As an important part of medical supplies, the logistics management of high-value medical consumables becomes a key link in modern hospital administration. Compare between the management of high-value medical consumables and modern supply chain management. Based on 4R theory, discusses and analyses the management of high-value medical consumables in Fuwai hospital. By means of 4R theory, modern supply chain management has been optimized for the actual consumable management. And found out a effective method to resolve bullwhip effect caused by the limitations of high-value medical consumables. This research demonstrate modern hospital want to win the competitive initiative only by the improvement of material flow management level.

Methylenetetrahydrofolate reductase (MTHFR) is an enzyme that plays a critical role in the folate and homocysteine metabolism.MTHFR mutation leads to decreased 5-methylenetetrahydrofolate synthesis.Consequently, it influences the conversion of homocysteine to methionine causing homocysteine accumulation.Homocysteine has been considered as an independent risk factor for a variety of diseases such as cardiovascular diseases , neurological and psychiatric disorders as well as cancers .The study on the correlation between methylenetetrahydrofolate reductase gene polymorphisms and diseases and the discovery of its clinical value is getting more and more attention.

Objective To assess the clinical efficacy of budesonide in combination with salbutamol sulfate and ambroxol through fog inhalation in the treatment of elderly patients older than 70 years with acute exacerbation chronic obstructive pneumonia disease (AECOPD). Methods A total of 58 elderly patients older than 70 years with AECOPD were randomly assigned to receive medication of budesonide in combination with salbutamol sulfate and ambroxol through fog inhalation in addition to conventional therapy ( n = 58 treatment group). In the control group,56 AECOPD patients received conventional therapy (including oxygen uptaking,anti-infection, medication, relieving asthma, eliminating sputum, nutritional support, et al). Results The overall effective rate in the treatment group was 76.79% (43/56) ,which was significantly lower than that in the control group 89. 66% (52/58) ( χ2 = 6. 46, P = 0. 007 ). Blood gas analysis ( pH, PaCO2, PaO2 ) and lung function ( FEV1/FVC, FEV1 occupy prospect% ) outcome were significantly improved after treatment (Ps ＜ 0.05 ). We found no significant difference in the comparison of the blood gas analysis improvement between the treatment and control ( Ps ＞ 0. 05 ), whereas significant difference was observed in the improvement on lung function between the two groups (P ＜ 0. 05 ). Conclusion Combined budesonide with salbutamol sulfate and ambroxol through fog inhalation in addition to conventional therapy has a significant better effect and less side effects on the treatment of AECOPD patients older than 70 years.

Malignant tumor is a serious threat to human health and its pathogenesis is complex , which caused by interaction of a variety of carcinogenic factors in the human body .SALL4 gene is a kind of newly dis-covered gene and it plays an important role in function of embryonic stem cell due to its protein transcription fac -tor with C2H2 zinc finger domain.Studies found that this gene mutation often results in occurrence of malignant tumor.This paper will summarize the molecular mechanism of SALL 4 in the occurrence and development of malig-nant tumor and its diagnosis and treatment on malignant tumor .

Objective: To optimize the formula and preparation process of metronidazole thermosensitive in situ gel.Methods: The temperature of gelation and 24-h cumulative release were used as the evaluation indices, and the orthogonal tests were carried out to investigate the amounts of poloxamer 407 (P407), poloxamer 188 (P188), sodium alginate and polyethylene glycol 4000 (PEG 4000) to screen the best formula of thermosensitive in situ gel.The in vitro release of metronidazole thermosensitive in situ gel was determined by HPLC and compared with that of commercially available gel.Results: The optimum formula of thermosensitive in situ gel was P407 of 20%, P188 of 18%, sodium alginate of 0.1% and PEG 4000 of 1.5%.The release rate of metronidazole thermosensitive in situ gel was high, and the temperature of gelation was suitable.Compared with that of the commercially available gel, the vaginal retention of the in situ gel was significantly improved.Conclusion: The formula of the in situ gel is reasonable and the preparation process is feasible.

BACKGROUND: It has been found that hypoxia inducible 1α (HIF1α) gene can improve the ability of tissues and cells to survive in the ischemic environment, which is of great significance in promoting blood vessel regeneration.OBJECTIVE: To investigate the effect of the recombinant adenovirus Ad-CMV-HIF1αmu-IRES-hrGFP-1 on the proliferation of bone marrow mesenchymal stem cells.METHODS: Passage 3 bone marrow mesenchymal stem cells were cultured and transfected with Ad-CMV-HIF1αmu-IRES-hrGFP-1 virus (experimental group), with non-mutated gene Ad-CMV-HIF1α-IRES-hrGFP (positive control group), with Ad-CMV-IRES-hrGFP-1 empty virus (negative control group), or with no virus solution (blank control group). After transfection for 24 hours, the expression of HIF1α mRNA and protein was detected. Cell proliferation was detected by MTT assay at 24, 48, 72, 96 and 120 hours after transfection.RESULTS AND CONCLUSION: (1) Except that the mRNA expression of HIF1α in the experimental group and the positive control group was significantly higher than that in the negative control group and the blank control group (P < 0.05), there was no significant difference between two groups. (2) The expression of HIF1α protein in the experimental group was significantly higher than that in the positive control group, the negative control group and the blank control group (P < 0.05), and there was no significant difference between the latter three groups. (3) Cell proliferation was faster in the experimental group than the positive control group and the blank control group (P < 0.05), and moreover, there was no significant difference between the latter two groups. Our experimental findings indicate that the recombinant adenovirus-mediated three-point mutant HIF1α combined with hrGFP gene transfected bone marrow mesenchymal stem cells could not only express the target protein, HIF1α, under normoxic conditions, but also promote the proliferation of bone marrow mesenchymal stem cells.

Objective To compare postoperative pulmonary infection in patients undergoing surgical operation at different surgical opportunities.Methods Patients who underwent surgical operation in a hospital from January to December 2014 were surveyed retrospectively,patients' data were reviewed,patients with postoperative pulmonary infection were compared.Results A total of 20 343 surgical patients were investigated,227(1.12％) had postoperative pulmonary infection.Postoperative pulmonary infection rate in patients undergoing emergency operation was higher than that of selective operation (5.13 ％ vs 0.70 ％,x2 =307.49,P＜0.001).Postoperative pulmonary infection rates in patients undergoing emergency neurosurgical,general surgical,and cardiothoracic surgical operation were all higher than selective operation (all P ＜ 0.001).Among patients with pulmonary infection following emergency operation,the proportion of those who aged ＜60 years,with preoperative irrational antimicrobial use,cardiovascular disease,hypertension,and tracheotomy were all higher than those who received selective operation (all P＜0.05);the proportion of patients with cancer is lower than that of elective surgery patients(P＜0.05).Conclusion Postoperative pulmonary infection rate in patients undergoing emergency operation is higher than selective operation,postoperative pulmonary infection rates in patients undergoing emergency neurosurgical,general surgical,and cardiothoracic surgical operation are high.Patients with cardiovascular disease and hypertension are the focus of protection;for elective surgery,cancer patients are the focus of protection.

Objective: To observe the clinical efficacy of acupuncture in treatment of chronic urticaria and the change in the content of serum immunoglobulin E (IgE), and to discuss the effect of acupuncture on the imbalance of T helper (Th)1/Th2 cell function via observing the changes in the contents of interferon-γ (IFN-γ) and interleukin-4 (IL-4). Methods: Ninety patients meeting the inclusion criteria of chronic urticaria were randomized into an acupuncture- medication group, an acupuncture group and a Western medication group by the random number table method. The acupuncture-medication group was intervened by acupuncture, cupping, collateral-pricking bloodletting and oral administration of cetirizine hydrochloride tablets; the acupuncture group was treated with acupuncture, cupping and collateral-pricking bloodletting; the Western medication group only received oral administration of cetirizine hydrochloride tablets. Before treatment and after 6-week treatment, the changes in the symptom scores and the contents of serum IgE, IFN-γ and IL-4 in the three groups were observed. Results: There were no significant differences in the total effective rate among the three groups (all P>0.05), but the cured and markedly effective rate was significantly higher in the acupuncture-medication group than that in the Western medication group (P<0.05). After treatment, the total symptom score decreased in the three groups (P<0.05), and the improvement of total symptom score in the acupuncture-medication group was more significant than that in the Western medication group (P<0.05). The component symptom scores all decreased after treatment in the three groups (all P<0.05); the improvements of the scores of itch intensity, and skin lesion size and number were more significant in the acupuncture-medication group than in the Western medication group (all P<0.05); the improvement of the skin lesion size score was more significant in the acupuncture group than in the Western medication group (P<0.01). The contents of IgE and IL-4 dropped (all P<0.05) and the content of IFN-γ increased (P<0.05) after treatment in the three groups; the post-treatment changes in the serum contents of IgE and IFN-γ were more significant in the acupuncture-medication group than in the Western medication group (both P<0.05). The incidence rate of adverse reactions was significantly lower in the acupuncture-medication group and acupuncture group than in the Western medication group (both P<0.05), and the relapse rate was significantly lower in the acupuncture-medication group than in the Western medication group (P<0.05). Conclusion: Combined acupuncture and medication can enhance the cured and markedly effective rate in treating chronic urticaria. Acupuncture is equivalent to cetirizine hydrochloride tablets comparing the clinical efficacy in treatment of chronic urticaria. Acupuncture plus medication and acupuncture alone both can effectively mitigate the clinical symptoms, with low incidence of adverse reactions. The relapse rate is low when using acupuncture together with medication. Acupuncture plus medication can work better in regulating the contents of IgE and IFN-γ and improving the imbalance of Th1/Th2 cell function.

Anorexia Nervosa(AN),one kind of eating disorder charactered by abnormal eating patterns,low body weight,and weight and shape concerns,is an intractable psychiatric illness which has the highest mortality rates.The etiology of AN is complex,and the neurobiology mechanisms of AN remain unclear.Much of the research provided indications that the pathogenesis of AN is associated with the oxytocin (OT) functions.Summarizing the recent advances on OT in AN,a systematic review of OT research was conducted that it pertains to regulation of feeding,social activity,emotion and bone metabolism in AN.OT probably play an important role in the development and progression of AN.OT system disorder may be an state indicator rather than a trait indicator of AN.Because of the variety physiological effects and the complex effects on AN,OT has the potential applications,especially for the treatment of AN.

Objective To compare the performance of newly developed Chronic Kidney Disease Epideniology Collaboration (CKD-EPI) equation and Modification of Diet in Renal Disease (MDRD) equation in patients with peripheral arterial diseases (PAD).Methods A total of 841 patients with PAD were enrolled in this retrospective cohort study.Estimated glomerular filtration rate (eGFR), calculated by MDRD and CKD-EPI equation respectively, was analyzed by Spearman correlation analysis, Bland-Altman method and Kappa test for the evaluation of correlation and consistency.Net reclassification improvement (NRI) was adopted to compare the death risk assessment between these two equations.Results Although the eGFR was 4.33 ml· min-1 · (1.73 m2)-1 higher with MDRD equation than with CKD-EPI equation, there were still significant correlation and fine consistency between eGFRMDRD and eGFRCKD-EPI (Kappa: 0.749, r=0.991, P＜0.05).The CKD-EPI equation re-classified 9 (1.1％) patients upward to higher eGFR category and 143 (17.0％) patients downward to lower eGFR category.Besides, the performance of risk assessment for all-cause death was better with CKD-EPI equation than with MDRD equation (NRI=0.059, P ＜ 0.05), which was not the case for cardiovascular death (NRI=0.022, P ＞ 0.05).Conclusions There is no solid evidence suggesting that CKD-EPI equation performs better than MDRD equation.