OBJECTIVE:To explore the ideas for the prescription comment of TCM injections,and provide reference for clini-cal rational use. METHODS:Totally 9 457 prescriptions in PIVAS and 400 hospitalized medical records in our hospital in 2015 were collected. The prescriptions and hospitalized medical records which contained TCM injections were retrospectively commented in aspects of indications,usage and dosage,drug combination,solvent selection and repeat medication,and analysis of typical case. RESULTS:In 2015,there were 2 544 prescriptions(26.90%)in PIVAS and 195 medical records(48.75%)that used TCM injections;the irrational use was mainly inappropriate solvent selection(50.70%),inappropriate usage and dosage(27.00%),inap-propriate indications (10.33%),inappropriate combination therapy (7.51%) and repeat medication (4.46%). CONCLUSIONS:Prescription of TCM injections should be commented with the medical records and individual analyzed;in terms of unreasonable prescriptions and medical records TCM clinical pharmacists should actively intervene unreasonable prescriptions by the bed.

Objective To investigate the early changes of cardiac output and vital signs in term neonates shortly after born from gestational diabetic women.Methods From January 2015 to April 2015, 22 term neonates of gestational diabetes mellitus (GDM) women with euglycemia during pregnancy (GDM group) and 20 term neonates of non complicated gravidas (control group) in Shanghai First Maternity and Infant Hospital were enrolled.Neonates in both groups were measured by ultrasonic cardiac output monitor (USCOM) for cardiac hemodynamics index, including aortic peak flow velocity, pulmonary artery peak flow velocity, left cardiac output, right cardiac output and Smith Madigan inotropy index at one and two hours after birth.Vital signs including heart rate, respiratory rate, blood pressure and peripheral blood glucose were measured as well.Two independent sample t-test and Chi square test were used for statistical analysis.Results The peripheral blood glucose of neonates in GDM group was significantly lower than that of the control [(3.0±0.4) vs (4.0± 0.4) mmol/L, t=8.400, P ＜ 0.01), but all within normal range.Vital signs including heart rate, respiratory rate, mean blood pressure showed no differences between the groups (all P ＞ 0.05).In GDM group, aortic peak flow velocity were (1.230±0.160) and (1.210±0.220) m/s, left ventricle cardiac output was (0.867±0.196) and (0.859±0.193) L/min, Smith Madigan inotropy index was (0.846±0.180) and (0.823±0.189) W/m2 at one and two hours after birth, respectively, which were significantly higher than those in the control group [aortic peak flow velocity: (1.080±0.130) and (1.090± 0.120) m/s;left ventricle cardiac output: (0.754±0.098) and (0.757 ± 0.099) L/min;Smith Madigan inotropy index: (0.746 ± 0.097) and (0.725 ± 0.086) W/m2;t=3.464, 2.265, 2.296, 2.187, 2.263 and 2.202, respectively, all P ＜ 0.05].But no statistically significant differences was found on pulmonary artery peak flow velocity and right cardiac output between the two groups.Cardiac hemodynamics index had no difference between one and two hours within each group (all P ＞ 0.05).Conclusion The left ventricular contractility and left cardiac work are increased in neonates of gestational diabetes mellims women with good sugar control during pregnancy.

Objective To study the clinical and pathological features of nemaline myopathy(NM) in 12 cases.Methods Clinical manifestations and pathological features of muscle-biopsy specimens were summarized and analyzed retrospectively in 12 NM cases.Results In 12 cases,7 patients with typical congenital type exhibited lower or four limbs weakness as the first symptom and benign course.Three patients with childhood onset type exhibited lower limbs weakness and progressive course,and this type of patient might have muscle atrophy.Two patients with adult onset type exhibited four limbs and throat muscle weakness,rapidly progressive course and obvious muscle atrophy,and one patient had already shown acute respiratory failure.High arched feet and elongated face were observed.Creatin kinase value in all patients was normal or mildly elevated,and all electromyography showed myogenic changes.In light microscopy,the nemaline bodies were observed in more than half muscle fibers,especially in type 1 fibers.All patients showed type 1 predominance and atrophy.Modified Gomori trichrome stains showed characteristic purplecolored rods.Muscle electron microscopy showed high electron dense nemaline bodies around nucleus and disorganized myofibrillar apparatus such as broken myofilaments,irregular myofibril and Z lines.Nemaline bodies under electron microscopy may be part of myofibril or high electron-dense bodies with no structure.Conclusions The 12 patients in this study with NM are divided into 3 types,of which adult onset type is the most severe one.The key diagnosis is based on the appearance of nemaline bodies in more than half of the muscle fibers and the muscle electron microscopy observation.

To construct a secretory-expression vector of antimicrobial peptide Bactenecin 7(Bac7),and identify the secretory-expression product in L.lactis MG1363 and its bioactivity.The splicing primers of regulation elements and Bac7 gene,which designed according to codon usage preferences of L.lactis MG1363,were chemically synthesized,and the overlap-extension PCR method was used to splice the full length of Bac7 gene.Then the Bac7 gene was linked to expression vector pMG36e to construct pMG36e/Bac7 vector,and pMG36e/Bac7 was transformed into L.lactis MG1363 by electrophoration.RT-PCR and Western blot assays were applied to investigate the expression of the Bac7 gene in L.lactis,and bioactivity of Bac7 in culture supernatant of L.lactis was tested with plate-diffusion method.The results showed that the Bac7 gene and its regulation elements was amplified and cloned in the vector pMG36e successfully,The secretory-expressed Bac7 in L.lactis MG1363 harboring pMG36e/Bac7 was identified by Western blot,and it had high bacteriostatic activity against E.coli.These results indicate that the recombinant L.lactis MG1363 could express bioactive Bac7,which lays a foundation for further study of oral administration of a Bac7-secreting L.lactis to treat intestinal bacteria infection.

Biopsy ; Biopsy, Needle ; Bone Marrow ; pathology ; Bone Marrow Examination ; methods ; Bone Marrow Neoplasms ; pathology ; secondary ; Breast Neoplasms ; pathology ; Cytological Techniques ; Female ; Humans ; Lung Neoplasms ; pathology ; Male ; Prostatic Neoplasms ; pathology ; Retrospective Studies ; Stomach Neoplasms ; pathology

OBJECTIVETo investigate the progression of visual field loss and to explore the prognosis of glaucomatous optic neuropathy in patients with chronic angle-closure glaucoma (CACG) after their intraocular pressures were well controlled under 21 mmHg.

METHODSForty-seven eyes of 29 patients in the Department of Ophthalmology in PUMC Hospital were included. All the patients had at least two separate tests of visual fields using the 24-2 program of the Humphery Visual Field Analyzer after their intraocular pressure were well controlled under 21 mmHg after sugery. The visual fields of patients were followed routinely for at least 1 year. In addition, all patients were divided into 2 groups according to follow-up period: 1-2 years group and over 2 years group. Visual field scores were calculated with the Advanced Glaucoma Intervention Study (AGIS) method. The visual fields were divided 5 sections and the sensitivity and defect depth of each section were calculated.

RESULTNo statistically significant differences were found in terms of AGIS scores, localized sensitivities and localized defects within the time interval of the observation.

CONCLUSIONGlaucomatous optic neuropathy is not likely to progressively deteriorate in CACG cases once their intraocular pressure are well controlled under 21 mmHg.

Aged ; Female ; Follow-Up Studies ; Glaucoma, Angle-Closure ; physiopathology ; surgery ; Humans ; Intraocular Pressure ; Male ; Middle Aged ; Optic Disk ; physiopathology ; Optic Nerve Diseases ; physiopathology ; Retrospective Studies ; Visual Fields

Objective To investigate the effect of hydrochloric acid (HCl) stimulation and mechanical stretch on epithelial-mesenchymal transition (EMT) and hyaluronan (HA) production in human lung epithelial cells. Methods Human lung epithelial cell line BEAS-2B was cultured in vitro, which was divided into phosphate-buffer saline (PBS) + static group, HCl + static group, PBS + stretch group, and HCl + stretch group respectively in the logarithmic phase. The BEAS-2B cells in two stretching groups were challenged by cyclic stretch with 20% amplitude, frequency of 0.33 Hz, sine wave of the FX-5000T system for 48 hours. The morphology changes in cells before and after stretch were observed with inverted microscope. The protein expressions of epithelial markers E-cadherin and cytokeratin-8 (CK-8) as well as mesenchymal markers vimentin and α-smooth muscle actin (α-SMA) were determined by Western Blot. The secretion of HA was determined by enzyme linked immunosorbent assay (ELISA). Results ① It was shown by microscopic observation that BEAS-2B cells displayed cobblestone morphology, linked closely and cell polarity in PBS + static group, which did not change obviously after HCl stimulation alone. Given purely mechanical stretch after 48 hours, the cells morphology changed from cobblestone shape into long spindle, and increased intercellular space obviously. Double hit of HCl and stretch changed the cells morphology more significantly. ② It was shown by Western Blot that compared with the PBS + static group, HCl alone or combined with purely mechanical stretch after 48 hours, the expressions of E-cadherin and CK-8 were decreased, while those of vimentin and α-SMA were increased, and it was more pronounced in HCl + stretch group [the expression quantity (gray value) as base 1 in PBS + static group, E-cadherin: 0.16±0.08 vs. 1, CK-8: 0.10±0.03 vs. 1, vimentin: 3.35±0.38 vs. 1, α-SMA: 3.10±0.45 vs. 1, all P < 0.01]. ③ It was shown by ELISA that both HCl stimulation and stretch could induce BEAS-2B cells secreting HA as compared with PBS + static group (μg/L: 55.763±0.687, 63.005±0.493 vs. 49.876±1.867), and the production of HA increased more remarkably after double hit (μg/L: 78.220±1.085 vs. 49.876±1.867, P < 0.01). Conclusions Both HCl and mechanical stretch could induce EMT and increase HA secretion in human lung epithelial cells in vitro. Double hit of HCl stimulation and mechanical stretch induced EMT apparently, and further increased the production of HA.

OBJECTIVETo investigate the status of visual disability and the demands for visual rehabilitation services in Beijing.

METHODSFive hundred and fifty-five persons with visual disability in Beijing from the Second National Survey on Disability of China were involved in this study. Their visual disability and demands for rehabilitation were evaluated.

RESULTSAbout three fourth of the visual disabled persons were over 60 years of age. Cataract, retinal and choroidal diseases, and glaucoma were the three leading causes of the visual impairment. Medical service was the number one (82.0%) demand for the persons with visual disability, although 89.4% of them had previously received some kinds of medial services. People who had received visual aid devices or rehabilitation training were 26.7% and 5.8%, respectively, while more people showed their demand for these service (36.6% and 11.9%, respectively). The demand for visual rehabilitation varied in different groups of age and severity of disability.

CONCLUSIONAccessibility of high quality medical services for preventable blindness diseases should be further promoted. Public health education on visual rehabilitation is also needed.

Adolescent ; Adult ; Aged ; Aged, 80 and over ; Child ; Child, Preschool ; China ; epidemiology ; Disabled Persons ; rehabilitation ; Female ; Health Services Needs and Demand ; Humans ; Infant ; Infant, Newborn ; Male ; Middle Aged ; Vision, Low ; epidemiology ; rehabilitation ; Young Adult

OBJECTIVETo study the agreement between ophthalmologists and community health workers in detecting shallow anterior chamber with oblique flashlight test.

METHODSTotally 425 subjects were given an eye examination in a community health center. The anterior chamber depth of each subject was examined by one ophthalmologist and two trained community health workers (one nurse and one non-professional health worker) using oblique flashlight test. Inter-observer agreement was determined using the weighted kappa statistic.

RESULTSAmong the enrolled subjects, 148 (35%) were male and 277 (65%) were female. Good agreement was noted in all the three observers. The comparison between the ophthalmologist and the nurse showed a kappa statistic of 0.42 for both eyes (P < 0.001). The kappa statistic was 0.54 and 0.52 for right and left eyes respectively between the ophthalmologist and the non-professional health worker (P<0.001). As for agreement between the nurse and the non-professional health, worker, the kappa statistic was 0.49 and 0.38 for right and left eyes, respectively (P < 0.001).

CONCLUSIONThe oblique flashlight test may be used as an applicable tool by trained community health workers for screening of shallow anterior chamber and play a role in blindness prevention in community.

Adult ; Aged ; Aged, 80 and over ; Anterior Chamber ; anatomy & histology ; pathology ; Community Health Workers ; Diagnostic Tests, Routine ; standards ; Female ; Glaucoma, Angle-Closure ; diagnosis ; pathology ; Humans ; Light ; Male ; Middle Aged ; Ophthalmology ; manpower ; Photic Stimulation ; Risk Factors ; Sensitivity and Specificity ; Young Adult

[Absract] Objective This paper was designed to reveal the new mechanism on ASI Ⅱ triggered CD4+T cells activation via regulating CD45 molecular and provide a basis for the theoretical foundation of antitumor immunotherapy of Astragalus.Methods The CD4+T cells were randomly divided into negative group,stimulated control group,ASI Ⅱ group,CD45 inhibitor group,and the combination of ASI Ⅱ and CD45 inhibitor group.Besides negative group,the cells from other groups were activated by anti-CD3/CD28 antibody.ASI Ⅱ group was treated with 10 nmol/L ASI Ⅱ,CD45 inhibitor group was treated with 0.8 μmol/L CD45 inhibitor,and the combination group were treated with 10 nmol/L ASI Ⅱ and 0.8 iμmol/L CD45 inhibitor.After 36h culture,the proliferation of CD4+T cells was detected by Ki-67 intracellular staining assay.Cytokine production of Th1 and Th2 were examined ELISA method.The proportion of surface marker (CD44 and CD25)and Th1 intracellular cytokines (IFN-γ) were detected by flow cytometry.Results Compared with stimulated group,Astragaloside Ⅱ group in CD4+Ki67+T positive proportion (5.37％ ± 0.92％ vs.1.19％ ± 0.23％),in CD4+CD25+ positive proportion (50.23％ ± 4.65 ％ vs.15.89％ ± 1.13％),in CD4+CD44+ positive proportion (33.16％ ± 6.08％ vs.15.36％ 4 1.45％),in CD4+IFN-γ+ positive proportion (1.42％ ± 0.44 ％ vs.0.38％ ± 0.06％) were significntly increased.And the secretion of IFN-γ,IL-4 and IL-2 in ASI Ⅱ group were higher than stimulated group.The anti-mouse CD45 Ab treatment markedly blocked the proliferation and Th1 cytokines production which induced by ASI Ⅱ.Furthermore,the anti-mouse CD45 Ab treatment significantly decreased the expression of surface marker (CD44 and CD25).Conclusions Activating CD45 protein tyrosine phosphatase may be involved in ASI Ⅱ triggered CD4+T cells activation.This study will provide a basis for antitumor immunotherapy of Astragalus.