OBJECTIVE:To construct the evaluation index system for the effects of rational drug use policy in the military hos-pital. METHODS:Based on methods like literature analysis,expert consultation,modified Delphi method,analytic hierarchy pro-cess(AHP),the evaluation index system was constructed and the weight of indicators was calculated. The feasibility of the index system was verified by experimental evaluation. Through comparing drug use level between military patients and local insurance for medical care,the effects of rational drug use policy were evaluated in military hospital. RESULTS & CONCLUSIONS:The index system includes 3 first-level indexes as rationality,accessibility,economics,10 second-level indexes and 20 third-level indexes. The results of the experimental evaluation in 176 military hospitals show that the economic indexes scoring rate is lower than the reasonable indexes and the availability indexes,and the difference value are 3.12%and 4.06%;the first-level indexes average scor-ing rate of divisional hospital is higher than that of regimental hospital,and the difference value is 21.6%. The index system solves the problems of false data,incomplete evaluation,inadequate check,improves informatization level of evaluation,and realizes long-term dynamic monitoring and remote evaluation.

Objective To explore the anti-tumor effect of 17XL strains of Plasmodium yoelii(P.y)infection on melanoma in mice. Methods B16F10 tumor cells were axillarilly injected into the right flank of 20 C57BL/6 mice to establish tumor-bearing mouse models. The next day,the mice were randomly divided into a P.y infection group and control group,10 mice each group. Each mouse of the P.y infection group was intraperitoneally injected with 1×106 red blood cells including 20% P.y infection red blood cells,and each one of the control group were intraperitoneally injected with 1×106 normal red blood cells of C57BL/6 mice. The time of tumor formation of the mice in the two groups was observed and the tumor volumes were measured. Results The time of tumor formation in the P.y infection group[(11.30 ± 0.21)d]was significantly later than that in the control group [(10.40 ± 0.22)d](P < 0.05). From the tumors could be accurately measured to the study end point,both the tumors of mice in the two groups were growing,and the tumor volumes of mice in the P.y infection group were significantly less than those in the control group at each time point(all P < 0.05). The growth rate of tumors in the P.y infection group[(71.10 ± 6.29)mm3/d]was significantly slower than that in the control group[(302.80 ± 49.94)mm3/d](P < 0.05),and the growth rates of tumors every day in the P.y infection group were significantly slower than those in the control group(all P < 0.05). Conclusion The P.y in-fection can delay the occurrence of tumor and inhibit the growth of melanoma.

Objective To summarize experience in the treatment of chronic refractory empyema with autologous myocutaneous flap implantation.Methods From January 2004 to December 2017,26 patients had been treated with autologous myocutaneous flap implantation in Shanghai Pulmonary Hospital for chronic refractory empyema.Among them,24 were men and 2 were women.The mediam age was 50.1 years(14-74 years).21 of them had medical histories of lung resection because of basic diseases(most of which accepted surgeries in other hospitals).Complications appeared after surgeries.15 of them had bronchopleural fistula while windowing,which could not be cured by conservative treatments such as drainage.Then we performed open-window thoracostomy and long-time dressing.6 of 21 had experienced pneumonectomy.Other 5 patients did not have primary operational histories.They experienced dressing by windowing because of chronic refractory empyema after the in effective conservative treatments like drainage without pulmonary re-expansion.Results No respiratory complications occurred in these patients.The catheters were successfully removed within 5 days and the patients were discharged within 3-6 weeks after the operations.The median follow-up period was 9 months.24 cases were successful with no recurrence of empyema or flap necrosis,the other 2 cases underwent recurrence of empyema.Conclusion The application of autologous myocutaneous flaps for the treatment of chronic refractory empyema is an effective and continuously improving method.

OBJECTIVE: The purpose of this study was to investigate whether three-dimensional (3D) magnetic resonance imaging could improve diagnostic accuracy for suspected posterior ligamentous complex (PLC) disruption. MATERIALS AND METHODS: We used 20 freshly harvested goat spine samples with 60 segments and intact surrounding soft tissue. The animals were aged 1–1.5 years and consisted of 8 males and 12 females, which were sexually mature but had not reached adult weights. We created a paraspinal contusion model by percutaneously injecting 10 mL saline into each side of the interspinous ligament (ISL). All segments underwent T2-weighted sagittal and coronal short inversion time inversion recovery (STIR) scans as well as coronal and sagittal 3D proton density-weighted spectrally selective inversion recovery (3D-PDW-SPIR) scans acquired at 1.5T. Following scanning, some ISLs were cut and then the segments were re-scanned using the same magnetic resonance (MR) techniques. Two radiologists independently assessed the MR images, and the reliability of ISL tear interpretation was assessed using the kappa coefficient. The chi-square test was used to compare the diagnostic accuracy of images obtained using the different MR techniques. RESULTS: The interobserver reliability for detecting ISL disruption was high for all imaging techniques (0.776–0.949). The sensitivity, specificity, and diagnostic accuracy of the coronal 3D-PDW-SPIR technique for detecting ISL tears were 100, 96.9, and 97.9%, respectively, which were significantly higher than those of the sagittal STIR (p = 0.000), coronal STIR (p = 0.000), and sagittal 3D-PDW-SPIR (p = 0.001) techniques. CONCLUSION: Compared to other MR methods, coronal 3D-PDW-SPIR provides a more accurate diagnosis of ISL disruption. Adding coronal 3D-PDW-SPIR to a routine MR protocol may help to identify PLC disruptions in cases with nearby contusion.
Adult ; Animals ; Contusions ; Diagnosis ; Female ; Goats ; Humans ; Ligaments ; Magnetic Resonance Imaging ; Male ; Models, Animal ; Protons ; Sensitivity and Specificity ; Spine ; Tears ; Weights and Measures

Objective:To investigate the expression level of bone marrow stromal antigen 2 (BST2) in patients with glioblastoma (GBM) gene and its correlation with DNA methylation level and prognosis.Methods:The datasets of GBM samples from the Cancer Genome Atlas (TCGA) database (35 cases), GSE22891 cohort (50 cases) within Gene Expression Omnibus (GEO) database, and China Glioma Genome Atlas (CGGA) database (105 cases), and non-tumor brains (NTB) (10 cases in TCGA database, 6 cases in GSE22891 cohort, 5 cases in CGGA database were used to make comparisons of gene expression level; 25 cases in GSE63347 cohort, 4 cases in GSE22891 cohort, 8 cases in CGGA database were used to make comparisons of methylation data). Based on gene expression chip and DNA methylation microarray data from public GBM databases, the expression level of BST2 gene in GBM and the association with non-CpG island DNA methylation, GBM molecular subtypes [CpG island methylation phenotype (G-CIMP) and non-G-CIMP proneural, neural, classical, mesenchymal], overall survival (OS) time and functional gene expression profiles were obtained by using intra-group comparison of BST2 gene expression level between GBM and NTB, survival analysis, and bioinformatic analysis.Results:Compared with NTB samples, BST2 mRNA was highly expressed in GBM (mRNA expression data were based on Z-score standardization) (TCGA database vs. GSE63347 cohort: -0.97±1.14 vs. -2.32±0.21, t = 3.74, P < 0.05; GSE22891 cohort: 9.03±1.28 vs. 7.18±0.22, t = 3.42, P < 0.05; CGGA database: -0.43±1.11 vs. -0.62±0.35, t = 2.09, P < 0.05). In TCGA database, BST2 mRNA was highly expressed in different tumor molecular subgroups (G-CIMP: -1.96±0.94; non-G-CIMP proneural: -1.74±0.88; neural: -0.83±0.98; classical: 0.71±1.18; mesenchymal: -0.55±1.01), which were compared with NTB samples (-2.32±0.21), and the differences were statistically significant (all P < 0.05). There were no statistically significant differences in the expressions of BST2 mRNA in the neural, classical, mesenchymal tumors (all P > 0.05), but the expression of BST2 mRNA in above three groups was higher than that in G-CIMP group and non-G-CIMP proneural group (all P < 0.05). Correlation analysis showed that non-CpG island DNA methylation level of BST2 was negatively correlated with the expression of its mRNA (TCGA database: r = -0.30, P < 0.05; GSE22891 cohort: r = -0.54, P < 0.05; CGGA database: r = -0.29, P > 0.05). Survival analysis showed that BST2 mRNA expression level of non-G-CIMP and non-proneural patients was negatively associated with OS ( HR = 1.18, 95% CI 1.00-1.39, P < 0.05); among those tumors with G-CIMP or proneural subtypes, BST2 mRNA expression was not associated with OS ( HR = 1.08, 95% CI 0.84-1.40, P > 0.05). Bioinformatic analysis showed that among non-G-CIMP and non-proneural samples of TCGA database, GBM samples with higher BST2 expression were enriched with functional gene sets related to negative regulation of immune responses and activation of nuclear factor κB (NF-κB) pathway. Conclusions:The upregulated expression of BST2 gene in GBM may be associated with non-CpG island DNA hypomethylation alteration. BST2 gene may become a potential prognostic biomarker for non-G-CIMP and non-proneural GBM.