In order to strengthen the supervision of the use of drugs in hospitals，the Sichuan Academy of Medical Sciences· Sichuan Provincial People’s Hospital took the lead in compiling the Principles for the Rational Use of National Key Monitoring Drugs （the Second Batch） with a number of experts from multiple medical units in accordance with the Second Batch of National Key Monitoring Rational Drug Use List （hereinafter referred to as “the List”） issued by the National Health Commission. According to the method of the WHO Guidelines Development Manual， the writing team used the Delphi method to unify expert opinions by reading and summarizing the domestic and foreign literature evidence of related drugs， and applied the evaluation， formulation and evaluation method of recommendation grading （GRADE） to evaluate the quality of evidence formed， focusing on more than 30 drugs in the List about the evaluation of off-label indications of drugs， key points of rational drug use and key points of pharmaceutical monitoring. It aims to promote the scientific standardization and effective management of clinical medication， further improve the quality of medical services， reduce the risk of adverse drug reactions and drug abuse， promote rational drug use， and improve public health.

Objective: To analyze the impact of cancer on the recurrence rate of atrial fibrillation (AF) after AF radiofrequency ablation and further evaluate the feasibility of radiofrequency ablation therapy in cancer patients with AF. Methods: This study was a single-center, retrospective study. Cancer patients with AF undergoing radiofrequency ablation for the first time in the First Affiliated Hospital of Dalian Medical University from May 30, 2008 to September 30, 2018 were included (cancer group). AF patients without cancer undergoing radiofrequency ablation for the first time during the same period served as non-cancer group. Clinical data including age, gender, past history, cancer and AF-related parameters, etc. were analyzed. Patients were followed up after radiofrequency ablation. The primary endpoints were AF recurrence or all-cause death. Kaplan-Meier survival analysis was used to analyze the effect of cancers on the recurrence after AF ablation. The multivariate cox regression analysis was further applied to correct for other confounding factors to analyze whether the impact of cancers on the recurrence of atrial fibrillation was statistically significant. Results: A total of 90 patients were enrolled, there were 30 patients in the cancer group (mean age (64.8±6.6) years, 16 (53.3%) males) and 60 patients in the non-cancer group (mean age (63.6±6.2) years, 32 (53.3%) males). Clinical data, such as age, gender, and cancer treatment, were similar between the two groups. During an average follow-up period of (328.7±110.2) days, there were 6 AF recurrences (recurrence rate 20.0%) in the cancer group, and 17 AF recurrences (recurrence rate 28.3%) in the control group. AF recurrence rate was similar between the two groups (P>0.05). During the follow-up period, there was no all-cause death in the two groups. Kaplan-Meier survival analysis showed that cancer was not related to AF recurrence after radiofrequency ablation (P = 0.383). After adjusting for other confounding factors, the multivariate Cox regression analysis showed that cancer was not an independent predictor of AF recurrence after radiofrequency ablation (HR=0.508, 95%CI: 0.192-1.342, P = 0.172). Conclusions: The combination of cancer has no impact on the recurrence of AF after radiofrequency ablation. For cancer patients with AF, radiofrequency ablation therapy can be considered as a feasible heart rhythm control treatment strategy.

To study the evolution of Chinese ancient and modern pharmacopoeia standards and compare the domestic and foreign pharmacopoeias, further understand the international requirements on chrysanthemum quality, and establish a more suitable and modern standard system for high quality Chrysanthemi Flos pieces. Newly Revised Materia Medica, Welfare Pharmacy, Collected Essentials of Species of Materia Medica (Bencao Pinhui Jingyao), Chinese Pharmacopoeia and other herbal remedies in various generations were reviewed to summarize the evolution of domestic standards on Chrysanthemi Flos pieces. Then they were compared with those in European Pharmacopoeia, United States Pharmacopoeia, Japanese Pharmacopoeia and other foreign Pharmacopoeias to establish a modern and international high-quality Chrysanthemi Flos pieces standard system with Chinese medicine characteristics and produce more internationally recognized high-quality Chinese medicine pieces.

Pulsed glow discharge mass spectrometric(Pulsed-GDMS) method for the measurement of 7 kinds of key elements(Mg,Fe,Cu,La,Ce,Pr and Nd) in rare earth alloys was established. The influence factors of measurement repeatability, such as pulse time, sample homogeneity, anode cap, flow tube, corn, and sample tablet density were systematically studied. The results showed that,for elements with mass fraction of more than mg/g, the parts (anode cap, flow tube and corn) had the largest influence on measurement repeatability. When the new graphitic parts were used and no parts were changed during the whole measurement,the relative standard deviation (RSD) was less than 3%. However, the RSD were 2%-11%and 3%-21% when the new graphitic parts and the reusable parts were used and changed,respectively. The second influence factor of measurement repeatability was the tablet density. The results showed that,the lower the density,the worse the measurement repeatability, and for the dense tablet, the RSD was less than 3%. Key elements in 1# rare earth alloy were measured by high resolution inductively coupled plasma-mass spectrometry (HR-ICP-MS), and the analytical results were used as reference values for the calibration of Pulsed-GDMS. The relative sensitivity factors (RSF) were obtained, and the key elements in 2# rare earth alloy were measured by Pulsed-GDMS after calibration. The analytical results of key elements in 2#sample by Pulsed-GDMS and HR-ICP-MS were compared, and the results showed that for the dense sample, the analytical results showed good agreement. Under the optimal conditions, the expanded uncertainty of measurement by Pulsed-GDMS reduced to 3%-10%.

Objective To explore the influence of Xihuang Pill on the levels of hormones and receptors in hypothalamus -pituitary-ovary axis and the index of ovary and uterus organs in rats .Methods Wistar female non-pregnant rats were randomly divided into 5 groups ( n =10 in each group):blank group,control group and medium,high and low dose experi-mental groups.Each rat in the control group was given 1.8 mg· kg-1· d-1 tamoxifen;and each rat in the high , middle and low dose experimental groups was given 2.16,1.08 and 0.54 g· kg -1· d-1Xihuang Pill for gastric perfusion,and the blank group was given distilled water with equal volume.The serum levels of gonadotropin -releasing hormone ( GnRH), follicle stimulating hormone (FSH) and luteinzing hormone (LH),estra-diol(E2),progesterone were detected by enzyme linked immunosorbent assay.The expression of follicle stimulating hormone receptor (FSHR) and luteinizing hormone receptor (LHR) in ova-ries were detected by Western blot.Results GnRH in blank group,control group and high,middle and low dose ex-perimental groups were ( 14.99 ±2.33 ), ( 14.63 ±3.39 ), ( 11.90 ±1.11 ), ( 5.55 ±1.05 ), ( 14.82 ±1.47 ) ng· L-1,respectively;comparison between high ,middle dose experimental groups and blank group ,the difference was significant ( all P ＜0.01 ) .E2in the 5 groups were ( 16.84 ±4.20 ), ( 9.10 ±4.76 ), ( 13.38 ±2.12 ), (13.45 ±4.14),(16.32 ±4.23) ng· L-1,respectively;comparison between control group and blank group ,the di-fference was significant ( P ＜0.01 ) .Progesterone in the 5 groups were ( 164.46 ±14.90 ), ( 189.99 ±23.35 ), (187.12 ±17.23),(196.25 ±15.87),(173.26 ±14.07) pmol· L-1,respectively;comparison between control group and high,middle dose experimental groups with blank group ,the difference was significant ( P＜0.05 or P＜0.01 ). Conclusion Xihuang Pill can reduce the contents of GnRH and E 2in serum of rats and increase the content of progesterone,which indicates that Xihuang Pill can have an influence on hypothalamic -pituitary-ovarian axis related hormones.

OBJECTIVETo investigate the blood test patterns for blood donors after nucleic acid detection in blood center.

METHODSThe collected blood samples after voluntary blood donors first were detected by conventional ELISA, then 31981 negative samples were detected via HBV/HCV/HIV combined nucleic acid test of 6 mixed samples(22716 cases) or single samples(9265 cases) by means of Roche cobas s201 instrument. The combined detection method as follows: the blood samples were assayed by conventional nucleic acid test of 6 mixed samples, at same time, 6 mixed samples were treated with polyethylene glycol precipitation method to concentrate the virus, then the nucleic acid test of blood samples was performed; the single detection method as follows: firstly the conventional nucleic acid test of single sample was performed, then the positive reactive samples after re-examination were 6-fold diluted to simulate the nucleic acid test of 6-mixed samples. The positive rate of positive samples detected by combined nucleic acid test, positive samples detected by nucleic acid test of mixed virus concentration and positive samples detected by single nucleic acid test was statistically analyzed. In addition, for HBVpersons the serological test yet should be performed.

RESULTSIn 22 716 samples detected by nucleic acid test of 6 mixed samples (MP-6-NAT) , 9 cases were HBV(0.40‰, 9/22716); at same time, the detection of same samples by nucleic acid test of mixed sample virus concentration showed 29 cases of HBV(1.28‰, 29/22716). In 9265 samples detected by single nucleic acid test(ID-NAT) 12 cases showed HBV(1.30‰, 12/9265), meanwhile the detection of these 12 samples with HBVby 6-fold dilution for virus concentration found only 4 samples with HBV. In serological qualified samples, ID-NAT unqualified rate was 1.28‰, which was higher than that of MP-6-NAT(0.4‰) (χ=8.11, P<0.05); but there was no statistical difference between unqualified rate of ID-NAT and MP-6-NAT(1.3‰ vs 1.28‰)(χ=0.00, P>0.05). In 41 samples with HBsAgHBV DNAdetected by ELISA, 36 samples were confirmed to be occult HBV infective(OBI) by HBsAb, HBcAb test of ELISA; out of these 41 samples, 33 samples showed HBcAb(91.66% of OBI), 5 might be HBV "window period" infective, moreover the HCV RNA and HIV RNA positive samples were not found.

CONCLUSIONTo avoid the missdiagnosis of donors with low level of virus, the nucleic acid test must be carried out after virus concentration of mixed samples when the blood test pattern of donors is nucleic acid test of mixed samples, otherwise the single nucleic acid test must be performed to obtain more high detected rate of virus nucleic acid. The HBcAb serologic test and physical examination of donors before blood donation must be enhanced on basis of serological test of HBsAg; for high risk people, the persuading no blood donation is simplest pattern.

OBJECTIVETo observe the regulatory effects of psoralen, oleanolic acid, and stilbene glucoside, three active components of psoralea fruit, glossy privet fruit and tuber fleeceflower root respectively, on Aβ25-35induced self-renewal and neuron-like differentiation of neural stem cells (NSCs).

METHODSEmbryonic NSCs werein vitro isolated and cultured from Kunming mice of 14-day pregnancy, and randomly divided into the control group, the Aβ25-35 group, the Aβ25-35 +psoralen group, the Aβ25-35 +oleanolic acid group, and the Aβ25-35 + stilbene glucoside group. The intervention concentration of Aβ25-35 was 25 µmol/L, and the intervention concentration of three active components of Chinese medicine was 10(-7)mol/L. The effect of three active components of Chinese medicine on the proliferation of NSCs was observed by counting method. The protein expression of Tubulin was observed by Western blot and immunofluorescence. The ratio of Tubulin+/DAPI was caculated. Results Compared with the control group, the sperical morphology of NSCs was destroyed in the Aβ25-35 group, the counting of NSCs, the expression of Tubulin protein, and the ratio of Tubulin /DAPI all decreased (P <0.01, P <0.05). Compared with the Aβ25-35 group, the counting of NSCs, the expression of Tubulin protein, and the ratio of Tubulin + /DAPI all increased in the three Chinese medicine treated groups (P <0. 01, P <0. 05).

CONCLUSIONS25 µmol/L Aβ25-35 could inhibit self-renewal and neuron-like differentiating of NSCs. But psoralen, oleanolic acid, and stilbene glucoside could promote self-renewal of NSCs and neuron-like differentiation.

Amyloid beta-Peptides ; physiology ; Animals ; Cell Differentiation ; drug effects ; Cell Proliferation ; drug effects ; Cells, Cultured ; Drugs, Chinese Herbal ; pharmacology ; Embryo, Mammalian ; Female ; Mice ; Neural Stem Cells ; Neurogenesis ; drug effects ; Neurons ; cytology ; Peptide Fragments ; physiology ; Pregnancy

To analyze the genetic characterization of epidemic rubella virus strains isolated in Liaoning from 2007-2012, a total of 145 rubella virus strains were isolated using Vero/Slam cell line from the patients' throat swabs during rubella outbreaks and sporadics cases in Liaoning Province from 2007 to 2012. Fragments of 945 nucleotides containing 1E gene from 145 rubella virus isolates were amplified by RT-PCR, the PCR products were sequenced and analyzed. Based on the 739 nucleotides of 1E gene, the phylogenetic trees were constructed with 32 WHO rubella reference strains of 13 genotypes downloaded from GenBank and 145 rubella virus strains. The results showed that the 145 rubella virus strains in 2007 -2012 belonged to genotype 1E, nucleotide acids and amino acids similarities were 97.2%-100.0% and 97.6%-100.0%, respectively. Compared to the 1E reference strains(Rvi/ Dezhou.CHN/02, RVi/MYS/01), the nucleotide acids and amino acids similarities were 96.6%-99.2% and 98.2%-100.0%, respectively except for one amino acid change (Val246-Ala246) of RVi/Shenyang. Liaoning. CHN/13.11/13, and Asp262-Asn262 of RVi/Shenyang. Liaoning. CHN/13.11/4 and RVi/Liaoyang. Liaoning. CHN/26. 11/2. there had no change found in the important antigenic epitope sites, the hemagglutination inhibition and neutralization epitopes of the other rubella viruses. All the 145 strains isolated had the same amino acid change (Leu338--Phe338) in E1 protein. These findings suggested that genotype 1E of rubella virus was the predominant genotype in Liaoning province. the rubella prevailed in recent six years was mainly caused by rubella viruses genotype 1E with multi-transmission routes.
Amino Acid Sequence ; China ; epidemiology ; Epidemics ; Genotype ; Humans ; Molecular Sequence Data ; Phylogeny ; Rubella ; epidemiology ; virology ; Rubella virus ; classification ; genetics ; isolation & purification ; Sequence Alignment ; Viral Envelope Proteins ; chemistry ; genetics

OBJECTIVETo assess the value of an infusion-based separation technique to assist in ultrasound (US)-guided percutaneous radiofrequency ablation (RFA) of liver cancers abutting the liver edge.

METHODSTwenty-four cases of malignant liver tumors abutting the hepatic edge were treated with US-guided puncture accompanied by the assistant infusion technique. The US-guided puncture was made with a 22-G needle through the hepatic tissue and into the abdominal cavity near the target tumor. Infusion of a saline solution was used to separate the liver from any surrounding structures so that percutaneous RFA could be safely performed. Complications, including gastrointestinal injury, hemorrhage and death, were recorded. Technical efficacy and safety were evaluated.

RESULTSAmong the 24 patients, the target tumors were adjacent to the right kidney (n=6), colon (n=6), stomach (n=5), pericardium (n=4), and gall bladder (n=3). Twenty-three patients received a successful radical percutaneous RFA with assistant infusion. The assistant infusion volumes ranged from 80-390 ml and created spaces ranging from 0.8-2.5 cm between the liver and surrounding structures. Five of the cases with tumors adjacent to the stomach or colon received the largest volume infusions. The infusion failed to create a separation space in only one case, due to the presence of an adhesion; as a result, this patient was treated with palliative RFA. The mean hospital stay for all 24 patients was four days after surgery. No severe complications or deaths occurred. At 1-month follow-up, computed tomography images showed that 22 cases had complete ablation, yielding a technical success rate of 95.7% (22/23). No needle track implantation was observed.

CONCLUSIONAssistant infusion for percutaneous radiofrequency ablation creates a protective space between the liver and surrounding structures in patients with liver tumors abutting the liver edge. This safe and effective assistant technique broadens the range of patients available for percutaneous RFA treatment.

Adult ; Aged ; Carcinoma, Hepatocellular ; surgery ; Catheter Ablation ; methods ; Female ; Humans ; Isotonic Solutions ; administration & dosage ; Liver Neoplasms ; surgery ; Male ; Middle Aged ; Treatment Outcome ; Ultrasonography, Interventional

OBJECTIVETo evaluate the chromium (Cr) levels in blood and urine among general population in China between 2009 and 2010, and thereby to analyze its prevalent features.

METHODSFrom year 2009 to 2010, a total of 11 983 subjects of general population aged between 6 and 60 year-old were recruited from 24 districts in 8 provinces in eastern, central and western China mainland, by cluster random sampling method. The information about their living environment and health status were collected by questionnaire, and 11 983 blood samples and 11 853 urine samples were also collected. Inductively coupled plasma mass spectrometry (ICP-MS) was applied to test the Cr level both in blood and urine; and the Cr distribution in blood and urine among groups of population in different ages, genders and districts, were then analyzed.

RESULTSAmong general population in China, the geometric mean (GM) of Cr concentration in blood was 1.19 µg/L, with median at 1.74 µg /L and 95% percentile at 5.59 µg/L. The Cr concentration in blood among males and females were separately 1.18 µg/L and 1.20 µg/L(P > 0.05); while its GM in the groups of population aged 6 - 12, 12 - 16, 16 - 20, 20 - 30, 30 - 45 and 45 - 60 years old were 1.00, 1.22, 1.01, 1.40, 1.27 and 1.30 µg/L (P < 0.01), respectively; and the figures in populations from eastern, central and western China were 1.00, 1.70 and 1.98 µg/L (P < 0.01), respectively. Among general population, the GM of Cr concentration in urine was 0.53 µg/L, with median was lower than 0.42 µg/L and 95% percentile at 3.53 µg/L. The Cr concentration in urine among males and females were separately 0.52 µg/L and 0.53 µg/L (P > 0.05);while its GM in the groups of population aged 6 - 12, 12 - 16, 16 - 20, 20 - 30, 30 - 45 and 45 - 60 years old were 0.56, 0.60, 0.52, 0.50, 0.52 and 0.46 µg/L (P < 0.01), respectively;and the figures in populations from eastern, central and western China were 0.58, < 0.42 and 0.60 µg/L (P < 0.01), respectively.

CONCLUSIONThe study reported the Cr levels in blood and urine among general population in China, and thereby provided basic data evidence for the following Cr biological monitoring studies in near future.

Adolescent ; Adult ; Child ; China ; Chromium ; blood ; urine ; Female ; Humans ; Male ; Middle Aged ; Population Surveillance ; Young Adult