Objective To analyze the status of quality indicators(QI) on specimen acceptability and establish preliminary qual ity specification.Methods Web based External Quality Assessment system was used to collect data of laboratories partici pated in "Medical quality control indicators in clinical laboratory" from 2015 to 2017,including once in 2015 and 2017 and twice in 2016.Rate and sigma scales were used to evaluate incorrect sample type,incorrect sample container,incorrect fill level and anticoagulant sample clotted.The 25th percentile (P25) and 75th percentile (P75) of the distribution of each QI were employed to establish the high,medium and low specification.Results 5 346,7 593,5 950 and 6 874 laboratories sub mitted the survey results respectively.The P50 of biochemistry (except incorrect fill level),immunology and microbiology reach to 6σ.The P50 of clinical laboratory is 4 to 6σ except for incorrect sample container.There is no significant change of the continuous survey results.Based on results in 2017 to establish the quality specification,the P25 and P75 of the four QIs is 0 and 0.084 4 ％,0 and 0.047 6 ％,0 and 0.114 2 ％,0 and 0.078 4 ％,respectively.Conclusion According to the results of the survey,most laboratories had a faire performance in biochemistry,immunology and microbiology,and clinical laboratory needs to be strengthened.Laboratories should strengthen the laboratory information system construction to ensure the actual and reliable data collection,and make a long time monitoring to achieve a better quality.

Objective To systematically evaluate the association between frailty and risk of postoperative delirium.Methods Systematic review of literature was conducted using eight electronic databases:PubMed,Embase,CENTRAL,Web of Science,CNKI,CBM,VIP and Wanfang Data,and prospective cohort studies about association between frailty and postoperative delirium published before March 2017 were included.Two authors independently screened the literature,extracted the data,and assessed the quality using NOS Scale,and meta-analysis was conducted by RevMan 5.3 software.Results A total of eight studies involving 846 patients were included in this review.Meta-analysis showed that:frailty was associated with higher risk of postoperative delirium [OR=3.63,95％CI (2.06,6.40),P＜0.001].Subgroup analysis showed that:①Frailty assessment tool:Fried frailty criteria and other frailty assessment were associated with increased risk of postoperative delirium[OR=5.81,95％CI(3.54,9.77),P＜0.001],[OR=1.76,95％CI(1.06,2.92),P=0.03].②Age:frailty patients aged 60～74 had increased risk of postoperative delirium [OR=5.05,95％CI (3.14,8.12),P＜0.001],but for patients aged ≥ 75,frailty wasn't associated with postoperative delirium [0R=1.73,95％CI (0.99,3.00),P=0.05].③Type of surgery:for cardiovascular and non-cardiovascular surgery patients,frailty was associated with increased risk of postoperative delirium [OR=3.40,95％CI (1.64,7.05),P＜0.001],[OR=4.95,95％CI (2.41,10.16),P＜0.001].Conclusion Frailty can increase the risk of postoperative delirium.In consideration of quantity and quality of included studies,the conclusion needs to be validated by multi-centered prospective cohort studies with large sample size.

Objective To observe the clinical efficacy and safety of ilaprazole enteric-coated tablets combined with clarithromycin tablets and furazolidone tablets in the treatment of elderly peptic ulcer.Methods Ninety-six elderly patients with peptic ulcer were randomly divided into control and treatment groups with 48 cases per group.Control group was treated with omeprazole enteric-coated capsules 40 mg per time,bid,orally + clarithromycin tablets 0.5 g per time,bid,orally + furazolidone tablets 100 mg per time,qd,orally,continuous treatment for 10 days.Treatment group was treated with ilaprazole enteric-coated tablets 5 mg per time,bid,orally + clarithromycin tablets 0.5 g per time,bid,orally,continuous treatment for 5 days,then treated with ilaprazole enteric-coated tablets 5 mg per time,bid,orally + furazolidone tablet 100 mg per time,qd,orally,continuous treatment for 5 days.The clinical efficacy,Helicobacter Pylori (Hp) positive rate,serum vascular endothelial cell growth factor (VEGF),basic fibtroblast growth factor (bFGF),nitric oxide (NO) and adverse drug reactions were compared between two groups.Results After treatment,the total effective rates of treatment and control groups were 95.83％ (46 cases/48 cases) and 72.92％ (35 cases/48 cases) with significant difference (P ＜0.05).After treatment,the main indexes in treatment and control groups were compared:the Hp positive rates were 4.17％ (2 cases/48 cases) and 20.83％ (10 cases/48 cases),the VEGF were(167.28 ± 12.94) and (145.26 ± 17.87) pg · mL-1,the bFGF were (144.38 ± 14.80) and (123.29 ± 14.46) pg · mL-1,the NO were (31.81 ± 3.50) and (40.92 ± 6.32) μmol · L-1,the differences were statistically significant (all P ＜ 0.05).The adverse drug reactions in the treatment group were dizziness,vomiting and constipation,which in control group were dizziness,rash and diarrhea.The total incidences of adverse drug reactions in treatment and control groups were 8.33％ and 16.67％ without significant difference (P ＞ 0.05).Conclusion Ilaprazole enteric-coated tablets combined with clarithromycin tablets and furazolidone tablets have a definitive clinical efficacy in the treatment of elderly peptic ulcer,which can regulate the levels of serum VEGF,bFGF and NO,without increasing the incidence of adverse drug reactions.

Oxazolidinones are a potent class of synthetic antimicrobial agents with activity mainly against Gram-positive strains.In this review,we summarize the mechanism of action and resistance,as well as the safety from clinical experience of oxazolidinones.The structural modifications and structure-activity relationships of oxazolidinones derivatives will also be presented.

Objective To evaluate the pharmacokinetics of multiple dose of antofloxacin hydroehloride tablet under fast and food state in Chinese healthy subjects.Methods A randomized,open and multiple dose study was conducted.Three dose groups with 16 subjects per group were given the dose of 200,400 and 600 mg antofloxacin hydrochloride tablet,once daily for 7 days respectively.8 subjects (4 male and 4 female) were administrated under fast state and 8 subjects (4 male and 4 female) under food state in each dose.The concentrations of antofloxacin in plasma and urine were determined by HPLC method.Results The main pharmacokinetics parameters of three dose (200,400 and 600 mg) under fast at first day were as follows:Cmax were (2.23 ±0.38),(4.59 ± 1.40),(5.03 ±0.77)mg · L-1,t1/2βwere(11.99 ±3.31),(10.97 ±5.33),(14.39 ± 1.63)h,tmax were (1.37 ±0.78),(2.04 ± 1.42),(2.90 ±2.02)h,AUC0-t were (27.61 ±6.14),(51.77 ±22.09),(73.62 ±10.14)mg · L-1 · h,AUC0-∞ were (38.28 ± 13.49),(72.28 ± 42.80),(108.91 ± 13.26) mg · L-1 · h,V/F were (92.84 ± 12.98),(91.90±14.55),(116.28±22.62)L,CL/F were (5.73 ±1.71),(7.67 ±4.65),(5.58 ±0.66)L· h-1,respectively;under food state at first day,Cmax were (2.36 ± 0.43),(4.11 ± 1.53),(5.60 ± 1.00) mg · L-1,t1/2β were (14.37 ±4.34),(11.25 ±5.39),(15.53 ±2.94) h,tmax were (2.69 ± 1.62),(2.40 ± 1.50),(2.65 ±1.29)h,AUC0-t were (33.69 ±4.00),(48.07 ±22.19),(78.01 ±17.18)mg · L-1 · h,AUC0-∞ were (50.71 ± 8.86),(67.37 ± 41.98),(121.31.66 ± 33.54) mg · L-1 · h,V/F were (81.04 ± 16.35),(106.32 ±34.33),(114.08±20.00)L,CL/Fwere (4.07 ±0.82),(8.28 ±5.29),(5.23 ±1.18)L · h-1,respectively.After 7 days,the main pharmacokinetics parameters of three dose (200,400 and 600 mg) under fast were as follows:Cmax were (3.69 ± 1.39),(7.54 ± 2.95),(8.50 ± 0.93) mg · L-1,t1/2β were (25.22 ± 3.34),(19.56 ±12.47),(15.95 ±2.85)h,tmax were (1.64±1.29),(1.31 ±0.79),(1.60±1.07)h;AUC0-twere (72.29 ± 24.00),(142.96 ± 67.20),(180.81 ± 35.33) mg · L-1 · h,AUC0-∞ were (75.90 ± 25.46),(148.26 ±69.86),(183.30±35.11)mg · L-1 · h,V/F were (184.77 ±52.51),(119.22 ±53.92),(118.91 ±30.13) L,CL/F were (5.06 ± 1.18),(4.75 ± 1.72),(5.15 ±0.72)L · h-1;under food state,Cmax were (3.53 ± 1.06),(6.54 ±1.43),(8.52 ±1.80)mg · L-1,t1/2βwere (24.08 ±6.12),(20.64 ±9.16),(18.69 ±6.49)h,tmax were (2.94 ± 1.02),(1.96 ± 1.05),(2.69 ±0.96)h,AUC0-t were (94.71 ±31.03),(142.17 ±52.46),(211.34.01 ±52.99)mg · L-1 · h,AUC0-∞were (99.32 ±33.93),(149.77 ±55.19),(213.76 ±53.00)mg· L-1 · h,V/F were (139.40±37.39),(140.24±71.11),(130.20 ±71.09)L;CL/F were (4.11 ±1.13),(4.81 ± 1.17),(4.69 ± 0.88)L · h-1.Urinary recovery rates after 7 days doses from zero to 120 h were (67.24±13.56)％,(68.62±14.45)％ and (74.31 ±12.99)％,respectively.Conclusion Food had no obvious influence on pharmacokinetics parameters after multiple oral dose of 200,400 and 600 mg antofloxacin hydrochloride tablet under fast and food state,except that tmax increased.There was no accumulation in human body.It can be considered that food had no effect in the clinical use of antofloxacin hydrochloride tablet.

The external medicine is an indispensable treatment of traditional Chinese medicine (TCM) surgery.The application of Hg is one of the characteristics of TCM surgery medicine for external use.This paper analyzes the present situation of clinical application of Hg and summarizes the common adverse reactions in the literature.The focus of the research on the development of new drugs containing Hg in traditional Chinese medicine is discussed.

The individual pathological and physiological characteristics of different patient population can significantly affect the pharmacokinetic (PK) behavior.Although the PK study results from healthy subjects play an important role in guiding clinical rational medication,they may not be necessarily applicable to the population of elderly,children and gravida,and may not be suitable for all morbid states.Therefore,this article will review the PK clinical studies of various special population.

Background Clinical studies indicated that the pathogenesis of most corneal dystrophy is associated with the mutation of the transforming growth factor beta-induced (TGFBI) gene.However,the molecular mechanism of mutated TGFBI gene in corneal dystrophy is unclear. Objective The present study was to investigate the expression of the TGFBI gene in human corneal tissue and cells in vitro.MethodsHuman corneal epithelial cells and keratocytes were cultured and passaged,and donor corneal tissue was obtained for the section preparation.RT-PCR was used to detect the expression of TGFBI mRNA in human corneal tissue and cells.Immunofluorescence was used to test the expression of the TGFBI protein in the human corneal tissue,and immunohistochemistry was used to test the expression of the TGFBI protein in human corneal epithelial cells and corneal stromal cells.ResultsRT-PCR analysis showed that TGFBI mRNA could be detected as a 1274 bp band in human corneal tissue and corneal stromal cells,but no TGFBI mRNA was observed in corneal epithelial cells.Immunofluorescence assay revealed that corneal stromal cells were positive ly expressed for the TGFBI protein,but the corneal epithelial cells did not express the TGFBI protein.Immunohistochemistry indicated that the expression of TGFBI was detected the red fluoressence in the cytoplasm of corneal stromal cells;however,no positive response was found in corneal epithelial cells.ConclusionsThe expression of the TGFBI gene occurs in human corneal stromal cells but not in the corneal epithelial cells.This result might be of helpful for studying the function and role of TGFBI gene in pathogenesis of corneal dystrophy.

Objective To investigate the oncolytic effect of E1B mutant adenovirus (d11520) on human malignant gliomas. Methods Ad-βgal vector was used to investigate the infectibility of dl1520.U251,Hep3B (positive control) and T24 (negative control) cell lines were infected with dl1520respectively at 50,5,0.5,0.005 and 0 pfu of multiplicity of infection (MOI).The replication efficiency of d11520 in host cells was assessed by plaque assay.The cytopathic effect (CPE) was assessed by crystal violet staining in a panel of tumor cells. Results Crystal violet staining showed the Hep3B cell line was the most sensitive to dl1520 and had the fastest CPE,followed by the U251 cell line,while the T24cell line had no CEP.The replication and infection rates ofdl1520 in the U251 cell line were lower than in the Hep3B cell line but significantly higher than in the T24 cell line (P＜0.05). Conclusion The E1B mutant adenovirus (dl1520) has a significant oncolytic effect on human malignant gliomas.