Objective To analyze the irrational prescriptions, improvement measures and improvement effect in our hospital in 2016. Methods 7200 outpatient and emergency prescriptions of our hospital in 2016 were randomly selected to study. 3600 prescriptions from January 2016 to June were selected as pre intervention group, and 3600 prescriptions from July 2016 to December were selected as post intervention group,First of all, the prescription of the pre intervention group was reviewed, according to the results of the review and literature review to determine the intervention measures. The types of prescription drugs, average amount of prescription, rate of antibiotic use and unreasonable prescription rate of two groups were observed. Results Types of prescription drugs(2.27 kinds vs. 1.93 kinds), average amount of prescription(171.74 yuan vs. 152.86 yuan), rate of antibiotic use(34.39% vs. 25.47%) and unreasonable prescription rate (9.36% vs. 2.14%)of post intervention group were significantly lower than those of pre intervention group(P<0.05). Conclusion The prescription comment and targeted intervention can reduce the incidence of irrational drug use and promote rational drug use in clinic, which has important clinical value.

Objective To investigate the effects of valsartan on the expression of acyl-coenzyme A: cholesterol acyltransferase-1(ACAT-1) and peroxisome proliferator activated receptor-gamma(PPAR-?) in atherosclerotic plaques on rabbit aortic wall.Methods Twenty-four male Japanese white rabbits were randomly assigned into three groups(8 each): control group,valsartan group and high cholesterol feeding group.All rabbits were fed according to the experimental protocol for 12 weeks.Blood samples were taken from vein for measurement of serum lipids.The ratio of intima/media thickness of the aorta was measured.ACAT-1 mRNA/protein and PPAR-? mRNA/protein were determined by reverse transcription polymerase chain reaction(RT-PCR) and Western blotting,respectively.Results After 12 weeks,the levels of serum total cholesterol(TC),triglyeride(TG) and low density lipoprotein-cholesterol(LDL-C) in valsartan group and cholesterol group were significantly higher than those in control group(P0.05).The intima thickness and the ratio of intima/media in carotid arteries in cholesterol group were significantly higher than those in control group and valsartan group(P

Objective To observe efficacy of percutaneous laser disc decompression (PLDD) and its correlation with plasma levels of β-endorphine and substance P in patients suffering from protrusion of lumbar intervertebral disc (PLIVD). Methods Seventy-eight patients with PLIVD were randomly divided into two groups, one group (40 patients) treated with PLDD and the other (38 patients) treated with lumbar spine traction and physical therapy as control. Their peripheral plasma levels of β-endorphine and substance P were measured before the procedure and one day, one week and four weeks after it, respectively.Meanwhile, the visual analogue scale (VAS)was applied to assess their pain index. Results Plasma level of substance P was (186±66) ng/L and (419±82) ng/L, and (127 +83) ng/L and (322 +47) ng/L,in treatment and control groups, one day and one week after the procedure, respectively, and that of β-endorphine was (313 ±27) mg/L and (187 ±56) mg/L, and (364 + 18) mg/L and (211 +39) mg/L,one day and one week after it, respectively ( all P ＜ 0. 01 ), with its clinical efficacy of 90% (36/40)and 66% (25/38) one week after it, respectively ( P ＜ 0. 01 ) . Four weeks after it, plasma level of substance P was (64 ±50) ng/L in treatment group as compare to that in controls (93 ±75) ng/L, and that of β-endorphine was (410 ± 21 ) mg/L and (317 ± 42 ) mg/L, respectively, with efficacy of 95% (38/40) and 84% (32/38), respectively. Conclusions Plasma level of substance P can be reduced and that of β-endorphine can be increased by PLDD in patients with PLIVD, thus relieving their pain.Measurements of substance P and β-endorphine can be used as objective indicators to evaluate clinical efficacy of PLDD.

Objective To determine the serum level of chernokine CCL27 in patients with psoriasis vulgaris,and to analyse its clinical relevance.Methods A total of 61 patients(40 in progressive stage and 21 in stable stage)with psoriasis vulgaris,with an average disease duration of 37.97±14.34 years,were included in this study.Appropriate thempy was given to these patients.Serum samples were collected from the patients before and after therapy,as well as from 45 healthy human controls.ELISA was applied to examine the serum concentration of CCL27.Clinical severity of psoriasis vulgaris was assessed by psoriasis area and severity index(PASI)score.Results Serum level of CCL27 was 670.02±262.15 ng/L in psoriatic patients,compared to 373.10±92.84 ng/L in the controls(t=8.18.P＜0.01).Increased serum level of CCL27 was observed in patients with progressive psoriasis vulgaris compared to those with stable psoriasis (799.94±214.54 ng/L vs 422.57±135.53 ng/L,t=8.39,P＜0.01).After 8 weeks of therapy,a significant decrease was noticed in the serum level of CCL27 in patients who experienced≥70%reduction in PASI score(t=9.95,P＜0.01).but not in those experiencing a PASI reduction of＜70%(t=1.84,P＞0.05).The serum level of CCL27 was positively correlated with PASI score(r=0.58,P＜0.01).Conclusions The serum level of CCL27 is significantly elevated in patients with psoriasis vulgaris,and it is correlated with the disease severity.

Objective To investigate the wall shear stress(WSS) in the common carotid artery of type 2 diabetes mellitus(DM) patients,and analyzed the spatial distribution of WSS by using quantitative visualization of blood flow shear stress analysis software.Methods Eighteen male type 2 DM subjects were enrolled as DM group and 18 age-matched healthy subjects were selected as control group.None of the participants was hypertensive,hyperlipidemic or a cigarette smoker.Intimal-medial thickness (IMT),number and size of plaques in the common carotid artery were evaluated by high-resolution echo-Doppler.Color Doppler flow images of common carotid arteries in the two groups were extracted from DICOM files.WSS in the common carotid arteries was calculated by shear stress visualization quantitative analysis software,and the corresponding spatial distribution maps of WSS were designed.Results WSS of the common carotid arteries in the control group were ranged from 4 to 14 dyne/cm2.WSS of the common carotid arteries in the DM group were ranged from 2 to 8 dyne/cm2.Compared to mean WSS value [(6.96 ± 1.17)dyne/cm2] of common carotid arteries in the control group,mean WSS value [(3.14 ± 0.79)dyne/cm2] of common carotid arteries in the DM group was significantly lower (t =9.380,P =0.000).Six diabetic participants had a plaque in one carotid artery and no lesions in the contralateral carotid.Among these subjects,mean WSS was significantly lower in the side with lesion (t =7.324,P =0.000).Therefore,IMT of common carotid arteries in participants was significantly inversely related to WSS (r =-0.76,P ＜0.01).Conclusions The common carotid arteries of DM patients are more prone to atherosclerosis which is associated with reduction of WSS.The hemodynamic profile might represent an additional factor contributing to the increased prevalence and severity of carotid atherosclerosis in diabetic patients compared with general population.

Background: Obesity classifications vary globally and the impact of older age adiposity on incident diabetes has not been well-studied. Methods: We examined a random sample of 2,809 participants aged ≥60 years in China, who were free of diabetes at baseline and were followed up for up to 10 years to document diabetes (n=178). The incidence of diabetes was assessed in relation to different cut-off points of body mass index (BMI) and waist circumference (WC) in multiple adjusted Cox regression models. Results: The diabetic risk in the cohort increased linearly with the continuous and quartile variables of BMI and WC. The BMI-World Health Organization (WHO) and BMI-China criteria analysis did not show such a linear relationship, however, the BMI-Asian/Hong Kong criteria did; adjusted hazards ratio (HR) was 0.42 (95% confidence interval [CI], 0.20 to 0.90) in BMI <20 kg/m2, 1.46 (95% CI, 0.99 to 2.14) in 23–≤26 kg/m2, and 1.63 (95% CI, 1.09 to 2.45) in ≥26 kg/m2. The WC-China criteria revealed a slightly better prediction of diabetes (adjusted HRs were 1.79 [95% CI, 1.21 to 2.66] and 1.87 [95% CI, 1.22 to 2.88] in central obese action levels 1 and 2) than the WC-WHO. The combination of the BMI-Asian/Hong Kong with WC-China demonstrated the strongest prediction. There were no gender differences in the impact of adiposity on diabetes. Conclusion In older Chinese, BMI-Asian/Hong Kong criteria is a better predictor of diabetes than other BMI criterion. Its combination with WC-China improved the prediction of adiposity to diabetes, which would help manage bodyweight in older age to reduce the risk of diabetes.

Objective To evaluate the performance of an artificial intelligence ( AI ) assisted diagnosis system for diabetic retinopathy ( DR) based on deep learning theory. Methods Diagnostic performance of a robot assisted diagnosis system called SongYue for DR was trained by using 25297 retinal images tagged by fundus doctors from multiple hospitals in China. Four types of DR detection model consisting of abnormal DR,referable DR,severe non-proliferative and proliferative DR as well as proliferative DR according to fundus leisions identification were established. The ability of the system to distinguish DR was determined by using receiver operator characteristic (ROC) analysis,sensitivity and specificity of the system. Results SongYue system achieved an area under the ROC curve ( AUC) of 0. 920 for successfully distinguishing normal images from those DR with a sensitivity of 96. 0％at a specificity of 87. 9％. The AUC of SongYue for referable DR was 0. 925,sensitivity was 90. 4％,and specificity was 95. 2％. For severe non-proliferative and proliferative DR,AUC was 0. 845,sensitivity was 72. 7％,and specificity was 96. 2％. For proliferative DR, AUC was 0. 855, sensitivity was 73. 5％, and specificity was 97. 3％. Conclusions SongYue robot assisted diagnosis system has high AUC,sensitivity and specificity for identifying DR, showing good clinical applicable benefits.

Aristolochic acid (AA), extracted from Aristolochiaceae plants, plays an essential role in traditional herbal medicines and is used for different diseases. However, AA has been found to be nephrotoxic and is known to cause aristolochic acid nephropathy (AAN).AA-induced acute kidney injury (AKI) is a syndrome in AAN with a high morbidity that manifests mitochondrial damage as a key part of its pathological progression. Melatonin primarily serves as a mitochondria-targeted antioxidant. However, its mitochondrial protective role in AA-induced AKI is barely reported. In this study, mice were administrated 2.5 mg/kg AA to induce AKI. Melatonin reduced the increase in Upro and Scr and attenuated the necrosis and atrophy of renal proximal tubules in mice exposed to AA. Melatonin suppressed ROS generation, MDA levels and iNOS expression and increased SOD activities in vivo and in vitro. Intriguingly, the in vivo study revealed that melatonin decreased mitochondrial fragmentation in renal proximal tubular cells and increased ATP levels in kidney tissues in response to AA. In vitro, melatonin restored the mitochondrial membrane potential (MMP) in NRK-52E and HK-2 cells and led to an elevation in ATP levels. Confocal immunofluorescence data showed that puncta containing Mito-tracker and GFP-LC3A/B were reduced, thereby impeding the mitophagy of tubular epithelial cells. Furthermore, melatonin decreased LC3A/B-II expression and increased p62 expression. The apoptosis of tubular epithelial cells induced by AA was decreased. Therefore, our findings revealed that melatonin could prevent AA-induced AKI by attenuating mitochondrial damage, which may provide a potential therapeutic method for renal AA toxicity.

Objective To investigate epidermal growth factor receptor(EGFR)gene T790M mutation in plasmatic ctDNA samples from 171 patients with non-small cell lung cancer and analyze the relationship between EGFR T790M mutation and the clinical factors. Methods The EGFR T790M mutation was detected in 171 cases by super amplification refractory mutation system(Super ARMS)in this paper. Rusults The EGFR gene T790M mutation was identified in 7.60%(13/171)plasmatic ctDNA samples which mostly came from patients withⅢb~Ⅳstages of lung cancer. The EGFR T790M mutation rate was identified in 2.05%(3/146)plasmatic samples of pa-tients who did not received treatment of EGFR-TKIs,which was lower than 40.00%(10/25,P<0.05)plasmatic samples of patients who received treatment of first generational EGFR-TKIs. The EGFR T790M mutation rate was identified in 75.00%(3/4) and 60.00%(6/10) plasmatic samples of patients who have received TKI for 6 to 10 months and more than 10 months,which was higher than 9.10%(1/11,P < 0.05)plasmatic samples of patients who have received TKIs for less than 6 months. Conclusions This article demonstrated that EGFRT790M muta-tion was more common in lately NSCLC patients who have received TKIs treatmentover 6 months,meanwhile the EGFR T790M mutation dynamical detective technology will effectively guide the clinic treatment.

Acute pancreatitis (AP) is a devastating disease characterized by an inflammatory disorder of the pancreas. P-selectin glycoprotein ligand-1 (PSGL-1) plays a crucial role in the initial steps of the adhesive at process to inflammatory sites, blockade of PSGL-1 might confer potent anti-inflammatory effects. In this study, we generated two non-human primate derived monoclonal antibodies capable of efficiently targeting human PSGL-1, RH001-6 and RH001-22, which were screened from immunized rhesus macaques. We found that RH001-6, can effectively block the binding of P-selectin to PSGL-1, and abolish the adhesion of leukocytes to endothelial cells in vitro. In vivo, we verified that RH001-6 relieved inflammatory responses and pancreatic injury in both caerulein and l-arginine induced AP models. We also evaluated the safety profile after RH001-6 treatment in mice, and verified that RH001-6 did not cause any significant pathological damages in vivo. Taken together, we developed a novel non-human primate derived PSGL-1 blocking antibody with high-specificity, named RH001-6, which can interrupt the binding of PSGL-1 and P-selectin and attenuate inflammatory responses during AP. Therefore, RH001-6 is highly potential to be further developed into therapeutics against acute inflammatory diseases, such as AP.