Objective To know the mechanism of the adverse effect of formaldehyde on cortex neurons. Methods In the present study, incubation of postnatal Wistar rat cortex neurons in culture with formaldehyde at 1.0, 2.0, 4.0, 8.0 mg/L (medium) was carried out to have knowledge of the effect of formaldehyde on the expressions of GluR2 and GABAR. For keeping the given concentration of formaldehyde, formaldehyde was added to the medium every hour for 4 consecutive hours. Results Immunocytochemistry showed a significant down-regulation of GluR2 and up-regulation of GABAR after 4 consecutive hours of formaldehyde treatment compared with the control (P

Objective To know the effect of ultraviolet A on energy metabolism in the cells in culture by using the primary cultured postnatal rat cortex neurons for in which there are many mitochondria. Methods The primary cultured postnatal SD rat cortex neurons in 60 mm dishes were exposed to UVA in a chamber in doses of 0, 3, 6 and 9 J/cm2 respectively. The exposure was followed by 4 hours culture and then the activity of cytochrome oxidase (COX) in the single neuron was determined by cytochemisty, the quantitative analysis was done with Image-Pro plus 4.0. Results In every exposure groups, after UVA exposure followed by 4 hours culture, no significant changed vital signs were found under the microscope, the activity of COX in the neurons significantly decreased compared with the control and a dose-response relationship was presented. Conclusion Low level UVA exposure may cause obvious energy metabolism decrease in the cells in culture before the significant changed vital signs are seen.

The morbidity and mortality of gastrointestinal malignancies are the highest in the world. For patients with poor response to conventional chemotherapy, new treatment methods are urgently needed. In recent years, under the background of precision medicine, antibody-drug conjugates (ADCs) with high tumor specificity and potent toxicity have become a hot research spot in the field of biomedicine. However, due to the complex structure and mechanism of ADCs, its pharmacokinetic research is facing great challenges which are the biggest resistance to the development of ADCs at present. In this case, it is of great significance to understand the pharmacokinetic properties of ADCs and make use of it to improve the efficacy of ADCs in the treatment of gastrointestinal malignancies. Based on the basic composition and mechanism of ADCs, this review summarizes the pharmacokinetic properties of ADCs, discusses its recent advances in the treatment of gastrointestinal malignancies, in order to provide more references for follow-up research on ADCs.

Objective:To analyze the effect and safety of blood glucose fluctuation in brittle diabetes treated with intensive insulin therapy combined with sodium-glucose transporter 2 inhibitor.Methods:Ninety-eight patients with brittle diabetes in Shenzhen Longhua District People's Hospital were selected from May 2017 to May 2019. They were divided into two groups by random number table, 49 cases in each group. The control group was treated with intensive insulin therapy combined with saglitine, while the observation group was treated with intensive insulin therapy combined with sodium-glucose transporter 2 inhibitor. Following up for 12 weeks, the plasma glucose and blood glycemic variations, insulin dosage, plasma 8-iso-prostaglandin F2α, hypersensitive C-reactive protein and safety related indicators were compared between the two groups before and after treatment.Results:Compared with the control group, the standard deviation of blood glucose [(1.8±0.5)mmol/L vs (6.5±1.4)mmol/L, t=7.235], large amplitude glycemic excursions [(6.5±1.1)mmol/L vs (17.3±4.7)mmol/L, t=13.446], postprandial glucose excursion [(1.2±0.4)mmol/L vs (9.2±2.0)mmol/L, t=8.921], inter-quartile range [(3.7±1.1)mmol/L vs (12.4±4.2)mmol/L, t=7.003], means of daily difference [(1.5±0.4)mmol/L vs (4.6±0.8)mmol/L, t=4.537] in the observation group were significantly decreased ( P<0.05), and the levels of plasma 8-iso-prostaglandin F2α [(7.8±1.2)ng/L vs (13.6±2.3)ng/L, t=4.882], hypersensitive C-reactive protein [(5.2±1.3)mg/L vs (8.7±1.3)mg/L, t=4.406], insulin dosage [(30.9±10.2)U/d vs (42.3±13.4)U/d, t=5.726] and body mass index [(18.3±1.2)kg/m 2 vs (21.0±2.3)kg/m 2, t=4.135] also decreased significantly ( P<0.05), and the incidence of hypoglycemic events [16.3%(8/49) vs 36.7%(18/49), χ 2=9.697] and severe hypoglycemia [0 vs 14.3%(7/49), χ 2=7.268] decreased significantly ( P<0.05). Conclusions:Combination of dapagliflozin and intensive insulin therapy can significantly improve glucose metabolism in brittle diabetes, and reduce insulin dosage and hypoglycemic events.

Objective To analyze the adverse drug reactions(ADRs)of edaravone in treatment of patients with acute cerebral infarction(ACI)by reviewing Chinese medical literature and to evaluate safety of edaravone treatment in ACI.Methods Publications from Pubmed and Chinese Biomedical Literature Datababe(CBMdisc)were reviewed and the ADR of edaravone was analyzed among the published 8645 cases.Literatures about randomed-control clinical trails(RCTs)on security of edaravone for treating ACI Was analyzed by meta-analysis.Results Abnormal hepatic function,especially mild elevation of aminotransferase,renal dysfunction and skin rash induced by edaravone were tIle most common ADRs.Among 8645 patients,ADRs were reported in 283(3.27 % ).The meta-analysis in RCTs showed that between the group treated with a combination of edaravone and routine and the group treated with routine treatment only,there was no significant difference in the occurrence rate of ADRs(OR=1.18,95 % CI0.70-2.00,P=0.536),elevation of aminotransferase(OR=1.23,95 % CI 0.57-2.68,P=0.595)or renal dysfunction including albuminutia,increased level of serum ereatinine and nitrogen(OR=1.65.95 % CI0.57- 4.79.P=0.353).Conclusion Edaravone has a low ADRs OCCurrence rate and iS safely used in cerebral infarction treatment.

Objective To investigate the significance of intensity modulated radiation therapy(IMRT)for spinal metastases during different target areas setting and evaluate the efficacy of pain relief before and after radiotherapy. Methods Forty-four cases of spinal metastases were treated with intensity modulated radiation therapy, including 18 males and 26 females; aging from 40 to 68 years with a mean of 56 years.Frankel grade before treatment: stage A in 2 patients, B in 2, C in 3, D in 3, E in 34. The target area was determined according to preoperative imaging, CT localization before radiotherapy and different anatomical characteristics of spinal cord segments. And then the intensity modulated radiation therapy was performed by means of 5-field irradiation. Prescription dose: 30-56 Gy, the average 40.5 Gy, the median dose of 40 Gy, 2-3 Gy/times, 5 times/week. Before and after radiotherapy for pain relief in patients, neurological function of spinal cord were compared and comprehensively evaluated. Results Among 44 patients undergone pain intensity modulated radiation therapy, 21 patients achieved complete remission, 17 achieved partial remission and 6 achieved minor effect, with a relief rate of 86.4% (38/44). Pain rating before treatment was not correlative with the state of pain relief. Evaluation of the effect of radiotherapy showed complete remission in 4 cases and partial remission in 33, no change in 7, with an efficiency rate of 84.1%(37/44). There was no relationship between pain relief with implant nails and implant bone cement. Ten patients with different degrees of neurological impairment before treatment were improved in Frankel grade after treatment. Conclusion IMRT can improve pain in patients with metastatic spinal tumors, and nerve dysfunction and other symptoms, which was not easy to result in radioactivity spinal cord and nerve injury.

OBJECTIVE:To provide reference for the construction and development of hospital modernization pharmacy in Chi-na,and to promote the application of pharmacy automation system in hospital. METHODS:By introducing the change of pharma-cy management due to the debugging and application of outpatient pharmacy automation system(rapid dispensing machine,intelli-gent access machine)in our hospital,the problems of automation system and countermeasures were put forward,and the effects of automation system in our hospital were evaluated. RESULTS:With the application of automation system,the pharmacy layout was adjusted,the drugs in the machine was debugged and optimized,the procedure on adding drugs and stocktaking drugs were im-proved,the reasonable scheduling work in outpatient pharmacy was worked,the complete management plan on validity of drugs was established;referring to the problems of automation system,the procedures of adding drugs by rapid dispensing machine and intelligent access machine were formulated as well as related working guide. The adding and delivering drug failure emergency han-dling procedure of rapid dispensing machine,intelligent access machine failure emergency handling procedure were formulated ac-cording to the possible fault of automation system. Related index evaluation showed that automation system was applied and continu-ously improved,which reduced labor intensity(step count of pharmacists adding drug decreased from 5 634.6 steps/day to 4 087.8 steps/day);the work efficiency was improved greatly(the number of prescriptions increased from 226.55 sheets/h to 311.55 sheets/h during rush hours);the work error was reduced(the number of dispensing internal error decreased from 54.75 items/week to 21.50 items/week). CONCLUSIONS:After appling the automation system in outpatient pharmacy,the drug dispensing and staff manage-ment has been standardized,and it become the hospital pharmacy development inevitable trend. But it is suggested to adjust and op-timize the automation system continuously so as to exert its maximal efficacy.

Objective To study the clinical value of bedside ultrasound in predicting the fluid responsiveness in pa?tients with septic shock in intensive care unit (ICU). Methods Forty-two mechanically ventilated patients with septic shock who admitted to ICU of the Affiliated Hospital of North China University of Science and Technology from January 2015 to April 2015 were included in this study. All patients were treated with volume expansion (VE) text. Hemodynamics in?dexes were obtained by ultrasound before and after each test, including stroke volume (SV), aortic peak blood flow velocity variation rate of breathing (△VpeakAO), inferior vena cava expansion index (△IVC) and brachial artery maximum speed vari?ation rate (△VpeakBA). Clinical data and central venous pressure (CVP) were recorded. Based on the responsiveness of SV, patients were divided into responsive group (R) and non-responsive group (NR), respectively. The differences of the above in?dexes were compared between two groups. The correlation of△IVC,△VpeakAO,△VpeakBA and△SV was determined. The role of the hemodynamic index for predicting volume responsiveness was evaluated by receiver operating characteristic ROC curves. Results A total of 47 VE tests were performed in 42 patients, 25 in R group and 22 in NR group. Before VE test, the hemodynamics indicators of△IVC,△VpeakAO and△VpeakBA were significantly higher in R group compared with those of NR group (P<0.05). The values of△IVC,△VpeakAO and△VpeakBA were positively correlated with△SV in two groups. The areas under the ROC curve of the hemodynamics indicators were 0.825, 0.853 and 0.866 for △IVC, △VpeakAO and△VpeakBA, and they all showed high sensitivity and specificity. Conclusion The hemodynamic index measured by bedside ultrasound can predict the volume responsiveness in mechanically ventilated patients with septic shock fluid therapy, and which can be used to fluid therapy with a high degree of specific and sensitivity in clinical practice.

Objective: To investigate the ultrasound evaluation on lfuid responsiveness in patients with septic shock. Methods: There 42 septic shock patients treated by mechanical ventilation in our hospital from 2015-01 to 2015-04 were studied. All patients received volume expansion (VE) text, ultrasound examination was conducted to measure hemodynamic parameters of inferior vena cava variation rate of breathing (ΔIVC), aortic peak blood lfow velocity variation rate of breathing (ΔVpeakAO), brachial artery maximum speed variation rate (ΔVpeakBA) and stroke volume (ΔSV) at before and after text. Based on the response to VE text, the patients were divided into 2 groups as Responsive group and Non-responsive group, the above indexes and their correlations to ΔSV were analyzed. The clinical values of those parameters for predicting volume responsiveness were evaluated by ROC curves. Results: A total of 47 VE tests were conducted in 42 patients including 25 cases in Responsive group and 22 cases in Non-responsive group. Before VE test, the parameters of ΔIVC, ΔVpeakAO and ΔVpeakBA were higher in Responsive group than Non-responsive group; ΔIVC, ΔVpeakAO and ΔVpeakBA were obviously related to ΔSV (r=0.631, 0.668 and 0.619). The area of ΔIVC, ΔVpeakAO and ΔVpeakBA under ROC curves were 0.817, 0.853 and 0.866 respectively, they were all with the high sensitivity and speciifcity. Conclusion: Ultrasound monitored hemodynamic parameters may predict the volume responsiveness in septic shock patients with mechanical ventilation, it could be used for guiding liquid treatment in relevant patients.

A discussion of the connotation and key issues of the new normal in the healthcare sector,with an introduction to the new normal.The furthering reform is unveiling roadblocks in the healthcare system.For example,human resources available can hardly support development of the sector, and revenue growth of tertiary hospitals in the cities will decline,while county hospitals will be further challenged by debt crisis.In the meantime of steady elevation of medical capabilities in both urban and rural areas,the gap between the two will be maintained for a while.The authors predict that the sector will be faced with restructuring essential medicine system,grading diagnosis and treatment practice,rising risks for health insurance,and growing market shares of commercial health insurance and private capital, as well as fiercer competitions to challenge public hospitals.