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OBJECTIVE To analyze the effects of the national centralized drug procurement （NCDP） policy on drug availability and the structure of drug use in public hospitals. METHODS Using hypoglycemic， lipid-lowering， antiviral drugs， and psychiatric drugs for the treatment of mental illness and depression as objects， the interrupted time series model was used to quantitatively evaluate the changes in consumption sum of drugs， consumption amount and daily cost of the target drugs in national sample hospitals as well as the changes in per capita medication frequency， outpatient prescription amount， and medical insurance surplus of target drugs in a third grade class A hospital before and after the implementation of NCDP policy. RESULTS After the implementation of the NCDP policy， the volume for the four bid-winning drugs increased significantly （P＜0.01 for the remaining three categories except for hypoglycemic drugs）， but DDDc （P＜0.01） and the amount of related drugs （P＜0.001） decreased significantly. The volume for the non-winning drugs （except for lipid-lowering drugs） decreased significantly （P＜0.05）， and DDDc also decreased significantly （P＜0.05 for other 3 categories except for psychiatric drugs）； the volume （P＜0.01） and DDDc （P＜0.01 only for psychiatric drugs） for alternative drugs all increased except for antiviral drugs. The structure of drug use for different drugs was affected differently by the NCDP policy，and that of hypoglycemic drugs was affected obviously； the proportion of alternative drugs increased after centralized procurement. The outpatient prescription amount of each hospital significantly decreased after centralized procurement，and the decrease in the cost paid by the patients using lipid-lowering and antiviral drugs related to centralized procurement was greater than 0.60； the remaining medical insurance amount for bid-winning drugs was approximately 1.252 5 million yuan. CONCLUSIONS NCDP policy effectively alleviates the burden of medical expenditure and also drives the structure changes of drug use such as the substitution of generic drugs for original drugs， the growth of the volume of alternative drugs.
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Objective To evaluate the histocompatibility of an original Chinese-made mid-urethral sling (Repelvica mid-urethral sling). Methods In total 10 female New Zealand white rabbits were implanted with Repelvica mid-urethral sling or tension-free vaginal tape-obturator tape (TVT-O;Gynecare). Both brands of sling were implanted under deep fascia of the abdominal wall and in the space between vagina and bladder. All animal groups were sacrificed at set time intervals (4 weeks and 12 weeks), and the abdominal and vaginal slings were harvested for histological evaluation. Results All slings appeared to be well incorporated into the abdominal wall and anterior vaginal wall. All specimens showed a thin, loose, fibrous interface between the synthetic graft and abdominal wall or vaginal wall, along with mild inflammatory reaction from 4 weeks to 12 weeks. Abdominal grafts of Repelvica mid-urethral sling and TVT-O induced comparable tissue reaction (histological score 10.5 versus 10.5 at 4 weeks, 10.0 versus 9.5 at 12 weeks; both P>0.05). Vaginal grafts of Repelvica mid-urethral sling had lower histological score than TVT-O (histological score 6.0 versus 12.0 at 4 weeks, 8.5 versus 12.5 at 12 weeks), however the differences were not statistically significant (both P>0.05). Conclusions Chinese-made Repelvica mid-urethral sling exhibits good histocompatibility. Vaginal graft of Repelvica mid-urethral sling evoks minor tissue reaction,which could be attributed to its lightweighted property and favored its clinical application.
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BACKGROUND: Human umbilical cord mesenchymal stem cells (HUMSCs) can differentiate into insulin-producing cellsafter induced by chemical drugs or co-culture methods, but insulin secretion is extremely low. Therefore, to inducemature pancreatic beta cell differentiation from stem cells by adenovirus transfection of specific genes involved in thedevelopment of pancreas is a research hotspot in recent years.OBJECTIVE: To study the differentiation potential of HUMSCs into insulin-producing cells after transfection withmusculoaponeurotic fibrosarcoma oncogene homologue A (MafA).METHODS: Ad-MafA-EGFP was transferred into passage 3 HUMSCs. After 7 days of induction, changes of cellmorphology were observed by inverted phase contrast microscope. Expression of pancreatic cell-specific genes(glucagon, PDX1, Nkx2.2) was detected by PCR technique.RESULTS AND CONCLUSION: After Ad-MafA-EGFP transfection, no significant morphological changes were observedin the HUMSCs under inverted phase contrast microscope. It was confirmed by fluorescence microscope thatAd-MafA-EGFP was transferred into the HUMSCs. After induction, the expression of human pancreatic precursorcell-related genes, including glucagon, PDX1 and Nkx2.2, was increased as detected by PCR. To conclude, thesefindings could provide experimental evidence for further differentiation and maturation of pancreatic β cells fromHUMSCs.
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Quinolones are widely used due to the wide antimicrobial spectrum and strong activity .The common adverse reactions of quinolones include gastrointestinal disturbances ,central nervous system reaction ,skin reaction ,etc .These adverse reactions are mild in severity and self-healing .Since some agents were withdrawn from the market due to severe adverse effects ,we should pay more attention to quinolones .Both internal and abroad literatures were reviewed ,the adverse effects , the high risk factors of the adverse effects and the application in special population were summarized to provide reference for ra-tional clinical drug use .
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Objective To investigate the stress reaction of the medical staff who suffered workplace violence,and provide reference for nursing interventions.Methods 13 medical staff who suffered work-place violence were interviewed through semi-constitutional formula,the data were analyzed by phenomenological method of qualitative research.Results The psychological stress of medical staff mainly included 3 themes:complex emotions,eager to help; psychological adjustment required internal and external integration; different stress reaction affected the psychological state.Conclusions The medical staff suffer seriously from the workplace violence both on the physical and mental health,individuals should learn how to deal with it correctly,and the relevant departments should pay full attention to the humane care to victims of violence,guide them to view the stress correctly,and to take effective measures to prevent and control workplace violence.
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Objective To observe the protective effect of asiatic acid on hyperlipidemia golden hamsters induced by high fat diet and explore its mechanism.Methods Hyperlipidemic golden hamsters fed with high-fat diet were administered orally with asiatic acid (8,16,32 mg/kg)for 4 weeks.Levels of serum lipid content,liver histology,hepatic GSH-PX and SOD levels,serum ALT and AST activities were evaluated in golden hamsters,fluorescence quantitative polymerase chain reaction(RT-PCR)is using to examine the liver lecithin cholesterol fatty acyl transferase(LCAT) and class B typeⅠscavenger receptor(SR-BⅠ)mRNA expression. Results Compared with model group,the levels of TC,TG,LDL-C,TC/HDL,ALT and AST in low and mediate asiatic acid groups were all significantly decreased but the levels of SOD and GSH-PX were significantly increased(P<0.01).HE staining results showed that fat deposition in the liver were improved by administration of asiatic acid,and the expression of LCAT and SR-BⅠmRNA were increased.Conclusion Asiatic acid can effectively reduce blood lipid levels,and alleviate liver damage of the hyperlipidemia golden hamsters by lipid regulation and antioxidative ability augmentation.The increased levels of LCAT and SR-BⅠmRNA expression maybe involved in the mechanism of hypolipidaemic effect of asiatic acid.
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To observe a PPAR-alpha agonist effect of N-oleoylethanolamine (OEA) on CB2 (cannabinoid receptor 2), an anti-inflammatory receptor in vascular endothelial cell, healthy HUVECs and TNF-alpha induced HUVECs were used to establish a human vascular endothelial cell inflammatory model. Different doses of OEA (10, 50 and 100 micromol x L(-1)) had been given to HUVECs, cultured at 37 degrees C for 7 h and then collected the total protein and total mRNA. CB2 protein expression was detected by Western blotting and CB2 mRNA expression was assayed by real-time PCR. As the results shown, OEA (10 and 50 micromol x L(-1)) could induce the CB2 protein and mRNA expression, but not 100 micromol x L(-1). To detect if anti-inflammation effect of OEA is partly through CB2, CB2 inhibitor AM630 was used to inhibit HUVEC CB2 expression, then the VCAM-1 expression induced by TNF-alpha was detected, or THP-1 adhere to TNF-alpha induced HUVECs was examined. OEA (50 micromol x L(-1)) could inhibit TNF-alpha induced VCAM-1 expression and THP-1 adhere to HUVECs, these effects could be partly inhibited by a CB2 inhibitor AM630. The anti-inflammation effect of OEA is induced by PPAR-alpha and CB2, suggesting that CB2 signaling could be a target for anti-atherosclerosis, OEA have wide effect in anti-inflammation, it may have better therapeutic potential in anti-inflammation in HUVECs, thus achieving anti-atherosclerosis effect.
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ObjectiveTo study the possibility of differentiation of human umbilical cord mesenchymal stem cells(HUCMSCs) into human male germ cells,and to explore a new source of cells for the treatement of male infertility.MethodsHUCMSCs were transplanted into the seminiferous tubules of the testis of infertile mice by microinjection.The survival rate,migration and germ cell markers of HUCMSCs in the mice testis were detected via immunohistochemistry,immunofluorescence and confocal laser scanning. ResultsHUCMSCs can survive in the mice testis for at least 120 days,and they can migrate from the lumens to the basement membrane.Immunofluorescence showed that HUCMSCs can further differentiate in the mice testicular environment,and express the germ cell marker.ConclusionsHUCMSCs can survive,migrate and differentiate into early male germ cell-like cells in the infertility mice testis after transplantation.