OBJECTIVE: To evaluate the current situation and trend of narcotic drug use in our hospital where the authors work in order to provide the reference for scientific management and rational use of these drugs. METHODS: The yearly amount of narcotic drugs administered in the whole hospital, the yearly amount in the separate departments, as well as drug expenditures and ratios between January 2002 and November 2005 were added up and analyzed statistically. RESULTS: The amount of bucinnazine use dominated in the first. The amount of morphine for oral use was increasing year by year. The amount of fentangl transdernal patch use was also bigger and increasing rapidly. However, the amount of pethidine and morphine for injection use was decreasing. CONCLUSION:Analgetics for oral and transdermal use will be the main categories of analgetics in the future.

Objective To explore and compare the effect of sevoflurane and disoprofol to inflammatory factors in patients received abdominal surgeries.Methods Patients with sevoflurane and disoprofol respectively were anaesthetized and detected IL-6,IL-8,IL-10 and TNF-α in their serum at T1 (when anesthesia induction),T2 (after anesthesia induction),T3 (30min after beginning of operations) and T4 (after operations).Results Compared with T1,the serum level of IL-6,IL-8,IL-10 and TNF-α increased significantly in all patients(all P ＜ 0.05) ; Compared with disoprofol group,the serum level of IL-6,IL-8 and TNF-α increased significantly (all P ＜ 0.05) ; Compared with sevoflurane group,the serum level of IL-10 increased significantly(all P ＜ 0.05).Conclusion Intravenous anesthesia with disoprofol in patients receiving abdominal operations is proper for maintenance of inflammatory balance.

Objective:Along with general hospital assessment opportunity, we explore to optimize ventilator management processes to reduce security risks by using the advanced quality management tools. Methods:Based on the ventilator maintenance statistical data in year 2012, we applied Pareto chart, Pareto curves and fishbone diagrams etc. quality management tools, and conducted PDCA cycle analysis on safety factors of ventilator clinical application. At the end, we summarized the results and provide improvements recommendations. Results:The cumulative proportions fell from 23.6%to 80%range, the human operator, compressor inlet;pipeline leaks and consumables management are a major are major factors. Through fishbone diagram analysis, we categorized them into 4 aspects:personnel, operations, equipment and supplies management. We optimized existing systems and processes from three areas:the device management, supplies management and training. By implementing these improvements plans, the security risk caused by supplies management was basically solved, the effect is very obvious. Conclusion:By using quality management tools, the safety problems during clinical application of ventilator can be reflected directly and clearly, and protect ventilator safe and stability to next level, so that it helps medical equipment management be more scientific, effective and normative.

Objective To investigate the protective function and mechanism of microRNA-1 (miR-1) downregula-tion in H2O2 injured cardiomyocytes. Methods The experiment was divided into 4 groups:Blank group, Negative Control group (NC), H2O2 group and H2O2+AS-miR-1 group. Cells in blank group were not underwent any treatment. Cells in NC group were transfected with random miRNA fragment. H2O2 and H2O2+AS-miR-1 groups were defined as H2O2 injured car-diomyocytes without or with transfected antisense miR-1 oligonucleotide(AS-miR-1). Real time PCR was used to test miR-1 transcription level, and cell vitality and apoptosis were analyzed by MTT and flow cytometry. The target gene of miR-1 was predicted by bioinformatics, then its mRNA transcription and protein expression level of Bcl-2 were detected by real time PCR and western blot respectively. Results There is no significant difference of all index between Blank group and NC group. H2O2 can induce cardiomyocyte injury, increase miR-1 level and rise apoptosis rate, reduce cell vitality and de-crease Bcl-2 expression level. Transfection of AS-miR-1 can decrease cell apoptosis, increase cell vitality and enhance Bcl-2 expression level. Conclusion Downregulation of microRNA-1 can protect cardiomyocytes that was injured by H2O2 through increasing anti-apoptosis factor Bcl-2 expression.

Objective:To provide reference for the pharmacy automation construction in outpatient pharmacy of domestic hospitals. Methods:The work process, application effect and patient satisfaction before and after the use of automatic drug dispensing machine were analyzed and compared by the data collection and questionnaire according to the operation practice of automatic drug dispensing machine in the outpatient pharmacy of our hospital. Results:After using the automatic dispensing machine, the work flow could be op-timized, the comprehensive benefit and the satisfaction of patients could be improved, and the investment return rate was promising. Conclusion:Automatic pharmacy is the direction of modern pharmacy construction, which has a good application prospect.

Objective Radiological grade of splenic injury was seldomly used in China trauma center now,though it had been established in 1994 by American Association for Surgery of Trauma (AAST) and widely used.The present study is aimed to analyze the imaging grade and clinical characteristics of traumatic splenic rupture in children,discuss the feasibility of conservative treatment,and the role of radiographic grading during clinical treatment.Methods Information (including age,gender,severity based on radiological findings,treatment strategies,and clinical outcome) regarding 59 hospitalized splenic injury patients whose injuries occurred between 2008 and 2014 was retrospectively analyzed.Results Between 2008 and 2014,59 pediatric patients with splenic injury were treated in our institution.Median age was 9.5 years (range,3 months to 16 years).Of all patients,41 (69.5%) were male.The injuries were primarily caused by traffic crash (45.7%),stumbling/falling from a height (38.9%).According to AAST,5 cases were grade Ⅰ,26 patients grade Ⅱ (44.1%),and 21 cases grade Ⅲ (35.6%),6 over grade Ⅳ,and only one was unclear.Of all patients,25 cases were with the other organs complications.All patients underwent fasting,bed rest,and antibiotics.Only 1 case was transferred to operation during the conservative treatment.Forty-nine patients underwent with CT scan over 2 times.Conclusion Imaging classification helps guide clinical treatment.Conservative treatment is feasible for traumatic splenic injury in children.Early imaging classification of splenic injury may be helpful in clinical judgment,and reduce children radiation exposure.

Objective To compare of clinical and pathological features between gastric polyps and colorectal polyps.Methods The clinical characteristics and pathological features of 2 125 patients with gastric polyps and 4 924 patients with colorectal polyps admitted in Wenzhou People's Hospital from 2004 to 2013 were compared.The detection rates,the indication of endoscopy,distribution,number,size and pathological type of gastric polyps and colorectal polyps were analyzed.Results The detection rate of gastric polyps was 3.1％ (2 125/69 575) and that of colorectal polyps was 24.5％ (4 924/20 124) (χ2 =9 886.401,P ＜0.01).The detection rates of gastric polyps in age groups ＜ 20,20-39,40-59 and ≥60 were 1.8％ (23/1 302),1.8％ (399/22 600),3.4％ (1 137/33 087) and 4.5％ (566/12 586),respectively (χ2 =238.867,P ＜ 0.01);and those for colorectal polyps were 6.6％ (14/211),11.6％ (623/5 385),26.0％ (2 622/10 070) and 37.3％ (1 665/4 458),respectively (χ2 =934.724,P ＜ 0.01).The detection rates of gastric polyps in age groups 20-39,40-59 and ≥60 were lower than those in colorectal polyps(all P ＜ 0.01).The detection rate of gastric polyps in males was lower than that in females(2.3％,848/36 447 vs.3.9％,1 277/33 128,χ2 =273.807,P ＜0.01),while the detection rate of colorectal polyps in males was higher than that in females (28.8％,3 239/11 230 vs.18.9％,1 685/8 894,χ2 =262.518,P ＜ 0.01).Diarrhea and gastrointestinal bleeding in patients with colorectal polyps was more common than those in patients with gastric polyps (23.5％,1 156/4 924 vs.2.5％,54/2 125,χ2 =558.080,P＜0.01;12.1％,597/4 924 vs.2.4％,51/2 125,χ2 =168.150,P ＜0.01).Single polyps were more common in gastric polyps than colorectal polyps(80.7％,1 714/2 125 vs.67.6％,3 331/ 4 924,χ2 =186.337,P ＜0.01).Polyps with size ≥ 1.0 cm were more common in colorectal polyps than those in gastric polyps (24.3％,1 197/4 924 vs.13.6％,289/2 125,χ2 =102.333,P ＜ 0.01).The proportion of inflammatory and hyperplastic types in gastric polyps was higher than that in colorectal polyps (67.1％,1 378/2 125 vs.27.5％,1 273/4 924,χ2 =934.394,P ＜0.01;26.9％,552/2 125 vs.9.9％,459/4 924,χ2 =319.588,P ＜0.01);while the proportion of adenoma and canceration in gastric polyps was lower than that in colorectal polyps (1.7％,34/2 125 vs.62.4％,2 893/4 924,χ2 =2 135.743,P ＜0.01;0.4％,9/2 125 vs.4.8％,221/4924,χ2 =80.362,P＜0.01).Conclusions In comparison with gastric polyps,the detection rate of colorectal polyps is higher.The detection rate of gastric polyps is higher in females,w hile that of colorectal polyps is higher in males.The detection rates of gastric polyps andcolorectal polyps increase with the age.The main pathological type of gastric polyps is inflammatory,while that of colorectal polyps is adenoma.The canceration of colorectal polyps is more common than that of gastric polyps.

SUMMARY Objective:To investigate the influence of cryoprotectants and cooling rates in vitrificationmethod on the spindles of rabbit M Ⅱ oocytes.Methods:Rabbit oocytes were verified by using cryoloopwith ethylene glycol(EG)singly or EG combined with dimethyl sulphoxide(DMSO)as cryoprotectants,and cooled by taking oocytes directly into liquid nitrogen or by vitrification machine.After frozen rabbit o-ocytes thawed,the microtubulin and chromosome of the spindles were fixation and stained by immunofluo-rescent method.Confocal microscope was used to reveal spindle configuration.Results:In the two proto-cols of single EG used and EG combined with DMSO,the spindles were severely injured.But in protocolof EG combined with DMSO and at ultra-rapid cooling rate,the normal configuration of spindle rate ofthawed rabbit oobytes was similar to that of the control group.Conclusion:The protocol of EG combinedwith DMSO as cryoprotectants and with extremely high cooling rate by vitrification machine can producethe best effect on conservation of spindle configuration in vitrification of rabbit oocytes.

Objective To build an antibody microarray based on direct labeling strategy for microalbnrninuria measurement, and evaluate it's technical potentiality for clinical application. Methods Urine samples of diabetic patients were collected. Antibody microarrays were constructed by preparation of array support, array fabrication, then protein assay and data analysis were performed. Procedure conditions for each step especially the labeling of samples were optimized. The set-ups were evaluated in terms of sensitivity, specificity and reproducibility. Urinary albumin excretion in the samples was detected by fabricated protein array, which was compared to that detected with immunoturbidimetry. Results The signal intensity was best when protein quality ratio of pure albumin or urine sample against NHS-biotin was 2:1. A calibration curve with a correlation coefficient of 0.9995 was established. The lower limit of detection was 0.0617 mg/L. Interehip and intrachip variation studies conducted on patient urine demonstrated CVs as 6.78%-9.22% and 3.35%-7.59%, respectively. Compared with the immunoturbidimetry, the antibody microarray was able to detect the extremely lower grade albumin in urine samples. The correlation coefficient of the results obtained by the two methods was 0.9199 (P <0.01). Conclusion An antibody microarray based on direct labeling strategy for microalbuminuria measurement is successfully established, which is comparable to immunoturbidimctry in its accuracy and will have great potential for clinical use with its high throughput, sensitivity, specifity and reproducibility.

Aortic valve calcification (AVC) is a pathological process correlated with multiple disease causes and actively regulated by cardiac valve cells. In this study, porcine aortic valve myofibroblasts cultured in vitro were treated with 50 μg z L(-1) of pathological factor tumor necrosis factor α (TNF-α). Tanshinone II A (TSN) with the concentration of 50 mg x L(-1) and TNF-α were combined in incubating cells for 72 h (3 d) and 120 h (5 d). The Western blotting and Real-time PCR were adopted to detect the changes in smooth muscle α actin (α-SMA), bone morphogenetic protein 2 ( BMP2), alkaline phosphatase (ALP) in cells, and expressions of key effect proteins GSK-3β and β-catenin on Wnt/β-catenin signal pathway. According to the findings, TNF-α can significantly increase the expression of myofibroblasts α-SMA and add the transformation activity to them, with nearly no expression of BMP2, ALP and mRNA in the control group and the TSN group but significant increase in their expressions in the TNF-α group (P < 0.01), which showed osteoblast-like phenotype. Moreover, TNF-α down-regulated the expression of up-streaming regulator GSK-3β and mRNA expression (P < 0. 01) , notably increased the expression of key effect protein β-catenin, but with no significant difference in mRNA with the control group and the TSN group. The result demonstrated that TSN showed a certain inhibitory effect on TNF-α's pathological impact (P < 0.05) in a time-dependent manner. Inflammatory factor TNF-α may promote the transformation of aortic valvular myofibroblasts to osteoblast-like phenotype by activating Wnt/β-catenin signal pathway in aortic valvular myofibroblasts, so as to cause AVC. Tanshinone II A can have a preventive effect in AVC by activating GSK-3β proteins and regulating signal transduction of Wnt/β-catenin signal pathway.
Animals ; Aortic Valve ; cytology ; drug effects ; metabolism ; Cells, Cultured ; Diterpenes, Abietane ; pharmacology ; Drugs, Chinese Herbal ; pharmacology ; Glycogen Synthase Kinase 3 ; genetics ; metabolism ; Glycogen Synthase Kinase 3 beta ; Myofibroblasts ; cytology ; drug effects ; metabolism ; Osteoblasts ; cytology ; drug effects ; metabolism ; Swine ; Tumor Necrosis Factor-alpha ; genetics ; metabolism ; beta Catenin ; genetics ; metabolism