OBJECTIVE:To study the implementation of Prescription Management Method (PMM) in our hospital and to promote rational drug use. METHODS: A total of 71 000 prescriptions were collected from Sept. 2006 to Dec. 2007 (before implementation) and from May to Dec. in 2007 (after implementation) for a statistical analysis and evaluation of the irrational prescriptions. RESULTS: The non-conformity rate of prescriptions was on the higher side before PMM implementation, accounting for 7.76% versus 3.38% after implementation (P

OBJECTIVETo investigate the application value of chemiluminescence method (CMIA) detection of Treponema pallidum (TP) specific antibodies in the blood test.

METHODSOver the same period the de novo enzyme linked immunosorbent assay (ELISA) and Abbott chemical luminescence method were used to detect the specific antibody of syphilis in a total of 66298 samples; TP-ELISA negative and TP-CMIA positive unpaid blood donation blood samples for syphilis specific antibody were detected and confirmed by Western blot.

RESULTSBlood samples from 66298 blood donors were detected by TP-ELISA, the positive samples was 250 and the positive rate was 0.38%. The positive samples of TP-CMIA was 297, the positive rate was 0.45%, the difference was statistically significant (P<0.05). The blood samples of 47 unpaid blood donors were confirmed by TP-Western blot method, as a result, 32 samples were positive, 15 were negative, and result detected by TP-ELISA method was negative.

CONCLUSIONTP-CMIA sensitivity is higher than that of TP-ELISA, and possesses higher sensitivity and specificity, and quick detection, simple operation, easy automation, suggesting greater application value in blood detection of Treponema pallidum.

OBJECTIVETo explore the key technique for preparation of the frozen platelet and efficacy of its clinical application.

METHODSThe influences of the donators' peripheral platelet count, starting time of freeze, injection rate and evenness of the freeze-protective agent, storage mode, re-melting temperature and the capacity of water-bath etc. on the quality of the frozen platelets were analyzed retrospectively in 3 257 samples of frozen platelets before platelet pheresis. Then, the platelet counts were examined in 150 cases transfused with frozen platelets at the time-points of 1, 24, 48 and 72 hrs after transfusion, 90 cases suffered from the obstetrical bleeding were transfused with 200 parts of the re-melting frozen platelets, and then the peripheral blood platelet count, platelet increasing index(CCI), bleeding time and blood clot retraction rate etc. were observed for determining the clinical efficiency of the frozen platelets.

RESULTSThe floccule in the re-melting frozen platelets from the donators with (175-250)×10(9)/L platelets were decreased significantly(P<0.01). The quality of frozen platelets was influenced by the following factors, such as injection of DMSO at a too fast and heterogeneous rate, blood bags stored in a multilamminar space, and re-melting in a water-bath of small capacity etc. The routine storage for 0 and 3 days did not influence the quality of the frozen platelets. The recovery rate of one year-freezing platelets all was higher than 80%. The effects of the frozen platelets transfused into the patients with obstetrical bleeding displayed good haemostatic results, and the blood transfusion reaction did not occur. However, the frozen platelets immediately were exhausted and displayed their function, but the counting after 48 hrs could not display a good effect of raising platelet number.

CONCLUSIONSThe peripheral platelet count before platelet pheresis, the injection rate and evenness of the protective agent, the number of stratum for blood bags and the capacity of re-melting water-bath etc. all are the key factors influencing the quality of the frozen platelets. The frozen platelets prepared in this study shows a good efficacy of clinical application.

Blood Platelets ; Blood Preservation ; Blood Transfusion ; Freezing ; Hemostasis ; Humans ; Platelet Count ; Platelet Transfusion ; Plateletpheresis ; Transfusion Reaction

AIM:To evaluated weather homocysteine(Hcy) and low density lipoprotein(LDL) had co-effects in pathogenesis of atherosclerosis (As). METHOD: Thiobarbituric acid reactive substance (TBARS) and apoptotic cells were measured after endothelial cell(EC) being exposed commonly or separated to Hcy and LDL. RESULTS: TBARS content in Hcy +LDL group was 4.9～7.7 times of that in single Hcy or LDL group, even put together TBARS contents of single Hcy or LDL groups, the co-effect of Hcy+LDL still showed 3 times higher than the former. Furthermore, Hcy+LDL showed obvious apoptosization effect on EC. The lipid peroxidization and EC apoptosization effects of Hcy+LDL were inhibited by adding folic acid , L-arginine+folic acid or glutamate+glycine. CONCLUSION: Hcy+LDL have co-injury effects on EC which may lead to As. The pathogenic factors of these effects probably involve the thiol groups of Hcy and their injury on nitric oxide system of EC.ESULTS :TBARScontentinHcy +LDLgro

Objective To examine the relationship between the profound hypotension in endotoxic shock and the dynamic changes of nitric oxide (NO) and endothelin-1 (ET-1), so as to figure out which of the NO or ET-1 was more involved in the pathogenesis of endotoxic shock. And to investigate whether an offset of their opposite vasoactive effects would occur during endotoxic shock.Results Plasma ET-1 achieved its peak level at 60 min post-endotoxin, and then waned. Plasma NO-3 started rising at 120 min post-endotoxin, then progressive increase continued till the last measurement at 180 min post-endotoxin. The decrease of blood pressure was significant at about 120 min post-endotoxin and further went down until death. The changes of hemodynamics and NO showed a quite close temporal correspondence between the increase of NO and the decrease of blood pressure. L-NMA and phosphoramidon obviously reduced the plasma levels of NO and ET-1 to below their respective baseline levels, and showed transient effect of increase on blood pressure. Soon afterwards, however, the status of hemodynamics was aggravated. Dexamethasone just inhibited the excessive increase of NO and ET-1 during endotoxic shock without interfering their baseline levels and showed most beneficial effects on hemodynamics.Conclusions Both NO and ET-1 increase during endotoxic shock, but only the increase of NO has a close temporal correspondence with the decrease of blood pressure. It suggests a more important role of NO in pathogenesis of endotoxic shock. The increase of NO and ET-1 is different in time-process, which indicates that an offset of their opposite vasoactive effects would not occur. Intreference against the increase of NO and ET-1 during endotoxic shock is most beneficial when their baseline levels are maintained.

OBJECTIVETo analyze in vitro the effect of mesenchymal stem cells (MSCs) on secreting cytokines by T lymphocytes and ratio of CD4⁺CD25⁺ T cells from patients with immune thrombocytopenia (ITP).

METHODSHuman bone marrow-derived MSCs were isolated by Ficoll Hypaque and cultured for proliferating to passage cells. Allogeneic T lymphocytes of health adults and ITP patients were isolated from peripheral blood by Ficoll Hypaque and nylon cotton column, and the ratio of CD4⁺CD25⁺ T cells was detected by flow cytometry. Then the different amounts of 1 × 10⁴, 5 × 10⁴, 2 × 10⁵ MSCs per well treated with mitomycin as stromal feeder layers were co-cultured with above-mentioned T lymphocytes, 5 days after cocultivation, the ratio of CD4⁺CD25⁺ T cells was detected by flow cytometry and the levels of IL-2, IFN-γ, IL-4, IL-10 were measured by enzyme- linked immune sorbent assay (ELISA).

RESULTSAfter co-cultured with 2 × 10⁵ MSCs for 5 days, the ratio of CD4⁺CD25⁺ T cells and CD4⁺CD25⁺/CD4⁺ were significantly higher than of separate T lymphocytes in ITP patients [(4.56 ± 0.70)% vs (2.24 ± 0.81)%, (9.91 ± 1.18)% vs (4.08 ± 1.17)%, respectively] (P<0.05). To compare with separate T lymphocytes in ITP patients, the cytokine concentrations of IL-2 and IFN-γ from the culture supernatants significantly reduced from (280.47 ± 17.33) pg/ml to (97.21 ± 12.07) pg/ml and from (129.33 ± 16.34) pg/ml to (72.75 ± 7.81) pg/ml, respectively. In contrast, the cytokine concentrations of IL-4 and IL-10 increased from (16.34 ± 2.60) pg/ml to (37.98 ± 4.05) pg/ml and from (54.78 ± 5.62) pg/ml to (113.77 ± 5.68) pg/ml, respectively.

CONCLUSIONMSCs significantly inhibited the cytokine levels of IL-2 and IFN-γ secreted by Th1 cells and promoted the releases of IL-4 and IL-10 by Th2 cells in ITP , thereby regulating the balance between Th1 and Th2 reaction, as well as up-regulating the expression of CD4⁺CD25⁺ T cells in vitro,then induced the immunologic tolerance of ITP.

Adolescent ; Adult ; CD4-Positive T-Lymphocytes ; secretion ; Cells, Cultured ; Female ; Flow Cytometry ; Humans ; Interferon-gamma ; metabolism ; Interleukin-10 ; metabolism ; Interleukin-2 ; metabolism ; Interleukin-4 ; metabolism ; Male ; Mesenchymal Stromal Cells ; cytology ; Middle Aged ; Thrombocytopenia ; metabolism ; Young Adult

Objective:To investigate the placenta tissue expression levels of monocyte chemotactic protein-1 (MCP-1), nuclear factor-κBp65 (NF-κBp65) and proliferating cell nuclear antigen (PCNA) in pregnant women with gestational diabetes mellitus (GDM), and to analyze their correlation with pregnancy outcomes.Methods:The clinical data of 124 pregnant women with GDM from May 2020 to December 2021 in PLA Northern Theater General Hospital were retrospectively analyzed. Among them, 62 pregnant women were willing to receive treatment (treatment group), while 62 pregnant women were unwilling to receive treatment (untreated group). In addition, 80 healthy pregnant women in the same period were selected as the healthy control group. The natural birth rate, neonatal Apgar score and the incidences of macrosomia, neonatal hypoglycemia, neonatal hyperbilirubinemia were record. The placenta tissue expression levels of MCP-1, NF-κBp65 and PCNA were detected by immunohistochemical.Results:The natural birth rate in untreated group was significantly lower than that in treatment group and healthy control group: 24.19% (15/62) vs. 75.81% (47/62) and 88.75% (71/80), the natural birth rate in treatment group was significantly lower than that in healthy control group, and there was statistical difference ( P<0.05). The Apgar score in untreated group was significantly lower than that in treatment group and healthy control group: (8.45 ± 2.02) scores vs. (9.46 ± 2.59) and (9.71 ± 3.21) scores, the incidences of macrosomia, neonatal hypoglycemia and neonatal hyperbilirubinemia were significantly higher than those in treatment group and healthy control group: 35.48% (22/62) vs. 11.29% (7/62) and 3.75% (3/80), 29.03% (18/62) vs. 8.06% (5/62) and 2.50% (2/80), 24.19% (15/62) vs. 9.68% (6/62) and 2.50% (2/80), and there were statistical differences ( P<0.05); there were no statistical difference in the indexes treatment group and healthy control group ( P>0.05). The positive expression rates of MCP-1, NF-κBp65 and PCNA in untreated group were significantly higher than those in treatment group and healthy control group: 72.58% (45/62) vs. 25.81% (16/62) and 12.50% (10/80), 69.35% (43/62) vs. 27.43% (17/62) and 13.75% (11/80), 69.35% (43/62) vs. 24.19% (15/62) and 11.25% (9/80), the indexes in treatment group were significantly higher than those in healthy control group, and there were statistical differences ( P<0.05). Conclusions:The placenta tissue expression levels of MCP-1, NF-κBp65 and PCNA in pregnant women with GDM are associated with adverse pregnancy outcomes. After active treatment, the positive rates of the three indexes in pregnant women with GDM significantly decrease, and the prognosis got improved.

Objective To investigate the effects of individualized medical nutrition therapy (IMNT) on the nutrition metabolism index and pregnancy outcome in gestational diabetic mellitus (GDM) patients during pregnancy and lactation periods. Methods Totally 98 female patients diagnosed with GDM from the Second Hospital of Hebei Medical University were selected from June 2014 to September 2015 and divided into the study group and the control group according to the principles of randomization. 51 patients in the study group received intervention of IMNT during pregnancy and lactation periods. 47 patients in the control group received traditional oral nutritional intervention model. The purpose was to observe the changes of biochemical indicators among different periods and pregnancy outcomes between two groups at the 3rd and 6th month after intervention. Results The metabolism index including fasting blood glucose ( FBG ) , postprandial blood glucose (PBG), HbA1c, Ca2+, CHOL, TG, TP, and ALB of the study group were significantly better than that of the control group ( P<0. 05 ) . The incidence rate of pregnancy-induced hypertension syndrome, polyhydramnios and other complications, and the Cesarean delivery rate was also significantly lower in the study group than those in the control group ( P<0.05) . Macrosomia, hypoglycemia, asphyxia, high blood bilirubin, fetal distress, premature birth rate, and the neonatal Apgar score ratio after postpartum in the study group were significantly better than the control group ( P<0.05) . The average weight gain among the pregnant women, the postpartum maternal weight, and the neonatal average birth weight of the study group were significantly lower than that of the control group (P<0.05). Conclusions IMNT can ensure good pregnancy outcome, and help to effectively control nutrition metabolic indices; It is a safe and important non-drug intervention to ensure the safety of mothers and their fetus.

OBJ ECTIVE To predict the quality marker （Q-Marker）of Forsythia suspensa . METHODS The fingerprints of 10 batches of F. suspensa were established by high performance liquid chromatography. The common peaks were confirmed. The candidate components of Q-Marker in F. suspensa were screened. The volatile oil of F. suspensa were analyzed by gas chromatography-mass spectrometry （GC-MS），and the candidate components of Q-Marker in volatile oil were screened. The network pharmacology analysis was performed for the candidate components of Q-Marker. The network diagram of the “candidate components of F. suspensa Q-Marker-target-pathway”was constructed to predict the Q-marker of F. suspensa . RESULTS & CONCLUSIONS Twenty-one common peaks were obtained for 10 batches of F. suspensa ，and four components were identified as phillyrin，forsythoside A ，pinoresinol-4-O-β-D-glucoside and rutin. Seven candidate components were obtained by GC-MS analysis，such as β-pinene，α-pinene，terpinen-4-ol，limonene，γ-terpinene，α-phellandrene，β-myrcene. By network pharmacology analysis， 16 key targets and 17 pathways were obtained. It was preliminarily predicted that phillyrin ， forsythoside A ， pinoresinol-4-O-β-D-glucoside，rutin，terpinen-4-ol，α-phellandrene，α-pinene and β-pinene were Q-marker of F. suspensa .

【Objective】 To explore the effect of low levels of calcium on the biological characteristics of ameloblasts. 【Methods】 Rat primary ameloblasts were cultured in standard DMEM medium. After five days they were identified by RT-PCR and immunohistochemistry. Then 0, 0.6 and 1.2 mmoL/L Ca²⁺ and 100 mL/L fetal bovine serum were added into DMEM medium without calcium. After 48 hours, the cell morphology was observed by inverted microscope. The proliferation and apoptosis of cells were separately examined by MTT and AnnexinV-PI. Real-time quantitative PCR was used to detect the expression levels of amelogenin and KLK4 mRNA. 【Results】 After Five days in standard DMEM medium, the cells were shaped like the paving pattern. RT-PCR showed that both amelogenin and KLK4 were expressed in the cells. Immunohistochemical staining showed that most cells had positive staining for amelogenin. After 48 hours of calcium intervention, some cells in 1.2 mmoL/L Ca²⁺ group had higher nuclear density and poor light transmittance, and more high columnar cells could be observed in 1.2 mmoL/L Ca²⁺ group than those in 0 and 0.6 mmoL/L Ca²⁺ groups. With the decrease in calcium concentration in the medium, MTT showed that the proliferation activity of ameloblasts reduced (P<0.01). Annexin V-PI showed that the percentage of apoptotic cells decreased, and there was a significant difference between 1.2 mmoL/L and 0 mmoL/L Ca²⁺ groups (P<0.05). Real time-PCR showed that the expressions of amelogenin and KLK4 mRNA reduced (P<0.01). 【Conclusion】 Low-level calcium may inhibit the differentiation of ameloblasts, thereby affecting the formation of enamel mineralization.