Effect analysis of PDCA cycle on prophylactic use of antibiotics in laparoscopic cholecystectomy during perioperative period / 中国药房

OBJECTIVE To evaluate the effect of PDCA cycle on prophylactic use of antibiotics in laparoscopic cholecystectomy during perioperative period and to conduct pharmacoeconomic analysis. METHODS Using retrospective analysis method， 80 discharged patients of each group underwent laparoscopic cholecystectomy were randomly selected from Hefei Second People’s Hospital before PDCA cycle （from May to June 2019）， after the first round of PDCA cycle （from May to June 2020）， after the second round of PDCA cycle （from May to June 2021） according to real or basic reasons for irrational drug use. The rationality of prophylactic use of antibiotics for patients was evaluated. The general situation， antibiotic use， clinical efficacy and treatment cost of patients were compared before cycle and after the first and second rounds of PDCA cycle. Cost-effectiveness analysis method and sensitivity analysis method were adopted to evaluate pharmacoeconomic significance of PDCA cycle. RESULTS After two rounds of PDCA cycle， the irrational rate of antibiotics， cost ratio of antibiotics， the number of days of antibiotics use， DDDs， drug utilization index， the frequency of antibiotics use per capita， the total amount of antibiotics， the cost of antibiotics， the total amount of drugs， and the total cost of hospitalization all decreased significantly （P＜0.05）. The results of cost-effectiveness analysis indicated that the pharmacoeconomic effect was the best after two rounds of PDCA cycle； the results of sensitivity analysis were consistent with it， which confirmed the reliability of the research results. CONCLUSIONS PDCA CPA- cycle promotes the rational use of antibiotics of laparoscopic cholecystectomy during perioperative period， reduces the cost of antibiotics and relieves the economic burden of patients.

Mining and analysis of risperidone adverse event signals based on FAERS database / 中国药房

OBJECTIVE To provide reference for safe use of risperidone in clinic. METHODS Data mining and analysis of risperidone-related adverse drug event （ADE） reports from the first quarter of 2017 to the third quarter of 2021 in the United States FAERS database were carried out using reported odds ratio and composite criteria methods from Medicines and Healthcare Products Regulatory Agency. RESULTS There were 101 181 ADE reports with risperidone as the primary suspect drug，involving a total of 33 179 patients. Among those reports，the male-to-female ratio was about 6.21 to 1； most of them were ＜18 years old （15.01%）； ADE was mainly reported by consumers （69.74%） and mainly reported by the United States （79.72%）； oral dosage form was the most used，accounting for 83.71%. A total of 409 ADE signals were obtained，including male breast development， pseudogynecomastia，abnormal increase in body mass，hyperprolactinemia and Wellens syndrome，etc. Twenty-six systems and organs were involved，mainly including reproductive system and breast diseases，various injuries，poisoning and operational complications， mental diseases，metabolic and nutritional diseases，and various nervous system diseases，etc. CONCLUSIONS The common ADE signals of risperidone and the system involved are consistent with the instructions，but we should also be alert to the ADE not recorded in the instruction，such as Wellens syndrome，fibroproliferative endocarditis，cavernous degeneration of portal vein，rabbit syndrome，etc.

Correlation of prolongation of PR interval with carotid atherosclerosis in middle-aged and elderly patients with type 2 diabetes mellitus / 中华内分泌代谢杂志

Objective:To investigate the relationship between prolonged PR interval and carotid atherosclerosis(CAS)in middle-aged and elderly patients with type 2 diabetes mellitus(T2DM).Methods:A total of 537 middle-aged and elderly inpatients with T2DM in the Southern Branch of the Sixth People′s Hospital of Shanghai Jiaotong University from January 2019 to January 2021 were selected as the research objects. Color Doppler ultrasound was used to detect bilateral carotid artery intima-media thickness(CIMT). The subjects were divided into carotid atherosclerosis group(CAS group, n=352)and non-carotid atherosclerosis group(NCAS group, n=185). The difference in the PR interval of ECG between the two groups was compared. Pearson or Spearman rank correlation analysis was used for evaluating the correlation of PR interval and CAS lesions with various clinical index. The relationship between PR interval and CAS lesions was adopted by multivariate logistic regression analysis. Results:The average PR interval of middle-aged and elderly patients with T2DM was(164.57±23.02)ms. The average PR interval in CAS group was significantly higher than that in NCAS group [(169.76±24.28) vs (154.70±16.42)ms, P<0.01]. The results of multifactorial logistic regression analysis showed that age, low density lipoprotein-cholesterol, serum osteocalcin, and PR interval were independent factors influencing the development of CAS lesions in middle-aged and elderly patients with T2DM( OR=1.079, 1.936, 0.879, 1.039, respectively, P<0.05 or P<0.01)where each 1 ms increase in PR interval was associated with a 3.9% increase in the risk of CAS in middle-aged and elderly patients with T2DM( OR=1.039, 95% CI 1.006-1.073, P=0.020). Multivariate logistic regression analysis showed that middle-aged and elderly type 2 diabetic patients with PR interval≥158 ms were 4.072 times more likely to have CAS lesions than those with PR interval<158 ms( OR=4.072, 95% CI 1.417-11.702, P<0.01). Conclusion:The PR interval of electrocardiogram is correlated with CAS lesions in middle-aged and elderly patients with T2DM. Middle-aged and elderly type 2 diabetic patients with significantly prolonged PR interval should be reminded to screen for CAS lesions early.

Overcoming chemotherapy resistance simultaneous drug-efflux circumvention and mitochondrial targeting

Multidrug resistance (MDR) has been considered as a huge challenge to the effective chemotherapy. Therefore, it is necessary to develop new strategies to effectively overcome MDR. Here, based on the previous research of -(2-hydroxypropyl)methacrylamide (HPMA) polymer-drug conjugates, we designed an effective system that combined drug-efflux circumvention and mitochondria targeting of anticancer drug doxorubicin (Dox). Briefly, Dox was modified with mitochondrial membrane penetrating peptide (MPP) and then attached to (HPMA) copolymers (P-M-Dox). Our study showed that macromolecular HPMA copolymers successfully bypassed drug efflux pumps and escorted Dox into resistant MCF-7/ADR cells endocytic pathway. Subsequently, the mitochondria accumulation of drugs was significantly enhanced with 11.6-fold increase by MPP modification. The excellent mitochondria targeting then resulted in significant enhancement of reactive oxygen species (ROS) as well as reduction of adenosine triphosphate (ATP) production, which could further inhibit drug efflux and resistant cancer cell growth. By reversing Dox resistance, P-M-Dox achieved much better suppression in the growth of 3D MCF-7/ADR tumor spheroids compared with free Dox. Hence, our study provides a promising approach to treat drug-resistant cancer through simultaneous drug efflux circumvention and direct mitochondria delivery.

The incidence of hashimoto's thyroiditis in medical examination population in Huanghua City, Hebei Province / 中华地方病学杂志

Objective To understand the detection rate of hashimoto's thyroiditis (HT) and the occurrence of abnormal thyroid function in medical examination population in Huanghua City,Hebei Province.Methods Using the retrospective analysis method,the thyroid examination data of residents of Huanghua City who were examined in the Cangzhou Hospital of Traditional Chinese and Western Medicine in Hebei Province from 2014 to 2016 were collected,the detection rate of HT and the occurrence of abnormal thyroid function were analyzed.Results A total of 4 413 people were examined,aged (45.76 ± 10.13) years old;including 2 099 males and 2 314 females.The HT detection rate of the medical examination population in Huanghua City was 6.55％ (289/4 413),and there was a trend of increasing year by year (x2trend =7.126,P ＜ 0.05).The difference in HT detection rates between different genders (male:2.86％,famale:9.90％) was statistically significant (x2 =89.077,P ＜ 0.05);there was a statistically significant difference in the HT detection rates among women of different age groups (x2 =18.541,P ＜ 0.05),and there was no significant difference in the detection rates of HT among men of different age groups (x2 =8.424,P ＞ 0.05).The incidence of abnormal thyroid function in HT patients was 25.61％ (74/289),of which the highest detection rate was 34.74％ (33/95) in the 40-＜ 50 years old group;the detection rates of HT with hyperthyroidism,hypothyroidism and subclinical hypothyroidism were 3.11％ (9/289),6.57％ (19/289) and 15.92％ (46/289),respectively.The detection rate of HT with subclinical hypothyroidism was higher.Conclusions The HT detection rate of the population in Huanghua City has increased year by year,and some HT patients are associated with abnormal thyroid function,and their detection rate of HT with subclinical hypothyroidism is the highest.Early diagnosis of HT should be strengthened,and appropriate prevention and treatment measures should be taken in time to reduce the occurrence of HT with abnormal thyroid function.

Effects of remote team nursing support on patients with brain tumor in release their negative emotions and improve their quality of life / 中国实用护理杂志

Objective To explore the effect of nursing support on negative emotion and quality of life in patients with brain tumor. Methods A total of 139 cases of brain tumor in Shandong Provincial Cancer Hospital of Shandong University from September 2014 to February 2016 by convenient sampling , according to the random number table, they were divided into the control group and the intervention group. The patients in the control group were given routine discharge follow-up, while the patients in the intervention group were given emote team nursing support on the basis of the control group. We used anxiety self rating scale (SAS), depression self rating scale (SDS) and quality of life assessment scale (QLICP-BN) evaluation two groups of patients with anxiety, depression and quality of life level in the patients when they were discharged from hospital and discharged after 1 month, 3 months. Results Comparing the two groups of patients with anxiety and depression level and quality of life in the hospital, there was no statistically significant difference (t=0.187,0.174, P > 0.05);1 month after discharge, the scores of SAS and SDS respectively (62.97 ± 485), (63.83 ± 5.24) points in the intervention group, the scores of SAS and SDS respectively (64.58 ± 5.15), (65.17 ± 5.11) points in the control group, the difference is statistically significant (t=2.753, 2.321, P<0.05);3 month after discharge, the scores of SAS and SDS respectively(61.04±4.13),(62.25±3.95)points in the intervention group, the scores of SAS and SDS respectively(63.91 ± 4.73),(64.83 ± 4.29)points in the control group, the difference is statistically significant (t=4.621,5.196, P < 0.01); 1month, 3 months after discharge, the total quality of life scores respectively (65.28 ± 12.53), (68.71 ± 12.78) points in the intervention group, the total quality of life scores respectively (62.07 ± 11.27), (63.86 ± 12.13) points in the control group, the difference is statistically significant (t=2.439, 3.803, P < 0.01). The intervention effects and time effects of anxiety, depression and quality of life were statistically significant (W Mauchly's were 0.823, 0.782, 0.757, P <0.05). Conclusions Remote team nursing support can effectively reduce the negative emotions of patients with brain tumor, improve the quality of life, can be used in the department to promote the quality of clinical care.

Optimization of the Formula and Preparation Technology of Demethoxycurcumin Nano-structured Lipid Carriers / 中国药师

Objective:To screen the optimal formula and technology of demethoxycurcumin nano-structured lipid carriers. Meth-ods:The encapsulation efficiency as the main investigation index, the single factor exploration and orthogonal design were used to study the main factors affecting the quality of the nanoparticles. The optimal formula and technology were obtained. Results:The optimized parameters were as follows:the ratio of drug to lipid materials was 1 ∶40, the ratio of liquid lipid to total lipid materials was 10%, the amount of surfactants was 4% and the amount of lecithin was 2%. The prepared nanoparticles were spheric and regular. The size dis-tribution of the nanoparticles was narrow with the average particle size of 110nm and PDI of 0. 199. Conclusion:The optimized formula and technology of demethoxycurcumin nano-structured lipid carriers are stable and practicable,which provide reference for the further research of demethoxycurcumin.

Analysis on drug resistance of Staphylococcus aureus between 2006 and 2011 / 国际检验医学杂志

Objective To study the drug resistance of Staphylococcus aureus in 2006 -2011 ,and to provide the evidence for treatment infection .Methods The isolated bacteria were identified and antibiotic sensitivity were tested by automated system in 503 Staphylococcus aureus collected from 2006 to 2011 .Methicillin resistant Staphylococcus aureus(MRSA) was screened by oxacillin disk diffusion .Results 503 strains mainly derived from secretion and sputum .The incidence of MRSA was 44 .9% during 6 years . Detection rate of MRSA was decreased year by year .The difference was statistically significant between 2009 ,2010 ,2011 and 2006 , 2007 ,2008(P<0 .05) .No resistance to quinupristin/dalfopristin ,linezoiid ,vancomycin and nitrofurantoin was found .The resistance of Staphylococcus aureus was below 30% to levofloxacin ,imipenem ,compound sulfamethoxazole and rifampicin ,above 80% to ce-fazolin and penicillin .Although the resistant to cefazolin ,levofloxacin ,imipenem was risen ,the resistant rate of rest antibiotics was downed year after year .Conclusion Monitoring of drug resistance should be strengthened .The antimicrobial therapy should be de-fined on the basis of drug-sensitive test in order to control the incidence of infection and to delay the growth of clinical resistant strains of Staphylococcus aureus .

Research Progress in Dosage Forms of Tetrandrine / 中国药师

Tetrandrinehasawiderangeofpharmacologicaleffectssuchasanti-inflammation,analgesiceffect,anti-tumor,anti-silicosis, lowering blood pressure and anti-arrhythmia. Up till now, only tablets and ordinary injections are on the market, which is hard to meet the clinical requirements. The paper reviewed the research progress in the new technology and dosage forms of tetrandrine to provide the basis for new dosage form development of tetrandrine.

Study on Regular Acupoint Selection for Cervical Vertigo Treatment / 世界科学技术-中医药现代化

This review tried to find regular acupointselection in the treatment of cervical vertigo through literature search. Bibliometric analysis and data mining were referenced. There were a total of 42 relative articles, which cov-ered 86 acupoints, with thefrequency of 382. The acupointsselection of the highest frequency were GB20-Fengchi, EX-Jingjiaji, DU20-Baihui. It was concluded that study on the regular acupoint selection in the treatment of cervical vertigo providedbasis for rational clinical acupoint combination. It had important meaning in the standardization and research of cervical vertigo.

Effects of oldhamianoside Ⅱ on the invasive ability of prostatic carcinoma cells / 国际肿瘤学杂志

Objective To observe the effects of oldhamianoside Ⅱ on the invasive 'ability of prostatic carcinoma DU-145 cells,and to investigate the potential mechanism.Methods After treatment of DU-145 cells with oldhamianoside Ⅱ,MTT assay was used to test the effect of oldhamianoside Ⅱ on the cell proliferation.The invasive ability was assessed with a transwell cell culture chamber.Immunocytochemistry stain was used to investigate the expression of matrix metalloproteinase(MMP-2)and CXC-chemokine receptor 4 (CXCR4).Results The proliferation of DU-145 cells was inhibited after treatment with oldhamianoside Ⅱ.In vitro invasion assay indicated that the cells moved through the membrane were(180.3 ± 14.6)/field in the control group,while decreased to(100.4 ±1.5),(80.2±2.7)and(60.1 ±5.3)/field in 0.25,0.5 and 1μg/mL oldhamianoside Ⅱ treated DU-145 cells respectively.Comparing to control group,the cells of oldhamianoside Ⅱ groups moved through the membrane were decreased remarkably(P ＜0.05).Immunocytochemistry showed that the expression of MMP-2 and CXCR4 were decreased of oldhamianoside Ⅱ groups.Conclusions Oldhamianoside Ⅱ can inhibit the invasiveness of DU-145 cells,which is related to the down regulation the expression of MMP-2 in DU-t45 cells.Oldhamianoside Ⅱ can inhibit the prostate cancer cells metastasis to the bone,which is related to the down regulation the expression of CXCR4 in DU-145 cells.

Expressions of programmed death 1 and programmed death ligand 1 in rat model of acute liver failure / 中华传染病杂志

Objective To study the expressions of programmed death 1 (PD-1) and programmed death ligand 1 (PD-L1) in liver injury of acute liver failure (ALF) in rats and the role of PD-1/ PD-L1 in liver inflammatory injury. Methods SD rats were divided into two groups: 6 in normal group and 30 in ALF model group. The ALF models in rats were induced by D-galactosamine (D-Gal). The sera and hepatic tissue samples were collected at 12, 24, 48, 72 and 120 hours after D-Gal injection. Expressions of PD-1 mRNA and PD-L1 mRNA in hepatic tissue samples were detected by reverse transcription-polymerase chain reaction (RT-PCR). Comparison of measurement data between groups was done by t test. Correlation test was performed using Pearson linear correlation analysis. Results The levels of alanine animotransferase (ALT) and aspartate animotransferase (AST) at 12 h of D-Gal injection were (217. 3±33. 7) U/L and (397. 2± 101.3) U/L, respectively,which were both significantly higher than those in normal group [(30. 5 ±3. 1) U/L and (78. 6±4.2) U/L, respectively; t=-8. 921 and -6. 121, respectively; both P＜0.01] and peaked at 48 h.The expression of PD-1 mRNA in model group at 12 h (0. 385±0. 074) was significantly higher than that in normal group (0. 097±0.009) (t= -7. 725, P＜0.01) , and peaked at 48 h (0. 927±0. 132),then decreased obviously at 72 h. The expression of PD-L1 mRNA in the liver tissue of normal rats was very little, while that in model group was increased gradually over time, then peaked at 48 h (0. 593±0. 105; t =- 10. 076, P＜0. 01). The expressions of PD-1 and PD-L1 were positively correlated with ALT level (r=0. 807 and 0. 792, respectively; both P＜0. 01). Conclusion The expressions of PD-1/PD-L1 may play an important role in liver inflammatory injury in rat model of acute liver failure.

Surveillance & management of out-of-plan re-operations / 中华医院管理杂志

A series of surveillance and management actions was taken to minimize out-of-plan re-operations. These actions include: 1) Building and completing the surveillance and management mechanism against unplanned re-operations; 2) Building a real-time surveillance and reporting mechanism; 3) Enhancing quality control and continuous improvement at the operating departments; 4) Enhancing the supervision on regulations implementation by quality control departments of the hospital; 5) Enhancing quality control for medical records; 6) Building a feedback mechanism for surveillance results; 7) Building a penalty and reward mechanism. Efforts for one year and a half on such surveillance and management proved successful, as the incidence of out-of-plan re-operations fell from 1.7% before these actions to 1.0% afterwards.

Expression of stromlysin in breast cancer tissue and its relationship with microvessel density / 中国综合临床

Objective To investigate the relationship between the biological characteristics and the expres-sion of stromlysin (MMP-7) and microvessel density (MVD) in breast cancer tissue and the effect of MMP-7 on MVD of breast cancer. Methods 60 fresh samples were obtained from patients with breast cancer,and then the ex-pression of MMP-7 and vascular endothelial cell CD34 were studied by means of immunohistochemical assay (SP method). The relationship between MMP-7, MVD and age, tumor size, histological type, lymph node metastasis and expression of ER, PR, PCNA, p53 and CerbB2 was studied. The relationship between the biological characteristics and the expression of MMP-7 and MVD in breast cancer were evaluated. Results The positive expression rote of MMP-7 in the d>2 cm group,the group with lymph node metastasis,the group with positive expression of PCNA, p53 and C-erbB-2 (78.1%,74.2%,71.8%,67.6% and 72.2%)were all higher than that in the d≤2 cm group, the group without lymph node metastasis,the group without positive expression of PCNA,p53 and C-erbB-2(32.1%, 41.3%,38.1%,38.5% and 33.3%) (P<0.05). MVD was higher in the positive breast cancer tissue of the group of d>2 cm(34.61±6.97), the group with lymph node metastasis (34.37±7.50), PCNA ( 33.24±8.39), p53 (33.28±8.94), C-erbB-2 (33.55±8.57) than in the negative breast cancer tissue of the d≤2 cm group ( 28.60±9.82), the group without lymph node metastasis (27.48±8.66), PCNA (26.88±7.89), p53 (21.71± 7.59),C-erbB-2(27.42±27.69) (P<0.05). MVD(33.62±7.36)/ high power lens in the MMP-7 positive group was higher than that (27.86±9.45)/high power lens in the MMP-7 of negative group(P<0.05). The posi-tive expression of MMP-7 was correlated with MVD (r=0.380, P<0.05). Conclusion The high expression of MMP-7 and MVD is associated with the development and metastasis of breast cancer. MMP-7 could promote the mi-crovessel development in mammary cancer.

Analysis of antibiotic-resistant gene mecA and pathogenic genes in Staphylococcus aureus / 中国感染与化疗杂志

Objective To investigate the antibiotic-resistant gene mecA and the prevalence of Panton-Valentine leukocidin (PVL) gene, toxic shock syndrome toxin (TSST-Ⅰ) gene in S. aureus. Methods A total of 74 S. aureus were collected from clinical specimens. The mecA, PVL and TSST-Ⅰ genes were detected by PCR.Results PVL gene was identified in 22 S. aureus isolates. The prevalence of PVL was 29.7% in S. aureus, 36.6% in MRSA and 21.2% in MSSA. The difference was not statistically significant (P>0.05). The prevalence of MRSA was 55.4% in 74 S. aureus. The prevalence of TSST-Ⅰ gene was 6.8%. TSST-Ⅰ gene was not detected in MSSA.Conclusions MRSA strains show highly resistant to antibiotics. PVL- and TSST-Ⅰ-positive S. aureus are more pathogenic.

Treatment of femoral neck fractures with posterolateral mini-incision total hip arthroplasty / 中华创伤杂志

Objective To introduce the experience of improved posterolateral mini-incision total hip urthroplasty(THA)in treatment of femoral neck fractures.Methods Of 199 patients(207 hips)treated with preliminary THA from October2002 to January 2005,them were46 patients(46 hips)with femoral neck fractures including31 fresh fractures and 15 old ones,which were then treated with posterolateral mini-incision THA.An observation was done on length of incision,operation time,volume of blood loss,drainage volume,hospital stays,postoperative complications,functional recovery and Harris score.Results All patients were followed up for 14-26 months(mean 17.2 months).The final Harris score during follow-up was(84.1±8.6)points in the fresh fracture group and(85.8±7.6)points in the old fracture group.Pestoperative X-ray showed sound position of the prosthesis.There was no statistical difference upon length of incision,operation time,blood loss,drainage volume and hospital stays between fresh fracture group and old fracture group(P＞0.05).Dislocation occurred in one patient in each group.Conclusion Posterolateral mini-incision THA is proved to be successful in reducing surgical trauma,accelerating rehabilitation and decreasing blood loss and complications for patients with femoral neck fractures.

Treatment of acute liver failure by xeno-transplantation of co-microencapsulated Sertoli cells and hepatocytes / 中华传染病杂志

Objective To evaluate the treatment effect of acute liver failure(ALF) by xeno-transplantation of co-microencapsulated Sertoli cells and hepatocytes and the intraperitoneal immune privilege effects of Sertoli cells on hepatocytes. Methods ALF rats were induced by intraperitoneal injection of D-galactosamine and, thereafter, were treated with physical saline, free hepatocytes, microencapsulated hepatocytes, or co-microencapsulated Sertoli cells and hepatocytes (CMSH), respectively. Alanine aminotransferase (ALT), aspartate aminotransferase (AST) and total bilirubin (TBil) were detected in rats' blood samples from various groups. Expression of Smac/Diablo and caspase-3 were determined by reverse transcription-polymerase chain reaction (RT-PCR). Fifteen rats in each group were used for survival rate analysis. The intraperitoneal microencapsules were observed and lymphocytes in ascites were counted. The data were analyzed by multi-factor or single factor analysis of variance and the comparison between groups was done by t test. Results In CMSH treatment group, ALT level decreased to (533.7 ± 76.5) U/L, AST level decreased to (381.2 5± 46.7) U/L after 48 h. TBil level reduced to (7.36 ± 2.18) μmol/L after 72 h. Albumin level increased to (28.4±2.5) g/L after 48 h. All these values were significantly different from those in other groups (F=10.7,6.5,12.2,8.4;P＜0.05). The expression levels of Smae/Diablo and caspase-3 mRNA at 48 h and 72 h were lower in CMSH group than in other groups (F=3.7,4.8,3.6,4.2; P＜0.05). Survival rates in microencapsulated hepatocytes group and CMSH group were similar while both of them were higher than other groups. Microencapsules neither in microencapsulated hepatocytes group nor in CMSH group were adhered to intraperitoneal mucosa. Lymphocyte counts in ascites of CMSH group were lower than those in microencapsulated hepatocytes group (t= 4.21, P＜0. 05). Conclusions Intraperitoneal transplantation with CMSH is a promising approach for ALF treatment. Furthermore, Sertoli cells can help reduce lymphocytes' aggregation caused by encapsulated hepatocytes in ascites.

Expression and significance of Fractalkine in rat model of acute liver failure / 中华传染病杂志

Objective To investigate the changes of fractalkine (FKN) in rat model of acute liver failure (ALF) and the role of FKN in liver inflammatory injury.Methods SD rats were divided into tWO groups:6 in normal group and 36 in model group.D-galactosamine(D-Gal) was used to induce ALF in model group.The sera and hepatic tissue samples were collected at 12,24,48,72,120 andl68 h.After D-Gal injection.FKN mRNA and nuclear factor(NF)-kB mRNA in hepatic tissue samples were detected by reverse transcription-polymerase chain reaction (RT-PCR).Results The levels of alanine aminotransferase (ALT) and aspartate aminotransferase (AST) at 12 h were(208.3±43.5)U/L and (375.2±117.3)lJ/L,respectively,which were both significantly higher than those in normal group[(31.8±2.9)U/L and (90.8±3.1)U/L](t=-9.912 and-5.935,respectively,both P<0.01);the levels of ALT and AST peaked at 72 h after D-Gal injection.The levels of FKN mRNA(O.086±0.009)in model group at 12 h were significantly higher than those (O.044±0.009) in normal group(t=-7.999.P<0.01),and peaked at 72 h (O.333±0.033),then decreased obviously at 120 h. The levels of NF-KB mRNA in the liver of normal rats were very little;and the levels in model group were increased gradually over time,then peaked at 72 h (O.583±0.i01,t=-12.607,P<0.01).FKN mRNA and NF0kB mRNA were positively correlated (r=0.760,P<0.01).Conclusion The FKN expression may play all important role in liver inflammatory injury in rat model of acute liver failure, which could provide a new approach for ALF therapy.

Investigation of the knowledge about cancer pain treatment among 128 nurses in 27 provinces in China: an analysis of the questionnaires / 中国组织工程研究

BACKGROUND: After reviewing the literature, the author found that most of the epidemiological data related to cancer pain was reported by physicians from the point of view of treatment, or of patients' response to the treatment. Although the nurses in oncology department are most direct participants in the cancer pain management, there is less investigation about the nurses' knowledge, attitudes to and skills of cancer pain management.OBJECTIVE: The purpose of this investigation was to provide information so as to suggest the nursing managers and educators in specifically propagating and disseminating the knowledge of cancer pain management.DESIGN: A sampled investigation.SETTING: Integrated Medicine Ward, College of Clinical Oncology,Peking University.PARTICIPANTS: The participants of this investigation were 128 nurses who took part in the National Tumor Care Academic Exchanges and Seminar Conference held in June 1998.METHODS: This investigation was carried out through a survey questionnaire and the questionnaire was designed on the basis of the Cancer Analgesics Questionnaire (for nurses use only) established by the Oncology Profession Committee of Chinese Nursing Association in 1993, furthermore,suggestions from experts were adopted.MAIN OUTCOME MEASURES:①The perception about "three-step analgesic ladder";②currently most commonly used analgesics in clinical;③assessment methods for cancer pain④knowledge of being addicted to analgesics⑤attitude of nursing staff to cancer pain management.RESULTS: The number of those who could correctly designate the relationship of three steps and pain intensity was 82(64.0% ). Only one person could correctly write down the contents of three steps analgesic ladder (0.7%) . Physician's orders for analgesics for cancer pain in the responders' hospitals were classified into the following types: temporary order:54.0%; when necessary, 38.0%; long-term order, 24.0%. But none of the nurses could mark correctly the range of mild, moderate and severe grade on the scale. Only 49.2% (63/128) of the nurses considered that "The pain scale should be determined according to the cancer patients' self-perception to the pain intensity(chief complaint)" . Among the responders, only 12.5% (16/128) of them accepted that "the incidence of addiction occurred as a result of analgesics used for pain control is less than 1% ". Only 26. 5% (34/128) of the responders could distinguish the concepts of tolerance, physical dependence, and addiction.CONCLUSION: From the results of the investigation, we can see that, the nursing professionals do not have sufficient knowledge about "three-step analgesic ladder". The popularization of related knowledge among nurses has been delayed severely. Nurses will obtain the knowledge of cancer pain management by clinical experience instead of in regular ways. The attitude of nursing personnel to cancer pain treatment is one of the important factors that affect the pain management. The frontline nurses should master the pharmacological characteristics of opioids so as to explain it to the patients and their relations distinctly. Nurses should bring into play a more powerful action in reducing the "addiction-phobia" due to their professional characteristics. We suggest that the latest new progress in cancer pain treatment should be incorporated into the normal textbooks on the management of cancer pain. We also propose that the methods of cancer pain treatment,contents of the principle of drug prescription be included in the training of a medical care personnel of oncology professional before entering into clinic.