OBJECTIVE:To provide references for drug administrator in coping with the challenge of drug shortage and the promotion of rational drug use. METHODS: With American Society of Hospital Pharmacists Guidelines on Managing Drug Shortages as references,the feasible management strategies for drug shortage in China were put forward based on the reality of our country and our experience in the practice of drug shortage management. RESULTS & CONCLUSIONS: It is advisable to draw experiences from U.S. Food and Drug Administration to tackle the problem of the shortage of essential drugs through the co-efforts of Ministry of Public Health,State Food and Drug Administration and Stage Development and Reform Committee and develop contingency planning strategy in health care organization to deal with the shortages of certain drugs and reduce potential clinical safety hazard induced by drug shortages.

Objective To investigate the expression of matrix metalloproteinase-2 (MMP-2) mRNA in lungs of rabbits with acute lung injury (ALI) induced by endotoxin (ET) and the effects of meloxicam in its treatment, and to explore the protective mechanism of meloxicam. Methods Twenty four Japanese flap-eared white rabbits were randomly assigned to three groups: control group, ET-challenge group and meloxicam-treatment group. There were eight rabbits in each group. ALI model of rabbits was replicated with intravenous ET injection (700?g/kg weight), and meloxicam (2.5mg/kg weight) was intravenously given afber ET challenge in the treatment group. During the experiment, arterial blood gases, lung wet/dry (W/D), lung water content, the pathologic changes in lung, the expressions of MMP-2 mRNA in the lungs were determined. Results Compared with control group, oxygen saturation index (PaO_2/FiO_2) was significantly decreased and pulmonary edema, hemorrhage, extensive inflammatory cells infiltration were observed in ET group. The lung wet/dry (W/D), lung water content and the expressions of MMP-2 mRNA were significantly higher in ET group than those in control group. In meloxicam-treatment group, PaO_2/FiO_2 remained in normal range, and the lung wet/dry (W/D), the lung water content and the expressions of MMP-2 mRNA were significantly lower than those in ET group. The pathologic changes in lung tissues were not severe in group C. Conclusion The up-regulation of MMP-2 mRNA expression was observed in ALI animal model. Meloxicam could down-regulate MMP-2 mRNA expression, producing protective effects on ALI induced by ET in rabbits.

Motion segment and extraction from continuous signals is the premise of surface electromyography (sEMG) analysis. For the problem that sEMG energy threshold required repeated manual testing to set, this the paper established a this mathematical model of continuous actions based on Gaussian sEMG energy curve, in which the energy threshold was set according to the distribution of Gaussian signal section, and differentiated the action signals from no-action signals combined with energy comparison method. The experiment results showed the method can achieve continuous repetitive action segmentation, and compared with manual segmentation of the same signal, has a higher degree of coincidence.
Algorithms ; Electromyography ; Humans ; Motion ; Pattern Recognition, Automated ; Signal Processing, Computer-Assisted

Objective To discuss the surgical management of von Hippel Lindau(VHL) syn drome.Methods The clinical data of four VHL patients who were clinically diagnosed from March1999 to October 2006 were reviewed.The first patient was a 56 year old man with the chief complaintof hypodynamia and low serum glucose as 2.37 mmol/L.CT scan showed three masses in the the leftkidney.He had a history of cerebral haemangioblastoma ten years before.The second case was a 57 year old woman with the chief complaint of lumbago in the left side.CT scan showed masses in theleft kidney,adrenal gland and panerease.The third case was a 39 year old woman with the chief com plaint of an accident mass in the left adrenal gland.She had the history of cerebellar hemangioblastoma9 years before,spinal hemangioblastoma resection 7 years before.The fourth case was a 41-year oldwoman,she was found brain tumors and cured by gamma radiation abalation.Bilateral renal masseswere found by B ultrasound one month later,CT scan showed four masses in the both kidneys,leftadrenal gland and pancreas.Results All 4 cases underwent surgical approach.The first case under went radical nephrectomy which pathological report was PEComa of kidney.The blood glucose wasnormal one week later.The second case underwent resection of the left adrenal gland,kidney,pancre atic body and tail and spleen.Pathological report was clear cell carcinoma,islet cell tumor and adrenal cyst.Three months later she was found spinal hemangioblastoma and refused treatment.The thirdcase underwent adrenalectomy in the left side and pathologieal report was adrenal pheoehromocytoma.There was not tumor reeurrenee during 2 years' follow up.The nephrectomy and adrenalectomy wasperformed for the last ease whose pathological report was clear celt carcinoma and pheochromoeytoma.Three weeks later,tumor enueleating of the right kidney was undertaken; the result was clear cellcancer.During the follow up for one year there was no relapse of tumor.Conclusions For VHL ac companied with multiple organ tumors,surgery resection is the proper approaeh when tumors of centralnervous system is large.Different approaches could be taken to deal with multiple tumors of VHL such aswatchful waiting,nephron sparing surgery.

Objective To investigate the effect of letrozole in decreasing the early-stage ovarian hyperstimulation syndrome (OHSS) occurrence during the luteal phase for patients of OHSS high-risk after oocyte retrieval.Methods A total of 176 high-risk OHSS patients were randomly divided into two groups after oocyte retrieval.Patients in experiment group (n=86) received 5 mg letrozole per day from the retrieval day and last for 5 days.Others in control group (n=90) received placebo.The serum concentration of FSH,LH,estradiol (E2),progesterone (P) and vascular endothelial growth factor (VEGF) from the day of hCG injection to days after injection (5 days,8 days,10 days) were measured.And the incidence of moderate and severe OHSS was observed.Results The concentration of E2 on the indicated days (5 days,8 days,10 days after hCG injection) in experiment group and control group were (5 727±2 089) versus (11 826±4 281) pmol/L,(1 613±879) versus (7 925±3 507) pmol/L,(193±90) versus (1 628±888) pmol/L; the concentration of VEGF on the indicated days in the two groups were (80± 14) versus (108± 19) ng/L,(66± 11) versus (126± 14) ng/L,(48±7) versus (148± 14) ng/L; the concentration of E2 and VEGF were lower than those in control group (all P＜0.01).The FSH concentration in experiment group were (2.1 ± 1.1) and (3.5± 1.3) U/L on the day of fifth and eighth day after hCG injection,which were significantly higher than (0.7±0.3) and (0.7±0.4) U/L in control group (P＜0.05); the LH concentration in experiment group were (0.26±0.19) and (0.72±0.60) U/L on the day of fifth and eighth day after hCG injection,which were significantly higher than (0.11 ±0.03) and (0.14±0.08) U/L in control group (P＜0.05).The incidence of moderate and severe OHSS was signicantly decreased after letrozole treatment compared with control group [2％ (2/86) versus 12％ (1 1/90),P＜0.05].Conclusion Administration of 5 mg/d letrozole for 5 days during the luteal phase can reduce the E2 and VEGF levels for the high-risk OHSS patients who needed cryopreserve all embryos,and also reduce the occurrence of early OHSS.

Objective To observe the pulmonary pathologic changes of endotoxin (ET)-induced acute lung injury (ALI) in rabbits and the potential protective effects of fructose-1,6-diphosphate (FDP) on the ET-induced ALI of rabbits. Methods 24 flap-eared albation rabbits were randomly assigned to 3 groups, 8 for each, as follows: control group (group A), ET-treated group (group B) and combination group (treated by ET and FDP, group C). ALI was induced by injection of ET at one time. Group A was only injected with placebo, normal saline. ET was given to the rest groups. In group C, FDP was given as an intervening measure after rabbits injured. Rabbits were sacrificed at 6h time point. The pulmonary pathologic changes were observed. Some markers of pulmonary tissues, including the content of lipid peroxide (LPO), thromboxane B2 (TXB2), 6-keto-prostaglandin F1α(6-keto-PGF1α), interleukin-13 (IL-13) and the activity of superoxide dismutase (SOD), were observed. Results Compared with group A, the contents of LPO and TXB2 of group B showed significant increase (P＜0.05, P＜0.01), the SOD activity of group B weakened obviously (P＜0.01), the contents of 6-keto-PGF1α and IL-13 showed no statistical differences. The LPO content and the SOD activity of group C were similar to those of group A, the contents of TXB2, 6-keto-PGF1α and IL-13 of group C were much higher than those of group A (P＜0.01). Estimated by light microscope and electron microscope, the structure of lung tissue of group A is basically normal, the pathologic injuries of lung tissue of group B were much more severer and that of group C were slighter. Conclusion In the progress of ET-induced ALI, the oxidative injury, imbalance of TXB2/6-keto-PGF1α ratio and the secretion deficiency of protective cytokines play important role in inducing pathologic injuries of lung tissues. FDP can inhibit oxidative injury, ameliorate TXB2/6-keto-PGF1α balance and promote the secretion of protective cytokines, which, in turn, can protect rabbits from ET-induced ALI to some extent.

10.3969/j.issn.1000-3606.2013.06.015

Objective To evaluate the role of transvaginal color Doppler ultrasound measurements of endometrial thickness,endometrium and subendometrial blood distribution patterns and flow index in predicting endometrial receptivity and pregnancy outcome of freezing embryo transfer(FET).Methods 468 cycles FET were analysed retrospectively.Endometrial thickness,endometrium and subendometrial blood distribution patterns,pulsatility index (PI),resistance index (RI),systolic /diastolic ratio (S/D) of endometrial and subendometrial blood flows with transvaginal ultrasonography were measured on the day of progesterone initiation.Based on the clinical pregnancy or not,patients were divided into two groups.The comparison of these indicators were carried out between pregnant group and non pregnant group.Results The endometrium and subendometrial blood distribution patterns had statistical difference between the two groups(P ＜0.05),the clinical pregnancy rate of Ⅰ,Ⅱ,Ⅲ blood distribution patterns were 31.0％,62.5％,79.0％ respectively.In the pregnancy group,the S/D,PI,and RI of endometrium were significantly lower than those in the nonpregnant group (P ＜ 0.05),and there was no significant difference between the pregnant group and nonpregnant group in endometrial thickness(P ＞0.05).Conclusions Endometrium and subendometrial blood distribution patterns and flow index measured with transvaginal color Doppler ultrasound could assess endometrial receptivity and guide the time selecting of FET transplantation.

Objective To study ovarian development in vitrificatiou of embryos born mice and expression of growth differentiation factor 9 ( GDF-9 ) in its.MethodsThe vitrification recovery embryos (vitrified-embryo group) and fresh embryos (fresh-embryo group) were transplanted into pseudopregnant mice,respectively.The female offspring mice in two groups were sacrificcd on the 3rd,7th,14th,21st,28th and 60th day after birth,the ovarian tissues were taken,6 mice in each time point of each group.The ovarian development was observed by HE staining,the expression of GDF-9 mRNA and protein at each time point of two groups were detected by reverse transcription(RT)-PCR and western blot.ResultsHE staining showed that no abnormal ovarian development was observed in offsprings at two groups.On the 3rd,7th,14th,21st,28th and 60th day after birth,the expression of GDF-9 mRNA in vitrified-embryo group were 0.14 ± 0.07,0.42±0.16,1.00±0.24,1.59±0.28,2.05 ±0.32 and 2.23 ±0.21,respectively,which in fresh-embryo group were 0.13 ±0.06,0.45 ±0.18,1.00 ±0.21,1.56 ±0.26,2.01 0.37 and 2.26 ±0.23,respectively,there was no statistical difference between two groups ( P ＞ 0.05 ) ; the expression of GDF-9 protein in vitrified-embryo group were 0.040 ± 0.030,0.120 ± 0.060,0.170 ± 0.030,0.250 ± 0.040,0.320± 0.060 and 0.330 ± 0.010,respectively,which in fresh-embryo group were 0.030 ± 0.020,0.110 ± 0.040,0.150 ± 0.010,0.210 ± 0.020,0.360 ± 0.070 and 0.350 ± 0.030,respectively,there was no statistical difference between two groups ( P ＞ 0.05 ).Conclusion The ovarian morphology in vitrification of embryos born mice and expression of GDF-9 in ovary has no any obvious change.

Objective To probe into the effect of nursing intervention on complications and compliance of cancer patients with PICC. Methods 86 tumor patients selected from June 2007 to June 2010were randomly divided into the intervention group and the control group with 43 patients in each group. After the two groups of patients were diagnosed they were treated with routine care, the intervention group wasgiven additional comprehensive nursing interventions aiming at PICC complications and compliance. The complications and treatment compliance of the patients were analyzed. Results Compared with the control group, the rate of full compliance significantly improved and the rate of partial compliance significantly decreased in the intervention group. At the same time, compared with the control group, the incidence rate of phlebitis, catheter-related bloodstream infection and catheter blockage and catheter off of the intervention group were significantly lower. Conclusions Nursing intervention for cancer patients with PICC can reduce complications and improve treatment compliance of them and is of great clinical significance.