OBJECTIVE:To promote the implementation of Prescription Administrative Policy(on trial).METHODS:The factors related to implementation of Prescription Administrative Policy(on trial)were analyzed,These included legal awareness of medical staff,the professional quality of pharmacists,deficiencies of electric prescription system,validity of prescribing right,and lack of standardization in drug names.RESULTS&CONCLUSIONS:Successful implementation of Prescription Admin?istrative Policy(on trial)is based on cooperation of relevant offices,consistent perfection of implementing regulations,and ed?ucational reform of pharmacy.

Feeding Behavior ; Humans ; Infant ; Infant Food ; Infant Nutritional Physiological Phenomena

With the progress of human civilization,the harmonious development of society is gradually realized by different researchers.Medicine,as a science directly serving humans,emphasizes more on humanism than other sciences.Medical research is not only characterized by scientificity and innovativeness,but also by ethicality.More and more biomedical journals are paying attention to issues of ethics.This review discussed the ethical issues in academic medical writing based on the Uniform Requirements for Manuscripts Submitted to Biomedical Journals published by International Committee of Medical Journal Editors (ICMJE) and the discussions by Committee on Publication Ethics (COPE).

Objective: To observe the effects of dietary zinc deficiency on the apoptosis of immunocytes in 3 weeks old rats and study the underlying mechanism. Methods: A zinc-deficient growing rat model was developed. Using TUNEL(terminal deoxynucleotidyl transferase-mediated dUTP nick end labeling) method, the apoptosis of thymocytes and spleen lymphocytes was checked. The expression of bcl-2, bax mRNA in thymus and spleen was detected by RT-PCR. Results: Compared with zinc adequate(ZA) and paired-fed(PF) groups, the percentage of apoptosis cells in thymus and spleen of zinc-deficient(ZD) rats was obviously higher, and the thymus and spleen of ZD rats had a higher expression of bax mRNA. Zinc supplementation could reverse these changes. Conclusion: Dietary zinc deficiency leads to the increase of apoptosis of lymphocytes in thymus and spleen. One important mechanism is that the thymus and spleen have higher expression of bax mRNA, which causes the decrease of bcl-2/bax ratio.

Objective: To observe the effects of zinc deficiency on peripheral blood lymphocyte phenotypic distribution and the balance between Th1 and Th2 cells in growing rats. Methods: Two-color cytofluorometric analysis was used. Results: Compared with zinc adequate (ZA) and paired-fed (PF) groups, peripheral blood lymphocytes in zinc deficient (ZD) rats had higher percentage of CD8+ cells (cytolytic T cells), lower percentage of CD4+ cells (T helper cells) and lower percentage of CD45RA+ cells (pure B lymphocytes).In addition, zinc deficiency selectively caused reduction of Th1-like CD45RC+CD4+ cells , but Th2-like CD45RC-CD4+cells had no significant changes in weanling rats. Zinc supplementation could reverse these changes. Conclusion: Dietary zinc deficiency leads to changes of lymphocyte phenotypic distribution and the imbalance of Th1 and Th2 subsets. These changes are reversible.

Objective To explore the relationship between infant feeding practices and infants growth,especially the weight gain for length in the first 6 months of life. Methods Two-hundred healthy full-term singlet normal birth weight 5 - 6 months old infants and their main care givers were recruited in Kongjiang community health service center in Shanghai. The questionnaires included infants feeding pattern, feeding environment and care givers feeding behaviors, and were completed on-site by investigators. The birth weight was obtained. The weight and length of infants at 6 months were measured. Results There were 70/200 (35.0%) infants overweight (BMI for age Z score>+1) at 6 months. There were more overweight boys than girls (40.0% vs. 30.9%, x2 = 1.798, P = 0.180). Compared with normal weight infants, the overweight infants had same birth weight (3.30 ± 0.35 kg vs. 3.35 ± 0.32 kg, t =1.010, P = 0.314) and same length at 6 months (67.64 ± 2.10 cm vs. 67.91 ± 1.97 cm, t=- 0.896, P = 0.371). However, the overweight infants gained much more weight for length in the first six months of life. At 6 months, the weight and BMI of overweight infants was significantly higher than that of normal weight infants (9.16 ± 0.67 vs. 7.94 ±0.64, t = 12.324, P < 0.01;19.86 ± 1.24 vs. 17.41 ± 0.80, t = 14.953, P < 0.01). The rates of exclusive breastfeeding for at least four months, continued breastfeeding at six months, complementary food consistency, and complementary feeding frequency, were not significantly differenct between overweight and normal weight infants (x2 =0.723 - 2.701, P > 0.05). The grandparents played an important role in infants feeding in Shanghai. There were 39.0% infants fed only by grandparents, and 23.0% infants fed jointly by grandparents and parents (x2 = 0.175, P > 0.05).The care givers' educational level and knowledge of feeding skill were similar in overweight and normal weight infants (x2 = 0.446, t = 0.949, P > 0.05). However, the overweight infants were fed more quickly than normal weight infants (Z = 2.753, P < 0.01), and there was less language communication between care givers and overweight infants during feeding (Z = 2.932, P < 0.01). In overweight infants, the overfeeding behaviors of care givers were positively correlated with BAZ (r = 0.281, P < 0.05). Conclusions Overweight in early life is associated with some particular infants feeding behaviors of care givers in Shanghai. The long term effect of more rapid weight gain for length in the first 6 months of life on the risk of childhood obesity warranted to be further followed and researched.

Objective To study multimodal analgesia in patients who underwent transarterial chemoembolization (TACE) for hepatocellular carcinoma (HCC).Methods 60 patients who underwent TACE for HCC from Aug.2016 to Nov.2016 were randomized into two groups:the multimodal analgesia group and the control group.The pain scores of these two groups of patient during the procedure and at different posttreatment time points,and the rates of adverse effect and pharmacoeconomic differences were recorded.Results When compared to the control group,the pain scores at 0 h,2 h,4 h,6 h,12 h after treatment in the multimodal analgesia group were significantly lower (P ＜ 0.05),and the satisfactory scores for the patients were significantly improved (96.6％ vs.66.7％).The multimodal group of patients also had significandy lower adverse effect rates of nausea and vomiting,and it was more cost-effective.Conclusions Patients who required multimodal analgesia had better pain relieve,patient satisfaction and less adverse reactions after TACE than patients in the control group.Multimodal analgesia was a safe,effective and economic way to control TACE pain and it was worth recommended in clinical practice.

Objective: To preliminarily evaluate the safety of the coplanar template-assisted ¹⁹²Ir hypofractionated stereotactic ablative brachytherapy (SABT) in patients with locally advanced non-small cell lung cancer (LA-NSCLC), and assess the effect of template-assisted technology upon the accuracy of SABT by comparing the consistency of dosimetric parameters between preoperative and operative plans. Methods: Fifteen patients histologically confirmed with LA-NSCLC (stage Ⅱ_B-Ⅲ_A) were recruited and received the template-assisted SABT delivered in a risk-adapted fractionation (30 Gy/1F). Preoperative planning, template-assisted needle implantation, operative planning and implementation were performed in all patients. Dosimetric results of preoperative and operative plans were statistically compared by assessing the dosimetric parameters of gross tumor volume (HI, CI, D₉₀, V₁₀₀ and V₁₅₀) and organ at risk(V₅, V₂₀ and mean dose of bilateral lung, D_2cc of spinal cord. The incidence of perioperative complications of SABT was recorded. The safety and feasibility of SABT were evaluated. Results: Slight changes were noted in terms of target dose and irradiated dose to the lung between preoperative and operative plans without statistical significance (both P>0.05). No severe adverse events, such as severe pneumothorax, hemothorax and hemoptysis were observed. Conclusions Application of the template-assisted SABT can enhance the accuracy of implantation, maintain the consistency of the dosimetric parameters between the preoperative and operative plans and guarantee the clinical efficacy.

Objective: To study the expression of ISYNA1 and association of ISYNA1 with clinicopathological significance in pancreatic ductal adenocarcinoma (PDAC). Methods: Collecting clinical data and specimens of 68 PDAC patients at Department of General Surgery, the First Hospital of China Medical University from March 2008 to December 2017.There were 39 males and 29 females, aged 33 to 81 years(median 59 years).The expression of ISYNA1 in 68 paraffin embedded PDAC specimens was detected by immunohistochemistry,in which 34 had paired non-cancerous pancreatic tissues,the relationship between ISYNA1 expression and clinicopathological parameters was analyzed; and the correlation between ISYNA1 and p53 in 48 PDAC specimens were estimated.qRT-PCR and Western blot were used to examine the expression of ISYNA1 mRNA and protein level in 17 paired fresh PDAC specimens and adjacent non-cancerous pancreatic tissues,respectively.siRNA interference was used to knockdown the expression of p53 in Capan-2,SW1990 and Miapaca-2 cells,and association of p53 with ISYNA1 expression was explored. Statistical methods included Student′s test,χ² test, Kaplan-Meier curve, Log-rank test and Pearson analysis, respectively. Results: Immunohistochemistry results showed that the expression of ISYNA1 in PDAC(3.681±2.198)was significantly lower than that in normal pancreatic tissues(6.012±3.428)(t=-3.611,P=0.001).In 17 paired fresh PDAC specimens,ISYNA1 mRNA expression in non-cancerous pancreatic tissues₍ΔC_T: _{3.721±2.234)was obviously higher than that in PDAC tissues (}ΔC_T: ₅.889±1.607) (t=-4.636,P<0.01), and ISYNA1 protein level in non-cancerous pancreatic tissues(0.815±0.418)was similarly higher than that in PDAC tissues(0.517±0.240)(t=2.948,P=0.009).χ² test showed the expression of ISYNA1 was negatively associated with tumor invasion depth(χ²=7.534,P=0.030)and vascular invasion(χ²=5.048,P=0.043);Pearson analysis showed there was no relationship between ISYNA1 and mutant p53(χ²=1.377,P=0.359).In p53 wild-type Capan-2 and SW1990 cells,Knockdown of p53 significantly down regulated ISYNA1 expression, whereas had no effect on ISYNA1 expression in p53 mutant Miapaca-2 cells. Kaplan-Meier survival analysis and Log-Rank test indicated patients with negative ISYNA1 expression had a shorter median survival time and poorer prognosis(χ²=4.953, P=0.026). Conclusions The expression of ISYNA1 in PDAC tissues is significantly decreased,which is associated with the prognosis of PDAC patients,it is only related to wild type p53,and has no relationship with mutant p53.Abnormal expression of ISYNA1 may play an important role in the progression of PDAC.