Objective To investigate the changes of cesarean section rate and indications in different level hospitals of different areas in China during 2000 to 2009. Methods Literatures published in Chinese journals on variation of cesarean section rate and indications from 2000 to 2009 were analyzed. Cochran-Armitage test was used to analyze the trend. The differences of cesarean section rate between different areas or different level hospitals were analyzed by chi-square test.Results Forty-nine papers were enrolled in this study.Cesarean section rate had risen from 2000 (32.1％,10 353/32 258) to 2009 (52.5％,3674/6992)(Z=-20.8267,P＜0.01).During 2000 to 2008,the average cesarean section rate of level one grade A hospital was 45.7％ (3754/8214),which was higher than 34.5％(25 015/72 507) in level three grade A hospital and 32.3％(28 140/87 121) in level two grade B hospital (P＜0.05,respectively).Except for level three grade A hospital,cesarean section rate had risen in the other two level hospitals during 2003 to 2008. The average cesarean section rate was 58.6％ (4982/8502) in northeast area during 2000 to 2007,which was higher than that of other areas (P＜0.01); and the average cesarean section rate was 27.5％ (12 264/44 595) in central China and 33.0％ (23 239/70 421) in southern China,which were lower than that of other areas (P＜ 0.01 ). Social factor,instead of dystocia,became the most important indication for cesarean section,and its proportion kept rising annually,from 11.3％ (1170/10 353) in 2000 to 27.1％(2094/7726) in 2008 and remained above 20.0％(5159/24 691) since 2004.The proportion of scar uterus rose from 6.7％(694/10 353) in 2000 to 12.5％ (459/3674) in 2009. Conclusions Cesarean section rate rises fast and its major indications had changed in China. It is suggested that special method should be taken to control the current situation.

OBJECTIVETo establish human heart valve interstitial cells calcification culture model in vitro, and observe the effect of bone morphogenetic protein-2 (BMP-2) on calcification of human heart valve interstitial cells.

METHODSHuman heart valve interstitial cells were cultured in vitro, and divided into control group: cells were cultured in conventional media plus recombinant human BMP-2 treatment and experimental group: besides above treaments, calcification inducers ( recombinant human BMP-2, β-glycerophosphate, L-ascorbic acid, dexamethasone) were added to the culture media. The two group of cells were cultured for 14 days and were stained by Von Kossa, then the cell calcification was observed in this valvular interstitial cells calcification culture model in vitro. Protein expression of intercellular adhesion molecule 1 (ICAM-1), interleukin 8, BMP-2 and BMP-4 was determined by Western blot and BMP-2 secretion was measured by ELISA.

RESULTSIn the control group, the structure of human heart valve interstitial cells was clear, and the spindle and radial growth shaped cellular morphology was visible, and Von Kossa staining was negative. In the experimental group, the nuclei become darker in color, and granular sediment distribution was seen surrounding cells, and Von Kossa staining was positive, the cells were forming nodules of calcification. The protein expression of ICAM-1, interleukin 8, BMP-2 and BMP-4 in the experimental was significantly higher than that of the control group (all P < 0.05). The expression of BMP-2 in the experimental group was also significantly higher than that in control group ((92.5 ± 4.9) pg/ml vs. (22.2 ± 1.9) pg/ml, P < 0.05).

CONCLUSIONHuman BMP-2, β-glycerophosphate, L-ascorbic acid, and dexamethasone can induce human heart valve interstitial cells calcification and enhance inflammation in vitro by stimulating the secretion of BMP-2.

Objective To investigate the effects ofviaminate on the proliferation and differentiation of HaCaT cells,a human keratinocyte cell line.Methods Cultured HaCaT cells were treated with various concentrations (2,5,10,15,20,25 and 30?g/mL) of viaminate for various durations.The cell proliferation was assessed by MTT method,the changes of cell cycle and apoptosis rate by flow cytometry,the changes of keratin 10 and involucrin mRNA expressions by semi-quantitative reverse transcription PCR.Results The proliferation of HaCaT cells was inhibited by the treatment with viaminate of≥2?g/mL for 48 h,and the inhibition rate was raised with the increase of treatment time and dosage.The viaminate of 30?g/mL inhibited the proliferation of HaCaT cells by 57.67% and 82.00% at 48 and 72 h after the incubation respectively,and elevated the mRNA expression of involucrin from 40.80% to 156.12%,decreased the mRNA expression of keratin 10 from 96.46% to 14.60%.The mRNA expression of involucrin increased with the elevation of viarninate dosage.Under the treatment with viaminate for 48 h,the cell population at G_1 phase significantly increased,that at S and G_2 phases decreased;the switching of G_1 to G_2 was inhibited;but the cell apoptosis was not affected.Conclusion Viaminate could inhibit the proliferation and induce the differentiation of keratinocytes.

AIM: To establish a method of simultaneously determining effective components in Ciwujia Naoling Oral Liquid by RP-HPLC. METHODS: Stationary phase: Alltech C_(18) column,the mobile phase was methanol(A)-0.4% HAC-water(B) with linear gradient elution.Detection was performed at wavelength of 344 nm,254 nm respectively for isofraxidin and schisandrin. RESULTS: The two effective components could be detected by this method,and their contents could be determined.A good linearity of isofraxidin and schisandrin was in the range of 0.88-17.6 ?g/mL,0.76-15.2 ?g/mL respectively.The average recoveries were 100.64%,100.33% respectively,RSD were 1.07%,0.65% respectively. CONCLUSION: The method is simple,feasible and reproducible and can be used for the quality control of Ciwujia Naoling Oral Liquid.

This paper summarized training status of the Master of Nursing Specialist (MNS) at home and abroad,described and analyzed the cultivation program at home and abroad,and discussed the problems about cultivation objective, enrollment, course system, specialty orientation, clinical training model, teaching method, connotation of practical ability, teachers strength, evaluation and assessment in cultivation of MNS in China. Then MNS training program is proposedso as to provide references for the future cultivation program of MNS in China.

Aims: This study aimed to investigate the suitability and efficacy of various encapsulation media in bioencapsulating the probiotic Lactococcus lactis subsp. lactis in Artemia franciscana nauplii. The impact of the encapsulation media on nauplii survival and probiotic recovery was also determined. Methodology and results: Various encapsulation media (sodium alginate, palm oil, starch, gum Arabic and gelatin) were prepared by dissolving the respective media in artificial sea water. Each media was prepared in four different concentrations: 0.25, 0.5, 1.0 and 2.0 g/L. To determine the suitability of encapsulation media on the survivability of A. franciscana, survival rate (SR) of Artemia nauplii was determined after 8 hours post-encapsulation. Instar II stage Artemia nauplii at 1 nauplii per mL was used for each replicate. The result revealed that A. franciscana reached 100 % SR in the encapsulation media at ≤ 0.5 g/L. All media enabled > 23 % recovery of L. lactis subsp. lactis from encapsulated A. franciscana, which is similar (p > 0.05) to the recovery of free-cells (non-encapsulated) of L. lactis subsp. lactis. Noticeably in sodium alginate (E1) treatment, the total counts of L. lactis subsp. lactis in bioencapsulated A. franciscana were the highest among others, accounting for 2.44 × 107 CFU/mL per A. franciscana tissue homogenate. Conclusion, significance and impact of study: Artemia nauplii bioencapsulated with L. lactis subsp. lactis using 0.5 g/L sodium alginate as encapsulation medium has the highest SR for nauplii and bioencapsulation efficiency, respectively. This result provides a basic guideline for Artemia bioencapsulation in fish/shrimp larval culture.
Lactococcus lactis

The experimental research literatures on traditional Chinese medicines in the treatment of systemic lupus erythematosus ( SLE) in recent years were systematically reviewed , which focused on single herb and its effective components , and compound herbs therapy.It is confirmed that Chinese medicines show exact therapeutic activity on SLE with multi-targeting effects.

OBJECTIVE:To systematically review the efficacy and safety of exenatide in the weight loss of obesity and over-weight,and provide evidence-based reference for clinical treatment. METHODS:Retrieved from Cochrane Library,PubMed,Med-line,EMBase,CJFD,VIP and Wanfang Database,randomized controlled trails (RCT) about exenatide versus placebo or other medicines in the treatment of obesity or overweight were collected. Meta-analysis was performed by using Rev Man 5.3.0 software after data extract and quality evaluation. RESULTS:A total of 25 RCTs were enrolled,involving 5 307 patients. Results of Meta-anal-ysis showed body mass in exenatide groups was significantly lower than placebo group[SMD=-2.06,95%CI(-2.97,-1.15),P<0.001],insulin group [SMD=-3.51,95%CI(-4.52,-2.51),P<0.001],glyburide group [SMD=-3.70,95%CI(-4.28,-3.12),P<0.001],rosiglitazone group [SMD=-1.25,95%CI(-1.71,-0.80),P<0.001] and sitagliptin group[SMD=-0.71,95%CI(-0.93,-0.48),P<0.001],and there was no significant difference with metformin group and tasilutai group. Incidence of ad-verse reactions in exenatide group was significantly higher than insulin group[RR=1.22,95%CI(1.06,1.41),P=0.006] and lower than tasilutai group [RR=0.95,95%CI(0.91,0.99),P=0.02],and there was no significant difference with placebo group and met-formin group. CONCLUSIONS:Exenatide can effectively reduce the body mass of obesity and overweight,however,digestive sys-tem shows more adverse reactions. Due to the limit of methodological quality,more high-quality,large-scale and long-term fol-low-up RCTs are needed for further verification for the conclusion.

OBJECTIVE:To build the off-label drug use control system,and to realize automatic prompt for off-label drug use by system when physicians prescribed drugs. METHODS:The module and flow chart of off-label drug use control system were de-signed based on B/S structure. The drugs of the prescriptions were verified one by one in terms of drug indication,drug dosage, age and gender of patient,route of administration,etc. The system prompted automatically off-label drug use when drug use didn’t agree with preset value;at the same time,the management effect of the system was evaluated by taken the amount of attention about antibiotics medical orders as an example. RESULTS:At present,265 kinds of drugs were involved in the system designed by our hospital. Since the system was applied,the system had prompted more than 50 thousand items of off-label drug use prescrip-tions/medical orders,accounting for 0.3% of total. Among the types of off-label drug use,the most number of medical orders were over single dose(745 items),followed by extra-indication(706 items)and over daily dose(671 items). Within 3 months after sys-tem used,the attention numbers of antibiotics medical orders of over daily dose decreased month by month. CONCLUSIONS:Es-tablished off-label drug use control system of our hospital has a stable running and convenient manipulation,and contains powerful practicability. It can monitor off-label drug use of some drugs.

Objective To evaluate the intervention effectiveness of collaboration among physicians, nurses and pharmacists for elderly people. Methods Randomized controlled trails ( RCT) of collaboration among physicians,nurses and pharmacists for elderly people were gathered from MEDLINE,EMbase,CENTRAL,CNKI,VIP and Wanfang. The retrieved studies were screened according to the inclusion and exclusion criteria, evaluated the quality of included studies, and then performed meta-analyses with The Cochrane Collaboration ' s Revman 5. 3. 0 software. Results Four randomized controlled trials of collaboration among physicians,nurses and pharmacists for elderly people were included. The results of meta-analyses showed that the hospitalization rate, emergency admission rate, mortality and potentially inappropriate medication use were not significantly better in the collaboration group than in the standard of care group [RR=1.02,95%CI (0.93,1.11),P=0.69;RR=0.97,95%CI (0.89,1.05),P=0.42;RR=1.03,95%CI (0.87,1.21),P=0.75;and RR=1.09,95%CI (0.84,1.41),P=0.51,respectively]. There were no statistically significant differences between the collaboration group and the standard of care group. Conclusion Collaboration among physicians, nurses and pharmacists is not therapeutically effective for elderly people. But its long-term efficacy still needs to be confirmed by performing more high quality,large sample RCTs with long term follow-up.