OBJECTIVE:To work out the optimal inventory levels in zero inventory management mode through model predic-tion and control strategy,by using the inventory upper & lower limits settings generally available in the information management system of health care institutions. METHODS:Multi-varieties joint ordering modelwas constructed by referring to operations management,time series analysis and quantitative approach to decision-making,that is,to make a prediction of upper&lower lim-its on medicine inventory based on historical data and applicable mathematical models(fixed order interval model and re-order mod-el,i.e. FOI and ROP),and compared with real results;based on above,specific medicine procurement and inventory control strat-egies would be developed and an evaluation of the application effects would be made. RESULTS:The error test and reproducibility test exhibited that the out-of-stock ratio remained under 3.36%,of which 71.24% could be effectively alarmed;under computer simulation and practical operation,the instant replenishment rate reduced by 9.33% and 13.03%,OOS ratio down by 11.11% and 27.45%,and average daily inventory turnover rate up by 30.19% and 15.85% respectively,all showing remarkable improvements compared to before the implementation of the mode. CONCLUSIONS:This model is of favorable accuracy and operability,there-fore it can lay foundation for rational and well-founded decisions in medicine procurement and inventory control in zero inventory management mode.

AIM:To study the effects of Hydrogen Peroxide(H2O2)and 11,12-epoxyeicosatrienoic acid(11,12-EET)on EDHF-mediated relaxation in the rat basilar arteries.METHODS: The relaxant effects of acetylcholine(ACh),H2O2,11,12-EET,and catalase(CAT) on rat arteria basilaris in vitro were detected by vasomotoricity experiment in vitro.RESULTS: In the rat basilar arteries,preconstricted by 30 mmol/L KCl in vitro,ACh(10-7-10-4.5 mol/L) had the concentration-dependent relaxation effect.3?10-5 mol/L N?-nitro-L-arginine-methyl-ester(L-NAME) and 10-5 mol/L indomethacin(Indo) could partly inhibit the relaxation effect of ACh to the rat basilar arteries,but non-No/non-PGI2-mediated relaxation was still significant(P

Objective To compare the prognosis of sentinel node-positive breast cancer patients forgoing axillary lymph node dissection.Methods A systematic literature search (Medline,Embase,Cochrane Library)ended in April 2014 was performed to identify all eligible articles.Two reviewers independently screened and extracted data.RevMan5 was used for statistical analysis.Results A total of 1026 abstracts were retrieved and 18 clinical controlled studies finally included,the total number of patients were 47 894,7389 had micrometastases in sentinel lymph node,35 217 had macrometastases in sentinel lymph node and 5288 had positive sentinel lymph node regardless of micrometastases or macrometastases.For patients with MIC,the 5-year axillary recurrence rate,5-year disease free survival and 5-year overall survival had no significant difference between patients who only received sentinel lymph node biopsy and patients who received further axillary lymph node dissection,(OR =1.78;95％ CI:0.72-4.39,P=0.21),(OR =0.76,95％CI:0.56-1.04,P=0.08),(OR=0.77,95％CI:0.43-1.40,P=0.39).For patients with MAC,the 5-year axillary recurrence rate had no significant difference between patients who only received sentinel lymph node biopsy and patients who received further axillary lymph node dissection,(OR =1.21;95％ CI:O.76-1.91,P =0.42).For patients with positive sentinel lymph node regardless of micrometastases or macrometastases,the 5-year axillary recurrence rate and 5-year overall survival had no significant difference between patients who only received sentinel lymph node biopsy and patients who received further axillary lymph node dissection,(OR =1.29;95％ CI:0.92-1.80,P =0.14),(OR =0.96,95％ CI:0.64-1.45,P =0.84).Conclusions Among patients with limited positive SLN of breast cancer,patients forgoing ALND compared with ALND did not have obvious affect on long-term survival.

BACKGROUND: Thin endometrial diseases are a challenge in clinical treatment at present. Scholars have found that bone marrow mesenchymal stem cells (BMSCs) transplantation has its unique curative effect and advantages, but few studies have been conducted on pathway or gene control. OBJECTIVE: To observe the effect of BMSCs transplantation in rats with thin endometrium based on the HOXA10 regulatory network. METHODS: Twenty-one adult female Sprague-Dawley rats of SPF grade (provided by the Animal Experimental Center, Guangzhou University of Chinese Medicine in China) were randomly divided into three groups (n=7/group): control group, model group, and BMSCs group. In the latter two groups, a thin endometrium model was prepared in each rat by filling the uterine cavity with 95％ ethanol. In the control group, normal saline was injected to fill the uterine cavity of rats. After extraction of ethanol or normal saline, the rats in the BMSCs group were injected intrauterinely with 1 mL of BMSCs suspension (1×1010 cells/L) , and those in the control and model groups were given the same volume of normal saline. After two estrous cycles, the uterus of each rat was removed. Hematoxylin-eosin staining was used to measure the thickness of the endometrium. Immunohistochemistry was used to detect the expression of vimentin, keratin, vascular endothelial growth factor, leukemia inhibitory factor and integrin αvβ3. qRT-PCR was used to detect the relative transcription of HOXA10 and miR-196 b. RESULTS AND CONCLUSION: (1) Compared with the control group, the endometrial thickness of the rats were significantly thinner in the model and BMSCs groups (P < 0.05) , while the endometrial thickness in the BMSCs group was thicker than that in the model group (P < 0.05). (2) The mean absorbance values of endometrial vimentin, keratin, vascular endothelial growth factor, leukemia inhibitory factor and integrin αvβ3 were highest in the control group, higher in the BMSCs group and lowest in the model group, and there were significant differences between groups (P < 0.05). (3) The relative transcript level of HOXA10 gene in the model and BMSCs group was significantly lower than that in the control group, while the relative transcript level of HOXA10 gene in the BMSCs group was significantly higher than that in the model group (P < 0.05). The relative transcript level of miR-196 b in the model and BMSCs groups was significantly higher than that in the control group (P < 0.05) , while the relative transcript level of miR-196 b in the BMSCs group was lower than that in the model group (P < 0.05). (4) HOXA10 was negatively correlated with miR-196 b gene, HOXA10 was positively correlated with the protein expression to different extents, and miR-196 b gene was negatively correlated with the protein expression to different extents. These findings suggest that BMSCs transplantation can improve the endometrial thickness and relevant protein levels of thin endometrium rats to some extent, which may be attributed to the negative regulation of HOXA10 gene by miR-196 b, and HOXA10 gene further promotes the expression of vascular endothelial growth factor, leukemia inhibitory factor and integrin αvβ3 proteins.

Objective To investigate the influence of severity of obstructive sleep apnea hypopnea syndrome (OSAHS)on acute ST -segment elevation myocardial infarction (STEMI).Methods 86 STEMI patients were divided into two groups,STEMI with OSAHS(OSAHS group,n=38)and STEMI without OSAHS(control group,n=48).Clinical data about biochemical index,cardiac function index and the duration of STEMI onset were compared between OSAHS group and control group.Logistic statistic analysis was used to investigate the risk factors that influ-ence the circadian rhythm of onset in STEMI.Results A total of 86 patients met the inclusion criteria,they were divided into two groups,STEMI with OSAHS(OSAHS group,n=38)and STEMI without OSAHS(control group,n=48).The incidence rate of STEMI onset during 0600 am~1 159 am was significantly higher in OSAHS group compared to control group(20.8% vs.44.7%,χ2 =5.626,P=0.018).This variation was weaken in mild OSAHS group compared to moderate-severe OSAHS group(20.8% vs.31.3%,χ2 =0.726,P=0.394;20.8% vs.54.5%,χ2 =7.956,P=0.005).Multivariate logistic analysis showed that the severity of OSAHS was a risk factor to the STEMI onset during 0600 am~1159 am(OR=2.458,95%CI 1.110~5.439,P=0.027).Conclusion The severity of OSAHS significantly increases the STEMI onset during 0600 am~1 159 am.

Objective: To investigate the urban and rural differences in adverse outcomes of pulmonary tuberculosis (PTB) in patients with pulmonary tuberculosis-diabetes mellitus comorbidity (PTB-DM), so as to provide insights into improving the prevention and treatment measures for PTB-DM. Methods: Patients with PTB-DM who were admitted and discharged from 14 designated tuberculosis hospitals in Hangzhou City from 2018 to 2022 were selected. Basic information, and history of diagnosis and treatment were collected through hospital information systems. The adverse outcomes of PTB were defined as endpoints, and the proportions of adverse outcomes of PTB in urban and rural patients with PTB-DM were analyzed. Factors affecting the adverse outcomes of PTB were identified using a multivariable Cox proportional hazards regression model. Results: A total of 823 patients with PTB-DM were enrolled, including 354 (43.01%) urban and 469 (56.99%) rural patients. There were 112 (13.61%) patients with adverse outcomes of PTB. The proportions of adverse outcomes of PTB in urban and rural patients were 14.41% and 13.01%, respectively, with no statistically significant difference (P>0.05). Multivariable Cox proportional hazards regression analysis identified first diagnosed in county-level hospitals or above (HR=2.107, 95%CI: 1.181-3.758) and drug resistance (HR=3.303, 95%CI: 1.653-6.600) as the risk factors for adverse outcomes of PTB in urban patients with PTB-DM, while the treatment/observed management throughout the process (HR=0.470, 95%CI: 0.274-0.803) and fixed-dose combinations throughout the process (HR=0.331, 95%CI: 0.151-0.729) as the protective factors for adverse outcomes in rural patients with PTB-DM. Conclusions There are differences in influencing factors for adverse outcomes of PTB in urban and rural patients with PTB-DM. The adverse outcomes of PTB are associated with first diagnosed hospitals and drug resistance in urban patients, and are associated with the treatment/observed management and fixed-dose combinations throughout the process in rural patients.

Objective To discuss the clinical features of bilateral multiple renal angiomyolipomas (RAML) with tuberous sclerosis complex (TSC).Methods Clinical data of 10 cases of bilateral multiple RAML associated with TSC treated from Jan.2003 to Dec.2010 were retrospectively reviewed.There were 4 males and 6 females in the study group,aged from 18 to 45 years,with an average age of 34 years.Three cases were treated urgently due to RAML hemorrhage.Five cases were treated due to back pain.One case was treated for hematuria.One case was diagnosed during physical examination.Facial angiofibroma occurred in 7 cases and facial flat speckle in 1 case.Epilepsy was indentified in 6 cases.Four cases had hypophrenia and 2 cases presented with symptoms of the classic triad:epilepsy,facial angiofibroma and hypophrenia.One case underwent urgent selective transcatheter arterial embolization (SEA).Eight cases (9 sides) underwent renal sparing operation.Conservative therapy was adopted in 2 cases.ResultsThe SEA was done successfully and bleeding ceased.AⅡ surgeries were completed successfully.The diameter of the biggest tumor resected was 8.0 cm.The number of tumors resected was 2 - 6,with an average of 3.5.The mean operative time was 70 min (range 50 to 120 min).The mean time of controlling the renal artery was 26 min.The mean intraoperative hemorrhage was 150 ml.One case required a blood transfusion.None of the cases re-hemorrhaged after operation.Pathology revealed RAML.There was no recurrence in 8 cases and follow-up ranged from 3 to 60 months,with an average of 25 months.A hemorrhage did occur on the oppositer side in 1 case 4 months after surgery.In 2 cases,a conservative therapy of regular monitoring and follow-up at 24 and 36 months was chosen.The serum creatinine of all the patients was in a normal range.Conclusions The bilateral multiple RAML associated with TSC must be diagnosed as soon as possible and treated depending on the size,location and developing circumstance of the tumor in a timely fashion.Renal sparing surgery and SEA are effective therapies.

Objective To investigate the prevalence and relevant factors of psychological disorders in patients with premature ejaculation (PE). Methods From September 2009 to October 2010,we employed the Self- Rating Anxiety Scale (SAS) and Self-Rating Depression Scale (SDS),Chinese Index of Sexual Function for Premature Ejaculation ( CIPE-5 ),NIH-Chronic Prostatitis Symptom Index (NIH-CPSI),International Index of Erectile Function (IIEF-5) and self-designed questionnaire to investigate the psychological status of 1164 patients with PE.The relevance between scores of SAS,SDS and such parameters as NIH-CPSI score,CIPE-5 score,erectile function,age,disease duration,occupation,education,personality characteristics and other factors were evaluated. Results The SAS and SDS scores of 1,164 cases with PE were 43.87 ± 10.53,44.05 ±9.81,respectively.If the cut-off points were set at SAS ≥ 50 and SDS ≥53,341 (29.3％) of cases had symptoms of anxiety and 217( 18.6％ ) patients had symptoms of depression.The SAS,SDS scores and detection rate of anxiety and depression were correlated with the CIPE-5 score,NIH-CPSI score,erectile function and duration of disease,personality characteristics ( P ＜ 0.05),while they were not correlated with age,occupation,and education. Conclusions Psychological disorders widely exist in patients with PE and may have a close relationship with a variety of factors.

Objective To evaluate the analysis capability of urine protein qualitative test between AX-4030 and Cobas U411 u-rine dry chemistry analyzer,and study on evaluating the performance of qualitative test.Methods According to Clinical and Laboratory Standards Institute(CLSI)EP12-A2 document,analyzed the bias and imprecision of urineprotein qualitative test between the Aution MAX AX-4030 and Roche CobasU411 system.Their C50 ,C5 ~C95 intervals and imprecision curves were compared.The protein of 310 specimens were simultaneously determined by both Cobas U411 and AX-4030,in order to eval-uate their concordance.Results C50 for AX-4030 system was less than that for Cobas U411;C5 ~C95 interval of AX-4030 system was narrower than CobasU411.The imprecision curve of AX-4030 system was steeper than Cobas U411.The com-parison of the two analysis systems showed that the concordance was 96.8%,the positive concordance was 82.7%,and the negative concordance was 99.6%.The 95% credibility interval (CI)was 94.2%~98.16% and the Kappa value was 0.88. Conclusion For the sensitivity and imprecision of urine protein test in the C50 critical value,the AX-4030 system was better than Cobas U411.The concordance of them in determining clinical specimens was pole-strength.The evaluation recommen-ded by the EP12-A2 document is practical and effective.

Objective To evaluate open and endovascular procedures for the treatment of visceral arterial naeurysms.Methods Clinical data of 93 cases were reviewed from Jan 2001 to Jan 2011,including 47 males,and 46 females.Splenic artery aneurysm in 45 cases,superior mesenteric artery aneurysm in 15 cases,renal artery aneurysms in 10 cases,common hepatic artery aneurysm in 7,celiac artery aneurysms in 11 and gastroduodenal artery aneurysm in 5 cases.All cases had either open procedures or endovascular procedures after comprehensive evaluation.Results Surgical open procedures were performed on 34 cases,and endovascular procedures were performed on 59 cases.The perioperative complication rate were 52.9％ and 13.6％ for open and endovascular groups respectively.The mean follow-up time was 36.8 months ( 11 months to 10 years).1 -year survival rate and 5-year survival rate were 100％and 60.6％ in open surgery group,compared with 100％ and 84.5％ in endovascular group.Conclusions Endovascular repair is effective for visceral artery aneurysm with lower perioperative complication rate and better long-term survival rate.