This paper analyzes the reform and challenge of the medical literature retrieval in the new situation and shows the view from teaching target,teaching staff development,course content,course system and teaching methods

OBJECTIVE: To investigate the characteristics and causes of adverse drug reactions (ADR) in Jiangxi region in order to improve the rational use of drug in clinic. METHODS: A total of 10 033 cases of ADR reports collected in Jiangxi region in 2008 were classified and analyzed statistically. RESULTS: The ADR were predominantly induced by antimicrobial drugs (53.76%), followed by TCM preparation (16.68%). Intravenous administration was the main cause of ADR(65.45%). 225 case of severe ADR reports accounted for 2.24% and 412 cases of new ADR reports 4.11%. 99 cases of severe ADR were characterized by the systematic damages.12 death cases and 12 sequelae cases were involved in 225 cases of severe ADR reports. CONCLUSION: Great importance should be attached to ADR monitoring, reporting and publicizing to promote rational use of drug in clinic.

Objective To investigate in knowledge rate of 120 first aid and satisfaction rate with emergency services among Nanchong citizens. Methods 360 patients who received prehospital first aid from three hospitals and their accompanies were selected from January to June 2010. The investigation content included knowledge rate of 120 first aid and satisfaction rate with emergency services. Results Results showed that about half of those surveyed still did not know the emergency phone"120" and its function, lacked self-help and self-protection knowledge, some respondents felt quite helpless upon daily life of electric shock, gas poisoning, coma and traumatic accidents. The attitude of the majority of emergency personnel was good or better, but still very stiff or irresponsible attitude existed in those few. This undermined the "120" and the image of credibility and emergency personnel. Conclusions There is an urgent need for universal coverage of on-site first aid knowledge and enhance awareness of first aid. Full-time staff in emergency department must pay close attention to the knowledge of first aid training, mastering the technique of bleeding control and bandaging, fixing, handling and CPR, as well as the use of instruments and equipment equipped in vehicles. Only in this way can we continuously improve the treatment of critically ill patients and increase survival rate.

Objective To explore the significance of NK cell activity,interleukin-2 receptors (sCD25) and glycosylated ferritin in the early diagnostic of acquired hemophagocytic lymphohistiocytosis (HLH).Methods 57 patients suspected of HLH from June 2005 to May 2008 and 25 healthy subjects were enrolled in the study.The patients suspected of HLH were divided into three groups i.e.(1) a group with diagnosis confirmed at first visit;(2) a group with diagnosis confirmed at subsequent visit and (3) a group with diagnosis unconfirmed according to HLH-2004 diagnostic criteria.Healthy subjects were enrolled as control.NK cell activity was determined with a released LDH assay.The percentage of glycosylated ferritin was determined with phytohemagglutinin adsorption assay,sCD25 was examined with ELISA double antibody sandwich assay.We compared the coincidence of each diagnostic index before and after diagnosis.Results The median percentage of NK cell activity was significantly lower in the first group ( 18.3±5.6) % and the second ( 16.7±6.7)% than that in the third group (33.4±6.8)% or in the controls (36.6±5.0)%.The median percentage of glycosylated ferritin was also significantly lower in the first group ( 15,4 ± 2.0)% and the second group (16.9 ± 3.4)% than that in the third group (40.4 ± 3.0)% or in the controls (45.2±2.2)%.Meanwhile,the median level of sCD25 was significantly higher in the first group (12 916±4328) ng/L and the second group (12 117 ± 5465) ng/L than that in the third group (4728±1482) ng/L or in the controls (3841 ± 993) ng/L.Furthermore,NK cell activity,sCD25 and glycosylated ferritin were abnormal in all the patients in the early stage of HLH.Conclusion NK cell activity,sCD25 and glycosylated ferritin may be helpful markers for the early diagnosis of HLH.

Aim To investigate the effect of irbesartan and spironolactone on expressions of connective tissue growth factor(CTGF),P-p38MAPK proteins during vascular remodeling in renovascular hypertensive rats(RHR).Methods Renovascular hypertension was induced by two kidney one clip(2K1C)operation.8 weeks later,RHRs were given irbesartan or(and)spironolactone for 8 weeks.After 8 weekstreatment,the morphometric measurements were performed in the mesenteric arterioles.Concertration of carboxyterminal propeptide of typeⅠprocollagen(PⅠCP)and N-terminal propeptide of type Ⅲ procollagen(PⅢNP)in blood serum was measured by enzyme linked immunosorbent assay method,and the media collagen area was assessed by collagne-specific Picro-sirius red staining with computerized video processing.Expressions of collagen type I,CTGF,P-p38MAPK proteins were detected using immunohistochemistry respectively.Results The arterial systolic pressure was attenuated significantly after the treatment of irbesartan,and this effect could not be enhanced by spironolactone.The media thickness over lumen ratio,media cross-sectional area over luminal area ratio of mesenteric arterioles,concertration of PⅠCP and PⅢNP,media collagen area,and expression of collagen typeⅠwere significantly increased in RHRs but ameliorated by irbesartan and spironolactone.Meanwhile,the expressions of CTGF,P-p38MAPK proteins were up-regulated in RHRs but blunted significantly after the treatment of irbesartan and spironolactone.The combined treatment had the synergic effects.Conclusions There is a synergistic effect of attenuating extracellular matrix(ECM)producing and amelioration of vascular remodeling(VR)by combined use of irbesartan and spironolactone.It maybe related to the expressions of CTGF and P-p38MAPK proteins down regulated by these two drugs.

Objective:To evaluate effects of different medication forms of dexmedetomidine on perioperative cognitive function in elderly patients undergoing radical operation of gastric carcinoma, and Ramsay sedation score.Methods:A total of 150 patients aged 65 years and 75 years scheduled for elective radical operation of gastric carcinoma from December 2018 to December 2019 in Shanxi Provincial Cancer Hospital were enrolled, and they were divided into 3 groups according to random number table method: different medication forms of dexmedetomidine groups (group A, group B) and the control group (group C), 50 cases in each group. The patients in group A and group B continued to pump dexmedetomidine at a rate of 0.5 μg·kg -1·h -1 and 0.3 μg·kg -1·h -1 respectively for 15 min before induction of anesthesia. And the patients in group C were given intravenous pumping of an equal volume of 0.9% NaCl for 15 min. Subsequently, patients in group A and group B received continuous intravenous infusion of 0.3 μg·kg -1·h -1 for 30 min before the end of operation, the patients in group C received 0.9% NaCl infusion of equal volume until the end of operation. The cognitive function of the patients was measured by using the Monterey cognitive assessment scale (MoCA) the day before surgery and on day 1,3 and 7 after surgery, and the incidence of perioperative neurocognitive disorder (PND) was counted. Ramsay sedation score at 30 min, 24 h and 48 h after surgery was compared among the three groups. Results:There were 3 patients in group A and 3 patients in group C were excluded because they were transferred to ICU due to serious postoperative complications. There were significant differences in MoCA score among the three groups on day 1, 3, 7 after operation (all P < 0.01); MOCA score of group A, B and C on day 7 after operation was (26.9±0.7) scores, (26.6±1.0) scores, (26.3±1.2) scores, respectively, and the difference between group A and group C was statistically significant ( P < 0.01). The incidence of PND among the three groups on day 1, 3, 7 after surgery had statistically significant differences (all P < 0.05), and the incidence of PND in group A was lower than that in group B and C (all P < 0.05). Ramsay sedation score among the three groups at 30 min and 24 h, 48 h after operation showed statistically significant differences (all P < 0.01), and that in group C was lower than that in group A and group B, and the differences were statistically significant (all P < 0.01). Ramsay sedation score at 24 h after operation in group A was high than that in group B and group C (all P < 0.01). Conclusions:Dexmedetomidine assisted with anesthesia can reduce the incidence of PND in elderly patients undergoing radical operation of gastric carcinoma and enhance the sedative effect. What's more, the most obvious effect is the infusion of 0.5 μg·kg -1·h -1 before anesthesia induction.

Objective To analyze the temporal and spatial variation characteristics of six common air pollutants in Xi'an, and to provide a scientific basis for the environmental protection departments to conduct targeted prevention and control. Methods Based on air pollution monitoring data with high temporal resolution, the temporal and spatial distribution characteristics of six common air pollutants in Xi_'an were analyzed, and the correlation between the pollutants was studied. Results Except for O_{3_8h}, the annual average concentrations of the other five air pollutants decreased year by year. By 2020, the annual average concentration of PM_2.5 and PM₁₀ still exceeded the second-level concentration limit. The annual average concentration of NO₂ was slightly higher than the first-level concentration limit, and the number of unqualified days of O_{3_8h} accounted for one-tenth of the entire year. The concentrations of PM_2.5, PM₁₀, CO, SO₂, and NO₂ all were the highest in winter, equivalent in spring and autumn, and the lowest in summer. The concentration of O_{3_8h} generally presented the characteristics of summer > spring > autumn > winter. In 2020, the annual average concentrations of PM_2.5 and PM₁₀ in 9 urban areas exceeded the second-level concentration limit. The annual average concentrations of NO₂ in Xincheng District, Lianhu District, Beilin District, and Yanta District all exceeded the second-level concentration limit. The annual average concentration of O_{3_8h} in Beilin District, Chang'an District, and Yanliang District all exceeded the average level of Xi'an. PM_2.5, PM₁₀, CO, SO₂, and NO₂ in general showed a positive correlation in varying degrees. In summer, O_{3_8h} showed a positive correlation with other air pollutants, but a negative correlation in other seasons. Conclusion The air pollution situation in Xi'an has been improving year by year, but the pollution of PM_2.5, PM₁₀, and O_{3_8h} still exceeds the standard, which will be the focus of long-term prevention and control of air pollution in Xi'an.

Objective: To evaluate the effect of docosahexaenoic acid (DHA) on microglial activation during oxygen-glucose deprivation and restoration (OGD/R) injury. Methods: N9 microglia were inoculated in 96-well culture plates at a density of 10⁴ cells/well for 3-5 days and divided into 3 groups (n=18 each) using a random number table method: control group (group C), group OGD/R and DHA+ OGD/R group. The cells were cultured for 24 h in an incubator at 37 ℃ (95% air-5% CO₂) in group C. In OGD/R and DHA groups, the culture medium was replaced by glucose-free culture medium, the cells were cultured for 12 h in an incubator at 37 ℃ (95% N₂-5% CO₂), and then cells were returned to the normal culture medium and cultured for 24 h in an incubator at 37 ℃ (95% air-5% CO₂) to establish the OGD/R injury model. The cells in group DHA were incubated with 25 μmol/L DHA at 12 h before OGD/R. The cell viability was detected using the methyl thiazolyl tetrazolium assay, the activity of lactate dehydrogenase (LDH) was measured by using chemical colorimetric method, activated microglia were counted by immunofluorescence staining, the expression of microglia activation marker iba-1 was detected by Western blot, and the concentrations of tumor necrosis factor-α (TNF-α), interleukin 6 (IL-6) and IL-4 and IL-10 in culture medium were determined using enzyme-linked immunosorbent assay. Results: Compared with the group C, the cell viability was significantly decreased, the LDH activity was increased, the number of activated microglia was increased, and the expression of iba-1 was up-regulated in OGD/R and DHA+ OGD/R groups, the concentrations of TNF-α and IL-6 were significantly increased in group OGD/R, and the concentrations of TNF-α, IL-6, IL-4 and IL-10 were significantly increased in group DHA+ OGD/R (P<0.05). Compared with group OGD/R, the cell viability was significantly increased, the LDH activity was decreased, the number of activated microglia was decreased, the expression of iba-1 was down-regulated, TNF-α and IL-6 concentrations were decreased, and IL-4 and IL-10 concentrations were increased in group DHA (P<0.05). Conclusion The mechanism by which DHA reduces OGD/R injury may be related to inhibiting activation of microglia and to reducing inflammatory responses.

Background Mitomycin C (MMC) is still irreplaceable until now.While it's current administration method has proved less than effective in the treatment of refractory glaucoma.To construct a MMC sustained release system which can maintain effective concentration and reduce toxicity is important for postoperative scarring regulation after glaucoma filtration surgery.Objective To evaluate the postoperative effect of use PTMC-F127-PTMC thermosensitive hydrogel as a new drug delivery carrier to sustained release MMC in rabbit trabeculactory.Methods Sixty rabbits,aged 10 to 14 weeks,were divided into 5 trabeculectomy groups in accordance with the random number table,including surgery only group,blank PTMC-F127-PTMC group and three sustained groups with 0.1 ml PTMC-F127-PTMC loaded with 0.05,0.10,0.20 g/L MMC injected after surgery.The MMC concentration of anterior chamber aqueous in three sustained release group with 0.1 ml PTMC-F127-PTMC loaded with 0.05,0.1,0.2 g/L MMC injected after surgery were tested by Guangzhou Analysis and Testing Center using high performance liquid chromatograph-mass spectrometer (HPLC-MS).At 3,7 days postoperatively,0.1 ml aqueous humor from 2 random selected rabbits in each group was extracted using 1 ml syringe with 30G needles from corneal limbus.At postoperative 1,3,5,7,10,14,28 days,bleb width and depth were calculated with caliper measurements and height was graded semiquantitatively by slit-lamp examinations,intraocular pressure (IOP) was measured with Tonopen.And corneal endothelial cell densities were examined by corneal endothelial counting before and 28 days after surgery.Sequential sections of the operative region were prepared and stained with hematoxylin and eosin and proliferating cell nuclear antigen (PCNA) after taking off the eyeballs from dead rabbits at 28 days later.Results MMC could be sustained released from PTMC-F127-PTMC hydrogel for more than 20 days.The mean postoperative bleb survival time in trabeculectomy surgery only group,blank hydrogel group and three sustained release groups were (5.3 ± 0.4),(5.5 ± 0.4),(12.2 ± 1.0),(25.1 ± 0.9),(26.7 ± 0.7) days respectively,the difference between each group was significantly (F =123.200,P =0.000).0.05 g/L MMC sustained release group has a better bleb survival time than that of surgery only group and blank hydrogel group (P =0.000).Compared with other groups,0.10 g/L and 0.20 g/L MMC sustained group has the longest bleb survival time (P =0.000),and more obvious IOP downtrending (F=53 010.000,P＜0.01).But the difference between the two groups was not significant.There was no difference in cornea endothelia cells counts between each group and no MMC was detected in aqueous humors.Histopathology test shows that the inflammatory response and fibrosis were lighter in MMC sustained release group,with stronger proliferation inhibition.Conclusions PTMC-F127-PTMC thermosensitive hydrogel can be a new drug delivery carrier to sustained release MMC.Sustain release MMC can extent bleb survival time with low toxicity.

Objective This report describes the mechanism of Ginsenoside Re to resist Exercise-induced fatigue based on the observation of effects on MDA content and SOD activity.Methods Thirty male SD rats were divided into 3 groups randomly:Ginsenoside Re group,model group and control group,10 rats in each group.Rats in Ginsenoside Re group were given gastric gavage of Ginsenoside Re once a day,while rats in model and control groups were given the same volume of normal saline.One hour after administration,rats of Ginsenoside Re groups and Model groups received medium-intensity treadmill exercise for 20 minutes at the speed of 15m/min,with a slope of 0 degree,and after 40-mimute break repeated it for another 20minutes.Fourteen days later,MDA content and SOD activity have been tested.Results MDA content in the serum,liver tissue and muscle tissue of Ginsenoside Re group was obviously lower than that in the model group (P