OBJECTIVE To analyze the quality of the disposable sterile medical appliances befoure used and give suggestions for managements.METHODS The acceptance process of the disosable sterile medical appliances during the past five years wes restropectively analyzed and the unqualified products were found out.RESULTS After examination of the sterile medical devices,the main problems were more ethylene oxide residues,packaging damaged,expiry date not clear,both within and outside the Model not matching the registration of medical device product number.Categories not matching the product and so on.CONCLUSIONS The above problems are not meet the national laws and regulations,and should be timely and effective monitored to achieve safety use of medical device.

0.05),Conclusion The possibihty of thymoma should be considered among those late-onset SLE patients.The glucocorticoid-based immunosuppressive therapy is effective for thymoma-associated SLE.To treat SLE is not an indication for thymectomy.

Objective To develop a hyperthermia temperature control system for the treatment of pelvic inflammatory disease. Methods Temperature was controlled by using PWM method based on a single chip computer. The system was heated by using heating wire. In the whole cycle of T, the heating wire's work time was divided into three different stages according to different temperature of system: in the lower temperature, the duty cycle of the heating wire's work time was 100%; when the system temperature entered to a certain stage, a control variable was obtained through the PID algorithm which was used to compare the difference between the current temperature and the temperature requirements. The control variable determined the duty cycle of the heating wire's work time: the more close to the temperature required for the temperature of system, the duty cycle of the heating wire's work time was more close to 0; if the temperature exceeded a predetermined value, then the heating wire would not heat in the whole cycle. Results The accuracy of the temperature control system was ?0.2 ℃, the overshoot of the temperature control system was ?0.3 ℃, and the response time of the temperature control system was 500 seconds. Conclusion The temperature control method has high precision, small overshoot, and the right response time, which can meet the requirements of constant temperature of hyperthermia treatment. Besides, it is simple and cheap.

Objective To compare the effects of telmisartan and (or) amlodipine on the reversal left ventricular re-modeling in two-kidney one clip hypertensive rats. Methods A total of 50 healthy male SD rats were randomly divided into 5 groups (n=10):two-kidney one clip renal hypertensive (2KIC) model group, sham group, telmisartan (10 mg/kg) group, am-lodipine (2.5 mg/kg) group and telmisartan (10 mg/kg)+amlodipine(2.5 mg/kg) group. The model of two-kidney one clip re-nal hypertensive rats was established. The tail arterial blood pressure was detected once a week. After 20 weeks, rats were sacrificed and specimens were collected. The left ventricular mass index (LVMI) was assessed. The myocardial ultrastructur-al changes were observed by electron microscope. Values of plasma renin activity (PRA), angiotensionⅡ(AngⅡ) and atrial natriuretic peptide (ANP) were measured by enzyme linked immunosorbent assay (ELISA).Results Compared with sham group, the levels of systolic blood pressure (SBP), LVMI, PRA, AngⅡand ANP were significantly higher in 2KIC group (P＜0.01). Compared with 2KIC group, values of SBP, LVMI, PRA and ANP were significantly lower in telmisartan group and am-lodipine group (P＜0.01), but the value of AngⅡwas significantly higher (P＜0.01). The levels of SBP, LVMI, AngⅡand ANP were significantly lower in combined medication group than those of single drug medication group (P＜0.01). There was no significant difference in the plasma PRA level between those groups (P>0.05). Results of myocardial electron microsco-py showed that the left ventricular remodeling was significantly improved in combined treatment group. Conclusion Telmisartan and amlodipine can effectively improve the left ventricular remodeling induced by hypertension. There was more effective therapy using both medications together.

Objective: To observe the expression of long non-coding RNA myocardial infarction associated transcript (LncRNA-MIAT) in tumor necrosis factor-α (TNF-α) induced endothelial cells (ECs) inflammation in vitroand to study the impact of LncRNA-MIAT on inflammatory regulation. Methods: LncRNA-MIAT expression in ECs was induced by TNF-α at different time and concentration. Expressions of intercellular adhesion molecule-1 (ICAM-1) and LncRNA-MIAT in inflammatory ECs were examined by quantitative real time polymerase chain reaction (qRT-PCR) and Western blot analysis. Moreover, ECs was transfected by siRNAMIAT to observe the effect of LncRNA-MIAT knock-down on ICAM-1 expression. Results: LncRNA-MIAT expression showed the increasing trend by elevated time and concentration of TNF-stimulation. Compared with TNF-α stimulation at 0h, 6h and 12h, LncRNA-MIAT expressions were increased at 24h and 48h of TNF-αstimulation respectively, allP<0.05; compared with TNF-α concentration at 0ng/ml and 0.125ng/ml, LncRNA-MIAT expressions were elevated by TNF-α stimulation at 1.000ng/ml and 10.000ng/ml respectively, allP<0.05. With siRNAMIAT knock-down, TNF-α induced ICAM-1 protein expression was significantly reduced in ECs,P<0.05. Conclusion: LncRNA-MIAT might be involved in ECs inflammatory response and it may play a role to promote inflammation.

OBJECTIVETo characterize the effect of omeprazole on the spectrum of gene expression in the cultured human umbilical vein endothelial cell (HUVEC) line (EA.hy926), and explore the underlying molecular mechanism.

METHODSAffymetrix U133 plus2.0 oligonucleotide microarray was used to detect the alteration in the gene expression profiles induced by 1×10(-5) mol/L omeprazole in HUVECs. Real-time PCR was employed to verify the results of selected differentially expressed genes, and Western blotting was performed to test the expression levels of the related proteins.

RESULTSA total of 282 genes were found to show at least 1.5-fold changes in EA.hy926 cells after treatment with omeprazole for 48 h, including 236 up-regulated and 46 down-regulated ones. These genes were involved in the regulation of transcription, inflammatory response, immune response, cell adherence, anti-apoptosis, and signal transduction.

CONCLUSIONOmeprazole modulates the function of endothelial cells by regulating the gene expression profiles of multiple pathways.

Cell Line ; Computational Biology ; Human Umbilical Vein Endothelial Cells ; drug effects ; Humans ; Oligonucleotide Array Sequence Analysis ; Omeprazole ; pharmacology ; Transcriptome ; drug effects

OBJECTIVETo compare the effects of clopidogrel combined with dihydropyridine calcium-channel blockers (CCBs) or non-dihydropyridine CCBs on coronary artery disease (CAD) in elderly patients.

METHODSThe study cohort was defined as all patients ≥60 years old hospitalized for CAD with the prescription of clopidogrel between January 2001 and February 2011. The primary endpoint was death of all causes, and the secondary endpoints were nonfatal myocardial infarction (MI), hospitalization for unstable angina, stroke, transient ischemic attack, or repeat revascularization (PCI or coronary artery bypass graft).

RESULTSA total of 1021 patients were enrolled, among whom 402 patients were prescribed with clopidogrel and 619 with clopidogrel combined with CCB (dihydropyridine in 547 and non-dihydropyridine in 72). In clopidogrel group and clopidogrel with CCB group, the incidence density of death was 50.55 per thousand and 42.02 per thousand, respectively. The crude RR was 0.83 (95%CI: 0.55-1.26), and the multivariable-adjusted RR was 0.47 (95%CI: 0.14-1.6), showing no statistical significance in the rate of deaths of call causes between the two groups (P>0.05); the incidence density of composite thromboembolic events showed no significant difference between the two groups, either (P>0.05). After weighting of the propensity score, the patients with clopidogrel coadministered with non-dihydropyridine CCB showed a significant increase in composite thromboembolic events than those taking dihydropyridine CCB, with a SMRW-adjusted OR of 1.97 (95%: 1.2-3.23, P=0.007). No significant difference was observed in death or composite thromboembolic events between Pgp-inhibiting CCBs and non-Pgp-inhibiting CCBs.

CONCLUSIONCompared with clopidogrel without CCB, clopidogrel with CCB does not increase the mortality or composite thromboembolic events in elderly CAD patients, but clopidogrel combined with non-dihydropyridine CCB is associated with significantly increased composite thromboembolic events in comparison with dihydropyridine CCB.

Aged ; Aged, 80 and over ; Calcium Channel Blockers ; therapeutic use ; Cohort Studies ; Coronary Artery Disease ; drug therapy ; Drug Therapy, Combination ; Humans ; Middle Aged ; Propensity Score ; Retrospective Studies ; Ticlopidine ; analogs & derivatives ; therapeutic use

Objective:To evaluate the efficacy of roxatidine and omeprazolein on preventing gastrointestinal bleeding in critically ill patients.Methods:A prospective cohort study was conducted in adult patients admitted to an intensive care unit (ICU), who had risk factors for stress related mucosal disease (SRMD), and had an estimated stay of no less than 5 days and mechanical ventilation for more than 48 h. Patients were randomized into the experiment group (Roxatidine 75 mg IV Q12 h) and control group (Omeprazole 40 mg IV Q12 h). Demographic data, acute physiology and chronic health score (APACHEⅡ) and SOFA score on day 1 were collected, intragastric pH values were tested every 2 hours for the first 5 days, the daily average of pH and proportion of patients with average pH≥4 were calculated. Stool occult blood were detected at day 1 and bacterial culture of gastric juice were performed before medication administration and on day 5 after medication administration. The implementation of enteral nutrition support, situation of gastrointestinal hemorrhage and adverse effects were analyzed. Furthermore, length of hospital stay and mortality in ICU and on the 28th day were acquired. SPSS 22.0 software was used for data analysis. Consecutive data were expressed as mean and standard deviation, categorical data were expressed as frequencies (percentage). Comparison of measurement data between groups was performed by analysis of variance or rank sum test. Comparison of count data between groups was performed by the Chi-square test. P<0.05 was regarded as statistically significant. Results:A total of 91 patients were recruited and randomly separated into experimental group ( n=46) and control group ( n=45) from October 2017 to March 2018. There were no statistical differences in gender, age, body mass index (BMI), enteral nutrition status, APACHEⅡ and SOFA score on day 1 between the two groups (all P>0.05). Roxatidine in the experiment group rapidly increased the intragastric pH to ≥4.0 and continued to stabilize at pH ≥4.0 during the monitoring period. Omeprazole increased and maintained intragastric pH≥5.0. The proportion of patients with average pH≥4.0 was 82.5% in the second 24 hours in the experiment group, and stably increased to 90% on day 5. There were no significant differences between groups in gastrointestinal bleeding, length of hospital stay, and mortality in ICU and on 28th day(all P> 0.05). No drug related adverse effects occurred during the study period. Logistic-regression analysis did not screen for risk factors of SRMD. Conclusions:Roxatidine acetate hydrochloride can rapidly elevate and maintain the gastric pH above 4.0, and has similar efficacy and safety as omeprazole in inhibiting gastric acid secretion and preventing SRMD with gastrointestinal bleeding.

Objective To explore the therapeutic effects and mechanisms of umbilical cord mesenchymal stem cells(UC-MSCs)implantation on knee osteoarthritis(OA)in rabbits. Methods The healthy adult New Zealand rabbits were divided into control group(n=4),OA model group(n=4),and treatment group(n= 4).OA model was induced by 4% papain injection(0.1 ml/kg for 2 times),and treatment group were treated with UC-MSCs implantation(1 ml,1×105/L).At 2 weeks after papain injection for preparation of osteoarthritis model,rabbits knee joints were examined by MRI,and synchrony serum levels of IL-6 and-8,MMP-3 and-13 were tested.At 3 weeks after papain injection for OA,1×106/L 1 ml UC-MSCs were injected into articular cavity in treatment group,and normal saline was injected into articular cavity in blank control group and OA model group.At 2 weeks and 4 weeks after the treatment,serum levels of IL-6 and IL-8,MMP-3 and MMP-13 were tested respectively.At 4 weeks after the treatment,knee joints were reexamined again by MRI.After this,the rabbits were sacrificed and synovium and articular cartilage were taken out for HE and immunohistochemistry examination.Serum levels of IL-6 and IL-8,MMP-3 and MMP-13 were tested by ELISA method. Results The levels of inflammatory cytokines such as IL-6,IL-8,MMP-3,MMP-13 were significantly higher in model group 〔(44.7 ± 14.5)μg/L,(7.6 ± 2.5)μg/L,(16.5 ± 4.3)μg/L,(4.50 ± 1.20)μg/L〕and in treatment group 〔(43.9 ± 15.2)μg/L,(9.8 ± 2.9μg/L),(18.3 ± 4.9) μg/L,(4.80 ± 1.80)μg/L〕than in control group〔(20.8 ± 11.2)μg/L,(1.2 ± 0.6)μg/L,(2.8 ± 0.9) μg/L,(0.02 ± 0.02)μg/L〕(all P < 0.05).The levels of IL-6,IL-8,MMP-3,MMP-13 were significantly lower after UC-MSCs treatment〔(23.8 ± 11.4)μg/L,(2.4 ± 1.3)μg/L,(10.5 ± 3.4)μg/L,(0.50 ± 0.20)μg/L〕than before treatment(all P<0.05).Based on magnetic resonance imaging,the treatment group versus model group showed an improved coarse cartilage surface,thickened subchondral bone and synovium,and decreased volume of joints effusion.Pathological finding showed lower levels of inflammatory reaction in cartilage and synovium in the treatment group versus model group.Immunohistochemistry showed lower levels of IL-6 and MMP-13(all P<0.05). Conclusions The inflammatory response of cartilage and synovial tissue induces OA progress,and the inflammation factors play a significant role in OA progress.UC-MSCs could protect cartilage and synovial membrane of joints and inhibit the inflammatory response.Therefore,this study provides new therapy method for OA.

Objective To analyze the pathogenic bacteria and drug resistance of peritoneal dialysis-associated peritonitis(PDAP),and provide a clinical reference for the rational use of antibiotics.Methods The demographic data of PDAP patients admitted to the peritoneal dialysis(PD)Center of the First Affiliated Hospital of Soochow University from July 1,2015 to December 30,2021 were collected,and the pathogens,drug resistance and prognosis were retrospectively analyzed.Results A total of 150 episodes of PDAP occurred in 92 patients.The positive rate of PD fluid culture was 61.33％,including 65 cases(70.65％)of Gram-positive(G+)bacteria,mainly Staphylococcus and Streptococcus.Gram-negative(G-)bacteria were in 16 cases(17.39％),mainly Escherichia coli and Enterobacter cloacae.There were 11 cases(11.96％)of multiple infections,including 5 cases of combined fungal infection.From 2016 to 2021,the incidence of G+bacteria-related PDAP decreased from 14 to 8 cases.G+strains were resistant to methicillin(35.00％),and were sensitive to linezolid(100.00％),teicoplanin(100.00％)and rifampicin(100.00％).The sensitivity rate to vancomycin was 98.59％.G-strains were sensitive to ceftazidime(86.36％),ceftizoxime(88.89％)and amikacin(100.00％).The MIC of vancomycin against Staphylococcus showed an upward trend in 2019-2021.The overall cure rate of PDAP was 81.33％in patients who responded to antibiotic treatment,and the cure rate of G+bacteria was higher than that of multiple infections(89.23％vs.36.36％,P＜0.01).The outcome of patients with multiple infections,especially those with concurrent fungal infection was poor.Conclusion The incidence of PDAP in the PD center has shown a decreasing trend in recent years.G+bacteria are still the main pathogenic bacteria causing PDAP,and they are highly resistant to methicillin,so vancomycin should be used as empirical therapy.For G-bacteria,cefotaxime and amikacin can be chosen as empirical therapy.There is a drift in the MIC values of vancomycin against Staphylococcus in the study period,so it is necessary to monitor the MIC of vancomycin against Staphylococcus and its changing trend.