Chronic atrophic gastritis （CAG） is a common and intractable disease in the digestive system characterized by the reduction or disappearance of gastric mucosal glands. The intestinal metaplasia or dysplasia in CAG is called precancerous lesion， which greatly increases the risk of cancerization. Dysactivation of nucleotide-binding oligomerization domain-like receptor protein 3 （NLRP3） inflammatory corpuscles can release a large number of inflammatory factors， induce inflammatory cascade reactions， and participate in the process of many diseases. As reported， the dysactivation of NLRP3 inflammatory corpuscles can cause long-term chronic inflammatory infiltration of gastric mucosa and induce the development of CAG. Mitochondrial dysfunction plays an important role in the activation of NLRP3 inflammatory corpuscles. The accumulation of reactive oxygen species （ROS） produced by mitochondrial dysfunction is the key to activating NLRP3 inflammatory corpuscles. Professor LIU Youzhang put forward the theory of "spleen-mitochondrion correlation"， which holds that the spleen mainly transports water and grains， generates qi and blood， transports nutrients to the whole body， and supplies energy and materials needed by the body. Adenosine triphosphate （ATP） generated by mitochondria through the circulation of tricarboxylic acid is the main energy source of the human body. The view that both of them serve as human energy processing plants coincides in terms of physiology. Pathologically， spleen deficiency is associated with mitochondrial oxidative phosphorylation dysfunction. Pathological products such as dampness， turbidity， phlegm， and blood stasis due to failure in transportation because of spleen deficiency are consistent with metabolites generated by mitochondrial dysfunction. Based on the theory of "spleen-mitochondrion correlation"， this study discussed the pathogenesis of CAG in traditional Chinese medicine （TCM）， analyzed the relationship between NLRP3 inflammatory corpuscles and the pathogenesis of CAG， and proposed that the activation of NLRP3 inflammatory corpuscles by mitochondrial dysfunction was the modern biological basis of the pathogenesis of spleen deficiency in CAG. The spleen-strengthening method may be related to improving the mitochondrial function and inflammatory response of patients with CAG and alleviating the damage of gastric mucosa， providing a new idea for TCM in the prevention and treatment of CAG.

Objective:To evaluate the difference of dosimetry between three-dimensional and two-dimensional plans based on CT images of occult perforation in brachytherapy of cervical cancer, aiming to provide clinical reference.Methods:A total of 817 patients with cervical cancer received simple intrauterine (intrauterine tandem plus vaginal colpostats) three-dimensional brachytherapy in Chongqing University Cancer Hospital from January 2019 to December 2020 were retrospectively reviewed. Among them, 16 patients had occul uterine perforation. Based on Oncentra Brachy Therapy plan system, the single prescription dose was 6Gy. Three-dimensional (3D group) and two-dimensional (2D group) plans were designed on the perforated CT images The target volume, conformal index (CI), conformal index coformity index (COIN) and organs-at-risk (OAR) D 2cm 3 parameters were used to assess the plans between two groups. Results:The incidence of pccult uterine perforation was 1.96%(16/817) during brachytherapy for cervical cancer. The volume of prescription dose curve in the 3D group was (40.74±14.98) cm 3, significantly smaller compared with (91.46±19.71) cm 3 in the 2D group ( P<0.05), whereas the volume of the high-risk clinical target area wrapped by prescription dose curve did not significantly differ between two groups ( P>0.05). The CI and COIN in the 3D group were 0.79±0.10 and 0.72±0.96, significantly higher compared with 0.38±0.09 and 0.37±0.18 in the 2D group (both P<0.05). The D 2cm 3 of bladder, rectum, sigmoid colon, small intestine in the 3D group were (306.06±77.57) cGy, (252.27±72.60) cGy, (127.25±62.84) cGy and (228.79±94.90) cGy, significantly lower than (548.03±164.21) cGy, (411.16±118.74) cGy, (227.45±94.48) cGy and (450.95±157.96) cGy in the 2D group (all P<0.05). Conclusions:Application of image guidance in brachytherapy of cervical cancer is helpful to detect occult uterine perforation. When occult uterine perforation occurs, the use of three-dimensional plan can basically meet the clinical needs, which is significantly better than the two-dimensional plan.

Through the functional combination of relevant departments involved in hospital procurement, to simplify and unify the work process, we establish a standardized procurement system, to realize the pre-procurement budget and approval, power balance, strengthen the fairness and openness of procurement process. By introducing the closed-loop process of in-process supervision to ensure the impartiality of review and post-evaluation control, it comprehensively strengthens the internal control of procurement management, and finally realizes the purpose of strengthening procurement risk prevention and procurement quality management.
Hospitals, Public ; Purchasing, Hospital ; Quality Control ; Research

Objective To investigate the effect of acupoint catgut embedding combined with Ziwu-Liuzhu theory based acupuncture on the clinical efficacy and sleep quality of depressive patients. Methods A total of 64 patients who met the inclusion criteria were randomly divided into two groups, 32 in each group. The control group was treated with routine electro-acupuncture, while the observation group was treated with acupoint catgut embedding combined with Ziwu-Liuzhu theory based acupuncture. Both groups were treated for 8 weeks. Sleep quality was assessed by Pittsburgh Sleep Quality Index (PSQI), and depression was assessed by Hamilton Depression Scale (HAMD) to evaluate the clinical efficacy. Results After treatment, the HAMD score (11.3 ± 2.4 vs. 14.5 ± 2.6, t=4.986) and PSQI index (9.6 ± 2.3 vs. 11.8 ± 2.5, t=3.307) in the observation group were significantly lower than those in the control group (P<0.01). The quality of life (12.9 ± 2.3 vs. 11.3 ± 2.5, t=2.598) and mental health score (13.5 ± 2.4 vs. 11.3 ± 2.6, t=3.413) of WHOQOL-BREF scale in the observation group were significantly higher than those in the control group (P<0.01). The total effective rate was 93.8％ (30/32) in the observation group and 75.0％ (24/32) in the control group. There were significant differences between the two groups (χ2=4.246, P=0.038). Conclusions Acupoint catgut embedding combined with Ziwu-Liuzhu theory based acupuncture can effectively improve depressive state, sleep quality and quality of life in patients with depression, and the curative effect is better than conventional electro- acupuncture treatment.

Objective To approach the brain protective effect and mechanism of Sini decoction on rats with cardiopulmonary resuscitation (CPR) syndrome.Methods Fifty Sprague-Dawley (SD) rats were divided into sham operation group (n = 10), CPR model group (n = 20) and Sini decoction treatment group (n = 20) by random number table. The rat models were established by trachea clipping to induce cardiac arrest, and after heart beat stopped for 5 minutes, CPR was carried out. In the Sini decoction group, Sini decoction 5 g/kg was given through a stomach tube, once per 24 hours, while in the sham and CPR model groups, the same amount of normal saline was given by the same method at the same time. Venous blood was collected before CPR and 6, 12, 24, 48 and 72 hours after CPR, and the levels of serum interleukin-6 (IL-6) and tumour necrosis factor-α (TNF-α) were determined by enzyme linked immunosorbent test (ELISA); after CPR for 72 hours, the rat brain tissue was obtained from all the groups, the content of caspase-3 in brain tissue was detected by immunohistochemistry method, and its protein expression caspase-3 was detected by Western Blot; the apoptosis situation of brain tissue was detected by terminal deoxynucleotidyl transferase-mediated duTP nick end labeling (TUNEL).Results With the prolongation of time, the levels of IL-6 and TNF-α in CPR model and Sini decoction groups showed a tendency firstly increased and then decreased, IL-6 reached its peak value after resuscitation for 24 hours, while TNF-α reached its peak value after resuscitation for 48 hours, and both IL-6 and TNF-α were decreased after resuscitation for 72 hours ; beginning from 6 hours after resuscitation, the levels of serum IL-6 (ng/L: 61.79±1.31, 62.49±1.42 vs. 21.48±0.79) and TNF-α (ng/L: 48.32±1.98, 25.32±1.96 vs. 18.34±2.45) in CPR model and Sini decoction treatment groups were all significantly higher than those in sham group, since 12 hours after resuscitation, the level of IL-6 was significantly lower in Sini decoction than that in CPR model group (ng/L: 70.41±2.21 vs. 88.32±1.59), and since 6 hours after resuscitation, TNF-α was obviously lower in Sini decoction group than that in CPR model group (ng/L: 25.32±1.96 vs. 48.32±1.98, allP < 0.05), both IL-6, TNF-α persisting to 72 hours after resuscitation, and their levels did not return to normal at the end of experiment in the two groups. After the end of resuscitation, the content and protein expression of caspase-3 and rate of cell apoptosis in the brain tissue in CPR model group were significantly higher than those in the sham group [caspase-3 content (A value,×103): 2.59±0.26 vs. 1.57±0.06, caspase-3 protein (gray value): 0.80±0.08 vs. 0.43±0.04, apoptosis rate: (2.01±0.08)% vs. (0.26±0.02)%, allP < 0.05], above indexes in the Sini decoction treatment group were significantly lower than those in the CPR model group [caspase-3 content (A value,×103): 1.89±0.08 vs. 2.59±0.26, caspase-3 protein (gray value): 0.57±0.02 vs. 0.80±0.08, apoptosis rate: (1.03±0.05)% vs. (2.01±0.08)%, allP < 0.05).Conclusion The Sini decoction has a protective effect on rats with post-resuscitation syndrome, and its mechanism is possibly realized by the inhibition of inflammatory factors and reduction of cell apoptosis.

OBJECTIVE:To investigate the effect of Xuebijing injection on coagulation function and prognosis in patients with sepsis. METHODS:50 patients with sepsis were randomly divided into control group and observation group according to the hospi-talization sequence,with 25 cases in each group. Control group received conventional treatment,and observation group was addi-tionally given Xuebijing injection(50 ml added into 5% Glucose solution or 0.9% Sodium chloride solution 250 ml intravenously, bid) on the basis of conventional treatment. Treatment course lasted for 7 d. The coagulation function,APACHE Ⅱscore after 7 days of treatment and 28 d mortality were compared between 2 groups. RESULTS:After 7 d treatment,the coagulation indexes were improved significantly in 2 groups compared with before treatment,and the APACHEⅡscores were decreased significantly in both groups;the observation group were significantly better than the control group,with statistical significance (P<0.05). After followed up for 28 d,the mortality rate of 2 groups were 16% and 28%,there was no statistical significance (P>0.05). CON-CLUSIONS:Xuebijing injection can inhibit blood clotting activation,correct the coagulation disorders,and improve the sepsis se-verity.

OBJECTIVE:To explore the construction effect of rational drug use monitoring system on the improvement of clini-cal drug use in the hospital. METHODS:The data about the construction of rational drug use monitoring system were collected from our hospital,including pharmacist workstation prescription check(check before prescription/medical order charging to realize warning in advance),clinical pharmacy management system prescription comment(realize prescription/medical order comment after-wards)and adverse drug reaction/adverse drug event(ADR)reporting information platform(realize online ADR reporting)during 2014-2015. The data was analyzed to evaluate the effectiveness of system construction. RESULTS & CONCLUSIONS:There were a total of 3 417 329 prescriptions audited by the pharmacist workstation within 2 years through improving system functions,includ-ing 7 315 prescriptions were returned to doctors to be modified,the percentage of which declined from 0.39% to 0.08%. The pass rate of prescription comment pre-judgment increased from 81.2% to 90.4% in 2015 by clinical pharmacy management system. The valid case number of ADR monitoring and reporting increased from 186 cases to 267 cases,involving all department of our hospi-tal. The construction of rational drug use monitoring system in our hospital can improve the standardization of prescription/medical orders,the level of rational drug use and the case number of ADR,which has achieved the expected results.

Objective To evaluate the effects of active cycle of breathing techniques (ACBT) on respiratory complications of postoperative lung cancer patients. Methods One hundred non-small-cell lung cancer patients who underwent pulmonary lobectomy or segmentectomy in thoracic surgery department from April 2012 to January 2014 were assigned into the control group , while the experiment group were paired patients from February 2014 to December 2014. We applied ACBT to the experiment group for 5 days after surgical resection and afterward compared the two groups in view of incidence of respiratory complications . Result The incidences of pulmonary infection, atelectasis and hypoxemia in the experiment group were all significantly lower than those in control group (P<0.05). Conclusion ACBT strengthens endurance and force of patients′respiratory muscle group, and therefore reduces postoperative pulmonary complications.

OBJECTIVE:To analyze the problems about the prescription review by the monitoring system for rational drug use (PASS 1.6.1.7) and discuss the countermeasures. METHODS:A retrospective method was adopted. A total of 4 942 prescriptions of our hospital in the first quarter of 2015 were selected at random,and reviewed by PASS and the pharmacist respectively. The re-view results were analyzed,and then countermeasures were put forward for the problems found to exist in the software review. RE-SULTS & CONCLUSIONS:The conformity rates of prescriptions which had been determined as acceptable through PASS review and pharmacist review were 81.20% and 97.40% respectively. PASS misjudged 929 (18.80%) rational prescriptions as irrational ones,mainly concerning administration and dosage,simultaneous existence of Western medicine and Chinese patent medicine on one prescription,repeated drug use and use with caution,etc. PASS misjudged 122(2.47%)irrational prescriptions as rational pre-scriptions,mainly concerning administration and dosage,inconformity between diagnosis and drug use,etc. The above-said prob-lem was attributed to imperfect hospital management and insufficient software intelligence. It is suggested that the hospital should strengthen the data maintenance and management of information system and PASS developer should improve software rules to in-crease the accuracy rate of prescription review.

[ ABSTRACT] AIM:In this study, we aim to obtain the induced pluripotent stem cells ( iPSCs) from the patients with sporadic Alzheimer disease ( AD) .METHODS:Three typical Alzheimer’ s patients were chosen, and the epithelial cells were isolated from their urine.We reprogrammed these cells into induced pluripotent stem cells by transfection of 4 factors (Oct4, Sox2, Klf4 and SV40LT) with the technique of electro-transfection.After getting these iPSCs, we continue to differentiate them into neural cells by a specific method—dual inhibition of Smad signaling.RESULTS: The primary cells from 3 AD patients were successfully reprogrammed to iPSCs, and these patients-derived iPSCs were differentiated into neural cells.There was no significant difference, during iPSCs reprogramming and neural differentiation, between cells from AD patients and normal people.CONCLUSION: The urine cells from AD patients were able to transfer to iPSCs, functional neurons and neurogliocytes.