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OBJECTIVE To analyze the characteristics and influencing factors of medicine cost for orthopedic surgery patients in Shanxi province, and to provide reference for the rational management of medicine cost in orthopedic surgery patients. METHODS A retrospective analysis was conducted on the case information of 584 204 orthopedic surgery patients in Shanxi province from 2016 to 2021. Medicine cost was analyzed by year, region, hospital level, type of surgery and type of surgical incision. Single factor analysis and generalized linear regression model were used to analyze the influencing factors of total medicine cost, and structural equation model was used for verification. RESULTS The research findings indicated that joint replacement surgery (42.61%) and post-fracture external fixation surgery (12.60%) were the most common types of procedures. There was statistical significance in medicine cost for different surgical types among different regions and hospital levels (P<0.05). In the Jinzhong region, the total medicine cost for post-fracture external fixation surgery was the highest ([ 11 719.97±4 374.73) yuan], while in tertiary grade A hospitals, the total medicine cost for post-fracture external fixation surgery was also the highest ([ 13 584.71±4 531.82) yuan]. Among class Ⅰ incision surgeries, the cost of antibiotics for post-fracture external fixation surgery was the highest ([ 1 176.25±341.42) yuan]. Generalized linear regression model revealed that hospital location, hospital level, gender, payment method, length of hospital stays, and surgical type were the independent influencing factors for total medicine cost (P<0.05). Structural equation model further disclosed that hospital level, payment type, and surgical type had significant effects on total medicine cost (P<0.05). CONCLUSIONS Attention should be paid to the high cost of antibiotics for class Ⅰ incision surgery, and further research on their rational use should be conducted.
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Objective:To construct the forewarning model of drug shortage in Shanxi province, so as to realize the early prediction of drug shortage.Methods:According to the drug shortage of data of each monitoring station in Shanxi province, from the four dimensions of drug factors, policy attributes, supplier factors and demander factors, 14 factors were selected for grey correlation analysis, for example whether they were urgent drugs for women and children, shortage types, etc. The main factors affecting the degree of drug shortage were selected, and the early warning analysis model based on two-step cluster analysis method was established.Results:A total of six factors with the highest correlation with the degree of drug shortage were determined in this study, in order: whether they were urgent drugs for women and children, shortage types, low-price drugs, the number of moving annual total monitoring enterprises in sale in the current month, shortage reasons, and whether they were basic drugs. Based on the two-step cluster analysis, a model of drug shortage forewarning in Shanxi Province was established, which was divided into four optimal clusters and the warning level was determined.Conclusions:This study establishes the early warning model of drug shortage in Shanxi province, which is helpful to find the risk of drug shortage as soon as possible, objectively predict the risk level, and assist the drug regulatory department to realize layered implementation and collaborative response.
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OBJECTIVE: To explore the relationship between occupational aluminum exposure and fasting blood glucose level in workers. METHODS: A cluster sampling method was used to select 178 occupational aluminum-exposed workers as the exposure group, and 178 workers without occupational aluminum exposure as the control group in a large aluminum factory in Shanxi Province. Glucose oxidase method was used to measure the fasting blood glucose level, and inductively coupled plasma mass spectrometry was used to measure the plasma aluminum level in these workers. A generalized linear model was used to analyze the correlation between plasma aluminum exposure level and fasting blood glucose in these workers. RESULTS: The blood aluminum level of workers in the exposure group was higher than that of the control group [median: 39.58 vs 16.67 μg/L, P<0.01]. The fasting blood glucose level of workers in the exposure group was higher than that of the control group [(5.33±0.79) vs(5.15±0.41) mmol/L, P<0.01]. The results of the generalized linear model analysis showed that the blood aluminum level of workers was positively correlated with their fasting blood glucose level after adjusting for age, body mass index, smoking, drinking, exercise, family history of diabetes, and incidence of diabetes(P<0.05). There was a dose-response relationship between the blood aluminum level and fasting blood glucose level of workers in the groups of junior high school and below and high school(all P_(trend)<0.01). There was no correlation found between blood aluminum level and fasting blood glucose level in the group of college and above(P_(trend)>0.05). There was a dose-response relationship between the blood aluminum level and the fasting blood glucose level in the workers in the non-exercise group(P_(trend)<0.01). There was no correlation found between the blood aluminum level and the fasting blood glucose level in the exercise group(P_(trend)>0.05). CONCLUSION: The blood aluminum level of workers exposed to occupational aluminum is positively correlated with their fasting blood glucose level. Higher education level or exercise can moderately reduce the effect of blood aluminum level on fasting blood glucose.
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Objective@#To establish a method for the determination of aluminum in blood, and to detect the aluminum content in the blood of occupational aluminum workers.@*Methods@#The morning blood of the aluminum workers was collected in an anticoagulation tube, and the supernatant was centrifuged. The supernatant was diluted with 4% nitric acid containing 1% Triton for 24 h at room temperature, and the supernatant was centrifuged. The supernatant was filtered and the blood aluminum concentration was measured by inductively coupled plasma mass spectrometry and quantified by external standard method.@*Results@#The detection limit of ICP-MS method was 0.39 μg/L, the linear range was 0-160 μg/L, the recoveries were 98.24%-99.65%, and the precision was 0.19%-0.28%. The recoveries of graphite furnace atomic absorption spectrophotometry (GFAAS) were 97.17%-111.18%, and the precision was 0.35%-0.44%. The average blood aluminum concentration of aluminum workers in the normal control group was (19.87±10.65) μg/L. The average blood aluminum concentration of aluminum workers in the expose group was (31.12±11.43) μg/L.@*Conclusion@#The method of ICP-MS for the determination of aluminum concentration in blood has a simple pretreatment process, high recovery rate, low detection limit and high precision, which is suitable for popularization.
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Aim To assess the effects of Trillium Tschonoskii Maxim ( TTM ) decoction on Tau protein phosphorylation and synaptic development in AD model rats induced by high activity GSK-3β. Methods The SD rats were divided into five groups of ten animals, named sham-operated group ( blank group) , AD model group, TTM group (0. 5, 0. 25, 0. 125 g·kg-1 · d-1 ) . Treatment group received gavage once a day for seven days with TTM decoction, while other groups by gavage once a day for seven days with drinking water. On 2nd day by gavage, Morris water maze test was used to assess the spatial learning and memory ability of the rats. After five days' training, rats in the treat-ment groups and AD model group were injected wort-mannin ( WT, PI3K specific inhibitor ) and GF-109203X (GFX, PKC specific inhibitor) (100 μmol ·L-1 of each, total volume of 10 μL) into the right lateral ventricle. Western blot was used to detect the levels of phosphorylation Tau protein at multiple sites and the expression level of PI3K, Akt, PKC, GSK-3β(S9, T216) and synapse-associated proteins. Immu-nohistochemical method was used to detect the hyper-phosphorylation of Tau protein in hippocampus of rats. Golgi staining was applied to detect the number and morphological changes of synaptic development and dendritic spines. Nissl' s staining was employed to ob-serve the development of neonatal neurons in hippo-campus and cortex. Results Western blot showed that the phosphorylation level of Tau in hippocampus increased in model group, and the activity of GSK-3βwas up-regulated. Among them, however, in middle dose TTM group, the phosphorylation level of Tau in hippocampus decreased and the activity of GSK-3βde-creased. The expression levels of p-PKC and p-Akt in low and middle dose treatment group were higher than those in model group, thus increasing the activity of PKC and Akt to inhibit the activity of GSK-3β kinase. Immunohistochemistry also indicated that TTM could decrease the biological effects of Tau phosphorylation in hippocampus of AD rats. Western blot showed that TTM could increase the expression levels of synapsin-1 , syn-aptophysin and GluR-1 in hippocampus of AD rats. Nissl staining showed that the number of Nissl bodies in hippocampal neurons of AD model group were signif-icantly fewer than those of sham operation group, which could be increased by TTM middle and high dose group, and the complexity and dendritic spine density of hippocampal neurons in AD rats could be en-hanced as well. Conclusion TTM can effectively im-prove the cognitive function of AD rats induced by the increase of GSK-3β activity, and its possible mecha-nism may be via down-regulating the activity of GSK-3β and inhibiting the phosphorylation of tau protein and promoting the development of neurons.
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Objective:To search the English literatures on prescription refills for chronic diseases for a systemic analysis and to explore the mode and the management measures in order to develop the prescription refill and medication therapy management service for patients with chronic diseases in China .Methods:In the pubmed database , the literatures related to prescription refills published before April 2016 was retrieved.The literatures were analyzed by classification of country or region , the types of drugs and the other in-formation.Results:It was found that the United States , Britain and Sweden were the countries with the most prescription refills .The medications for hypertention , diabetes , hyperlipidemia and other chronic diseases respectively were the most types of medications men -tioned.Age, educational level, race, language, type of medication, and so on.were the factors that affected patient compliance . Pharmacists played a role in auditing , intervention and follow-up in prescription refills programs .Conclusion: The programs of pre-scription refills is well developed in America and Europe , which may be a good way to solve the demand in long-term caremedication therapy for those patients in China .
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Aim To assess the effects of Banqiao Codonopisis Pilosula(BCP)decoction on learning and memory dysfunction in AD model rats induced by high activity GSK-3β and its possible mechanism.Methods The SD rats(4 months old,♂)were divided into five groups,namely,sham-operated group(blank group),AD model group,BCP high-dose(2.16 g·kg-1·d-1)group,BCP medium-dose(1.08 g·kg-1·d-1)group,and BCP lower-dose(0.54 g·kg-1·d-1)group.Treatment group received BCP decoction by gavage once a day for 14 days,while other groups were offered drinking water by gavage once a day for 14 days.The autonomous behavior activities of all rats were observed and recorded after gavage.In the last seven days by gavage,Morris water maze test was used to test the spatial learning and memory ability of the five groups.After five days training,treatment groups and AD model group were injected wortmannin(WT,PI3K specific inhibitor)and GF-109203X(GFX,PKC specific inhibitor)(100 μmol·L-1 of each,total volume of 10 μL)into the right lateral ventricle of the rats.The blank group was only injected 2%DMSO.The spatial memory retention was detected by water maze 24 hours after lateral ventricle injection.Then,changes in the spatial learning memory of rats were observed.The level of Tau phosphorylation in SD rat hippocampus and the expression and activity changes of related protein kinase GSK-3β were detected by Western blot and immunohistochemistry.The changes of Nissl bodies in SD rat hippocampus were observed by Nissl′s staining.Results After intragastric administration of BCP,the rat autonomous behavior activities in each group all showed a declining trend,and the differences in low-dose and middle-dose groups had statistical significance compared with blank group.The Morris water maze tests showed that the latency navigation of model group was significantly longer than that of blank group(P<0.01),while that of the BCP three doses groups was shorter than that of model group(P<0.05).Compared with the same group,the latency navigation of the three groups after gavage BCP low,middle and high dose was significant shorter than that without gavage(P<0.05).Western blot results showed that the activity of GSK-3β in AD model group was up-regulated compared with the blank group.However,BCP inhibited activity of GSK-3β.Western blot and immunohistochemistry results showed the level of Tau phosphorylation in AD model group was increased compared with the blank group in the area of CA3(P<0.05).Compared with AD model group,the level of Tau phosphorylation was decreased in treatment group.Nissl′s staining results showed that dendritic spines in AD model group was significantly attenuated compared with the blank group(P<0.05).Far more dendritic spines were observed in treatment group than in AD model group.The number of Nissl′s bodies in neuron cells of hippocampus in hippocampal CA3 was obviously larger in treatment groups than in AD model group.These effect of BCP was dose-dependent.Conclusions BCP can prevent the learning and memory dysfunction in AD model rats induced by high activity of GSK-3β.The mechanism may be related to inhibiting GSK-3β activity and then reducing the level of phosphorylation of Tau and improving neural development.
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Objective@#To investigate the influence of aluminum chloride (AlCl3) solution on the embryon-ic development of zebrafish and neurobehavior of juvenile fish.@*Methods@#The embryos of zebrafishat 6 hours after fertilization were exposed to AlCl3 solution at a concentration of 0, 55.0, 60.5, 66.6, 73.5, 80.5, or 100.0 mg/L, and embryonic hatching rates at 48 and 72 hours after fertilization were calculated. The embryos of zebrafishat 6 hours after fertilization were exposed to AlCl3 solution at a concentration of 0, 60.0, 72.0, 86.4, 103.7, or 124.4 mg/L, and the embryonic mortality rates at 12, 24, 48, 72, and 96 hours after fertilization were calculat-ed. The embryos of zebrafish at 6 hours after fertilization were exposed to AlCl3 solution at a concentration of 0, 50, 100, 200, 400, or 800 μg/L, and the changes in the neurobehavior of juvenile fish were observed after hatching, including touch-escape reaction at 72 hours after fertilization and autonomic movement and panic es-cape reflex at 7 days after fertilization.@*Results@#Compared with the 0 mg/L group, the≥66.6 mg/L group had a sig-nificant reduction in embryonic hatching rate at 48 and 72 hours after fertilization, and the ≥72.0 mg/L group had a significant increase in embryonic mortality rate at 96 hours after fertilization (P<0.05) . Compared with the 0 μg/L group, the≥100 μg/L group had a significant reduction in the number of times of touch-escape reaction (P<0.05) .Compared with the 0 and 50 μg/L groups, the 100-800 μg/L groups had significant reductions in total movement distance and average speed (P<0.05) . Compared with the dark period before illumination, all groups had a significant increase in movement speed during the light period of the panic escape reflex test (i.e., the third minute) (P<0.05) ; within 2 minutes after the light was turned off, there was no significant change in movement speed in the 0-200 μg/L groups (P>0.05) ; the 400 and 800 μg/L groups had a significant increase in movement speed (P<0.05) .@*Conclusion@#AlCl3 exposure may cause embryonic developmental disorder in zebrafish and ab-normal neurobehavior in juvenile fish.
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<p><b>OBJECTIVE</b>To investigate the off-label use of oral glucocorticoids in outpatients.</p><p><b>METHODS</b>The information of outpatient glucocorticoids prescriptions from January 1st to June 30th in 2012 were collected from the information system in our hospital, then the software of Excel was employed to statistically analyze the data including the amount of drugs used in different departments,as well as the age, sex, and diagnosis of the patients. The diagnoses were compared with those included in the labels approved by China Food and Drug Administration and US Food and Drug Administration and domestic and foreign guidelines.</p><p><b>RESULTS</b>It was found that 16.53% of the cases were off-label use,and dexamethasone had the highest proportion (60.50%) of off-label use. Most of the off-label use had evidence support, such as multiple myeloma and myasthenia gravis, while some cases did not, such as epilepsy and sudden deafness.</p><p><b>CONCLUSION</b>The management of off-label use should be further strengthened to promote the safe and rational use of glucocorticoids.</p>
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Humanos , Administración Oral , China , Epilepsia , Glucocorticoides , Uso Fuera de lo Indicado , Pacientes AmbulatoriosRESUMEN
Objective: To investigate the effect of asarone on the zebrafish embryonic development and behavior. Methods: The 3 hours post fertilization (hpf) zebrafish embryos were exposed to different concentrations (0, 25,50,100, 200 and 400 μmol/L) of asarone solution. The asarone solution was replaced each 24 h. Microscope was used to observe embryos morphology at 24,48,72 and 96 hpf, respectively. Spontaneous movements at 24 hpf. heart rate at 48 hpf, hatch rate, deformity rate and mortality rate were evaluated.The sepnl gene expression of zebrafish in 96 hpf was detected by RT-qPCR. With Noldus tracking system the behaviors of zebrafish larvae exposed to asarone were recorded. Results: After zebrafish embryos were exposed to the different concentrations of asarone. their spontaneous movements were decreased. Compared with the control group, the 100,200 and 400 μmol/L groups were significantly decreased (P<0.01). Tłiere was a significant difference (P<0.01) in 48 hpf heart rate between all asarone groups and control group. Spine curvature, pericardial edema, yolk sac edema and other deformity were observed at 72 hpf and 96 hpf. Compared with the control group, the 100, 200 and 400 μmol/L groups showed significant decreased hatch rate (P<0.01). There was a significant difference (P<0.05) in mortality rate between the 400 μmol/L group and control group. With concentrations of asarone increasing, the speed and distance of movement of 200 and 400 μmol/L group were significantly reduced compared to the control group (P<0.05). There was a significant difference between the 200.400 μmol/L groups and the control group in activity (P< 0.01).At 96 hpf. the expression of sepnl gene in arone groups were decreased compared to control group, especially the 100 μmol/L group (P<0.05), and the 200 and 400 μmol/L groups (P<0.01). Conclusion: Asarone had teratogenic effect on zebrafish embryos and larvae, and inhibitory effect on larvae behavior .We should be careful to use asarone in infant medication.
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This article is trying to find out the historical and realistic reasons of the restriction of the process of modernization of traditional Chinese medicine (TCM) from the history of TCM theory and practice of TCM institutional setup and related policies and many other aspects.Then it points out that the TCM in the background of the development of science and technology today is already has the necessary conditions of modernization,but the process can not be succeed overnight,it ought to be a systematic engineering.
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<p><b>OBJECTIVE</b>To observe the expressions of discoidin domain receptor 2 (DDR2) in different phases of alcoholic liver fibrosis (ALF) in a rat model and to study the possible association between DDR2 and collagen deposition in ALF.</p><p><b>METHODS</b>After an ALF rat model was established by alcohol gastrogavage and an olive oil diet, the liver histopathology was observed in different phases of the development of fibrosis. The expressions of DDR2 mRNA and protein were also detected by RT-PCR and Western blot respectively to make a dependability analysis with the index of ALF.</p><p><b>RESULTS</b>(1) The expressions of DDR2 mRNA and protein increased gradually along with ALF aggravation. In the normal control group, they were respectively 1.023+/-0.132 and 0.321+/-0.027; in the model 1 group (week 12) they were 3.644+/-1.686, 0.476+/-0.046; in the model 2 group (week 16) they were 8.337+/-2.387, 0.738+/-0.057; and in the model 3 group (week 20) they were 15.730+/-4.569, 0.997+/-0.049. The differences of DDR2 mRNA (F = 21.74, P less than 0.01) and protein (F = 10.38, P less than 0.01) among these four groups were significant. (2) The expressions of DDR2 had a positive correlation with collagen type I, III, IV contents and the serum index of ALF, especially with type III and IV collagen and serum hexadecenoic acid.</p><p><b>CONCLUSION</b>The expression of DDR2 in this ALF model correlates closely with collagen deposition in the liver, suggesting that it may play an important role in ALF pathogenesis.</p>