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 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.

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.

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 investigate assessment value of high-resolution computed tomography(HRCT)for the condition of patients with connective tissue disease(CTD)combined with interstitial lung disease(ILD)and its relationship with the abnormalities of antinuclear antibody(ANA).Methods:A total of 60 CTD-ILD patients who hospitalized in the Department of Rheumatology of the People's Hospital of Bozhou from January 2020 to June 2023 were collected,and they were divided into positive ANA group(33 cases)and negative ANA group(27 cases)according to whether ANA was positivity.All patients underwent HRCT examination and ANA level test,and the lung HRCT scores of them were obtained by lung function assessment.The receiver operating characteristic(ROC)curve was adopted to analyze the diagnostic value of lung HRCT score for CTD-ILD,and Spearman correlation analysis was adopted to assess the correlation between the complicated ILD and the abnormality of ANA level in patients with CTD.Results:In 60 CTD patients,29 cases had interlobular septal thickening,and 25 cases had ground-glass-like change,and 13 cases existed grid shadow,and 10 cases had bronchial vascular bundle thickening,and patients with the honeycomb lung and who with nodular foci were all 6 cases,and 5 cases had mosaic infusion,and 3 cases had lung consolidation.There were significant differences in ANA level and HRCT score of lung among different patients with different characteristics of HRCT images(F=7.115,178.080,P<0.05),respectively.In addition,the order of ANA levels from high to low was lung consolidation,honeycomb lung,mosaic perfusion,ground-glass-like change,bronchial vascular bundle thickening,grid shadow,nodular foci and interlobular septal thickening.Lung HRCT score[(4.67±1.02),ANA level(60.14±10.01)units]of positive ANA group were significantly higher than that[(2.12±1.03),ANA level(7.13±1.13)]of negative ANA group,and the difference was statistically significant(t=23.753,27.333,P<0.05).The area under curve(AUC)of ROC curve of lung HRCT score,ANA alone and the combination of them were 0.765,0.618 and 0.797 in diagnosing CTD-ILD,respectively,and all of them were>0.5,and the AUC values of lung HRCT score and the combined diagnosis were between 0.7-0.9.The results of the Spearman-correlation analysis showed that there was a positive correlation between lung HRCT score and ANA(r=0.463,P<0.001).Conclusion:The HRCT examination and lung HRCT score are helpful to assess the CTD-ILD condition,and patient with higher lung HRCT score has more severe CTD-ILD condition and higher abnormality of ANA.There is a positive correlation between lung HRCT score and ANA abnormality.

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.

Histone H3 lysine 4 trimethylation (H3K4me3) is well known to occur in the promoter region of genes for transcription activation.However,when investigating the H3K4me3 profiles in the mouse cerebrum and testis,we discovered that H3K4me3 also has a significant enrichment at the 3' end of actively transcribed (sense) genes,named as 3′-H3K4me3.3′-H3K4me3 is associated with ～15％ of protein-coding genes in both tissues.In addition,we examined the transcriptional initiation signals including RNA polymerase II (RNAPII)binding sites and 5′-CAGE-tag that marks transcriptional start sites.Interestingly,we found that 3′-H3K4me3 is associated with the initiation of antisense transcription.Furthermore,3′-H3K4me3 modification levels correlate positively with the antisense expression levels of the associated sense genes,implying that 3′-H3K4me3 is involved in the activation of antisense transcription.Taken together,our findings suggest that H3K4me3 may be involved in the regulation of antisense transcription that initiates from the 3′ end of sense genes.In addition,a positive correlation was also observed between the expression of antisense and the associated sense genes with 3'-H3K4me3 modification.More importantly,we observed the 3'-H3K4me3 enrichment among genes in human,fruitfly and Arabidopsis,and found that the sequences of 3'-H3K4me3-marked regions are highly conserved and essentially indistinguishable from known promoters in vertebrate.Therefore,we speculate that these 3'-H3K4me3-marked regions may serve as potential promoters for antisense transcription and 3′-H3K4me3 appear to be a universal epigenetic feature in eukaryotes.Our results provide a novel insight into the epigenetic roles of H3K4me3 and the regulatory mechanism of antisense transcription.

Purpose To investigate the diagnostic value of postsystolic shortening in ischemia with non-obstructive coronary arteries(INOCA).Materials and Methods A total of 85 INOCA patients admitted to People's Hospital of Liaoning Province from May 2020 to December 2022 were selected and divided into two groups according to the ratio of distal diastolic average blood velocity of left anterior descending branch before and after treatment obtained by thymosidine load echocardiography(coronary flow velocity reserve,CFVR):CFVR<2.0 was in the coronary microvascular dysfunction(CMD)group(n=40),and CFVR≥2.0 was in the control group(n=45).Conventional echocardiographic parameters of all enrolled subjects were measured:left ventricular end-diastolic diameter index(LVEDDI),left ventricular end-diastolic volume index(LVEDVI),left ventricular end-systolic volume index(LVESVI),left ventricular ejection fraction(LVEF),early and late mitral valve diastolic blood flow velocity(E,A),E/A,average velocity of mitral valve annulus and interventricular septum in early diastolic(e')and E/e'on the wall and septal side were measured.The global longitudinal strain(GLS)and the post systolic index(PSI)of the left ventricle were measured by two-dimensional speckle tracking automated functional imaging.The differences of echocardiographic parameters,GLS and PSI between CMD group and control group were observed.The relationship between CFVR and PSI in CMD group was analyzed.Results There were no significant differences in LVEDDI,LVEDVI,LVESVI,LVEF,E,A,E/A,e',E/e'and GLS between control group and CMD group(t=-0.577-1.472,P>0.05).There was a statistically significant difference in PSI increase between CMD group and control group(t=-5.370,P<0.05).There was a good correlation between CFVR and PSI in CMD group(r=-0.486,P<0.05).The receiver operator characteristic curve showed that the area under the curve predicted by PSI for CMD was 0.786,the sensitivity was 68.0%,and the specificity was 77.8%.Conclusion PSI has good application value in evaluating left ventricular systolic function in INOCA patients,and can detect left ventricular systolic function injury in such patients at an early stage.