Objective To study the effect of spider venom from Macrothele raveni on proliferation and cell cycles of human hepatocellular carcinoma cell line SMMC-7721 and the molecular mechanism of the(effect.) Methods Proliferation of SMMC-7721 cells was determined by MTT assay.DNA synthesis of SMMC-7721 cell pre-and post-treatment with spider venom from M.raveni was tested by -TdR(assay.) The induction of apoptosis and the change of cell cycle in SMMC-7721 cells treated with spider(venom) from M.raveni were investigated by Flow Cytometry.The effect of spider venom from M.raveni on expression of c-myc protein in SMMC-7721 cells was studied by Western Blot.Results MTT assay showed that the proliferation of SMMC-7721 cells in vitro was inhibited by spider venom from M.raveni((P

Background and purpose:Pterostilbene is a natural antioxidant, whose role in retinoblastoma remains unclear. The aim of this study is to probe the effects of pterostilbene on the proliferation, apoptosis and autophagy in retinoblastoma WERI-Rb-1 cell lines.Methods:Cell counting kit-8 (CCK-8) assays were used to analyze the effects of pterostilbene on the proliferation of WERI-Rb-1 cells. Apoptosis rate was determined by Annexin V/PI. Autophagic vacuoles were observed by acridine orange staining. LC3 and P62 protein expressions were determined using Western blot.Results:Pterostilbene significantly inhibited the proliferation of WERI-Rb-1 cells (P<0.01). The cell viability were (93.02±0.47)%, (55.10±2.04)% and (30.33±1.45)% after WERI-Rb-1 cells were treated with 25, 50 and 100 μmol/L pterostilbene for 24 h, and the cell viability were (88.38±3.70)%, (53.37±1.17)%, (29.60±1.05)% after WERI-Rb-1 cells were treated with 50 μmol/L pterostilbene for 12, 24 and 48 h. Pterostilbene induced cell apoptosis (P<0.01), the apoptosis rates of control group, 24 h treated group and 48 h treated group were (4.08±0.79)%, (13.44±2.12)% and (23.49±2.01)%. Pterostilbene induced autophagy of WERI-Rb-1 cells, increased LC3 expression, downregulated P62 expression and increased the number of autophagic vacuoles in WERI-Rb-1 cells (P<0.01). 3-MA and Beclin1 were able to rescue pterostilbene-induced cell death (P<0.01). After 3-MA was used to blunt autophagosome formation, the apoptosis rate markedly decreased in 3-MA+pterostilbene-treated cells compared with cells treated with pterostilbene alone [(12.97±2.09)%vs (8.35±1.11)%], and after siRNA was used to knockdown Beclin1, the apoptosis rate had the same change [(13.80±2.19)%vs (9.62±0.52)%].Conclusion:Pterostilbene can inhibit the proliferation of WERI-Rb-1 cells and induce cell apoptosis via autophagy activation.

Objective The aim of this report was to study the early and mid-term outcome in hospital and follow-up mortality, predictors for late pulmonary stenosis (PAS) and insufficiency of neo-aortic valve (neo-AVI) in patients with transposition of great arteries (TGA) and Taussig-Bing malformation undergoing arterial switch operation ( ASO ). Methods Between January 2004 and December 2007, 169 patients (129 male, 40 female; mean age of [(11.71 ± 26.3 ) months] with TGA or Taussig-Bing malformation underwent ASO. The patients were divided into Group Ⅰ (n = 56 ): TGA with intact ventricular septum and Group Ⅱ ( n = 113 ): TGA with ventricular septal defect (VSD). All patients were followed up in out-patient department by ultrasonic cardiogram. The mean follow-up periods was (27.66 ± 14.6 ) months. Multiple logistic regression analysis was performed to find out the risk factors. Results The overall hospital mortality was 11.24% (19/169)and there was no significant difference between the two Groups. With the improving of perioperative management, the hospital mortality decreased from 16.67% in 2004 to 3.92% in 2007. The overall actuarial survival at 1-, 3- and 5-year follow-up was 94.00%,91.33%, and 91.33%, respectively. The multivariate analysis revealed that age above 6 months was a strong predictor for poor postoperative survival. Predictors for neo-AVI were: combined with VSD, age > 6 months and postoperative neo-AVI Z-score > 1. Predictors for moderate to severe PAS were age ＜ 1 months and pulmonary artery plasty with an unstretchable patch. Conclusion ASO remains the optimal choice for treating various forms of TGA with an acceptable early and mid-term outcome regarding overall survival rate. Patients with TGA should be treated as early as possible. Age >6 months is a predictor for poor postoperative survival and neo-AVI. Mismatch between the neo-aortic root and distal aorta may induce neo-AVI. Unstretchable patch in pulmonary artery plasty may induce PAS.

Objective: To establish the standardized management mode for emergent medicines of inpatient area based on JCI. Methods:The expiry verification data of emergent medicines in hospital wards were collected from 2013 to 2015. The number and the amount of emergent medicines expired in the last three months in each calendar month during the three years were analyzed, the exist-ing problems in the management mode were found out and gradually optimized using PDCA cycle. Results:From 2013 to 2015, the re-placement amount of emergent medicines expired in the next month was 3497. 37 yuan. The number of emergent medicines expired in current month was 62. A total of 420 times of emergent medicines didn' t meet the requires of expiry verification from 2013 to 2015. After the check-in form redesign for emergent medicines and the standardization of replacement process, the number of expired medi-cines in the rescue carts was reduced, and the validity and quantity of drugs in all the rescue vehicles could be clearly shown in the new form. Conclusion:The standardization of emergent medicine management model can guarantee the safety of emergent medicines used in patients.

Objective To shorten the turn around time of positive blood culture results by optimizing the blood culture positive specimen processing flow.Methods In January 26,2015,the microbiology department started the blood culture positive specimen processing flow optimization project,and applied the Lean Six Sigma method in the microbiological process management.The TAT data of 124 positive blood cultures containing Enterobacteriaceae were collected before and after the start of the project in about two months.We analyzed the turnaround time median,mean and standard deviation and reference Z value,process performance index,millions of error opportunities.We decompose the turnaround time into six time periods to find the key points of the process improvement and the influencing factors,and then put forward the reform measures to optimize the blood culture inspection process.MiniTab17.0 statistical software was used to process capability analysis and double sample t test.Results After the implementation of the project,the average turnaround time of the blood culture was shortened from 77.10 h to 64.03 h,improved by 13.06 h(16.94％).Process performance greatly improved in Ppk value increased from 0.49 to 0.88,the benchmark Z value increased from 1.48 to 2.63.After the improvement,except the positive alarm time of blood culture,the mean of the other decomposition time was significantly shorter than before.Conclusions The application of Six Sigma in process management can greatly improve the work efficiency and process performance.This project can save a lot of manpower,material and financial resources,reduce the waiting,shorten turnaround time,that achieve the desired results.

Background and purpose:Tetrandrine is a natural compound whose role in retinoblastoma remains unclear. This study investigated the effects of tetrandrine (Tet) on human retinoblastoma cells.Methods:CCK-8 assays were performed to analyze the effects of Tet on viability of retinoblastoma cells. The apoptosis rate was determined by Annexin V/PI assays. After staining with 2′,7′-dichlorolfuorescin diacetate (DCFH-DA), cellular reactive oxygen species (ROS) was measured by lfow cytometry. Akt and p-Akt were detected by Western blot.Results:Tet inhibited cell viability of retinoblastoma cells. After treatment with Tet (4, 8, 10 and 20μmol/L) for 24h, cell viability inhibition rates of WERI-Rb-I were 5.7%, 25.0%, 55.1% and 84.9%, whereas inhibition rates of Y79 cells were 2.4%,2.9%, 23.8% and 54.2% (P<0.01). In cells treated with 10μmol/L of Tet for 12, 24 and 48 h, cell viability inhibition rates of WERI-Rb-I were 6.0%, 45.5% and 74.7%, whereas inhibition rates of Y79 cells were 2.9%, 19.4% and 43.3% (P<0.01). Tet induced retinoblastoma cell apoptosis. After treatment with Tet (10 μmol/L) for 24 and 48 h, apoptosis rates of WERI-Rb-I were (23.70±1.75)% and (34.83±3.15)%, respectively, whereas apoptosis rates of Y79 cells were (9.62±2.69)% and (14.97±1.50)%, respectively (P<0.01). Apoptosis inhibitor Z-VAD-FMK attenuated Tet-induced cell death (P<0.05). ROS levels were indeed increased in cells treated with Tet (10 μmol/L) for 6 and 12 h (P<0.01), while N-Acetyl-L-cysteine (NAC) decreased Tet-induced ROS (P<0.01). After ROS was inhibited by NAC, apoptosis rate was decreased compared with the control (P<0.01). Further study indicated that Tet inhibited PI3K/Akt pathway in retinoblastoma cells.Conclusion:Tet induces cell apoptosis via increasing ROS synthesis and inhibiting PI3K/Akt pathway.

Objective To observe the anti-inflammatory and analgesic effects of CNZ,an optimized prescrition of Liushen Wan based on our previous studies,so as to provide some pharmacological evidence for its further clinical use. Methods Both acetic-acid-induced increased mouse vascular permeability and carrageenan-induced mouse footpad edema were used to study the anti-inflammatory activity of CNZ.Meanwhile,its analgesic activity was evaluated in mice model of pain induced by thermal stimulus and acetic acid.The above activities were compared with those of Liushen Wan.Results CNZ significantly reduced acetic-acid-induced dye leakage at the doses of 16,32 and 64mg/kg after single oral administration.Meanwhile,CNZ at the two higher doses also markedly inhibited carrageenan-induced foot- pad edema,which exerted the strongest effect at 3 hours after carrageenan injection,and lasted over 5 hours.On the other hand,CNZ remarkably suppressed acetic-acid-induced writhing response at low,moderate-and high-doses, and significantly prolonged pain threshold in hot plate assay at moderate-and high-doses 0.5 hour after oral adminis- tration,lasting over 3 hours.Overall,its potency was similar to that of Liushen Wan.Conclusion CNZ has significant anti-inflammatory and analgesic activities.

Objective To explore the effect of ciliary,neurotrophic factor (CNTF)-coated polyglycolic and polylactic acid (PGLA) nerve conduits treated by pulsed plasma to repair canine tibial nerve defects. Methods A 2.5 cm long tibial nerve defect was made in eighteen cross-bred dogs.The nerve defects were re- constructed by three different methods:group A:pulsed plasma treated and CNTF coated PGLA nerve conduits (n=6);group B:PGLA nerve conduits alone (n=6);group C:nerve autografts (n=6).HE staining, Massons' trichrome staining,S-100 immunostaining,electrophysiological test and axon counting were used to evaluate the results of nerve regeneration in three groups.In addition,the dynamic walking pattern was recor- ded individually.The observation period lasted for three months.Results All nerve conduits were well vas- cularized and mostly degraded as well as absorbed.It was found that the regenerating axons could traverse all nerve conduits.In regard to nerve conduction velocity and axon counting there was no significant difference be- tween group A and group C (P＞0.05),while the data of group A and group C were significantly better than those of group B(P＜0.05).The dogs in group A and C recovered nearly normal walk pattern while those in group B were still crippled.Conclusion Pulsed plasm-treated and then CNTF-coated PGLA nerve conduits could effectively repair 2.5-cm-long canine tibial nerve defects,and the effect is similar to that of autografts.

OBJECTIVE:To provide reference for improving related policy and list about medical insurance medicines in China. METHODS:The descriptive analysis method was used to compare 2017 and 2009 edition of Medicine List for National Basic Medical Insurance,Employment Injury Insurance and Maternity Insurance in respects of item,medicine classification (including classification code,grading and name),medicine types(including new type,removed type),dosage(including new dosage classification,adjusted dosage form),the limit of payment and use.The trend of its development and the existing problems were discussed. RESULTS:Compared with 2009 edition,2017 edition of medicine list added the item of"drug classification code"and removed the item of"English name". The grading of drug classification code was reduced from six grades to four grades. The code and name of four grades classification were in accordance with the first four grades classification rules of the anatomical-therapeutic-chemistry(ATC). A total of 2 535 types were included in 2017 edition,increasing by 362 types compared to 2009 edition(151 chemical medicines,211 Chinese patent medicines). 15 types of chemical medicines were removed,and 4 types were transferred to Chinese patent medicine list;11 types of Chinese patent medicines were removed,and one type was transferred to chemical medicine list. 2017 edition was actually 20 more dosage forms than 2009 edition,involving 31 types;dosage forms of 231 types were adjusted(143 chemical medicines,88 Chinese patent medicines). Chemical medicines of usage and payment restriction increased from 239 to 302,and Chinese patent medicines increased from 72 to 115,respectively. CONCLUSIONS:2017 edition of list increases the number of medicine,expands the scope of clinical medication and improves the classification structure of the list.The number of medical insurance cost control type shows a growing trend.