OBJECTIVE:To provide new ideas for the supervision of TCM decoction for patients. METHODS:The mode of outsourced TCM decoction for patients in Nanjing and Hangzhou area were investigated and analyzed,especially their operation mode. The safety problems of quality of the mode were analyzed from the legitimacy and standardization. RESULTS & CONCLU-SIONS:The present problems include the mismatch of professional and technical personnel of TCM decoction pieces and their qua-lification requirements;the lack of communication of pharmacists and prescribers;no restrictions for outsourced decoction of toxic TCM decoction pieces for patients;the insufficient attention for the quality and safety of packaging materials;being difficult to im-plement the main responsibility of medical institutions,etc. It is suggested to establish the filing system of centralized TCM decoc-tion institution for patients;the stationed system of pharmacy technician in medical institutions;the training and evaluation system of dispensing,decocting and other stations;the regular inspection system of health and pharmaceutical administration department;the quality evaluation system of TCM decoction for patients by following up medical staff and patients. So that it can explore a new idea for monitoring ofclearing the powers of regulatory,full participation in medical institutions,standardization and management of pharmaceutical wholesale enterprises,active supervision by patients.

Objective To evaluate the postoperative analgesic effects of parecoxib for laparoscopic urological surgery.Methods Forty patients with ASA scale ofⅠto Ⅲ underwent laparoscopic urological surgery were randomly divided into two groups: the flurbiprofen group(group Ⅰ,n=20) with IV flurbiprofen 100 mg at 2 hours after operation,and 100 mg twice a day during 3 days after operation;and the parecoxib group(group Ⅱ,n=20)with IV parecoxib 40 mg at 2 hours after operation,and 40 mg twice a day during 3 days after operation.The VAS score at 2,4,16,24 and 48 hours after operation and the adverse effects were recorded.Results The average VAS score of the two groups was 4 to 5 at 2 hours after operation,and was 0~3 at other time points.There was no significant difference among two groups in the VAS score.Conclusion Parecoxib can provid effective postoperative analgesia for patients underwent laparoscopic urological surgery as flurbiprofen.

Objective To evaluate NucliSens HIV-1 QT(bioMerieux,Netherlands) in quantitating human immunodeficiency virus type 1(HIV-1) RNA in whole semen or seminal plasma from HIV-1-infected people.Methods Five levels of HIV-1 RNA were spiked to whole semen,seminal plasma and blood plasma samples from healthy people,and then measured by NucliSens HIV-1 QT.The same method was used to measure HIV-1 RNA in seminal plasma and blood plasma samples from 15 HIV-1 infected people.Results Nucleic acid amplification inhibitors were found in whole semen but not in seminal plasma when using NucliSens HIV-1 QT.No significant difference was found between normal seminal plasma and blood plasma samples spiked with HIV-1 RNA,and no false positive result was found in 10 normal seminal plasma samples.For 15 cases of HIV-1 infection,HIV-1 was detected in 80%(12/15) of the plasma samples and 40%(6/15) of the seminal plasma samples,with viral loads of

Objective:To evaluate the clinical effects of amended concave position in gynecological laparoscopy surgery.Methods: Eighty ASAⅠ~Ⅱ patients with gynecological laparoscopy surgery were randomly divided into two groups, the patients in group A were adopted Trendelenburg position; the patients in group B were adopted amended concave position. The Ppeak and PETCO2 in the two groups were recorded during surgery, the time of extubation and the adverse effects as nausea, vomiting, shivering was recorded after surgery.Results: The Ppeak and PETCO2 of group A were higher than that of group B(t=2.526,t=2.838, t=2.881;P<0.05). The time of extubation of group A were higher than that of group B after surgery(t=2.515,t=2.436;P<0.05).Conclusion: Adopting amended concave position can reduce Ppeak and PETCO2 in gynecological laparoscopic surgery, and it is helpful for postoperative recovery of the patients with gynecological laparoscopy surgery.

Fibroblast growth factor receptor 3(FGFR3)plays important roles in cell proliferation,diffe rentiation,and angiogenesis.Recent studies have demonstrated that FGFR3 is associated with progression of breast cancer and has effects in endocrine therapy resistance breast cancer.It has also been showed that FGFR3 is correlated with breast cancer prognosis.

Objective To summarize the application of ATP bioluminescence assay in surveillance of terminal disinfection of effects ,so as to provide the basis for intervention of disinfected effects .Methods ATP bioluminescence assay were employed to randomly test the surfaces of operating objects in therapeutic rooms and beside tables in wards ,total 144 object surfaces ,of each clinical departments in the whole hospital .The values of ATP bioluminescence assay were read on‐site ,0-250 RLU was recognized as qualification ,while disqualification when >250 RLU .The disqualified object surfaces were performed on‐site intervention that all of them were re‐disinfected ,the results were compared .Results Both the surfaces of operating objects and beside tables were dis‐qualified before disinfection ,and the values of ATP bioluminescence assay were 780 ± 10 .34 RL and 853 ± 13 .29 RLU respectively . The pass rates of ATP bioluminescence assay was 61 .97% of operating surfaces and 79 .45% of beside table surfaces the first dis‐infection .The disqualified sites were retested following on‐site intervention .The values of ATP bioluminescence assay were 431 .02 ± 0 .53 before intervention and 1 .43 ± 0 .59 after intervention ,and the difference was statistically significant .Conclusion ATP bi‐oluminescence assay can get more immediately ,simple and timesaving in evaluating the effect of disinfection and estimate the effi‐ciency of disinfection timely ,which can also provide the scientific basis on on‐site intervention so as to improve the execution power of hospital infection management .

BACKGROUND:The surface of dental impression is inevitable to carry various bacteria caused by direct contact with the patient saliva, mucosa and blood during preparation;therefore, disinfection of the dental impression is necessary. OBJECTIVE:To evaluate the disinfection efficiency of glutaraldehyde, chlorine dioxide and electrolyzed oxiding water on dental impressions and to investigate the dimensional stability of impressions after disinfection, thus providing basis for establishing a standard and reasonable disinfection method. METHODS:Alginate impression materials were contaminated in vitro, and then immersed in glutaraldehyde, chlorine dioxide and electrolyzed-oxiding water for 5, 10 and 15 minutes, respectively. The colonies were counted after germiculture to compare the disinfection efficiency of three disinfectants. The impressions were poured in die stone after immersion, the dental models were structured-light scanned and three-dimensional digital dental models were reconstructed. Al the data were global y registered, and linear dimensions were measured on the digital models to deduce the influence of disinfection on surface accuracy and dimensional stability of the impressions. RESULTS AND CONCLUSION:The disinfecting rate reached 100%through immersion in 2%alkaline glutaraldehyde for 5 minutes, and the disinfection of kil ing the hepatitis B virus was effective after 10-minute immersion. The disinfecting rate of 600 ppm chlorine dioxide for 15 minutes kil ing experimental bacteria reached 99%and effective for kil ing the hepatitis B virus. While the disinfecting rate of kil ing experimental bacteria was less than 99%through immersion in electrolyzed oxiding water for 15 minutes, and was not effective for hepatitis B virus. The three-dimensional digital dental models did not differ significantly. These results suggest that immersion in 2%alkaline glutaraldehyde for 10 minutes or 600 ppm chlorine dioxide for 15 minutes can effectively disinfect alginate impressions and make no significant effect on the dimensional stability.

Objective Knowledge?based radiotherapy ( KBRT ) can reduce the plan quality variability induced by different experiences between physicians and improve the quality of treatment plans. Methods The Varian Rapid Plan system was used to train a dose?volume histogram ( DVH) prediction model. The obtained model was preliminarily applied to semi?automatic design of the preoperative treatment plans for rectal cancer. Eighty high?quality volumetric modulated arc therapy plans were imported into the model training set of the Rapid Plan system. The structures of the plans were matched to the corresponding labels and codes as listed in the library. The training started after the verification of prescription. The residual plots,regression curves,geometric plots for organ at risk ( OAR) ,in?field DVH plots,and model training logs were examined. After removal of the mismatch, the original plans were assessed to rule out outliers and influential data points. More similar plans may be added for another round of training. Ten KBRT plans were designed using the final model and compared with the clinical plans. Results For the two major OARs,the femoral head and bladder,the average goodness of fit of the principal component were 0?999 415/1.0 and 0?999 963/1.0 for the DVH model,and 0?999 651/1.0 and 0?999 945/1.0 for geometry?based expected dose model,respectively. In all the plans, 11 had Cook ’ s distance values exceeding the tolerance and 4 had studentized residual values exceeding the tolerance. The outliers were all kept in the training set to generalize the scope of the model. The 10 KBRT plans had significantly improved homogeneity indices for PGTV and PTV than the original plans (P=0?00,0?04).The 10 KBRT plans also had significantly reduced D50% to the femoral head and bladder as well as significantly reduced mean doses to the bladder than the original plans (P=0?042,0?000,0?005). Conclusions In this study,the Rapid Plan system is used to train a KBRT model for design of preoperative radiotherapy plans for rectal cancer. The results of preliminary application meet the clinical requirements.

Aim To investigate effects of glutamate(GLU) and ?-aminobutyric acid(GABA) on levels of neurosteroids synthesized and released by primary cultured rat brain cortical astrocytes.Methods Primary cultured rat brain cortical astrocytes were treated with GLU or GABA for 48 h respectively.Unconjugated(dehydroepiandrosterone,DHEA;pregnenolone,PREG;allopregnanolone,AP) and conjugated neurosteroids(dehydroepiandrosterone sulfate,DHEAS;pregnenolone sulfate,PREGS) in culture media were extracted by solid phase extraction(SPE) and analyzed by HPLC-MS.Results Compared with saline control group,GLU treatment decreased PREG and PREGS levels and increased DHEAS level significantly;GABA treatment decreased PREG level and increased AP level significantly.Conclusion Both GLU and GABA were shown to inhibit the genesis of PREG.While GLU significantly promoted the genesis of DHEAS and GABA promoted the genesis of AP.The genesis of PREGS was also inhibited by GLU treatment in primary cultured cortical astrocytes.

A description of the concept,origin and development,and key contents of the system safety theory,and an analysis of the presence and future of China's medical safety management,holding that such a theory enjoys a promising perspective in medical safety managemenL Medical safety management needs to follow such a theory as fl guideline,and its principles to set system safety objectives,and to determine the scope of the safety system_By building a comprehensive feedback mechanism,clarifying the responsibility borders and advocating a safety culture,medical safety management can be significantly upgraded.