OBJECTIVE:To consummate the flow sheet in drug storehouse management so as to improve the management efficiency.METHODS:5S management,visible management and demand-oriented management stated in lean management were applied in drug storehouse management.RESULTS:Due to the application of the methods in lean management,the storage capability of hospital drug storehouse was increased,medicine circulation was accelerated,and the work efficiency was enhanced.CONCLUSIONS:The application of lean management theory is conducive to the upgrading of scientific management as well as the enhancing of both efficiency and performance of hospital drug management.

The structure and properties about encoding protein of lactate dehydrogenase A from Taenia solium(Ts LDH-A)were analyzed and predicted by bioinformatics in this study.The immunological characteristics of this novel gene were also analyzed by cloning and expressing.The full-length cDNA encoding Ts LDH-A was identified from the cDNA plasmid library by blastx and rpsblast programs provided by NCBI.The physico-chemical properties and structures of Ts LDH-A were analyzed by tools provided by ExPASy.And the B cell epitopes of Ts LDH-A were predicted by the B Cell Epitope Prediction Tools provided by IEDB Analysis Resource.The PCR amplified coding region of Ts LDH-A was cloned into the prokaryotic expression vector pET-28a (+) and expressed in E.coli BL21 with IPTG induction.The immunogenicity of the purified recombinant protein was analyzed by Western Blotting.It was demonstrated that the amino acid sequence of Ts LDH-A had identity with that of LDH-A from other specie and there was a conserved LDH domain in the deduced amino acid sequence.The full-length cDNA sequence encoding Ts LDH-A included a complete open reading frame(ORF)of 1332 bp and coded to a putative protein with 331 amino acids.The molecular weight of Ts LDH-A was predicted to be 35461.1 Da and the coding protein was demonstrated to contain 3 trans-membrane regions and 4 main B cell epitopes.The active site of L-lactate dehydrogenase located at the epitope aa190-199.The 3 key residues in the catalytic site of enzyme were conserved in different species and located near to each other in spatial position.PCR,double enzyme restriction and DNA sequencing were used to identify pET28a (+)-Ts LDH-A.The recombinant protein could react with the rat's sera as well as the sera from the patients and the swine infected Taenia solium.It is clear that the full-length cDNA sequence encoding Ts LDH-A can be screened from the cDNA library of adult Taenia solium by bioinformatics analysis and can be used to investigate the structure and properties about gene and encoding protein of Ts LDH-A as well as the immunological activities of gene expression in the prokaryotic system.

Objective To investigate about establishment the animal model of atrial fibrillation(AF) by high thyroxine and electrophysiological study of left atrium.Methods 49 rabbits were randomly divided into three groups, control group (10, injection of saline), withdrawal group (20, injection of levo-thyroxine 50μg/kg, change to inject isodose saline after two months), continuous dosing group (19, injection of levo-thyroxine 50μg/kg everyday).the data of left atrium effective refractory period(AERP), conduction velocity(CV), wavelength(WL) and AF induced ratio were collected after four months.Results The withdrawal group and continuous dosing group AERP200, AERP150 were more shorter than the control group after two months(P<0.05), The continuous dosing group AERP200, AERP150 was shorter significantly than withdrawal group and control group after four months ( P<0.01 ).The withdrawal group and continuous dosing group CV were slower than control group after two months ( P<0.05 ).The continuous dosing group CV was slower significantly than withdrawal group and control group after four months ( P<0.01 ).The withdrawal group and continuous dosing group WL were shorter than control group after two months(P<0.05), The continuous dosing group WL was shorter significantly than withdrawal group and control group after four months (P<0.01).The AF induced ratio in the continuous dosing group increased significantly(P<0.01). After four months, but the withdrawal group decreased, the control group did not induce AF.Conclusion It's feasible to establish the rabbit model of AF by high thyroxine, with left atrium electrophysiological changes, which provides animal model for further to study the pathogenesis of AF cause of hyperthyroidism.

BACKGROUND:Donkey-hide glue reinforcing bone oral solution (DGRBOS) is effective on preventing and treating fracture, but the mechanism of harmacology is still not clear. Vascular endothelial growth factor (VEGF) and fibroblast growth factor 2 (FGF-2) are important cytokines, which can promote blood vessel growth and osseous anabolism during fracture healing.OBJECTIVE: To investigate the effects of DGRBOS on expression of VEGF and FGF-2 in the process of fracture healing of SD rats' fracture of tibia in bony callus, and explore the mechanism of DGRBOS in the treatment of fracture.DESIGN: A completely randomized controlled study.SETTING: Department of Traumatic Orthopedics, Union Hospital Affiliated to Tongji Medical College of Huazhong University of Science and Technology.MATERIALS: Ninety female Sprague-Dawley (SD) rats, with a mean weight of (368±40) g, aged about 3 months, wereprovided by Center of Animal Experiment, Tongji Medical College, Huazhong University of Science and Technology.Experimental drug: DGRBOS was donated by Xinjiang Huashidan Pharmaceutical Co., Ltd. The qili linking bone pill,positive control drug, was purchased from Hunan Pharmaceutical Co., Ltd.METHODS: This experiment was carried out in the Laboratory for Bone Metabolism of Integration of Chinese and Western Medicine (Laboratory of Provincial Level), Union Hospital, Tongji Medical College, Huazhong University of Science and Technology from June to November 2005. Transverse midshaft fractures were produced on the right tibia in these rats using three-point bending technique, and 90 rats were randomly divided into three experimental groups:the DGRBOS group (n =30): according to medicine conversional method between human being and animal, 2 mL DGRBOS was fed to every mouse by intragastric administration at 2 vices/day; the qili linking bone pill group (positive control group, n =30): the pills dissolved in distilled water at 225 g/L, and consequently were administered intragastrically into mice at 2 mL/vice and 2 vices/day; normal saline group (negative control group, n =30): normal saline was administered intragastrically into mice at the coordinative capacity and same frequences. Selecting 4, 7, 14,21 and 28 days during the experiment, the immunohistochemistry method was adopted to detect the change of expression of VEGF and FGF-2 through computing value of mean optical degree (MOD) and number of the positive cells.

Objective To investigate the expression of TXNIP and NLRP3 in atherosclerotic plaque of coronary artery and their relationship with secondary lesion of plaque and sudden death of coronary heart dis-ease.Methods A total of 105 cases of cardiac coronary samples extracted from autopsy anatomy and related data in the Forensic Judicial Appraisal Center of Guizhou Medical University from January 2019 to March 2022 were analyzed retrospectively.They were divided into the non-lesion group (n=20) and plaque group (n=85) according to whether or not having harden plaque in coronary artery.Then the plaque group was divided into the non-coronary heart disease sudden death group (n=25),coronary heart disease sudden death without sec-ondary lesion group (n=30) and coronary heart disease sudden death complicating secondary lesion group (n=30).The hematoxylin-eosin (HE) dyed section was prepared.The IPP6.0 image analysis software was used to measure the thickness of coronary intima and lesion,the thickness of fibrous cap,the thickness of nec-rotic lesion and the degree of lumen stenosis.Immunohistochemical method,Western blot and real-time fluo-rescent quantitative reverse transcription-PCR (qRT-PCR) were used to detect the distribution characteristics and expression levels of TXNIP and NLRP3 in coronary arteries.Results Compared with the non-lesion group,the thickness of the intima,lesion,fibrous cap and necrosis lesion in the other three groups was thicker,the stenosis degree of lumen was higher,and the differences were statistically significant (P<0.05).Com-pared with the coronary heart sudden death without secondary lesion group,the thickness of the intima,lesion and necrose lesion in the coronary heart disease sudden death complicating secondary lesion group was thic-ker,the necrosis degree of lumen was higher,and the differences were statistically significant (P<0.05).The TXNIP and NLRP3 proteins expressions were not seen in the coronary arterial wall of the no-lesion group.The strong positive expression rates of TXNIP and NLRP3 in the non-coronary sudden death group were 40.0% and 36.0%,the weak positive expression rates were 32.0% and 36.0%,and the weaker positive ex-pression rates were 28.0% and 28.0%.The strong positive expression rates in the coronary heart disease sud-den death without secondary lesion group were 50.0% and 43.3%,the stronger positive expression rates were 33.3% and 36.7%,and the weak positive expression rates were 16.7% and 20.0%;the strong positive ex-pression rates in the coronary heart disease sudden death complicating secondary lesion group were 73.3% and 76.7%,the stronger positive expression rates were 26.7% and 23.3%.The coronary artery TXNIP and NLRP protein and mRNA levels in the coronary heart disease sudden death complicating secondary lesion group were higher than those in the other three groups with statistical difference (P<0.05).TXNIP in coro-nary arterial plaque was positively correlated with the absorbance value of NLRP3 expression absorbance val-ue,protein and mRNA expression level (P<0.05).The TXNIP and NLRP3 expression levels were positively correlated with the intima and lesion thickness,and negatively correlated with the fibrous cap thickness (P<0.05).The necrosis lesion area of coronary artery was positively correlated with the TXNIP and NLRP3 (P<0.05).Conclu-sion TXNIP and NLRP3 could serve as the diagnostic indicators of coronary heart disease sudden death.

Objective To explore the therapeutic mechanism of maggot for psoriasis-like lesions in mice from the perspective of immune stress and complement activation regulation.Methods Thirty-six male C57BL/6 mice were randomly divided into control group,model group,maggot(1.25%,2.5%,and 5%)groups,and Benvitimod(1%)group.Psoriasis-like lesions were induced by application of imiquimod cream,and the severity of skin lesions was assessed using the modified Psoriasis Area and Severity Index(MPASI)score.Auricular swelling of the mice was observed,and histopathological changes of the skin lesions were examined with HE staining.Scratching behavior of the mice was observed and the spleen index was calculated.Toluidine blue staining was used to detect mast cells in the skin lesions,and serum levels of IgG,IgM,the complements CH50,C1s,C3,C3a,C5 and C5a,and the inflammatory factors IL-23,IL-17A and TNF-α were determined with ELISA.Results In mice with imiquimod-induced psoriasis-like skin lesions,treatment with the maggot at the 3 doses significantly decreased MPASI score,alleviated auricular swelling and pathologies in the skin lesions,reduced scratching behaviors,spleen index,and the number of mast cells in the lesions.Treatment with high-dose maggot significantly lowered serum levels of IgG,C1s,C3a,C5a,IL-23,IL-17A and TNF-α and the levels of C1s,C3,C3a,C5 and C5a in the lesion tissue,and increased serum levels of CH50,C3,and C5.The therapeutic effect of maggot showed a dose-effect dependence.Conclusion Maggot can alleviate psoriasis-like skin lesions in mice by inhibiting immune stress and complement activation.

Objective To explore the therapeutic mechanism of maggot for psoriasis-like lesions in mice from the perspective of immune stress and complement activation regulation.Methods Thirty-six male C57BL/6 mice were randomly divided into control group,model group,maggot(1.25%,2.5%,and 5%)groups,and Benvitimod(1%)group.Psoriasis-like lesions were induced by application of imiquimod cream,and the severity of skin lesions was assessed using the modified Psoriasis Area and Severity Index(MPASI)score.Auricular swelling of the mice was observed,and histopathological changes of the skin lesions were examined with HE staining.Scratching behavior of the mice was observed and the spleen index was calculated.Toluidine blue staining was used to detect mast cells in the skin lesions,and serum levels of IgG,IgM,the complements CH50,C1s,C3,C3a,C5 and C5a,and the inflammatory factors IL-23,IL-17A and TNF-α were determined with ELISA.Results In mice with imiquimod-induced psoriasis-like skin lesions,treatment with the maggot at the 3 doses significantly decreased MPASI score,alleviated auricular swelling and pathologies in the skin lesions,reduced scratching behaviors,spleen index,and the number of mast cells in the lesions.Treatment with high-dose maggot significantly lowered serum levels of IgG,C1s,C3a,C5a,IL-23,IL-17A and TNF-α and the levels of C1s,C3,C3a,C5 and C5a in the lesion tissue,and increased serum levels of CH50,C3,and C5.The therapeutic effect of maggot showed a dose-effect dependence.Conclusion Maggot can alleviate psoriasis-like skin lesions in mice by inhibiting immune stress and complement activation.

Objective Comprehensive mortality risk analyses and therapeutic assessment in real-world practice are beneficial to guide individual treatment in patients with Carbapenem-resistant Klebsiella pneumoniae bloodstream infections(CRKP-BSI).Methods Retrospective analysis of the clinical characteristics of 81 CRKP-BSI patients in our intensive care unit from July 2016 to June 2020,to indentify the risk factors of death and treatment effects of different antibiotic regimens.Results In 81 CRKP-BSI cases,the majority source were from abdominal and respiratory,accounting for 56.79%(46 cases)and 22.22%(18 cases),respectively.The 28-day mortality and hospitalization mortality of CRKP-BSI were 54.32%(44 cases)and 65.43%(53 cases).Multivariate regression analysis suggested that biliary tract disease before admission(P=0.026)and increased SOFA score at the onset of BSI(P=0.006)were independent risk factors for 28-day mortality.There was no statistically significant difference in 28-day mortality between the groups of antibiotic treatment based on tigecycline(44 cases)and polymyxin B(26 cases)[56.82%(25/44)vs.57.69%(15/26),P=0.943].Patients were evaluated based on their age(≤65 years vs.>65 years),gender,body mass index(≤25 kg/m2 vs.>25 kg/m2),and APACHEⅡ score(≤20 vs.>20),the use of renal replacement therapy and mechanical ventilation,there was no difference in the mortality among each subgroup.Conclusions Biliary tract disease before admission and SOFA score were independent risk factors for 28-day mortality.There was no significant difference outcomes between tigecycline-and polymyxin B-based therapy.

Objective To systematically review the worldwide simulation model studies on the natural history of breast cancer and to summarize related parameters.Methods A structured literature search was conducted in PubMed and the Cochrane Library to identify articles during 1980-2015.Articles were screened independently by two researchers.Health states in the natural history and relevant parameters were extracted.Results A total of 36 studies were included for analysis,within the earliest one was published in 1990.Most studies were from Europe and America countries,and 2 studies from China.Markov model was mostly applied to evaluating breast cancer screening programs (n=32).Reported health status included “healthy” (n=36),ductal carcinoma in situ (DCIS,n=17),invasive breast cancer (IBC,n=36),and death (n=27).There were two definite classifications for IBC,tumor size (n=9) and TNM staging (n=9,3 studies reported transition rates).The median (range) of annual transition rates from DCIS to stage-I IBC,I to Ⅱ,Ⅱ to Ⅲ,Ⅲ to Ⅳ were 0.279 (0.259-0.299),0.150 (0.069-0.430),0.100 (0.060-0.128) and 0.210 (0.010-0.625),respectively.A total of 15 studies reported the mean duration from predinical to clinical stage for IBC was 1.95-4.70 years,which gradually increased with age,and 7 studies reported that for DCIS.Conclusions Despite closer attention was paid to breast cancer natural history models,in recent years atypical hyperplasia has been neglected.Data on the mean duration of DCIS requires reasonable conversion.Various classifications for IBC exist whereas transition rates are limited.Current findings would be valuable references but challenging for the Chinese-population specific natural history model,development.

ObjectiveTo explore the possible mechanism of the Yiqi Jiedu formula （YQ） in treating ischemic stroke （IS） from the perspective of the microbial-gut-brain axis （MGBA）. MethodRats were randomly divided into five groups， with six in each group， including sham surgery group， model group， and low， medium， and high dose YQ groups （1， 5， and 25 mg·kg^-1）. Except for the sham surgery group， all other groups were established with a middle cerebral artery occlusion （MCAO） model using the thread occlusion method. The success of modeling was determined through neurobehavioral scoring， and the protective effect of YQ on IS was evaluated. Then， the changes in gut microbiota before and after MCAO modeling and YQ administration were compared using 16S rDNA sequencing technology， and the possible biological pathways related to the effect of this formula were analyzed. The expression of inflammatory factors such as interleukin-6 （IL-6）， interleukin-17A （IL-17A）， and interleukin-10 （IL-10） in serum was detected by enzyme-linked immunosorbent assay （ELISA）. Western blot was used to detect the expression of tight junction proteins ZO-1 and Occludin in brain and intestinal tissue， and hematoxylin-eosin staining （HE） was used to observe pathological changes in the cerebral cortex and colon， so as to validate the possible mechanism of action. ResultYQ significantly improved the neurobehavioral score of MCAO rats （P<0.01） and played a good regulatory role in intestinal microbial disorders caused by enriched pathogens and opportunistic pathogens during the acute phase. Among them， significantly changed microorganisms include Morgentia， Escherichia Shigella， Adlercreutzia， and Androbacter. Bioinformatics analysis found that these bacteria may be related to the regulation of inflammation in the brain. Compared with the blank group， the detection of inflammatory factors in the serum of IS model rats showed an increase in inflammatory factors IL-6 and IL-17A （P<0.01） and a decrease in the content of anti-inflammatory factor IL-10 （P<0.01）. Compared with the model group， the content of inflammatory factors IL-6 and IL-17A in the serum of the treatment group decreased （P<0.05）， and that of anti-inflammatory factor IL-10 increased （P<0.01）. The expression results of barrier proteins ZO-1 and Occludin in brain and intestinal tissue showed that the expression levels of both decreased in IS model rats （P<0.05）， while the expression levels of both increased in the treatment group （P<0.05）. ConclusionAcute cerebral ischemia can lead to an imbalance of intestinal microbiota and damage to the intestinal barrier， and it can increase intestinal permeability. YQ can regulate intestinal microbiota imbalance caused by ischemia， inhibit systemic inflammatory response， and improve the disruption of the gut-blood brain barrier， preventing secondary cascade damage to brain tissue caused by inflammation. The MGBA may be an important mechanism against the IS.