OBJECTIVE:To scientifically establish the variety scope of expensive drugs and to reduce the stock level to a maximum degree under the premise of supply security. METHODS: The variety scope of expensive drugs was established by modified ABC (activity-based costing) analytical method,and the management on expensive drugs was carried out by fixed-quantity system (FQS) together with fixed-interval system (FIS). RESULTS: The practice of the optimized management effectively reduced the stock quantity of expensive drugs,increased the amount of money of 75 stocked drugs to 2.473 7 million yuan from 3.935 7 million yuan;the turnover rate rose from 238.36% to 461.86%,and the turnover days were decreased from 13.03 days to 8.29 days. CONCLUSION: Computer management in combination with the modified ABC analytical method together with FQS and FIS management led to an effective and accurate inventory management of expensive drugs,which then resulted in a speedy turnover rate,decreased fund occupying and lowered drug cost.

Air Pollution, Indoor ; analysis ; prevention & control ; Benzene ; analysis ; Housing ; standards ; Humans

Objective To explore the impacts of preeclampsia and the different extent of proteinuria on maternal and perinatal outcomes.Methods The retrospective analysis was conducted according to the perinatal clinical data of preelacmpsia,pregnancy-induced hypertension in pregnant women and normal pregnant women from the Fifth People's Hospital of Shanghai,excluding twins,diabetic mellitus and patients with chronic kidney disease previously.Patients were divided into three groups on the basis of their conditions:① preeclampsia patients (A group,220 cases); ② patients with gestational hypertension (B group,189 cases); ③ normal pregnant (C group,220 cases).Patients with pre-eclampsia according to the degree of proteinuria were further divided into three subgroups:A1:patients with mild proteinuria (n =109); A2:patients with moderate proteinuria (n =72); A3:patients with severe proteinuria (n =39).Results Compared with the other two groups,the patients in A group had higher blood pressure,serum creatinine,uric acid,cesarean section rate,perinatal prematurity,stillbirth,fetal distress and neonatal asphyxia in preeclampsia group.However,the serum albumin level,eGFR,neonatal birth weight,length and Apgar scores were lower in A group compared with B and C group (P ＜ 0.05).In three subgroups,serum creatinine level,uric acid level,cesarean section rate,perinatal prematurity and fetal distress were significantly increased in A3 group compared with A1 group,while the serum albumin level,eGFR,gestational age and neonatal birth weight were obviously lower in A3 group than in A1 group (P ＜ 0.05).In patients with preeclampsia,24 h urinary protein was negatively related with the levels of serum albumin and eGFR (P ＜ 0.05),and positivly related with the blood pressure,serum creatinine and caesarean production rate (P ＜ 0.05).Large amounts of proteinuria was a risk factor of adverse outcome for pregnant patients with preeclampsia (OR =2.899,P ＜ 0.05).Conclusions Preeclampsia patients with large amount of proteinuria have poor maternal and perinatal outcomes.Massive proteinuria is a risk factor of adverse outcome for patients with pre-eclampsia.

Objective To evaluate prourodynamic study and somatosensory evoked potentials(SEPs)before and after operation of children with lipomyelomeningocele(LMMC)and its clinical significance.Methods Urodynamic study(UDS)and SEPs in 31 cases of LMMC who underwent microsurgical release within 1 week preoperatively and 3 months postoperatively were conducted.The 4 parameters used for UDS evaluation were bladder volume,compliance,detrusor activity and residual urine;parameters used for SEPs evaluation were latent period and amplitude.Results There was a statistics significant difference between operation and control group;the similar result was attented in the comparison of before and after operation,also in the comprison of the improved group and the group without improvement after operation.Conclusions UDS and SEPs investigation can provide guidance for the treatment of tethered cord syndrome(TCS)and evaluate clinical prognosis.These cases with the severity changing in UDS and somatosensory shall be avoided unnecessary action in operation.

Objective To investigate the effect of edaravone pretreatment on myocardial injury induced by carbon dioxide pneumoperitoneum in patients undergoing laparoscopic gynecologic surgery.Methods Thirty patients undergoing laparoscopic gynecologic surgery,ASA Ⅰ or Ⅱ grade,were divided into two groups by random digits table with 15 cases each:control group and edaravone group.Edaravone group following tracheal intubation received vein infusion of edaravone 0.5 mg/kg,control group received equal volume of 0.9％ sodium chloride.The carbon dioxide pneumoperitoneum pressure was maintained at 10-15 mm Hg (1 mm Hg =0.133 kPa).Venous blood samples were collected before anesthesia induction and after operation 8 h for the measurement of the serum creatine kinase (CK),creatine kinase-MB (CK-MB),aspartate aminotransferase (AST) and lactate dehydrogenase (LDH).Results The serum levels of CK and AST were significantly higher after operation 8 h in control group than those of before anesthesia induction in control group and after operation 8 h in edaravone group [(205 ± 27) U/L vs.(123 ± 25) and (123 ± 29)U/L,(48±5) U/L vs.(34 ±3) and (36 ±5) U/L,P＜0.05].There was no significant difference in the serum levels of CK-MB and LDH between two groups and the group (P ＞ 0.05).Conclusion Pretreatment with edaravone 0.5 mg/kg can protect myocardium in patients undergoing laparoscopic gynecologic surgery.

This article summarized circumstances and influential factors of post-transfusion HIV/AIDS in recent years. Laws and regulations were emphasized in respective duties of every blood transfusion related departments. The strictly controlled imported blood products, carefully blood screening on donor, standardized blood products, tightened control on indication of use of blood, and finally, carefully told rare-happened HIV/AIDS to recipients were the key measures to avoid forensic cases of post-transfusion HIV/AIDS. Main evidences in Medical legal identification of post-transfusion HIV/AIDS were also proposed.
Acquired Immunodeficiency Syndrome/etiology* ; Blood Donors ; Expert Testimony/legislation & jurisprudence* ; Forensic Medicine ; HIV Infections/transmission* ; Humans ; Transfusion Reaction

OBJECTIVETo analyze the related factors of the infection after operation of open tibiofibula fractures.

METHODSThe clinical data of 141 patients with open tibiofibula fractures underwent surgical treatment from June 2009 to December 2012 were retrospectively analyzed. All the patients were male and aged from 18 to 61 years old with an average of 39.2 years; all the fractures were unilateral. According to Gustilo typing of fracure, 5 cases were type I, 44 cases were type II, 27 cases were type III a, 56 cases were type III b and 9 cases were type III c. These clinical data included patients' age, gender, body mass index (BMI), underlying diseases, time of operation, fracture site, fracture type, fixation method, postoperative drainage, debridement condition and so on. The postoperative infection conditions were recorded, and the correlation between above factors and infections were analyzed. Finally, the significant related variables were introduced into a Logistic regression model to evaluated their risk.

RESULTSAmong the 141 patients, 22 cases developed with infection (15.6%). The significant relative factors with infection contained fixation method, debridement condition, underlying diseases and postoperative drainage (P < 0.05). The correlativities were stepped up in order, their odds ratios value was 2.451, 3.164, 3.414, 5.117, respectively.

CONCLUSIONActive treatment for underlying diseases before operation, thorough debridement for open wound, suitable fixation method for fracture and thorough draining are effective measures in preventing postoperative infection.

Adolescent ; Adult ; Debridement ; Fibula ; injuries ; Fractures, Open ; surgery ; Humans ; Logistic Models ; Male ; Middle Aged ; Postoperative Complications ; etiology ; Retrospective Studies ; Risk Factors ; Surgical Wound Infection ; etiology ; Tibial Fractures ; surgery

Patients who get tooth loss would also lost their esthetic, stability and functional aspect suddenly. They have to get provisional restoration immediately. This case reports a satisfied result that thermoforming technique is good for patients to get injury from unexpected tooth loss.
Dentures* ; Humans ; Tooth Loss

Aim at the two problems in the field of traditional Chinese medicine (TCM) mechanism elucidation, one is the lack of detailed biological processes information, next is the low efficient in constructing network models, we constructed an auxiliary elucidation system for the TCM mechanism and realize the automatic establishment of biological network model. This study used the Entity Grammar Systems (EGS) as the theoretical framework, integrated the data of formulae, herbs, chemical components, targets of component, biological reactions, signaling pathways and disease related proteins, established the formal models, wrote the reasoning engine, constructed the auxiliary elucidation system for the TCM mechanism elucidation. The platform provides an automatic modeling method for biological network model of TCM mechanism. It would be benefit to perform the in-depth research on TCM theory of natures and combination and provides the scientific references for R&D of TCM.
Animals ; Automation ; instrumentation ; methods ; Databases, Factual ; Drugs, Chinese Herbal ; chemistry ; pharmacology ; Gene Regulatory Networks ; Humans ; Medicine, Chinese Traditional ; Plants, Medicinal ; chemistry

Objective To construct the murine IL-21 (mIL-21) tumor vaccine modified by glyco-syl phosphafidylinositol(GPI), and to evaluate its anti-tumor effect and mechanisms. Methods The IL-21-GPI gene was acquired by overlap PCR and inserted into PeDNA3.1. The recombinant plnsmid pcDNA3.1/ IL-21-GPI was transformed into cell B16F10, and the expression of mIL-21 on cell membrane was deter-mined by cell indirect immumofluorescence and flow cytometry (FCM). The bioactivity of mIL-21 was iden-tiffed according to its effects on the proliferation of mouse spleen cells. The anti-tumor effect was evaluated depending on the tumor size and the survival of tumor-beating mice after the tumor vaccine was inoculated into C57BL/6 mice. And the activity of cell-mediated immunity in immunized mice was detected at the same time. Results The recombinant plasmid pcDNA3.1/IL-21-GPI was correctly constructed, which could ex-press mIL-21 binding the membrane with good bioactivity. The vaccine had good anti-tumor effect, and the cell-mediated immunity had been improved in immunized mice. Conclusion The GPI modified mIL-21 tumor vaccine with anti-tumor activity was constructed successfully, which provided a good foundation for studying anti-tumor immunity and therapy in future.