OBJECTIVE:To explore approaches on how to perfect and standardize the invitation for bid in the centralized drug stocking.METHODS:Problems in the bidding such as once bidding,dead price,contradiction between prices and quality and that between bidding and stocking of drugs were solved by applying methods such as blocky bidding,stratified bidding and approval of double-certifications,etc.RESULTS&CONCLUSION:Positive effects of invitation for bid in the centralized drug stocking should be encouraged.Invitation for bid in the centralized drug stocking should be available with the premise of giving profits sincerely and with the cooperation and harmonization of multi-sides as a guarantee.The false high drug price can be attributed to many factors,which should be fathered comprehensively.

Objective To set up a determination method of warfarin,coumatertralyl,bromadiolone and brodifacoum.Methods HPLC-ESI-MS/MS was used to detect warfarin,coumatertralyl,bromadiolone and brodifacoum using ZORBAX sb-aq(1 50mm×2.1 mm×3.5 μm)as chromatographic column at constant temperature 30℃ while methanol of 0.1%formic acid and water as mobile phase in the grads program.The flow rate was 0.4 mL/min;Detection was performed on an electrospray ionization(ESI)in the negative model and the MRM condition.Results The limit of qualitation was found to be less than 40 pg for four raticides at one time and 10pg for every raticide in the MRM condition;The four raticides linear range were suitable and r were more than 0.999.Matrix affection Was also determined.Conclusion This method is simple,sensitive and accurate for the determination of warfarin,coumatertralyl,bromadiolonc and brodifacoum in the biological tissue.

Adenocarcinoma, Clear Cell ; Humans ; Laryngeal Neoplasms ; Male ; Middle Aged

Objective To identify predictors of prescription initiation and persistence of warfarin in non-valvular atrial fibrillation ( NVAF ) patients with high risk of stroke ( CHA2 DS2-VASc≥2 ) . Methods NVAF patients consulted in our hospital from Aug , 2011 to Apr, 2015 were enrolled.Patients who underwent radiofrequency catheter ablation were excluded . Patients were divided into two groups (warfarin group and non-warfarin group).Logistic regression was used to estimate the predictors of initiation warfarin prescription.Kaplan-Meier survival and Cox proportional hazards model was performed to determine rate of warfarin persistence and its associated factors .Results A total of 622 AF patients were enrolled and 490 patients with CHA2DS2-VASc≥2.Ten patients lost follow up and 480 patients were followed up with a mean follow-up period of ( 40.0 ±11.55 ) months.Of which 245 NVAF patients ( 51%) had a warfarin prescription.Patients with ischemic stroke ( OR 2.447 , 95%CI 1.435-4.171 , P=0.001 ) , heart failure ( OR 2.009 , 95%CI 1.084-3.724 , P=0.027 ) and persistent AF ( OR 2.231 , 95%CI 1.448-3.437 , P=0.0001 ) had a higher likelihood of warfarin prescription .Anemia ( OR 0.479 , 95%CI 0.238-0.964 , P=0.039), concommitant Traditional Chinese Medicine (TCM) use (OR 0.638, 95%CI 0.456-0.891, P=0.008 ) and longer distance to hospital ( OR 0.759 , 95%CI 0.610-0.945 , P=0.014 ) decreased the likelihood of warfarin prescription . One hundred and seventy-six ( 71.8%) warfarin users continued persistent therapy and the overall proportion of warfarin persistence was 78.3% for one year , 71.0% for 3 years.Seventy-six existing warfarin users continued the warfarin therapy (80%, 76/95),one hundred new users showed persistence to therapy ( 66.7%, 100/150 ) .Warfarin use before enrollment significantly increased warfarin persistence than new prescription ( P =0.008 ) .Variables associated with higher discontinuation were new prescription ( HR 1.786 , 95% CI 1.029-3.100 , P=0.039 ) , TCM use ( HR 1.687 , 95%CI 1.201-2.37 , P=0.003 ) and longer distance to hospital ( HR 1.446 , 95% CI 1.121-1.865, P=0.005).Conclusions In anticoagulation clinic, concommitant TCM use, distance to hospital and other factors were associated with warfarin initiation prescription and persistence .Identifying factors associated with warfarin treatment could help in developing adherence of patients .

Objective To examine the neural basis of item memory and source memory with fMRI approach.Methods Eight male and eight female healthy fight-handed native Chinese speakers were involved in this study.The item memory and source memory task were conducted with 504 highly frequent Chinese double-character words in the Block-designed experiment.Participants underwent such a double- round procedure as fMRI scanning following study.The fMRI data collected from a GE 1.5T MRI system were analyzed to generate corresponding activation maps for females and males respectively(P20)using statistical parametric mapping software(SPM).Results For females,item memory task activated the bilateral dorsolateral prefrontal cortex(BA6,the number of activated voxel clusters was 62 or 11 in the left and the right,respectively),source memory more activated the left dorsolateral prefrontal cortex(BA6/46,the number was 59).For males,item memory activated the right dorsolateral prefrontal cortex(BA6/46,the number was 64),source memory activated the bilateral dorsolateral prefrontal cortex(BA6,9 and 40 in the left and the right).Conclusion On the neural basis of item or source memory,there exists dissociation,which is that right dorsolateral prefrontal areas are more activated by item memory while left dorsolateral prefrontal areas by source memory.For the difference of gender,it is suggested that left dorsolateral prefrontal areas(BA6/46)are more activated in females while right dorsolateral prefrontal cortex(BA6/46)more in males.

Aluminum Compounds ; pharmacology ; Animals ; Bone and Bones ; drug effects ; metabolism ; Chlorides ; pharmacology ; Decalcification Technique ; methods ; Formates ; chemistry ; Humans

Objective On patients with mechanical ventilation spontaneous breathing trial (SBT) success, out of breath machine smoothly pulled out after endotracheal intubation for active airway moist sequential therapy of clinical new method and new technology. Methods Between January 2013 and May 2014 respiratory endotracheal intubation implementation of mechanical ventilation with intensive medicine successful withdraw machine pulled out of 135 patients with tracheal intubation, they were divided into group A(68 cases) and group B(67 cases) by random digits table method. The patients in group A were treated with buoy type oxygen device, group B with active airway moist heat treatment unit. The breathing rate, PaO2, SpO2, heart rate, Clinical Pulmonary Infection Score(CPIS) were measured after 72 h of pull out endotracheal intubation in two groups. Sputum viscosity was evaluated by Airway Secretions Score before pull out endotracheal intubation and after 24, 48, 72 h of pull out endotracheal intubation in two groups. Results There were no significant differences between two groups in gender, age, clinical diagnosis, mechanical ventilation time, acute physiology and chronic health evaluation systemⅡrating etc (P>0.05). The breathing rate, heart rate and CPIS score respectively (20.94 ± 0.89), (80.79±4.67) times/min and (7.13 ± 2.54) points after 72 h of pull out endotracheal intubation in group B, and (24.12 ± 0.97), (86.32 ± 5.12) times/min and (8.79±3.56) points in group A, and there were significant differences(t=5.113, 7.298, 5.597, all P<0.01). PaO2, SpO2 were (93.24±1.96) mmHg(1 mmHg=0.133 kPa), 0.973 2±0.014 8 in group B, and (87.35±2.32) mmHg, 0.937 8±0.013 2 in group A, and there were significant differences(t=9.279, 4.548, all P<0.01). There was no significant difference in sputum viscosity before pull out endotracheal intubation between two groups (P>0.05). After 24, 48 and 72 h of pull out endotracheal intubation, group B of patients with sputum viscosity was suitable in group A (Z=-2.684,-2.870,-2.771, all P < 0.01). Conclusions Mechanical ventilation in patients with ventilator buoy type oxygen device for the pull out after endotracheal intubation success does not favor the sputum drainage, improve patients with dyspnea and hypoxemia is not obvious. By positive airway plus temperature humidity to sequential therapy is helpful to correct hypoxemia, improve the patients' respiratory function, reduce the breathing difficulties, reduce sputum viscosity, promote the airway drainage unblocked, shortening the time of lung infection.

Objective To evaluate the clinical efficacy of super-selective prostatic arterial embolization(PAE) for the treatment of benign prostatic hyperplasia(BPH).Methods From February 2012to March 2015,a total of 17 patients with BPH who failed in medical treatment,or unwilling to accept surgery were selected for PAE as the study group.The mean age was 73 years (range 61-84 years) and the mean prostatic volume was 64.6 ml (ranging 50-85 ml).The study group underwent super selective arterial embolization.The internal iliac artery angiography was performed and the main blood vessel of prostate was showed.The femoral artery was punctured under local anesthesia and X-ray monitoring,a F4-5 Cobra catheter was inserted,and then the Embosphere microspheres were implanted.A total of 40 patients who underwent transurethral resection of the prostate(TURP) were selected as the control group.The mean age was 70 years (ranging 59-87 years).The mean prostatic volume was 68.7 ml(ranging 55-90 ml).All cases were followed up for 1 year.The changes of prostatic volume (PV),international prostate symptom score(IPSS),quality of life (QOL),pre-and post-treatment peak urinary flow (Qmax) were evaluated.Results For the 17 patients who underwent PAE,the PV decreased from (64.6 ± 10.2) ml to(42.0 ± 7.5) ml,the IPSS decreased from 23.9 ±4.9 to 13.1 ±3.5,QOL decreased from 4.1 ±0.7 to 2.1 ±0.7,and Q increased from (9.5 ± 3.7) ml/s to(21.8 ± 4.2) ml/s,which were statistically significant (P ＜ 0.05) compared with the pre-treatment parameters.The post-operative parameters of the control group were also significantly improved compared with the preoperative parameters (P ＜ 0.05).Conclusions PAE is safe and effective in treating BPH,especially for those failing in medical treatment,or unwilling to accept surgery.

0.05). CONCLUSION The sound localization apparatus can test the localization ability of person, and it can be used in simply and reasonably.

Objective To investigate certain risk factors for postoperative atrial fibrillation (AF) in elderly patients with coronary heart disease after off-pump coronary artery bypass grafting (OPCAB)surgery in order to provide a basis for the prevention and treatment of AF after OPCAB.Methods A total of 139 elderly patients with coronary heart disease who had undergone OPCAB surgery in our hospital were collected as research subjects and divided into the AF group and the nonAF group according to the occurrence of AF after operation.The patients' general information and clinical data were retrospectively analyzed.Risk factors for AF after OPCAB surgery in elderly patients with coronary heart disease were investigated.Results The incidence of AF after OPCAB was 15.8％ in elderly patients with coronary heart disease.There were no statistical differences in gender,history of diabetes,history of myocardial infarction,preoperative β-blocker usage,number of coronary artery lesions,or operation time between the AF group and the non-AF group (P＞0.05).The percentage of patients who were of older age (t=9.960) or had a left ventricular ejection fraction ≥40％ (x2=4.942),a left atrial diameter ≥40 mm (x2 =4.491),a history of hypertension (x2 =12.357),dopamine medication after operation (x2 =8.511),or a bypass vessel count≥ 3 (x2 =5.385) was higher in the AF group than in the non-AF group (all P＜0.05).Logistic regression analysis showed that age,history of hypertension,dopamine medication after operation,left atrial diameter and bypass vessel count were the risk factors for AF after OPCAB surgery in elderly patients with coronary heart disease (OR 3.080,2.435,2.465,3.593,and 1.921,respectively,P＜0.05 for all).Conclusions The incidence of AF after OPCAB is high in elderly patients with coronary heart disease and is affected by many risk factors.These risk factors should be assessed before surgery so that appropriate prevention measures can be taken.