with STEMI. Coordinated system including prehospital ECG and transtelephonie notification is proved to be feasible and effective.

Objective: To evaluate the safety and efficacy of overlapping Sirolimus-eluting stents (SES) in very long lesions during primary percutaneous coronary intervention (PCI) in patients with ST-elevated myocardial infarction (STEMI).Methods: A total of 297 consecutive patients with STEMI underwent primary PCI from January to December 2007 in our hospital were studied.We identified the patients who had 2 or more SES implanted in single long lesion with a single procedure.6 months angiographic and clinical follow-up was performed.The incidences of restenosis and major adverse cardiac event (MACE) during hospitalization and at the follow-up time were analyzed.Results: We identified 31 patients with 31 long lesions who had been implanted more than 2 stents.A median of 2.1 stents were implanted, the median lesion length was 47.2±10.3mm and a median implanted stents'length was 53.2±10.5 mm.6 months clinical follow up rate was 100% and 6 months angiographic follow-up rate was 74.2%, respectively.The incidence of MACE was 8.7% which including target lesion revascularization (TLR).No cardiac death and no fatal myocardial infarction were found.Conclusion: Implantation of SES for very long target lesions seemed to be safe and effective in patients with ST elevated myocardial infarction.Its long-term safety and effectiveness should be further investigated.

Objective To study the mangiferin absorption process of mangiferin polymorphs in SD rats thus to find out the optimal crystal form and explore the factors that may affect the clinical effects of mangiferin. Methods Each rat was given one of three crystal forms of mangiferin. Plasma concentration of mangiferin were determined by HPLC-MS method. After liquidliquid extraction by ethyl acetate, the chromatographic separation was carried out on an Agilent ZORBAX SB-C18 (2.1 mm× 100 mm,3.5 μm) with a mobile phase consisting of methanol-0.1％ formic acid aqueous solution (30:70) . Mass spectrometry were performed in positive ion mode. Ion mass-to-charge ratio was set at 445 and 447 for mangiferin and, cefuroxime sodium (internal standard) respectivel for quantitive analysis. Results The main pharmacokinetic parameters of mangiferin form II, Ⅴ, Ⅵ were as follows: AUC(0-24 h) were (1323. 27 ± 218. 07) ,(1974. 34 ± 469. 24) ,(1737. 79 ± 623. 06) ng · mL-1 · h, respectively; Cmax were (321.92±85.18) ,(455.83±277.07) ,(319.92±86.07) μg·L-1, respectively; tmax were (0.70±0.45) , (0.50±0.32) ,(0.50± 0.34) h, respectively; t1/2z were (2.78± 1.72) ,(5.29± 2.67) ,(5.31± 2.82) h, respectively. Conclusion The main pharmacokinetic parameters of mangiferin polymorphs in plasma of rats are different, and mangiferin form Ⅴ has the hightest AUC(0-24 h) and Cmax.

Objective To investigate the role of hydrogen therapy in reducing radiation-induced lung injury and the specific mechanism. Methods Forty C57BL/6 mice were randomly divided into four groups: normal control group, model group, hydrogen therapy group I, and hydrogen therapy group II. A mouse model of radiation-induced lung injury was established. The pathological changes in the lung tissue of the mice were examined with HE staining. Immunofluorescence staining was used to detect the expression of surface markers of M1 and M2 macrophages to observe macrophage polarization. The expression of interleukin (IL)-6, tumor necrosis factor-α (TNF-α), and IL-10 in the lung tissue was measured by immunohistochemistry. The expression of nuclear factor-kappa B (NF-κB) p65 and phosphorylated NF-κB (P-NF-κB) p65 was measured by Western blot. Results HE staining showed that compared with the control group, the model group exhibited alveolar septal swelling and thickening, vascular dilatation and congestion, and inflammatory cell infiltration in the lung tissue; the hydrogen groups had significantly reduced pathological damage and inflammatory response than the model group, with more improvements in hydrogen group II than in hydrogen group I. Immunohistochemical results showed that compared with those in the control group, the levels of the inflammatory cytokines IL-6 and TNF-α were significantly increased in the model group; the hydrogen groups showed significantly decreased IL-6 and TNF-α levels and a significantly increased level of the anti-inflammatory factor IL-10 than the model group, which were more marked in hydrogen group II than in hydrogen group I. Immunofluorescence results showed that compared with the control group, the expression of the surface marker of M1 macrophages in the model group was significantly upregulated; the hydrogen groups showed significantly downregulated M1 marker and significantly upregulated M2 marker, and hydrogen group II showed significantly increased M2 marker compared with hydrogen group I. Western blot results showed that compared with that in the control group, the ratio of P-NF-κB p65/NF-κB p65 in the model group was significantly increased; the P-NF-κB p65/NF-κB p65 ratio was significantly reduced in the hydrogen groups than in the model group, and was significantly lower in hydrogen group II than in hydrogen group I. Conclusion Hydrogen inhalation therapy may reduce the inflammatory response of radiation-induced lung injury by inhibiting the NF-κB signaling pathway to promote the polarization of the macrophage M1 subtype to the M2 subtype.