Humans ; Oral Medicine ; Photofluorography

Acute Disease ; Electrocardiography ; Humans ; Myocardial Infarction ; chemically induced ; physiopathology ; Poisoning ; complications ; physiopathology

To study the pharmacokinetics of ginsenosides Rg1 and its metabolites after iv and oral administration in Wistar rats, the LC-MS/MS method was selected to determine ginsenosides Rg1 and its metabolites in plasma and their pharmacokinetic parameters were calculated. After oral administration of ginsenosides Rg1 to rats, ginsenosides Rg1, Rh1, F1 and protopanaxatriol (Ppt) could be detected in plasma. Their Tmax were 0.92, 3.64, 5.17, and 7.30 h, respectively; MRT were 2.68, 5.06, 6.65, and 5.33 h, respectively; AUC(o-t), were 2 363.5, 4 185.5, 3 774.3, and 396.2 ng x mL(-1) x h, respectively. After iv administration of ginsenosides Rg1 to rats, ginsenosides Rg1, Rh1 and FI could be detected in plasma. Their T1/2betaS were 3.12, 5.87, and 6.87 h, respectively; MRTs were 1.92, 5.99, and 7.13 h, respectively; AUCo-tS were 1 454.7, 597.5, and 805.6 ng x mL(-1) x h, respectively. So, it can be concluded that after oral administration, the amounts of metabolites were higher than the prototype in vivo, and the distribution and elimination of the metabolites were relatively slow. After iv administration, the amount of prototype were higher than that of the metabolites in vivo, and the distribution and elimination of the metabolites were relatively slow.

Objective To analyze drug resistance of pathogenic bacteria from the blood culture and distribution in clinical departments,and to guide the rational clinical drug use.Methods We retrospectively analyzed 11 275 samples of blood cultures in The Central Hospital of Wuhan from 2012 to 2014.The blood specimens were cultured by VersaTREK(USA).The pathogenic bacteria were identified and their drug resistance was analyzed by BD-PHOENIX 100 automicrobiological identification systems(USA).Results Among the 11 275 blood cultures,636 bacterial strains were detected.The top four bacterial strains were Escherichia coli,Staphylococcus aureus,Klebsiella pneumonia and Enterococcus f aecium.A vancomycin-resistant Enterococcus faecium strain and a pandrug-resistant Klebsiella pneumoniae strain were detected.The top three clinical departments with distribution of pathogens were Gastroenterology Department,Nephrology Department and Intensive Care Unit (ICU).Pathogens isolated from ICU were evenly distributed.Conclusion Distributions of pathogenic bacteria in the blood culture are different in clinical departments.Identification of pathogenic bacteria and result of drug susceptibility can reduce use of broadspectrum antimicrobials and enhance antimicrobial de-escalation.

OBJECTIVE:To provide reference for further comprehensive evaluation of the improvement of the accessibility of family medicines after the implementation of the new health care reform. METHODS:Sampled as 180 households from 2 urban ar-eas,2 counties and 2 rural areas in Chengdu,a questionnaire survey was adopted based on the WHO’s manual for the Household Survey to Measure Access and Use of Medicines to investigate the situation of drug use,storage and accessibility,and the results were statistically analyzed. RESULTS:Totally 180 questionnaires were sent out,179 were effectively received with effective recov-ery of 99.44%. In the terms of medicines taken for the acute illness,there were more than 60% rural households obtained drugs from the public health care facilities,while more than 60% counties households purchased drugs in public medical and health insti-tutions;in the terms of medicines taken for the chronic illness,the proportion of households reporting a chronic illness who did not take any medicines was low(3.80%);in terms of medicines storage,the proportion of households without reserve drugs was low (13.41%). In terms of drug accessibility,the proportions of respondents who agreed that the location and opening hours of their public healthcare facility were convenient were high;there was no situation for“patients did not take prescribed drugs because med-icines were not available at the healthcare facility and drug store”,while more than 95% respondents who agreed that drugs were available at their public health care facilities and drug stores;the essential medicines in the household use of chronic drugs in Chengdu accounted more than 60%;more than 85% can afford the drug costs,while the proportion of the monthly costs for acute illness and chronic illness in the total month costs was low;the health insurance coverage reached 90% in the survey households, but the proportions of households which could reimburse acute,chronic illness drug cost were lower(14.13% and 12.66%). CON-CLUSIONS:At present,the level of drug accessibility in Chengdu is high;the implementation of National Essential Medicines System has a positive effect on reducing the economic burden of chronic disease family. But there are shortcomings in the Medicare reimbursement levels and antibiotics use,it is suggested to take effective measures to solve it,such as exploring the stable and ef-fective medical insurance fund raising channels,improving the compensation level and the level of insurance reimbursement,formu-late and implement the corresponding antibacterial drugs supervision system and regulate the rational use of antibiotics in residents.

According to interactive teaching,Problem-based Learning (PBL),visual teaching and other theories,combining with the characteristics of medical practice teaching,the paper puts forward a set of informatization methods used for medical teaching and practice,verifies that the application of informatization technology to medical teaching can obviously improve the teaching efficiency and quality,and meanwhile proposes the follow-up construction contents,in order to provide reference for further development of informatization medical teaching.

Objective To analyze the distribution of tophus in ankle and tarsal joints by multislice spiral computed tomography (MSCT)and to explore the pathogenesis of gout.Methods 34 patients with a documented diagnosis of gout underwent CT examina-tion of bilateral ankle and tarsal joints,and 55 ankle and tarsal joints were observed tophus.The sites of tophus deposition were cate-gorized into groups of ligament,tendon and joint in order to record and analyze.Results The tophus were showed at the anterior talofibular ligament (n=38),the medial ligament (the site of talus and calcaneus)(n=30)and the interosseous talocalcaneal liga-ment (n=29)(P <0.05)in the group of ligament;at achilles tendon (n= 18),followed by tibialis posterior tendon (n= 7)(P <0.05)in the group of tendon;at articulations intercuneiformes (n=1 5)and inferior tibiofibular articulation (n= 10)(P <0.05 )in the group of joint.Conclusion In ankle and tarsal joints,tophus is commonly deposited at the anterior talofibular ligament,at the achilles tendon and the articulationes intercuneiformes.

Aim To investigate the angiogenic promoting effect of Morinda officinalis How oligosaccharides(MOO) in the ischemic myocardium of rats after acute myocardial infarction(AMI).Methods 40 male Wistar rats were established into AMI model successfully and were randomly divided into 5 groups equally, i. e. the low, medium and high doses of MOO groups, the Shexiangbaoxin group and the model group. They were treated with different doses of the water fraction of the ethanolic extract of Radix morinda officinalis (0.7, 1.4, 2.8 mg·kg~(-1) ·d~(-1)), suspension liquid of Shexiangbaoxin Pill(30 mg·kg~(-1) ·d~(-1)) and distilled water with the same volume respectively.Besides, a sham operated group with 10 rats was set up for control. All rats were sacrificed after 6-week-treatment.The Ⅷ coagulation factor, vascular endothelial growth factor(VEGF) and basic fibroblast growth factor(bFGF) protein in ischemic myocardium of rats in each group were detected by immunohistochemistry assay.The microvessel density(MVD) was calculated. Gray values of protein expression of VEGF and bFGF in ischemic myocardium were calculated and analyzed by image analysis system.Results The MVD, the gray values of VGF and bFGF were higher in the medium and high doses of MOO groups than those in the model group(P <0.05), but still lower than those in the Shexiangbaoxin group(P <0.05). The MVD and the gray values of VEGF among 3 doses of MOO groups showed significant differences (P <0.05).Significant differences of gray value of bFGF were observed between small and middle doses of MOO groups, also between small and large doses of groups(P <0.05).Conclusion MOO can obviously promote angiogenesis in the ischemic myocardium of the rats after AMI.And up-regulating expressions of VEGF and bFGF protein in the ischemic myocardium may act as one of its angiogenic promoting mechanisms.

Objective To investigate in knowledge rate of 120 first aid and satisfaction rate with emergency services among Nanchong citizens. Methods 360 patients who received prehospital first aid from three hospitals and their accompanies were selected from January to June 2010. The investigation content included knowledge rate of 120 first aid and satisfaction rate with emergency services. Results Results showed that about half of those surveyed still did not know the emergency phone"120" and its function, lacked self-help and self-protection knowledge, some respondents felt quite helpless upon daily life of electric shock, gas poisoning, coma and traumatic accidents. The attitude of the majority of emergency personnel was good or better, but still very stiff or irresponsible attitude existed in those few. This undermined the "120" and the image of credibility and emergency personnel. Conclusions There is an urgent need for universal coverage of on-site first aid knowledge and enhance awareness of first aid. Full-time staff in emergency department must pay close attention to the knowledge of first aid training, mastering the technique of bleeding control and bandaging, fixing, handling and CPR, as well as the use of instruments and equipment equipped in vehicles. Only in this way can we continuously improve the treatment of critically ill patients and increase survival rate.

Objective To evaluate the effect of continuous blood purification (CBP) on cardiorenal syndrome (CRS) type Ⅰ.Methods Clinical data of 42 patients with CRS type [at our hospital were collected from January 2012 to June 2014.We observed and compared changes in mean arterial pressure (MAP),heart rate,respiration rate,acute physiology and chronic health evaluation (APACHE) Ⅱ score,and urinary volume before and 5 days after CBP.Meanwhile,levels of serum creatinine (Scr),cysteine proteinase inhibitor Cystatin C (CysC),serum creatinine (cTn) and B-type natriuretic peptid (BNP) were monitored.In addition,dynamic changes in cardiac index (CI),intrathoracic blood volume index (ITBI),global end-diastolic volume index (GEDI),central venous pressure (CVP),and extravascular lung water index (ELVWI) were monitored using the pulse induced contour cardic output plus monitoring system (PiCCO plus),and changes in left ventricular ejection fraction (LVEF) before and 5 days after CBP was measured by color Doppler ultrasound.Results There was no significant difference in MAP in patients with CRS type Ⅰ before and 5 days after CBP (P=0.08).Tacbycardia and tachypnea improved,while urine volume increased and the APACHE Ⅱ score decreased significantly,5 days after CBP(allP＜0.05).Plasma levels of Scr,CysC,cTn and BNP after treatment were lower than those before treatment [(126.8±68.3) μmol/L vs.(413.6±126.1) μmol/L,(1.1±0.8) g/L vs.(4.1±1.1) g/L,(2.6±0.4) μg/L vs.(3.5± 0.7) μg/L,(807.6±427.7) ng/L vs.(3300.3±567.6) ng/L,all P＜0.05)].Myocardial contractility,cardiac preload and lung related parameters also significantly improved after CBP (allP ＜0.05).Conclusions CBP can alleviate clinical symptoms of CRS type Ⅰ,improve cardiac and renal function,and is promising as an important auxiliary measure for the treatment of patients with cardiorenal syndrome type Ⅰ.