Study on the Rationality Evaluation Indicator System of Antibiotics with Delphi Method / 中国药房

OBJECTIVE： To provide scientific evidence for establishing perfect rationality evaluation indicator system of antibiotics. METHODS： On the basis of literature research， Delphi method was used to conduct several rounds of consultations on 30 experts in related fields with E-mail and questionnaire field investigation. After several rounds of consultations， rationality evaluation index system for antibiotics was determined. The effective recovery rate of expert consultation questionnaire was used to express the positive coefficient of experts； the authoritative coefficient was used to express the authoritative degree of experts； the index importance assignment and the full score ratio were used to reflect the concentration degree of experts’ opinions； the coefficient of variation and the coefficient of coordination were used to express the coordination degree of experts’ opinions. RESULTS & CONCLUSIONS： After two rounds of consultations， response rates of the questionnaire in two rounds of surveys were 100％ and 96.67％， indicating experts were highly motivated. The authoritative coefficients were 0.91 and 0.88， indicating experts had a high degree of authority. Finally， an evaluation index system for rationality of antibiotics was established， which included four first-level indicators （indications， drug selection， medication process， management indicators） and 35 second-level indicators. Among them， the mean value of importance scoring of first-level indicators ranged from 4.28 to 5.00， the full score ratio from 0.93 to 1.00， the coefficient of variation from 0.00 to 0.15 and the coefficient of coordination was 0.446 （P＜0.001）. While， the mean value of importance scoring of second-level indicators ranged from 3.83 to 4.79； the full score ratio from 0.67 to 1.00； variation coefficient from 0.10 to 0.26 and the coefficient of coordination was 0.115 （P＜0.001）， which indicating the system was reliable.

Effects of Tiaozhi mixture on lipid metabolism disorder in patients with chronic hepatitis C virus infection complicated with fatty liver / 中华实验和临床病毒学杂志

Objective@#To investigate the effects of Tiaozhi mixture on lipid metabolism disorder in patients with chronic hepatitis C virus infection and fatty liver.@*Methods@#The clinical data of 122 cases of patients with chronic hepatitis C virus infection and fatty liver admitted to our hospital from January 2016 to January 2017 were retrospectively analyzed. Control group was only given antiviral treatment, and observation group was given antiviral treatment and Tiaozhi mixture. The blood lipids parameters, decrease of HCV RNA load, negative conversion rate of serum anti-HCV.@*Results@#After treatment, the levels of blood lipids, i. e., triglycerides (TG), total cholesterol (TC) and low density lipoprotein-cholesterol (LDL-C) were decreased significantly in the two groups, and the decreases of blood lipid levels of TG, TC and LDL-C in observation group were greater than those in control group. The level of high density lipoprotein-colesterol (HDL-C) was increased significantly in observation group, and the level of HDL-C in control group was basically unchanged. The liver function tests for alanine aminotransferase (ALT) and total bile acid (TBA) levels were all decreased effectively, and the decrease in observation group was greater than that in control group, and the aspartate aminotransferase (AST) level in the two groups was reduced, but there was no significant difference between the two groups. The decrease of HCV RNA load and negative conversion rate of serum anti-HCV in observation group were higher than those in control group. There was no significant difference in the incidence rate of adverse reactions between the two groups after treatment(χ2=0.000, P=1.000).@*Conclusions@#In the clinical treatment of chronic hepatitis C virus infection with fatty liver, combined Tiaozhi mixture can effectively increase the antiviral efficacy, reduce the possibility of adverse reactions, and help patients with liver function recovery, and it has high safety. Thus it is worthy of clinical promotion.

Effect of oxycodone on microglial activation in brain tissues of rats / 中华麻醉学杂志

Objective To evaluate the effect of oxycodone on microglial activation in brain tissues of rats. Methods Primarily cultured microglial cells of Sprague?Dawley rats were seeded in 24?well plates (1 ml∕well)at a density of 1×105cells∕ml and divided into 5 groups(n=40 each)using a random num?ber table: control group(group C), lipopolysaccharide(LPS)group(group L)and low, medium and high concentrations of oxycodone groups(O25, O50, O100groups). The cells were cultured in serum?free medium for 24 h in group C. LPS was added at the final concentration of 1 μg∕ml in L, O25, O50and O100 groups, and in addition oxycodone was added at the final concentration of 25, 50 and 100 ng∕ml at 24 h of incubation with LPS in O25, O50and O100groups, respectively. Cells were collected at 1 h of incubation or culture for determination of the expression of tumor necrosis factor?α(TNF?α), interleukin?1β(IL?1β), IL?10 and transforming growth factor?1β(TGF?1β)mRNA(by real?time polymerase chain reaction)and expression of TGF?1β and phosphorylated Smad2(p?Smad2)(using Western blot). The concentrations of TNF?α, IL?1β and IL?10 in the supernatant were detected by enzyme?linked immunosorbent assay. Results Compared with group C, the expression of TGF?β1, IL?1β and TNF?α mRNA, TGF?β1 and p?Smad2 was significantly up?regulated, and the concentrations of IL?1β, IL?10 and TNF?α in the supernatant were increased in group L(P<0.01). Compared with group L, the expression of TGF?β1, IL?1β and TNF?α mRNA, TGF?β1 and p?Smad2 was significantly down?regulated in O50and O100groups, the expression of IL?10 mRNA was significantly up?regulated, and the concentrations of IL?1β and TNF?α in the supernatant were decreased in group O100(P<0.05), and no significant change was found in the parameters mentioned above in group O25(P>0.05). Conclusion Oxycodone can inhibit microglial activation in brain tissues of rats.

Analysis on the association of risks related to maternal factors and placental inflammation with necrotizing enterocolitis in preterm infants / 中国医师杂志

Objective To investigate the association of risks related to maternal factors with the subsequent development of necrotizing enterocolitis (NEC) in very preterm infants and to determine whether the placental inflammatory lesions were also related to the NEC.Methods This retrospective cohort study examined newborns born at ＜ 32 weeks (n =180) between July 2006 and July 2015 and their mothers at our hospital,recorded the maternal age,body mass index (BMI),multiparity situation,and the usage of prenatal steroids or antibiotics.Medical records of eligible newborns and their mothers were reviewed.Maternal blood white blood cell and differential counts were measured at admission and the placentas were examined histologically after delivery.The primary outcome measure was NEC Bell Stage Ⅱ a.Bivariate analyses and multivariate logistic regression were used for the statistical analyses.Results NEC was diagnosed in 14 of 180 very preterm infants (7.8％),including 11 Stage Ⅱ and 3 Stage Ⅲ infants,and the overall mortality rate of these infants was 7.1％ (n =1).Multivariate regression analysis identified maternal neutrophil-to-lymphocyte ratio (OR =1.07,P =0.002),muhiparity (OR =3.39,P =0.013),and birth weight (OR =0.06,P =0.01) were significantly associated with an increased risk of NEC development.Neonatal neutrophil-to-lymphocyte ratio (NLR) as measured within 24 hours of birth (P =0.65) was not associated with NEC development.Clinical chorioamnionitis (P≥0.99) and histological chorioamnionitis (P =0.46) and funisitis (P =0.21) could not be used as significant predictors of NEC.Conslusions The development of NEC in very preterm infants is associated with the maternal NLR,parity,and birth weight,not with clinical and histological chorioamnionitis and funisitis.

Influence of different volumes of ropivacaine with the same solubility on diaphragmaticparalysis following ultrasound-guided supraclavicular brachial plexus block / 临床麻醉学杂志

Objective To investigate the effects of different volumes of ropivacaine with the same solubility in supraclavicular brachial plexus block(SCBPB) under ultrasound guidance on ipsilateral diaphragmaticparalysis.Methods Seventy two patients (32 males,40 females, aged 18-65 years, of ASA Ⅰ or Ⅱ, scheduled for the right upper limb fracture internal fixation removal were randomized into group A (0.375% ropivacaine 20 ml) and group B (0.375% ropivacaine 30 ml), 36 cases in each group.The onset and duration of sensory and motor block were observed as well as complication.Diaphragmatic excursion were evaluated by M type ultrasound before and 30 min after drug injection under eupnea and forced respiration through observing diaphragmatic excursion to study diaphragmatic paralysis.Results The onset time of sensory block and maintaining time of sensory block or motor block had no significant difference between the two groups.Compared with group A,the onset time of motor block in group B was significantly shorter (P<0.05).Twelve cases (33.3%) in group A and 22 cases (61.1%) in group B respectively showed complete or partial hemidiaphragmatic paralysis 30 min after drug injection.Compared with group A, the rate of diaphragmatic paralysis in group B was significantly higher (P<0.05).Conclusion Supraclavicular brachial plexus block under ultrasound guidance with 0.375% ropivacaine 20 ml or 30 ml both can provide excellent anesthetic effect.0.375% ropivacaine 20 ml is less likely to lead to diaphragmatic paralysis.

Effect of lamivudine and silymarin on liver fibrosis-relevant factors in HBV transgenic mice with alcohol drinking / 中南大学学报(医学版)

Objective:To observe the role of lamividine and silymarin preventing and curing liver fibrosisrelevant factors induced by alcohol drinking in hepatitis B virus (HBV) transgenic mice (Tg mice).Methods:Forty HBV-Tg BALB/C mice with 1.3 copy were randomly divided into 4 groups:a control group,a model group,a lamivudine group and a silymarin group.Tg mice in control group were treated with normal saline via intragastric administration;Tg-mice in the model group were treated with 50％ alcohol (5 mL/kg) once a day via intragastric administration;while Tg-mice in lamivudine group and silymarin group were treated with alcohol (5 mL/kg) plus laminvudine (100 mg/kg) and silymarin (200 mg/kg) once a day via intragastric administration respectively.All groups were raised for 10 weeks.The levels of HBV-DNA copy number,ALT,AST in serum,the degree of inflammation,the degree of fibrosis,the mRNA expression levels of TGF-β 1,Smad3,Smad7 and connective tissue growth factor (CTGF),and the protein expression levels of TGF-β1,CTGF and α-SMA in liver tissue were detected.All the images were scanned with electronic computer and the data were analyzed with SPSS13.0 software.Results:Compared with the control group,liver injury were significantly aggravated,while HBVDNA copies,mRNA levels ofTGF-β1,Smad3,Smad7 and CTGF as well as the protein levels of TGF-β1,CTGF and α-SMA were significantly increased (P＜0.05).Compared with the model group,liver injury were significantly attenuated in silymarine group and lamivudine group,while mRNA levels of TGF-β 1,Smad3 and CTGF as well as the protein levels of TGF-β1,CTGF and α-SMA were significantly decreased;mRNA level of Smad7 was further increased (P＜0.05);the levels of ALT and AST in serum were decreased in the silymarine group (P＜0.05).Conclusion:Lamivudine and silymarin relieve the histological damage in the liver of alcohol-fed Tg mice.The mechanisms for the beneficial effects of lamivudine or silymarin might be related to inhibiting the expression of TGF-β 1,Smad3 and CTGF,modulating the expression of Smads and suppressing the activation of HSC.

Effect of Polymorphisms of the Methylenetetrahydrofolate Reductase Gene (C677T,A1298C and G1793A)on Stillbirth / 现代检验医学杂志

Objective To determine the relationship between Methylenetetrahydrofolate reductase (MTHFR)(C677T, A1298C and G1793A)polymorphisms and stillbirth.Methods 33 unexplained stillbirth and 582 normal livebirth were col-lected for case-control study from August 2014 to August 2016.The genotyping of C677T,A1298C and G1793A polymor-phisms of the MTHFR gene was tested by using restriction fragment length polymorphism polymerase chain reaction.The relationship between MTHFR polymorphisms and stillbirth susceltibility was analyzed by logistic regression.Results There was no significant difference in the genetype frequencies of A1298C and G1793A of MTHFR polymorphisms between case and control.But there was significant difference in the genetype frequencies of C677T between case and control (CT:P=0.02,χ2=3.67;TT:P=0.02,χ2=3.65).Heterozygous CT and homozygous TT would be high risk factors of stillbirth. C677T was found in one (14.3%)of the cases with early stillbirth and in three (11.5%)of the cases with late stillbirth, having no significant difference.Twin pregnancy and MTHFR C677T increased the risk 8-fold (P<0.001,χ2=13.28)and 3.4(P=0.02,χ2=3.65)for stillbirth,respectively.Conclusion MTHFR C677T polymorphism is high risk factors associ-ated with the susceptibility of stillbirth.MTHFR C677T may be used as a prognostic marker of pregnancy cases predisposed to preterm delivery.

Progress in research on obstructive sleep apnea syndrome with hypertension / 中南大学学报(医学版)

Obstructive sleep apnea syndrome (OSAS) is a complicated chronic disease caused by certain reasons, characterized by obstruction of the upper airway and apnea or hypopnea during sleep, which can be followed by anoxia, snoring and daytime sleepiness. Recent studies have shown that hypertension is closely connected to OSAS. OSAS can lead to hypertension by several possible mechanisms. The diagnosis of OSAS mainly depends on the medical history, sign, polysomnogram (PSG) result and the frequency of apnea and hypopnea. OSAS can be relieved by continuous positive airway pressure (CPAP), oral orthodontic treatment, medicine, change of lifestyles and others. This brief review focuses on the mechanism of hypertension due to OSAS and the diagnosis criteria and treatment of OSAS.

Research progress of cellular immunotherapy for hematological malignancies / 实用肿瘤学杂志

In recent years,considerable progress has been made in the treatment of hematologic malig-nancies.However,most patients will eventually relapse and suffer from severe side effects caused by chemotherapy or radiation.Thus,as a well tolerated,safe,effective and innovative therapy,adoptive cellular immunotherapy e-merges at this very moment.This therapy can kill tumors or control recurrence by reinfusing the in vitro amplifi-cated or treated immune effective cells into the patients.It has been actively used in the treatment of various he-matological malignancies and achieved significant effects,which brings hope for more and more patients with re-lapsed or refractory hematological diseases.

Influence of different volumes of ropivacaine with isodosage on diaphragmatic excursion following ultra-sound-guided interscalene brachial plexus block / 临床麻醉学杂志

Objective To investigate the influence of different volumes of ropivacaine with isod-osage on diaphragmatic excursion following ultrasound-guided interscalene brachial plexus block. Methods Sixty ASA Ⅰ-Ⅱ patients scheduled for right ulnoradial fracture internal fixation removal were randomized into group A (0.5% ropivacaine 20 ml)and group B (0.75% ropivacaine 13.3 ml) (n=30,each).Diaphragmatic excursion were evaluated by M type ultrasound before,1 5 min and 30 min after drug injection. The degree and duration of sensory and motor block were recorded. Results The anesthetic effect and maintain time had no significant difference between groups;Com-pared with group A,group B had lower incidence of diaphragmatic paralysis (P <0.05).There were 28 (93%)and 22 (73%)cases of patients in group A and group B respectively showed reduction of diaphragmatic excursion more than 50% or even complete paralysis 30 min after drug injection (P <0.05).Conclusion Ultrasound-guided interscalene brachial plexus with 0.5% ropivacaine 20 ml or 0.75% ropivacaine 13.3 ml both can provide excellent block.Compared with 0.75% ropivacaine 13.3 ml,0.5% ropivacaine 20 ml is more likely to lead to diaphragmatic paralysis.

Analysis of influencing factors of professional adaptability for college nursing students / 中华医学教育探索杂志

Objective To understand the influencing factors of professional adaptability for college nursing students and the mechanism. Methods A group of 1 105 college students from grades 2010 and 2011 were surveyed with questionnaire for professional adaptability. The data were analyzed with SPSS 16.0. Measurement data were expressed as x±s while enumeration data were expressed as percentage. t test and variance analysis were used to compare the differces among groups of different grades and genders. Results The professional adaptability mean score of college nursing students was (102.66 ± 14.93) and significant differences in professional adaptability were observed between different grades and genders (P=0.004 3, P=0.001 5). The possible influencing factors professional adaptability were different sources of students, family location, family income, etc. There were statis-tic differences in professional promise between arts and science students and between rural an urban students (P=0.029 8, P=0.007 0). Conclusion Grade and genders are the main influencing factors for professional adaptability of college nursing students while other factors exert little effect on it.

A comparative study of effectiveness about systemic rehabilitation exercise on chronic schizophrenic patients / 中国基层医药

Objective To examine the influence of systemic rehabilitation exercise on social functioning in chronic schizophrenic patients.Methods 60 qualified cases selected from chronic psychiatric inpatient department were randomly divided into two groups according to admission number (AD).30 cases in treatment group accepted hospitalized systemic rehabilitation exercise and 30 controls accepted ordinary treatment for 6 months.Social functio-ning evaluated with SSPI and PSP.Results The total score of SSPI(t=1.322,P=0.256) and PSP(t=1.563,P=0.362) were not significantly higher(P>0.05),The total score of SSPI [(37.44 ±4.33)points,t=2.719,P=0.001]and PSP[(72.14 ±6.86)points,t=3.985,P=0.000]total score in the treatment group were significantly higher than that in the control group(P0.05).Conclusion Systemic rehabilitation training does influence on social functioning in chronic schizophrenic patients.

Investigation in correlation between social factors and postpartum depression / 中国实用护理杂志

Objective To investigate the correlation between social factors and postpartum depression.Methods A total of 182 parturients were investigated with Edinburgh Postnatal Depression Scale (EPDS)and self-designed questionnaire.The social factors and postpartum depression of parturients were analyzed using univariate and multivariable logistic regression analysis.Results Family income,relation of family,relation of couples,sex of newborns and negative life events were associated with the risk of postpartum depression.Conclusions Low family income,bad relation of family,bad relation of couples,female newborns,and negative life events during pregnancy may increase the risk of postpartum depression.

The effect and mechanism of alcohol on liver injury in hepatitis B virus transgenic mice / 中国药理学通报

Aim To investigate the synergistic effects and possible molecular mechanism of hepatitis B virus (HBV) and alcohol on liver injury in HBV transgenic mice(HBV-Tg mice).Methods 20 HBV-Tg mice and 20 wild-type mice were randomly divided into 4 groups:alcohol-fed Tg mice and alcohol-fed Wt mice, and they were given intragastric administration with alcohol. Control Tg mice and control Wt mice received intragastric administration with saline.All groups were rasied for 10 weeks.The levels of ALT and AST in serum, the degree of inflammation, the degree of fibrosis, the mRNA expression of TGF-β_1, Smad3, Smad7, CTGF and the protein expression of TGF-β_1, CTGF, α-SMA in liver tissue were detected.Results The serumlevel of ALT and AST, the mRNA expression of TGF-β_1, Smad3, Smad7, CTGF and the protein expression of TGF-β_1, CTGF, α-SMA in liver all increased markedly in alcohol-fed Tg mice. Alcohol consumption induced hepatocyte steatosis and hepatic inflammation in alcohol-fed Tg mice, but the change of liver fibrosis was not remarkable.Conclusion HBV and alcohol have synergistic effects on early liver injury, possibly by enhancing the expression of TGF-β_1, Smad3, CTGF, α-SMA and inducing unbalanced expression of Smads.