OBJECTIVE:To provide reference for enhancing and standardizing the storage,dispensing and clinical use of the photophobic drug. METHODS:The management system and directory of photophobic drugs were set up in our hospital,and photo-phobic drug were classified into drugs used away from light strictly and drugs used away from light appropriately. Special training for nursing staff and monthly inspection of photophobic drug storage and use by inspection group could help finding problems and doing timely rectification. The number of wards where the problems of clinical photophobic drug use were found were compared be-fore and after management. RESULTS & CONCLUSIONS:After 3-quarter management,the quantity of wards with problems de-creased from 69 to 2,decreasing by 97.1%. The management reinforce of photophobic drug can effectively promote the manage-ment of drugs to be standard and scientific and improve the safety and effectiveness of photophobic drug use.

Objective To study the clinical meaning of Transgelin expression in heptacellular carcinoma(HCC) in prognosing recurrence after hepatectomy. Methods The expression of Transgelin in cancerous lesions and tissue adjacent to cancer lesions from 223 operation samples was detected by immunohistochemical staining combined with tissue microarray techniques. The correlation between the level of Transgelin expression and the prognosis was analyzed by means of log- rank test, Kaplan- Meier analysis and multivariate Cox regression analysis. Results Transgelin was higher expressed in tumor tissue than in tissue adjacent to cancer lesions. Transgelin was positively correlated with the presence of tumor size, portal vein invasion, pTNM tumor stages and serum AFP level. Patients with positive expression of Transgelin had worse tumor free survival than those with negative ones (P ＜0. 01). The multivariate Cox regression analysis showed that Transgelin expression level was one of the independent prognostic factors in tumor free survival after surgery. Conclusions The expression of Transgelin in hepatocellular carcinoma was significantly associated with recurrence in patients with HCC after hepatectomy, and this protein could be the biomarker of the prognosis in HCC surgery.

Objective To observe effects of ginsenoside Rb1 on phosphorylation of microtubule-associated protein 2 (pMAP-2) in hippocampus and amygdala of depressive model rats. Methods Thirty male Wistar rats were randomly divided into control group, model group and treatment group. The depression rat model was produced by giving chronic unpredicted mild stress (CUMS). Treatment group was given daily intragastric administration of ginsenoside RB 1 (1 g/mL crude drug, 1 mL/100 g body weight) for 22 days during modeling. Western blot assay was used to detect expressions of MAP-2 and pMAP-2 protein, and real-time PCR was used to detect expressions of pMAP-2 mRNA respectively. Results The expressions of pMAP-2 protein and mRNA in hippocampus and amygdala were significantly lower in model group than those of control group (P < 0.05). The expressions of pMAP-2 protein and mRNA were significantly higher in treatment group than those of model group (P<0.05). Conclusion Ginsenoside Rb1 can play anti-depression role by inhibiting the phosphorylation of MAP-2 in rats.

Objective To investigate the effect and significance of regulating endoplasmic reticulum stress on the expression of histone methyltransferases SET7/9 in the kidneys of db/db mice.Methods Db/db mice were randomly divided into two groups according to random number table method:diabetic nephropathy model group (DN group,n=18) and betaine treatment group (DN+B group,n =18),db/m mice were defined as normal control group (NC group,n =18).At the end of 4,8 and 12 weeks,the expression of GRP78,SET7/9,H3K4me2,and monocyte chemoattractant protein 1 (MCP-1) was determined by real-time fluorescence PCR and Western blotting.24-hour urinary protein excretion rate (UPER) and urine MCP-1 were measured by enzyme linked immunosorbent assay (ELISA).The dynamic changes of blood glucose(BG),serum creatinine (Scr),blood urea nitrogen (BUN) were tested by completely automatic biochemistry analyzer.The morphology of kidney was estimated by special staining of periodic acid-schiff (PAS).Results The levels of BG,BUN,UAER and MCP-1 were significantly higher in DN group than those in NC group (P ＜ 0.05),and were in time-dependent manner.Glomerular basement membrane thickening and mesangial cells proliferation began to emerge in DN group at the end of week 4 and mesangial matrix expansion was more obvious at the end of week 12.The mRNA and protein expression of GRP78 and SET7/9 were elevated significantly in DN group as compared to NC group.The H3K4me2 protein expression level was also increased in time-dependent manner.Compared with the DN group,in DN+B group glomerular lesions attenuated and the GRP78 and SET7/9 expression levels obviously decreased (P ＜ 0.05).Furthermore,the levels of BG,BUN,UPER,MCP-1,H3K4me2 in DN+B group were also reduced (P ＜ 0.05).Conclusion Endoplasmic reticulum stress may be the upstream mechanism of mediating the expression of SET7/9 in the kidneys of DN mice.

Objective To explore the diagnosis and treatment of upper limb trauma fracture complicated with deep vein thrombosis ( DVT) during preoperative period. Methods The data of 16 patients with upper limb trauma fractures complicated with DVT was analyzed retrospectively. The methods of diagnosis included color Doppler ultrasonography,multi slice CT angiography ( CTA) ,artery and vein visual-ization of upper limbs,and D-dimer detection. The treatment was majored in thrombolysis by urokinase and anticoagulation by low molecular heparin. Results There were 14 patients with increased levels of D-dimer,8 patients diagnosed by color Doppler ultrasonography,3 patients diagnosed by CTA and 5 by artery and vein visualization. The DVT of 5 patients before operation were disappeared after treatment and cured. Among the 10 patients received operation,8 cases were succeeded and 2 cases complicated with pulmonary embolism,and 1 case was died. Conclusion The color Doppler ultrasonography is the first priority for diagnosis of upper limb trauma fracture complicated with DVT. The patients should be discovered in time and arranged thrombolysis and anticoagulation in early time.

Objective To measure the bone mineral density in children with dual-energy X-ray absorptiometry and examine the relevance of bone mineral density with the risk of pediatric upper limb fracture.Methods A total of 864 children (8-14 years of age) admitted into our hospital in 2009 were involved in the study.The bone mass density (Z score) at the left radius was measured using dual-energy X-ray absorptiometry.Children were grouped according to their Z score and age to observe correlations of Z value and age with the incidence of fractures.Results Thirty-three children were lost to follow-up.For the other 831 children,the mean duration of follow-up was 2 years.Z sore was ≤-2 in 66 children and ＞-2 in 765 children.There was significant difference in fracture incidence between children with Z score of ≤-2 and ＞-2 (27.27％ vs 5.49％,P ＜0.01).Furthermore,fracture incidence in children at age group of 8-10 years and 11-14 years revealed significant difference (10.83％ vs 5.03％,P ＜ 0.01).Conclusions Bone mineral density is closely related to upper limb fracture in children and increases with aging.Early application of dual-energy X-ray absorptiometry to detect the bone density is an effective primary measure for prevention of fractures in children.

Objective To observe the effects of endoplasmic reticulum stress (ERS) on the activation of monocytes induced by high glucose and explore the underlying mechanism.Methods The monocyte cell line THP-1 was stimulated with high glucose,and then treated with molecular chaperone betaine.The levels of glucose regulation protein 78 (GRP78) and p-JNK,which were associated with ERS were detected by real-time PCR and Western blotting.The proliferation of the cell line was detected by MTT method.Transwell and immunofluorescence were applied to observe the chemotaxis and phenotype of cells respectively.Results The levels of GRP78 and p-JNK of THP-1 cells stimulated by high glucose were significantly increased compared with the normal control group (all P ＜ 0.05).The proliferation and chemotactic were also enhanced (all P ＜ 0.05).The number of cells in M1 phenotype was increased remarkably (P ＜ 0.05).All the indexes above could be rescued by betaine.Conclusion The activation of THP-1 cells can be induced by high glucose through ERS,while molecular chaperone betaine can reverse the activation.

Objective To investigate the correlation between plasma proteasome and endothelial dysfunction in patients with uremia. Methods Forty-five uremic patients who did not receive hemodialysis were defined as A group; seventy-five uremic patients who had received hemodialysis for 6 to 12 months were divided into sufficient hemodialysis group (44 cases,B group)and insufficient hemodialysis group (31 cases,C group).The primary disease of these patients was chronic glomerulonephritis.Fifteen healthy people were defined as healthy control group (D group).The diameter of radial artery lumen (DRL),intima-media thickness (IMT),intima-media area (IMA),endothelium-dependent or independent dilation (EDD or EID) of radial artery in right forearm were detected by diasonography.The levels of 20S proteasome,tumor necrosis factor α (TNF-α),C-reaction protein (CRP) and transforming growth factor β 1 (TGF-β1) of plasma and supernatant of cultured human umbilical veins endothelium (HUVEC) were determined by enzyme linked immunosorbent assay (ELISA).20S proteasome activity was analyzed by special substrate.Results Compared with D group,the level and activity of 20S proteasome,as well as TNF-α,CRP and TGF-β1 in A,B and C groups were significantly increased.Compared with A group,these plasma indices levels were significantly decreased in B group but strongly increased in C group.IMT and IMA were elevated,while DRL,EDD and EID were decreased significantly in A,B and C groups when compared with D group.These parameters were worse in C group than those in A and B groups.After co-culture of HUVEC with above mentioned human uremic serum,the level and activity of 20S proteasome and TNF-α were higher in A,B,C groups than that in D group.In A and C groups,there were negative correlations of EDD with the level or activity of 20S proteasome,TNF-α,CRP and TGF-β1,and there were positive correlations of 20S proteasome level or activity with TNF-α,CRP and TGF-β1. Conclusions 20S proteasome level and activity are significantly increased in uremic patients.There is a close correlation between 20S proteasome and endothelial dysfunction of radial artery.

Objective To investigate the clinical value of 123I-metaiodobenzylguanidine (MIBG) SPECT/CT imaging in the diagnosis and treatment of pediatric patients with neuroblastoma ( NB) . Methods A total of 196 NB patients (103 males, 93 females;age 1-14 years) who underwent 123I-MIBG SPECT/CT imaging in Beijing Friendship Hospital between February 2018 and December 2018 were reviewed retrospec-tively. All patients underwent whole-body planar imaging and local SPECT/CT imaging. According to the clinical data and 123 I-MIBG imaging results, patients were divided into 3 groups ( group 1: patients under-went preoperative planar imaging; group 2: patients with positive results in postoperative planar imaging;group 3:patients with negative results in postoperative planar imaging). The final diagnosis was made ac-cording to pathological results, other related imaging results and clinical follow-up results. The diagnostic consistency between planar imaging or SPECT/CT imaging and final diagnosis in each group was calculated and compared using χ2 test. Results For group 1 ( n=34) , the diagnostic consistencies of planar imaging and SPECT/CT imaging with the final diagnosis were 38.2％(13/34) and 82.4％(28/34) respectively (χ2=13.82, P<0.01), while those were 13.3％(12/90) and 74.4％(67/90) for group 2 (n=90;χ2=68.24, P<0. 01). In these two groups, SPECT/CT imaging improved the planar imaging results by 44.12％(15/34) and 61.11％(55/90) respectively. For group 3 (n=72), the diagnostic consistencies of planar imaging and SPECT/CT imaging with the final diagnosis were 88.9％(64/72) and 94.4％(68/72;χ2=1.45, P>0.05), and planar imaging results in only 5.56％(4/72) patients were improved by SPECT/CT imaging. Conclu-sions For patients undergoing preoperative imaging and those with positive results in postoperative planar imaging, SPECT/CT imaging should be added. For patients with negative results in postoperative planar im-aging, unnecessary SPECT/CT imaging should be limited.

Objective:To evaluate the efficacy of endoscopic stenting drainage for patients with malignant hilar biliary obstruction caused by unresectable hepatocellular carcinoma.Methods:Data of 106 patients with malignant hilar obstruction caused by unresectable hepatocellular carcinoma who received endoscopic stenting drainage in the Third Affiliated Hospital of Naval Medical University from January 2012 to January 2019 were retrospectively analyzed. According to the different stent types, they were divided into the metal stent group (30 cases) and the plastic stent group (76 cases). The observation indexes included clinical success rate, complication incidence, stent patency and overall survival time. The independent predictors for stent patency and overall survival of patients were analyzed by multivariate Cox regression model.Results:The overall clinical success rate was 67.9% (72/106) and the incidence of postoperative cholangitis was 29.2% (31/106). The clinical success rates were 93.3% (28/30) and 57.9% (44/76) ( χ2=12.40, P<0.001), and the incidences of postoperative cholangitis were 13.3% (4/30) and 35.5% (27/76) ( χ2=5.12, P=0.024) in the metal stent group and the plastic stent group, respectively. The median stent patency was 5.2 (95% CI:3.7-6.0) months, and the overall survival time was 3.0 (95% CI:2.5-3.7) months. Multivariate Cox regression analysis showed that hepatic drainage volume <30% was an independent predictor for stent patency ( HR=2.12, 95% CI:1.01-4.46, P=0.048). Bismuth type Ⅳ ( HR=2.06, 95% CI:1.12-3.77, P=0.020), Child-Pugh class C ( HR=4.09, 95% CI: 2.00-8.39, P<0.001) and plastic stent ( HR=1.87, 95% CI:1.21-2.90, P=0.005) were independent predictors for overall survival time. Conclusion:Hepatocellular carcinoma involving the hilar bile duct has a poor prognosis. Compared with plastic stents, metal stents show advantages in clinical success rate and incidence of postoperative cholangitis. Hepatic drainage volume <30% is an independent predictor for stent patency, and Bismuth type Ⅳ, Child-Pugh class C and plastic stent are independent predictors for overall survival time.