OBJECTIVE:To provide reference for rational application of Levofloxacin hydrochloride injection in the clinic. METHODS:With reference to the package insert of Levofloxacin hydrochloride injection,the guiding principles of clinical use of antibiotics,by reviewing related literatures,based on the weighted TOPSIS methods,detailed rules for drug utilization review (DUR) of Levofloxacin hydrochloride injection were made. And then 100 archived medical records of Levofloxacin hydrochloride injection in the first half of 2014 were evaluated in respect of medication rationality based on these rules. RESULTS:Among 100 cases,relative proximity of 51 cases was more than 70%(51.0%);that of 37 was between 50%-70%(37.0%);that of 12 cases was between 30%-50%(12.0%). CONCLUSIONS:Established DUR method of Levofloxacin hydrochloride injection on the basis of weighted TOPSIS methods can be used to evaluate the rationality of drug use and promote more rational evaluation behavior. And the results indicate that unreasonable use of Levofloxacin hydrochloride injection is still common in the hospital.

Objective To investigate the optimal scanning parameters for diffusion tensor imaging of the cervical cord.Methods MRI and diffusion tensor imaging of the cervical cord was performed in 80 healthy adult volunteers.Different parameters including b values,the number of the diffusion sensitive gradient directions,the number of excitations,and slice thickness were applied and their effects on the quality of the images were compared.DTI was performed on the cervical spinal cord with different b-values (400,700,and 1000 s/mm~2)in group 1,with different numbers of diffusion gradient directions(6,13, and 25)in group 2,with different numbers of excitations(2,4,and 8)in group 3,and with different slice thicknesses(2,3,and 4 mm)in group 4.Two radiology experts gave a score to every image with double blind methods,then compared the image quality.Results In the comparison of the four different parameters,DTIs using a b value of 700 s/mm~2(2.25?0.58)showed better image quality than those with the b values of 400 s/mm~2(1.86?0.53)and 1000 s/mm~2(1.48?0.35)(P

China ; epidemiology ; Cross Infection ; epidemiology ; Drug Resistance, Fungal ; Female ; Hospitalization ; Humans ; Male ; Microbial Sensitivity Tests ; Mycoses ; epidemiology ; Prevalence ; Respiratory Tract Infections ; microbiology ; Sentinel Surveillance

China ; epidemiology ; Cross-Sectional Studies ; Female ; Hospitalization ; Humans ; Infusions, Intravenous ; statistics & numerical data ; Male

OBJECTIVETo evaluate the time course of granulocyte-colony-stimulating-factor (G-CSF), estrogen and various doses of atorvastatin on endothelial progenitor cells (EPCs) mobilization.

METHODA total of 48 male New Zealand White rabbits were treated with placebo, estrogen (0.25 mg.k(-1).d(-1)), Atorvastatin (2.5, 5, or 10 mg) and G-CSF (50 microg/rabbit/d), respectively. Peripheral EPCs number was surveyed weekly for 4 weeks by FACS analysis (double-positive for PE-CD34/FITC-CD133) and under fluorescent microscope (double-positive for FITC-UEA-1/Dil-acLDL). Serum nitric oxide (NO) and lipids were also measured at the third week.

RESULTSPeripheral EPCs was significantly increased in G-CSF treated animals and remained constant for 4 weeks compared to placebo treated animals. Atorvastatin increased peripheral EPCs dose-dependently from 2.5 to 5 mg and peaked at the third week while peripheral EPCs number was not affected by 10 mg.k(-1).d(-1) atorvastatin during the first 3 weeks and was significantly higher only in the fourth week compared to placebo group. Estrogen also significantly increased peripheral EPCs at the third and fourth week compared to placebo group. At the third week, serum NO was similar in G-CSF group, significantly higher in atorvastatin 5 mg.k(-1).d(-1) and estrogen groups while significantly lower in atorvastatin 10 mg.k(-1).d(-1) group compared to placebo group. Serum lipids were similar among various groups.

CONCLUSIONAtorvastatin, estrogen and G-CSF could mobilize EPCs. The mobilization efficacy is as follows: G-CSF > atorvastatin 5 mg.k(-1).d(-1) > estrogen > atorvastatin 2.5 mg.k(-1).d(-1) > atorvastatin 10 mg.k(-1).d(-1). NO might partly contribute to the mobilizing effect of estrogen and atorvastatin.

Animals ; Atorvastatin Calcium ; Endothelial Cells ; cytology ; drug effects ; Estrogens ; pharmacology ; Granulocyte Colony-Stimulating Factor ; pharmacology ; Heptanoic Acids ; pharmacology ; Hypolipidemic Agents ; pharmacology ; Lipids ; blood ; Male ; Nitric Oxide ; blood ; Pyrroles ; pharmacology ; Rabbits ; Recombinant Proteins ; Stem Cells ; drug effects

Objective To assess the income status of primary care providers and to explore the determinants of income in a county of Dali. Methods In August 2016, the questionnaire was employed to collect the data of income status of 191 rural health workers and 217 village doctors in the county. Results Through the study, we found that the income of rural health workers in the county was 34, 000 (26, 000, 46,000) yuan with a satisfaction rate of 62.3% (95% CI 55.4%～69.2%) and no change (74.7%) was seen in the income among majorities after implementing the Zero Mark-up Policy for essential medicines. For the village doctors, the income was 20,000 (15,000, 24,000) yuan with a satisfaction rate of 40.6% (95% CI 34.0%～47.1%) and a fall of the income was found in more than half of the doctors after the implement of the policy. Conclusion Health care workers in towns are quite satisfied with their income whereas those in health stations of villages are not content, compared with the average income at the national level. We should increase government's investments on grass-root healthcare team, improve the incentive pay plans and promote the integrated management of health facilities in towns and villages.

Objective To investigate the risk factors of postoperative delirium in elderly patients undergoing spine surgery.Methods The basic case data of 566 patients who underwent spine surgery under general anesthesia from January 2021 to Jan-uary 2023 were retrospectively analyzed.There were 296 males and 270 females with an average age of(71.58±4.21)years old.There were 195 cases of cervical spine surgery,26 cases of thoracic spine surgery and 345 cases of lumbar spine surgery.According to the occurrence of postoperative delirium,the patients were divided into postoperative delirium group(41 patients)and non-delirium group(525 patients).Univariate analysis was used to analyze the possible influencing factors such as gen-der,age,weight,smoking history,drinking history,surgical site,preoperative anxiety,intraoperative hypotension times,blood loss and so on,and binary Logistic regression was used to analyze the univariate factors with P＜0.05.Results A total of 41 pa-tients developed postoperative delirium.Univariate analysis showed that age(P=0.000),duration of surgery(P=0.039),preop-erative anxiety(P=0.001),blood loss(P=0.000),history of opioid use(P=0.003),history of stroke(P=0.005),C-reactive protein(P=0.000),sodium ion(P=0.000)were significantly different between delirium group and non-delirium group.These factors were included in the binary Logistic regression analysis,and the results showed that age[OR=0.729,95％CI(0.569,0.932),P=0.012],opioid use[OR=21.500,95％CI(1.334,346.508),P=0.031],blood loss[OR=0.932,95％CI(0.875,0.993),P=0.029],C-reactive protein[OR=0.657,95％CI(0.485,0.890),P=0.007],preoperative anxiety[OR=23.143,95％CI(1.859,288.090),P=0.015],and sodium[OR=1.228,95％CI(1.032,1.461),P=0.020]were independent risk factors for the development of delirium after spinal surgery in elderly patients.Conclusion Age,opioid use,blood loss,preoper-ative anxiety,elevated c-reactive protein,and hyponatremia are independent risk factors for the development of postoperative delirium in elderly patients undergoing spinal surgery.

AIMTo investigate the effect of ligustrazine (LGT) on expression of Fas/FasL mRNA during pulmonary ischemia/reperfusion injury (PI/RI) in the rabbits.

METHODSSingle lung ischemia/reperfusion animal model was used in this study. The rabbits were randomly divided into three groups (n = 30, in each): sham operated group (Sham), I/R group (I/R) and I/R + LGT group (I/R + LGT). Changes of several parameters which included apoptotic index (AI), wet to dry ratio of lung tissue weight (W/D) and index of quantitative assessment of histologic lung injury (IQA) were measured at 1h, 3h, 5h after reperfusion in lung tissue. Meanwhile the location and expression of Fas/FasL mRNA were observed. Lung tissue was prepared for light microscopic and electron microscopic ob servation at 1 h, 3 h, 5 h after reperfusion.

RESULTSAs compared with group I/R, Fas/FasL mRNA slightly expressed in intima and extima of small pulmonary artery, alveoli, and bronchiole epithelia in group LGT. The values of AI, W/D and IQA showed significantly lower in group I/R + LGT than that in group I/R at 1 h, 3 h, 5 h after reperfusion in lung tissue (P < 0.01 and P < 0.05). Meanwhile, abnormal changes of the lung tissue in morphologically were lessen markedly in group I/R + LGT.

CONCLUSIONLigustrazine has notable protective effects on PI/RI in rabbits by inhibiting Fas/FasL mRNA express in lung tissue and decreasing apoptosis.

Animals ; Apoptosis ; Fas Ligand Protein ; metabolism ; Lung ; blood supply ; Lung Injury ; metabolism ; pathology ; Pyrazines ; pharmacology ; RNA, Messenger ; genetics ; Rabbits ; Reperfusion Injury ; metabolism ; pathology ; fas Receptor ; metabolism

OBJECTIVETo study the mechanism of action of Tougu Xiaotong Capsule (透骨消痛胶囊, TGXTC) ex vivo in suppressing chondrocyte (CD) apoptosis induced by sodium nitroprussiate (SNP).

METHODSThirty New Zealand rabbits, 2 months old, were randomized by lottery into five groups, six in each: the blank group treated with saline, the positive control group treated with Zhuanggu Guanjie Pill (壮骨关节丸, 70 mg/kg), and the three experimental groups, EGA, EGB, and EGC, treated with low dose (35 mg/kg), moderate dose (70 mg/kg), and high dose (140 mg/kg) of TGXTC, respectively. All treatments were administered via gastrogavage twice a day for 3 days. Arterial blood was collected from the abdominal aorta and drug or drug metabolites-containing serum was prepared. CDs obtained from knee joints of 16 four-week-old New Zealand rabbits were cultured to the third passage and confirmed by toluidine blue staining. SNP of various final concentrations (0, 0.5, 1.0, and 2.0 mmol/L) was used to induce CD apoptosis, and the dosage-effect relationship of SNP in inducing CD apoptosis was determined. Serum samples from the blank, control, and three dosages of TGXTC-treated rabbits were tested in the CD culture in the presence of SNP. Cell apoptosis was determined by Hoechst 33342 staining, viability of CDs was quantified by MTT, CD apoptosis rate was determined by annexin V-FITC/PI staining, levels of p53 and Bcl-2 mRNA expression in CDs were determined with RT-PCR, and contents of caspase-3 and caspase-9 proteins were determined by colorimetry.

RESULTSCD apoptosis was induced by SNP at all concentrations tested and in a dose-dependent manner. The SNP concentration of 1 mmol/L and treatment duration of 24 h appeared to be optimal and were selected for the study. Serum samples from the positive control rabbits and from the two higher doses of TGXTC-treated rabbits showed reduction of SNP-induced CD apoptosis, decrease in p53 mRNA expression, inhibition of catalytic activities of caspase-3 and caspase-9, and increase in Bcl-2 mRNA expression when compared with the serum from the blank group (P<0.05).

CONCLUSIONTGXTC-containing sera antagonized SNP-induced CD apoptosis and the molecular basis for the action was associated with up-regulation of Bcl-2, down-regulation of p53 expression, and inhibition of caspase-3 and caspase-9 catalytic activities.

Animals ; Apoptosis ; drug effects ; Biocatalysis ; drug effects ; Capsules ; Caspase 3 ; metabolism ; Caspase 9 ; metabolism ; Cell Survival ; drug effects ; Cells, Cultured ; Chondrocytes ; drug effects ; enzymology ; pathology ; Drugs, Chinese Herbal ; pharmacology ; Gene Expression Regulation ; drug effects ; Male ; Models, Biological ; Nitroprusside ; Proto-Oncogene Proteins c-bcl-2 ; genetics ; metabolism ; Rabbits ; Reproducibility of Results ; Serum ; chemistry ; Tumor Suppressor Protein p53 ; genetics ; metabolism

OBJECTIVETo compare the effects of matrix metalloproteinase (MMP) inhibitor doxycycline, losartan, and their combination on the expression of MMP-8, 13, tissue inhibitor of MMP-1, 2 (TIMP-1, 2), and collagen remodeling in the noninfarcted myocardium after acute myocardial infarction (AMI) in rats.

METHODSTwo hundred and fifty-four AMI rats, induced by left coronary ligation, were randomly assigned to the following groups: (1) AMI controls group (n = 64); (2) doxycycline group (30 mg x kg(-1) x d(-1), n = 63); (3) losartan group (10 mg x kg(-1) x d(-1), n = 62); (4) concomitant doxycycline and losartan group (30 and 10 mg x kg(-1) x d(-1) respectively, n = 65); and (5) Sham-operated rats (n = 30), which were randomly selected to serve as noninfarction controls. Each group was further divided into three subgroups of 1, 2, and 4 weeks that received treatment. After the completion of treatment, the rats were killed. The mRNA and protein expression of MMPs and TIMPs in the noninfarcted myocardium were quantified by RT-PCR and Western blot, respectively. The type I and type III collagen volume fraction (CVF) of the noninfarced myocardium were assessed immunohistochemically.

RESULTSNo significant difference existed in myocardial infarction sizes among the 12 subgroups of AMI controls and the three treatment groups (42%-48%, all P > 0.05). Compared with sham operated rats, the mRNA and protein expression of MMP-8 and 13 significantly increased by 39%-183% in all three subgroups of AMI controls (all P < 0.05), except both of their mRNA expressions in 2-week subgroups; the mRNA and protein levels of TIMP-1 increased only in 1-week subgroup of AMI controls by 104% and 67%, respectively (both P < 0.05); the mRNA of TIMP-2 increased in all 1, 2, and 4-week subgroups by 144%-232% (all P < 0.05), but its protein expression lagged and only enhanced in 2 and 4-week subgroups of AMI controls by 231% and 332%, respectively (both P < 0.05). Meanwhile, both type I and type III CVF of noninfarcted myocardium significantly increased in all three subgroups of AMI controls (type I CVF: 3.01%-5.64% vs 1.53%-1.67%, P < 0.01-0.001; type III CVF: 2.19%-4.42% vs 1.46%-1.59%, P < 0.05-0.001), with type I CVF being higher in 4-week than in 1 and 2-week subgroups (5.64% vs 3.01% and 3.02% respectively, all P < 0.05). Compared with AMI controls, all three kinds of treatment significantly reduced the increased mRNA and protein expressions of MMP-8, 13 and TIMP-1, 2 after AMI by 14%-60% (all P < 0.05), as well as type I/III CVF in their 2 and 4-week subgroups (type I CVF: 1.56%-2.38% vs 3.02%-5.64%, P < 0.05-0.001; type III CVF: 1.92%-2.65% vs 4.19%-4.42%, P < 0.05-0.01), except for doxycycline's effect on type III CVF in any of its three subgroups (all P > 0.05). Among the three treatment groups, significant differences existed in the above mentioned indicators only at some subgroup levels (all P < 0.05).

CONCLUSIONSLike losartan, doxycycline can also suppress the enhanced mRNA and protein expression of MMP-8, 13 and TIMP-1, 2, and reduce type I collagen deposition in the noninfarcted myocardium after AMI in rats. However, it has no effect on type III collagen deposition.

Angiotensin II Type 1 Receptor Blockers ; pharmacology ; Animals ; Collagen Type I ; biosynthesis ; genetics ; Collagenases ; biosynthesis ; genetics ; Doxycycline ; pharmacology ; Drug Synergism ; Female ; Losartan ; pharmacology ; Matrix Metalloproteinase 13 ; Matrix Metalloproteinase 8 ; biosynthesis ; genetics ; Matrix Metalloproteinase Inhibitors ; Myocardial Infarction ; metabolism ; Myocardium ; metabolism ; RNA, Messenger ; biosynthesis ; genetics ; Random Allocation ; Rats ; Rats, Sprague-Dawley ; Tissue Inhibitor of Metalloproteinase-1 ; biosynthesis ; genetics ; Tissue Inhibitor of Metalloproteinase-2 ; biosynthesis ; genetics ; Tissue Inhibitor of Metalloproteinases ; biosynthesis ; genetics