OBJECTIVE:To provide reference for the enhancing of the quality of hospital preparations.METHODS:The disqualified reports on Shanghai hospital preparations published in "Shanghai drug and medical equipment quality bulletin" between 2004 and 2007 were collected to investigate the main quality problems.RESULTS:A total of 105 batches(19 dosage forms were covered)of unqualified preparations were reported in spot checks,of which,74(70.5%)were external preparations,17(16.2%)oral preparations,and 14(13.3%)sterility preparations.The common unqualified items include package amount(34.5%),description(15.4%),content(15.4%),pH value(13.6%),and microbial limit(8.2%).The major quality problems were related to package containers and technology.CONCLUSIONS:It is suggested that the concerned department to tighten control on quality of hospital preparations aimed at the above-mentioned problems.

Objective To optimize physical examination processes,to manage physical examination scientifically in order to meet the needs of medical staff.Methods Medical guidelines were updated by using modern information systems.Meanwhile,the internal structure of medical examination center was rearranged reasonably.The examination process was stuck on the wall which integrated people oriented idea.Results After process reengineering,the return rate of examination menu was 98.55％,project completion rate was 99.16％,one time completion rate was 98.41％,physical examination time was reduced to (1.80±1.50) h.The satisfaction degree of the physical examinees was also increased.All parameters had significant differences compared with the former.Conclusions Scientific process reengineering of health examination plays a scientific and informatization management role.It can improve physical examination quality,increase physical examination capacity,and achieve good social benefit.

Objective To investigate the effect and safety of the recombinant tissue plasminogen activator ( rt-PA) combined with reduced glutathione ( RGSH ) in the treatment of acute ST-elevation myocardial infarction ( ASTEMI) .Methods 110 cases of ASTEMI were randomly divided into the control group and the observation group,55 cases in each group.The control group was intravenously injected 50mg rt-PA once a day,while the observa-tion group was injected 1200 mg RGSH freeze-dried powder once a day based on the control group .The vascular reca-nalization rate,the changes of myocardial enzymes ,cardiac structure and function parameters before and after treat-ment and adverse reactions in two groups were compared .Results The recanalization rate of the observation group and the control group reached 92.73%and 89.09% respectively,the difference between two groups was not signifi-cant (P>0.05).After treatment,the levels of CK,AST,cTnT,cTnI and CK-MB in the observation group were signifi-cantly lower than those of the control group (P<0.05),while the level of SOD was significantly higher than the con-trol group(P<0.05).The LVEDd and LVESd in the observation group were (52.24 ±5.83)mm and (39.95 ± 7.06)mm respectively,which were significantly lower than those in the control group (P <0.05),while the EF [(63.25 ±9.38)%] was significantly higher than that of the control group (P<0.05).The total adverse reaction rate in the observation group was 10.91%,which was significantly lower than 21.82% in the control group ( P<0.05).The reinfarction rate in the observation group was 3.63%,which was significantly lower than 12.73% in the control group(P<0.05).Conclusion The rt-PA routine thrombolysis therapy combined with RGSH could improve the recanalization rate and left ventricular structure and function of the ASTEMI patients and has less adverse reac -tion.The curative effect is better than single rt-PA.

Objective To understand patients with gestational diabetes mellitus (GDM)in postpartum dia-betes incidence,and analyze risk factors of postpartum diabetes.Methods 144 cases with GDMwere selected as the research objects,according to the 5 year follow -up results,they were divided into the abnormal glucose tolerance group,diabetes group and normal blood glucose group,blood glucose during pregnancy,HbA1c,before the number of pregnancy,the changes of BMI and age were compared,the risk factors of postpartum diabetes was observed.Results Gestational diabetes mellitus patients 5 years postpartum diabetes morbidity rate was 25%,Postpartum diabetes gesta-tional fasting blood glucose(5.6 ±1.2)mmol/L and HbA1c(4.3 ±1.6)% were higher than those of the abnormal glucose tolerance group(6.6 ±1.3)mmol/L,(6.7 ±2.4)% and normal blood glucose group (7.3 ±1.2)mmol/L, (8.2 ±2.9)%.The difference among the three groups had statistical significance(P <0.001);HOMA -beta index (82.4 ±39.5)were lower than the other two groups(P =0.001),Pregnancy HbA1c(OR =6.37,P =0.001)and fasting blood glucose(OR =4.32,P =0.003)as well as previous pregnancies (OR =5.51,P =0.006)were inde-pendent predictors of postpartum diabetesindications.Conclusion Pregnancy HbA1c and fasting blood glucose level can determine the risk of gestational diabetes mellitus patients with postpartum diabetes;Have a family history of dia-betes and previous history of pregnancy patients.The risk of postpartum diabetes mellitus increase.

Aim To investigate the in vivo effects of cilostazol,a novel phosphodiesterase III inhibitor,on signaling regulation,that is PPARs and NF-?B on vascular cell adhesion molecule-1(VCAM-1) in aorta of diabetic rats.Methods Diabetes was induced by intraperitoneally injecting fasted SD rats with streptozocin(STZ) at the dose of 65 mg? kg~(-1).32 diabetic rats were randomly divided into three groups,diabetes mellitus group(DM,n=12),high dosage of cilostazol group(GX,27 mg?kg~(-1)?d~(-1),n=10) and low dosage of cilostazol(DX,9 mg?kg~(-1)?d~(-1),n=10),plus normal control group(NC,n=8).After treatment for 8 weeks,using immunohistochemitry(IHC),in situ hybridyzation(ISH) and electrophoresis mobility shift assay(EMSA),we determined expression of VCAM-1,translocation of P65 subunit and activity of NF-?B in aorta tissues.PPAR? and PPAR? were examined by RT-PCR or Real-Time PCR.Results ①Compared with NC group,diabetic groups had elevated VCAM-1 expression of protein and mRNA(P

Objective To investigate the effect of montelukast sodium chewable tablets joint Tongqiaobiyan particles in the treatment of children with allergic rhinitis.Methods 108 children with allergic rhinitis according to the methods were divided into A group and B group,54 cases in each group.Both A and B group were given Tongqiaobiyan particles,weight <25kg patients,each half bag(1g),3 times a day;weight >25kg patients,each bag, 3 times a day.At the same time the A group was given montelukast sodium chewable tablets:2 to 5 years old,each 4mg,once daily.6 to 14 years old,each 5mg,once daily.Period of treatment for two weeks.Total efficiency and snee-zing,nasal congestion,runny nose,itchy nose symptoms and dry cough improve time,the recurrence rate after one month,two months of the two groups were compared.Results After the treatment,94 cases were accomplished,falled off in 14 cases.Among them,the A group completed in 48 cases,falled off in 6 cases;The B group completed in 46 patients from,falled off in 8 cases.The total effective rate of the A group was 95.8%,which was significantly high-er than 78.3% in the B group(χ2 =6.513,P <0.05).The sneezing,nasal congestion,runny nose,nasal itching and dry caugh of the A group were relieved more significantly than the B group(t =2.628,3.30,2.74,3.58,3.09,all P <0.05).Followed up 1 month and 2 months,the recurrence rates of A group and B group were 6.5% and 20%, 15.2% and 25%,respectively,there were no significant difference between with the two groups(χ2 =1.122,1.338, all P >0.05).Conclusion Tongqiaobiyan particles jointly montelukast sodium chewable tablets integrative curative in treatment of allergic rhinitis can significantly improve clinical symptoms,and has no significant adverse reactions. This method should be popularized and applied.

Objective:To Compare the two-dimensional gel electrophoresis(2D-PAGE)with cerebrospinal fluid(CSF)of Parkinson’s disease patients and control group(patients with headache),and to find out the disease-specific proteins(DSPs)which are closely correlated with Parkinson’s Disease. Methods:proteins extracted from CSF were run in immobilized pH gradient isoelectic focusing(IPG-IEF)at the first dimension,and then run in vertical flat sodium dodecyl sulphate polyacrylamide gel electrophoresis(SDS-PA GE)at the second dimension. The protein spots in gels were visualized by silver staining protocol followed by gel scanning and analysised by Pdquest 8.0 software.Then differentially displayed protein spots were searched and identifiyed by MALDI-TOF-MS.Results:Three DSPs were found and they were Protein-tyrosine phosphatase 1B,Apolipoprotein E and E3 ubiquitin-protein ligase. Conclusion:There were different protein expressing in 2D-PAGE of Parkinson’s disease and control group.These proteins may be the DSPs of Parkinson’s disease and may be taked as biomarkers of Parkinson’s disease.

Objective To explore the clinical effect of laparoscopic splenectomy caused by liver cirrhosis portal hypertension .Methods 38 patients treated with splenectomy as a result of hypersplenism induced by liver cir-rhosis portal hypertensions were selected .Laparotomy splenectomy was used in 18 cases ( OS group ) , laparoscopic splenectomy was used in 20 cases(LS group).Operation time , amount of bleeding during operation ,duration of hos-pital stays,liver and kidney function,blood routine,AYM were retrospectively analyzed.Results Compared with the preoperative group,LS ALT 2D after operation,postoperative 3~6d were significantly decreased(t=6.75,9.32,all P<0.05);3~6d AST levels after operation in LS group significantly decreased (t=8.87,P<0.05);LS group 2D after operation,postoperative 3~6d GGT levels were significantly lower than that of the preoperative (t=6.54,10.76, all P<0.05);group LS patients urea nitrogen levels falling postoperation ,there was statistically significant difference (t=3.43,P<0.05),leukocyte levels,PLT and HBG in the two groups increased postoperation ,these were statistical-ly significant difference(t=19.32,10.21,8.42,6.76,9.32,13.32,all P<0.05),OS group increased more obvious-ly.Conclusion LS has a better treatment effect on hypersplenism caused by liver cirrhosis ,which is worthy of popu-larization and application .

Objective:To investigate the effect of Operation Maps application on relieving anxiety of patients of the nurses of operation room preoperative visits. Methods:39 cases of operation were randomly divided into the application of operation maps 19 cases and routine visit group 20 cases, regular visiting group received routine preoperative interview content, and on the basis of content, the original application mapping group are visited by nurses carrying atlas album, and according to the related content the nurses explain to patients in the album when they introduce the patients the operating room environment surgery, surgical notes, position, etc. At the same time, the self rating anxiety scale measurement measures the anxiety of patients when they are admitted and after into operation room, and blood pressure, heart rate, pain intensity, the first time getting out of bed, exhaust time, clearing time, and they compare the difference. Results:The anxiety values of the original application mapping group mapping group, systolic blood pressure, heart rate are lower than regular visits group(t=2.28, t=4.756, t=10.28;P<0.05). Intensity of pain after operation in the two groups , get out of bed the first time, exhaust time showed no significant differences(t=3.04, t=3.06, t=2.56;P<0.01). Conclusion:Application of operation atlas of systematic, standardized preoperative visit is an important psychological guidance, and it can reduce the anxiety level of patients and effectively improve the quality of medical operation period.