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In the context of public health emergencies, a Hospital used the existing SPD supply chain model as a basis, research and practice proceeded simultaneously and formed a set of "three-group three-port" emergency plan by itself. The program played a positive role and effectiveness in this emergency incident, assisting the hospital to obtain a valuable experience in closed-loop management of emergency supplies. This article elaborated on how the hospital can supply materials in case of emergency medical supplies shortage after emergencies by focusing on the three groups of closed-loop working group, inventory management group, and material procurement group, and the three ports of material storage port, logistics receiving and dispatching port, and closed-loop releasing port. In the case of emergency medical supplies being in short supply after emergencies, how can hospitals ensure adequate and balanced supply of supplies; barrier-free demand information; command and dispatch without chaos and reasonable deployment; materials receiving and dispatching are efficient and distributed in an orderly manner.
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Humans , Emergencies , Equipment and Supplies, Hospital , Hospitals , Public HealthABSTRACT
AIM:To understand the clinic effect of intravitreal anti-vascular endothelial growth factor(VEGF) drugs injection in the treatment of fundus disease in the real-world study (RWS).METHODS:The clinical cases treated with anti-VEGF drugs in our department from September 2012 to June 2015 were enrolled in this study.Retrospective investigation was reviewed to the kinds of diseases, frequency, usage, efficacy, adverse reaction, and the effects on visual acuity, fundus and macular thickness which were treated with intravitreal anti-VEGF drugs injection.RESULTS:In 305 patients (340 eyes) treated with anti-VEGF drugs, 53 patients (60 eyes, 17.6%) were wet age-related macular degeneration (AMD), polypoidal choroidal vasculopathy (PCV) 16 cases (18 eyes, 5.3%), diabetic macular edema (DME) 120 cases (134 eyes, 39.4%), branch retinal vein occlusion (BRVO) secondary macular edema 61 cases (68 eyes, 20.0%), central retinal vein occlusion (CRVO) secondary macular edema 29 cases (32 eyes, 9.4%), idiopathic choroidal neovascularization (ICNV) 16 cases (18 eyes, 5.3%), high myopia with choroid neovascularization 4 cases (4 eyes, 1.2%), neovascular glaucoma 4 cases (4 eyes, 1.2%), retinal angiomatous proliferation (RAP) 1 cases (1 eyes, 0.2%) and optic papillary neovascularization 1 cases (1 eyes, 0.2%).The minimum age was 16 years old, and the maximum age 90 years old.There were 247 cases (275 eyes, 80.9%) were treated with intravitreal ranibizumab injection, 58 cases (65 eyes, 19.1%) intravitreal conbercept injection.The time number of all patients accepted anti-VEGF drugs treatment was 465, with an average of 1.7 times per eye.Which, the 3 + PRN treatment method in 98 patients (109 eyes, 32.1%), 1 + PRN treatment in 207 patients (231 eyes, 67.9%).69 cases (77 eyes, 22.6%) were used alone to receive anti-VEGF drugs therapy, 10 cases (11 eyes, 3.2%) combined with intravitreal triamcinolone injection(TA), 35 cases (39 eyes, 11.5%) combined with vitrectomy, 26 cases (29 eyes, 8.5%) combined with photodynamic treatment (PDT), 165 cases (184 eyes, 54.1%) combined with simple laser treatment.After anti-VEGF drug treatment, majority of patients' the best corrected visual acuity (BCVA), fundus and central macular thickness(CMT) were significantly improved, compared with the pre-treatment, the difference is significant (P<0.05).So that anti-VEGF drugs can effectively improve visual function and ocular fundus for fundus diseses.There were no serious adverse reactions except 3 patients appearling skin redness, itching, rash, 1 patient low low-grade fever and 1 patient acute cerebral infarction during the treatment.CONCLUSION:Intravitreal anti-VEGF drugs injection can significantly improve the visual function and ocular fundus for patients with fundus diseases, but there are still some adverse events, which should be attached great importance to medical workers.
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To investigate the effect of the hyperforin (HF) on learning and memory function and Aβ₁₋₄₂, βAPP and BACE1 protein expressions in hippocampus of five-month-old APP/PS1 double transgenic mice, and discuss the underlying mechanism of HF. The five-month-old APP/PS1 double transgenic mice were randomly divided into the model group, rosiglitazone group (12 mg•kg⁻¹•d⁻¹) and HF high dose, middle dose and low dose groups (600, 300 and 150 mg•kg⁻¹•d⁻¹) in each group; in addition, 15C57BL/6J mice with the same months and background were selected as normal group. Drugs were diluted in the same volume before using, and then administrated by ig for 7 months, 1 time a day; the mice in normal group and model group received the same volume of distilled water. The learning and memory ability was tested by Morris water maze; Aβ₁₋₄₂, βAPP and BACE1proteinexpressionlevelswere tested by immunohistochemistry and Western blot. The Morris water maze results showed that as compared with the normal group, the learning and memory ability was significantly impaired in mice of model group (P<0.01); as compared with the model group, the learning and memory ability was improved in mice of rosiglitazone group and HF high, middle and low dose groups(P<0.01 or P<0.05). Immunohistochemistry and western blot results showed thatas compared with the normal group, the Aβ₁₋₄₂, βAPP and BACE1 protein expression levels in hippocampus were significantly increased in mice of model group (P<0.01);as compared with the model group, Aβ₁₋₄₂, βAPP and BACE1 protein expression levels in hippocampus were decreased in mice of rosiglitazone group and HF high, middle and low dose groups (P<0.01 or P<0.05). HF may improve the learning and memory ability of AD model mice via inhibition of βAPP and BACE1 protein expressions, thus reduced the generation of Aβ₁₋₄₂ proteins and amyloid plaque deposits in the brain.
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Background Many methods are widely studied to improve the therapeutic effect of trabeculectomy for glaucoma,and the clinical effectiveness of the amniotic membrane application during trabeculectomy is one of the research hotspots.Objective This study was to evaluate the efficacy and safety between trabeculectomy with (TE-AMT) and without amniotic membrane transplantation (TE-noAMT) for treating glaucoma.Methods Articles published from 1965 to December 2010 were searched from The Cochrane Library,PubMed,EMBASE,CNKI,Chinese Biomedicine Database,internet by computer,and manual search then was performed according to the predetermined strategy.Randomized controlled trials (RCT) on TE-AMT and TE-noAMT were included.The quality of included articles were scored based on Jadad table,and the relative parameters and information were extracted,including author,design of the trials,country,number of eyes and patients,gender,follow-up duration,age,classification of glaucoma,baseline IOP and loss rate.The main analysis indicators were the percentage of IOP reduction,completely operative successful rate,qualified success rate and adverse events.The pooled estimates were carried out with RevMan version 5.0 software.Results Nineteen RCTs documents were reviewed by meta-analysis with the Jaded scores ≥3 in 2 papers and ＜3 in 17 papers.Total 977 eyes of 818 patients were included.The weighted mean differences (WMD) of the percentage of IOP from baseline were (WMD =8.47％,95％ CI:5.20-11.75) at 6 months and (WMD=9.37％,95％ CI:4.97-13.77) at 12 months postoperatively.Relative risk (RR) of complete success rate and qualified success rate at postoperative 6 months were (1.40,95％ CI:1.19-1.65) and (0.47,95％ CI:0.22-1.00),respectively.RR values of adverse event such as shallow anterior chamber,hyphema,hypotony and choroidal detachment,failed filtering blebs at 6,12 months were 0.51 (95 ％ CI:0.30-0.85),0.43 (95％ CI:0.20-0.92),0.51(95％CI:0.26-1.00) and 0.57(95％CI:0.14-2.31),0.31(95％CI:0.20-0.47),0.31 (95％ CI:0.17-0.55),respectively.Conclusions TE-AMT appears to have better efficacy in lowering IOP,increasing complete success rate and reducing adverse event I in comparison with TE-noAMT.
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Background Glucocorticoid is a common drug for treatment of thyroid-associated ophthalmopathy (TAO) with good effectiveness.But some adverse reactions of glucocorticoid are inevitable.At recent years,99technetium-methylene bisphosphonate(99Tc-MDP) is being paid more and more attentions in the treatment of TAO,but its effectiveness and safety is worthy of comparison to traditional treatment methods.Objective This study was to evaluate the efficacy of treatment with intravenous injection of 99Tc-MDP for TAO.Methods The Cochrane Library,CNKI,PubMed,Wanfang database,Weipu net were searched in computer and Google Scholar was searched manually.The randomized controlled trail (RCT) of intravenous injection of 99Tc-MDP for TAO were collected from establishment of database through April,2012.The quality of included literature was assessed based on the methodology of the study.The evaluating indexes included the primary treating outcomes,such as total efficacy,exophthalmic extent and recurrence rate as well as secondary outcomes such as adverse effect.RevMan 5.1 software was used for Mate analysis.Results A total of 11 RCTs were identified with 706 patients.Subgroup analysis was carried out based on the outcome measures and intervention.No significant difference was found in the overall effective rate between intravenous injection of 99Tc-MDP and immunosuppressive treatment (RR =0.96,95 ％ CI:0.76 to 1.22,P=0.740).However,the effective rate was significant different between intravenous injection of 99Tc-MDP and oral prednisone (RR =1.25,95 ％ CI:1.06-1.46,P =0.007) or between intravenous injection of 99 Tc-M DP and the blank control group (RR =2.53,95 ％ CI:1.68-3.81,P =0.000).Significant difference also was found in the total effective rate between intravenous injection of 99Tc-MDP with methyprednisone and methyprednisone alone (RR =1.27,95％ CI:1.05-1.53,P =0.010).There were significant differences in the effective rate of proptosis between intravenous injection of 99Tc-MDP and oral prednisone (RR=2.02,95％ CI:1.44-3.56,P=0.020).The recurrence rate of TAO was significant different between intravenous injection of 99Tc-MDP and oral prednisone (RR =0.51,95％ CI:0.33-0.78,P=0.002).Less adverse responses were seen in the intravenous injection of 99Tc-MDP group than the oral prednisone group and immunosuppressive treatment group.Conclusions Intravenous injection of 99Tc-MDP for TAO appears to be of a similar effectiveness to immunosuppressive method.The combination of intravenous injection of 99Tc-MDP with methyprednisone seems to be more effective than methyprednisone alone,with little systemic adverse effect after application.
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Objective: To prepare curcumim thermoresponsive nanogels and study its release characteristics in vitro. Methods: Poly (N-isopropyl acrylamide) (PNIPAm) thermoresponsive nanogels were synthesized by emulsion polymerization method, and then curcumin loaded-PNIPAm nanogels were prepared. The characteristics of PNIPAm nanogels, the drug loading, and the drug release in vitro were investigated. Results: Atomic force micriscopy (AFM) observation showed that PNIPAm nanogels were spherical in shape with homogenous size. Moreover, PNIPAm No. 5 showed a high drug loading (27%). In vitro release study revealed that the 24 h accumulative in vitro release reached 75.2%. Conclusion: The method used to prepare curcumin thermoresponsive nanogels is simple. It is expected to become a novel vehicle potentially nanoparticle drug delivery system of curcumin.
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<p><b>OBJECTIVE</b>To compare the clinical efficacy between total aortic arch reconstruction with open triple-branched stent graft placement and total aortic replacement combined with stented elephant trunk implantation for patients with Stanford A aortic dissection.</p><p><b>METHODS</b>Patients with Stanford A aortic dissection treated with surgical treatment from January 2006 to May 2011 were included in this study. The patients were divided into two groups. Group I (n = 20) patients were treated by total arch replacement with stented elephant trunk procedure. Group II (n = 8) patients received open triple-branched stent graft placement. Echocardiography and aortic CT angiography were performed before and at 1 month after operation.</p><p><b>RESULTS</b>Age, gender and disease severity were similar between the 2 groups (all P > 0.05). Operation was successful in all 28 patients. Cardiopulmonary bypass time, aortic cross clamp time, circulation arrest time and duration of ventilator assisted breathing were significantly longer; postoperative drainage volume and blood transfusion volume were significantly larger and hospitalization cost was significantly higher in group I patients compared those in group II patients (all P < 0.05). One month after operation, the maximum internal diameter of aorta was smaller than pre-operation in both group I [(30.2 ± 3.1) mm vs. (42.5 ± 6.5) mm, P < 0.05] and group II [(31.5 ± 2.5) mm vs. (44.1 ± 7.3) mm, P < 0.05].</p><p><b>CONCLUSIONS</b>Short-term procedural success rate was similar between the two groups. The total aortic arch reconstruction with open triple-branched stent graft placement procedure is simpler, shortens the operation time, reduces the blood transfusion volume and is more cost-effective compared to the classical aortic arch operation.</p>
Subject(s)
Adult , Female , Humans , Male , Middle Aged , Aortic Dissection , General Surgery , Aorta, Thoracic , General Surgery , Aortic Aneurysm , General Surgery , Stents , Treatment OutcomeABSTRACT
<p><b>OBJECTIVE</b>To construct the RNA interference expression vector for expression of human neuropathy target esterase (NTE) gene in mammalian cells.</p><p><b>METHODS</b>Spe I and Xho I-digested insert from pSUPER, which comprised H1 RNA polymerase III promoter and the multiple cloning sites, were cloned into the compatible in the pcDNA3.1 (+) to generate pSUPER/neo that could express small interfering RNA in mammalian cells. The annealed oligos targeting the expression of NTE were ligated into pSUPER/neo vector digested with Bgl II and Hind III to generate pSUPER/neo-NTE, which was transfected into COS7 and SH-SY5Y cells. The inhibitory effect of the expression of NTE was detected by western blot analysis and the enzyme activity assay.</p><p><b>RESULTS</b>pSUPER/neo-NTE could stably express double-stranded RNA of NTE. The expression of pSUPER/neo-NTE in COS7 and SH-SY5Y cells could efficiently inhibit the activity of NTE in the mammalian cells.</p><p><b>CONCLUSION</b>Stable eukaryotic expression vector of double-stranded RNA of NTE, pSUPER/neo-NTE, has been constructed successfully with promoter substitution strategy.</p>
Subject(s)
Animals , COS Cells , Carboxylic Ester Hydrolases , Genetics , Physiology , Cell Line, Tumor , Chlorocebus aethiops , Genetic Vectors , RNA Interference , RNA, Small Interfering , Genetics , TransfectionABSTRACT
Objective To summary the experience of management for orthotopic homologous heart transplantation,heart-lung co-transplantation and to discuss the postoperative treatment of short-term complications.Methods Orthotopic homologous heart transplantation and heart-lung co- transplantation on 9 cases were performed from May 2004 to February 2006.The patients were traced closely and all complications were treated in time.Results During hospital stay,hypertension oc- curred in one case,right heart insufficiency in one case,infection of mycetes and cytomegalovirus in 2 cases after the heart transplantation,and in the patient undergoing heart-lung co-transplantation,renal inadequacy,bronchial anastomosis stenosis and fungus infection occurred.All patients obtained symp- tomatic relief before discharge.Conclusion Proper perioperative management,immunosuppressive therapy and management of postoperative complications could reduce mortality and obtain satisfactory therapeutic effect in the near future.
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To construct a hepatic stellate cells (HSCs) subtracted cDNA library to find differentially expressed genes in normal mice and mice infected with Schistosoma japonicum (S. japonicum). Suppression subtractive hybridization (SSH) was used. The cDNA fragments of normal mouse were compared to those of schistosoma-infected mice to find differentially expressed genes. Then differentially expressed cDNA fragments were directly inserted into T/A cloning vector to set up the subtractive library. Amplification of the library was carried out with transformation of DH5alpha. The amplified library contained more than 400 positive bacterial clone, which were then hybridized with forward and backward subtracted probes for differential screening. One hundred positive bacterial clones were randomly selected for sequencing and BLAST analysis. Finally, virtual Northern Blot confirmed such differential expression. The subtracted cDNA library of differentially expressed genes of HSCs was constructed successfully, the library is efficient and lays foundation for screening and cloning new and specific genes of schistosomiasis.
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Animals , Male , Mice , Base Sequence , Blotting, Northern , DNA, Complementary , Genetics , Gene Expression Regulation , Genetics , Gene Library , Hepatocytes , Metabolism , Liver , Cell Biology , Metabolism , Mice, Inbred BALB C , RNA, Messenger , Genetics , Schistosoma japonicum , Schistosomiasis japonica , GeneticsABSTRACT
<p><b>OBJECTIVE</b>To investigate the correlative factors of weight gain in very low birth weight infants (VLBW).</p><p><b>METHODS</b>Fifty-one cases of VLBW from July 1998 to March 2004 were analyzed retrospectively.</p><p><b>RESULTS</b>Twenty two cases were small for gestational age (SGA) and 29 cases were appropriate for gestational age (AGA). The age of first feeding was (2.35 +/- 2.29) d. Caloric intake was (377.61 +/- 121.50) kJ/(kg.d) [(90.25 +/- 29.04) kcal/(kg.d)] and protein intake was (2.18 +/- 0.83) g/(kg.d). The age of birth weight regained was (7.41 +/- 3.57) d and the velocity of weight gain was (16.38 +/- 9.29) g/d or (12.63 +/- 7.15) g/(kg.d). Single factor analysis found that early feeding and caloric supply and protein supply had significant influence on weight gain (P < 0.05). The result of multivariate linear analysis showed that the significant risk factors were associated with supply of calorie and protein. The equation was Y (weight gain) = -6.426 + 0.120X(1) (caloric supply) + 3.737X(2) (protein supply) (P < 0.01). The caloric supply of the cases that achieved the nutritional goal was (468.19 +/- 67.11) kJ/(kg.d), [(111.90 +/- 16.04) kcal/(kg.d)], and that with enteral nutrition and partial parenteral nutrition was [(520.62 +/- 21.59) kJ/(kg.d)], [(124.43 +/- 5.16) kcal/(kg.d), (451.49 +/- 68.41) kJ/(kg.d)], [(107.98 +/- 16.35) kcal/(kg.d)] respectively. There was significant difference between the two groups (P < 0.05). The mean rank of time of birth weight regaining, the time in hospital stay and duration of parenteral nutrition providing at least 75% of the total daily fluid volume was 18.58, 20.24 and 20.11 in the group of early feeding, and it was 33.00, 32.48 and 31.83 in the group of late feeding, respectively. There were significant differences between the two groups (P < 0.05).</p><p><b>CONCLUSION</b>Sufficient supply of calorie and protein should be ensured in VLBW infants, especially in SGA and severely ill infants. It was very important to feed VLBW infants as early as possible, which could improve feeding tolerance and gastrointestinal maturation. VLBW infants should receive parenteral nutrition as supplements to enteral feeding.</p>
Subject(s)
Humans , Infant, Newborn , Enteral Nutrition , Infant, Small for Gestational Age , Infant, Very Low Birth Weight , Multivariate Analysis , Parenteral Nutrition , Retrospective Studies , Risk Factors , Weight GainABSTRACT
<p><b>OBJECTIVE</b>To explore the effect of organophosphorus insecticides (OPs) on the nicotinic autoreceptor function (NAF) in rat cortical synaptosomes and to understand alternative target of the OPs for human and other animals.</p><p><b>METHODS</b>In vitro experiment, synaptosomes from the rats were incubated with [(3)H] choline and then superfused with physiological buffer. The [(3)H] acetylcholine release from the synaptosomes after the addition of paraoxon or chlorpyrifos to the superfusion system was recorded and the changes of NAF were calculated. In vivo experiment, NAF and acetylcholinesterase (AChE) activity in the cortical synaptosomes in the adult rats dosed with chlorpyrifos were also determined 96 h after OPs treatment.</p><p><b>RESULTS</b>Paraoxon caused slight effect on NAF (average inhibition rate: < 23%) while chlorpyrifos oxon caused > 100% of inhibition on NAF in vitro. Chlorpyrifos markedly reduced NAF by 66% 96 h after treatment and inhibited the AChE activity by 91% in vivo.</p><p><b>CONCLUSION</b>The OPs may have different effects on the NAF of rat cortical synaptosomes while chlorpyrifos may certainly inhibit the NAF in cortical synaptosomes of adult rats.</p>
Subject(s)
Animals , Rats , Acetylcholine , Bodily Secretions , Brain , Metabolism , Chlorpyrifos , Toxicity , In Vitro Techniques , Insecticides , Toxicity , Paraoxon , Toxicity , Receptors, Nicotinic , Physiology , Synaptosomes , MetabolismABSTRACT
<p><b>OBJECTIVE</b>To explore the mechanism of cytotoxic effects of the organophosphates (OPs) with delayed neurotoxicity on human neuroblastoma cells.</p><p><b>METHODS</b>The proliferation of neuroblastoma SH-SY5Y cells was determined by MTT spectrometry. (45)Ca uptake was determined by adding (45)CaCl(2) and tri-o-cresyl phosphate (TOCP) or methamidophos into the cultured medium for the SH-SY5Y cells. The cells were incubated and then lysed and finally counted in a Beckman LS 6000 liquid scintillation spectrometer.</p><p><b>RESULTS</b>Methamidophos stimulated the cell proliferation of SH-SY5Y at its lower concentrations (7 x 10(-7) mol/L to 7 x 10(-6) mol/L), with an increase by 28% at 7 x 10(-7) mol/L; however, it inhibited the proliferation at higher ones (7 x 10(-4) mol/L to 7 x 10(-3) mol/L) with 62% inhibition at 7 x 10(-3) mol/L. TOCP only inhibited the cell proliferation at high concentration (with 34% inhibition at 7 x 10(-3) mol/L) and markedly inhibited calcium uptake of the cells up to 55% at higher concentrations (1 x 10(-6) mol/L to 1 x 10(-4) mol/L); while the uptake was stimulated by OPs up to 241% of increase at lower concentrations (1 x 10(-9) mol/L to 1 x 10(-7) mol/L).</p><p><b>CONCLUSION</b>The interference of growth in nerve cells and disturbance of calcium homeostasis may be involved in the mechanisms of neurotoxicity of OPs.</p>