1.Effects of China's national essential medicines policy on the use of injection in primary health facilities.
Xiaoxi, XIANG ; Chunyan, YANG ; Difei, WANG ; Jing, YE ; Xinping, ZHANG
Journal of Huazhong University of Science and Technology (Medical Sciences) 2012;32(4):626-9
The overuse of injection exists more than 20 years since economic reform in China. It is a persistent problem and seems becoming a new challenge in the new health reform period. This study was designed to assess the effect of national essential medicines policy (NEMP) on injection use at primary health facilities in China by investigating their prescription information. Questionnaires were designed and disseminated to collect empirical data on injection use at 120 primary health facilities in 6 provinces from January to September in 2010 and 2011. The injection use was measured as the indicator as the percentage of prescriptions with one or more injections. The results showed that the percentage of prescriptions with one or more injections was decreased from 38.91% to 36.82% (χ (2)=11.158, P=0.001) in the all survey areas during the NEMP reform. The difference in level of the injection use in 2011 was significant among the eastern, central and western regions (χ (2)=223.584, P=0.000); level of the injection use in western region was the lowest (27.73%), while that in the central region was the highest (43.10%). The level of the injection use in 2011 among different provinces was also of great difference (26.00%-58.25%, range: 32.25%). The level of the injection use in 2011 was still much higher than the standard suggested by WHO for developing countries (13.4%-24.1%). It was concluded that NEMP has improved injection use in China, but the injection abuse situation remains serious, indicating that one of the priorities to the next stage of NEMP is to promote the rational use of drugs, especially the injection use.
2.Identification of Pinelliae Rhizoma and Its Adulterants Based On ITS2 Sequence
Yaqin ZHANG ; Ming SONG ; Wei SUN ; Li XIANG ; Xiaoxi MA ; Jiajia FAN ; Jun WANG ; Xiaocun ZHANG ; Xia LIU
World Science and Technology-Modernization of Traditional Chinese Medicine 2014;(8):1725-1729
In this study, the ITS2 sequence was used to identify Pinelliae Rhizoma and its adulterants to ensure its market circulation, clinical effect and safety. All genomic DNA from 59 samples were extracted successfully. The Kimura 2-Parameter (K2P) distances and NJ tree were calculated using software MEGA 6.0. The length of the ITS2 sequence of Pinelliae Rhizoma was 251 bp. The intraspecific genetic distance was smaller than the interspecific ones;The NJ tree indicated that Pinelliae Rhizoma distinguished from its adulterants obviously. The results showed that the ITS2 sequence can be used to distinguish Pinelliae Rhizoma from its adulterants accurately and stably.
3.Identification of Psammosilene Radix and Its Adulterants by ITS2 Sequence
Ming SONG ; Wanbing ZHANG ; Yaqin ZHANG ; Wei SUN ; Li XIANG ; Jinli SHI ; Xiaoxi MA ; Jun WANG ; Jiajia FAN ; Xiaochun ZHANG ; Xia LIU
World Science and Technology-Modernization of Traditional Chinese Medicine 2014;(8):1730-1734
Psammosilene Radix is a famous miao national herb and it is rare and endangered nowadays. However, it is often confused with the root of Silene viscidula. In this study, the ITS2 regions was used to identify Psam-mosilene Radix and its adulterants. All DNA samples of Psammosilene Radix and its adulterants were extracted. The ITS2 regions were amplified and sequenced, and the final sequences were assembled using the CondonCode Aligner. The genetic distances were calculated by kimura 2-parameter (K2P) model and the Neighbor-Joining(NJ) phylogenetic trees were constructed using MEGA5.1.BLAST 1, the nearest distance and phylogenetic tree (NJ-tree)methods were used to assess the identification efficiency of the ITS2 region. Results indicated that the length of ITS2 sequences of Psammosilene Radix w 229 bp, the identification effficiency of ITS2 region using BLAST 1 was 100%;and the maximum intra-specific K2P distance were lower than the minimum inter-specific K2P distance. Additionally, the NJ tree based on ITS2 sequence indicated that Psammosilene Radix and its adul-terants could be distinguished clearly . In conclusion , the ITS2 region as DNA barcodes could identify Psammosi-lene Radix and its adulterants stably and accurately. Furthermore, the application of ITS2 barcode in the identifi-cation of TCM has a good prospective .
4.Identification of Xanthii Fructus and Its Adulterants Based on ITS2 Sequence
Jun WANG ; Xia LIU ; Yaqin ZHANG ; Ming SONG ; Yunhan LIN ; Xiaoxi MA ; Wei SUN ; Li XIANG ; Zhigang HU ; Lan WU ; Xueqiong ZHANG ; Weiyi HU
World Science and Technology-Modernization of Traditional Chinese Medicine 2014;(2):329-334
Objective: To identify Xanthii Fructus and secure its quality and safety in medication. Methods: Total ge-nomic DNA was extracted from Xanthii Fructus and its adulterants. ITS2 sequences were amplified, and purified PCR products were sequenced. Sequence assembly and consensus sequence generation were performed using the CodonCode Aligner V 4.2. The Kimura 2-Parameter (K2P) distances were calculated using MEGA 5.0. The neigh-bor-joining (NJ) phylogenetic trees were constructed. Results: The intraspecific genetic distances of Xanthii Fructus were 0. The interspecific genetic distances between Xanthii Fructus and its adulterants were ranged from 0.009 to 0.542. The NJ tree showed that Xanthii Fructus could differ from its adulterants obviously. Conclusion: ITS2 can be used to identify Xanthii Fructus from its adulterants effectively, and our study further confirmed the effectiveness of ITS2 to identify traditional Chinese medicinal materials.
5.Effects of China's national essential medicines policy on the use of injection in primary health facilities.
Xiaoxi XIANG ; Chunyan YANG ; Difei WANG ; Jing YE ; Xinping ZHANG
Journal of Huazhong University of Science and Technology (Medical Sciences) 2012;32(4):626-629
The overuse of injection exists more than 20 years since economic reform in China. It is a persistent problem and seems becoming a new challenge in the new health reform period. This study was designed to assess the effect of national essential medicines policy (NEMP) on injection use at primary health facilities in China by investigating their prescription information. Questionnaires were designed and disseminated to collect empirical data on injection use at 120 primary health facilities in 6 provinces from January to September in 2010 and 2011. The injection use was measured as the indicator as the percentage of prescriptions with one or more injections. The results showed that the percentage of prescriptions with one or more injections was decreased from 38.91% to 36.82% (χ (2)=11.158, P=0.001) in the all survey areas during the NEMP reform. The difference in level of the injection use in 2011 was significant among the eastern, central and western regions (χ (2)=223.584, P=0.000); level of the injection use in western region was the lowest (27.73%), while that in the central region was the highest (43.10%). The level of the injection use in 2011 among different provinces was also of great difference (26.00%-58.25%, range: 32.25%). The level of the injection use in 2011 was still much higher than the standard suggested by WHO for developing countries (13.4%-24.1%). It was concluded that NEMP has improved injection use in China, but the injection abuse situation remains serious, indicating that one of the priorities to the next stage of NEMP is to promote the rational use of drugs, especially the injection use.
China
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Health Facilities
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standards
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Health Policy
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Humans
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Injections
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standards
6.Validation for access recirculation and access flow rate measurement by contrast-enhanced ultrasonography during hemodialysis.
Xiaoxi SHA ; Ning JIANG ; Wei CAI ; Zhen NI ; Luo YAN ; Yulan PENG ; Lei YU ; Xiang ZHOU
Journal of Biomedical Engineering 2012;29(1):84-88
To evaluate the feasibility and accuracy of contrast-enhanced ultrasonography (CEUS) for the measurement of hemodialysis access recirculation (AR) and access flow rate (Qa), a two pump system was used to simulate access and dialyzer flow. AR and Qa under different conditions, such as reversal connection of dialysis lines and the needle orientation, were compared with each other. The value of access flow and recirculation flow were calculated based on the formulas introduced in this paper, and the correlation and consistency between true flow rate and calculated values were analyzed. The measured R correlated well with true value of flow rate (r = 0.57, P = 0.038, Qa > Qb; r = 0.95, P = 0.001, Qa < Qb). The Bland-altman test showed good agreement between the calculated value based on CEUS and true values. The CEUS can be used as a new advanced technology for AR and Qa measurement.
Arteriovenous Shunt, Surgical
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Blood Flow Velocity
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Computer Simulation
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Contrast Media
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Humans
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Kidney Failure, Chronic
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blood
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therapy
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Models, Biological
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Monitoring, Physiologic
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instrumentation
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Regional Blood Flow
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Renal Dialysis
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methods
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Ultrasonography
7.Minimal invasive treatment of dorsocervical fat pad using tumescent liposuction and its anatomic study in autopsy
Hongbin XIE ; Jianfang ZHAO ; Xiang XIE ; Xiaoxi LI ; Ran BI
Chinese Journal of Medical Aesthetics and Cosmetology 2020;26(2):138-141
Objective:Dorsocervical fat pad is common in middle-aged women. Current treatments include surgical excision and liposuction. We evaluated the therapeutic effect of tumescent liposuction on dorsocervical fat pad. Anatomical study was also carried out to explore the anatomical structure and significance of dorsocervical fat pad.Methods:From Jan. 2009 to Dec. 2018, twenty-seven patients with dorsocervical fat pad were treated with tumescent liposuction in Peking University Third Hospital. Small incisions were made in bilateral scapular region and 4 mm suction cannula was applied. A female cadaver fixed with formaldehyde was dissected to investigate the structure of posterior cervical and dorsal region. The specimens were stained with HE and Masson staining.Results:14 patients were followed up for no less than 6 months, with an average follow-up time of 27 months. Patients' dorsocervical area were flat and smooth after the surgery. Patient satisfaction rate was 100% and no severe complication was reported except bruise and pain. The symptoms of dorsocervical pain in two patients were significantly improved after operation. Anatomical study showed that the dorsocervical fat pad was composed of superficial and deep layer of adipose tissue, with clear boundary between the two layers and no obvious capsule. The collagen fibers in deep layer were more and denser than those in superficial layer.Conclusions:Tumescent liposuction can effectively treat dorsocervical fat pad. The surgery outcome is ideal with little complication.Through the study of the anatomical structure of the dorsocervical fat pad, the operation method and principle of liposuction can be improved and the operation efficiency can be enhanced.
8.Influencing factors for acute necrotizing pancreatitis in Eastern and Western countries: A meta-analysis
Shuli MA ; Xiaoxi YANG ; Chen CHEN ; Jing YU ; You ZHOU ; Guotao LU ; Xiaoxing XIANG ; Weijuan GONG ; Weiwei CHEN ; Juan CHEN
Journal of Clinical Hepatology 2023;39(7):1643-1656
Objective To investigate the differences in the influencing factors for acute necrotizing pancreatitis (ANP) and infectious pancreatic necrosis (IPN) between Eastern and Western countries, and to provide a theoretical basis for the prediction and prevention of ANP. Methods Databases including PubMed, Embase, the Cochrane Library, and Web of Science were searched for articles on the influencing factors for ANP and IPN published up to January 21, 2021, and a Meta-analysis was performed. Results A total of 59 studies were included, with 22 studies from Eastern countries and 37 studies from Western countries.The Meta-analysis showed that in Eastern countries, male sex (odds ratio[ OR ]=1.51, 95% confidence interval[ CI ]: 1.18-1.91, P < 0.01), C-reactive protein (CRP)(standardized mean difference[ SMD ]=1.39, 95% CI : 1.06-1.71, P < 0.01), D-dimer ( SMD =0.44, 95% CI : 0.07-0.81, P =0.02), Acute Physiology and Chronic Health Evaluation Ⅱ (APACHE-Ⅱ) score (mean difference[ MD ]=3.51, 95% CI : 1.38-5.64, P < 0.01), alcoholic etiology ( OR =3.57, 95% CI : 2.68-4.75, P < 0.01), and biliary etiology ( OR =0.60, 95% CI : 0.46-0.77, P < 0.01) were the influencing factors for ANP, and in Western countries, male sex ( OR =1.63, 95% CI : 1.30-2.05, P < 0.01), CRP ( SMD =2.09, 95% CI : 1.12-3.05, P < 0.01), APACHE-Ⅱ score ( MD =4.28, 95% CI : 2.73-5.83, P < 0.01), Ranson score ( MD =2.99, 95% CI : 2.50-3.47, P < 0.01), and organ failure ( OR =10.87, 95% CI : 2.62-45.04, P < 0.01) were the influencing factors for ANP.In Eastern countries, age ( MD =2.16, 95% CI : 0.43-3.89, P =0.01), body mass index (BMI)( MD =1.74, 95% CI : 1.23-2.25, P < 0.01), albumin level ( SMD =-0.43, 95% CI : -0.75 to-0.12, P < 0.01), CRP ( SMD =0.58, 95% CI : 0.04-1.11, P =0.03), procalcitonin ( SMD =0.80, 95% CI : 0.56-1.04, P < 0.01), D-dimer ( MD =0.23, 95% CI : 0.15-0.31, P < 0.01), APACHE-Ⅱ score ( MD =2.47, 95% CI : 0.73-4.22, P < 0.01), Ranson score ( MD =1.60, 95% CI : 1.46-1.73, P < 0.01), and extent of necrosis ≥30%( OR =2.52, 95% CI : 1.26-5.06, P < 0.01) were the influencing factors for IPN, while in Western countries, age ( MD =4.07, 95% CI : 1.82-6.31, P < 0.01), APACHE-Ⅱ score ( MD =3.28, 95% CI : 1.39-5.17, P < 0.01), Ranson score ( MD =2.18, 95% CI : 1.75-2.62, P < 0.01), SIRS score ( OR =3.88, 95% CI : 1.58-9.51, P < 0.01), alcoholic etiology ( OR =0.61, 95% CI : 0.42-0.87, P < 0.01), and organ failure ( OR =3.63, 95% CI : 1.11-11.92, P =0.03) were the influencing factors for IPN. Conclusion Current evidence shows that biliary etiology and alcoholic etiology are unique influencing factors for ANP in the Eastern population, while Ranson score is a unique influencing factor in the Western population.BMI and extent of necrosis ≥30% are unique influencing factors for IPN in the Eastern population, while alcoholic etiology is a unique influencing factor in the Western population.