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ObjectiveTo analyze the effectiveness and safety of clinical use of different types of stem cells to provide evidence for governmental supervision of key issues in clinical utilization of stem cells. MethodsSix literature databases in China and abroad were searched for relevant literature published from January 2010 to July 2020， and a systematic review was conducted. ResultsThe study showed 72 studies concerning the effectiveness and safety of different types of stem cells in clinical utilization. Although clinical utilization of stem cells had some therapeutic effects for certain diseases， their long-term effect and safety need to be further evaluated， especially their potential risk of tumorigenicity. ConclusionTo protect the patients’ interest， physicians should fully weigh the benefits against the risks of clinical utilization of stem cells， and relevant governmental departments should strengthen supervision of ethics of clinical research and therapies involving stem cells as well as supervision of stem cell products.
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OBJECTIVE To s tudy the improvement effects of sinapic acid on Aβ42-induced injury of PC 12 cells and the mechanism. METHODS PC12 cells were divided into five groups ：control group ，model group ，sinapic acid group ，phosphoinositide- 3-kinase（PI3K）inhibitor group and extracellular signal-regulated kinase （ERK）inhibitor group. Each inhibitor group was added with LY 294002 and U 0126（10 μmol/L）for 1 h；except for control group ，other four groups were treated with 2 μmol/L Aβ42 for 24 h to replicate the Alzheimer ’s disease cell model ；except for control group and model group ，other three groups were added with 100 μmol/L sinapic acid respectively. After 24 hours of continuous culture ，survival rate of PC 12 cells was detected and the morphology of PC 12 cells was observed. The content of Aβ42，mRNA expression of cAMP response element binding protein （CREB），protein expression of cyclic adenosine monophosphate （cAMP），protein kinase A （PKA），CREB signaling pathway and phosphorylated CREB （p-CREB）were detected. RESULTS After treated with sinapic acid ，the survival rate of PC 12 cells，mRNA expression of CREB and protein expressions of cAMP ，PKA and p-CREB were increased significantly （P＜0.05），while the content of Aβ42 was decreased significantly （P＜0.05）；cell morphology was significantly improved and synapses increased. After intervened with PI 3K and ERK inhibitors ，the survival rate of PC 12 cells，above mRNA and protein expressions were reversed significantly （P＜0.05 or P＜0.01）；cell morphology was irregular ，the fragments increased ，and the synaptic connections decreased. CONCLUSIONS Sinapic acid can improve the survival rate of PC 12 cells injured by A β 42，improve cell （No.2021-KYYWF-0349） morphology and decrease the content of Aβ42，the mechanism of which may be associated with promoting the gene transcription of CREB ， and activating cAMP/PKA/CREB signaling pathway.
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Objective:To analyze the effects of prescription reviews of key monitored drugs using the drug regulatory platform in a district of Shanghai, and the influencing factors for the rate of unqualified prescriptions.Methods:A drug regulatory platform in a district in Shanghai began to implement prescription reviews since June 2018, extracting the reviewed prescriptions of all key monitored drugs and related information from June to December. Taking the unqualified rate of prescription in June as the baseline data, the χ2 test and the logistics regression model were used for data analysis. Results:From June to December 2018, clinical pharmacists reviewed 19 084 outpatient and emergency prescriptions and 10 607 inpatient prescriptions. The unqualified rates of outpatient and emergency prescriptions and inpatient prescriptions dropped from 16.52% and 23.28% in June to 4.45% and 13.80% in December, respectively. Logistics regression analysis showed that the rate of unqualified reviews of outpatient and emergency prescriptions was lower than that of inpatient prescriptions, and the rate of unqualified prescriptions in hospital was significantly lower than that in community health service centers; the rate of unqualified prescriptions for auxiliary drugs and nutritional drugs was significantly lower than that of antibacterial drugs.Conclusions:The prescription reviews of key monitored drugs can effectively promote the rational use of drugs. In the future, it is recommended to strengthen technical support for community health service centers and professional training for clinicians and pharmacists.
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OBJECTIVE：To study the improvement effects of sinapic acid （SA）on PC 12 cell damage induced by Aβ1-42，and to investigate its effect on brain-derived neurotrophic factor （BDNF）/tyrosine kinase B （TrkB）/extracellular signal-regulated kinase （ERK）signaling pathway. METHODS ：PC12 cells were divided into blank group ，model group ，SA low-dose and high-dose groups（50，100 μmol/L）. Except for blank group ，cell damage was induced by Aβ1-42 in other groups ；24 h after modeling ， administration groups were added with the corresponding solution and cultured for 24 h. Morphological changes of cells in each group were observed. Cell survival rate ，mRNA expression and protein level of BDNF ，protein expression of TrkB ，ERK1/2 and phosphorylated ERK 1/2（p-ERK1/2）were detected. p-ERK/ERK ratio was calculated. RESULTS ：Compared with blank group ，the model group had shorter synapses ，looser intercellular junctions ，poor adhesion ，dim cytoplasm and more granules in cytoplasm. Cell survival rate and mRNA expression and protein level of BDNF ，the relative expression of TrkB and p-ERK 1/2 protein，p-ERK/ ERK ratio were significantly decreased （P＜0.05 or P＜0.01）. Compared with model group ，in SA high-dose group the pathological changes of the cells were significantly improved ，the survival rate of the cells ，the mRNA expression and protein level of BDNF，the relative expression of TrkB and p-ERK 1/2 protein， p-ERK/ERK ratio were significantly increased （P＜0.05 or P＜ 0.01）. CONCLUSIONS：SA can i mprove PC 12 cells damage induced by Aβ1-42，the mechanism of which may be associated with activating BDNF/TrkB/ERK signaling pathway. qq.com
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OBJECTIVE：To investigate the mechanism of sinapic acid （SA）against PC 12 cell injury induced by Amyloid β1-42 protein（Aβ1-42）based on PI 3K/Akt/GSK3β signaling pathway. METHODS：PC12 cells of rats were randomly divided into control group，Aβ group（Aβ1-42 2 μmol/L），Aβ+SA group（Aβ1-42 2 μmol/L+SA100 μmol/L），Aβ+SA+LY group [Aβ1-42 2 μmol/L+SA 100 μmol/L+LY294002（PI3K inhibitor ）10 μmol/L]，Aβ+LY group（Aβ1-42 2 μmol/L+LY294002 10 μmol/L）and LY group （LY294002 10 μmol/L）. Except for control group and LY group ，the cells of other groups were replicated the damage model with Aβ1-42. After 24 hours of culture ，the morphology of cells was obsened in each group with a microscope ，and MTT assay was adopted to determine the cell viability of PC 12 cells in each group. Western blotting assay was used to detect the expression of PI 3K，p-PI3K， Akt，p-Akt，GSK3β and p-GSK3β in cells of each group. RESULTS：Compared with control group ，the number of cells decreased and some synaptic breaks disappeared in Aβ group while cell viability，ratio of p-PI 3K/PI3K，p-Akt/Akt and p-GSK 3β/GSK3β in Aβ group were decreased significantly（P＜0.05 or P＜0.01）. Compared with Aβ group，the cells became round and synapses became more in Aβ+SA group while cell viability，the ratio of p-PI 3K/PI3K，p-Akt/Akt and p-GSK 3β/GSK3β were increased significantly（P＜0.05）. Compared with Aβ+SA group，some synaptic breaks occurred in Aβ+SA+LY group while cell viability， the ratio of p-PI 3K/PI3K，p-Akt/Akt and p-GSK 3β/GSK3β were decreased significantly（P＜0.05）；Aβ+LY group had more cell debris，and t he cell viability was decreased ，but the difference was not significant ，and the ratio of p-PI 3K/PI3K，p-Akt/Akt and p-GSK3 β/GSK3 β had no significant change （P＞0.05）; LY294002 alone had no significant effect on morphology ，cellviability and the ratio of p-PI 3K/PI3K，p-Akt/Akt or p-GSK 3β/ GSK3 β （P＞0.05）. CONCLUSIONS ： SA may play aprotective role against PC 12 cell injury induced by A β 1-42 through activating PI 3K/Akt/GSK-3β.
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Objective@#To compare the efficacy and safety of surgical resection and thermal ablations in patients with hepatocellular carcinoma in China using a network Meta-analysis.@*Methods@#References related to eligible randomized controlled studies (RCTs) were searched from China Biology Medicine, China National Knowledge Infrastructure(CNKI), PubMed, Embase and Cochrane Library from 1st January 2010 to 1st December 2017, and were selected according to the criteria. The 1-year, 3-year, and 5-year survival rates and incidence of serious complications were compared among surgical resection (SR), radiofrequency ablation (RFA), and microwave ablation(MWA) by network Meta-analysis based frequency and Bayesian methods.@*Results@#A total of 24 RCTs were included in this study. The results of surface under the cumulative ranking probabilities (SUCRA) showed that when all RCTs were included, the frequency model supported MWA had the highest 5-year overall survival rate (66.1%), while the Bayesian model supported SR had the highest 5-year overall survival rate (64.7%). When the tumor diameter of hepatocellular carcinoma was less than 5 cm and the liver function was Child-Pugh A/B, the frequency and Bayesian model both supported SR had the highest 5-year overall survival rate (89.1% and 88.3%, respectively). When all RCTs or RCTs were included with the tumor diameter less than 5 cm and liver function was Child-Pugh A/B, both the frequency and the Bayesian model supported RFA had the best safety (serious complications rate) (16.4%, 18.7%, 12.6 and 12.8%, respectively).@*Conclusion@#SR should be the first choice for early and small hepatocellular carcinoma, while RFA and MWA have their own indications.
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Objective To analyze the allocation and utilization of class-B large medical equipments at public hospitals under Pudong New Area,Shanghai.Methods Data on the allocation and utilization of class-B large medical equipments were collected by a questionnaire survey of 17 public hospitals under Pudong New Area from June to July 2017 and were analyzed in descriptive statistics.Results There were 55 units of class-B large medical equipments at the public hospitals under by Pudong New Area.The average utilization rates of MRI,CT and DSA were 52.62％,61.49％ and 24.43％ respectively.Conclusions The number of class-B large medical equipments has increased at such hospitals,but the services using DSA need to be extended.
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Objective To analyze the return on investment of 3 types of large medical equipments at Pudong's public hospitals in Shanghai.Methods Data on the numbers and purchasing expenditure, annual utilization headcounts, annual income and annual costs of the MRIs, CTs and DSAs were collected from these hospitals, and their breakeven points and recovery period were analyzed in the study. Results At these hospitals, CTs had relatively a higher return on investment in 2016, with 95 000 headcounts per hospital. At the interest rates of 1% , 3% and 5% , nine hospitals could recover their investment, at an average recovery period of 2.88 years, 3.23 years and 3.84 years respectively. That for DSS was poor. Conclusions These hospitals should improve the business performance of these equipments by means of rational purchase, enhanced utilization and sharing mechanism.
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Objective To analyze the allocation and equity of Class-A and Class-B large medical equipment in Shanghai, and to compare them with those in other parts of China and in other OECD countries. Methods The data of large medical equipments were collected from the Health and Family Planning Commission of Shanghai, government websites, relevant research reports and the database of OECD. Gene-coefficients were adopted to evaluate the equity of large equipment allocation. Results In terms of Class-A and Class B large equipments like CTs, MRIs and DSAs per million population, the number for Shanghai by the end of 2015, was 1.325, 5.30, 2.13 and 3.81 units respectively. Except for CTs, this figure was higher than national average, yet lower than average of other OECD countries. In addition, the equity in allocation of Class-B large medical equipment was better than that of Class-A large medical equipment in Shanghai. Conclusions The overall deployment level of large medical equipments in Shanghai remains to be increased, and the equity in allocation of Class-A large medical equipment deserves more attention.
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This paper analyzed the foreign measurement and evaluation system of physician professionalism,from the perspectives of the evaluation of occupation behavior,the multi sources of evaluation,the evaluation of empathy,and the cross-cultural background.It also discussed the basic condition of the development of domestic evaluation and evaluation system,and analyzed it from the diversity and comprehensiveness of evaluation perspectives,the specific and objectivity of evaluation items,the clarity and quantitative feature of evaluation indexes,as well as the openness and feedback of evaluation system.In addition,this paper reviewed the domestic and foreign measurement and evaluation methods of physician professionalism in recent years and pointed out that the construction of good measurement and evaluation system is the only way to deepen the research of physician professionalism.
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Objective To study the compliance of medical care with corresponding national clinical pathways for inpatients of cholecystectomy for cholecystolithiasis with acute cholecystitis at public hospitals of China. Methods Thirty medical records of the inpatients with cholecystectomy admitted in 2014 were randomly sampled from 18 public hospitals in Shanghai, Hubei province and Gansu province, for assessment on their compliance with corresponding national clinical pathways. Results The average compliance rate of inpatient care of cholecystectomy at public hospitals was 67. 7%. The study found low compliance rates in both severity assessment and timely examinations/diagnosis within two days after admission ( 5. 8% and 35. 3%, respectively) . Conclusions Public hospitals in China should strengthen their supervision over the medical care process for inpatients of cholecystectomy with acute cholecystitis, and the clinical pathways in question should be updated and improved in time.
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Objective To study the compliance of medical care at public hospitals in China with corresponding clinical pathway for inpatients of community acquired pneumonia ( CAP) . Methods Thirty medical records of inpatients with CAP admitted in 2014 were randomly sampled from 18 public hospitals in Shanghai, Hubei province and Gansu province, for assessment on their compliance with corresponding clinical pathways. Results The average compliance rate of inpatient care of CAP at public hospitals was 65. 1%. The study the lowest compliance rates in both timely examinations/diagnosis and severity assessment within three days after admission (0. 7% and 26. 6%, respectively). The compliance rate of reasonable initial antibiotic use was 48. 5%. Conclusions The compliance rate of inpatient care of CAP is low in China. Thus admission examinations, patient severity assessment and antibiotic utilization should be enhanced accordingly for their compliance.
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Objective To study the compliance of medical care with corresponding national clinical pathways for inpatients of cholecystectomy for cholecystolithiasis with acute cholecystitis at public hospitals of China. Methods Thirty medical records of the inpatients with cholecystectomy admitted in 2014 were randomly sampled from 18 public hospitals in Shanghai, Hubei province and Gansu province, for assessment on their compliance with corresponding national clinical pathways. Results The average compliance rate of inpatient care of cholecystectomy at public hospitals was 67. 7%. The study found low compliance rates in both severity assessment and timely examinations/diagnosis within two days after admission ( 5. 8% and 35. 3%, respectively) . Conclusions Public hospitals in China should strengthen their supervision over the medical care process for inpatients of cholecystectomy with acute cholecystitis, and the clinical pathways in question should be updated and improved in time.
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Objective To study the compliance of medical care at public hospitals in China with corresponding clinical pathway for inpatients of community acquired pneumonia ( CAP) . Methods Thirty medical records of inpatients with CAP admitted in 2014 were randomly sampled from 18 public hospitals in Shanghai, Hubei province and Gansu province, for assessment on their compliance with corresponding clinical pathways. Results The average compliance rate of inpatient care of CAP at public hospitals was 65. 1%. The study the lowest compliance rates in both timely examinations/diagnosis and severity assessment within three days after admission (0. 7% and 26. 6%, respectively). The compliance rate of reasonable initial antibiotic use was 48. 5%. Conclusions The compliance rate of inpatient care of CAP is low in China. Thus admission examinations, patient severity assessment and antibiotic utilization should be enhanced accordingly for their compliance.
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Objective To study onclinical researches of 3D printing technology in Orthopedics.Methods Through literature search,107 literatures were included and systematically reviewed,and the status of clinical researches of 3D printing technology in orthopedics was described.Results The clinical researches of 3D printing technology in Orthopedics were mainly focused on males and adults population conducted from 2007 to 2012.3D printing technology frequently used in Orthopedics were reduction and internal fixation,deformity correction,pedicle screw placement,tumor resection,revision and reconstruction,and knee replacement.Conclusion 3D printing technology in Orthopedics is still at an initial stage of clinical development.
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Objective To assess the effect of clinical application of three-dimensional printing technology (3D printing) in Orthopedics.Methods Comparing the effect of clinical application of three-dimensional printing technology with traditional Standardized technology,through using a systematic review and Meta Analysis.Results Meta analysis of 25 studies included in the research showed that application of 3D printing reduced operation time by 26 minutes,decreased intraoperative blood loss by 77 ml,and increased accuracy rate or success rate of screw implanting(increased by 2.10 times compared with tradit onal standardized technology).Conclusion The application of 3D printing in Orthopedics has good short-term effect But its deVelopment in clinical application should be cautious.
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Objective To evaluate the safety and efficacy of clinical application of three-dimensional printing technology (3D printing) in Orthopedics.Methods The safety and effectiveness of clinical application of three-dimensional printing technology in Orthopedics were analyzed by systematic review of non-control studies.Results Non-control studies showed that cortical perforation rate of screws was 3.83％ (calculated by the number of screw).Complication rate was 2.13％,surgical infection rate was 0.28％,prosthesis problematic rate was 0.79％,the average operation time was 139.23 minutes,and some results of the indicators for safety and effectiveness were similar between studies with and without control groups.Conclusion Although 3D printing application in Orthopedics has some clinical value,and its extension needs economic assessment.
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Using a UHPLC-TOF/MS method combined with software of Masslynx V4.1 and database in the literatures, a total of 20 polygala oligosaccharide esters (POEs) were identified in 60% ethanol extract of Kai Xin San (KXS-60%E). Furthermore, 14 POEs as well as 4 POE-metabolites were identified in rat plasma. The results revealed that POEs and POE-metabolites which were identified in rat plasma, were key components in KXS-60%E and the potential bioactive compounds for KXS action in the treatment of AD.
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Objective To analyze the key factors influencing the number of diseases or conditions in which clinical pathways ( CPs) were implemented at public hospitals of China. Methods Based on the questionnaire survey of 51 public hospitals that had implemented CPs in Shanghai, Hubei province, and Gansu province, a multivariate logistic model was used to analyze the factors that influenced the number of CPs implemented in hospitals. Results In terms of the 14 issues and difficulties found in CPs′implementation, the overall acceptance rate was 38. 8% on average among surveyed hospitals, yet with a great variation(from 7. 1% to 100. 0%). A multivariate logistic model showed that the recognition of public hospitals on the issues and difficulties in CPs′implementation did not affect the number of implemented CPs, and tertiary public hospitals had significantly higher number of CPs implemented than secondary hospitals. Conclusions The resources and management capabilities of public hospitals in China are the determinants of CPs′promotion.
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Objective To analyze the implementation of clinical pathways ( CP) at public hospitals at different levels and in different regions in China. Methods The status of CPs′ implementation at 54 public hospitals in Shanghai, Hubei province and Gansu province was surveyed by questionnaires from March to May of 2015. Results 51 (94. 4%) of the surveyed public hospitals put in place clinical pathway(s), where the average CPs implemented were 45 and the average percentage of the cases using CPs was 52. 7%. There were great variations among these hospitals. In addition, the common diseases with definite diagnostic and treatment options were found with the highest implementation rates of CPs at such hospitals. Conclusions CPs are implemented widely at public hospitals of China, yet enhanced implementation strategies are expected to further CPs′adoption.