Objective To evaluate feasibility, effectiveness , safety, and complications of superselective bronchial artery embolization with coaxial microcatheter system for hemoptysis. Methods 32 times of superselective bronchial artery embolization were performed for 29 cases with hemoptysis resulted from a variety of causes, age grade from 35 to 71(mean 54) year old. The causes of hemoptysis included bronchiectasis (9 cases), tuberculosis (12 cases), and pulmonary carcinoma (8 cases). All studies were performed with standard percutaneous transfemoral catheterization. Results The success rate of superselective catheterization was 96 9% (32/33). Hemoptysis control was achieved in 96 9% (31/32), with complete control rate of 65.6% (21/32) and partial control rate of 31.3% (10 /32),inefficacy case:only one.One patient with bronchiectasis, 6 patients with pulmonary carcinoma and 3 patients with chronic fibrosis tuberculosis were included in the partial control group. Rebleeding occurred in 7 patients (4 patients with pulmonary carcinoma and 3 patients with chronic fibrosis tuberculosis) during 2 months to 32 months followed-up period. No severe complications occurred in the procedure. Conclusions Superselective bronchial artery embolization for hemoptysis with coaxial microcatheter is a safe, effective way to control hemoptysis, has excellent long term efficacy, and without severe complications.

It is suggested in this article that medical ethics should be conceived as the integral part of quality education for students of medical sciences,based on the high consistency of medical ethics with the quality education in higher educational institutions and its close relationship with the cultivation of the qualities of medical students.

Objective:To explore the diagnostic value of 64‐slice spiral CT for in‐stent restenosis (ISR) after percuta‐neous coronary intervention (PCI) in patients with coronary heart disease (CHD) .Methods :A total of 120 CHD patients after PCI received 64‐slice spiral CT angiography and routine coronary angiography (CAG ) respectively . Then coronary ISR was assessed .Results:With CAG as the gold standard ,sensitivity ,specificity ,positive predictive value and negative predictive value were 87.5% ,95.3% ,80.0% and 97.3% respectively for 64‐slice spiral CT cor‐onary angiography in diagnosis of ISR .Conclusion :The 64‐slice spiral CT coronary angiography possesses high sensitivity and accuracy diagnosing coronary in‐stent restenosis ,which can be used as one of noninvasive measures for postoperative follow‐up after percutaneous coronary intervention .

Objective To investigate hepatic pathohistological changes(including pathology,HBV markers in liver tissue)in patients with KBeAg negative chronic hepatitis B after adefovir therapy for 1 year.Methods 35 patients with HBeAg negative chronic hepatitis B were administered with 10mg adefovir once a day for one year.The needle biopsy of liver were performed before and after treatment.The routine HE stained liver tissue sections were evaluated and Knodell pathological score were done.HBsAg and HBeAg in liver tissue were examined by immunohisochemisty method.Results After 1 year,18,17 and 11 cases had a significant reduction of their total hepatic HAI score,necroinflammation and fibrosis score.The immunohistochemistry examination showed HBeAg in liver decreased significantly,but HBsAg had no obvious alteration.Conclusion Significant improvement in both necroin flammation and fibrosis can be obtained in the majority of patients treated with adefovir for 1 year.More significant improvement in live histology can be obtained after extended treatment.

Objective To explore the influence of different positive end-expiratory pressure (PEEP) levels on cerebral blood flow (CBF) and cerebrovascular autoregulation in patients with acute respiratory distress syndrome (ARDS).Methods A prospective study was conducted.Moderate or severe ARDS patients admitted to Department of Critical Care Medicine of Jiangxi Provincial People's Hospital from January 1st,2013 to October 1st,2013 were enrolled.The changes in hemodynamics,respiratory mechanics and gas exchange under different levels of PEEP were observed.CBF velocity of middle cerebral artery (MCA) was measured using transcranial Doppler (TCD),and breath-holding index (BHI) was also calculated.Results 35 patients with ARDS were included.The oxygenation index (OI),peak inspiratory pressure (PIP),plat pressure (Pplat) and central venous pressure (CVP) were markedly elevated [OI (mmHg,1 mmHg=0.133 kPa):324.7± 117.2 vs.173.4± 95.8,t=5.913,P=0.000; PIP (cmH2O):34.7 ± 9.1 vs.26.1 ± 7.9,t=4.222,P=0.000; Pplat (cmH2O):30.5 ± 8.4 vs.22.2 ± 7.1,t=4.465,P=0.000; CVP (mmHg):12.1 ± 3.5 vs.8.8 ± 2.2,t=4.723,P=0.000] when PEEP was increased from (6.4 ± 1.0) cmH2O to (14.5-± 2.0) cmH2O (1 cmH2O=0.098 kPa).But no significant difference in the heart rate (beats/min:85.5 ± 19.1 vs.82.7 ± 17.3,t=0.643,P=0.523),mean arterial pressure (mmHg:73.5 ± 12.4 vs.76.4 ± 15.1,t=0.878,P=0.383) and CBF velocity of MCA [peak systohc flow velocity (Vmax,cm/s):91.26 ± 17.57 vs.96.64 ± 18.71,t=1.240,P=0.219; diastolic flow velocity (Vmin,cm/s) 31.54 ±7.71 vs.33.87 ±8.53,t=1.199,P=0.235; mean velocity (Vmean,cm/s) 51.19 ± 12.05 vs.54.27 ± 13.36,t=1.013,P=0.315] was found.18 patients with BHI＜0.1 at baseline demonstrated that cerebral vasomotor reactivity was poor.BHI was slightly decreased with increase in PEEP (0.78 ± 0.16 vs.0.86 ± 0.19,t=1.905,P=0.061).Conclusions Some of moderate or severe ARDS patients without central nervous system disease have independent of preexisting cerebral autoregulation impairment.However,independent of preexisting cerebral autoregulation may not further be impaired when a high PEEP was chosen.

To investigate the effects of traditional Chinese compound recipe Yiqi Zengmin (YQZM) formula on expression of glucose transporter 4 (GLUT4) in skeletal muscle of rats with type 2 diabetes induced by high-fat diet combined with low-dose-streptozotocin injection.

OBJECTIVE:To provide reference for the establishment of work mode of automatic dispensing system in large-scale integrated pharmacy. METHODS:Introducing the establishment and optimization situation of the automatic pharmacy dispensing system in the outpatient pharmacy of our hospital,changes of related deployment indexes before and after optimization were compared,and the main measures for improving the work efficiency of automatic dispensing system were explored. RE-SULTS:Based on setting and regularly adjusting stored drug varieties,numbers of occupied tracks and unbundled drug factors,de-signing deployment operation mode that the system automatically dispensing preparations to immediate-dispensing and pre-dispens-ing windows,establishing operational specifications and management refinement,the outpatient pharmacy had established automat-ic dispensing system with prescription deployment number more than 12000 pieces/d and optimized work mode. Compared with be-fore optimization,host,auxiliary and smart cabinet varieties were increased in the case of the same number of total staff,immedi-ate-dispensing windows were increased and pre-dispensing windows were decreased. Proportion of full-automatically-dispensed pre-scriptions was increased (up from 41.18% to 48.32%) in the case of total prescription increasing in peak hours,and numbers of hourly prescription deployment were increased in both immediate-dispensing and pre-dispensing windows. Average time to wait for medicine of patients was shortened(down from 5.63 min to 5.18 min),supplemental medicine error and inner errors rate of deploy-ment (down from 0.48% to 0.44%) were decreased (P<0.05). CONCLUSIONS:The established automatic dispensing system mode can meet the needs of prescription deployment in large-scale integrated outpatient pharmacy,and improve the work efficiency by continually optimization.

OBJECTIVE:To provide guidance for pharmacists to adopt a right method in participating in clinical drug treatment work.METHODS:In participating in clinical drug treatment work,pharmacists identified physicians’ drug treatment schemes by sticking to Guiding Principle of Clinical Use of Antibacterials and made remarks on the evaluation results.RES-ULTS & CONCLUSION:Through participating in clinical medical quality ward round,pharmacists can bring their professional advantages into full play,timely find out problems existed in the clinic drug treatment,guide clinical rational drug use,and play a key role in promoting drug treatment.

Objective To investigate the impact of reduced glutathione(GSH) on the prolifera- tion,oxidative stress and transforming growth factor?1(TGF-?1) expression of human hepatocytes and hepatic stellate cells(HSCs)(LX-2 cell line).Methods Human hepatocytes and HSCs were incubated with various concentrations of GSH(0.5—50 mmol/L or 0.5—10 mmol/L).The effects of GSH on the proliferation of hepatocytes and HSCs were studied by 3-(4,5-dimethylthiazol-2-yl)-2,5-diphennyhera- zolium bromide colorimetric assay.Human hepatocytes and HSCs were co-cultured with GSH and ferric nitrilotriacetic acid,superoxide dismutase (SOD) activity and malondialdehyde (MDA) contents were detected.HSCs were incubated with high(5.0 mmol/L),media(2.5 mmol/L) and low (0.5 mmol/L) concentrations of GSH,the expressions of TGF-?1 mRNA and protein were detected by ELISA and real- time PCR.Results In concentration ranged from 2.5 to 10 mmol/L,the GSH could promote the pro- liferation of hepatocytes but no HSCs,significantly increased the activity of SOD and decrease the con- tents of MDA in hepatocytes and HSCs,and inhibited the expression of TGF-?1 in HSCs.Conclusions GSH can not only promote the proliferation of hepatocytes,but also protect hepatocytes and HSCs from oxidative stress,and inhibit the secretion of TGF-?1 in HSCs.GSH may play a role in hepatocellular protection,antioxidation and anti-fibrosis.

Objective To investigate the correlations of Mycoplasma penetrans(MPe)infection with the differentiation.invasiveness and metastasis of stomach and colorectal calFcinomas.Methods Sixty five patients with stomach carcinoma,57 patients with colorectal carcinoma and 80 healthy individuals as controls were enrolled in this study.MPe was isolated and then confirmed by PCR.χ2 test was performed to analyze the correlations of MPe infection with the differentiation,invasiveness and metastasis of carcinoma.Results The rate of MPe isolated from stomach carcinoma group(41/65,63.1%)was significantly higher than that from stomach ulcer group(χ2=38.2,P＜0.01).The rate of MPe isolated from eolorectal carcinoma group (1/20,5%)was also significantly higher than that from colorectal polyps group(χ2=21.2,P＜0.01).The proportion of poor differentiation and the invasiveness in MPe positive stomach carcinoma group were significantly higher than those in MPe negative group(χ2:33.4 and 25.0.P＜0.01).The proportion of poorly differentiation and lymphatic metastasis(N3)in MPe positive colorectal carcinoma group were significantly higher than those in MPe negative group(χ2=34.4,P＜0.01).Conclusion Differentiation,invasiveness and metastasis are highly correlated with MPe infection in stomach and colorectal carcinomas.