Objective To understand the situation of off-label use of sildenafil, so as to provide reference for developing off-label drug use policy. Methods A stratified random sampling method was used to collect prescription data of sildenafil in Guangdong Women and Children Hospital in 2015. The off-label drug use situation was analyzed according to drug labels. The situations of drug use in all departments were summarized, and off-label drug use occurrences were analyzed.Results A total of 1044 prescriptions with sildenafil were collected and analyzed to discover the occurrence of off-label use was up to 69. 54%. The top 3 departments of off-label use of sildenafil were assisted reproductive center, heart center and neonatal intensive care unit (NICU). The top 3 types of off-label use were non-indication(50. 35%), over drug population(31. 76%) and over drug administration(17. 89%). The top 3 diseases for non-indications were infertility, pulmonary hypertension and congenital heart disease. Conclusion Sildenafil off-label use was common in Guangdong Women and Children Hospital in 2015, especially in assisted reproductive center, heart center, and NICU. The result suggests that more clinical studies about sildenafil on cardiovascular system are expected to provide more evidence for drug use, so as to ensure the safety of drug use in special populations and avoid potential medical risk.

Objective To explore the clinical effects of pyloroplasty on proximal gastrectomy in patients with lesions in cardia of the bottom of stomach.Methods One hundred cases of the proximal gastric diseases who were enrolled in the second affiliated hos-pital of Chongqing medical university from the January 2010 to December 2013 were selected in this prospective randomized con-trolled experimental study.Among them,6 cases were excluded,and the other 94 cases were divided into two groups:the experimen-tal group (A),in which 54 patients were underwent additional pyloroplasty surgery;the control group (B),in which 40 patients were underwent with no strings attached pyloroplasty.All patients were followed up.Then,the clinical indicators during hospitaliza-tion,term complications and repeated endoscopy prompted pyloric stenosis and reflux esophagitis situation three months after dis-charged from hospital were observed.Results There was no significant difference in the incidence rate of gastroplegia (P >0.05);there were significant differences in other clinical indicators during the postoperative hospitalization and the incidence rate of compli-cations (P <0.05).Conclusion Proximal gastrectomy additional pyloroplasty could reduce gastric retention,decrease the incidence of reflux esophagitis,shorten the hospital period and could be helpful for recovery,thus it is recommended to be further promoted.

Hemolysins of Leptospira interragans have been shown to be the virulence factor in the pathogenesis of leptospirosis and 10 potential hemolysin genes were charecterized by genomic annotation of L.interrogans serovar.Lai strain 56601. In the present study, the LA0202 gene supposed to encode one of the new potential hemolysin was cloned and the protein encoded was purified. The purified protein was shown to have highly hemolytic activity as demonstrated on the sheep blood agar plate. It was also confirmed that the LA0202 protein-mediated hemolysis on sheep erythrocytes was osmotically protected by PEG6000. Meanwhile, this protein could induce pore formation on sheep erythrocytes and cause damages on the membrane of human L-02 liver cells. In addition, it could induce apoptosis of human L-02 liver cells after treatment of cells with this protein for 24 hours. It is evident that LA0202 protein acting as a pore-formong hemolysin can induce cytotoxic damage on mammalian cells.

Two highly conserved and with abundant quantity of lipoproteins in outer membrane of pathogenic species,but not in saprophytic species of leptospira ,LipL32 and LipL21,were selected to construct the fusion gene DNA vaccine pVAX1/LipL21-LipL32,and its ability to induce immune responses in BALB/c mice inoculated with this recombinant DNA vaccine was investigated in the present study.Expression of the fusion-protein LiPL21-LiPL32 was demonstrated in HEK293 cells following transfection with the fusion gene DNA vaccine and the immune responses induced after intramuscular inoculation with this DNA vaccine in BALB/c mice was then evaluated by microscopic agglutination test (MAT),meanwhile the ELISA assay was used to detect the cytokines induced.It was demonstrated that significant level of specific antibodies agglutinating antigens of Leptospira interrogans could be detected by MAT after DNA vaccine inoculation.The production of cytokines IL-10 and TNF-β in mice inoculated with DNA vaccine pVAX1/LipL21-LipL32 was significantly increased in comparison with that of the group inoculated with pVAX1 alone.These results indicate that the recombinant DNA vaccine pVAX1/LipL21-LipL32 may be of potential value to design and develop new generation of vaccines against leptospirosis.

Objective To establish a real-time monitoring system for hospital special drugs based on internet of things. Methods According to the regulations of special drug administration, combining with the internet of things technology, realtime management of drugs in terms of purchasing, receiving, using and reporting loss recovery were realized. Results After the special drug management system was used, intelligent management of drug use, inventory supervision, application management and prescription audit was realized. Conclusion Establishnment of special medical institutions and drug dynamic supervision information platform and system can realize the whole process of the traceability management, not only improving the work efficiency, also improving the drug safety and management level.

Objective:To analyze the influencing factors of early miscarriage after in vitro fertilization/intracytoplasmic sperm injection-embryo transfer treatment.Methods:From January 2015 to August 2018, 461 cases of pregnant women who received mid luteal phase ovulation induction in Beijing Obstetrics and Gynecology Hospital, Capital Medical University were retrospectively analyzed.According to the pregnancy outcome, the patients were divided into early miscarriage group (54 cases) and delivery group (407 cases). The general situation and ovulation induction outcome of the two groups were compared, and the related factors of early spontaneous miscarriage were analyzed.Results:There was no significant difference in age, pre pregnancy body mass index, type of infertility, history of abortion, thyrotropin, basal endocrine level, number of antral follicles, daily hormone level of hCG injection, and number of oocytes retrieved between early miscarriage group and delivery group (all P>0.05). Logistic regression analysis showed that age and basal follicle stimulating hormone were risk factors for early miscarriage.The risk of early miscarriage in patients with age ≥ 35 years old was 1.854 times higher than that in patients younger than 35 years old, 95% CI 1.027-3.347, P=0.041; the risk of early abortion in patients with basal FSH ≥ 10 U/L was 1.499 times higher than that in patients with basal FSH<10 U/L, 95% CI 0.776-2.895, P=0.048. Conclusion:Age and basal follicle stimulating hormone are risk factors for early miscarriage after long protocol assisted pregnancy in mid luteal phase.

OBJECTIVETo investigate the effects of anti-apoptosis gene (bcl-X(L)), cytochrome c and caspase-3 activity on chemoresistance in cisplatin-resistant human ovarian cancer cell lines (A2780/DDP, COC1/DDP).

METHODSThe expression of bcl-X(L) cisplatin treated cytochrome c and caspase-3 activity were monitored by RT-PCR and Western blot in cisplatin-resistant (A2780/DDP, COC1/DDP) and cisplatin-sensitive (A2780, COC1) cell lines. The apoptotic rates of A2780, COC1, A2780/DDP and COC1/DDP were detected with flow cytometry after having been treated by cisplatin.

RESULTSThe expression of bcl-X(L) in A2780/DDP and COC1/DDP was significantly higher than that in A2780 and COC1 cells, whereas the expression of cytochrome c, caspase-3 activity and apoptotic rates of A2780/DDP and COC1/DDP were significantly reduced more than those of A2780 and COC1 after having been treated by cisplatin (P < 0.05).

CONCLUSIONThe overexpression of anti-apoptotic gene bcl-X(L), which downregulates cytochrome c and decreases caspase-3 activity, may be related to cisplatin-resistance in human ovarian cancer cell lines.

Antineoplastic Agents ; pharmacology ; Apoptosis ; Caspase 3 ; Caspases ; metabolism ; Cisplatin ; pharmacology ; Cytochrome c Group ; metabolism ; Drug Resistance, Multiple ; physiology ; Drug Resistance, Neoplasm ; physiology ; Female ; Humans ; Ovarian Neoplasms ; pathology ; Proto-Oncogene Proteins c-bcl-2 ; metabolism ; Tumor Cells, Cultured ; bcl-X Protein

Objective:To analyze the viral genome sequence of novel coronavirus infected persons in Baotou City, understand the mutation characteristics of novel coronavirus genome in the process of transmission among cases, and explore the transmission rule of novel coronavirus in the clustered populations.Methods:Nine throat swabs samples (No. 1 - 7, No. 9, and No. 10), two sputum samples (No. 8, No. 11, and No. 11 sample was from No. 10 case), and one surface smear sample (No.12, and No. 12 sample was from No. 10 case) were collected from 10 confirmed cases of novel coronavirus infection in Baotou City from January 25 to February 21, 2020. Samples 1 and 3 were from single cases, and the rest were from clustered cases. The virus genome was sequenced by metagenomic next-generation sequencing (mNGS), and single nucleotide polymorphism (SNP) mutation sites were screened by comparing with NC_045512, a reference strain of novel coronavirus. Combined with relevant epidemiological information, gene mutation, virus typing, and evolutionary traceability analysis were carried out.Results:The results of viral genome mNGS showed that 76 SNP mutation sites were detected in 12 samples compared with the reference strain NC_045512, including 3 (3.95%) transitions and 73 (96.05%) reversals. There were 19 (25.00%) synonymous mutations and 57 (75.00%) non-synonymous mutations. The analysis of nucleotide and amino acid variation sites showed that mutations were found at five sites (T2821C, C6548T, T16464C, G16858A and T251C) in all the clustered cases (cases 2, 4 - 10). In the single cases, sample 1 had mutations at C9245T and A15340T, and sample 3 had mutation at C13T. The virus typing analysis showed that the samples 1 and 3 belonged to the L type of novel coronavirus, while the rest belonged to the S type of novel coronavirus. The results of genomic evolutionary relationship analysis showed that all the samples could be divided into two branches. The branches of sample 1 and 3 belonged to single cases, and the rest belonged to family clustered cases.Conclusion:The genomic characteristics of the clustered cases of novel coronavirus infection in Baotou City are basically consistent with the epidemiological investigation results, and the transmission of the virus is mainly related to close contact and family gathering.

Objective:To study the changes in serum small molecule metabolites after brucella infection in humans using untargeted metabolomics methods, and screening representative biomarkers. Methods:A total of 109 serum samples collected from January 2019 to December 2021 at the Brucellosis Clinic of the Baotou Center for Disease Control and Prevention were divided into acute phase group ( n = 40), chronic phase group ( n = 35) of brucellosis, and healthy group ( n = 34) based on clinical diagnosis. Ultra-high performance liquid chromatography quadrupole time-of-flight mass spectrometry technology was used to test serum samples and screen for differential metabolites. Receiver operating characteristic curve was used to evaluate the predictive ability of differential metabolites for brucellosis. Enriched pathways were screened using Kyoto Encyclopedia of Genes and Genomes (KEGG) pathway to identify metabolic pathways significantly affected. Results:A total of 17 differential metabolites were screened between the acute phase group and the healthy group, and 12 differential metabolites were screened between the chronic phase group and the healthy group. There were a total of 5 differential metabolites (oleamide, linoleamide, stearamide, palmitoleic acid, α-linolenic acid) statistically significant among the three groups ( F = 16.84, 17.52, 14.31, 13.01, 20.76, P < 0.05). KEGG pathway analysis showed that the differential metabolites in the acute phase group were enriched in metabolic pathways such as ether lipid metabolism, glycerophosphate metabolism, sphingolipid signal and sphingolipid metabolism. The differential metabolites in the chronic phase group were enriched in metabolic pathways such as glycerophosphate metabolism, ether lipid metabolism, protein digestion and absorption metabolism. Conclusion:Untargeted metabolomics methods can screen out serum small molecule metabolites that undergo changes after brucella infection in the human body, including oleamide, linoleamide, stearamide, palmitoleic acid, α-linolenic acid can serve as potential biomarkers to distinguish brucellosis patients from healthy people.