OBJECTIVE: To evaluate potentially inappropriate medication among hospitalized older patients. METHODS: A total of 426 inpatients aged 60 s years old were included in study. The incidence of potentially inappropriate medication was defined on the basis of Beers Criteria (2003 edition). RESULTS: 426 inpatients whose mean ages were 74.8 years old took 8 kinds of medicine per patient. Our study revealed that 58 cases (13.6%) of potentially inappropriate medication were associated with drugs; 47 cases (11.0%) were dependent on disease or condition. CONCLUSIONS: A high prevalence of potentially inappropriate medication in hospitalized older patients requires further steps to prevent its occurrence.

OBJECTIVE: To evaluate the effect of intervention measures enforced by clinical pharmacists on reducing dosage of benzodiazepines. METHODS: Clinical pharmacists described benzodiazepine withdrawal scheme for adult patients who were treated with repeated benzodiazepine prescription more than 3 months. 10% of benzodiazepines dose was reduced every two weeks and single blind drug withdrawal was carried out. RESULTS: Consumption of benzodiazepine was reduced significantly by 70.50% after intervening by pharmacists. CONCLUSION: Clinical pharmacists play an important role in benzodiazepine withdrawal, whose intervention is rapid and useful method for physicians reducing dosage of benzodiazepines.

Objective To investigate the inhibition of proliferation and the regulation of histone acetylation modification in Jurkat cells treated by sodium valproate(VPA). Methods Jurkat cells were treated with VPA.Cell proliferation was determined by CCK-8 assay, and cell cycle were analyzed by flow cytometry (FCM). mRNA of HDAC1 was detected by semi-quantitative RT-PCR, and protein expression of HDAC1 and acetylation of histone H3, H4 was examined by Western blotting. Results VPA inhibited the proliferation of Jurkat cells in concentration-and time-dependent manners. After exposure to VPA in different concentrations for 48h,cell cycle was arrested obviously at G0/G1 phase (P <0.05), and with increasing concentration, the percentage of G0/G1 phase cells was increased and that of S phase were decreased. HDAC1 mRNA expression were inhibited with the increasing concentration of VPA. The protein level of HDAC1 was down-regulated, while acetylation of histone H3、H4 was up-regulated in Jurkat cells by VPA. Conclusion VPA can inhibit proliferation of Jurkat cells and induce G0/G1 phase arrest. The mechanism may be that VPA increase acetylation of histone H3/H4 by inhibiting expressions of HDAC1 gene.

Objective To investigate the relationship between promoter hypermethylation of secreted frizzled-related protein (SFRP) gene and acute leukemia (AL). Methods We examined the promoter methylation starus of SFRP1, 2, 4 and 5 in primary or relapsed AL patients, cell lines ( HL60,NB4, Molt-4 and Jurkat) and peripheral blood mononuclear cells from healthy people with methylationspecific PCR (MSP). Results None of the normal mononuclear cells showed methylation of any SFRP genes. The frequencies of aberrant methylation among the samples were 33.9% (20/59) for SFRP1,23.7%(14/59) for SFRP2, 6. 8% (4/59) for SFRP4 and 10. 2% (6/59) for SFRP5 in acute myelocytic leukemia (AML), and 39.3% (11/28) for SFRP1, 28.6% (8/28) for SFRP2, 25.0% (7/28) for SFRP4 and 32. 1% (9/28) for SFRP5 in acute lymphoblastic leukemia (ALL). Hypermethylation of SFRP1, 2, 5genes were present in the 4 AL cell lines. SFRP4 was methylated in NB4, Molt-4 and Jurkat cell lines.However, methylation and unmethylation of SFRP4 were both detected in HL60. Conclusions Hypermethylation of SFRP genes is a common event in the evolution of AL. Methylation of SFRP genes might serve as potential independent biomarkers for early detection of AL.

Objective To evaluate the protective effects of Sipunculus nudus preparation(SNP) on mice irradiated by 60Co.Methods The mice were divided into control group,model group and 0.5,1.0,and 2.0g?kg-1?d-1 SNP groups.SNP was administrated by intra-gastric infusion with the volume of 0.4mL per 20g.In the fifteenth day,the model group and the treated groups were irradiated by ?-ray of 60Co(0.83Gy/h) with the dose of 5 Gy.Peripheral blood WBC,RBC,PLT,the spleen(SI) and thymus index(TI),the BMNC,SOD and MDA in serum,testicle index,germ cells were detected.Results Comparing with the model group,TI,SI and peripheral blood WBC,RBC and BMNCs were higher.The activities of SOD in serum were increased,while MDA decreased.Testicle index and germ cells were increased,and germ abnomality rate was decreased in SNP groups.Conclusion SNP has protective effects on mice irradiatied by 60Co.

Objective:To explore the effect of group psychotherapy on damage of theory of mind (TOM) in patients with early-onset schizophrenia.Methods:Totally 60 patients with early-onset schizophrenia were included and divided into the intervention group (n ＝ 30) and the health education group (n ＝ 30).The patients in the intervention group were offered 10 twice a week 2-hour sessions of group psychotherapy,and those in the control were offered group health education twice a week.All participants completed baseline measures and post-intervention measures with the Eye Emotion Recognition and Theory of mind Picture-sequencing Task (TOM-PST).Results:Totally 23 patients in the intervention group and 29 patients in the health education group finished the post-intervention measures.After 5-week intervention,subscores of sad and fear and total score of emotion recognition,total score of TOM-PST,understanding first order error belief,second order error belief,third order error belief,sense of reality,detecting fraud compared to baseline had statistically significant difference in intervention group.In health education group,subscores of joy emotion recognition,understanding first order error belief,third order error belief,total score of TOM-PST compared to baseline had statstically significant difference.The patients with group psychotherapy got higher scores of total score of TOM-PST and understanding second order error belief and third order error belief than the health education group after 5-week intervention (P ＜ 0.05).Conclusion:This study suggests the group psychotherapy could partially improve theory of mind with early-onset schizophrenia,and promote the recovery of social cognition.

Objective To investigate the incidence of contrast-induced nephropathy (CIN) in the elderly undergoing coronary angiography and the correlated clinical risk factors.Methods 0.90% sodium chloride (1 ml · kg~-1 · h~-1 ) was administered 6 hours before and 12 hours after contrast media administration for 195 elderly patients,and the dose of sodium chloride was half when the patients were suffering from severe congestive heart failure.The levels of serum creatinine (Scr) and cystatin C were measured 3 days before and on the 2nd,5th day after the administration of contrast,respectively .Results(1) The incidence of CIN was 8.7% (17/195).The renal function of 11 cases recovered to baseline level 3 months after the use of contrast,2 cases had transformation to chronic renal failure but without undergoing maintenance hemodialysis,and 3 cases were dependent on maintenance hemodialysis,while 1 case developed multiple organ dysfunction until death.(2) There was no significant difference between pre-and post-contrast administration in the level of cystatin C (t=O.137,P= 0.891). But the concentration of Scr was reduced significantly on the 2nd day compared with the baseline (t=4.776,P = 0.000).Both the cystatin C and Scr recovered to the baseline on the 5th day.(3) There were no significant differences between the CIN and non-CIN group in gender,the dose of contrast,the baseline Scr,and the proportion of coronary heart disease.But there were significant differences in age,the baseline serum cystatin C,the proportions of diabetes mellitus,hypertension and congestive heart failure.(4) The clinical risk factors of CIN were the baseline Scr (OR = 1.039),the baseline serum cystatin C (OR=6.654),diabetes mellitus (OR=8.104) and congestive heart failure (OR=9.597) according to the analysis of logistic regression.ConclusionsWith the hydration and the use of low-osmolar nonionic contrast,it is safe to receive contrast examination for the elderly patients.The baseline serum levels of Scrand cystatin C,diabetes mellitus and congestive heart failure are the clinical risk factors of CIN.Compared with Scr,serum cystatin C is the more powerful predictor for the development of CIN.

Objective:To compare the therapeutic effects of percutaneous nephrostomy and ureteral stent drainage in the treatment of infectious hydronephrosis.Methods:From June 2017 to June 2018, 92 patients with infectious hydronephrosis in the First Hospital of Jiaxing were selected.The patients' hospital number was entered into the computer and the patients were divided into group A(percutaneous nephrolithotomy and drainage treatment, 46 cases) and group B(transurethral ureteral stent drainage treatment, 46 cases) by lottery.The treatment effect and safety were compared between the two groups.Results:There were no statistically significant differences in age, male/female, duration of disease, site of renal disease, primary disease, and underlying disease between the two groups(all P>0.05). There was no statistically significant difference in the success rate of disposable catheter placement between group A and group B(97.73% vs.100.00%, χ 2=0.126, P>0.05). The efficacy of group A was significantly higher than that of group B(97.73% vs.81.40%, χ 2=4.617, P<0.05). There were no statistically significant differences in the incidence rates of bleeding, infection, drainage tube abscess and puncture abscess between the two groups(all P>0.05). Conclusion:Percutaneous nephrostomy in the treatment of infectious hydronephrosis is more effective than ureteral stent drainage.Both of two methods have high safety of treatment.Clinical treatment should be based on the specific circumstances of the patients to obtain a significant clinical effect.

AIM:To investigate the alleviating effect of ethyl acetate extract from Platycladus orientalis leaves(EAEPOL)on diabetic cardiomyopathy(DCM)and its mechanisms.METHODS:Healthy adult C57BL/6 mice were ran-domly divided into normal control group,DCM group,and EAEPOL group.Cardiac structure and function of the mice were assessed by echocardiography.Myocardial fibrosis was evaluated though myocardial hydroxyproline content determi-nation,myocardial Masson and Sirius red staining,and collagen type I(Col I)and collagen type Ⅲ(Col Ⅲ)immunohis-tochemistry.The degree of myocardial oxidative stress was assessed by measuring malondialdehyde(MDA),superoxide dismutase(SOD)and total antioxidative capacity(T-AOC)levels using kits,as well as detection of nuclear factor E2-re-lated factor-2(Nrf-2)and heme oxygenase-1(HO-1)expression by qRT-PCR and Western blot.Endothelial-mesenchy-mal transition(EndMT)was evaluated by detecting CD31 and α-smooth muscle actin(α-SMA)protein expression by Western blot,and cadherin 5(CDH5)and fibroblast specific protein 1(FSP1)mRNA expression by qRT-PCR,as well as α-SMA immunofluorescence staining.RESULTS:(1)Mouse echocardiography revealed that compared with normal control group,heart rate(HR)and ejection fraction(EF)were significantly reduced in DCM group(P<0.05 or P<0.01),while left ventricular anterior wall thickness at systole and diastole(LVAWs and LVAWd)and left ventricular pos-terior wall thickness at systole and diastole(LVPWs and LVPWd)were significantly increased(P<0.05).Compared with DCM group,the mice in EAEPOL group showed significant increases in HR and EF(P<0.01),and marked decreases in LVAWs,LVAWd,LVPWs and LVPWd(P<0.05).(2)Compared with normal control group,the content of hydroxypro-line in mouse myocardium,the collagen area ratio shown by Sirius red and Masson staining,and the immunohistochemical positive area ratio of Col I and Col Ⅲ in DCM group were significantly increased(P<0.01).Compared with DCM group,the above myocardial fibrosis indicators in EAEPOL group were significantly reduced(P<0.05 or P<0.01).(3)Com-pared with normal control group,the myocardial MDA content and the expression of Nrf-2 in DCM group were significantly increased,while the SOD activity,the T-AOC and the expression of HO-1 was significantly decreased(P<0.01).Com-pared with DCM group,the myocardial MDA content in EAEPOL group was significantly reduced,while the SOD activity,the T-AOC,and the HO-1 and Nrf-2 expression were significantly enhanced(P<0.05 or P<0.01).(4)Compared with normal control group,the myocardial expression of CD31 and CDH5 in DCM group was significantly reduced,the expres-sion of α-SMA and FSP1 was significantly enhanced(P<0.05 or P<0.01),and the α-SMA positive area ratio by immuno-fluorescence staining was also increased(P<0.01).Compared with DCM group,EAEPOL significantly up-regulated the expression of CD31 and CDH5 and down-regulated the expression of α-SMA and FSP1,and the α-SMA positive area ratio by immunofluorescence staining was evidently decreased(P<0.05 or P<0.01).CONCLUSION:EAEPOL may attenuate myocardial fibrosis and improve cardiac function in DCM mice by suppressing oxidative stress and alleviating EndMT.

Objective:Based on the specific cleavage and non-specific "trans-cleavage" activities of the clustered regularly interspaced short palindromic repeats (CRISPR) and CRISPR-associated protein(CRISPR/Cas13), we established a visually amplification-free rapid detection technique of 2019-nCoV nucleic acid. This technique is easily processed with a low detection limit and good specificity.Methods:According to the 2019-nCoV gene sequence, specific CRISPR RNAs were screened and designed by bioinformatics analysis, and then synthesized as universal signal-strained RNA transcription targets in vitro to establish and optimize the reaction system. Moreover, the 2019-nCoV pseudoviral nucleic acid was used as a standard substance to evaluate the detection limit. A total of 65 positive samples were collected from various 2019-nCoV variants, while 48 negative samples included other clinically common respiratory pathogens, such as influenza A virus, influenza B virus, human parainfluenza virus, Klebsiella pneumonia, etc. All samples were tested by quantitative PCR (qPCR), digital PCR, and the method established in this study. The sensitivity and specificity of the newly established method were analyzed and evaluated. Results:With the newly established technique, the detection time for 2019-nCoV nucleic acid could be minimized to 6 minutes. In addition, the detection limit was 14 copies/μl when assisted by the displaying instrument, whereas it increased to 28 copies/μl with the naked eye. This technique had a sensitivity and specificity of 98.5% (66/67) and 100% (46/46) respectively, showing no statistically significant difference compared to the gold standard qPCR( P=1). Conclusions:This study has successfully established a CRISPR/Cas13a-based visually rapid detection technique for 2019-nCoV nucleic acid. This technique offers the advantages of a simple process, convenient operation, low environmental operating requirements, a detection limit close to qPCR, and a strong potential for on-site testing applications.