OBJECTIVE:To explore the application and feasibility of tracer methodology in the continuous improvement of high-alert medications management in the hospital,and to improve the quality of high-alert medications management and ensure the safety of clinical medication. METHODS:According to the theory and requirements of tracer methodology,a series of interven-tions were applied to the management of high-alert medications in our hospital. The comparisons on the mastery of high-alert medi-cations knowledge,review and evaluation results and the incidence of adverse events were conducted before and after applying trac-er methodology,so as to evaluate the improvement effect of tracer methodology on high-alert medications management. RESULTS:After implementing intervention measures such as the reduction of high-alert medications list and medical staff training about high-alert medications,compared to before management,medical staffs had improved the knowledge level of high-alert medica-tions (the average awareness rate increased from 69.6% to 88.5%);the review and evaluation results had been improved signifi-cantly (the proportion of the terms with qualified level evaluation results or above increased from 66.67% to 88.89%);the inci-dence of adverse events was reduced(from 0.321% to 0.139%). CONCLUSIONS:The tracer methodology has a significant effect on the management of high-alert medications in our hospital. It is feasible and can be widely used in the management of high-alert medications in the hospitals.

Background Evidences indicated that oxidative stress damage is an essential pathological process in primary open angle glaucoma.Sulforaphane (SFN) can play an antioxidative stress role to many tissues and cells by activating Nrf2/ARE single pathway.However,whether SFN has a protective role to oxidative stress induced damage of trabecular meshwork cells is still unclear.Objective This study was to investigate the antioxidant effect of SFN against H2O2-induced oxidative damage in bovine trabecular meshwork cells.Methods Trabecular cells were isolated from fresh black bovine eyeballs and primarily cultured and passaged.The third generation of cells were incubated to 96-well dish at a density of 1 ×103/well for 24 hours and divided into 4 groups.The cells were incubated using 100 μl serum-free medium in the blank control group.Oxidative damage models were established by adding 100 μmol/L H2O2(100 μl) in medium in the H2O2 group.The cells were cultured with the medium containing 10 μmol/L SFN (100 μl) in the SFN group,and 100 μl H2O2 at the final concentration of 100 μmol/L was added in the SFN-treated cell medium in the SFN +H2O2 group.The cell vitality in various groups was assayed by using cell counting kit-8 (CCK-8).The apoptosis rate of the cells was detected by Annexin V-FITC/PI double-staining with flow cytometry.Results Cultured cells showed a spindle shape with uniform size,abundant cytoplasm,numberous pigmented particles and big nucleolus.The relative cell vitality reduced to (67.00± 1.27)％ and (80.00±6.25)％ in the H2O2 group and SFN+H2O2 group in comparison with 100％ in the blank control group,and the cell vitality in the SFN+ H2O2 group was lower than that in the SFN group but higher than that in the H2 O2 group (both at P＜0.01).The mean apoptosis rate was (11.33 ±0.77) ％,(32.31 ± 1.03) ％,(10.44 ±0.68) ％ and (17.68 ±0.21) ％ in the blank control group,H2 O2 group,SFN group and SFN+H2O2 group,respectively,showing a significant difference among the groups (F=539.96,P＜0.01),and the apoptosis rate in the SFN+H2O2 group was significantly lower than that in the H2O2 group but higher than that in the blank control group and SFN group (all at P＜0.01).Conclusions SFN can improve the antioxidative stress ability of trabecular meshwork cells and alleviate the damage induced by oxidative stress.

Objective To study the effect of data envelopment analysis evaluation on nursing efficiency in general hospitals.Method The input indexes including the number of enrolled nurse,indirect nursing time,average annual nursing consumables and average annual continuing education time and the output indexes including hospitalized patient number and year-round nursing income of 10 nursing units in our hospital during October 2012 to October 2013 were collected and analyzed with C2R,C2GS2 model and C2R/ C2GS2 ratio from Data Envelopment Analysis.Result About 5 nursing units were effective in terms of overall efficiency,8 ones in terms of unit technical efficiency and 5 one in terms of nursing unite scale efficiency.Conclusions We need improve nursing efficiency in our hospital.Nursing managers should pay attention to the results and improve working process aiming at the practical situations.

The total volatile components were extracted from safflower by ultrasonic-assisted solvent extraction （USE） and their chemical constituents were analyzed by gas chromatographymass spectrometry （GC-MS） to provide scientific basis for the quality control of safflower. Five different solvents （diethyl ether, ethanol, ethyl acetate, dichloromethane and acetone） were used and compared in terms of number of volatile components extracted and the peak areas of these components in TIC. The results showed that USE could be used as an efficient and rapid method for extracting the volatile components from safflower. It also could be found that the number of components in the TIC of ethyl acetate extract was more than that in the TIC of other solvent ones. Meanwhile, the volatile components of safflower from Xinjiang Autonomous Region and Henan Province of China were different in chemical components and relative contents. It could be concluded that both the extraction solvents and geographical origin of safflower are responsible for these differences. The experimental results also indicated that USE/GC-MS is a simple, rapid and effective method to analyze the volatile oil components of safflower.

An inductively coupled plasma mass spectrometry （ICP-MS） or inductively coupled plasma atomic emission spectrometry （ICP-AES） was developed to determine 19 elements in safflower, a traditional Chinese medicinal herb from Xinjiang Autonomous Region and Henan Province of China. Totally 19 elements in safflower included heavy metals, i.e. As, Cd, Cu, Hg and Pb, and wholesome elements, i.e. Al, Ca, Co, Cr, Fe, Mg, Mn, Mo, Ni, P, Se, Sr, V and Zn. The results showed that the concentrations of heavy metals in safflower samples were both low, all of which met the national hygiene standards except for Pb in Xinjiang sample. Meanwhile, the distribution tendency of elements in the two samples was similar, which indicated that the plant might absorb given elements in a proportional way. The method can be used for the quality control of elements in safflower, and it provides a way for the determination of the contents of safflower from Xinjiang and Henan.

Objective To investigate the effect of 3-n-butylphthalide (NBP) on learning and memory abilities in vascular demensia (VD) rats. Methods VD model rats was established by two-vessel method. 60 3-month-old Wistar male rats were randomly divided into VD group, sham-operate group and NBP group. Rats in NBP group were given NBP 120 mg · kg-1 · d-1 ,VD and sham-operate group were given equal quality vegetable oil.Morris water maze was used to assess the learning and memory abilities in each group and HE staining was used to observe the hippocampus morphology of the rats. Results The escape latency in hidden plat test was( (38.34 ±2.46 ) s, ( 14.83 ± 3.77s ), ( 75.74 ± 6.33 ) s ) and the original platform quadrant time was ( ( 26.45 ± 4.66 ) s,(35.21 ±3.78)s, ( 18.67 ±5.39)s) in NBP group,sham-operate group and VD group respectively. Compared to VD group, NBP group had obviously decreased escape latency in hidden plat test, increased original platform quadrant time and distinctly decreased the necrosis of the neurons in HE dyeing. Conclusion NBP can improve the learning and memory deficits in VD rats.

Objective To systematically review the efficacy and safety of acupuncture and moxibustion at Fenglong point (ST40) for the treatment of hyperlipemia.Methods Systematic searches were conducted in PubMed, EMbase, the Cochrane Library, CNKI, VIP, CBM and WanFang Data, assisted by manual retrieval, and the RCTs of comparative study on acupuncture and moxibustion at Fenglong point and oral administration drugs were included. Data were extracted and evaluated by two reviewers independently with a specially-designed extraction form. The Cochrane Collaboration's RevMan 5.0 software was used for Meta analysis.Results A total of 6 RCTs involving 701 patients were included. The results of Meta analysis showed that the total effective rate in acupuncture and moxibustion at Fenglong point for the treatment of hyperlipemia was similar with statins medicine or Xuezhikang capsule. Acupuncture Fenglong point and statins medicine had significant difference in decreasing cholesterol and increasing HDL-C, with less side effects.Conclusion Acupuncture at Fenglong point is safe and effective in the treatment of hyperlipemia, but still needs more high-quality RCTs for confirmation.

Objective To establish rat model of type 2 diabetes through a single subcutaneous injection of lipopolysaccharide which induced chronic inflammation.Methods The male Wistar rats(n = 30)were randomly divided control group (n = 10)and model group (n=20).Model group with LPS (300 μg·kg-1 ·day-1 )subcutaneous injection of eight weeks,rats in control group received isometric stroke-physiological saline solution injection in the same way.The changes in appearance,weight and fasting blood glucose (FBG)of rats were observed every week.At the end of the 8th week,thelevels of tumor necrosis factor a (TNF-α), interleukin-1(IL-1),interleukin-6 (IL-6),monocyte chemotactic protein-1(MCP-1)and fasting insulin(FINS)were measured.Oral glucose tolerance test (OGTT)and insulin release test(IRT)were also performed.The successful rat model was determined by the standards that FBG was ≥11.1 mmol/L.Results Model group rats reached the standard of type 2 diabetes after six weeks of LPS injection.Model group blood sugar is significantly higher than the control group (P <0.05).In addition,model group′s expression level of inflammatory cytokines in serum TNF-α,IL-1,IL-6,MCP-1 and FINS were significantly higher than control group (P <0.05).Oral glucose tolerance test,blood glucose levels higher than normal in model group,the insulin peak is lower than the normal group (P <0.05).Conclusion The success of establishing the animal model of type 2 diabetic rats which were injected of low dose of LPS by subcutaneous may be provide certain help for the etiology of diabetes research.

The total volatile components were extracted from safflower by ultrasonic-assisted solvent extraction (USE) and their chemical constituents were analyzed by gas chromatographymass spectrometry (GC-MS) to provide scientific basis for the quality control of safflower.Five different solvents (diethyl ether,ethanol,ethyl acetate,dichloromethane and acetone) were used and compared in terms of number of volatile components extracted and the peak areas of these components in TIC.The results showed that USE could be used as an efficient and rapid method for extracting the volatile components from safflower.It also could be found that the number of components in the TIC of ethyl acetate extract was more than that in the TIC of other solvent ones.Meanwhile,the volatile components of safflower from Xinjiang Autonomous Region and Henan Province of China were different in chemical components and relative contents.It could be concluded that both the extraction solvents and geographical origin of safflower are responsible for these differences.The experimental results also indicated that USE/GC-MS is a simple,rapid and effective method to analyze the volatile oil components of safflower.

An inductively coupled plasma mass spectrometry (ICP-MS) or inductively coupled plasma atomic emission spectrometry (ICP-AES) was developed to determine 19 elements in safflower,a traditional Chinese medicinal herb from Xinjiang Autonomous Region and Henan Province of China.Totally 19 elements in safflower included heavy metals,i.e.As,Cd,Cu,Hg and Pb,and wholesome elements,i.e.AI,Ca,Co,Cr,Fe,Mg,Mn,Mo,Ni,P,Se,Sr,V and Zn.The results showed that the concentrations of heavy metals in safflower samples were both low,all of which met the national hygiene standards except for Pb in Xinjiang sample.Meanwhile,the distribution tendency of elements in the two samples was similar,which indicated that the plant might absorb given elements in a proportional way.The method can be used for the quality control of elements in safflower,and it provides a way for the determination of the contents of safflower from Xinjiang and Henan.