Objective To assess the methodological quality of randomized controlled trials (RCTs) of rheumatoid arthritis (RA) treated with preparations of Tripterygium wilfordii to provide a scientific basis for the improvement of clinical trials and systematic review. Methods CBMdisc (1978-2000) and TCMLRS (1984-2000) were searched for RCTs on rheumatoid arthritis treated with preparations of Tripterygium Wilfordii. Jadad scale and the evaluating scale designed by the EBM methodological research group of Guangzhou University of TCM were used to evaluate the methodological quality of the trials. Results Of the 27 randomized trials included in this study, seven described the methods for randomization and only one had randomized concealment. Blindness was used in six of the trials. Twenty-four of the trials were found to be of low methodological quality with Jadad scores below three. Although all of the trials had their diagnostic standards for subject selection, only 37% described the inclusion and (or) exclusion criteria. Information about drug safety was not reported in 21% of the trials. Conclusions In general, the methodological quality of the studies is disappointing. Many shortcomings exist in the methodology of the included literatures, which calls for future attention to the correct use of the principles of randomization, control and blindness in randomized control trials.

Management of hospital water supply facilities is key to its logistics management.This paper cited the domestic water supply facilities management as an example, and summed up practical experiences in both JCI certification and review along with the hospital′s fine management of water facilities.On such basis, it described such aspects as the establishment of management system, operation standards and work flow, implementation of preventive maintenance, renovation, emergency protection, inspection supervision, file management and staff training.These efforts provide reference for how to establish the fine management mode of water supply facilities.

Objective To study the effects of Semen Cassiae extract on lipid metabolism of hyperlipidemia model mice.Methods In this experiment,mice were sc injected with two different concentration of Semen Cassiae extract,and sacrificed at 1,2,and 4 h.The blood samples were withdrawn from the eye vein.The plasma biochemical indexes were detected by using the kit,and real time PCR was used to analyze the expression of adipogenesis genes with time series.Results For hyperlipidemia model mice treated with Semen Cassiae extract serum total cholesterol(TC),triglyeride(TG),and low density lipoprotein cholesterol(LDL-C) could be decreased significantly(P

Objective To observe the short-term and long-term effect of mask bi-level positive airway pressure (BiPAP) combined with recombinant human brain natriuretic peptide (rhBNP) on acute heart failure.Methods One hundred cases of acute heart failure patients were divided into BiPAP combined with rhBNP group (51 cases) and conventional treatment group (49 cases) by random digits table.Conventional treatment group was given routine drug for heart failure treatment,and BiPAP combined with rhBNP group on the basis of routine treatment,was given BiPAP combined therapy with rhBNP.Arterial blood oxygen partial pressure (PaO2),arterial blood oxygen saturation (SaO2),and the change of clinical symptoms were recorded before and 30 min,2 h after treatment.All patients were followed up for 3 months,and cardiovascular events,related parameters of echocardiography and 6 min walking distance test were compared between two groups.Results Clinical symptoms (respiratory frequency and heart rate) and blood gas analysis index (PaO2,SaO2) were significantly improved after treatment in two groups,and BiPAP combined with rhBNP group improved more significantly.There was significant difference (P ＜ 0.05).After 3 months' follow-up,the incidence of cardiovascular events in BiPAP combined with rhBNP group was lower than that in conventional treatment group [17.6％ (9/51) vs.38.8％ (19/49),P ＜ 0.05].The left ventricular end-diastolic diameter (LVEDd),left ventricular ejection fraction (LVEF) in BiPAP combined with rhBNP group was better than that in conventional treatment group [(55.0 ± 6.1) mm vs.(63.3 ± 6.5) mm,(52.5 ±7.2)％ vs.(44.7 ± 6.8)％] (P ＜ 0.05).The 6 min walking distance test in BiPAP combined with rhBNP group was higher than that in conventional treatment group [(325.6 ± 36.4) m vs.(210.2 ± 34.1) m] (P ＜0.05).Conclusion BiPAP combined with rhBNP in short-term treatment of acute heart failure is effective and safe,and can improve the long-term prognosis of patients.

Objective To investigate the inhibitory effect of inhibitor 4 of growth(ING4)delivered by adenovirus on human breast carcinoma cell MDA-MB-231.Methods MDA-MB-231 human breast carcinoma cells were irfected with Ad-ING4.The expression level of ING4 gene was detected by RT-PCR and Western blot;The growth inhibition,cell-cycle alteration,and apoptosis were detected by MTT,Flowcytometry and Hochest33258 staining.respectively.RT-PCR was used to detect the transcription of Bax,Bc1-2,Survivin genes;The expression level of Ang-1 gene was detected by ELISA;Ad-ING4 was given intratumorally in athymic nude mice beating MDA-MB.231 tumors.and then tumor growth was monitored;The expression of Bc1-2,Bax and Caspase-3 was analyzed by immumohistochemistry.Results ING4 was successfully transcribed and translated iU MDA-MB-231 cells:Ad-ING4 significantly inhibited the proliferation and induced G_2/M phase arrest to(24.86±1.24)% and cell apoptosis of MDAMB-231.Intratumoral injection of Ad-ING4 suppressed the tumor growth obviously with a inhibitory rate of 49%;Immumohistochemistry showed that the expression of Bax,Caspase-3 were up-regulated and the expression of Bc1-2.Survivin,CD34 were down-regulated by Ad-ING4.Conclusions Ad-ING4 can inhibit the growth of MDA-MB-231 cells and induce apoptosis in vitro and in vivo.

Objective To investigate the association between the systolic/diastolic orthostatic hypotension (OH-S/OH-D) and myoeardial infarction (MI) in the elderly.Methods Health screening physical examination were carried in 1081 subjects without MI aged over 65 years in Guangzhou Military region.The orthostatic blood pressure and heart rate were measured in supine position after resting for more than 5 minutes and at 0 and 2 minutes after standing.All the cases were divided into systolic or diastolic group on the basis of definition of orthostatic hypotension and followed up by telephone or inpatient medical records with mean period of 315.8 days.The primary endpoint was MI occurrence.Results The prevalence of OH in this cohort was 24.5％ ( OH-S/OH-D:19.3％/17.2％ ).Significant differences in the occurrence of OH and OH-S were found in the elderly and the very elderly subjects( ≥80 years) (26.1％ vs 20.1％,P=0.045; 21.0％ vs 14.6％,P =0.018),while no difference was found in OH-D.The prevalence of MI in the OH positive subjects was significantly higher than that in the OH negative subjects,as well as in OH-S or OH-D group.After adjustment of age,supine blood pressure,creatinine and cerebrovascular history by logistic regression,the association was observed between MI and OH ( HR 15.635,95 ％ CI 3.299-74.091,P=0.001),OH-S(HR 8.760,95％CI2.487-30.851,P=0.001)and OH-D(HR 3.889,95％ CI 1.097-13.790,P =0.035 ).Conclusion OH-S and OH-D hypotension are robust predictors for MI in the elderly.

ObjectiveTo evaluate the clinical value of the pumping and popliteal vein thrombosis contact thrombolytic treatment of lower extremity deep venous thrombosis(LEDVT).MethodsFor thirty deep venous thrombosis patients with ipsilateral popliteal vein approach through a comprehensive intervention,the line of the inferior vena cava filter was implanted under the premise of first balloon mechanical thrombus fragmentation and thrombus aspiration by 10 F improved the inferior vena cava stents conveying sheath,followed by the line of contact thrombolytic therapy.Four patients underwent iliac vein in the thrombolytic treatment of stent implantation.Vein patency and venous patency score and health and poor limb circumference difference were used to assess efficacy of treatment.Patients were followed up for at least 1 year.ResultsThe technical success rate was 100％.At six months after sugery,the mean lower limb circumference difference of the 30 patients was＜ 1.5 cm.Lower limb venous angiography showed significantly improved vein patency score [ (9.5 ± 2.6) vs.(3.6 ± 2.1 ),Z =1.65,P ＜ 0.01 ].Venous patency rate was ( 69.5 ± 13.2) ％.No serious complications during treatment and the period of follow-up.Conclusion Transpopliteal vein interventional treatment of lower extremity deep venous thrombosis is simple,safe and effective.

OBJECTIVE:To provide reference for rational use of antibacterial drugs in the clinic. METHODS:In retrospective study,outpatient and emergency antibacterial drugs prescriptions were randomly selected from a hospital during 2013-2014,and then analyzed statistically. DDDs of antibacterial drugs were analyzed by using DDD method. RESULTS:From 2013-2014,the ap-plication rate of antibacterial drugs in the hospital declined substantially from 13.8% to 11.9%,and the rate of irrational use dropped from 2.7% to 1.2%. The application rate of antibacterial drugs was higher in pediatric department,emergency department and urology department;drug cost per capita was higher in infectious department,nephrology department and emergency depart-ment. The application rate of antibacterial drugs in pediatric department decreased greatly in 2014,compared with 2013,maintain-ing about 40%. The application rate of antibacterial drugs in emergency department during Jan.-Sept. in 2014 was lower than corre-sponding period in 2013,and that of the hospital during Jan.-Sept. in 2014 was lower than corresponding period in 2013,but dur-ing Oct.-Dec. in 2014 was slightly higher than corresponding period in 2013. Single type of antibacterial drugs were mainly used in outpatient department,accounting for 91.50% and 90.77% of antibacterial drug prescriptions in 2013 and 2014;two-drug account-ed for 8.44% and 9.11%. The top 3 antibacterial drugs in the list of DDDs during 2013-2014 were roxithromycin,cefuroxime and cefminox. CONCLUSIONS:The use of antibacterial drugs is up to the requirements of Nation Special Rectification Actirity for Clin-ical Application of Antibacterial Drugs in 2013. The prescription comment improve the quality of antibacterial drug prescriptions and rational use index greatly in outpatient department,but the application rate of antibacterial drugs is too high in some depart-ment. There still is irrational use of antibacterial drugs.

Aim To construct the eukaryotic expression vector of hIL-24 cDNA,and express it in CHO cells and detect its anti-tumor effect of recombinant hIL-24 protein.Methods Constructed pcDNA3-hIL-24 was identified by endonucleases digestion & PCR.The recombinant expression plasmids were transfected into CHO cells,human hIL-24 expressed in CHO cells was detected with RT-PCR.The apoptosis-inducing activities of recombinant protein hIL-24 was tested by MTT assay,Hoechst& FCM assay,and the expression of IL-6 and IFN-? from PBMC induced by rhIL-24 was tested by ELISA.Results The eukaryotic expression vector pcDNA3-hIL-24 was constructed correctly.Stable expression of human IL-24 in CHO cells was identified with RT-PCR.The apoptosis of A549 cells induced by hIL-24 was proved by Hoechst & FCM assay,and the expression of IL-6 and IFN-? from PBMC induced by rhIL-24 was identified with ELISA.Conclusion The successful stable expression & experimental study of apoptosis effect of human IL-24 gene lay the foundation for the further study of molecular mechanism of hIL-24 on anti-tumors and potential application.

Objective To observe the influence of Simvastatin on the ATP-sensitive K+Channels and L-type Ca2+ Channels in mouse pancreatic beta cell line MIN6.Methods MIN6 cells were divided into 0.05 ％ dimethyl sulfoxide (DMSO) group,normal control group and low-,middle-,high-concentration of Simvastatin treatment groups,that were cultured for 48 h with high-glucose DMEM containing 15％ fetal bovine serum plus 0.05％ dimethyl sulfoxide,0,2,5 and 10 μmol/Lsimvastatin,respectively.Whole-cell patch-clamp technology was used to record the currents of ATP-sensitive K+ channels and L-type Ca2+ channels in MIN6 cells.Results The mean potassium current density in normal external solution perfusion group was (92.81 ±4.10) pA/pF.Compared with normal external solution perfusion control group,2,5 and 10 μmol/L Simvastatin treatments markedly enhanced the current density of ATP-sensitive K+ Channels,reaching to (117.94 ± 3.67)pA/pF,(153.91±12.38) pA/pF,(307.01±6.40) pA/pF (all P＜0.01),respectively.The current density in L-type Ca2+ Channels was (-21.03 ± 0.55) pA/pF in glucose external solution group.Compared with glucose external solution group,the current density in 2,5 and 10 μmol/L Simvastatin treatment groups were decreased to (16.31±0.51) pA/pF,(-10.75±0.71) pA/pF,(-3.30±0.46) pA/pF (all P＜0.01),respectively.Conclusions Simvastatin inhibits insulin secretion and glycometabolism in mouse pancreatic beta cell line MIN6 via enhancing the current density of ATP-sensitive K+ Channels and inhibiting the current density of L-type Ca2+ Channels.