Traditional Chinese medicine emphasizes the overall state of health, pays attention to individual health condition, highlights maintaining health rather than diseases, shows the clinical effectiveness with flexible treatment. It is the unique resource of health service in our country. Currently, the qualification and certification of traditional Chinese medicinewere only applied in medical practitioners of traditional Chinese medicine and Gua sha.This led to the status quo of vacuum to the traditional Chinese medicine in the fields of access system and standardization. Thus, it is urgent to unify and standardize the access and qualification traditional Chinese medicine, in order to TCM inheritance and development. The establishment of the system should be based on clinical effect and difference among the clinical application. The system can be divided into easy, middle and senior level TCM therapist. TCM therapist with different levels can apply the qualification and certification based on their own levels.

OBJECTIVE: To probe into the regularity of drug consumption and to provide evidence for drug price control.METHODS: The actual purchase price,selling price,consumption sum and consumption quantity of all the drugs used in our hospital from 2003 to 2007 were taken as primary data to analyze the variation of drug price and consumption sum as well as the effect of the factor of drug price variation on drug consumption.RESULTS: The price fluctuation has big impact on the drug consumption,especially on the application structure of drugs characterized by the disappearance of the low price drugs from the market and substituting them with the "new drugs" which were prepared by altering dosage form,specification,package or brand name.CONCLUSION: It is advisable to adopt comprehensive measures rather than simple price reduction policy to control the artificial high price of drugs.

BACKGROUND: Homocysteine(HCY) is emerging as an independent risk factor for atherosclerosis. Its damage to the structure and function of endothelial cell(EC) is seemingly an important mechanism that leads to atherosclerosis.OBJECTIVE: To investigate the effect of HCY on fibrinolysis in elderly patients with coronary heart disease(CHD).DESIGN: A case-controlled study based on CHD patients and normal people as control group.SETTING: Department of general internal medicine and department of cardiology in a university hospital.PARTICIPANTS: The study was completed in the Department of Gerontology Internal Medicine and Department of Cardiology, Beijing Chaoyang Hospital, Capital University of Medical Science. Altogether 177 inpatients and outpatients from this hospital during December 2001 to August 2003 were selected and divided into three groups according to the results of coronary angiography(CAG): CHD group( n = 91 ) with 50 males and 41 females with the mean age of(66 ± 6) years, negative CAG group( n = 86) with 43 males and 43 females with the mean age of(60 ± 6) years, and normal control group( n = 85) with 43 healthy males and 42 healthy females with the mean age of(55± 5) years.METHODS: Peripheral blood samples were collected. ELISA double antibody method was applied to test tissue-type plasminogen activator(t-PA), plasminogen activator inhibitor-1 (PAI-1) and yon Willebrand factor(vWF). HCY was assayed with EIA method and the ratio of PAI-1 to t-PA was calculated.MAIN OUTCOME MEASURES: HCY level, t-PA, PAI-1 and vWF activities, and the ratio of PAI-1 to t-PA.RESULTS: The levels of HCY, PAI-1, PAI-1/t-PA and vWF in CHD group were significantly higher than those in negative CAG group and normal control group( P ＜ 0.01 ); however, the level of t-PA was significantly lower than that in control group( P ＜ 0. 01) . HCY was positively correlated with PAI-1,PAI-1 / t-PA and vWF, while it was negatively correlated with t-PA.CONCLUSION: The increase of serum HCY is accompanied with fibrinolytic dysfunction. HCY is positively correlated with PAI-1 and vWF but negatively correlated with t-PA. Therefore, HCY is a predictor for early coronary lesions,and can provide related laboratory data for the primary prevention and early treatment of CHD.

Objective To study to the effect of 1064-nm Q-switched Nd:YAG laser irradiation on the melanogenesis in a human epidermal melanocyte line PIG. Methods Cultured PIG cells were irradiated with 1064-nm Q-switched Nd:YAG laser (Medlite C6) at different energy densities for 10 times. After additional culture for various durations, cell viability was detected by MT assay, tyrosinase activity by dopa oxidation assay, mRNA and protein expressions of tyrosinase, tyrosinase related protein (TRP)-1 and TRP-2 by real-time quantitative fluorescent RT-PCR and Westen blotting respectively, Results The irradiation with Q-switched Nd:YAG laser at energy densities from 1 to 3 J/cm2 had no obvious effect on the viability of PIG cells. After irradiation with Nd:YAG laser at 1 J/cm2, PIG cells showed a significant increase in the tyrosinase activity,mRNA expressions of tyrosinase and TRP-1 compared with unirradiated cells (0.563 ± 0.014 vs 0.501 ±0.019, 1.40±0.11 vs 1.0, 1.28 ± 0.03 vs 1.0, all P＜ 0.05), but both the mRNA (0.91 ± 0.17 vs 1.0, P＞0.05) and protein expressions of TRP-2 experienced no significant changes before and after the irradiation.However, a significant decrease was noted in PIG cells irradiated with Nd:YAG laser at 3 J/cm2 in tyrosinase activity, mRNA and protein expressions of tyrosinase (0.70 ± 0.02 vs 1.0, 0.64 ± 0.05 vs 1.0, both P ＜ 0.05),TRP-1 (0.73±0.04 vs l.0, 0.86±0.17 vs l.0, both P＜0.05) andTRP-2 (0.68±0.04 vs l.0,0.69±0.11vs 1.0, both P ＜0.05) in comparison with unirradiated PIG cells. Conclusions The 1064-nm Q-switched Nd:YAG laser irradiation may affect the melanogenesis in PIG cells. With no influence on cell viability, the 1064-nm Q-switched Nd:YAG laser at 1 J/cm2 could enhance melanogenesis, while that at 3 J/cm2 could suppress melanogenesis, in PIG cells.

BACKGROUND:Adipose-derived mesenchymal stem cells have the ability to self-renew and have pluripotent potential under specific conditions in vitro, which have broad application prospects in clinical practice. However, isolation and culture of adipose-derived mesenchymal stem cells stil appear to have many difficulties and shortcomings. OBJECTIVE:To isolate and culture rabbit adipose-derived mesenchymal stem cells in vitro in order to study their morphology, cellsurface markers and biological properties as wel as to investigate the osteogenic and adipogenic potentials of adipose-derived mesenchymal stem cells in vitro. METHODS:Primary adipose-derived mesenchymal stem cells were isolated from the subcutaneous adipose tissue of posterior cervical region from New Zealand white rabbits and digested by 0.1%col agenase I. The cells were passaged and amplified by the trypsin digestion. The passage 4 adipose-derived mesenchymal stem cells were induced to differentiate after exposure to adipogenic or osteogenic medium. The oil red O staining, alkaline phosphatase and alizarin red staining were used to detect the results. The cellviability was detected by the cellcounting kit 8 method to drawn the growth curve. cellsurface markers were examined using flow cytometry. RESULTS AND CONCLUSION:The adipose-derived mesenchymal stem cells isolated from the subcutaneous adipose tissue of rabbits exhibited a fusiform adherent growth in a vortex pattern, and had a strong capability of proliferation that could be passaged stably to the 10th generation. Flow cytometry results showed that the cells highly expressed CD29, CD90, CD44, but lowly expressed CD45 and CD34. After adipogenic induction, the adipose-derived mesenchymal stem cells were positive for oil red O staining;after osteogenic induction, the cells were both positive for alkaline phosphatase and alizarin red staining. These findings suggest that the adipose-derived mesenchymal stem cells were successful y isolated and cultured from the subcutaneous adipose tissue of rabbits, and these cells are pluripotent with the potential to differentiate into adipocytes and osteoblasts, which are expected to be ideal seed cells for bone tissue engineering.

ObjectiveTo explore the clinical effect of omeprazole combined with octreotide in treatment of patients with non-variceal upper gastrointestinal hemorrhage.Methods96 patients with non-variceal upper gastrointestinal hemorrhage were randomly divided into two groups.All the cases were received basic treatment of fluid infusion,transfusion and nutritional support.The control group( n =48) was treated with omeprazole alone,and the treatment group(n =48) was treated with omeprazole and octreotide.The course of treatment was 3 days.The vital signs,24h urine output,the number of cases of rebleeding in 72 h and adverse drug reactions was observed and recorded.ResultsThe total effective rate in treatment group and control group was 91.7％ and 72.9％,respectively.The difference between the two groups was statistically significant( x2 =5.79,P ＜0.05 ).The time of hemostasis and blood transfusion volume in treatment group were significantly less than those in control group(t =7.69,9.91,all P ＜0.05).The rebleeding rates after 72 hours of hemostasis between the two groups(8.3％ vs 25.0％ ) was significantly different ( x2 =4.80,P ＜ 0.05 ).In the course of treatment,the side effects weren' t found in both groups.ConclusionOmeprazole combined with octreotide was more effective and safe than omeprazole alone in fast stopping bleeding and reducing rebleeding rate.

Transplantation of engineering cartilage is a better choice for the treatment of articular cartilage lesions.Constructing engineering cartilage needs seeded cells and scaffold materials.The property of scaffold materials has a great influence on the biomechanical features of engineering cartilage.A variety of materials can be used for constructing engineering cartilaginous framework.Exploring the research development of scaffold materials and comparing the effects of their clinical applications is of great significance for further improvement of biomechanical characteristics of the engineering cartilage.

Objective To investigate DJ-1 expression and protective effect against H2O2-induced oxidative stress in primary human melanocytes.Methods The expression and location of DJ-1 in primary melanocytes were identified by immunofluorescence.After cultured melanocytes were exposed to H2O2 for 24 hours,modified MTT assay was used to assess the proliferation of cells and to choose the suitable concentration of H2O2 for the following experiment.Western blot was used to detect D J-1 expression in melanocytes after being treated with 0.5 mmol/L H2O2 for 24 hours.Some melanocytes were divided into 3 groups to be reversely transfected with PBS(mock control group),non-targeting siRNA(negative control group)and DJ-1 targeting siRNA(DJ-1 group).Optical microscopy was utilized to observe the morphologic changes of transfected melanocytes.At 48 hours after the transfection,the melanocytes were stimulated with H2O2 for 24 hours.Subsequently,modified MTT assay,2′,7′-dichlorofluorescein diacetate(DCFH-DA)and annexin Ⅴ-fluorescein isothiocyanate/propidium iodide were used to determine cell viability,intracellular reactive oxygen species (ROS)level and apoptosis rate respectively.Results DJ-1 was expressed in both melanocyte nucleus and cytoplasm,and predominantly in the nucleus.H2O2 inhibited the cell viability in a dose dependent manner.After treatment with H2O2 of 0.5 mmol/L for 24 hours,the cell viability began to decrease in melanocytes with the expression level of DJ-1 being 2.23 times that in the untreated melanocytes(both P ＜ 0.05).Compared with the mock control group,the dendrites of melanocytes in DJ-1 group were obviously shortened with cytoplasm vacuolization.After 24-hour treatment with H2O2 of 0.5 mmol/L,the cell viability in the DJ-1 group dropped to 35％ of that in the mock control group(P ＜ 0.05),while the intracellular ROS fluorescence intensity( FI) and apoptosis rate were higher in the DJ-1 group than in the mock control group (902 ± 40 vs.529± 32,58q％ ± 6.1％ vs.30% ± 3.8％,both P ＜ 0.05).Conclusion DJ-1 can protect melanocytes against H2O2induced oxidative stress likely by decreasing intracellular ROS production and inhibiting ceU apoptosis.

This paper aims to retrospectively analyze the nursing management of one-stop hybrid procedures and to sum up the clinical experience.The key point of successful implementation of nursing management of one-stop hybrid procedures lies in the layout of hybrid operation room,in the intraoperative nursing cooperation and the professional nursing personnel training,and in the establishment of a new talent training mode that contains flexible allocation mechanism of nursing human resources as well as short-term post rotation of professional nursing staff.The one-stop hybrid operation is a minimally-invasive procedure for the treatment of complex diseases.Scientific nursing management is the strong guarantee to ensure a successful “one-stop” hybrid operation.

Objective To investigate the effects of pulsed electromagnetic fields (PEMFs) of different intensities on bone metabolism in ovariectomized rata. Methods Sixty 10-month-old female Sprague-Dawley rats were randomly divided into a normal group, an ovariectomized control group, a 0. 14 mT group, a 0. 16 mT group, a 0.18 mT group and an estrogen group. All rats except those in the normal group were subjected to bilateral ovariectomy. Beginning one week after the operation, the rats in the 0. 14 mT, 0. 16 mT and 0.18 mT groups were treated with PEMFs at 50 Hz, 60 min daily for 90 days, while those in the estrogen group received estrogen instead. During the experiment, the bone mineral density (BMD) of the whole body was observed dynamically, and local BMDs and biochemical indexes were measured after 3 months of treatment. Results Alkaline phosphatase (ALP) activity in the normal group was significantly lower than in the other groups. Tartrate-resistant acidic phosphatase 5b (TRAP5b)activity was elevated significantly, in the control and 0.14 mT groups compared with the normal group. After 2 months of treatment, whole body BMD was reduced significantly in the 0.14 mT group compared to the normal group. After 3 months of treatment, whole body BMD in the ovariectomized controls and the 0.14 mT group was reduced significantly compared to the normal group, but significantly elevated in the 0. 16 mT, 0.18 mT and estrogen groups when compared to the ovariectomized control group. At the end of 3 months of treatment, the trends in lumbar vertebral BMD were similar to those of the whole body BMD, with the femoral BMD in the ovariectomized group and the 0.14 mT group significantly lower than in the normal group, though the differences among the other groups were not statistically significant. Conclusions PEMF treatment at 50 Hz and 0.16 mT or 0.18 mT can promote bone formation. PEMFs at 50 Hz and 0.14 mT might stimulate bone resorption. An intensity-window effect exists in the action of PEMFs on bone metabolism in ovariectomized rats.