Irrational use of medicine has some reasons subjectively and objectively.Under a system of new framework,the key link of achieving rational medical use is that how to strengthen the effeetive regulation.Construeting a scientific surveillance system.innovating monitoring system,intelligent using of modern management techniques,controlling the entire process of the implementation of medicine,to promotion the rational use of medicineprovides a strong institutional guarantee and technical support.

Objective To investigate the clinical value of knee joint infection indexes of white blood cell (WBC),C reactive protein (CRP),erythrocyte sedimentation rate (ESR) and procalcitonin (PCT),interleukin-6 (IL-6) and absolute value of neutrophil (GR).Methods One hundred and twelve cases of preoperative knee joint infection in our hospital from June 2010 to March 2015 were selected as the research group and contemporaneous 112 cases of no preoperative and postoperative knee joint infection were selected as the control group.The venous blood was collected for observing the changes of the above indexes before operation and at postoperative 1,3,5,7,14 d.Results The levels of WBC,CRP,ESR,PCT,IL-6 and GR before operation and at postoperative 1d in the study group were significantly higher than those in the control group (P<0.05);the levels of WBC,CRP,PCT and IL-6 at postoperative 3 d in the study group were significantly higher than those in the control group (P<0.05);the levels of WBC,CRP,ESR and IL-6 at postoperative 5 d in the study group were significantly higher than those in the control group (P<0.05);the difference at the other time points between the two groups was not statistically significant (P>0.05);in the Logistic regression analysis,the six indicators of WBC,CRP,ESR,PCT,IL-6 and GR6 all could predict knee joint infection (P=0.005,0.004,0.000,0.002,0.003,0.007).Conclusion WBC,CRP,ESR,PCT,IL-6 and GR have certain value for early diagnosis and prevention of infection,and further study on expanded sample size cn carry on.

Objective To investigate the prevention effect of Ezetimibe with loaded dose on hematologic parameters and re-infarction in patients undergoing PCI.Methods 240 cases of patients with non ST segment elevation myocardial infarction performed PCI from October 2012 to October 2014 were selected and randomly divided into two groups,the control group received conventional dose Ezetimibe 10 mg every time,qd,the study group received loading dose ezetimibe 20 mg every time, qd, both two groups treatment 30 days.The inflammatory factors, myocardial injury and vascular endothelial function were compared before, 24 h and 30 d after the operation, and patients were followed up for two years,record adverse reactions. Results Compared with before treatment,levels of serum inflammatory factor,myocardial injury and vascular endothelial function index in different time points had differences by single factor analysis of variance(P<0.05),and compared with the control group, levels of serum hs-CRP,TNF-α,IFN-γand IL-6 in the study group were lower, levels of serum CK-MB,cTnI and BNP were lower,the contents of ET in serum were lower,and the contents of NO were higher(P<0.05).The improvement degree in the study group of myocardial microcirculation perfusion after treatment was higher(P<0.05).No case shedding phenomenon occurred during the two year follow-up, and there was no statistical significance in the incidence of cardiovascular events between two groups.Conclusion Loading dose of ezetimibe can protect myocardium,and it can inhibit the inflammatory reaction and vascular endothelial injury caused by operation,it also can improve myocardial microcirculation.

Objective To assess the efficacy of radiofrequency catheter ablation ( RFCA) in premature ven-tricular contractions ( PVCs) by electrophysiological mapping.Methods 60 patients with symptomatic PVCs original from the right ventricular outflow tract underwent RFCA guided by pace mapping and activation mapping,ablation was performed by a catheter with temperature control.The patients were divided into 3 groups,20 cases in each group.The first group ( the combination group ) was the combination with pacing mapping and activation mapping underwent RFCA.The second group ( the activation mapping group) was guided by activation mapping underwent RFCA.The third group( the pacing mapping group) was guided by pacing mapping underwent RFCA.Successful ablation immedi-ate end was that PVCs disappeared and could not be induced by isoproterenol.The success rate,time and composition ratio of the three groups were observed.Results The immediate success rate of ablation of either the combination group or the activation mapping group was higher than that of the pacing mapping group.But the ablation time of the combination group was the shortest.There was no statistical difference between the baseline results of each test group. The cardiac arrhythmia originated from the septum was usual (45/60,75.0%),and the arrhythmia originated from the free wall (15/60,25.0%) was less.The success rate of PVCs ablation of right ventricle was high,and the total success rate was 91.7%(55/60).There was no significant difference in the success rate of the combined mapping and the activation mapping (χ2 =0.084,P>0.05),but were significantly higher than those in the pacing mapping group (χ2 =0.032,0.047,all P<0.05).The ablation time of the pacing mapping group and the combination group were significantly lower than that of the activation mapping group(all P<0.05).Conclusion The effect of the com-bination with pacing mapping and activation mapping is the best.Pacing mapping is better than activation mapping during RFCA of PVCs.

Objective To study the feasibility of composite of human fibrinous gel and transgeneic MSCs aiming at replicating adenoviruses-bone morphogenetic proteins-2 (Ad-BMP-2) in repair of segmental bone defects. Methods Bone defects for 10 mm were created on the bilateral radius of 14 Japanese big ear rabbits and treated with four kinds of implantations (seven radii per group), ie, composite of transgeneic MSCs and fibrinous gel (Group A), composite of MSCs and fibrinous gel (Group B),fibrinous gel alone (Group C) and nothing as control group. The defects were observed radiologically and histologically and examined by biomechanical test at the 12th week after operation. Results The defects treated in the Group A were repaired and regenerated much more new bone, bridged earlier and stronger than those in the Group B 12 weeks after operation. The defects treated in the Groups C and D could not attain osseous tissue healing. Conclusions The composite of transgeneic MSCs and fibrinous gel can be used to effectively repair segmental bone defects.

Autophagy is a cellular catabolic pathway that is essential for survival,differentiation,development and homeostasis.The dual roles of autophagy as a tumor-promoting mechanism and a tumor suppressor mechanism have been elucidated in the recent cancer research.The double function is accomplished by some neoplasms-associated signaling pathways which include mTOR-dependent signaling pathway,Beclin1 network,LKB1-AMPK signaling pathway,p53 and p53-related regulators of autophagy.Thus it can be seen that these signaling pathways function dependently and correlatively as inducing and inhibiting autophagy and play different roles in the process that involves growth and development of neoplasms.

0 05) Conclusion There is significant increase in the levels of serum myocardial enzyme and CSF LDH of adult patients with acute intracranial infection The levels of serum myocardial enzyme and CSF LDH is helpful to the diagnosis and the differential diagnosis of intracranial infection in early stage

The situation of the ongoing fifth epidemic (beginning October,2016) of human infection with avian influenza A (H7N9) virus are more serious than the first four ones.As of March 8,2017,the fifth epidemic reported 40.00％ of the cumulative cases.Recently,the pathogenic study reported two new human infections in Guangdong with an influenza A(H7N9)virus strain for which gene sequencing analysis revealed mutations in the haemagglutinin (HA) gene that resulted in the insertion of basic amino acids at the cleavage site of this protein,known to confer increased pathogenicity in chickens.However,most strains show no obvious difference in pathogenic characteristics compared with those detected during the first four waves.Although epidemiological studies showed that 3 clusters with limited human-to-human transmission have been investigated during the current wave,there are no indications of sustained person-to-person spread.Based on epidemic analysis and risk assessment results,it's likely that human infections with H7N9 virus will continue to occur in China,but epidemiological and pathogenic analysis suggested that it's unlikely to have a continued transmission of this virus.Profound public health significance would be presented by strengthening etiology and epidemiology studies of avian influenza A(H7N9) virus.

Aim To investigate the influence of Ramu-lus mori polysaccharides ( RMP) on blood glucose and anti-oxidative effect in streptozotocin ( STZ )-induced diabetic mice .Methods Diabetic mice were induced by intraperitoneal injection with 120 mg? kg -1 STZ and were randomly divided into the following 5 groups with 20 animals per group: model group , valsartan group ( 20 mg? kg -1 ) , low-, medium-, high-dose (0.3,0.6,1.2 g? kg -1 ) of RMP groups.Other 20 normal mice were treated as normal control group .The mice were administered orally for 90 d.On 45 d of ad-ministration , the 24 h urine was collected through met-abolic cages for urine protein detection .Pathological changes of kidney tissues were observed through HE staining .The serum levels of urea nitrogen ( BUN) and creatinine ( Cr ) were detected by automatic biochemical analyzer; and the manganese superoxide dismutase (Mn-SOD), catalase(CAT), malonaldehyde(MDA) and mitochondrial respiratory chain complex Ⅰ,Ⅲac-tivity of kidney tissues were also determined .ELISA method was used to detect ROS content in renal cortex . The SIRT1 , FOXO1 and NF-κB protein expressions were analyzed by Western blot .Results Compared with model group, the FBG, microalbuminuria, BUN and Cr were decreased by RMP medication ( P <0.05).The activities of Mn-SOD, CAT and mitochon-drial respiratory chain complex Ⅰ,Ⅲ in RMP groups were enhanced , while MDA and ROS levels were re-duced. Moreover, the expressions of SIRT1 and FOXO1 were up-regulated by RMP , the expression of NF-κB was down-regulated ( P<0.05) .Conclusion RMP exerts renal protective effect through up-regula-ting the expressions of SIRT1 and FOXO1 in renal cor-tex , which may relate to the improvement of anti-oxida-tive capability .