OBJECTIVE:To probe into the utilization of sedative hypnotics in outpatient prescriptions of our hospital. METHODS: In Mar. 2008, 1 317 prescriptions of sedative-hypnotics randomly selected from total 49 791 outpatient prescriptions were analyzed regarding the rationality of the utilization of top 5 drugs on the list of DDDs. RESULTS: The top 5 sedative hypnotics on the DDDs list were Alprazolam tablets, Estazolam tablets, Lorazepam, Zolpidem tablets (Stilnox) and Clonazepam tablets, and their DUIs were 0.54, 0.73, 0.19, 0.81 and 0.53, respectively. CONCLUSION: The dosages of sedative hypnotics in our hospital were basically reasonable and in conformity with the indications listed in package inserts.

Objective To investigate the protective effects of morphine preconditioning on the lungs against ischemia-reperfusion (I/R) injury and the possible mechanisms.Methods Twenty-four Japanese long-ear white rabbits weighting 2.5-3.0 kg were used in this study. The animals were anesthetized with intramuscular atropine 0.5 mg and intravenous 3 % pentobarbital 30 mg ?kg-1, tracheostomized and mechanically ventilated ( VT 10 ml?kg-1, RR 30 bpm, FiO2 100% , PEEP 1 cm H2O) . Right carotid artery was cannulated for BP monitoring and blood sampling. An elastic band was placed around the hilum of left lung via thoracotomy to perform lung ischemia. Body temperature was maintained at 36-38℃( rectal) . The animals were randomly allocated to one of 3 groups (n = 8 each) : (1) Sham group; (2) I/R group was subjected to 2 h in situ left hilar occlusion followed by 2 h reperfusion and (3) morphine preconditioning group received morphine 4 mg?kg-1 via pulmonary artery 30 min before I/R. Mean pulmonary artery pressure (MPAP) and peak inspiratory pressure (PIP) were monitored and recorded. Arterial blood samples were taken before occlusion of lung hilum (baseline) and at 5, 30, 60, 90 and 120 min of reperfusion for blood gas analysis, and determination of plasma endothelin-1 concentration. The animals were killed at the end of 120 min reperfusion. The lungs were removed for determination of lung water content (W/ D ratio), percentage of neutrophils in the broncho-alveolar lavage fluid ( BALF) and microscopic examination.Results MPAP and PIP were significantly lower while PaO2 was significantly higher at 30, 60, 90 and 120 min of reperfusion in morphine preconditioning group than in I/R group. Plasma endothelin-1 concentration was significantly lower at 60 and 120 min of reperfusion in morphine preconditioning group than in I/R group ( P

AIM To explore the effects of Sini Decoction (Aconiti lateralis Radix Praeparata,Zingiberis Rhizoma,Glycyrrhizae Radix et Rhizoma) on rat myocardial fibrosis induced by isoproterenol.METHODS Forty SD rats were randomly divided into blank,model,captopril [100 mg/(kg · d)] and Sini Decoction [3.8 g/(kg · d)] groups,with ten rats in each group.Except for the blank group,the rest rats were given subcutaneous injection of isoproterenol [5 rg/(kg · d)] to prepare myocardial fibrosis model,and successive administration lasted for four weeks.At 20 h after the last administration,hemodynamics changes of heart were detected;heart weight indexes were calculated;the changes of myocardial pathological morphology were observed by HE and Masson staining;NO level in serum was measured by nitrale reduetase;SOD activity in serum was measured by xanthinoxidase method;MDA level in serum was measured by thiobarbituric acid method;the protein expressions of RhoA,ROCK1 and eNOS in myocardial tissue were detected by Western blot method.RESULTS Compared with the model group,the cardiac function of rats was significantly improved;the myocardial collagen content was significantly decreased;the MDA level in serum was obviously decreased;the NO level and SOD activity were significantly increased;the protein expressions of RhoA and ROCK1 in myocardium tissue were significantly reduced,and the protein expression of eNOS was markedly increased in the Sini Decoction group.CONCLUSION Sini Decoction can improve the isoproterenol-induced myocardial fibrosis in rats,and its mechanism may be related to inhibiting the RhoA/ ROCK signaling pathway,in turn,raising the expression of eNOS,which leads to reduced oxidative stress.

The change of hemodynamics and hemorrheology induced by hypoxia challenge in the dog were investigated. The results showed that hypoxia caused significant decrease of cardiac output,increased pulmonary artery pressure and pulmonary vascular resistance. Hypoxia also caused increase of blood viscosity. In terms of changes of the reduced viscosity is directly related to the deformation and agglutination properties of red blood cells.

Objective:In order to provide policy-makers with basis and reference for improving the operational efficiency of county general public hospitals, this paper studies the changes in overall efficiency, technical efficiency and scale efficiency of 40 county general public hospitals in Fujian province from 2009 to 2014 , as well as how the to-tal factor productivity changes over the time. Methods: After collecting the relevant data of hospital operations from 2009 to 2014, this paper uses CCR, BBC, Malmquist model and other data envelopment analysis (DEA) methods to analyze the data. Results:The vast majority of those 40 county general public hospitals are in decreasing state. The total factor productivity of 40 hospitals from 2009 to 2014 is 1. 019. There are 21 hospitals (52. 5%) that slightly im-proved their productivity, of which 3 hospitals increased their productivity mainly due to technological progress, 3 hospitals due to efficiency increase, and the rest 15 hospitals due to the effect of both technological progress and effi-ciency increase. Conclusions:The operational efficiency of county general public hospitals in Fujian province is gen-erally insufficient, and there are significant differences between operating efficiency of different regions. The efficien-cy of hospitals in mountainous areas had increased, but the efficiency of hospitals in coastal areas had decreased. Therefore, in order to increase investment in county general public hospitals, the government should take differential policy and pay attention to the reasonable control of hospital size, as well as to strengthen the connotation building and attach importance to improving medical service technologies.

Objective To screen primers used in polymerase chain reaction (PCR) for detecting Trichomonas vaginalis. Methods Three pairs of PCR primer reported in the literatures (TVA5-TVA6, TV1-TV2 and TVK3-TVK7) were screened. For each PCR, four components, including primers, Mg2+, dNTPs and Taq polymerase, were optimized using Taguchi methods to determine the optimal PCR conditions. With the optimal conditions, the sensitivities of three PCR were compared. Vaginal swabs were collected to detect Trichomonas vaginalis by culture and PCR, and the PCR with highest sensitivity was evaluated. Results All three PCR were of high specificity, and the PCR with primers of TVK3-TVK7 had the highest sensitivity. Of 25 clinical vaginal swabs, T. vaginalis was detected in 7 samples by the culture, however, it was detected in 8 samples by the PCR. All culture-positive samples were also positive by PCR. Conclusions The PCR with the primers of TVK3-TVK7 is highly sensitive and specific, which could be useful to detect T. vaginalis in vaginal swab samples.

OBJECTIVE To investigate the distribution of bacteria detected from blood culture of pediatric patients and to observe the antibiotic resistance of these bacteria. METHODS The BacT/Alert blood culture system was applied for culture.Species identification and antibiotic resistance tests were performed by the VITEK automicroscan system. RESULTS Coagulase-negative staphylococcus(CNS) and Staphylococcus aureus accounted for 67.2% and 7.8%, respectively.The proportion of Gram-negative bacteria was 14.4%.The resistant rate of CNS and S.aureus to oxacillin was 85% and 36%,respectively.The strains producing the extended spectrum beta-lactamases(ESBLs) of Gram-negative bacteria were often detected. CONCLUSIONS Gram-postive bacteria are the main pathogens detected from the blood culture of pediatric patients.Detection rate of CNS is the highest.Multiresistant strains are common.

Thiopurine S-methyltransferase (TPMT) is an important and key cytoplasmic enzyme in the metabolism of thiopurine drugs,whose activity can directly determine the amount of thiopurine drugs metabolized to cytotoxic 6-thioguanine nucleotides and consequently influence clinical efficacy and adverse drug reactions of thiopurine drugs.In order to deepen knowledge and role of genetic polymorphism of tpmt in the individualized thiopurine drug treatment,this present review mainly covered the following three frequently concerned aspects,including i) whether or not to determine the activity of TPMT priot to treatment of thiopurine drugs;ii) to genotype or to phenotype;iii) how to choose genotype methods.

The concepts of two modes of government Procurement,invitation bidding and public bidding,are explained. Their characteristics are also analyzed and compared to each other. That is very propitious for us to choose the better mode and get the most benefit of the public bidding.

ObjectiveTo investigate the karyotypes of amiotic fluid cells and compare the incidence of chromosomal abnormality as well as to evaluate the clinical significance of abnormal karyotypes. MethodsA total of 13 648 pregnant women came to Shanghai Jiai Genetics and IVF Institute, Obstetrics and Gynecology Hospital, Fuclan University to do amniocentesis from September 1998 to November 2010, and 13 795 amniotic fluid specimens were successfully extracted and cultured, thus 13 795 fetuses received karyotype diagnosis. These fetuses were grouped according to different indications. If maternal age was ≥ 35, the fetuses were grouped into the advanced maternal age group (4065) ; and if maternal serum screening test revealed high-risk of trisomy 18 or trisomy 21, the fetuses were grouped into the high-risk serum screening group (6462) ; and those with abnormal signs of ultrasound screening were grouped into the abnormal ultrasound signs group (1539); and if either of the parents was with chromosome abnormalities, the fetus was grouped into the paternal/maternal abnormality group ( 108 ) ; whereas the remainder were grouped in other factors group ( 1621 ). The amniotic fluid cells were in-situ cultured on coverslips, harvested by conventional G-banded methods, and then analyzed by two doctors. In order to get rapid diagnosis, some pregnant women whose gestational age ≥26 weeks accepted fluorescense in situ hybridization (FISH). FISH was done on 78 uncultured amniotic fluid specimens using probes located at chromosome 13,18,21, X,Y. Some parents were required to analyze lymphocyte karyotype to help judging the origin of abnormal karyotype. Results( 1 ) Classification and composition of abnormal karyotypes in each group : a total of 388 abnormal karyotypes were found among 13 795 fetuses, and the abnormal rate was 2. 813％ (388/13 795).Of the 388 fetuses, aneuploidy was the most common pattern which was up to 59. 8％(232/388);autosomal structural abnormality rate was 24. 7％ ( 96/388 ) ; mosaicism was 12.4％ (48/388). Other uncommon abnormal karyotypes included marker chromosome (5/388,1.3％), sex chromosomal structural abnormality (4/388,1.0％) and triploid (3/388, 0. 8％ ). Aneuploidy was the most common in most groups except the patemal/matemal abnormality group. There were four cases of rare aneuploid in the advanced maternal age group,the high-risk serum screening group and the abnormal ultrasound signs group respectively. Every type of abnormality could be found in the abnormal ultrasound signs group, and autosomal structural abnormalities were concentratedin paternal/maternalabnormality group. Mosaicism mainly distributed in the high-risk serum screening group, accounting for 20. 0％ (29/145) of abnormalities in this group. (2) Abnormal types and the incidence: the most common type was trisomy 21 ( 138/388,35.6％ ),followed by autosomal balanced structural rearrangements( 80/388, 20. 6％ ), mosaicism(48/388,12. 4％ )and trisomy 18 (44/388,11.3％ ). Others included non-balanced autosomal structural rearrangements (16/388,4. 1％ ), 45 ,X0 ( 16/388,4. 1％ ) and 47 ,XXY( 15/388,3.9％ ). (3) Lymphocyte karyotype analysis of the couples: parents of 153 fetuses were analyzed to determine the origin of abnormal karyotype. Fifty-eight familial and 95 de novo abnormalities were found. FISH results were the same with G-banding karyotype, and two of these were trisomy 21. Conclusions Abnormal karyotype composition is different according to different maternal amniocentisis indications. There is a variety of abnormal karyotypes in the second trimester pregnancy, and the risk of fetal malformation is related with the kind of abnormal karyotype.