Discussion on the Monitoring Platform of Rational Use Management Indexes of Key Monitored Drugs of Medical Institutions in China / 中国药房

OBJECTIVE：To d iscuss the monitoring platform of rational use management indexes of key monitored drugs ，and to provide reference for improving their clinical application management. METHODS ：The method of literature research and expert demonstration was adopted ，the indexes of key monitored drugs in medical institutions were put forward. RESULTS & CONCLUSIONS：Finally，Eight general indexes as the list of top 20 drugs purchased by medical institutions ，the specifications of key monitored drugs purchased ，the utilization rate of key monitored drugs of inpatient ，the proportion of key monitored drugs revenue，the increase in the cost of key monitored drugs of inpatient ，the increase in the cost of key monitored drug of single inpatient，the increase of the cost per time of key monitored drugs of inpatient ，the proportion of doctor ’s order review for key monitored drugs were defined. Four major data acquisition projects as the general information of medical institutions ，medical record homepage ，inpatient medication data ，and medical institution drug procurement data were also defined. The monitoring platform of key monitored drugs in medical institutions can provide reference for improving the management of clinical application of key monitored drugs.

Genome Size Evolution Mediated by Gypsy Retrotransposons in Brassicaceae / 基因组蛋白质组与生物信息学报·英文版

The dynamic activity of transposable elements (TEs) contributes to the vast diversity of genome size and architecture among plants. Here, we examined the genomic distribution and transposition activity of long terminal repeat retrotransposons (LTR-RTs) in Arabidopsis thaliana (Ath) and three of its relatives, Arabidopsis lyrata (Aly), Eutrema salsugineum (Esa), and Schrenkiella parvula (Spa), in Brassicaceae. Our analyses revealed the distinct evolutionary dynamics of Gypsyretrotransposons, which reflects the different patterns of genome size changes of the four species over the past million years. The rate of Gypsy transposition in Aly is approximately five times more rapid than that of Ath and Esa, suggesting an expanding Aly genome. Gypsy insertions in Esa are strictly confined to pericentromeric heterochromatin and associated with dramatic centromere expansion. In contrast, Gypsy insertions in Spa have been largely suppressed over the last million years, likely as a result of a combination of an inherent molecular mechanism of preferential DNA removal and purifying selection at Gypsy elements. Additionally, species-specific clades of Gypsy elements shaped the distinct genome architectures of Aly and Esa.

Machine Learning Models for Genetic Risk Assessment of Infants with Non-syndromic Orofacial Cleft / 基因组蛋白质组与生物信息学报·英文版

The isolated type of orofacial cleft, termed non-syndromic cleft lip with or without cleft palate (NSCL/P), is the second most common birth defect in China, with Asians having the highest incidence in the world. NSCL/P involves multiple genes and complex interactions between genetic and environmental factors, imposing difficulty for the genetic assessment of the unborn fetus carrying multiple NSCL/P-susceptible variants. Although genome-wide association studies (GWAS) have uncovered dozens of single nucleotide polymorphism (SNP) loci in different ethnic populations, the genetic diagnostic effectiveness of these SNPs requires further experimental validation in Chinese populations before a diagnostic panel or a predictive model covering multiple SNPs can be built. In this study, we collected blood samples from control and NSCL/P infants in Han and Uyghur Chinese populations to validate the diagnostic effectiveness of 43 candidate SNPs previously detected using GWAS. We then built predictive models with the validated SNPs using different machine learning algorithms and evaluated their prediction performance. Our results showed that logistic regression had the best performance for risk assessment according to the area under curve. Notably, defective variants in MTHFR and RBP4, two genes involved in folic acid and vitamin A biosynthesis, were found to have high contributions to NSCL/P incidence based on feature importance evaluation with logistic regression. This is consistent with the notion that folic acid and vitamin A are both essential nutritional supplements for pregnant women to reduce the risk of conceiving an NSCL/P baby. Moreover, we observed a lower predictive power in Uyghur than in Han cases, likely due to differences in genetic background between these two ethnic populations. Thus, our study highlights the urgency to generate the HapMap for Uyghur population and perform resequencing-based screening of Uyghur-specific NSCL/P markers.

Simultaneous Determination of 7 Kinds of Components in Qing'e Pills by HPLC / 中国药房

OBJECTIVE:To develop a method for simultaneous determination of psoralen,isopsoralen,bergapten,imperato-rin,trimethylpsorale,neobavaisoflavone and bavachin in Qing'e pills. METHODS:HPLC method was adopted. The separation was performed on Kinetex-C18 column with mobile phase consisted of methanol-0.1% glacial acetic (gradient elution) at the flow rate of 1.0 mL/min. The detection wavelength was set at 248 nm. The column temperature was 30 ℃. The sample size was 20 μL. RESULTS:The linear ranges were 1.012-101.2 μg/mL for psoralen(r=0.9999),1.007-100.7 μg/mL for isopsoralen(r=0.9997), 1.010-101.0μg/mL for bergapten(r=0.9999),1.021-102.1μg/mL for imperatorin(r=0.9999),1.002-100.2μg/mL for trimethyl-psorale(r=0.9996),1.008-100.8 μg/mL for neobavaisoflavone(r=0.9999),1.025-102.5 μg/mL for bavachin(r=0.9998),re-spectively. The limits of quantitation were 0.15,0.15,0.30,0.30,0.15,0.30,0.30 μg/mL,and the limits of detection were 0.05, 0.05,0.10,0.10,0.05,0.10,0.10 μg/mL,respectively. RSDs of precision,stability and reproducibility tests were lower than 2.0%. The recoveries were 95.3%-99.6%(RSD=1.9%,n=6),96.1%-99.3%(RSD=1.2%,n=6),95.2%-98.4%(RSD=1.4%,n=6),95.4%-99.2%(RSD=1.5%,n=6),96.1%-99.3%(RSD=1.5%,n=6),95.6%-98.9%(RSD=1.4%,n=6), 95.2%-99.6%(RSD=1.6%,n=6),respectively. CONCLUSIONS:The method is simple and accurate,can be used for simultane-ous determination of 7 kinds of components in Qing'e pills.

Clinical analysis of 11 cases undergoing transanal minimal invasive or combined laparoscopy total mesorectal excision for rectal cancer / 中华胃肠外科杂志

<p><b>OBJECTIVE</b>To explore the feasibility and safety of transanal minimal invasive or combined laparoscopy total mesorectal excision.</p><p><b>METHODS</b>Clinical data of 11 cases with rectal cancer undergoing transanal total mesorectal excision(taTME) in our hospital between September 2014 and May 2015 were analyzed retrospectively.</p><p><b>RESULTS</b>Among 11 patients, 3 underwent pure-taTME successfully without abdominal incision and ileostomy, whose operation time was 210, 230, 215 min respectively, while other 8 patients underwent laparoscopy-assisted taTME(hybrid-taTME) with operation time ranging from 150 to 290 (median 205) min. No patient was transferred to open operation, while larger tumors of two patients were removed from hypogastric 5 cm incision. Postoperative first day VAS score was 1 to 3(2.0±0.6), the first flatus was 6 to 70(30.2±17.3) h, hospital stay was 4 to 12(7.5±2.5) d, the blood loss was (104±127) ml and the liquid food intake was (28.3±6.3) h. Postoperative complications included 1 case of subcutaneous emphysema, 1 case of anastomotic stoma bleeding, 2 cases of dysuria, which were cured by conservative therapy. One patient developed rectovaginal fistula 20 days after operation and then underwent ileostomy. No relapse of tumor or death during follow-up.</p><p><b>CONCLUSIONS</b>For suitable rectal cancer patients, taTME or hybrid-taTME is feasible.</p>

Value of ultrasound-guided nasotracheal intubation in patients undergoing oral maxillofacial surgery: a comparison with blind intubation / 中华麻醉学杂志

Objective To evaluate the value of ultrasound-guided nasotracheal intubation in the patients undergoing oral maxillofacial surgery by comparing with blind intubation.Methods Forty ASA physical status Ⅰ or Ⅱ patients of both sexes,aged 18-75 yr,weighing 45-90 kg,scheduled for elective oral maxillofacial surgery,were randomly divided into blind intubation group (group B,n =20) and ultrasound group (group U,n =20) according to a random number table.Nasotracheal intubation was performed after routine topical analgesia and conscious sedation.The front end of catheter was adjusted to the aditus glottidis according to the sound of respiratory air,and tracheal intubation was placed when the strongest inspiratory phase appeared in group B.A linear array probe (frequency 7-15 MHz) was used,and the images of glottis expansion and wired catheter insertion were visualized in the thyroid cartilage window in U group.Before intubation and at 0,1,3 and 5 min after successful intubation,mean arterial pressure (MAP),HR and SpO2 were recorded.The development of responses to intubation was recorded during intubation.The successful intubation at first attempt,the number of intubation,intubation time,and postoperative complications such as sore throat or hoarseness were recorded.Results Compared with group B,the number of intubation was significantly reduced,intubation time was shortened,the rate of successful intubation at first attempt was increased,the failure rate of intubation and incidence of sore throat and hoarseness were decreased,and no significant changes were found in the parameters of hemodynamics and incidence of responses to intubation in group U.No intraoperative awareness of intubation occurred in patients.Conclusion Compared with blind intubation,ultrasound-guided nasotracheal intubation can raise the probability of successful intubation at first attempt,reduce the number of intubation,and shorten intubation time,and it is safe and convenient and provides significant value clinically for the patients undergoing oral maxillofacial surgery.

Effect of Hydroxypropyl Starch Vacant Capsules on the Content of Spironolactone / 中国药师

Objective:To investigate the effect of vacant capsules made from hydroxypropyl starch on the content of spironolac-tone. Methods:The spironolactone capsules were placed under the conditions with (4 000 ± 500) lx, 40℃ and RH (75 ± 5) % for 5 days and 10 days, respectively. An HPLC method was used to analyze the content of spironolactone, and the changes in appearance, color and the other traits were also observed. Results:The content of spironolactone was within the range of 93. 45%-100. 37% after the above tests, which was conformed to the standard(93. 0%-107. 0%). Conclusion:The vacant capsules made from hydroxypropyl starch rival have good compatibility with spironolactone.

Effect of heating in a calorstat to the oxygen-carrying function of red blood cell / 临床麻醉学杂志

Objective To study the change of the oxygen-carried function of stored red blood cells,which was warmed in room temperature and calorstat.Methods Randomly removed from 4 ℃storage refrigerator,red blood cell suspension were put in room temperature 30 min (group N)and 37℃ calorstat 30 min (group H),and samples taken to examine electrolyte,blood gas,free Hb,ATP content,2,3-DPG content,oxygen affinity(P50).Results In two groups,blood pH value and blood Na+ did not change obviously due to heating.The content of blood K+ and free Hb increased,glucose fell,but there was no statistically significant difference.The content of ATP and 2,3-DPG in eryth-rocyte increased and P50 increased after heating (P <0.05),which increased more significantly in group H compared with group N (P<0.05).Conclusion Heating stored blood up to 37 ℃ can in-crease the oxygen-carried function of red blood cells,which contribute to improve the effectiveness of transfusion.

Determination of Residual Organic Solvents in Poly(lactic-co-glycolide) / 医药导报

Objective To establish a capillary gas chromatography( GC)method for the determination of residual organic solvents in poly( lactic-co-glycolide)( PLGA),including methanol,acetone,dichloromethane,and toluene. Methods A capillary GC method was carried out. DB-624 capillary column(30 m× 0. 32 mm,1. 80 μm)with programmed temperature chromatography was employed. The initial temperature was kept at 40 ℃ for 8 min. Then the temperature was raised to 200 ℃ at a rate of 10 ℃·min-1 . The injection port temperature was 180 ℃,and the split ratio was 10:1. The carrier gas was nitrogen. The temperature of FID was set at 250 ℃,and the sample volume was set at 3 μL. Results Four residual organic solvents consisting of methanol,acetone,dichloromethane and toluene in PLGA were completely separated. The linear range of concentration of methanol,acetone,dichloromethane and toluene was within 10. 0-50. 0( r=0. 999 8 ),16. 7-83. 3( r=0.9998),2.0-10.0(r=0.9993),and3.0-14.8(r=0.9997)μg·mL-1,respectively.Therecoveryofmethanol,acetone, dichloromethane and toluene was 99. 9%( RSD=1. 5%),100. 8%( RSD=0. 9%),100. 1%( RSD=1. 1%),and 99. 5%(RSD=0. 6%),respectively. Six batches of samples met the requirements. Conclusion The method is proven to be sensitive and accurate after the validation. It is suitable for the determination of residual organic solvents in PLGA.

Implementation of hospital information system based on VMware virtualization / 中华医院管理杂志

Contemporary hospital information systems normally contain multiple applications,which are traditionally deployed as one application per server.More servers in the system will incur high system costs,low server efficiency and poor management and maintenance.The information system reform project of Wuxi Maternal and Child Health Hospital called into play the virtualization based on VMware.The project brought forth a number of merits,namely sizably raising efficiency of servers integration,simplifying server group management,reducing cost and promoting hospital informationization.

Accuracy of stroke volume variation in monitoring blood volume during one-lung ventilation in patients undergoing thoracoscopy operation / 中华麻醉学杂志

Objective To evaluate the accuracy of stroke volume variation (SVV) in monitoring blood volume during one-lung ventilation in patients undergoing thoracoscopy operation. Methods Twenty-two ASA Ⅰ or Ⅱ patients ( 12 male, 10 female) aged 18-60 yr undergoing thoracoscopy operation under general anesthesia were studied. Anesthesia was induced with midazolam, sufentanil, propofol and rocuronium and maintained with TCI of propofol and remifentanil and intermittent iv boluses of vecoronium. Robertshow double-lumen endobronchial tube was inserted. Correct position of the tube was verified by fiberoptic bronchoscopy. The patients were mechani40 mm Hg. Radial artery was cannulated and connected to FloTrac pressure transducer and Vigileo monitor. A loading dose of 6% HES 5 ml/kg was infused over 10 min. MAP, HR, CO and SVV were recorded before and at 3 min after loading dose. The change rate of SVV (SVV) and CI (△CI) were calculated. Increase in CI by 11% was considered effective volume expansion. The ROC curve for SVV in determining the volume expansion efficacy was plotted. The area under the curve for SVV and 95% confidence interval were calculated. Results (1) CO were significantly increased while SVV decreased after a loading dose of HES. (2) During two-lung ventilation 12 patients responded to the 6% HES loading dose.SVV correlated with△CI ( - 0.710, P ＜ 0.05). The volume expansion efficacy was determined by SVV 11.5 % (sensitivity = 82 %, specificity = 92 % ). The area under the curve for SVV and 95% confidance interval were 0.880 (0.580-0.987). (3) During one-lung ventilation 11 patients responded to the 6 % HES loading dose. SVV correlated with CI ( - 0.668 , P ＜ 0.05). The volume expansion efficacy was determined by SVV 9.5 % ( sensitivity = 77 %, specificity = 63 % ). The area under the curve for SVV and 95% confidance interval were 0.971 (0.917-1.024). Conclusion One-lung ventilation does not alter the ability of SVV in monitoring blood volume in patients undergoing thoracoscopy operation.