OBJECTIVE:To strengthen quality management of drug microbiology laboratory and provide reference for relevant inspection institutions. METHODS:Taking measures from the laboratory document management,personnel training,quality con-trol,quality supervision,process control and biological safety,the elements of laboratory quality management were analyzed,and effectively measures were put forward to improve the management level. RESULTS & CONCLUSIONS:The laboratory should es-tablish strict,standardized,systematic laboratory management rules and regulations,quality documents,operating procedures, work guide,etc. to achieve documented management;develop various forms of annual training and assessment programs to con-struct a professional team;strengthen internal(developing an annual internal quality monitoring plan,conducting quality control ac-tivities,regularly checking the suitability of the medium) and external (capability testing,inter-laboratory comparison) manage-ment control level,and reasonably formulate the contents and frequency by combing with actual situation. Besides,the laboratory should strengthen inspection process control,attach great importance to the biological safety management to reduce the risk of labo-ratory quality to a minimum.

Introducing information-knowledge-wisdom transformation law and its four sub processes including information acquisition,recognition,decision and implementation,the paper summarizes the process of Evidence-based Medicine (EBM) information services,analyzes the scope of carrying out EBM information services by the hospital library under the guidance of new perspective,and discusses the specific forms of EBM information services by exampling the practice of EBM information services carried out by the library of the First Affiliated Hospital of Chongqing University of Medical Sciences.

AIM: To get the IR spectrums of chrysanthemums from the different producing areas,and to find out the characters of IR spectrums,and the data of IR spectroscopy of chrysanthemums from the different producing areas. METHODS: Using Fourier transform infrared spectroscopy. RESULTS: The FTIR spectrums、Second-order derivative spectrums、Two-dimensional spectrums of chrysanthemums from the different producing areas have their obvious IR characters. CONCLUSION: We can discriminate chrysanthemums from the different producing areas macroscopically and holistically by IR spectroscopy.IR spectroscopy can give us the digital descriptions of TCM,so it is a new analytical method to discriminate TCM.

The information-knowledge-intelligence transformation rules were introduced as the theory for the transformation of information service main body for evidence-based medicine according to the analysis of domestic and foreign institutional main body and personal main body for the information service of evidence-based medicine.It was proposed that medical library as the institutional main body should be transformed into information repository + thinking library and clinical medical librarians as the personal main body should be transformed into evidence witness + decision making adviser with associated literacy.

Objective To evaluate the growth inhibition of human gastric carcinoma cell lines SGC 7901 in vitro and the expression of bcl-2, bcl 2l12 and bax with docosahexaenoic acid (DHA) and 5-fluorouracil (5-FU). Methods The effect of DHA and 5-FU was measured by trypan blue, and the interaction between two agents was judged by combination index (CI). Cells were observed by inverted microscope. Flow cytometry was used for analysis of apoptosis by PI staining and Annexin-V/PI. RT-PCR was used to analyze the levels of bcl-2, bcl 2l12 and bax mRNA. Results DHA significantly inhibited the growth of SGC 7901 cells in a dose- and time-dependent way ( P < 0. 05 ), the IC50 of 24 h and 48 h was 67. 81 μg/ml and 45.76 μg/ml, and a strong synergism was found in the combination of DHA and 5-FU (CI < 1 ,P <0. 01 ). Treated by DHA and 5-FU for 48 h, cells became sparse under inverted microscope. DHA or 5-FU was able to induce apoptosis and the effect became even more significant by the combination of DHA and 5-FU. Cells were holted in phase of G01/G1 and S. RT-PCR showed that DHA or 5-FU down-regulated the expression of bcl-2 and bcl 2l12 mRNA, while bax mRNA expression was not downregnlated. Conclusions DHA could inhibit the growth of gastric carcinoma cells, DHA and 5-FU had synergetic effect in the inhibition of the cells growth and blockage of the cell cycles possibly by down-regulating the expression of bcl-2 and bcl 2l12.

AIM:To detect the treatment of K562 leukemia cells with bortezomib altering the expression of genes fas,bcl-2,bcl2l12,bim,bax,caspase-9 and caspase-3.METHODS:MTT assay was used to detect the inhibition of proliferation.Apoptosis was detected by Annexin-V staining and mitochondrial transmembrane potential(??m).RT-PCR was used to analyze the mRNA expressions of fas,bcl-2,bcl2l12,bim,bax,caspase-3 and caspase-9.RESULTS:Bortezomib caused a time-and dose-dependent inhibition of cell proliferation and IC50 of 24 h and 48 h were 161.41 nmol/L and 96.33 nmol/L,respectively.At the concentration of 104 nmol/L,bortezomib induced apoptosis in a time-dependent manner,including increasing annexin-V positivity and decreasing the ??m.RT-PCR showed that bortezomib up-regulated the mRNA expression of fas,bcl2l12,caspase-9 and caspase-3,but mRNA expressions of bcl-2,bim and bax did not changed obviously.CONCLUSION:Bortezomib inhibits the proliferation of K562 and induces apoptosis,in which fas,bcl2l12,caspase-9 or caspase-3 gene is one of the main genes taking part in.

Objective To evaluate the performance of Zika virus (ZIKV) disease prevention and control.Methods Descriptive epidemiological analysis was conducted on the clinical manifestations,laboratory detection results and disease progression of the third imported ZIKV disease case in the mainland of China.Results On 19 February 2016,a ZIKV disease case was confirmed in Yiwu,Zhejiang province,which was the third imported case of ZIKV disease confirmed by China CDC laboratory and expert consulting.The patient just had a travel to Fiji and Samoa and had mosquito bite history in Samoa.The patient was hospitalized on 16 February after the onset on 14 February and the eruption on 15 February.The body temperature of the patient became normal on 17 February,the rash disappeared on 19 February and the conjunctivitis resolved on 20 February.The positive detection of the viral nucleic acid in blood was only for 3 consecutive days,and the viral nucleic acid could be detected in urine even after negative detection in blood for 4 days.Conclusion The symptoms of the patient were typical.ZIKV can be detected by using blood sample in early phase,but after body temperature become normal,the virus can be detected in urine.

Objective: To summarize the peri-operative management experience of pulmonary endarterectomy (PEA) in patients with chronic thromboembolic pulmonary hypertension (CTEPH). Methods: A total of 56 CTEPH patients received PEA in our hospital from 2015-01 to 2016-11 were retrospectively analyzed. Our study was focused on the medication in respiratory and circulatory system during ICU stay, peri-operative application of vasoactive drug and target drug to pulmonary hypertension (HP), usage of ventilators, mechanical assisted devices and other management experiences. Results: No peri-operative death occurred. There were 2/56 (3.6%) patients with lung reperfusion, 2 (3.6%) with PH crisis. Compared with pre-operation, the post-operative pulmonary artery hemodynamics parameters were improved as right heart catheter measured pulmonary artery systolic pressure (PASP) decreased from (85.05±22.40) mmHg to (36.83 ±17.21) mmHg and pulmonary vascular resistance decreased from (773.84±342.95) dyn·s·cm-5 to (293.59±214.95) dyn·s·cm-5. Post-operative oxygen saturation was maintained at (95-100) % in all patients. Echocardiography found that PASP from pre-operation (85.03±25.78) mmHg decreased to (39.44±19.24) mmHg at follow-up period, P<0.01.Conclusion: A comprehensive peri-operative management of PEA was helpful to improve pulmonary hemodynamics in CTEPH patients; meanwhile, effective prevention and treatment of severe complication could obviously reduce peri-operative mortality.

Objective To assess the efficacy of immunoprophylaxis against mother-to-infant transmission of hepatitis B virus (HBV) in a real-world setting since the implementation of charge-free hepatitis B immunoglobulin (HBIG) and hepatitis B vaccine in China. Methods The screening rate and the prevalence of hepatitis B surface antigen (HBsAg) in 61 790 puerperants, and the administration of combined immunoprophylaxis in infants of HBsAg-positive mothers in Rugao City of Jiangsu Province from July 1, 2011 to June 30, 2016 were retrospectively analyzed. HBV infection status of infants born to HBV infected mothers was followed up after 7 months of age. HBsAg-positive infants and their mothers were followed up again for HBV markers in April 2018. Fisher's exact test and Cochran-Armitage trend test were used to statistically analyze the differences between groups and various years, respectively. Results All 61 790 puerperants were screened for HBsAg and the prenatal screen rate was 98.6% (60 937/61 790) with an increasing trend over time (χ2trend=750.908, P<0.001). HBsAg-positive puerperants accounted for 5.5% (3 397/61 790) with a decreasing trend over time (χ2trend=32.667, P<0.001). In total, 778 offspring (399 boys and 379 girls) of 759 HBsAg-positive mothers were followed up at (13.7±6.9) months of age, among which 751 (96.5%) were administered and 25 (3.2%) were probably administered standard combined immunoprophylaxis after birth, and the rest two (0.3%) were not. Fourteen infants (1.8%) were HBsAg positive and all born to mothers with positive hepatitis B e antigen (HBeAg). None of the 538 infants born to HBeAg-negative mothers was HBsAg-positive. HBsAg-positive rate in infants born since 2013 was lower than those in 2011 and 2012 (χ2trend=13.352, P=0.000 3). Eleven HBsAg-positive mothers and their children were followed up again 4–5 years later in April 2018. HBV DNA levels of all mothers were within the range of (7.34–28.2)×107 IU/ml except one case of spontaneous HBeAg seroconversion. One out of the 11 infected children also had HBeAg seroconversion. Phylogenetic analysis of HBV S gene showed that the 11 pairs of mothers and children were all infected with HBV of genotype C. Conclusions The implementation of charge-free HBIG and hepatitis B vaccine for newborns achieves fruitful results in Rugao city as the mother-to-infant transmission of HBV in the real-world had been further reduced to a similar level reported in literature survey.

OBJECTIVESTo establish an algorithm to predict the warfarin maintenance dose in Chinese Han population and validate the accuracy of this algorithm.

METHODSA total of 488 Chinese Han patients, hospitalized in Fuwai hospital and had a stable dose of warfarin and a target international normalized ratio (INR) of 1.5 to 3.0, were recruited. Indications for warfarin use included prosthetic heart valve, atrial fibrillation and pulmonary embolism. These patients were divided into derivation group (n = 323) and validation group (n = 165) according to the enrollment time. A warfarin maintenance dose algorithm was established based on genetic information, demographic characteristics and concomitant medications by multiple linear regression analysis in derivation group. In the validation group, we evaluated the accuracy of our algorithm by comparing the predicted dose with the actual dose.

RESULTSOur algorithm included VKORC1-1639G > A, CYP2C9*3 and CYP4F2 genotype, age, Body hight, body weight, amiodarone and digoxin use (R(2) = 0.652, P < 0.001) .In the validation group, the average predicted dose by our algorithm had no statistical difference with the actual dose [(3.51 ± 1.03) mg vs. (3.53 ± 1.41) mg, P = 0.779]. Our algorithm identified 100 out of 165 (60.6%) patients in the validation group, whose predicted dose of warfarin was within 20% of the actual dose, and predicted warfarin dose was underestimated in 17.6% (29/165) patients and overestimated in 21.8% (36/165) patients.

CONCLUSIONOur algorithm based on VKORC1, CYP2C9 and CYP4F2 polymorphisms can help to predict the warfarin maintenance dose in Chinese Han Population.

Adult ; Aged ; Algorithms ; Asian Continental Ancestry Group ; genetics ; China ; Cytochrome P-450 CYP2C9 ; genetics ; Cytochrome P-450 Enzyme System ; genetics ; Cytochrome P450 Family 4 ; Female ; Humans ; International Normalized Ratio ; Male ; Middle Aged ; Models, Theoretical ; Polymorphism, Genetic ; Vitamin K Epoxide Reductases ; genetics ; Warfarin ; administration & dosage ; therapeutic use