OBJECTIVE:To provide reference for the realization of normalization and standardization of quality control and management of Pharmacy intravenous admixture service(PIVAS). METHODS:The management and effectiveness of PIVAS quali-ty control in our hospital were introduced from aspects of the establishment of internal quality control system,the key indicators and effects of quality control. RESULTS:According to checking items from aspects of examining once in a month,on prescription checking,preparation,infection control,equipments,drugs,consumable materials,sanitation;holding 1 monthly quality control reviews;and analyzing unqualified indexes and existing security risks,the quality control of PIVAS had achieved good results. The qualified percentage of quality control index was increased from 84%(Jan. 2016)to 90%(Jun. 2016),error rate in the same peri-od was decreased from 0.579‰ to 0.099‰. CONCLUSIONS:Developing quality control of the implementation of detailed quality control key indexes for the whole process of intravenous infusion in PIVAS can effectively regulate the position working process,re-duce preparation error and ensure the quality of infusion preparation.

OBJECTIVE To study the risk factors and clinical characteristics of nosocomial infection in senile patients with acute myelogenous leukemia who received chemotherapy.METHODS Ninety-one cases of senile patients with acute myelogenous leukemia received 304 times of chemotherapy with etiological examination,to analyze the relationship between nosocomial infection and absolute neutrophil count in peripheral blood,the cellularity of the marrow and chronic systemic disorder.RESULTS All indicators of senile patients with acute myelogenous leukemia were higher than those of younger patients(P0.05).CONCLUSIONS Age,different stage of chemotherapy,the neutrocytopenia level and prolongation,and hypocellularity of bone marrow are related to the nosocomial infection in senile patients with acute myelogenous leukemia,and the chronic systemic disorder is not a risk factor.

Objective The aim of this study was to determine the content of phthalate in disposable plastic tableware sold on Chengdu market,and to provide primary data for safety evaluation.Methods Sample selection was based on stratified sampling.Sixteen phthalate compounds were investigated in 60 disposable plastic tableware,divided into seven groups.The analysis was performed by gas chromatography-mass spectrometry (GC-MS).Results In this survey,diethyl phthalate,diisobutyl phthalate,dibutyl phthalate and diethylhexyl phthalate were detected,while the other 12 phthalate compound were not.The positive rates of the four detected phthalate were 6.7％ (4/60),10.0％ (6/60),46.7％ (28/60) and 28.3％ (17/60) respectively,and the highest concentrations were 10.3,6.4,7.2 and 65.6 mg/kg,respectively.Conclusion The observed level of detection rates and maximum concentrations were relatively high in this survey.In addition,some subgroups of PAEs that were not allowed to use in food contact materials were detected.Therefore,the migration in different food simulant would be analyzed in the next step for further health outcome assessment.

Objective To study the prevalence of HIV-1 drug-resistant strains in antiretroviral therapy-naive HIV-1 infectors,and provide background information for HIV-1 drug resistance survey and clin-ical antiretroviral therapy in Beijing in 2008. Methods Referring to the guidelines for HIV drug resistance threshold survey(HIVDR-TS) of WHO, collecting 60-70 plasma samples of HIV-1 infectors who were detec-ted in 6 months and not more than 25 years,we detected HIV-1 pol genotype and genetic mutations associated with drug resistance,counted the prevalence of drug-resistant strains, and evaluated the prevalent level. Re-Sults Of 61 plasma samples answering for the standards, 50 were successfully sequenced and genotyped pol sequence. The major infection route was homosex, which accounted for 62%. B, CRF01_AE, and CRF07_ BC were major genetic subtype, which accounted for 42%, 28% and 26%, respectively. One Pl-resistant strain was found, the incidence of which was 2% (1/50). One NRTI-resistant strain was found, the inci-dence of which was 2% (1/50). No NRTI-resistant strain was found, the incidence of which was 0. The in-cidence of drug-resistant strains in the protease (PR) region was 2%, and the incidence of reverse tran-scriptase (RT) region was also 2%. Both of the prevalence were classified as low level ( <5% ). Conclu-sion PR, RT-resistant HIV-1 strains were found in drug-naive infectors, and the prevalence was low in Beijing. Current antiretrovirai therapy regiments were still feasible. Most of the AIDS patients did not need to test drug resistance before antiretroviral therapy.

Objective: To explore the intra-host genetic evolution of HIV-1 pol gene via follow-up for treatment-naïve HIV infections, and estimate the infection time with Bayesian coalescent theory, so as to support the evaluation of HIV epidemic. Methods: Five cases were recruited and followed up. The pol gene fragments were amplified for the characteristics of transmitted drug resistance ( TDR ) by RT-PCR. Bayesian coalescent theory was utilized to construct maximum clade credibility ( MCC ) tree for genetic evolution and calculate the time to the most recent common ancestor ( tMRCA ). Results: The five cases were all male, and aged from 27 to 50 years old.Five to nine sampling times were obtained from each case, and the pol gene sequences from each case formed a unique subcluster (posterior probability: 100% ), with different evolution characteristics, in the MCC tree. The three cases in primary HIV-1 infection were estimated to be infected one to five months before the first positive reaction of HIV screening, whereas the two HIV-1 diagnosed cases at first screening were extrapolated to get infected fourteen months and seven months before diagnosis, respectively. One case with acute HIV-1 infection carried TDR mutation ( M46I ) , expressing fast disease progress and quasispecies variation. Conclusions The general infection time can be estimated by analyzing the characteristics of intra-host genetic evolution of HIV-1 pol gene with Bayesian coalescent theory, and this method can help to estimate the HIV epidemic.

TMTP1, a 5-amino acid peptide NVVRQ, obtained by using the flagella peptide library screening in our previous studies, can be used for the labeling of malignant in situ and metastatic lesions, and even micro-metastases. In this study, TMTP1 was assessed for its ability to specifically target the malignant hematopoietic cells and metastatic lesions of hematological malignancies. FITC-TMTP1 was chemically synthesized. Immunofluorescence assay and competitive test were carried out to determine the specific binding capacity of TMTPl to hematological malignant cell lines, including HL60, k562, SHI-1, Jurkat, Raji, El-4 and umbilical cord blood mononuclear cells. Mononuclear cells were isolated from the bone marrow of healthy subjects and patients with chronic myeloid leukemia. Then the cells were co-clutured with TMTP1 or scrambled peptides and the binding and affinity of TMTP1 peptide to the primary cells of hematological malignancies were flow cytometrically analyzed. The binding specificity of TMTP1 to target hematological malignancies was measured in vivo by intravenous injection of FITC-conjugated TMTP1 into El-4 lymphoma-bearing mice. The results showed that TMTP1 specifically bound to the cells of a series of hematological malignancies, including HL60, k562, Jurkat, Raji, El-4 and chronic myeloid leukemia primary cells but not to bone marrow mononuclear cells from healthy subjects. By contrast, TMTP1 could bind to the metastatic foci of lymphoma originating from the EL-4 cell line while the scrambled peptide failed to do so. Moreover, the occult metastases could be identified, with high specificity, by detecting FITC-TMTP1. We are led to conclude that TMTP1, as a novel tumor-homing peptide, can serve as a marker for primary malignant and metastatic lesions for the early diagnosis of hematological malignances and a carrier of anticancer drugs for cancer treatment.

TMTP1,a 5-amino acid peptide NVVRQ,obtained by using the flagella peptide library screening in our previous studies,can be used for the labeling of malignant in situ and metastatic lesions,and even micro-metastases.In this study,TMTP1 was assessed for its ability to specifically target the malignant hematopoietic cells and metastatic lesions of hematological malignancies.FITC-TMTP 1 was chemically synthesized.Immunofluorescence assay and competitive test were carried out to determine the specific binding capacity of TMTPI to hematological malignant cell lines,including HL60,k562,SHI-1,Jurkat,Raji,El-4 and umbilical cord blood mononuclear cells.Mononuclear cells were isolated from the bone marrow of healthy subjects and patients with chronic myeloid leukemia.Then the cells were co-clutured with TMTP1 or scrambled peptides and the binding and affinity of TMTP1 peptide to the primary cells of hematological malignancies were flow cytometrically analyzed.The binding specificity of TMTP 1 to target hematological malignancies was measured in vivo by intravenous injection of FITC-conjugated TMTP1 into El-4 lymphoma-bearing mice.The results showed that TMTP1 specifically bound to the cells of a series of hematological malignancies,including HL60,k562,Jurkat,Raji,El-4 and chronic myeloid leukemia primary cells but not to bone marrow mononuclear cells from healthy subjects.By contrast,TMTP1 could bind to the metastatic foci of lymphoma originating from the EL-4 cell line while the scrambled peptide failed to do so.Moreover,the occult metastases could be identified,with high specificity,by detecting FITC-TMTP1.We are led to conclude that TMTP1,as a novel tumor-homing peptide,can serve as a marker for primary malignant and metastatic lesions for the early diagnosis of hematological malignances and a carrier of anticancer drugs for cancer treatment.

Objective To investigate the efficacy and white matter integrity of low frequency repetitive transcranial magnetic stimulation (rTMS) and the modified electroconvulsive therapy (MECT) in patients with schizophrenia. Methods From May 2015 to October 2016,120 cases with schizophrenia were randomly enrolled into the MECT group and of the rTMS group. Patients in the MECT group were treated with the modified electric convulsive therapy for 8 times ,while patients in the rTMS group were treated with the repetitive transcranial magnetic stimulation for 12 times. PANSS were used to evalue the clinical effects. Repeatable battery for the assess-ment of neuropsychological status was used to assess the cognitive function. Treatment emergent side-effect scale was used to assess the adverse effects. Brain fractional anisotropy was used to assess white matter integrity. Results After treatment,the PANSS scores were significantly lowered,however,the RBANS scores were signifi-cantly higher in the MECT group and rTMS group than those before treatment ,with significant differences (P <0.05). No significant differences for the PANSS scores and the RBANS scores were observed between the two groups before and after treatment. There was no significant difference for the TESS scores between the two groups before treatment(P > 0.05). After treatment,the TESS scores in the MECT group were significantly higher than those in the rTMS group(P < 0.05). After treatment,the FA values of left anterior cingulate gyrus,left posterior cingulate gyrus ,left prefrontal cortex and genu of corpus callosum for both MECT group and rTMS group were significantly increased (P < 0.05 ,respectively). Compared with the MECT group ,the FA value significantly increased in the rTMS group after treatment (P < 0.05). Conclusions Both MECT and rTMS have significant clinical efficacies and can improve the cognitive function of schizophrenics. rTMS is more safe than MECT ,with a stronger effect on preventing the integrity of white matter than MECT.

OBJECTIVETo make an open label prospective trial for comparing the therapeutic effects of mycophenolate mofetil (MMF) vs cyclophosphamide (CYC) pulse therapy on patients with diffuse proliferative lupus nephritis (DPLN).

METHODSForty-six patients with biopsy proven active DPLN were enrolled in this study. Twenty-three patients were given MMF orally at a dosage of 1.0 - 1.5 g/d (MMF Group). Another 23 cases received conventional intermittent CYC pulse therapy (CYC Group). Supplemental steroid treatment was offered in the same manner to both groups. The age, sex distribution and severity of renal damage were matched in two groups. Therapeutic effects were evaluated at the end of six-month treatment. Fifteen patients in the MMF Group and 12 patients in the CYC Group had repeated renal biopsy at that time.

RESULTSMMF therapy was more effective in reducing proteinuria and hematuria. A 50% reduction of urinary protein and urinary red blood cell excretion from baseline value in 69.6% and 91.3% patients in the MMF Group, while only 47.8% and 65.2% in the CYC Group. MMF was more effective in inhibiting autoantibody production (especially anti-dsDNA antibody) and in decreasing serum cryoglobulin levels. Pathologically, the MMF group showed more markedly reduction in glomerular immune deposits with less glomerular necrosis, and less microthrombi, less crescent formation and vascular changes in the repeated renal biopsy as compared with the CYC group. Adverse reactions related to the treatment included gastrointestinal symptoms 26.1% and 43.5% in the MMF and CYC Groups respectively, infection 17.4% in the MMF group and 30.4% in the CYC group.

CONCLUSIONMMF was more effective in controlling the clinical activity of DPLN and renal vascular lesions as compared with CYC pulse therapy in a 6 month follow-up study.

Adult ; Cyclophosphamide ; adverse effects ; therapeutic use ; Female ; Gastrointestinal Diseases ; chemically induced ; Humans ; Immunosuppressive Agents ; adverse effects ; therapeutic use ; Infection ; chemically induced ; Kidney ; drug effects ; pathology ; Lupus Nephritis ; drug therapy ; Male ; Mycophenolic Acid ; adverse effects ; analogs & derivatives ; therapeutic use ; Pneumonia ; chemically induced ; Prospective Studies ; Treatment Outcome

Objective:To investigate the molecular expression and pathological features of endothelial cell (EC) in a murine model of choroidal neovascularization (CNV) based on single-cell RNA sequencing (scRNA-seq).Methods:Six C57BL/6 mice aged 6-8 weeks were randomly divided into two groups, with 3 mice in each group.Bilateral eyeballs were enucleated.The choroidal tissues from the two groups were isolated by shearing the complex and scraping the choroid, respectively.Single-cell suspension was prepared by continuous digestion with trypsin/type Ⅰ collagenase at 37 ℃, and the cell viability and EC ratio were detected by flow cytometry to determine the preparation method of single-cell suspension.Another 6 mice were randomly assigned into the control group and the CNV group, with 3 mice in each group.The CNV model was induced by laser photocoagulation and single-cell suspensions were prepared 7 days after modeling.Gene expression library construction was performed using the Chromi-um (10x Genomics) instrument.High throughput sequencing was performed using the Illumina Novaseq6000 to obtain the expression matrix.The EC subpopulations were classified according to previous researches and the Cellmarker database.Pseudo-time analysis was performed in EC, revealing the gene expression matrix of different states.CNV-EC were further selected with preliminary analysis of the expression characteristics.Another 6 mice were selected to establish the CNV model and eyeball frozen sections were prepared 7 days after modeling.Expression and distribution as well as the area percentage of EC marker Pecam1, mitochondrial outer membrane proteins Tomm20 and mt-Co1, and capillary markers Kdr and Plvap were observed by immunofluorescence staining, and the vascular diameter was calculated.The use and care of animals followed the ARVO statement.This study protocol was approved by the Experimental Animal Welfare and Ethics Committee of Air Force Military Medical University (No.20200181).Results:The cell viability of the single-cell suspension prepared from choroidal-scleral fragments and choroidal scrapings was 99.4% and 99.1%, respectively, both of which met the sequencing requirements.The percentage of EC detected by flow cytometry was approximately 1.58%.The scRNA-seq result revealed that both the normal control and CNV groups contained 13 choroidal cell clusters.Compared with the normal control group, the proportions of rod/cone photoreceptor cells, EC and hematopoietic cells all increased, while the retinal pigment epithelium (RPE) and Schwan cells reduced in the CNV group.Among all clusters, EC constituted 18.4%.The pseudo-time analysis demonstrated that EC could be further divided into 4 states.The percentage of state 2 EC was 29.1% in the CNV group, which was significantly higher than 9.5% in the normal control group.Differentially expressed gene analysis showed that the expression of mitochondrion-related genes, including mt-Nd4 and mt-Atp6, were upregulated in state 2 EC, while capillary-related genes, including Kdr and Esm1, were downregulated.Immunofluorescent staining revealed that the area of Tomm20 and mt-Co1 in Pecam1-positive EC in the CNV area was (19.50±4.68)% and (4.64±2.82)%, respectively, which were both higher than (3.00±2.09)% and (0.18±0.34)% in normal area ( t=7.88, 3.84; both at P<0.01). The area of Kdr and Plvap in Pecam1-positive EC in the CNV area was (1.50±0.29)% and (0.79±0.97)%, respectively, which were both lower than (31.30±5.44)% and (10.43±2.28)% in the normal area ( t=13.40, 9.48; both at P<0.01). The vascular diameter in the CNV area was (5.52±1.85)μm, which was larger than (4.21±1.84)μm in the normal area ( t=9.57, P<0.001). Conclusions:When CNV occurs, the proportion of EC in choroid increases, and CNV-EC shows pathologic features of mitochondrial metabolic activation and loss of capillary properties, suggesting the mitochondrial activation of EC may play a role in the formation of CNV.