Objective:To provide the scientific reference basis in order to establish a perfect cost controlled system for medical consumable. To analyze game factors, such as main resource, the price-off influence and price-off aspiration and so on, from different views, such as medical institutions, patients, manufacturers and other stakeholders and so on, based on game theory and situation of medical consumables management.Methods: To collect the management information of medical consumables cost from a tertiary referral center hospital in Fujian in recent 3 years, and adopt descriptive study to analyze the income situation of medical consumable, medical consumable proportion and medical consumable cost per capita.Results: The medical consumable proportions from 2013-2015 were 14.44%, 16.27% and 18.75%, respectively. Medical consumable cost per patient from 2013-2015 were 3547.95RMB, 4122.3 RMB and 5059.02RMB, respectively. All of these datum contained the drug information.Conclusion: It is obvious that the medical consumable proportions and medical consumable cost per patient were enhancement from 2013 to 2015. The necessity of medical consumable leaded to the direct influence on medical cost. On the other hand, the artificially high price and unreasonable implement of medical consumable are the urgent problems and must be resolved as soon as possible.

Objective:To provide scientific references for establishing a whole informatization management system of reagent used in science and research of hospital based on the root cause analysis (RCA). And to find existed problems and analyze main reasons from reagent management, material, time, financial, personnel and other factors through fishbone chart, and to provide relative management measurement of informatization.Methods: The reagent consumptions used in science and research of a tertiary referral center hospital in Fujian province in 2015 year were collected, and then the purchase amount and ratio of them were analyzed.Results: The purchase amount of reagent for science and research of this tertiary referral center hospital in Fujian province was more than 2.55 million RMB in 2015 year, and the ratio of national clinical key special projects was 23.32% and that of provincial clinical key special projects was 6.85%. The two items spent more purchase amount, and the type and ratio of reagent of various department was different depended on their own various developed situation.Conclusion: The informatization management and service mode of reagent used in science and research have very important role in the construction of soft power of hospital. In present, a series of disadvantages existed in various clinical and research department, for example, the use of reagents are scatter, involved professional span is larger and disperse, and accurate trace, dynamic tracking and flexible deploy machines are difficultly achieved. Therefore, how to promote comprehensive informatization management for relative resource, for optimizing structure configuration, for controlling cost and ensuring quality of reagent has became the most important task for informatization management of reagent used in science and research.

Atropine ; therapeutic use ; Humans ; Organophosphate Poisoning ; Poisoning ; drug therapy ; Quinuclidines ; therapeutic use

Objective To observe the effects and mechanism of pretreatment in rats with prostaglandin E1 on liver after hemorrhagic shock and resuscitation(HSR).Method In total,32 male SD rats were randomly(random number)divided into four groups(n=8):group A(sham group),group B(shock group),group C(HSR group)and group D(Lipo-PGEl+HSR).In group B,rats were sacrificed 90 min after shock,and in group C,rats were anesthetized and then subjected to hemorrhagic shock followed by resuscitation.In group D,rats were pretreated with Lipo-PGEI one hour before HSR.Liver function,NO and ET.1 were measured,and pathological changes of liver tissue in each group were observed,and the expres8ions of iNOS and ET.1 of liver tissue were measured by using immunohistochemistry 6 hours after HSR.Data were analyzed by analysis of variance,and P<0.05 was considered as significantly different in statitistics.Results The levels of liver iNOS and ET-I increased in HSR group compared with shock group [(O.225±0.080)vs.(0.082±0.021)and(0.292±0.047)vs.(0.082±0.035),P<0.05].Pretreatment with Lipo-PGEl markedly reduced the damage of Liver function,and lowered the levels of NO and ET-I.which were consistent with decrease in iNOS and ET-16 hours after HSR[(0.116±0.034)vs.(0.225±0.080)and(0.198±0.041)vs.(0.292±0.047),P<0.05].Conclusions Pretreatment with Lipo-PGEl could reduce liver injury after HSR.The mechanisms might be attributed to inhibiting iNOS and ET-1,regulating the balance of NO/ET-I.

Objective To improve the accuracy of X-ray diagnosis of the deltoid ligament injury by evaluating the influence of plantar flexion on the diagnosis.Methods Twenty-four patients with ankle supination-extemal rotation fracture which was distal fibula fracture but no medial malleolus fracture were treated from February 2010 to December 2010.All the patients were taken Mortise radiograph with the ankle in four positions of plantar flexion(0°,15°,30° and 45°)applied with rotational stress and the deltoid ligament injury was identified with MRI.The medical clear space(MCS)and the superior clear space(SCS)on each radiograph were measured.The results were tested by a one-way analysis of variance model(ANOVA),based on the following criteria:(1)the MCS≥ 4 mm and MCS ＞ SCS,or when MCS≥5 mm and MCS ＞SCS.The MRI examination was taken as the gold standard to compare the influence of X-ray diagnosis of the deltoid ligament injury with different plantar flexions and different standards.Results The average MCS in four positions of plantar flexion(0°,15°,30°,and 45 °)with rotational stress were(4.10 ±0.79)mm,(4.55 ±0.72)mm,(4.99 ±0.56)mm and(5.71 ±0.86)ram,with statistical difference(P ＜0.05).The average SCS in four positions of plantar flexion(0°,15°,30°,and 45°)were(3.56 ±0.41)mm,(3.50 ±0.43)mm,(3.71 +0.44)mm and(3.93 ±0.51)mm,with no statistical difference in the four groups(P ＞0.05).With the MSC≥4 mm and MSC ＞ SCS as the diagnostic criteria,the prevalence of false-positive findings of deltoid injury based on the ratio with the four positions of plantar flexion(0°,15°,30° and 45°)were 50.0％,66.7％,88.9％ and 94.4％ respectively.With the MSC≥5 mm and MSC ＞SCS as the diagnostic criteria,the prevalence of false-positive findings of deltoid injury based on the ratio with the four positions of plantar flexion(0°,15°,30° and 45°)were 5.6％,11.1％,38.9％ and 77.8％ respectively.Condusions Different plantar flexion angle is an important factor for X-ray diagnosis of deltoid ligament injury of the ankle joint.The prevalence of false-positive findings of deltoid injury increases with the increase of plantar flexion.

Objective To investigate the effect on electrical restitution of β1-adrenergic receptor antagonist esmolol administered during cardiopulmonary resuscitation in the porcine ventricular fibrillation model. Method Ventricular fibrillation untreated for four minutes was induced by dynamic steady state pacing protocol in 40 healthy male pigs, in which local unipolar electrograms were recorded using one 10-electrode catheter that was sutured to the left ventrieular epicarditan. During CPR, animals were randomized into two groups to receive saline as placebo or esmolol after two standards doses of epinephrine. At postresuscitation 2-hour, six pigs were randomly selected from each group and the second VF induction was performed. Local activation-recovery intervals (ARI) restitutions and the VF inducibility between control group and esmolol group were compared. Western blotting was performed to determine cardiac ryanodine receptor (RyR2) protein expression, and their phosphorylation status. Results No sig-nificant differences were observed at the restoration of spontaneous circulation between two groups. Higher postre-suseitation 2-hour survival rate was observed in the esmolol group. Esmolol significantly flattened ARI restitution slope, lessened regional difference of ARI restitution, decreased the VF inducibility, and alleviated RyR2 hyper-phosphorylation. Conclusions Esmolol given during CPR significantly improved postresuscitation 2-hour survival rate. Its effects on modulating electrical restitution property and intracellular calcium handling make up the most important reasons why β1-blockade significantly reduced the onset and maintenance of VF.

AIM:To optimize formulation of Xiao'er Magan Orally Disintegrating Tablet by central composite design-response surface methodology. METHODS:By two factors and five levels central composite design,independent variables were the proportion of optimized microcrystalline cellulose 50 and mannitol and the pressure,while disintegrating time and tensile strength were dependent variables. Binary linear and quadratic models were used to estimate the relationship between the dependent and the indepedent variables,and to delineate response surface method and overlay contour plots in order to select the optimal formulations. RESULTS:The binomial regression equation were TS =0. 096 88X1 + 0. 027 6X1X2(r = 0. 759),DT = 9. 845 4X1 -63. 196X2 + 40. 092 9X22 (r = 0. 838) which indicated the quantitative relationship between the factors and the evaluation indexes was characterized. The optimal formulation were the ratio of microcrystalline cellulose 50 and mannitol in the range of 0. 35 and 0. 6,and the pressure was in the range of 6 and 8 KN. CONCLUSION:The optimized formulation validation is close to the estimated value,indicating that the method has a good predictability and reliability.

Objective To systematically assess the diagnostic value of gene detection for spontaneous bacterial peritonitis (SBP) .Methods A literature search was performed in the database of PubMed ,Web of Science ,Cochrane Library and China National Knowledge Internet (CNKI) from databases establishing to March 2015 .Relevant studies on diagnostic value of gene detection for SBP were retrieved .Quality assessment of diagnostic accuracy studies (QUADAS ) was applied for the included studies .Meta-analysis was conducted using bivariate random effects model .Summary receiver operator characteristic curves (SROC) was conducted to calculate area under curve (AUC) and was compared using Z test .Results Five studies with 423 specimen involved were included in the meta-analysis .The pooled sensitivity ,specificity ,diagnostic odds ratio (DOR) ,positive likelihood ratio and negative likelihood ratio of gene detection for the diagnosis of SBP were 0 .56 (95% CI:0 .49 -0 .62) ,0 .88 (95% CI:0 .83 -0 .92 ) ,9 .94 (95% C I:1 .76-56 .27 ) ,4 .35 (95% C I:1 .05 -18 .10 ) and 0 .47 (95% C I:0 .25 -0 .88 ) , respectively .The pooled sensitivity was significantly higher than that of bacterial culture (0 .25[95% CI:0 .19-0 .31]) .The AUC of SROC of gene detection was 0 .810 9 ,which was significantly higher than that of bacterial culture (AUC=0 .659 8 ,Z=3 .14 ,P<0 .01) .Subgroup analysis was conducted in patients with polymorphonuclear neutrophils (PMN)≥250 × 106/L in ascites .All the diagnostic indices of gene detection were inferior to those of bacterial culture for SBP ,except for the sensitivity of gene detection for SBP (0 .64[95% CI:0 .53 -0 .74] vs 0 .39[95% CI:0 .29 -0 .51]) .The diagnostic value of quantitative polymerase chain reaction (qPCR) detection for SBP was inferior to that of bacterial culture in all the aspects except for the sensitivity (0 .54 [95% CI:0 .47 -0 .61 ] vs 0 .25 [95% CI:0 .19 -0 .31 ]) . Conclusions Gene detection shows higher sensitivity than bacterial culture .The diagnostic value of gene detection is influenced by diagnostic standards .qPCR also shows high sensitivity for SBP diagnosis ,while the diagnostic value was inferior to bacterial culture .More researches with high quality are required to validate the results of this study .

BACKGROUND:Under certain conditions, bone marrow mesenchymal stem cels can be differentiated into hepatocytes, which are an important source of liver cels. Moreover, multiple factors can be involved in this induced differentiation process. OBJECTIVE:To investigate the inducible effect of cholestatic serum on the differentiation of bone marrow mesenchymal stem cels into hepatocytes. METHODS:Cholestatic animal model was prepared in rats to extract cholestatic serum. Bone marrow mesenchymal stem cels isolated from rats were divided into three groups and cultured in serum-free hepatocyte medium, serum-free hepatocyte medium plus cholestatic serum, serum-free hepatocyte medium plus normal serum, respectively. RESULTS AND CONCLUSION:The positive expression of alpha fetoprotein and keratin 18 and mass concentration of albumin were significantly higher in the serum-free hepatocyte medium plus cholestatic serum group than the other two groups (P < 0.05). These findings indicate that cholestatic serum has a certain inducible role in the differentiation of bone marrow mesenchymal stem cels into hepatocytes.