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OBJECTIVE To analyze the status quo of performance appraisal of pharmacy intravenous admixture services （PIVAS） in China based on literature analysis， and provide reference for the implementation of performance management of PIVAS in China. METHODS Retrieved from domestic and foreign databases such as CNKI， VIP， Wanfang， PubMed， Embase， the Cochrane Library and CBM， the literature on the status quo evaluation of performance appraisal of PIVAS in China was included from the inception to Sept. 2022. The descriptive analysis was carried out on performance appraisal measures， performance appraisal indicators， performance appraisal achievement， etc. RESULTS Twelve pieces of literature were included， involving 8 before-and-after controlled studies and 4 experience sharing. The performance appraisal subjects of 10 pieces of literature were all staff and those of 2 pieces of literature were nurses. The measures of PIVAS performance appraisal were roughly the same， mainly involving contents and indicators of workload， work quality （including errors）， clinical service satisfaction， labor discipline， department contribution， personal comprehensive evaluation， and so on， but the main accounting proportion was different. Performance appraisal indicators mainly included the rate of medical order review， dispensing rate， check rate， delivery rate， finished product review rate， etc. The performance appraisal achievement mainly included the improvement of work efficiency， the improvement of work quality， the reduction of error rate， and the improvement of clinical satisfaction and employee satisfaction. CONCLUSIONS By building performance appraisal system and adopting corresponding performance management measures of PIVAS， it can improve the work efficiency and quality， reduce the error rate， ensure the safety of patients’ medication， and promote the standardized management of PIVAS in China.
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OBJECTIVE To establish the fingerprint of Huangqin decoction （HQD）， to separate the phase states and screen the active phase states of antidermatophytic activity so as to study the spectrum-effect relationship. METHODS HPLC method was adopted using baicalin as reference， the fingerprints of 10 batches of HQD were drawn and the similarity evaluation was carried out using the Similarity Evaluation System of Chromatographic Fingerprint of TCM （2012 edition） to determine the common peak； the phase states of HQD were separated and characterized by high-speed centrifugation and membrane dialysis. The minimum inhibitory concentrations （MIC） of HQD and its different phase states against Trichophyton mentagrophytes were determined simultaneously. Using the peak area of 37 common peaks as independent variable， MIC as dependent variable， Pearson correlation analysis was performed by using SPSS 21.0 software. RESULTS A total of 37 common peaks were obtained in HPLC fingerprints of 10 batches of HQD， with the similarity higher than 0.99. Ten components were identified， such as albiflorin， paeoniflorin， liquiritin apioside， baicalin， melaleuca glycoside A， wogonoside， baicalein， glycyrrhizic acid， wogonin and oroxylin A. HQD was split into 3 phase states， such as precipitation phase （HQD-P）， solution phase （HQD-S） and nano phase （HQD-N）. The morphology of HQD-P was irregular granular， and the average particle size was 4.670-91.522 μm. The morphology of HQD-S was uniform flakes， and no particle size was detected. HQD-N was spherical in shape and the particle size was （129.0±12.9） nm. MIC values of each phase state of HQD against T. mentagrophytes in different phase states were HQD-N （4.64 mg/mL） ＜HQD （5.85 mg/mL） ＜HQD-P （7.37 mg/mL） ＜HQD-S （12.89 mg/mL） at the same dosage. Pearson correlation analysis showed that the peak area of 25 of the 37 common peaks （including identified components） was significantly negatively correlated with MIC （absolute values of correlation coefficient＞0.95 and P＜0.05）. CONCLUSIONS The chemical composition of 10 batches of HQD is consistent； HQD-N is the active phase state of HQD. Ten components such as paeoniflorin， liquiritin apioside and baicalin may be the main active components of HQD. The antidermatophytic effect of HQD is closely related to its component content and physical phase state.
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OBJECTIVE To study the effects of self-assembled nanoparticles from Shaoy ao gancao decoction （SGD-SAN）on the in vitro release and intestinal absorption of the main components of Glycyrrhiza uralensis . METHODS Gancao single decoction （GSD），Shaoyao single decoction （SSD），mixed suspension of Shaoyao and Gancao single decoction （MSSGD）and SGD （i.e. Shaoyao-Gancao decoction ）were prepared ，and SAN was characterized. HPLC method was adopted to determine the contents of 7 main components （liquiritin apioside ， liquiritin， isoliquiritin apioside ， isoliquiritin， liquiritigenin， glycyrrhizic acid ， isoliquiritigenin）in G. uralensis . The dialysis bag method was used to investigate the effects of the formation of SGD-SAN on in vitro release of 7 main components in G. uralensis with pH 1.2 HCl solution and pH 6.8 phosphate buffered solution （PBS）as release media. Single-pass intestinal perfusion study was performed to investigate the effects of the formation of SGD-SAN on the intestinal absorption of 7 main components from G. uralensis . RESULTS SAN with particle size of 200-300 nm and polydispersity index of 0.3-0.5 was found in GSD ，MSSGD and SGD. GSD-SAN and MSSGD-SAN were in rod shape while SGD-SAN was irregularly spherical under transmission electron microscope. The results of in vitro release study showed that the formation of SGD-SAN could significantly increase in vitro release of liquiritigenin ，isoliquiritigenin and glycyrrhizic acid ，and had no effect on other components of G. uralensis in pH 1.2 HCl solution. The formation of SGD-SAN also had no effect on the release of each component from G. uralensis in pH 6.8 PBS. The results of intestinal perfusion experiments showed that the formation of SGD-SAN could significantly promote the absorption of each component from G. uralensis in the ileum. CONCLUSIONS- The formation of SGD-SAN significantly improves the in vitro release of poorly soluble components from G. uralensis and promotes the intestinal absorption of main components from G. uralensis ，which is the physical structure basis for the compatibility and synergy of Paeonia lactiflora and G. uralensis .
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Objective: To explore MRI features of primary angiitis of central nervous system (PACNS). Methods Clinical and imaging data of 16 patients with PACNS were retrospectively analyzed. MRI features of PACNS were observed. Results Among 16 patients with PACNS, 9 patients were found with single lesion and 7 with multiple lesions. A total of 45 lesions were detected with MRI in all 16 patients, including 38 lesions (38/45, 84.44%) on the supratentorial, 4 lesions (4/45, 8.89%) in the brainstem, 2 lesions (2/45, 4.44%) in the spinal cord and 1 lesion (1/45, 2.22%) in cerebellum. Lesions of 14 patients were demonstrated large or patchy shaped on MRI, while multiple masses or single mass like lesions were found in the other 2 patients. For MR plain scan, the lesions were mainly hypointense on T1WI, hyperintense on T2WI and FLAIR images. Hemorrhage lesions were found in 6 patients. For DWI, hyperintense lesions were found in all of 16 patients, including 13 with hyperintense and 3 with hypointense in ADC map. Various degrees of edema were shown around the lesions. For enhanced MRI, enhanced lesions were found in 14 patients, while lesions without obvious enhancement were found in the other 2 patients. Only 1 patient underwent MRA, with A4 segment of the left anterior cerebral artery stenosis. Conclusion: MRI manifestations of PACNS are complex and diverse. Comprehensive analysis of MRI features is needed, but mass-like PACNS is still difficult to be distinguished from brain tumors.
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Objective To investigate the MRI classifications and imaging findings of dysembryoplastic neuroepithelial tumor(DNET). Methods MR images of 34 patients with pathologic confirmed DNET of Beijing Sanbo Brain Hospital were retrospectively reviewed in this study. The classification was made according to the number of pseudocysts, scope of involvement, morphology and location. Results MRI appearances of DNET were divided into three subtypes: cystic‐like, polycystic‐like and diffuse type. Twelve cases had cystic cortical, including front lobe (5 cases), temporal lobe (5 cases), parietal lobe (2 cases). These cases presented quasi‐circular or oval shape, with hypointense on T1WI and strongly hyperintense on T2WI. T2‐FLAIR was observed hyperintense ring sign in the tumor periphery and the cystic content was close to CSF but having the largest difference to that of CSF, which signal was higher than CSF. Twenty cases were polycystic‐like, front lobe (7 cases), temporal lobe (7 cases), parietal lobe (5 cases), occipital lobe (1 case). In these 20 cases, they had slightly hypointense on T1WI and strongly hyperintense on T2WI. Located in the cortex and subcortical matter, with wedge shape, gyriform or triangle shape.On T2‐FLAIR, internal septation and hyperintense"ring sign"were observed. Two cases were diffuse type, bilateral (1 case), unilateral (1 case). In these 2 cases, diffuse lesions involving multiple areas with hyperintense ring and internal septation on FLAIR, including subcortical white matter, deep nucleus and periventricular area. Conclusions The MR appearances of DNET are variable. Understanding the MR imaging type of DNET might improve the MR diagnosis of DNET.
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Objective To establish a prostate urethral re-epithelialization model with Chinese rural canine by 2 μm laser vaporization resection.Methods We used 2 μm laser to vaporiz prostate of 15 uncastrated male Chinese rural canines from March to April in 2016.These canines mean age was (6.3 ± 0.6) years(ranging 5-7 years),and weight was (20.5 ± 1.3) kg(ranging 18-22 kg).We began to surgery in which we saw the protruding part of the prostate in urethra,and narrow prostate urethra after a successful anesthesia by intraperitoneal injection of chloral hydrate.The operation time,anesthesia time,survival rate,first time to drink water,first time to feed,first time to stand,first time to defecate,the time when canine bladders rinse became clear,wound healing time were recorded.After 3 days,1 week,2 weeks,3 weeks and 4 weeks,we randomly select 3 canines to observe regeneration of prostate urethra wound under cystoscope.After surgery,the bladder,prostate and prostate distale urethra were removed to make specimen and measure the diameter size of prostate.The HE staining and immunohistochemistry was performed in each sample.Results The experimental operation time was (70.5 ± 18.3) min (ramging 50-90 min).The average anesthesia time was (120.1 ± 21.1) min (ranging 95-145 min).The survival rate was 100％.In post surgery duration first standing time,first eating time,first drinking water time,first defecation time were (6.5 ± 1.8) h,(10.3 ± 2.1) h,(23.7 ± 5.6) h,(26.3 ± 3.1) h,respectively.The time when canine bladders rinse became clear and wound healing time were (5.2 ± 1.6) d,(8.7 ± 1.5) d respectively.Cystoscopy observated that the wound was covered by pale necrotic tissue 3 d and 1 week after operation,covered by epithelium 2 weeks after operation,covered by more thicker epithelium 3 weeks after operation,covered by epithelium which color was close to normal urothelium 4 weeks after operation.HE staining observated that the wound wasn't covered by epithelium 3 d after operation,partial wound was covered by flaky single or 2-3 cubic regenerated epithelial 1 week after operation,all wound was covered by epithelial which was lack of polar 2 weeks after operation,wound was covered by polarity epithelium which was thicken to 5-6 layer and observated a little umbrella cells on the surface 3 weeks after operation,wound was covered by polarity epithelium which was thicken to 5-6 layer and observated much umbrella cells on the surface 4 weeks after operation.Immunohistochemical staining observated that urinary spot protein from the wound or epithelium was negative 3 d,1 and 2 weeks after operation,urinary spot protein from the part of epithelium was positive 3 weeks after operation,and urinary spot protein from all epithelium was positive 4 weeks after operation.Conclusion It is feasible to establish prostate urethral re-epithelialization model in the Chinese rural canine by 2 μm laser vaporization resection of the prostate.
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OBJECTIVE:To provide reference for the selection of new edition of Essential Medicine List by quantitative com-prehensive evaluation for additional essential medicine. METHODS:The evaluation factors were established according to Delphi method,and Analytic Hierarchy Process(AHP)was conducted to compare the factors in pairs,construct the judgment matrix,cal-culate the weight coefficients of every factor and do the consistency test. RESULTS:The evaluation model was composed of 6 first-class indexes(including effectiveness,safety,stability,availability,affordability and adaptability)and 24 second-class index-es,and the weight of each index to the target layer was calculated. Among them,the weight of validity and security is the top two. CONCLUSIONS:The weight coefficient can be determined scientifically and reasonably by AHP,and the reliability and operability of the evaluation index system can be improved. It is a useful attempt to explore the selection system of additional essential medi-cine.
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OBJECTIVE:To systematically evaluate therapeutic efficacy of Yanhuning injection in the treatment of epidemic mumps,explore valid way of evidence-based review,provide reference for the selection of new essential medicine list. METH-ODS:Retrieved from PubMed,CJFD,Wanfang database and VIP,randomized controlled trials(RCTs)about Yanhuning injection alone or combined with other positive drugs(trial group)vs. other positive drugs(control group)in the treatment of epidemic mumps. Meta-analysis was conducted by using Rev Man 5.3 statistical software after quality evaluation by modified Jadad scale. RE-SULTS:Totally 26 RCTs were included,involving 2613 patients. Results of Meta-analysis showed,overall response rate [OR=5.28,95%CI(3.92,7.11),P<0.001] of trial group was significantly higher than that of control group;defervescence time [MD=-1.97,95%CI(-2.83,-1.12),P<0.001],swelling disappearance time [MD=-2.05,95%CI(-2.53,-1.58),P<0.001] and pain disappearance time [MD=-1.39,95%CI(-2.02,-0.75),P<0.001] of trial group were significantly shorter than those of control group,there was statistical significance. CONCLUSIONS:Yanhuning injection has good curative effect for epidemic mumps,and can significantly shorten defervescence time,swelling disappearance time and pain disappearance time.
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Objective To evaluated the clinical value of laparoscopic techniques in radical cystectomy surgery for the treatment of bladder cancer. Methods Clinical data of 49 patients underwent radical cystectomy with Bricker ileal conduit diversion were retrospectively analyzed from October 2009 to August 2014, which laparoscopic radical cystectomy with Bricker ileal conduit 20 cases (Group A), open radical cystectomy with Bricker ileal conduit 29 cas-es (Group B). The blood loss during operation, operating time, gastrointestinal function recovery after operation, hos-pital stay after operation and complications were observed between the two groups. Results The blood loss during operation was significantly lower in Group A (416.66 ± 232.73) ml than in Group B (964.16 ± 445.73) ml ( <0.05), and hospital stay after operation was significantly lower in Group A (14.93 ± 2.72) days than in Group B (19.50 ± 3.16) days ( < 0.05), complication after operation was significantly lower in Group A than in Group B ( < 0.05). The operating time and gastrointestinal function recovery has no significantly difference between the two groups. Conclusions Laparoscopic radical cystectomy have advantages of minimal invasion, less blood loss, rapid recovery and less postoperative complications. It is a safe and effective surgical method. Long term effect need evaluated by follow up.
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Objective To evaluate the effect of lung cancer bone metastasis on serum osteocalcin(OC)in Chinese population using me-ta-analysis.Methods Searched the date of PubMed,Web of science,Embase,Cochrane Library,CBM,CNKI,VIP database and Wanfang da-tabase to identify potentially studies which involved the correlation between bone metastasis and serum OC in Chinese patients with lung canc-er.Standardized mean difference(SMD)and 95%CI was used to access the results.Results 8 studies were included.The study showed that the OC in serum would increase significantly when bone metastases happened in Chinese lung cancer patients.SMD(95%)CI was 0.58 [0.15,1.01]and 0.776[0.20,1.34]compared with controls and BM-,respectively.SMD and 95%CI of BM-compared with controls was -0.15[-0.54,0.23],insignificantly.Conclusion Lung cancer bone metastases may raise serum osteocalcin levels in Chinese popu-lation meanwhile this phenomenon will not happen without bone metastasis.
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Objective To investigate the molecular mechanisms of glial cell derived neurotrophic factor in promoting proliferation of spermatogonial stem cell.Methods RNAi expression vectors,targeted at GDNF,were constructed and transfected into SSCs from 5 to 7 days old mice.The SSCs with highest effectiveness of GDNF interfere was set as study group.And the SSCs without GDNF interfere was considered as control group.The ELISA method was used to compare the proliferative rate between study group and control group.Flow cytometry,RT-PCR were used to detect the expression of GDNF,RTKs,Fyn and FAK's mRNA,and the apoptosis of SSCs.Results From 1 to 4 days after transinfection,the absorbable A value in study group was 0.45 ± 0.02,0.68 ± 0.03,1.12 ± 0.03,2.24 ± 0.04,respectively.Meanwhile,the same item in control group was 0.46 ± 0.03、0.73 ± 0.02、1.32 ± 0.05、1.15 ± 0.06,respectively (P ＜ 0.05).There were significant different between experiment groups (25.43 ± 1.91) ％ and control group (5.61 ± 0.16)％ in the apoptosis rates of SSCs (P ＜ 0.05).Significant differences were noted between experimental group and control group(P ＜ 0.05).The mRNA expression rates of GDNF was (12.32 ± 1.22) ％ in study group and (54.25 ± 1.34)％ in control group (P ＜0.01).The mRNA expression rates of RTKs and Fyn and FAK in study group and control group were (16.24 ± 1.35)％ vs (45.35 ± 1.37)％,(18.32 ±1.34)％ vs (38.37 ± 1.55)％,(20.04 ± 1.65)％ vs (43.27 ± 1.28)％,respectively (P ＜0.05).Conclusions The glial cell line derived neurotrophic factor was important in course of SSCs' proliferation,which may up-regulating the expression of RTKs,Fyn and FAK.
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Objective: To study the effects of acute cold stress on connexin43 (Cx43) protein expression with drug intervention, and cell to cell conduction with its mechanism in neonatal rats’ myocardial cells. Methods: The primary neonatal rats’ myocardial cell culture was conducted in 4 groups. Group① , the cells were normally cultured, Group②, the cells were cultured at 4℃, Group③, the cells were cultured at 0℃and Group④, the anti-arrhythmia peptide (AAP 10) was added in Group②and Group③. The apoptosis rate of myocardial cells was evaluated by lfow cytometry assay, mRNA and protein expressions of CX43 were examined by RT-PCR and Western blot analysis, and CX43 phosphorylation product (P-CX43) was detected. Results: Compared with normally cultured cells, the myocardial cell apoptosis rate was obviously increased by acute cold stress at 4℃and 0℃with time extension. The mRNA expression of Cx43 was decreased at varying degrees at 4℃and 0℃stimulation, the protein expression of Cx43 was decreased at varying degrees at 4℃and 0℃stimulation with time extension, and P-Cx43 level was decreased. While the APP 10 intervention may obviously elevate the protein levels of Cx43 and P-Cx43. Conclusion: Acute cold stress could reduce the protein expression of CX43 and P-CX43, while APP 10 intervention may elevate such expression and improve the cell to cell conduction in neonatal rats’ myocardial cells.
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Objective To evaluate the clinical efficacy and safety of capecitabine continuous maintenance in treatment of re-currence of triple-negative breast cancer,which had responded to combined chemoradiotherapy.Methods The triple-negative breast cancer was defined as negative of ER,PR and HER2.A total of 46 patients of triple-negative breast cancer were divided into the treatment group (23 patients)and the control group (23 patients).The treatment group was given capecitabine continuous mainte-nance after 6 cycles of chemotherapy.The control group was given 6 cycles of combined chemotherapy only.The clinical efficacy and safety was evaluated between the two groups.Results The PR,PD,RR,and DCR in the treatment group were significantly higher than those in the control group(P 0.05).Conclusion Capecitabine continuous maintenance after combined chemoradiotherapy in treatment of recurrence of triple-neg-ative breast cancer is more effective,lower toxicity and tolerable.
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Objective To compare the safety and efficacy of the 2μm laser and the bipolar electrotome used in transurethral re-section of bladder tumor(TURBT)for treating non-muscle invasive bladder cancer(NMIBC).Methods The clinical data in the pa-tients with NMIBC treated by TURBT in our hospital from March 2009 to May 2013 were retrospectively analyzed.All patients were divided into the 2μum laser group(n=89)and the bipolar electrotome group(n=82).The operation time,complications,post-operative hospital stay and recurrence rate were compared between the two groups.Results There were no statistically significant differences in the operation time,postoperative hospital stay and recurrence rate between the two groups(P>0.05).Compared with the 2 μm laser group,the bipolar electrotome group showed significantly higher occurrence rate of the obturator nerve reflex (20.7%vs.0,P<0.05)and the bladder perforation(7.3% vs.0,P<0.05)and longer postoperative bladder irrigation time [(3.1±0.9)d vs.(2.2±1.0)d,P<0.05],the differences between the two groups had statistical significance.Conclusion Com-pared with bipolar electrotome,the 2μm laser used in TURBT is safe and effective with few complications for treating NMIBC.
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Objective To analyze the hidden blood loss following primary total hip arthroplasty (THA) and put forward corresponding treatment measures.Methods A retrospective study was done on the 138 patients with hip disease managed with THA for the preliminary unilateral replacement from January 2009 to January 2011.There were 48 males and 90 females,at age range of 45-71 years (mean,62 years).The pre-and post-operative blood routine and intra-and post-operative blood loss and transfusion were analyzed and hidden blood loss during peri-operation period was evaluated.Results All the patients were trnsfused with autologous blood intra-operatively.Intra-operative blood loss was (495 ± 105) ml and postoperative drainage volume was ( 121 ±29) ml.In addition,116 patients were given red cell suspension (RCS) and blood plasma to raise the level of hemoglobin and the RCS transfusion volume was (600 ± 225) ml.The total blood loss was (1 521 ±156) ml including hidden blood loss of (822 ±96) ml (57.2％).No obvious differences were observed in the indicators between males and females.Conclusions Hidden blood loss is an important factor that affects the prognosis of the patients treated by THA.In order to secure their safety in perioperative period and benefit their recovery,assessment of the amount of bleeding in THA should fully take the hidden blood loss into consideration and prompt treatment measures should be taken to fully and effectively recover their effective circulation blood volume.
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BACKGROUND:Vitamin A has important effects on growth of spermatogonial stem cells.At present,we have not found an inductive substance of promoting growth and differentiation of spermatogonial stem cells during in vitro culture.OBJECTIVE:To investigate the effect of Vitamin A on growth and proliferation of mouse spermatogonial stem cells in vitro culture.METHODS:Bilateral testis of Kunming male mice aged 5-7 days were sterileiy collected.Spermatogonial stem cells were isolated and purified using adherence and noncontinuity Percoll density gradient centrifugation.Bilateral testis was obtained from Kunming male mice aged 12-15 days under sterile conditions.Sertoli cells were isolated and purified by using enzyme digestion method.Following adherence and polarization,Sertoli cells served as feeder layer.The spermatogonial stem cells were seeded on simple-layer Sertoli cells.We set two groups,In the experimental group,1 g/L Vitamin A was added in the DMEM/F12.In the control group,Vitamin A was not added.Growth and proliferation of spermatogonial stem cells were measured using enzyme linked immunosorbent assay.The cell cycle of spermatogonial stem cells was determined by flow cytometry.RESULTS AND CONCLUSION:At days 6,9,12 and 15 following coculture,absorbance value of spermatogonial stem cells in experimental group was faster than control group(P ＜ 0.05 or 0.01).With prolongation of coculture,quantity of chromosome in S phase in spermatogonial stem cells was increased,and then decreased in the experimental group.Another division cycle began.Compared with experimental group,quantity of chromosome in S phase in spermatogonial stem cells was slowly increased in the control group(P ＜ 0.05).During in vitro culture of mouse spermatogonial stem cells,Vitamin A can improve the proliferation and polarization of spermatogonial stem cells.
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Objective To study therapeutic efficacy of Aredia in treating malignant metastatic bone tumors. Method 60～ 90 mg Aredia was administrated iv in 31 cases with malignant metastatic tumors,once each week. Results Pain in 12 cases was significantly relieved.14 cases acquired relif.Total effective rate was 83.9% .Activity ability was improved by 80.6% .No apparent toxicological and adverse effects as well as fever and cold symptoms were observed.Conclusion Aredia is a kind of ideal drugs for treatment of pain caused by malignant metastatic bone tumors.It is convenient in use and could be endured by patients.