Clinical efficacy of redo rectal resection and coloanal anastomosis / 中华消化外科杂志

Objective:To investigate the clinical efficacy of redo rectal resection and coloanal anastomosis.Methods:The retrospective and descriptive study was conducted. The clinicopatholo-gical data of 49 patients who underwent redo rectal resection and coloanal anastomosis for the treatment of local recurrence of tumors and failure of colorectal or coloanal anastomosis after rectal resection in the Sixth Affiliated Hospital of Sun Yat-sen University from November 2012 to December 2021 were collected. There were 32 males and 17 females, aged 57(range,31-87)years. Redo rectal resection and coloanal anastomosis was performed according to the patient′s situations. Observa-tion indicators: (1) surgical situations; (2) postoperative situations; (3) follow-up. Measurement data with normal distribution were represented as Mean± SD, and measurement data with skewed distri-bution were represented as M( Q1, Q3) or M(range). Count data were described as absolute numbers or percentages. Results:(1) Surgical situations. All 49 patients underwent redo rectal resection and coloanal anastomosis successfully, with the interval between the initial surgery and the reopera-tion as 14.2(7.1,24.3)months. The operation time and volume of intraoperative bold loss of 49 patients in the redo rectal resection and coloanal anastomosis was 313(251,398)minutes and 125(50,400)mL, respectively. Of the 49 patients, there were 38 cases receiving laparoscopic surgery including 12 cases with transanoscopic laparoscopic assisted surgery, 11 cases receiving open surgery including 2 cases as conversion to open surgery, there were 20 cases undergoing Bacon surgery, 14 cases undergoing Dixon surgery, 12 cases undergoing Parks surgery, 2 cases undergoing intersphincter resection and 1 case undergoing Kraske surgery, there were 20 cases undergoing rectum dragging out excision and secondary colonic anastomosis, 13 cases undergoing dragging out excision single anastomosis, 12 cases undergoing rectum dragging out excision double anastomosis, 4 cases undergoing first-stage manual anastomosis, there were 21 cases with enterostomy before surgery, 16 cases with prophylactic enterostomy after surgery, 12 cases without prophylactic enterostomy after surgery. The duration of postoperative hospital stay of 49 patients was (14±7)days. (2) Postoperative situations. Fifteen of 49 patients underwent postoperative complications, including 8 cases with grade Ⅱ Clevien-Dindo complications and 7 cases with ≥grade Ⅲ Clevien-Dindo complications. None of 49 patient underwent postoperative transferring to intensive care unit and no patient died during hospitalization. Results of postoperative histopathological examination in 23 patients with tumor local recurrence showed negative incision margin of the surgical specimen. (3) Follow-up. All 49 patients underwent post-operative follow-up of 90 days. There were 42 cases undergoing redo rectal resection and coloanal anastomosis successfully and 7 cases failed. Of the 37 patients with enterostomy, 20 cases failed in closing fistula, and 17 cases succeed. There were 46 patients receiving follow-up with the median time as 16.1(7.5,34.6)months. The questionnaire response rate for low anterior resection syndrome (LARS) score was 48.3%(14/29). Of the patients who underwent redo coloanal anastomosis and closure of stoma successfully, there were 9 cases with mild-to-moderate LARS.Conclusion:Redo rectal resection and coloanal anastomosis is safe and feasible for patients undergoing local recurr-ence of tumors and failure of colorectal or coloanal anastomosis after rectal resection, which can successfully restore intestinal continuity in patients and avoid permanent enterostomy.

Analysis on influencing factors on loneliness in the elderly aged 60 and above in China / 中华流行病学杂志

Objective: To analyze the influential factors of loneliness in the elderly aged ≥60 years in China. Methods: Data used in this study were obtained from participants aged ≥60 years from the China Longitudinal Aging Social Survey, with a sample size of 7 593. Loneliness was measured with loneliness scale, and the influence of subjective and objective factors on loneliness and their interaction were analyzed with stepwise linear regression model and simple slope test. SPSS 25.0 was used for statistical analysis. PROCESS 3.3 macro program was used for simple slope test. Results: A total of 8 926 participants were included. Among the objective factors, the elderly with poor family network have a higher level of loneliness (P<0.05), and community provision of elderly care services could reduce the loneliness of the elderly (P<0.05). Elderly people with subjective aging age ≤60 years old and poor social adaptation and emotional perception have higher levels of loneliness (all P<0.05). Subjective aging age plays a negative regulatory role in the impact of community elderly care services on loneliness (P<0.05), Social adaptation and emotional perception play a negative regulatory role in the impact of family network on loneliness (P<0.05). Conclusions: Elderly people aged ≥60 years of feeling of loneliness was affected by both subjective and objective factors and subjective factors play an important regulatory role in the influence of objective factors on elderly people's feeling of loneliness in China. Therefore, while creating a good aging environment to provide strong external support for the elderly, the subjective initiative of the elderly should also be fully mobilized, to alleviate the loneliness of the elderly from these two aspects.

Risk factors of recurrence and canceration for premalignant vocal fold lesions after surgery / 临床耳鼻咽喉头颈外科杂志

Objective:To analyze the risk factors of recurrence and canceration for premalignant vocal fold lesions after surgery, and to provide a reasonable basis for preoperative evaluation and postoperative follow-up. Methods:This study retrospective analyzed the relationship between clinicopathological factors and clinical outcome（recurrence, canceration, recurrence-free survival, and canceration-free survival） in 148 patients undergoing surgical treatment in Chongqing General Hospital from 2014 to 2017. Results:The five-year overall recurrence rate was 14.86% and the overall recurrence rate was 8.78%. Univariate analysis showed that smoking index, laryngopharyngeal reflux and lesion range were significantly associated with recurrence（P<0.05）, and smoking index and lesion range were significantly associated with canceration（P<0.05）. Multivariate logistic regression analysis showed that smoking index ≥600 and laryngopharyngeal reflux were independent risk factors for recurrence（P<0.05）, and smoking index ≥600 and lesion range ≥1/2 vocal cord were independent risk factors for canceration（P<0.05）. The mean carcinogenesis interval for the postoperative smoking cessation group was significantly longer（P<0.05）. Conclusion:Excessive smoking, laryngopharyngeal reflux and a wide range of lesions may be related to postoperative recurrence or malignant progression of precancerous lesions in the vocal cord, and further large-scale multi-center prospective randomized controlled studies are needed to clarify the effects of the above factors on recurrence and malignant changes in the future.

Dose distribution prediction in cervical cancer brachytherapy based on 3D U-net / 中华放射医学与防护杂志

Objective:To establish a three-dimensional (3D) U-net-based deep learning model, and to predict the 3D dose distribution in CT-guided cervical cancer brachytherapy by using the established model.Methods:The brachytherapy plans of 114 cervical cancer cases with a prescription dose of 6 Gy for each case were studied. These cases were divided into training, validation, and testing groups, including 84, 11, and 19 patients, respectively. A total of 500 epochs of training were performed by using a 3D U-net model. Then, the dosimetric parameters of the testing groups were individually evaluated, including the mean dose deviation (MDD) and mean absolute dose deviation (MADD) at the voxel level, the Dice similarity coefficient (DSC) of the volumes enclosed by isodose surfaces, the conformal index (CI) of the prescription dose, the D90 and average dose Dmean delivered to high-risk clinical target volumes (HR-CTVs), and the D1 cm 3 and D2 cm 3 delivered to bladders, recta, intestines, and colons, respectively. Results:The overall MDD and MADD of the 3D dose matrix from 19 cases of the testing group were (-0.01 ± 0.03) and (0.04 ± 0.01) Gy, respectively. The CI of the prescription dose was 0.70 ± 0.04. The DSC of 50%-150% prescription dose was 0.89-0.94. The mean deviation of D90 and Dmean to HR-CTVs were 2.22% and -4.30%, respectively. The maximum deviations of the D1 cm 3 and D2 cm 3 to bladders, recta, intestines, and colons were 2.46% and 2.58%, respectively. The 3D U-net deep learning model took 2.5 s on average to predict a patient′s dose. Conclusions:In this study, a 3D U-net-based deep learning model for predicting 3D dose distribution in the treatment of cervical cancer was established, thus laying a foundation for the automatic design of cervical cancer brachytherapy.

Analysis of perioperative efficacy and safety of cytoreductive surgery in the treatment of colorectal cancer peritoneal metastases / 中华胃肠外科杂志

Objective: To analyzed perioperative safety of cytoreductive surgery (CRS) for patients with colorectal cancer peritoneal metastasis (CRPM) and to construct a predictive model for serious advese events (SAE). Methods: A descriptive case-series study was conducted to retrospectively collect the clinicopathological data and treatment status (operation time, number of organ resection, number of peritoneal resection, and blood loss, etc.) of 100 patients with peritoneal metastases from colorectal cancer or appendix mucinous adenocarcinoma who underwent CRS at the Sixth Affiliated Hospital of Sun Yat-sen University from January 2019 to August 2021. There were 53 males and 47 females. The median age was 52.0 (39.0-61.8) years old. Fifty-two patients had synchronous peritoneal metastasis and 48 had metachronous peritoneal metastasis. Fifty-two patients received preoperative neoadjuvant therapy. Primary tumor was located in the left colon, the right colon and the rectum in 43, 28 and 14 cases, respectively. Fifteen patients had appendix mucinous adenocarcinoma. Measures of skewed distribution are expressed as M (range). Perioperative safety was analyzed, perioperative grade III or higher was defined as SAE. Risk factors associated with the occurrence of SAEs were analyzed using multivariate logistic regression. A nomogram was plotted by R software to predict SAE, the efficacy of which was evaluated using the area under the ROC curve (AUC) and correction curves. Results: The median peritoneal cancer index (PCI) score was 16 (1-39). Sixty-eight (68.0%) patients achieved complete tumor reduction (tumor reduction score: 0-1). Sixty-two patients were treated with intraperitoneal hyperthermic perfusion chemotherapy (HIPEC). Twenty-one (21.0%) patients developed 37 SAEs of grade III-IV, including 2 cases of ureteral injury, 6 cases of perioperative massive hemorrhage or anemia, 7 cases of digestive system, 15 cases of respiratory system, 4 cases of cardiovascular system, 1 case of skin incision dehiscence, and 2 cases of abdominal infection. No grade V SAE was found. Multivariate logistic regression analysis showed that CEA (OR: 8.980, 95%CI: 1.428-56.457, P=0.019), PCI score (OR: 7.924, 95%CI: 1.486-42.259, P=0.015), intraoperative albumin infusion (OR: 48.959, 95%CI: 2.115-1133.289, P=0.015) and total volume of infusion (OR: 24.729, 95%CI: 3.956-154.562, P=0.001) were independent risk factors for perioperative SAE in CRS (all P<0.05). Based on the result of multivariate regression models, a predictive nomogram was constructed. Internal verification showed that the AUC of the nomogram was 0.926 (95%CI: 0.872-0.980), indicating good prediction accuracy and consistency. Conclusions: CRS is a safe and effective method to treat CRPM. Strict screening of patients and perioperative fluid management are important guarantees for reducing the morbidity of SAE.

Comparative proteomic profiling of hippocampi in mice treated with Jingui Shenqi Pills and Liuwei Dihuang Pills / 中国中药杂志

The effects of Jingui Shenqi Pills(Jingui) and Liuwei Dihuang Pills(Liuwei) which respectively tonify kidney Yang and kidney Yin on brain function have attracted great attention, while the differences of protein expression regulated by Jingui and Liuwei remain to be studied. This study explored the difference of protein expression profiles in the hippocampi of mice orally administrated with the two drugs for 7 days. The protein expression was quantified using LC-MS/MS. The results showed that among the 5 860 proteins tested, 151, 282 and 75 proteins responded to Jingui alone, Liuwei alone, and both drugs, respectively. The ratio of up-regulated proteins to down-regulated proteins was 1.627 in Jingui group while only 0.56 in Liuwei group. The proteins up-regulated by Jingui were mainly involved in membrane transport, synaptic vesicle cycle, serotonergic synapse, dopaminergic synapse and so on, suggesting that Jingui may play a role in promoting the transport of neurotransmitter in the nervous system. The proteins down-regulated by Liuwei were mainly involved in membrane transport, synapse, ion transport(potassium and sodium transport), neurotransmitter transport, innate and acquired immune responses, complement activation, inflammatory response, etc. In particular, Liuwei showed obvious down-regulation effect on the members of solute carrier(SLC) superfamily, which suggested that Liuwei had potential inhibitory effect on membrane excitation and transport. Finally, consistent results were obtained in the normal mouse and the mouse model with corticosterone-induced depressive-like behavior. This study provides an experimental basis for understanding the effect of Jingui and Liuwei on brain function from protein network.

Status quo and insights in building national regional medical centers from the perspective of resources integration / 中华医院管理杂志

The constrution of national regional medical centers has been included in the 14th Five-Year Plan. As a major project to build a high-quality and efficient medical health service system in China, it is imperative to expand such high quality medical resources and balance their regional distribution. The authors analyzed the dual resources integration attributes of regional medical centers—horizontal expansion and vertical extension—from the perspective of medical resources integration, and by means of literature methodology and content analysis methods. With both two work paths and progresses led by the National Development and Reform Commission and the National Health Care Commission, the authors identified setbacks in the construction of such medical centers in terms of building a synergy system, optimizing the cooperation modes, and enhancing the awareness of the entity bodies. On such basis, the authors suggested that government departments should hold on to the leadership in general, while in the construction process, output hospitals and input hospitals should respectively take their entity responsibilities in both operation management and cooperation.

Membrane-disruptive peptides/peptidomimetics-based therapeutics: Promising systems to combat bacteria and cancer in the drug-resistant era

Membrane-disruptive peptides/peptidomimetics (MDPs) are antimicrobials or anticarcinogens that present a general killing mechanism through the physical disruption of cell membranes, in contrast to conventional chemotherapeutic drugs, which act on precise targets such as DNA or specific enzymes. Owing to their rapid action, broad-spectrum activity, and mechanisms of action that potentially hinder the development of resistance, MDPs have been increasingly considered as future therapeutics in the drug-resistant era. Recently, growing experimental evidence has demonstrated that MDPs can also be utilized as adjuvants to enhance the therapeutic effects of other agents. In this review, we evaluate the literature around the broad-spectrum antimicrobial properties and anticancer activity of MDPs, and summarize the current development and mechanisms of MDPs alone or in combination with other agents. Notably, this review highlights recent advances in the design of various MDP-based drug delivery systems that can improve the therapeutic effect of MDPs, minimize side effects, and promote the co-delivery of multiple chemotherapeutics, for more efficient antimicrobial and anticancer therapy.

Numerical Simulation on Fluid Flow within Rat Alveolar Bone under Orthodontic and Occlusal Loading / 医用生物力学

Objective To study fluid flow within alveolar bone under orthodontic and occlusal loading, so as to provide references for understanding the regulatory mechanism of bone remodeling during orthodontics. Methods An animal model for orthodontic tooth movement on rats was first constructed. The finite element model of tooth-periodontal ligament-alveolar bone was established based on micro-CT images and the strain field in alveolar bone under orthodontic or constant occlusal loading was analyzed. Then finite element model of alveolar bone was constructed from the bone near the cervical margin or apical root of mesial root. The fluid flow in this model under orthodontic and cyclic occlusal loading was further predicted by using fluid-solid coupling numerical simulation. Results The fluid velocity within alveolar bone cavity mainly distributed at 0-10 μm/s, and the fluid shear stress (FSS) was mainly distributed at 0-10 Pa. FSS on the surface of alveolar bone near the apical root was higher than that close to the cervical margin. Conclusions FSS at different levels could be produced at different location within alveolar bone cavity under orthodontic and cyclic occlusal loading, which might further activate biological response of bone cells on the surface of trabeculae and finally regulate the remodeling of alveolar bone and orthodontic movement of tooth. The results provide theoretical guidance for the clinical treatment of orthodontics.

Acupuncture at pharyngeal acupoints for true bulbar paralysis after cerebral infarction: a randomized controlled trial / 中国针灸

OBJECTIVE@#To compare the clinical effect of acupuncture at the affected side and both sides of the pharyngeal acupoints for true bulbar paralysis after cerebral infarction.@*METHODS@#A total of 66 patients with true bulbar paralysis after cerebral infarction were randomly divided into an unilateral group and a bilateral group, 33 cases in each group, 1 case dropped off in each group at last. On the basis of conventional drugs and electro-nape-acupuncture treatment, the patients in the unilateral group were treated with acupuncture at the affected side's , and (Extra), while patients in the bilateral group were treated with acupuncture at the both sides' , and The treatment was performed once a day, 6 days a week, and the clinical effect was assessed after 21-day therapy. The swallowing and vocalization of the two groups were evaluated by dysphagia grading scale, Kubota water swallowing test and GRBAS grading scale before and after treatment.@*RESULTS@#After 21 days of treatment, the scores of the dysphagia grading scale in the two groups were both improved (<0.01), and the unilateral group was superior to the bilateral group (<0.01). The GRBAS grading scale and Kubota water swallowing test grading after treatment were improved in both groups (<0.01), and the unilateral group was superior to the bilateral group (<0.05, <0.01).@*CONCLUSION@#Acupuncture at the pharyngeal acupoints of the affected side achieves much better therapeutic effect on true bulbar paralysis as compared with the acupoints of the bilateral sides.

Fluid-solid coupling numerical simulation on ideal porous structure of rat alveolar bone / 生物医学工程学杂志

Fluid shear stress (FSS) caused by interstitial fluid flow within trabecular bone cavities under mechanical loading is the key factor of stimulating biological response of bone cells. Therefore, to investigate the FSS distribution within cancellous bone is important for understanding the transduction process of mechanical forces within alveolar bone and the regulatory mechanism at cell level during tooth development and orthodontics. In the present study, the orthodontic tooth movement experiment on rats was first performed. Finite element model of tooth-periodontal ligament-alveolar bone based on micro computed tomography (micro-CT) images was established and the strain field in alveolar bone was analyzed. An ideal model was constructed mimicking the porous structure of actual rat alveolar bone. Fluid flow in bone was predicted by using fluid-solid coupling numerical simulation. Dynamic occlusal loading with orthodontic tension loading or compression loading was applied on the ideal model. The results showed that FSS on the surface of the trabeculae along occlusal direction was higher than that along perpendicular to occlusal direction, and orthodontic force has little effect on FSS within alveolar bone. This study suggests that the orientation of occlusal loading can be changed clinically by adjusting the shape of occlusal surface, then FSS with different level could be produced on trabecular surface, which further activates the biological response of bone cells and finally regulates the remodeling of alveolar bone.

Pharmacokinetics and pharmacodynamics of desmopressin acetate in rabbits after intraocular administration / 药学学报

We compared the pharmacokinetic and pharmacodynamic profiles of desmopressin acetate after intraocular, intravenous and intragastric administration in rabbits to better understand the systemic delivery of peptide drugs through intraocular administration. Fifteen rabbits were randomly divided into three groups (intraocular administration, 7 μg·kg-1; intravenous administration, 0.7 μg·kg-1; and intragastric administration, 7 μg·kg-1). Blood samples were taken from the heart at predetermined time points after dosing and the plasma desmopressin concentration was analyzed by enzyme-linked immunosorbent assay (ELISA). Another 21 rabbits were randomly divided into three groups (intraocular administration, 7 μg·kg-1; intravenous administration, 0.7 μg·kg-1; intragastric administration, 7 μg·kg-1) for a pharmacodynamics study. Urine was collected at predetermined intervals after dosing. The pharmacokinetic parameters after intravenous administration were as follows: Cmax was 143.0 pg·mL-1; the area under the plasma concentration–time curve for desmopressin (AUC0-t) was 999.9 pg·h·mL-1. The pharmacokinetic parameters after intraocular administration were as follows: tmax was 5 min, Cmax was 125.6 pg·mL-1, AUC0-t was 873.1 pg·h·mL-1, and absolute bioavailability (F) was 8.7%. The pharmacokinetic parameters after intragastric administration were as follows: tmax was 10 min, Cmax was 104.1 pg·mL-1, AUC0-t was 451.8 pg·h·mL-1, and absolute bioavailability was 4.5%. Intraocular administration and intravenous administration of one tenth of the dosage showed a similar effect, and the urine volume remained decreased for 12 h, but urine volume increased significantly in the second collection period after intragastric administration, and there was no decrease in volume 12 h after dosing. This study demonstrates that peptide drugs such as desmopressin can be absorbed more rapidly after intraocular administration than after intragastric administration and can exert systemic therapeutic effects. In this study, the program of animal testing had been approved by the Laboratory Animal Care and Use Committee at Anhui University of Chinese Medicine.

Analysis of characteristics of HIV cases aged 15-24 in Jiaxing City / 中国学校卫生

Objective@#To understand the epidemiological characteristics and differences of HIV-positive cases among 15-24 years old in Jiaxing city and provide evidence for the development of targeted prevention and control measures.@*Methods@#A descriptive epidemiological method was used to analyze the data of HIV cases aged 15-24 reported in Jiaxing from 1999 to 2018.@*Results@#A total of 375 cases of young HIV were reported in 1999-2018, with an average age of 21.29±1.90 years, of which 42 were students. The ratio of male to female was 2.47∶1. The proportion of foreign household registration was higher (76%, 285 cases). The proportion of off-campus youth cases in total cases showed a downward trend(χ2=8.26, P=0.00), but the proportion of student cases showed an upward trend(χ2=15.73, P<0.01). Off-campus youth cases were mainly heterosexual transmission(59.16%, 197 cases), and the students’ cases were mainly homosexual transmission(88.10%, 37 cases). There were significant differences in gender, age, household registration, education level, route of transmission, late detection, CD4 level and source of detection among students and off-campus adolescents(P<0.05).@*Conclusion@#The prevalence of AIDS in adolescents and students is worthy of attention. The characteristics of adolescents inside and outside the school are different. Targeted prevention measures should be taken to reduce the harm of AIDS to young people.

Clinical effects of the implantation of porous tantalum rod under three-dimensional C-arm positioning in treating ARCO I-II non-traumatic necrosis of the femoral head / 中华骨科杂志

Objective@#To evaluate the clinical effects of the implantation of porous tantalum rod under three-dimensional (3D) C-arm positioning in the treatment of ARCO I and II non-traumatic femoral head necrosis.@*Methods@#Fifty patients (58 hips, 39 males and 11 females, mean age 33.52 years) with non-traumatic femoral head in ARCO I-II were included from January 2009 to December 2011. All patients received implantation of porous tantalum rod. The 3D C-arm X-ray positioning was used in 24 patients (29 hips), while traditional C-arm X-ray positioning was performed in the other patients. The visual analogue scale (VAS), Harris score and superior rate were evaluated at 0.5, 1, 2, and 4 years after the surgery. Total hip arthroplasty was regarded as the end event for survival rate.@*Results@#In the 3D C-arm X-ray positioning group, the VAS score decreased from 7.17±1.00 points preoperatively to 2.38±0.86 points at half year, to 2.10±1.40 points at 1 year, to 2.38±1.66 points at 2 years, and to 2.21±1.47 points at 4 years postoperatively (F=98.78, P=0.00). Meanwhile, the Harris score increased significantly from 73.97±3.49 points preoperatively to 89.90±1.93, 89.93±3.26, 89.21±5.83, 88.57±5.70 points at the follow up, respectively (F=84.35, P=0.00). According to the analysis of the pre-operative and post-operative image data, there was no significant difference in progress in the ARCO staging at 23 hips duration the follow-up. Four hips were developed to ARCO III and two hips to ARCO II. Thus, the success rate of operation was 79% (23/29). There were two hips underwent total hip arthroplasty, so the survival rate of femoral head was 93% (27/29). The trend of VAS score and Harris score in the C-arm X-ray positioning group was in accordance with the 3D C-arm X-ray positioning group but without statistically significant difference (P>0.05). The operation duration 31.38±3.96 min, blood loss 36.72±5.59 ml, the ratio of distance of metal rod to bone cortex in femoral neck 0.48±0.10, and the distance of mental rod to center of necrosis 0.18±0.07 cm in 3D C-arm X-ray positioning group was superior to C-arm X-ray positioning group (respectively 41.97±4.64 min, 41.49±4.46 ml, 0.46±0.06, 0.23±0.10 cm, P<0.05).@*Conclusion@#The implantation of tantalum rod in treating ARCO I-II non-traumatic femoral head necrosis can increase the function of hip joint, relieve the symptoms of necrosis of femoral head, alleviate the progress of femoral head necrosis in X-ray, and obtain a higher survival rate. The 3D C-arm positioning in surgical operation could improve the accuracy and safety of surgery.

Construction and Practice of Smart Pharmacy Management Model in Our Hospital Based on “Internet+TCM” / 中国药房

OBJECTIVE： To explore the management model of smart pharmacy under the background of “Internet+TCM”， and to promote the improvement of the work and service quality of smart pharmacy. METHODS： The information platform and internal organization of smart pharmacy in our hospital were combined； the supervision and management of smart pharmacy and the establishment of quality control system in smart pharmacy were summarized and the development and supervision effectiveness of smart pharmacy in our hospital were evaluated. RESULTS： Our hospital established the information platform on the basis of the “Internet+TCM”. Hospital information setting were divided into online and offline. The prescriptions that were not suitable for online handling decoction and distribution service were clearly defined and the system locking settings were set up to realize effective information transmission from hospital to smart pharmacy. The service platform of smart pharmacy were set up including electronic prescription circulation system， whole-course prescription barcode recognition management system， electronic prescription audit and dispensing system， intelligent decoction control management system， smart pharmacy distribution management system， etc. It had realized seamless connection of information between smart pharmacy and patients. The internal organization included six departments： prescription audit center， dispensing center， decoction center， individualized preparation production center， logistics center and customer service center. Our hospital conducted daily supervision and management of the entire work process of the smart pharmacy from aspect of hospital management and pharmacy management. The internal service quality of smart pharmacy could be controlled by quality control system of prescription reviewing center， dispensing center， decocting center， individualized preparation center， logistics center and customer service center and pharmaceutical personnel training mechanism in smart pharmacy. Since the start of the smart pharmacy in June 2015， the number of people receiving the services of smart pharmacy had increased significantly， and the types of services and service opportunities for patients had added； the distribution service had added， and the service of individualized preparation processing and distribution had also added. Moreover， the service capacity of smart pharmacy far exceeded the demand of our hospital， and other medical institutions could share the platform of smart pharmacy. By simply counting the situation in our hospital， the average number of daily prescription increased from 387 in Jun.-Dec. of 2015 to 1 433 in 2018； the error rate showed a downward trend， among which the abnormal rate of prescription reviewing， the dispensing error rate， the decoction error rate and customer service complaints rate decreased from 2.10％， 0.13％， 0.52％， 0.13％ in Jun.-Dec. of 2015 to 0.45％， 0.05％， 0.27％， 0.04％ in 2018； total timely investment rate in logistics increased from 93.20％ in Jun.-Dec. of 2015 to 97.06％ in 2018. At present， the existing information platform， internal organization， quality control system and supervision system could ensure the orderly operation of smart pharmacy and could ensure the quality of drugs， decoction and distribution. CONCLUSIONS： However， the development of smart pharmacy in our hospital is still in its infancy. In the future， it is still necessary to strengthen the construction of information software and hardware， standardize the operation of various links， strengthen personnel training， establish an effective quality control system and explore more objective supervision mechanisms.

Preliminary results and risk factors of retinopathy screening for premature infants in Sichuan Province / 国际眼科杂志(Guoji Yanke Zazhi)

@#AIM:To investigate the incidence and risk factors of retinopathy of prematurity(ROP)in Sichuan Province.<p>METHODS: From July 2017 to Augest. 2018, 238 premature infants(476 eyes)with gestational age of 34wk or less, or birth weight of 2500g or less, were examined by RetCamⅢ for ROP screening. The infants were divided into ROP group and non-ROP group according to the results of screening. Meanwhile, the general condition of the premature infants and maternal health during pregnancy were assessed and recorded to determine the risk factors of ROP.<p>RESULTS: In 238 infants(476 eyes), ROP developed in 35 infants and the incidence of ROP was 14.7%, which including 14 cases(28 eyes)suffering from stage 1, 11 cases(22 eyes)from stage 2, 8 cases(16 eyes)from stage 3, 2 cases(4 eyes)from stage 4, 0 cases from stage 5. 12 cases(24 eyes)received laser therapy. The gestation age and birth weight in non-ROP group were higher than ROP group, significant difference was found between the two groups(<i>P</i><0.01). The incidence of ROP was statistically significant between different gestational age groups and different birth weight groups(<i>P</i><0.01). The ratios of oxygen inhalation>72h, hypoxic-ischemic encephalopathy and mechanical ventilation in non-ROP group and ROP group were statistically significant(<i>P</i>=0.034; <i>P</i>=0.001; <i>P</i>=0.004). However, the significant difference had not been found with other systemic diseases of the premature infants sand maternal health during pregnancy between the two groups(<i>P</i>>0.05).<p>CONCLUSION: The incidence of ROP in Sichuan Province is 14.7% from July 2017 to Augest 2018. The gestation age, birth weight, oxygen inhalation>72h, hypoxic-ischemic encephalopathy and mechanical ventilation are high risk factors for the occurrence of ROP.

The role of hypoxia-related molecules in the pathogenesis of osteoarthritis / 中华创伤骨科杂志

Osteoarthritis is one of the most common chronic diseases in orthopedics.With increasing populations of aging and obese people,its incidence has risen year by year and become a major public health problem.The hallmark of osteoarthritis is cartilage destruction,the main cause of which is degradation of extracellular matrix by catabolic enzymes and death of chondrocytes caused by apoptosis or autophagy.Articular cartilage is a hypoxic environment because it lacks blood supply and the joint cavity is relatively closed.A hypoxic environment induces chondrocytes to produce a series of hypoxia-related molecules which can regulate the expression of catabolic enzymes,autophagy and apoptosis of chondrocytes for osteoarthritis.This paper aims to review recent reports on the relationship between hypoxic-related molecules and pathogenesis of osteoarthritis and discuss the role of hypoxia-related molecules in the pathogenesis of osteoarthritis.

Targeted binding of estradiol with ESR1 promotes proliferation of human chondrocytes by inhibiting activation of ERK signaling pathway / 南方医科大学学报

OBJECTIVE@#To investigate the effect of estradiol (E2)/estrogen receptor 1 (ESR1) on the proliferation of human chondrocytes and explore the molecular mechanism.@*METHODS@#The Ad-Easy adenovirus packaging system was used to construct and package the ESR1-overexpressing adenovirus Ad-ESR1. Western blotting and qPCR were used to detect the expression of ESR1 protein and mRNA in human chondrocyte C28I2 cells. In the cells treated with different adenoviruses, the effects of E2 were tested on the expressions of proteins related with cell autophagy and apoptosis and the phosphorylation of ERK signaling pathway using Western blotting. Immunofluorescence assay was used to observe the intracellular autophagic flow, flow cytometry was performed to analyze the cell apoptosis rate and the cell cycle changes, and qPCR was used to detect the expressions of PCNA, cyclin B1 and cyclin D1 mRNAs. The inhibitory effect of the specific inhibitor of ERK on the expressions of autophagy- and apoptosis-related genes at both the protein and mRNA levels were detected using Western blotting and qPCR.@*RESULTS@#Transfection with the recombinant adenovirus overexpressing ESR1 and E2 treatment of C28I2 cells significantly enhanced the expressions of autophagy-related proteins LC3, ATG7, promoted the colocalization of LC3 and LAMP1 in the cytoplasm, increased the expressions of the proliferation-related marker genes PCNA, cyclin B1 and cyclin D1, and supressed the expressions of cleaved caspase-3, caspase-12 and pERK. RNA interference of ESR1 obviously lowered the expression levels of autophagy-related proteins in C28I2 cells, causing also suppression of the autophagic flow, increments of the expressions of apoptosis-related proteins and pERK, and down-regulated the expressions of the proliferation marker genes. Blocking ERK activation with the ERK inhibitor obviously inhibited the effects of E2/ESR1 on autophagy, proliferationrelated gene expressions and cell apoptosis.@*CONCLUSIONS@#The targeted binding of E2 with ESR1 promotes the proliferation of human chondrocytes possibly by inhibiting the activation of ERK signaling pathway to promote cell autophagy and induce cell apoptosis.

Association between DRD2 gene polymorphisms and the dosage used on methadone maintenance treatment program / 中华流行病学杂志

Objective To investigate the association between three single nucleotide polymorphism (SNP) genes DRD2 (rs1800497,rs6275,and rs1799978) and the dosage used on methadone maintenance treatment (MMT).Methods From the methadone maintenance treatment centers,257 MMT patients were recruited to participate in a case-control study and divided into two groups—control groups under low dosage (n=89) and case (n=168) group with high dosage.Quanto software was used to estimate the sample size as 180.Information related to social-demographic status,history on drug use and medication were collected.And DRD2 SNPs were genotyped to explore the relationship between polymorphism of DRD2 gene and the dosage of methadone maintenance treatment.Results Distributions of DRD2 rs6275 between different groups were significantly different.Patients carrying TC genotype needed lower dose of methadone when compared to the patients that carrying CC genotype counterparts (OR=0.338,95％ CI:0.115-0.986).Patients that carrying C allele at rs6275 needed lower methadone dose than those that carrying genotype TT (OR=0.352,95％CI:0.127-0.975).Distributions of genotypes,alles in the other two SNPs (rs1800497,rs1799978) were not significantly different between groups under different dosages.Conclusion DRD2 rs6275 was associated with dosage of methadone used for the MMT patients.However,no significant associations were found between rs 1800497,rs 1799978 and the dosage of methadone.

Structure and Anti-HIV Activity of Betulinic Acid Analogues / 华中科技大学学报（医学）（英德文版）

Firstly discovered in 1980s,human immunodeficiency virus (HIV) continues to affect more and more people.However,there is no effective drug available for the therapy of HIV infection.Betulinic acid existing in various medicinal herbs and fruits exhibits multiple biological effects,especially its outstanding anti-HIV activity,which has drawn the attentions of many pharmacists.Among the derivatives of betulinic acid,some compounds exhibited inhibitory activities at the nanomolar concentration,and have entered phase Ⅱ clinical trials.This paper summarizes the current investigations on the anti-HIV activity of betulinic acid analogues,and provides valuable data for subsequent researches.