Drug management system of No.1 Military Medial Project is an important component of hospital information management system. This paper introduces four pieces of application experience of drug management system and presents seven suggestions about it.

Objective To analyze the clinical characteristics of single renal transplantation from infant kidney donation after death (DCD) and summarize the nursing measures for nursing the infants. Method The clinical data of 36 cases of single kidney transplantation from 18 infant donors from January 2014 to June 2016 in our centre were reviewed and summarize the nursing experience. Results Pulmonary infection occurred in 3 cases, incision infection occurred in 2 cases and graft vascular complication occurred in 2 cases. Urinary fistula occurred in 2 cases, ureteral obstruction occurred in 1 case, delayed graft function (DGF) occurred in 16. Postoperative follow-ups for 1 to 20 months showed all the grafted kidneys survived and 34 of them were well recovery in view of renal function of grafted kidney and the rest two had the grafted kidneys resected because of arterial and venous thrombus in them. Conclusions The renal transplantation from infant DCD is difficult. The nurses should handle postoperative care to the patients, paying attention to the complications. On the other hand, intra-and post-operative monitoring of blood pressure, control of input and output and early observation of complications and treatment is of value for the improvement of survival rate of grafted kidneys, reduction of complication incidence and propelled recovery of the patients.

Objective To analyze the outcomes and the prognostic factors of allogeneic peripheral blood stem cell transplantation (allo-PBSCT) for acute lymphoblastic leukemia (ALL).Method From Feb.2002 to Feb.2014,a total of 95 patients with ALL were treated with alloPBSCT in our hospital.Of these,73 cases obtained the first CR (CR1),11 cases obtained late CR,7 patients were in relapse and 3 patients suffered from primarily refractory disease (PRD) before transplant.The median age was 26 (4-57) years.Conditioning regimens including total body irradiation (TBI)/ etoposide/semustine/cyclophosphamide or busulfan/semustine/cyclophosphamide were used.Matched sibling transplantation was performed on 68 patients,and matched unrelated donor transplantation was performed on 27 patients.Combination of CsA,MTX and low-dose,short-course mycophenolate mofetil was used for graft-versus-host disease (GVHD) prophylaxis.The average fellow-up was 57 months.Result Hematopoietic reconstitution was achieved in all 95 patients.Five-year estimate of overall survival (OS) was 54.3％,disease free survival (DFS) was 51.2％,relapse rate (RR) was 30.2％ and transplant-related mortality (TRM) was 24.0％.The 5 year OS and DFS were significantly longer in patients with CR1 than in late CR and relapse/PRD patients before allo-PBSCT (P＜0.001).There was no significant difference in OS between the two different conditioning regimens.Multivariate analyses revealed that Ⅱ-Ⅳ aGVHD and cGVHD were correlated with higher TRM,CR1 before allo-PBSCT and TBI were associated with a lower RR,and non Ⅱ-Ⅳ aGVHD and CR1 before allo-PBSCT were favorable factors which were associated with OS and DFS.In the patients with DFS≥1 year after allo-PBSCT,DFS and OS were shorter in patients with cGVHD (P =0.008).Conclusion Allo-PBSCT in adult ALL patients should be performed in CR1.Severe acute and chronic GVHD are not associated with improved survival.

〔Abstract〕 The paper introduces the characteristics, methods and achivements of regional health informatization construction of Luoy-ang health information security project, overviews the construction ideas of regional informatization, providing basis for future development and references for similar projects implementation.

Objective To investigate the expressions of regulatory T cell (Treg) and interleukin-35 (IL-35) in patients with cholangiocarcinoma and to explore their clinical significance.Methods Flow-cytometry,PCR,Enzyme-linked immunosorbent assay (Elisa) and immunohistochemistry were used to detect the levels of Treg and IL-35 in peripheral blood and cholangiocarcinoma tissues in 42 patients with cholangiocarcinoma.Healthy volunteers were used as a control group.Result The percentage of Treg cells to CD4 + T cells in patients with cholangiocarcinoma was (5.6 ± 1.7) ％,while that in the normal control group was (2.9 ± 0.8) ％.There was a significant difference between the two groups (P ＜ 0.05).The plasma levels of IL-35 in patients with cholangiocarcinoma was (198.4 ± 81.4) pg/ml,while that in the normal control group was (33.7 ± 18.0) pg/ml.Again,a significant difference was observed between the two groups (P ＜ 0.05).In peripheral blood mononuclear cell,the IL-35 mRNA level was positively correlated with the plasma IL-35 level (p35,R =0.795,P ＜0.05;EBI3,R =0.812,P ＜ 0.05).Immunohistochemical studies showed that FOXP3 + tumor cells and Treg cells increased significantly in tumor tissues.Conclusion Overexpressions of Treg and IL-35 in peripheral blood and tumor tissues of patients with cholangiocarcinoma suggested that they may play important roles in the development of cholangiocarcinoma.

Objective To study and correlate serum bilirubin and regulatory T cell (Treg) levels in patients with bile duct stone.Methods Flow-cytometry and Enzyme-linked immunosorbent assay (Elisa) were used to study the peripheral blood expression level of Tregs and the bilirubin level in 27 patients with bile duct stones and jaundice.The changes in the expression level of Tregs and the bilirubin level were studied and correlated before and after treatment.Results After treatment,both the peripheral blood bilirubin level,the Tregs expression level and the cell cytokines decreased significantly.The total bilirubin level decreased from (102.8 ± 33.1) mmol/L to (15.3 ± 5.7) mmol/L (P ＜ 0.05),the direct bilirubin level decreased from (38.1 ± 12.8) mmol/L to (5.0 ± 1.6) mmol/L (P ＜0.05);the percentages of CD4+ CD25 +Foxp3 + T cells in CD4+ T decreased from (4.2 ± 2.0) ％ to (2.4 ± 1.0) ％ (P ＜ 0.05).Before treatment,the levels of IL-10 and TGF-β were 171.4 ± 13.7 and 2016 ±657 pg/ml but after treatment,the two cytokines decreased to 92.1 ± 7.4 and 1 686 ± 168 pg/ml,respectively (P ＜ 0.05).Conclusions Patients with bile duct stones and jaundice presented with high expressions of bilirubin and Tregs level.These expressions returned to normal after effective treatment.The Tregs expression level was positively correlated with the bilirubin level.

Objective To evaluate the therapeutic effect of low-dose herringtonine in lupus nephritis.Methods Harringtonine1mg,which was dissolved in500ml normal saline,was infused intravenously everyday for5to7days as a single course.The total therapeutic period was consisted of3to6courses.Each course was given every2to3weeks.12patients with lupus nephritis were treated in this study.Results Seven patients(58%)achieved complete clinical remission while5(42%)had partial clinical remission.The overall response rate was100%.Conclusion This study suggests that low-dose harringtonine is an effective therapeutic regimen for lupus nephritis with relatively low toxicity and low price.It has the potential to be used widely in treating lupus nephri-tis.

Objective Using infrared spectroscopy to analyze three kinds of lignum Chinese medicine to provide a theoretical basis for the establishment of medicinal overall quality evaluation system. Methods Functional groups identification, Fourier Transform-infrared spectroscopy(FT-IR) and the second derivative infrared spectroscopy (SD-IR) could be applicable to analyze and identify the overall chemical composition of three kinds of lignum Chinese medicine. Results The main chemical components of Aquilariae Lignum Resinatum (ALR), Dalbergiae Odoriferae Lignum (DOL) and Sappan Lignum (SL) were cellulose, lignin and aromatics. The main chemical compositions of Sappan Lignum (SL) were cellulose, lignin and aromatics. The differences in FT-IR and SD-IR of DOL and SL indicated that they had different aromatic compounds. Conclusion Infrared spectroscopy can be used as a simple and accurate quality control method of three kinds of lignum Chinese medicine.

Objective To synthesize 131I labeled anti-neuropilin-1 monoclonal antibody A6 (131IA6) and evaluate its biodistribution and imaging in malignant glioma xenografts.Methods (1) A6 was labeled with 131I by Iodogen method under the optimum labeling conditions,then the labeling efficiency,radiochemical purity and stability were measured in vitro.(2) In vitro bioactivity,cellular uptake and receptor affinity of 131I-A6 with U87MG cells were measured.(3) The nude mice bearing human U87MG cells were randomly divided into 5 groups with 5 in each group.The nude mice were sacrificed by cervical dislocation and dissected at 24,48,72,96,and 120 h,respectively,after intravenous injection of 1.2 MBq 131I-A6.The biodistribution of the agent was measured as ％ID/g,and the ratios of tumor/blood (T/B) and tumor/muscle (T/M) were calculated.(4) SPECT/CT imaging was performed in 6 mice including 3 in the competitive inhibition control group at 24,48,72,96,and 120 h post injection.Two-sample t test was used for data analysis.Results (1) The labeling yield of 131I-A6 was (95.46±3.34)％,and the radiochemical purity was more than 95％.At 96 h of incubation in PBS,the radiochemical purity was more than 85％.(2)131I-A6 had rapid accumulation in U87MG cells and reached the peak of (15.80±1.30)％ at 1 h.When the probe was incubated with large excesses of non-radioactive A6,the uptake level of 131I-A6 in U87MG cells was significantly inhibited (t=2.862,P＜0.05).Kd of 131I-A6 binding to NRP-1 was (1.67±0.14) nmol/L in U87MG cells.(3) Biodistribution study showed that the uptake in blood,liver and tumor was (8.00±1.42),(7.68±1.56) and (6.00±1.24) ％ID/g at 24 h,respectively.The uptake in muscle,brain and bone was lower.The T/B and T/M were 0.78±0.10 and 3.20±0.30 at 24 h,and they reached the highest level of 1.87±0.50 and 7.13±0.24 at 120 h.(4) The SPECT imaging showed that the tumors could be visualized at 24 h and delineated more clearly at 120 h post injection of 131I-A6.Conclusions 131I-A6 can be easily synthesized by Iodogen method with high radiochemical purity.The specific tumor uptake of 131I-A6,which correlates with NRP-1 expression in gliomas,suggests that it may be a new promising tumor targeting radiotracer.

Objective To investigate the changes in plasma very long chain fatty acids (VLCFAs),and to explore its relationship with obesity-related index in obese children.Methods One hundred and sixty-six obese children aged 7 to 12 years old were investigated and 148 health children matched with age and sex were selected as control group.Their height,weight,and waist circumference (WC) were measured.The percentage of body fat (PBF) was tested by dual-energy X-ray absorptiometry.Fasting blood triglycerides (TG),total cholesterol (TC),high density lipoprotein-cholesterol (HDL-C),low density lipoprotein-cholesterol (LDL-C) levels,fasting plasma glucose,and fasting insulin (FINS) were determined.The body mass index (BMI),BMI-Z score,waist to height ratio (WHtR),and homeostasis model assessment for insulin resistance (HOMA-IR) were calculated.The plasma VLCFAs were analyzed by gas chromatography-mass spectrometry.Results (1) Compared with normal control children,body weight,BMI,BMI-Z score,WC,WHtR,PBF,TG,TC,LDL-C,FINS,and HOMA-IR in obese children were increased (all P ＜ 0.05),and the level of HDL-C was decreased (P ＜ 0.05).(2) The plasma levels of docosamonoenoic acid (C22 ∶ 1 n-9) and arachidonic acid (C20 ∶ 4n-6) were decreased while the levels of arachicacid (C20 ∶ 0) and eicosapentaenoic acid (C20 ∶ 5n-3) increased in obese children compared to non-obese children.(3) The linear correlation analysis showed that PBF was positively correlated with C20 ∶ 0 and C20 ∶ 5n-3,and negatively correlated with C20 ∶ 4n-6.WHtR was negatively correlated with C22 ∶ 1 n-9 and positively correlated with C20 ∶ 0 (4) The multiple stepwise regression analysis showed that C20 ∶ 0 was the main factor for PBF,and C22 ∶ 1 n-9 and C20 ∶ 0 were the main factors for WHtR.Conclusion The metabolic abnormality of plasma very long chain fatty acids exists in obese children.The changes in C20 ∶ 0,C22 ∶ 1 n-9,and C20 ∶ 5n-3 may be associated with obesity in children.