Effect and Practice of Sub-category Management of Chinese Patent Medicine in the Improvement of the Qualified Rate for Outpatient Prescriptions of Chinese Patent Medicine / 中国药房

OBJECTIVE：To provide reference for improving the qualified rate of outpa tient prescriptions of Chinese patent medicines and ensuring the rational use of medicines. METHODS：Refering to the Beijing Basic Medical Insurance Medicines Catalog， Clinical Medicine Instructions and （No.17Z13） MCDEX，Chinese patent medicine were classified according to the main functions indications and disease syndromes types. The classification results were reviewed by the member of expert group of Hospital Pha rmacy Committee ，and were recorded by medical department of the management department ，finally were embedded into the outpatient HIS and were docked with prescription pre-audit and comment system. Total number of reviewed Chinese patent medicine prescriptions ，the number of repeated prescriptions ，the number of repeated prescriptions intercepted by HIS system ，the number of prescriptions actively modified by the prescribing physician ，the ratio of repeated prescriptions ，the frequency of active modification by the prescribing physician and average cost of each prescription were compared between the third quarter of 2017（initial stage of sub-category management of Chinese patent medicine ）and the forth quarter of 2019. RESULTS ：Chinese patent medicines in our hospital could be divided into eight categories as internal medicine ，surgery medicine ，oncology medicine ，gynecology medicine ，ophthalmology medicine，otorhinolaryngology medicine ，orthopedics medicine and dermatology medicine ；they contained 14，1，2，4，2，2，3， 1 sub-categories，respectively；some sub-categories were subdivided again . In the third quarter of 2017，159 610 prescriptions of Chinese patent medicines were reviewed ，and 421 prescriptions were unreasonable. Among which ，there were 200 prescription of repeated prescriptions ，accounting for 47.15％；676 repeated prescriptions were actively intercepted by HIS and 476 intercepted prescriptions were actively modified by prescribing physicians ，with active modification rate of 70.14％. In the forth quarter of 2019，138 869 prescriptions of Chinese patent medicines were reviewed ，and 381 prescriptions were unreasonable. Among which ， there were 47 prescription of repeated prescriptions ，accounting for 12.43％；266 repeated prescriptions were actively intercepted by HIS and 259 intercepted prescriptions were actively modified by prescribing physicians ，with active modification rate of 97.37％. There were statistical significances in the ratio of repeated prescription and the rate of active modification by physicians between initial stage and the forth quarter of 2019（P＜0.01）. The average cost of each prescription were 278.78 yuan in the third quarter of 2017 and 220.85 yuan in the forth quarter of 2019，decreasing by 20.78％ . CONCLUSIONS ：The sub-category management of Chinese patent medicine is adopted in the pharmacy department of our hospital ，which realize the pre-audit of all prescriptions of Chinese patent medicines ，and increased the pass rate of outpatient chinese patent medicine prescriptions . It i s helpful for doctors to dialectically use drugs ，memorize the varieties of Chinese patent medicines and improve their professional level；it is helpful for prescription reviewers to rapidly identify repeated prescriptions ，improve the information audit and management level of prescriptions. It is convenient for facilitate prescription reviewers to check the amount of prescriptions used and found out the deficiency of the medicine list in our hospital. However ，there are also some problems such as the conflict between individualized medication and part of management system ，and doctors and pharmacists have different opinions on medicine classification.

Neglect and associated factors among left-behind middle school students in undeveloped area of Guangdong Province / 中国学校卫生

Objective@#To explore prevalence and associated factors of neglect among left-behind middle school students in undeveloped area of Guangdong, and to provide scientific basis for effective intervention measures.@*Methods@#A total of 1 105 middle school students were selected from Yangjiang and Qingyuan by random cluster sampling, neglect and left-behind was assessed by a self-reported questionnaire.@*Results@#The prevalence of neglect was 70.9% among left-behind middle school students aged 11-17 years in Yangjiang and Qingyuan areas. Univariate analysis suggested that high parental education, democratic and strict parenting, and frequent contacts with parents associated with low rate of neglect (P<0.05). After adjusted for gender, parental education, parenting style, contact frequency, Logistic regression analysis revealed that parenting discipline(rough, cold, capricious)(OR=2.01, 95%CI=1.23-3.26), contact with parents more than once every two weeks (OR=1.75, 95%CI=1.12-2.72) , peer or self-care (OR=1.85, 95%CI=1.04-3.30) were positively associated with neglect, while higher mother education was negatively associated with neglect.@*Conclusion@#The prevalence of neglect is high among left-behind students in Yangjiang and Qingyuan, which deserves further attention from family, community, school and government to promote healthy development.

Effect of stromal cell derived factor-1α/CXCR4/CXCR7 axis on migration of the bone marrow mesenchymal stem cells / 解剖学报

Objective To investigate expression of CXCR4 and CXCR7 protein and mRNA, which are the receptors of stromal cell derived factor-1α(SDF-1α), in the bone marrow mesenchymal stem cells (BMSCs);to explore the role of SDF-1α/CXCR4/CXCR7 axis in migration of BMSCs in vitro and the possible mechanism .Method BMSCs were isolated from rats and cultured in vitro.CD29, CD44 and CD34 of the cells were identified by flow cytometry .CXCR4-selective antagonist AMD 3100 and CXCR7-specific neutralizing antibody were applied to block CXCR 4 and CXCR7 respectively.The expressions of CXCR4 and CXCR7 mRNA and protein on BMSCs were detected with RT-PCR and Western blotting .Transwells chamber test was used to observe the migration of BMSCs .The BMSCs were divided into the BMSCs group ( A ) , the AMD3100 pretreated BMSCs group ( B ) , the CXCR7-specific neutralizing antibody pretreated BMSCs group(C), the AMD3100 +CXCR7-specific neutralizing antibody pretreated BMSCs group ( D).Result Flow cytometry showed that the expressions of CD 44 and CD29 were positive, while the expression of CD34 was negative in the third passage of BMSCs (P3-BMSCs).CXCR4 and CXCR7 protein and mRNA were both expressed in P3-BMSCs. Compared with the A group, the expression of CXCR4 and CXCR7 protein declined significantly in the B group and the D group;the protein expression of CXCR7 in the C group was lower compared with the A group (P<0.05).However, the expression of CXCR4 mRNA and CXCR7 mRNA had no significant difference between groups .SDF-1αfactor promoted migration of BMSCs ( P <0.05 ).Compared with the 0μg/L group, the numbers of migrated cells were increased significantly in both of the 10μg/L group and the 100μg/L group ( P<0.01 ) .The number of migration of BMSCs was significantly higher in the 100μg/L group than that of the 10μg/L group ( P <0.01 ) .AMD3100 and CXCR7-specific neutralizing antibody both inhibited significantly the migration of BMSCs ( P<0.05 ) , and the attenuate effect was more significant when they worked together ( P<0.05 ) .Conclusion CXCR4 and CXCR7 receptors are co-expressed in P3-BMSCs;the SDF-1αfactor can promote the migration of BMSCs in the concentration dependent manner ;SDF-1α/CXCR4/CXCR7 axis is involved in the migration of BMSCs , and both of the CXCR4 and CXCR7 receptors have a synergistic promoting effect to the BMSCs migration .

Effects of propofol on expression of hippocampal survivin and Caspase-3 in newborn rats / 中华儿科杂志

<p><b>OBJECTIVE</b>Intravenous anesthetics, such as propofol, are widely used in general anesthesia. Neurodegeneration and neurocognitive impairment after exposure to propofol in neonatal rats have raised concerns regarding the safety of pediatric anesthesia. We examined the effects of neonatal propofol exposure on brain cell viability, as well as expression of hippocampal survivin and Caspase-3 mRNA and protein.</p><p><b>METHODS</b>One hundred male Sprague-Dawley rats aged 7 d that were weighed 10-15 g were randomly divided into 4 groups (n = 25 each group). Group A: the rats were injected with no drugs. Group B: the rats were intraperitoneally injected with 50 mg/kg propofol. Group C: the rats were first intraperitoneally injected with 50 mg/kg propofol and another 50 mg/kg propofol was used when the dynamic response of rats appeared again. Group D: the rats were first intraperitoneally injected with 50 mg/kg propofol and another 50 mg/kg propofol was used three times once the dynamic response of rats appeared. To study the effects of propofol exposure on respiratory and metabolic function, arterial blood was aspirated from the left ventricle of neonatal rats 2 h after discontinuation of propofol. pH, PaO(2), PaCO(2), HCO(3)(-), BE and SaO(2) were detected by blood gas analyzer. Moreover, to examine the effects of propofol exposure on short-term cellular viability, the ultrastructure of neurons was observed by transmission electron microscope and Fluoro-Jade B (FJB) staining was performed to examine neuronal degeneration in hippocampal CA1 region of neonatal rats. Survivin and Caspase-3 mRNA and protein expression in hippocampus were detected by semi-quantitative reverse transcription polymerase chain reaction (RT-PCR) and Western blotting 2 h after discontinuation of propofol.</p><p><b>RESULTS</b>The time of anesthesia maintaince in newborn rats was the longest in Group D and the time of anesthesia maintaince in Group C was longer than that in Group B. Two hours after discontinuation of propofol, pH, PaO(2), PaCO(2), HCO(3)(-), BE and SaO(2) of arterial blood in rats were not significantly different among groups A, B, C and D (P > 0.05). The structure of hippocampal neurons was normal in Group A and Group B while 100 mg/kg propofol resulted in nuclear blebbing and 200 mg/kg propofol led to nuclear fragmentation, chromatin condensation and apoptotic bodies. Cellular degeneration, as measured by Fluoro-Jade B staining, significantly increased in hippocampal CA1 region in the anesthesia groups compared with littermates in the no anesthesia group. FJB-positive stained degenerative neurons in groups B, C and D were (2.5 ± 1.3), (7.1 ± 2.3) and (9.4 ± 2.6), which were different from that in Group A (0.6 ± 0.3) (P < 0.05). Moreover, the number of FJB-positive neurons was the highest in Group D, that in Group C was more than that in Group B. At the same time point, apoptosis was measured by expression of Caspase-3 and Survivin mRNA and protein in hippocampus of rats. Caspase-3 mRNA in groups A, B and C was (0.78 ± 0.12), (0.84 ± 0.17) and (0.89 ± 0.19), while Caspase-3 protein in groups A, B and C was (0.22 ± 0.05), (0.26 ± 0.07) and (0.21 ± 0.06). Survivin mRNA in groups A, B and C was (0.56 ± 0.12), (0.58 ± 0.15) and (0.53 ± 0.16), while Survivin protein in these 3 groups was (0.24 ± 0.07), (0.21 ± 0.05) and (0.23 ± 0.06). Compared with that in Group A, Caspase-3 and Survivin mRNA and protein were not significantly different among Group B and Group C (P > 0.05). However, Caspase-3 mRNA and protein in Group D were (1.21 ± 0.14) and (0.42 ± 0.12), which were higher than that in the other 3 groups (P < 0.05). Survivin mRNA and protein in Group D were lower than that in the other 3 groups (P < 0.05).</p><p><b>CONCLUSIONS</b>A high dose of propofol exposure may destroy the structure of neurons, induce neurodegeneration, increase Caspase-3 activity and inhibit survivin expression in hippocampus of newborn rats in vivo.</p>

Identification of Swertia mussotii and its adulterant Swertia species by 5S rRNA gene spacer / 中国中药杂志

<p><b>OBJECTIVE</b>This research focused on analyzing the differences of 5S rRNA gene spacer sequences on Swertia mussotii and its commonly used adulterants, including S. franchetiana, S. wolfangiana and S. chirayita.</p><p><b>METHOD</b>DNA was extracted from the collected Swertia samples. 5S rRNA intergenic spacers were amplified by PCR, sequenced and analyzed.</p><p><b>RESULT</b>5S rRNA gene spacer sequences were different between S. mussotii and its other three adulterants. Sequence divergence among species ranged from 30.6% to 65.0%.</p><p><b>CONCLUSION</b>5S rRNA spacers may be used as molecular authentication markers to differentiate S. mussotii and other commonly used Swertia adulterants. This result provides reliable and simple reference for the authentication of Swertia genus species.</p>

The vasoactive material and pulmonary vascular structural remodeling in rats / 中国应用生理学杂志

<p><b>AIM</b>To investigate the role of vascular endothelial growth factor (VEGF) and endothelin-1 (ET-1) on pulmonary vascular structural remodeling in rats and pika.</p><p><b>METHODS</b>The Wistar rats which reside at 2 260 m were carried to 3 417 m. After they were fed 24 hours,2 weeks and 3 weeks respectively, the level of VEGF and ET-1 were measured using a kit by ELISA method. Pulmonary tissue was taken out to stain with elastica-Van Gieson. The amount of pulmonary arteries (< 100 microm) and the component ratio of MA, PMA,and NMA were calculated by using a light microscope. The ratio of right ventricle weight to left ventricle plus septum weight (RV/LV + S) were measured.</p><p><b>RESULTS</b>The ET-1 was significantly different in pika as compared with 24 h, 2 weeks, 3 weeks hypoxic rats (P < 0.01) respectively. The levels of VEGF in 2 weeks, 3 weeks rats were much higher than that of pika but no difference was found between pika and 24 h hypoxic rats. The ratio of MA, PMA obviously increased, and NMA decreased significantly, right ventricular hypertrophy was developed in differ groups of hypoxic rats.</p><p><b>CONCLUSION</b>The VEGF and ET-1 participate the muscularization of pulmonary vessels during hypoxia and play an important role in the process of hypoxic pulmonary hypertension in rats, however the VEGF and ET-1 may be maintainable only normal organic function in pika.</p>

Changes of Ultrastructure of Xenograft Model of Human Hemangioma on Nude Mice / 实用儿科临床杂志

Objective To investigate the development of ultrastructure in grafts from a xenograft model of human hemangioma on nude mice.Methods Human infantile hemangioma tissue was obtained in surgery and planted into subcutaneous layer of nude mice in small pieces.The grafts were harvested on the 2~(nd),5~(th),15~(th),30~(th),45~(th) day and then at 2~(nd),3~(rd),4~(th),6~(th) month for transmission electron microscopic view.Results In early stage after transplantation,signs of degeneration and necrosis were more evident.On the 30~(th) day,the number of endothelial cells increased and some of the endothelial cells were larger in size with high nuclear to plasm ratio.At the 2~(nd) month,the number of endothelial cells increased,while some of these cells turned flat.Later,high endothelial cells decreased in number and collapse and pyknosis of plasm,formation of secondary lysosome,margination of chromatin,fragmentation of nucleus were evident with surrounding deposition of adipose and collagen.Conclusions With xenotransplantation of human infantile hemangioma tissue onto nude mice,the grafts may survive ischemia and proliferate,and then gradually involute.The development resembles a natural course of human infantile hemangioma.

Psychological and Psychosomatic Status in Children with Pectus Excavatum / 实用儿科临床杂志

Objective To study the psychological and psychosomatic status of children with pectus exca vatum and the significance of orthotherapy. Method Eighty-seven patients and 87 healthy children were interviewed with the Achenba ch Child Behavior Checklist (CBCL),the symptom Checklist (SCL-90)and the psycho logical and psychosomatic status checklist contrived. Results The children with pectus excavatum showed higher frequency in interpersonal sens itivity, depression,anxiety,obsession compulsion and also more mental difficul ties than those of control group.The differences between the patients and health y children were significant statistically.Conclusions The psychological and psychosomatic status of children with pectus excavatum are worse than those of healthy children,so it is reasonable to perform an operati on earlier for improvement of physiological, psychological ,social aspects in ch ildren with pectus excavatum. J Appl Clin Pediatr,2005,20(2):178-179