OBJECTIVE:To investigate the utilization and trend of drugs for herpes zoster patients from 22 hospitals of Shanghai area,and to provide reference for rational use of drugs.METHODS:The utilization of drugs for herpes zoster patients from 22 hospitals of Shanghai area during 2013-2015 was analyzed statistically in respects of proportion of patients,consumption sum,DDDs,DDC,etc.RESULTS:Herpes zoster was more likely to occur in adults,mostly in more than 45 year-old group (＞75％).The proportions of patients of neurotrophic antivirals,anti-herpes virus and acesodyne drugs ranked in the top three.Topical,immu nomodulatory and glucocorticoid drugs accounted for a certain proportion.Among antivirals,the consumption sum and DDDs of valaciclovir ranked the first place,and DDC of brivudine was the highest.Among acesodyne,the proportions of patients of antiepileptic drugs was the highest (13.78％),and its compound growth rate was also the highest (30.77％);the number of patients of gabapentin was the largest.Among neurotrophic drags,the proportions of patients of mecobalamine was the highest (32.98％).Among immunomodulatory drugs,the number of patients of thymalfasin was the largest,which may be irrational.CONCLUSIONS:The treatment of herpes zoster in Shanghai area is basically in accordance with the guidelines.The irrational use of immunomodulatory drugs should be paid attention to and supervised.

BACKGROUND:Human umbilical cord blood-derived mesenchymal stem cels are able to repair and regenerate the injured myocardium, which is a new therapy for myocardial infarctionvia transplantation. OBJECTIVE:To explore the therapeutic efficacy of intracoronary injection of human umbilical cord blood-derived mesenchymal stem cels on acute myocardial infarction in rats. METHODS:Thirty-two rats were selected to make animal models of ligation of the left anterior descending coronary, and then model rats were randomized equaly to transplantation group and model group. Human umbilical cord blood-derived mesenchymal stem cels were isolated and prepared into cel suspension. Rats in the transplantation group were subjected to transplantation of human umbilical cord blood-derived mesenchymal stem cels. RESULTS AND CONCLUSION: Human umbilical cord blood-derived mesenchymal stem cels were successfuly isolated and cultured in vitro. Compared with the model group, the microvessel density, left ventricular end-systolic pressure and ±dp/dtmax were significantly increased in the transplantation group (P < 0.05), while the left ventricular end-diastolic pressure was decreased dramaticaly (P < 0.05). Electrocardiography findings showed that the heart function of rats in the transplantation group was improved slightly. These findings indicate that human umbilical cord blood-derived mesenchymal stem cels can promote myocardial angiogenesis and improve heart function of rats with myocardial infarction.

BACKGROUND:Stem cels have multi-directional differentiation and self-replication abilities, under certain conditions, which can differentiate into myocardial cels to repair the damaged myocardium. OBJECTIVE: To investigate the effects of transplantation of umbilical cord mesenchymal stem cels derived at different gestational weeks on infarct size and angiogenesis in the infarct region of experimental rabbits with myocardial infarction. METHODS: Ten ful-term umbilical cord samples and 10 umbilical cord samples of aborted fetuses at 10-12 gestation weeks were selected to in vitro isolate umbilical cord mesenchymal stem cels that were subjected to BrdU labeling. HLA-G expression was detected in the cels. Thirty white rabbits were selected to make myocardial infarction models, and 2 weeks after modeling, the model rabbits were randomized into aborted cel transplantation group, ful-term cel transplantation group and control group (n=10 per group). Then, BrdU-labeled cels were injected correspondingly into the infarct region of rabbits in the two cel transplantation groups. Rabbits in the control group were subjected to an equal volume of serum-free. Four weeks after transplantation, heart function of rabbits was monitored using electrocardiogram, and myocardial tissues were taken to measure infarct size and blood capilary density. RESULTS AND CONCLUSION: HLA-G expression was different in different sources of umbilical cord mesenchymal stem cels: high HLA-G expression was found in the aborted umbilical cord mesenchymal stem cels, and meanwhile, low HLA-G expression was found in the ful-term umbilical cord mesenchymal stem cels. Compared with the control group, the left ventricular end-diastolic volume and left ventricular ejection fraction of aborted and ful-term cel transplantation groups were significantly improved, especialy in the aborted cel transplantation group (P < 0.05). BrdU-positive cels were found in the infarct site in both transplantation groups. Compared with the control group, the infarct size and capilary density were improved most significantly in the aborted cel transplantation group folowed by the ful-term cel transplantation group (P < 0.05). Electrocardiogram findings showed significant improvement in both cel transplantation groups compared with the control group (P < 0.05), especialy in the aborted cel transplantation group. These findings indicate that umbilical cord mesenchymal stem cels derived at low gestational weeks improve the heart function more significantly than the ful-term umbilical cord mesenchymal stem cels, which have the potential to become a better source of cardiomyocytes for transplantation.

BACKGROUND:A large amount of inflammatory mediators from myocardial cels are secreted in response to myocardial injury after myocardial ischemia. Moreover, inflammatory cytokines in infarction and ischemia regions contribute to myocardial tissue repair and adaptation.
OBJECTIVE:To investigate the effect of tumor necrosis factor-α (TNF-α) pretreatment on cardiac function of myocardial infarction rabbits undergoing umbilical cord blood mesenchymal stem cel transplantation.
METHODS: Thirty-six white rabbits were equally randomized into sham, model, non-TNF-α, and TNF-αgroups. Animal models of myocardial infarction were made in the latter three groups. Twenty-four hours after modeling, PBS, umbilical cord blood mesenchymal stem cells pretreated with or without TNF-α were injected at infarct center and border, respectively, in the model, TNF-α and non-TNF-α groups.
RESULTS AND CONCLUSION: Model rabbits in the TNF-α and non-TNF-α groups showed better cardiac function and lower size of myocardial infarction and fibrosis than those in the model group. Compared with the non-TNF-α group, moreover, the TNF-α group showed better outcomes in these indicators. These findings indicate that TNF-α pretreatment canmarkedly improve the therapeutic efficacy of umbilical cord blood mesenchymal stem cel transplantation on myocardial infarction.

Objective By investigating the departments of ECG and the staff in China,to study the current ECG status and thus provide references for training ECG workers,improving the work environment and stabilizing the ECG professional team.Methods One hundred and twenty four domestie grass-root hospitals were investigated through real-name questionnaire surveys.The data was collected and analyzed.Results Among the 124 investigated hospitals,the educational background description is:(1) The ECG workers in provincial or municipal hospitals had mainly been entitled with Bachelor's degree or above accounting for 72.7％ of whole ECG workers;the ECG workers in the county or township hospitals were entitled with college degree or below,accounting for 85.7％ of whole ECG workers.The difference between the two kind of workers was significant(P＜0.01).(2) The proportion of ECG workers owning senior professional titles in provincial or municipal hospitals and county or township hospitals were both low,which were 12.2％ and 3.6％,and the former one was significantly higher than the later(P＜0.01).(3) The proportion of hospitals which established dependent department of ECG was low;the percentage of provincial or municipal hospitals was 23.4％,which was significantly higher than that of county or township hospitals (3.3％,P＜0.05).(4) The provincial or municipal hospitals were well equipped and also conducted various of inspection projects in comparison to county or township hospitals.Conclusions The grass-root ECG staff in China has no satisfying education background and professional titles;ECG department belonging varies and the special inspection projects are insufficient and the economic benefit was low.So this study suggest that the competent departments take measures in improving ECG personnel enthusiasm,improving the working environment,and ensuring the healthy and orderly development of ECG profession.

As a special profession in our society,doctor has its special rights.An investigation of Jinzhou,Chaoyang,Huludao,Panjin,Fuxin and Tieling,Anshan in the Liaoning province review that violation of doctors' right occurs from time to time.There are several reasons for the violation,mainly coming from doctors,patients and their relatives,guidance of social media and social causes in depth.

Objective To evaluate the effectiveness and safety of percutaneous transhepatic balloon dilation for the removal of common bile duct stones.Methods 60 patients of common bile duct stone were divided into two groups:PTBD group (30 cases) and endoscopic sphicterotomy (EST) group (30 cases).Postoperatively biliary tract was drained for three days.Results All stones were removed in 28 patients (93％) in PTBD group and 29 cases (97％) in EST group.Early complications occurred in 13％ in PTBD patients and in 17％ in EST patients(x2 =0.35,x2 =0.13,P ＞0.05).There was no mortality in neither group.Long-term complications such as gallstone recurrence and cholangitis in PTBD group was significantly less than that in EST group (x2 =6.41,P ＜ 0.05).Conclusions The success rate of PTBD was similar to that of EST and while in PTBD the function of Oddi's sphincter was well reserved.PTBD procedure is a valuable alternative to EST in patients with bile duct stones,especially in patients who are not suitable for EST.

BACKGROUND:The mechanism of steroid-induced avascular necrosis of the femoral head is stil unclear, Cx43 protein as the main gap junction in bone tissue, through transmitting information between osteoblasts, regulates bone cel growth and differentiation, compensatory bone increase or decrease. The relationship between Cx43 protein and steroid-induced avascular necrosis of the femoral head is stil rarely reported.
OBJECTIVE:To explore the changes in Cx43 expression in rabbit models of steroid-induced vascular necrosis of the femoral head.
METHODS:Forty New Zealand rabbits were equal y and randomly divided into model group and control group. Rabbits in the model group were used to establish models of steroid-induced avascular necrosis of the femoral head using endotoxin and hormone. Rabbits in the control group were injected with the same volume of physiological saline at the same time points.
RESULTS AND CONCLUSION:At 4 weeks after model establishment, hematoxylin-eosin staining results revealed that in the model group, the trabecula became thin and distributed disorderly in the femoral subchondral area. Empty lacuna increased significantly. Adipocytes increased. Hematopoietic cel s in medul ary cavity apparently diminished. In the control group, trabecula arranged orderly and empty lacuna could be seen. Bone marrow cel s were abundant, but adipocytes were less. Immunohistochemical method demonstrated that Cx43 protein expression was observed in osteoblasts of the edge of trabecula, cytoplasm of osteoblasts of trabecula, and bone marrow stromal cel s. Western blot assay results showed that alkaline phosphatase and Cx43 protein expression was lower in the model group than in the control group (P<0.05). Results indicated that Cx43 protein expression decreased in the model rabbits, which may be the key link of the occurrence and development of steroid-induced avascular necrosis of the femoral head.

Objective To evaluate the effect of cisplatin on analgesia with morphine in rats with incisional pain.Methods Forty-two adult male Sprague-Dawley rats,weighing 180-220 g,were randomly divided into 6 groups (n =7 each) using a random number table:normal saline group (group C),normal saline + Pglycoprotein inhibitor LY335979 group (group CL),normal saline + morphine group (group CM),cisplatin group (group S),cisplatin + morphine group (group SM) and cisplatin + morphine + LY335979 group (group SML).Cisplatin 2 mg/kg was injected intraperitoneally once every two days for 5 times in S,SM and SML groups,while the equal volume of normal saline was injected intraperitoneally in C,CL and CM groups.At 2 days after the end of administration,the incisional pain models were established.At 10 min after establishing the model,normal saline 2 ml was injected subcutaneously in C and S groups; LY335979 20 mg/kg was injected via the caudal vein and normal saline 2 ml was injected subcutaneously in group CL; morphine 2 mg/kg was injected subcutaneously in CM and SM groups; LY335979 20 mg/kg was injected via the caudal vein and morphine 2 mg/kg was injected subcutaneously in group SML.Cumulative pain score was used to evaluate analgesia.Results Compared with group C,cumulative pain scores were significantly decreased in group CM,and no significant change was found in cumulative pain scores in CL and S groups.Compared with group CM,cumulative pain scores were significantly increased in group SM,and no significant change was found in cumulative pain scores in group SML.Cumulative pain scores were significantly lower in group SML than in group SM.Conclusion Cisplatin can weaken analgesia induced by morphine in rats with incisional pain through enhancing P-glycoprotein function in the blood-brain barrier.