OBJECTIVE:To understand the drug use of sample hospitals,and to provide reference for drug production,man-agement and service department. METHODS:Statistical analysis was conducted in the data of drug use in national 1 248 sample hos-pitals during 4th quarter of 2012-3rd quarter of 2013. RESULTS&CONCLUSIONS:Anti-infection medicine,Chinese patent medi-cine,nervous system drugs has being ranked the top 3 in the list of consumption sum,and that of various drugs is in an upward trend. Top 20 drugs in the list of consumption sum mainly are biological products,drugs for the nervous system,digestive system drugs;that of human albumin and deproteinized calf serum have increased greatly. Top 10 imported pharmaceutical enterprises or joint ventures in the list of consumption sum mainly are multinational enterprises,and they are stable in ranking. The development of pharmaceutical enterprises should focus on brand,quality,price and service,etc.,so that their competitiveness can be improved.

Objective To investigate the role of the chemokine receptor CXCR3 and its ligands in the migration of lymphocytes and acute hepatic failure. Methods BALB/cJ mice (6-8 weeks, female) were intraperitoneally injected with 100 PFU mouse hepatitis virus-3(MHV-3). The proportions and numbers of T cells and NK cells in liver, spleen, and blood as well as the expression of CXCR3 in T cells, and NK cells post MHV-3 infection was analyzed by flow cytometry. The hepatic mRNA level of the CXCR3-associated chemokines(CXCL9 and CXCL10) was detected by real-time PCR. A transwell migration assay was used to assess the chemotactic effect of MHV-3-infected hepatocytes and CXCL10 on the splenic lymphocytes. Results Following MHV-3 infection, the number of hepatic NK cells and T cells and the frequencies of hepatic NK cells and T cells expressing CXCR3 increased markedly; however, in the spleen and peripheral blood, they both decreased significantly. Moreover, the hepatic mRNAs levels of CXCL9 and CXCL10 were significantly elevated post infection. The transwell migration assay demonstrated that MHV-3-infected hepatocytes have the capacity to attract and recruit the splenic NK cells and T cells, and CXCL10 plays a key role in lymphocyte mobilization from the spleen. Conclusion Interactions between CXCR3 and its ligands (CXCL9 and CXCL10),especially CXCL10 may play a key role in the recruitment of intrahepatic lymphocytes and subsequent necroinflammation and acute hepatic failure in MHV-3 infection.

Purpose:To summarize the experences of treating malignant obstructive jaun- dice by percutaneous transhepatic drainage of the bile duct,as well as discussing its clinical effect and practical value.Materials and Methods:Among the 39 patients who were all unsuitable for sur- gical operations,5 were benign,34 were malignant.All patients underwent percutaneous transhep- atic puncture of bile duct.38 cases who were successfully aspirated continued to undergone canal- ization of the obstructive parts 28 be finally successful.Among these patients,metallic stents were placed in 17 cases,balloon dilation in 2 cases,canalization with multi-side-hole catheter in 9 patients.Only external biliary drainage were performed in 10 patients.Results:All of there canal- ization method effected well in verious degrees,but the best result was obtained in the metallic stents group.Conclusion:(1)There is less injury and complication in percutaneous transhepatic drainage,either external or antegrade biliary drainage,and it ts also easy to operate,Interventional treatment is the first choice for patients who suffered from benign or malignant obstructive jaundice unahe undergone surgical operation(2)All the methods amend with each other,but the placement of metallic stent is the best one.

Objective To explore the clinical effect and lung CT change of long-term used of low-dose roxithromycin in treatment for bronchial expansion patients in stable phase. Methods 94 cases collected in the Department of Respiration, The Second Hospital Affiliated to Suzhou University from February 2011 to December 2012 were diagnosed as bronchiectasis, 34 cases in control group were given oral treatment for ambroxol 30 mg, three times one day, 60 cases in treatment group were added roxithromycin 75 mg on basis of control group, two times one day. Patients in two groups were both treated for 6 months. The therapeutic effect and the score of life quality and dyspnea scores in two groups were observed, and the changes of CT data were compared before and after treatment. Results After treatment, the life quality score and dyspnea score of two groups were all improved, but the treatment group was signiifcantly higher than the control group (P<0.05). The effective rate in treatment group was 86.67%, which was signiifcantly higher than 70.59%in the control group (P<0.05). After treatment, chest CT imaging score of patients in treatment group were improved, signiifcantly better than that in the control group (P<0.05). Conclusion Long-term low dose administration of roxithromycin can control and stable bronchiectasis symptoms, and improve signs and symptoms .

Objective To investigate the correlation between the expression of the activating and inhibitory receptors on periph-eral natural killer (NK) cells with the liver injury in the patients with hepatitis B virus related acute-on-chronic liver failure (HBV-ACLF) .Methods The peripheral blood samples were collected from 20 patients with HBV-ACLF and 20 patients with HBV-chro-nic hepatitis B(CHB) .The expressions of the activating receptors (NKP30 ,NKP46 ,NKG2D) and the inhibitory receptor (CD158a) on peripheral NK cells were detected by the multicolor flow cytometry .Results Compared with the HBV-CHB patients ,the ex-pression of the activating receptors NKP30 and NKP46 in the HBV-ACLF were remarkably unregulated(P<0 .05) ,but the expres-sion of the inhibitory receptor CD158a was markedly downregulated(P<0 .05) .Conclusion The enhanced expression of the activa-ting receptors NKP30 and NKP46 and the weakened expression of inhibitory receptor CD158a may be the important factor of the NK cells activation and the subsequent HBV-ACLF immune-mediated hepatocyte injury .

OBJECTIVE:To analyze the blood concentration monitoring data of 4 commonly used antiepileptic drugs(AEDs, sodium phenytoin,carbamazepine,sodium valproic acid,oxcarbazepine)in order to provide reference for rational use of drugs in the clinic. METHODS:415 patients underwent 4 AEDs blood concentration monitoring were selected from our hospital during 2014-2015,and the results of blood concentration monitoring were analyzed statistically. RESULTS:There were 680 cases of AE-Ds blood concentration monitoring in total. The main objects of serum concentration monitoring were young and middle-aged(range from 19 to 60),involving 449 cases in total(66.03%). 360 cases were in the normal range(52.94%). Among 361 patients receiving single drug therapy,the rates of serum concentration in the normal range were 80.77%for carbamazepine,which was higher than oth-er 3 AEDs(30.00% for sodium phenytoin,47.40% for sodium valproic acid and 40.38% for oxcarbazepine),with statistical signifi-cance(P<0.05). Among 54 patients receiving combination therapy,the serum concentration monitoring data of 67.65%patients treat-ed with double-combination therapy and 100%patients treated with triple-combination therapy deviated from normal range. CONCLU-SIONS:The rate of AEDs blood concentration reaching the normal range are in low level in our hospital. It’s necessary to strengthen medication education for patients to improve the compliance of patients;clinical efficacy of AEDs is evaluated on the basis of blood concentration monitoring and clinical symptom,and combination therapy should be avoided as much as possible.

Objective To explore SIRT4 gene expression in tumor tissue and investigate the clinicol-pathological features in osteosarcoma .Methods In this study ,SIRT4 protein expression was detected in 106 os-teosarcoma tissues and 36 paired neighboring non -tumorous tissues by immunohistochemistry and determined the correlation between the SIRT 4 expression and the clinicopathological features .Results SIRT4 protein was dra-matically decreased in osteosarcoma cells compared with neighboring non -tumorous bone cells .The low expres-sion of SIRT4 was notably associated with a poor overall survival and disease -free survival in osteosarcoma pa-tients.By using univariate and multivariate analyses ,we confirmed that the increased SIRT 4 expression was an in-dependent factor in predicting better prognosis for patients .Conclu is on SIRT4 expression might be an inde-pendent biomarker for prognostic evaluation of osteosarcoma .

Objective: To investigate the effects of Ala-Gln induced heat shock protein 70 (HSP70) expression on myocardial ifbrosis and connexin43 (Cx43) remodeling in experimental rats’ model.
Methods: A total of 32 SPF male SD rats were randomly divided into 4 groups:①Control group,②Model group, the rats received isoprenaline (ISO) 5m/(kg·d),③Intervention group, the rats received ISO+Ala-Gln 0.75mg/(kg·d),④Quercetin group, the rats received ISO+quercetin 100mg/(kg·d)+Ala-Gln+DMSO. n=8 in each group. All animals were treated for 7 days and killed in 4 weeks for relevant examinations. HE and Masson staining was conducted to observe myocardial ifbrosis, then calculate collagen volume fraction; immunohistochemistry was applied to measure myocardial HSP70 expression,
extracellular signal regulated kinase (p-ERK1/2) and Cx43 distribution, then conduct semi-quantitative analysis by speciifc soft ware.
Results: HE and Masson staining indicated that Control group had no obvious myocardial ifbrosis, Model group and Quercetin group had obvious ifbrosis, and Intervention group showed less ifbrosis than the other 2 groups, all P<0.01. The fibrosis level was similar between Intervention group and Control group, P>0.05. The myocardial HSP70 expression was similar among Control, Model and Quercetin groups, P>0.05, while HSP70 expression was signiifcantly higher in Intervention group than the other 3 groups, all P<0.01. The myocardial p-ERK1/2 level was lower in Intervention group than Model and Quercetin groups, all P<0.01. The myocardial Cx43 level was similar between Control group and Intervention group with linear distribution, while it was higher in Intervention group than Model and Quercetin groups with disordered distribution, all P<0.01.
Conclusion: Ala-Gln inducing the higher expression of HSP70, which may reduce myocardial ifbrosis in experimental rats, it could be because of HSP70 down regulating p-ERK1/2 expression and inhibiting ERK signaling pathway.

The knowledge of endocrine metabolic diseases represented by type 2 diabetes mellitus is highly specialized, complicated, and has many clinical guidelines. In this context, team based learning teaching combined with case teaching based on evidence-based medicine was applied in the actual class teaching. The class was divided into several groups and the students were encouraged to discuss and study from each other with the guidance of teachers. Consequently, students' learning interests and spirit of team-work were greatly enhanced, the way of thinking using evidence-based medicine and their ability to solve the practical clinical problems were also improved.

Objective:To investigate the difference of curative effect between zero-profile bridge-shaped locking cage (ROI-C) and anterior cage combined with titanium plate fixation in the treatment of two-level and three-level cervical spondylotic myelopathy.Methods:A total of 85 patients (43 males and 42 females), aged 52.3±8.0 years (range from 28 to 66 years) with bi- and three-level cervical spondylotic myelopathy who received surgical treatment from June 2017 to October 2019 were retrospectively analyzed. There were 63 cases of two levels and 22 cases of three levels. 45 cases were treated with zero-profile bridge-shaped locking cage ROI-C (ROI-C group), and 40 cases with anterior cage combined with titanium plate fixation (titanium plate group). The main observation indicators include operation time, intraoperative blood loss, cervical Cobb angle, fusion segment Cobb angle, average intervertebral height, pain visual analogue scale (VAS), Japanese Orthopaedic Association (JOA) Score and neck disability index (NDI).Results:All of 85 patients were followed up for 16.9±2.0 months (range 12 to 22 months). The operation time of two-level ROI-C group was 110.37±8.25 min, which was shorter than 139.5±10.54 min of titanium plate group; the intraoperative blood loss was 15.74±8.10 ml, which was less than 23.71±9.70 ml of titanium plate group; the operation time of three-level ROI-C group was 130.00±5.70 min, which was shorter than 162.83±5.59 min of titanium plate group, while the difference in the intraoperative blood loss between the two groups had no statistical significance. One year after operation, Cobb angle of cervical vertebra in double and three-level ROI-C groups were 15.31°±1.55° and 15.20°±0.42°, respectively, which were largerthan 11.23°±2.03° and 9.20°±1.14° before operation; in titanium plate group, they were 15.89°±1.13° and 16.08°±1.88°, which were higher than 11.25°±2.01° and 9.00°±1.60° before operation, and the differences had statistical significance. The differences between the two groups before operation and 1 year after operation had no statistical significance. One year after operation, the VAS scores of double and three-level ROI-C groups were 1.83±0.66 points and 2.60±0.52 points, respectively, which were less than the preoperative 7.49±0.51 points and 7.60±0.52 points; the titanium plate group was 1.79±0.50 points and 2.41±0.51 points, which were less than the preoperative 7.61±0.63 points and 7.42±0.52 points, and the differences had statistical significance. There was no significant difference between the two groups before operation and 1 year after operation. One year after operation, the JOA scores of double and three-level ROI-C groups were 15.00±0.84 points and 14.70±0.95 points, respectively, which were higher than the preoperative 7.20±0.87 points and 6.60±1.27 points; the scores of titanium plate group were 15.29±0.85 points and 14.83±0.58 points, which were higher than the preoperative 6.89±1.03 points and 6.92±0.67 points, and the differences had statistical significance. The differences between the two groups had no statistical significance. The postoperative JOA improvement rate was excellent. Postoperative dysphagia occurred in 1 case (2.22%, 1/45) in ROI-C group and 8 cases (20.00%, 8/40) in titanium plate group, and the difference in the incidence rate between two groups had statistical significance ( χ2=5.32, P=0.02). Conclusion:Both ROI-C and anterior cage combined with titanium plate fixation in the treatment of double and three-level cervical spondylotic myelopathy can achieve good short-term clinical efficacy, with shorter operation time and lower incidence rate of postoperative dysphagia using ROI-C.