OBJECTIVE： To explore the management model of smart pharmacy under the background of “Internet+TCM”， and to promote the improvement of the work and service quality of smart pharmacy. METHODS： The information platform and internal organization of smart pharmacy in our hospital were combined； the supervision and management of smart pharmacy and the establishment of quality control system in smart pharmacy were summarized and the development and supervision effectiveness of smart pharmacy in our hospital were evaluated. RESULTS： Our hospital established the information platform on the basis of the “Internet+TCM”. Hospital information setting were divided into online and offline. The prescriptions that were not suitable for online handling decoction and distribution service were clearly defined and the system locking settings were set up to realize effective information transmission from hospital to smart pharmacy. The service platform of smart pharmacy were set up including electronic prescription circulation system， whole-course prescription barcode recognition management system， electronic prescription audit and dispensing system， intelligent decoction control management system， smart pharmacy distribution management system， etc. It had realized seamless connection of information between smart pharmacy and patients. The internal organization included six departments： prescription audit center， dispensing center， decoction center， individualized preparation production center， logistics center and customer service center. Our hospital conducted daily supervision and management of the entire work process of the smart pharmacy from aspect of hospital management and pharmacy management. The internal service quality of smart pharmacy could be controlled by quality control system of prescription reviewing center， dispensing center， decocting center， individualized preparation center， logistics center and customer service center and pharmaceutical personnel training mechanism in smart pharmacy. Since the start of the smart pharmacy in June 2015， the number of people receiving the services of smart pharmacy had increased significantly， and the types of services and service opportunities for patients had added； the distribution service had added， and the service of individualized preparation processing and distribution had also added. Moreover， the service capacity of smart pharmacy far exceeded the demand of our hospital， and other medical institutions could share the platform of smart pharmacy. By simply counting the situation in our hospital， the average number of daily prescription increased from 387 in Jun.-Dec. of 2015 to 1 433 in 2018； the error rate showed a downward trend， among which the abnormal rate of prescription reviewing， the dispensing error rate， the decoction error rate and customer service complaints rate decreased from 2.10％， 0.13％， 0.52％， 0.13％ in Jun.-Dec. of 2015 to 0.45％， 0.05％， 0.27％， 0.04％ in 2018； total timely investment rate in logistics increased from 93.20％ in Jun.-Dec. of 2015 to 97.06％ in 2018. At present， the existing information platform， internal organization， quality control system and supervision system could ensure the orderly operation of smart pharmacy and could ensure the quality of drugs， decoction and distribution. CONCLUSIONS： However， the development of smart pharmacy in our hospital is still in its infancy. In the future， it is still necessary to strengthen the construction of information software and hardware， standardize the operation of various links， strengthen personnel training， establish an effective quality control system and explore more objective supervision mechanisms.

Chimeric antigen receptor (CAR) T lymphocyte has shown attractive prospects in the treatment of lymphohematopoietic malignancies including B-cell lymphoblastic leukemia, B-cell lymphoma and multiple myeloma. Many applicants have submitted investigational new drug (IND) applications to Center for Drug Evaluation of National Medical Products Ggency, however, many of the INDs have problems in patient selection, prognostic indicators and risk management, etc, which might hinder the evaluation of the safety and efficacy of CAR-T cells. Thus, we made some suggestions on the above-mentioned problems through summarizing clinical experience and communicating with domestic clinical experts, which the sponsors and researchers can refer to when conducting CAR-T cell clinical trials for registration.

In this paper, scientific theory was used to prove that the meridian was the resonant channel of information energy of life, and experiment and demonstration was performed to reveal meridians to explore the significance of revealing meridian. Based on the theory of physics, biochemistry, molecular biology and information theory, the essence of meridian was demonstrated in theory. According to TCM meridian theory, acupuncture was applied at selected acupoints; the infrared thermograms of stomach meridian of foot , large intestine meridian of hand , small intestine meridian of hand , pericardium meridian of hand , heart meridian of hand , triple energizer meridian of hand , liver meridian of foot , bladder meridian of foot were recorded before and after acupuncture. As a result, thermogram recorded and showed the visual image of the meridian. It is indicated that an energy transmission network which cannot be dissected existing in the body, which was believed to be meridian. It was the resonant channel of information energy of life, and could be shown by thermogram. These experiments and theory have significance in science.
Acupuncture ; Acupuncture Points ; Humans ; Meridians

BACKGROUND:Mechano growth factor has the potential to activate muscle satelite cels and promote myogenic cel growth, and has dual roles in maintaining bone mass and repairing bone defects.
OBJECTIVE: To explore the mechanism underlying osteogenic differentiation of rabbit bone marrow mesenchymal stem cels promoted by the mechano growth factor.
METHODS:The best concentration and time of mechano growth factor to promote osteogenic differentiation of rabbit bone marrow mesenchymal stem cels were detected by MTT. The mRNA and protein expressions of alkaline phosphatase and osteocalcin were detected by qPCR and western blot, respectively. The phosphorylation level of AKT and mTOR were detected by western blot assay.
RESULTS AND CONCLUSION:The best concentration and time of mechano growth factor was 45 μg/L and 5 days for promoting the osteogenic differentiation of rabbit bone marrow mesenchymal stem cels. The expressions of alkaline phosphatase and osteocalcin at mRNA and protein levels were highest after 4-hour intervention with 45 μg/L mechano growth factor, and meanwhile, the phosphorylation levels of mTOR and AKT were also highest. These findings indicate that the mechano growth factor can promote the differentiation of rabbit bone marrow mesenchymal stem cels into osteoblastsvia PI3K/AKT pathway, and its best concentration and time are 45 μg/L and 4 hours, respectively.

A method was developed for the determination of tetrodotoxin in marine organisms by high perfor-mance liquid chromatography-mass spectrometry with immunoaffinity column. The samples were extracted with 1% acetic acid methanol solution and diluted with phosphate buffer at pH 7-8. After cleaned up by immuno-affinity column, the samples were analyzed by LC-MS/MS and quantitatively determined by external standard method. The chromatographic separation was performed on an ACQUITY UPLC BEH Amide column with gradient elution by using acetonitrile and 5 mol/L ammonium acetate solution containing 0. 1% formic acid as mobile phase. Detection was carried out by electrospray positive ionization mass spectrometry in the multiple reaction monitoring mode. Linear ranges of TTX was in the range of 0. 3 -20. 0 μg/L with correlation coeffi-cient more than 0. 997. The quantification limit of the method was 0. 3 μg/kg. The recoveries of standard addition for tetrodotoxin were 88. 7%-102. 3%, and the relative standard deviation was 2. 0%-6. 4%. The method could be used to identify and quantify tetrodotoxin in marine organisms with satisfactory reproducibility and sensitivity.

Objective To investigate the relationships between baseline R2? of blood oxygenation level-dependent magnetic resonance imaging(BOLD-MRI) and Semi-quantitative parameters of dynamic contrast-enhanced magnetic resonance imaging(DCE-MRI) in cervical cancer,to lay a foundation for the further development of assessing tumor hypoxia techniques. Methods Twenty-four patients with cervical cancer were subjected to DCE-MRI and BOLD-MRI before treatment,Semi-quantitative parameters(SI-I、MER、Tmax、IAUC) of DCE-MRI and the baseline R2?of BOLD-MRI produced by special post-processing softwares,the relationships between baseline R2?of BOLD-MRI and Semi-quantitative parameters of DCE-MRI were analyzed. Results Significant positive correlations were observed between baseline R2?and Tmax(r=0.423,P=0.014),there were no correlation between baseline R2? and SI-I、MER or IAUC(P>0.05). Conclusion Semi-quantitative parameters of DCE-MRI and baseline R2? of BOLD-MRI respectively reflected the oxygenation of tumor in different principle. The combined use of the above parameters is expected to improve the performance for defining tumor hypoxia.

Objective To examine the expression and clinical significance of MyD88 in ovarian carcinomas.Methods Specimens from 115 patients with ovarian carcinomas managed in our hospital between Augest 2000 and February 2010 were included in this study.Immunohistochemical staining was used to detect the expression of MyD88 in ovarian carcinomas and normal tissues.All the specimens were confirmed by pathology for ovarian carcinomas and normal tissues by HE staining.The correlation between the expression and clinical significance of patients was analyzed.Results The positive expression rate of MyD88 in ovarian carcinomas and normal tissues was 70.4％ and 23.5％,respectively.MyD88 expression was significantly associated with tumor stage and distant metastasis (P ＜ 0.05).According to the survival analysis of 115 ovarian carcinomas patients,cases in the MyD88 positive-expression group showed poorer overall survival rate when compared with negative-expression group (P ＜ 0.001).Conclusion These results indicate that the expression of MyD88 was related with in the progression of ovarian carcinomas and may have clinical utility in the prediction of prognosis of ovarian carcinomas.

OBJECTIVETo analyze the prevalence states of hypertension and prehypertension and to explore relevant influencing factors among adult residents in Shandong province.

METHODS15 600 residents aged between 18 and 69 from 20 counties in Shandong province were selected by multiple stratified and clustered sampling method from July to September, in 2011, to acquire related information by questionnaire survey and physical measurement. The prevalence of hypertension and prehypertension was estimated by special statistic method used to deal with complex sampling data, and the relevant influencing factors were also analyzed.

RESULTSA total of 15 350 subjects were actually completed the survey, with age at (41.4 ± 14.1) years old. The average systolic blood pressure and diastolic blood pressure were 121.1(95%CI: 119.7-122.4) and 78.8(95%CI: 77.8-79.9) mmHg (1 mmHg = 0.133 kPa) respectively. And also 3776 hypertension patients and 5721 subjects with prehypertension were detected, and the weighting prevalence of hypertension and prehypertension were 23.4% (95%CI: 20.9%-26.0%) and 37.1% (95%CI: 34.7%-39.5%) with adjustive prevalence at 20.7% and 36.5% respectively. The multiple SURVEYLOGISTIC analysis showed that age above 40 years old (OR = 3.24, 95%CI: 2.56-4.10), overweight(OR = 2.22, 95%CI: 1.70-2.89) and obesity(OR = 5.84, 95%CI: 3.54-9.66), smoking history(OR = 1.82, 95%CI: 1.03-3.23), constantly drinking (OR = 1.71, 95%CI: 1.08-2.70), diabetes (OR = 1.99, 95%CI: 1.29-3.07), abnormal TC(OR = 1.64, 95%CI: 1.24-2.17), abnormal TG(OR = 1.75, 95%CI: 1.24-2.48) and high 24 h urine Na/K ratio (OR = 1.05, 95%CI: 1.02-1.08) were risk factors of hypertension, while education equal to or above junior middle school (OR = 0.68, 95%CI: 0.52-0.89) was protective factor of hypertension; age above 40 years old (OR = 1.49, 95%CI: 1.15-1.91), overweight(OR = 1.76, 95%CI: 1.25-2.48) and obesity (OR = 3.50, 95%CI: 2.05-5.97), abnormal TC (OR = 1.54, 95%CI: 1.10-2.14), abnormal TG (OR = 1.79, 95%CI:1.25-2.56) and high 24 h urine Na/K ratio (OR = 1.02, 95%CI: 1.01-1.04) were risk factors of prehypertension, while female (OR = 0.41, 95%CI: 0.31-0.56) and education level equal to or above junior middle school (OR = 0.67, 95%CI: 0.52-0.87) were protective factors.

CONCLUSIONThe hypertension, especially prehypertension tends to be at high prevalence states currently, which may be affected by many factors.

Adolescent ; Adult ; Aged ; China ; epidemiology ; Cross-Sectional Studies ; Female ; Humans ; Hypertension ; epidemiology ; Male ; Middle Aged ; Prehypertension ; epidemiology ; Risk Factors ; Young Adult

Objective To evaluate the biocompatibility of acellular bladder matrix patch as the pelvic floor repair alternative ma-terial .Methods The combination of in vivo and in vitro biological experiments including cytotoxicity ,haemolysis and vaginal im-plant tests were employed to evaluate the biocompatibility of this material .Results In the cytotoxicity test ,the material toxicity was the grade 0-1 .The hemolysis rate of the material extract liquid was 1 .5% .The general and histological observation showed that the material did not cause the host immunologic rejection and led to slight foreign body reaction after implanting ,which was ba-sically degraded in 12 weeks after transplantation .Conclusion Acellular bladder matrix exhibits better biocompatibility ,but needs to adjust its degradation rate in order to adapt to the requirements of pelvic floor repair operation .

Objectives To develop a measurement for obesity assessment which could be used as a simple tool of risk screening. Methods The data of National Nutrition and Health Survey ( 2002 ) were used to analyze the relationship between body mass index ( BMI ), waist circumference (WC) and chronic diseases, based on which chronic disease index ( CRI ) was established. Receiver operating characteristic curve (ROC) was used to determine the cut-off of CRI and to compare the predictive effectiveness of CRI,BMI and WC on chronic diseases. The kappa test was chosen to estimate the consistency of different cut-off of CRI with BMI and WC. The odds ratios of chronic diseases in different cut-offs of CRI were calculated by multiple Logistic regression analysis. Results CRI was calculated as CRI = BMI + 3.5 WC. In ROC curve,the cut-off of CRI was 300. The predictive effectiveness of CRI was higher than that of BMI and WC. CRI at 300 showed the best consistency with 24 kg/m2 BMI and 85 cm WC (P <0. 05 ). In comparison with CRI <300,the risk of chronic diseases was significantly increased with an increase of 20 U CRI. Conclusion CRI shows good predietive effectiveness and could be used to identify those with higher risk of chronic diseases.