China ; Evidence-Based Medicine ; methods ; Humans ; Orthopedics ; methods

Objective:To evaluate the utilization of oral hypoglycemic drugs in 34 hospitals of Nanjing to provide clinical reference for the drug rational use. Methods: According to the sales data of oral hypoglycemic drugs in 34 hospitals of Nanjing from 2011 to 2013,the utilization of oral hypoglycemic drugs was analyzed retrospectively in respect of consumption sum,DDDs and defined daily cost ( DDC) by daily dose limit analysis method. Results: The top 3 oral hypoglycemic drugs in the list of consumption sum were acarbose,glimepiride and metformin. In terms of DDDs,glimepiride, metformin and gliclazide ranked the top 3. The consumption sum and DDDs of oral hypoglycemic drugs were increased year by year in Nanjing. The ratio of serial number of consumption sum and DDDs was from 0. 3 to 2. 0. Conclusion: The demanded quantity of oral hypoglycemic drugs is increased year by year from 2011 to 2013. The application conforms to the safe, effective and economic principle. The drugs should be chosen according to the drug characteristics in order to improve the abnormal glucose metabolism and prevent and treat the complications.

Translational medicine is an emerging idea in current medical research area. Typically, for the purpose of bridging the gap between basic and clinical research, it not only emphasizes the urgency and necessity to break the traditional working formats, including single subject centered research team and limited cooperation among different scientific groups, but also highlights a more close and frequent interaction between basic scientist and clinician. In order to reach this goal, the theory and method of systems biology should be employed. This paper mainly focused on a central issue that how to carry out an investigation on early clinical diagnosis of xenobiotic-induced intrauterine growth retardation (IUGR) by using research concept of translational medicine and method of systems biology. Briefly, a hypothesis of common mechanism of IUGR was first proposed and subsequent validation was performed via integrating--omics (e.g. genomics, proteomics, cytomics, metabonomics/metabolomics) and molecular biology techniques. Metabonomics was further utilized to explore IUGR biomarker and establish preliminary forecasting model by bioinformatics and computational biology, which is available for early diagnosis of IUGR and make a complement to current evaluation criteria.

In condition of direct vision on fundus of eye, microperimeter can quantitatively detect the retinal light sensitivity of macular area, and record real time tracking of the eye, automatically analyze the location and stability of fixation. Microperimeter matches fundus image with micro cyclogram point-to-point, thus it achieves the combination of visual function and structure. The characteristics of microperimeter have good relations with subjective vision, so it can be a new method for the accurate vision evaluation and has application potential to assess the visual function in legal medicine. In this ar-ticle, we summarize the principle, method and parameters of microperimeter. Also, the applications of microperimeter in vision assessment are focused in order to provide a reference for the assessment of visual function in the legal medicine.

Objective To compare the CT and magnetic resonance imaging (MRI) examination in the application value in the diagnosis and treatment of osteonecrosis of the femoral head.Methods 42 cases of early avascular necrosis of the femoral head were underwent CT and MRI examination,and two kinds of imaging methods were compared.Results MRI diagnosis of avascular necrosis of femoral head in 1 patient detection rate (87.50％) was significantly higher than that of CT (56.25％),and the difference was statistically significant (x2 =3.96,P ＜0.05).While the overall MRI coincidence rate (96.78％) and CT (88.71％) had no significant difference (x2 =3.00,P ＞0.05).The detection rate of MRI diagnosis for single cystic degeneration (93.75％) and CT (75.00％) had no significant difference (x2 =2.13,P ＞ 0.05).MRI in the diagnosis of bone trabecular structure fuzzy detection rate (75.00％) was significantly higher than that of CT (12.50％),and the difference was significant (x2 =12.70,P ＜ 0.05).Conclusion In the early diagnosis of osteonecrosis of the femoral head,MRI could detect changes of early avascular necrosis of the femoral head bone marrow edema and fat necrosis sensitively.MRI was superior to CT in accuracy,harmfulness and sensitivity.It could intuitively reflect the shape of lesions and pathological changes.So it could improve the overall level of diagnosis of osteonecrosis of the femoral head.

In condition of direct vision on hindus of eye, microperimeter can quantitatively detect the retinal light sensitivity of macular area, and record real time tracking of the eye, automatically analyze the location and stability of fixation. Microperimeter matches hindus image with micro cyclogram point-to-point, thus it achieves the combination of visual function and structure. The characteristics of microperimeter have good relations with subjective vision, so it can be a new method for the accurate vision evaluation and has application potential to assess the visual function in legal medicine. In this article, we summarize the principle, method and parameters of microperimeter. Also, the applications of microperimeter in vision assessment are focused in order to provide a reference for the assessment of visual function in the legal medicine.
Forensic Medicine/legislation & jurisprudence* ; Humans ; Retina ; Vision, Ocular ; Visual Acuity ; Visual Field Tests

Hypoplastic myelodysplastic syndrome(Hypo-MDS),with the derangement of BM texture,is characterized by the hypoplasia of bone marrow(BM)accompanied with the deterioration of MDS. Hitherto there isn't a definite therapeutic definition about Hypo-MDS. Is therapy should be paid more attention to. This article introduces the study of therapy of Hypo-MDS.

OBJECTIVE:To provide reference for perioperative rational application of antibiotics in gynecologicalⅡandⅢinci-sion surgery. METHODS:The perioperative patients of typeⅡandⅢincision surgery were collected from our hospital during Jul.-Dec. 2013-Jul.-Dec.2014,and then divided into pre-rectification group and post-rectification group. The prophylactic application of antibiotics in 2 groups were analyzed statistically. RESULTS:After rectification,rational rate of prophylactic medication in-creased from 5.38% to 89.69%(P<0.01);rational rate of prophylactic medication time increased from 11.83% to 91.75%(P<0.01);prophylactic medication duration decreased from (12 ± 2.1)d to(5.5 ± 1.9)d(P<0.01);after rectification,both total drug cost and drug cost per capita decreased significantly (P<0.01);postoperative infection rate showed no significant change before and after rectification (P>0.05). After rectification,usage and dosage of β-lactam antibiotics were in line with pharmacokinetics, Intravenous drip was adjusted from once a day to twice a day,and its rational rate increased significantly compared to before rectifi-cation(P<0.05). CONCLUSIONS:The antibiotics special rectification activities significantly promote the rationality of periopera-tive prophylactic application of antibiotics in gynaecologyⅡandⅢincision surgery of our hospital,reduce adverse drug reactions and resistant strains due to irrational use of drugs,and decrease the drug cost.

Objective:To design and produce the device of central preparation and supply system of dialysate according to the clinical requirement as the relative standards which this system should abide, and to enhance the medical quality of dialysate.Methods: The optimal design and process program of every section were discussed according to the requirement of national standards and industrial standards and the technical requirement of researching central preparation and supply system of dialysate. The requirements of quality system were implemented in every section of the design and application in the central preparation and supply system of dialysate and these requirements were continuously improved, and finally, they were applied in the blood purifying center of hospital.Results: After the central preparation and supply system of dialysate was installed and applied in the blood purifying center, a series of contaminations of the system, such as air contamination, particle contamination, microorganism contamination and endotoxin contamination, were efficiently controlled, and the purity of concentrated solution of dialysate was increased to higher level. Therefore, the dialysate of high quality were obtained.Conclusion: The central preparation and supply system of dialysate is a development tendency in large dialysate center, and it can efficiently increase work quality and work efficiency. A better central preparation and supply system will achieve ultra pure dialysate in real meaning, and it can make profits for patients, achieve medical safety, enhance efficiency, cost saving and achieve clean and tidy. It represents the industrial development direction, and it can contribute the whole development and outside influence of hospital.