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ObjectiveTo establish the quality standard for Fraxini Cortex（Fraxinus chinensis） dispensing granules based on standard decoction， and to provide a basis for the quality control of this dispensing granules. MethodHigh performance liquid chromatography（HPLC） specific chromatograms of 15 batches of Fraxini Cortex（F. chinensis） standard decoctions and 3 batches of Fraxini Cortex（F. chinensis） dispensing granules were established with the mobile phase of 0.1% phosphoric acid aqueous solution（A）-acetonitrile（B） for gradient elution（0-10 min， 12%-15%B； 10-30 min， 15%-32%B） and the detection wavelength of 220 nm. And similarity evaluation， cluster analysis and principal component analysis（PCA） were also carried out. HPLC quantitative analysis of multi-components by single marker（QAMS） was established to determine the contents of the main components in the standard decoctions and dispensing granules. The contents of the corresponding components in Fraxini Cortex（F. chinensis） decoction pieces were also detected， and the transfer rates from decoction pieces to standard decoctions and dispensing granules were calculated. ResultThe similarities between specific chromatograms of 15 batches of Fraxini Cortex（F. chinensis） standard decoctions and 3 batches of Fraxini Cortex（F. chinensis） dispensing granules were all>0.9， and 7 common peaks were identified. The results of cluster analysis and PCA showed that there was some differences in the composition of different batches of standard decoctions， but did not show aggregation of origin. As the standard decoctions， the extract rate was 6.18%-11.62%， the contents of esculin， syringin， fraxin， esculetin， fraxetin， calceolarioside B were 44.92-103.51， 1.36-11.87， 33.26-90.73， 4.63-29.75， 2.40-16.86， 2.49-17.35 mg·g-1， and the transfer rates from decoction pieces to standard decoction were 25.21%-42.54%， 52.57%-88.84%， 43.43%-79.45%， 49.15%-88.27%， 49.22%-72.69%， 27.66%-47.67%， respectively. The extract rates of Fraxini Cortex（F. chinensis） dispensing granules were 10.4%-10.7%， the transfer rates of the above six components from decoction pieces to dispensing granules were 42.76%-43.17%， 80.01%-80.90%， 59.59%-59.88%， 51.35%-52.67%， 60.50%-60.93%， 37.98%-38.37%， respectively， which were generally consistent with the transfer rates from decoction pieces to standard decoctions. ConclusionThe established quality control standard of Fraxini Cortex（F. chinensis） dispensing granules based on standard decoctions is reasonable and reliable， which can provide reference for the quality control and process research of this dispensing granules.
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After the completion of the pilot work of traditional Chinese medicine formula granules （TCMFGs）， the national and provincial medical products administrations have published and implemented about 440 varieties of TCMFGs standards. Based on the previous work， this paper analyzed technical problems encountered in the review and evaluation of Shandong TCMFGs standards， mainly involving the executive standards and distinguishing technologies of raw materials， the adding process of excipients in the procedure item， the rationality of quality control methods， the information content and reproducibility of characteristic chromatograms， the nomenclature and accessibility of reference materials， etc. The common problems such as the coverage of standards， specification differences， and the integrity of quality control items of current TCMFGs standards were discussed deeply. It is proposed to promote the upgrading of provincial standards to national standards， accelerate the research and development of reference materials， advocate the use of high-quality raw materials， explore the evaluation methods of high-quality products， and strengthen the quality supervision of the whole process. Suggestions of this paper is hoped to provide references for the formulation of national and provincial TCMFGs standards， promote the continuous improvement of TCMFGs standard system， and ensure the healthy and orderly development of the TCMFGs industry.
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OBJECTIVE： To establish HPLC fingerprint of Nüjin pills， and to conduct cluster analysis and principal component analysis. METHODS： HPLC method was adopted. The determination was carried out on Agilent ZORBAX Eclipse Plus C18 column with mobile phase consisted of acetonitrile-0.2％ formic acid solution （gradient elution） at the flow rate of 1.0 mL/min. The detection wavelength was set at 270 nm， and column temperature was 30 ℃. The sample size was 10 μL. Using baicalin as reference， HPLC fingerprints of 10 batches of samples were determined. The similarity of 10 batches of samples was evaluated by TCM Chromatographic Fingerprint Similarity Evaluation System （2012 edition） to confirm common peak. Cluster analysis and principal component analysis were performed by using SPSS 22.0 software. RESULTS： There were 21 common peaks in HPLC chromatograms of 10 batches of samples， the similarity of which was all over 0.95， which indicated that in 10 batches of samples， the chemical composition was consistent， but the contents of these components were different. When euclidean distance was equal to 25，10 batches of sample were divided into two categories； S3 was included in the first category， and others were included in the second category. When euclidean distance was equal to 5， the second category could be divided into three sub-categories， one sub-category was S2， S4， S6 and S10； one sub-category was S5， S9； one sub-category was S1， S7， S8. Through the principal component analysis， the cumulative contribution rate of three main component factors was 90.642％， and comprehensive score of S3 was the highest with the best quality. CONCLUSIONS： Established HPLC fingerprint， the results of cluster analysis and principal component analysis can provide reference for quality evaluation of Nüjin pills.
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OBJECTIVE:To develop a method for simultaneous determination of chlorogenic acid,baicalin,aloe emodin,rhe-in,emodin,chrysophanol and physcione in Kangjun xiaoyan tablets. METHODS:RP-HPLC method was adopted. The determina-tion was performed on Agilent Extend C18 with mobile phase consisted of acetonitrile-0.5% phosohoric acid solution(gradient elu-tion)at the flow rate of 1.0 mL/min. The detection wavelengths were set at 327 nm(chlorogenic acid),280 nm(baicalin)and 450 nm(aloe emodin,rhein,emodin,chrysophanol,physcione). The column temperature was 30℃,and sample size was 10μL. RE-SULTS:The linear ranges of chlorogenic acid,baicalin,aloe emodin,rhein,emodin,chrysophanol and physcione were 0.2094-4.1880μg(r=0.9999),0.3720-7.4400 μg(r=0.9999),0.0063-0.1262 μg(r=0.9999),0.0116-0.2322 μg(r=0.9999),0.0053-0.1060 μg(r=0.9998),0.0128-0.2564 μg(r=0.9999),0.0165-0.3303 μg(r=0.9998),respectively. The limits of quantita-tion were 2.01,1.93,0.76,1.25,1.24,0.53 and 1.53 ng;the limits of detection were 0.98,0.65,0.25,0.42,0.41,0.18 and 0.52 ng,respectively. The recoveries were 98.41%-100.40%(RSD=0.76%,n=9),96.17%-100.10%(RSD=1.58%,n=9), 96.11%-100.10%(RSD=1.33%,n=9),96.29%-100.80%(RSD=1.85%,n=9),96.88%-100.10%(RSD=1.22%,n=9), 97.81%-101.90%(RSD=1.64%,n=9),96.46%-101.30%(RSD=1.85%,n=9),respectively. CONCLUSIONS:The method is accurate,reliable and reproducible. It can be used for simultaneous determination of 7 components in Kangjun xiaoyan tablets.
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Objective To explore the clinical efficacy and safety of leflunomide combined with prednisone in the treatment of immunoglobulin A nephropathy.Methods 80 patients with IgA nephropathy were chosen and randomly divided into two groups,40 cases in each group.The control group was orally given prednisone(initial dose 1 mg · kg-1 · d-1),after 2 months of treatment 5mg/2 weeks reduction,and 10mg/d as maintenance therapy,while the observation group was treated with 20mg/d leflunomide treatment based on the treatment of control group.All the two groups had 3 months as a course of treatment.Before treatment and after treatment,the 24h urinary protein,serum albumin,serum creatinine,glomerular filtration rate,cholesterol,triglycerides,cystatin C levels and urinary vascular cell adhesion molecule-1 after treatment (urinary VCAM-1) and interleukin-18 (IL-8) in the two groups were recorded and compared,as well as the clinical efficacy and adverse reactions.Results The total effective rate in the observation group was 92.5％,which was significantly higher than 75.0％ in the control group (x2 =4.501,P ＜ 0.05).After treatment,the serum creatinine,serum albumin,cholesterol,triglycerides,cystatin C,24h urine protein,glomerular filtration rate and urinary VCAM-1,IL-8 in the two groups were all significantly improved (t ≥ 1.945,all P ＜ 0.05).After treatment,the cholesterol and triglycerides in the two groups had no significant differences (t =0.322,1.307,all P ＞ 0.05).After treatment,in the observation group,the serum creatinine,cystatin C,24h urinary protein excretion,VCAM-1 and IL-8 in urine were significantly lower than those in the control group,while serum albumin and glomerular filtration rate were significantly higher (t ≥2.632,all P ＜ 0.05).In the observation group,the total effective rate of Ⅳ,Ⅴ grade by Lee classification were significantly higher (x2 =4.269,4.600,all P ＜ 0.05).And in the two groups,the total effective rate of Ⅰ,Ⅱ grade by Lee classification had no statistically significant differences(x2 =0.000,0.000,all P ＞0.05).In the observation group,the incidence rate of adverse reaction was 10.0％,that in the control group was 8.6％,there was no statistically significant difference between the two groups (x2 =0.157,P ＞ 0.05).Conclusion Leflunomide combined with prednisone in the treatment of IgA nephropathy has better clinical efficacy and higher safety,its mechanism may be associated with decreased urinary VCAM-1 and serum IL-18 levels.
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Objective To discuss the curative effects of alfacalcidol combined with losartan potassium tablets in the treatment of early diabetic nephropathy (EDN).Methods 90 EDN patients in our hospital were chosen and randomly divided into the observation group and control group (45 cases in each group).The control group was given losartan potassium tablets treatment,while the observation group was given alfacalcidol combiend with telmisartan treatment.All the two groups were treated for 3 months.Before and after treatment,the fasting blood glucose (FBG), 24h urine trace albumin quantitative (UAER),24h urine protein (24h pro),serum creatinine (SCr),25 -hydroxyl vitamin D [2 5 (OH )D ],blood calcium (Ca2+),potassium (K+),glycosylated hemoglobin (HbA 1 C )and serum inflammatory factors[C-reactive protein (CRP),tumor necrosis factor alpha (TNF-α),interleukin-6 (IL-6 )] were observed,and the correlation between 25 (OH)D and UAER,24h pro was analyzed.At the same time,the clinical curative effects and adverse reactions during treatment were evaluated.Results In the observation group,the total effective rate was 93.3%,which was significantly higher than 71.1% in the control group (χ2 =7.601,P0.05).After treatment,Scr,24h pro and UAER in the two groups were all significantly reduced compared with before treatment (P0.331).After treatment,25(OH)D in the observation group decreased significantly compared with before treatment (t=12.000,P0.436).Pearson correlation analysis showed that 25 (OH)D level was negatively correlated with 24h pro and UAER (r=0.483,0.778,all P0.151 ).Conclusion Alfacalcidol combined with losartan potassium tablets can significantly reduce the proteinuria levels of EDN patients and inflammation,which has better clinical curative effects and higher safety.
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Objective To observe the clinical efficacy and safety of prednisone and mycophenolate mofetil in treatment of IgA mesangial proliferative glomerulonephritis.Methods Ninety-six cases of IgA mesangial proliferative glomerulonephritis were divided into control group and treatment group with 48 cases each.The patients in two groups were given conventional treatment and prednisone [prednisone usage of 0.5mg/ (kg ·d),4 weeks after the gradual reduction of weekly 5-10 mg/d].On this basis,the patients in treatment group were given mycophenolate mofetil [1.5 g/d (before 6 months) ; 1.0 g/d (6-12 months) ; 0.5g/d (12 months)].The clinical efficacy,physiological indicator and adverse reactions in two groups were observed.Results The total effective rate was 87.5％(42/48) in treatment group and 60.4％ (29/48) in control group,and there was significant difference (P ＜0.05).There was no significant difference in the physiological indicator before treatment between two groups (P ＞ 0.05).The urine volume,urine protein,albumin,blood creatinine and total cholesterol after treatment in treatment group was improved compared with that in control group [(1812 ± 355) ml/24 h vs.(1365 ± 287) ml/24 h,(2.2 ± 0.6) g/24 h vs.(3.3 ±0.6) g/24 h,(30.2 ±3.1) g/L vs.(21.9 ±4.6) g/L,(116.5 ±9.9) μmol/L vs.(143.5 ± 10.6) μmol/L,(4.7 ± 0.8) mmol/L vs.(5.8 ± 0.7) mmol/L],and there was significant difference (P ＜ 0.05).There were no serious adverse reactions in the beth groups.Conclusion Prednisone and mycophenolate mofetil can improve renal function in patients with IgA mesangial proliferative glomerulonephritis and achieve better clinical efficacy with less adverse reactions.It should be widely applied.
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Problem-based learning (PBL) teaching method can improve students' ability of study,analysis and problem-solving.Network platform based PBL teaching mode combines the network education and PBL teaching mode; it has clear superiority in information acquisition,communication and transmission.Furthermore,it can also solve the problem of inadequate teaching sources.Network platform based PBL teaching mode was applied in neurology teaching to investigate the best scheme and form for teaching plan compilation,network platform building-up and teaching process implementation.At the same time,teaching effect was evaluated and summarized in an aim to improving neurology teaching quality and speeding up the reform of network-based PBL teaching.
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@#ObjectiveTo analyse the requirement and attitude to mental health knowledge and the influence factors among the psychosis patients, the caregivers and the healthy pepople.MethodsThe questionnaire survey conducted among the psychosis patients, the caregivers and the healthy pepople from 12 communities which served as the stations for the psychosis where 12 prefectures were organized uniformly by Guangdong Provincial Federation of Disabled Persons.Results1080 sheets of questionnaire were provided, and 986 replied to meet the requirements. The caregivers showed significant difference in requirment and attitude to mental health knowledge compared to the psychosis patients and the healthy pepople(P＜0.05-0.001). The main influence factors were cultural education, regional economic, the frequency of inpatient, the anxiety emotion of the caregivers, which were statistical significance(P＜0.05-0.001).ConclusionIt is lack in the requirement and cognition to mental health knowledge among the psychosis patients, the caregivers and the healthy pepople. Cultural education and economic development are the effective measures to improve the level of the mental health knowledge.
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Objective To evaluate the effect of combination treatment by psychological intervention and a new atypical antipsychotic Paliperidone extended-release tablets(paliperidone ER)on first-episode schizophrenic out-patients.Methods All 62 patients diagnosed as first-episode schizophrenia by DSM-Ⅳ were randomly allocated into,combination treatment group and control group,for a 12-month treatment study.The combination treatment group was treated by paliperidone ER once a day and psychological counseling once a month,while the control group was treated only by paliperidone ER.The efficacy and social function were assessed by Positive and Negative Syndrome Scale(PANSS)and Personal and Social Performance Scale(PSP)individually at baseline,and following 1,3,6,9,12 months.The remission rate was calculated at the end of the 3rd,6th,9th month.The safety and tolerability were assessed using Barnes Akathisia Scale(BARS),extrapyramidal side effects scale(SAS)and involuntary movement scale(AIMS).Results Twenty-seven patients of combination treatment group and seventeen patients of the control group completed the trial with the discontinuation rate 12.9% and 45.2%,respectively.The difference between the above two groups was statistically significant(P＜0.05).The mean total score of PANSS and the PSP of the both groups were significantly improved(P＜0.05)after treatment.PANSS total score reduced more than 30% compared with baseline,and PSP total score increased more than 7.The remission rate of combination treatment group was 74.2%,51.6% and 67.7% at the end of 3rd,6th,and 9th month,which was better than the control group(45.2%,38.7% and 38.7%)(P＜0.05).Both incidence and types of adverse events were almost same between the two groups.The major adverse events were extrapyramidal symptoms,tachycardia,gastrointestinal discomfort and akathisia.Conclusion Paliperidone ER treatment combined with psychological intervention on first-episode schizophrenia out-patients can improve their treatment compliance by reducing the discontinuation rate.And this combination treatment can increase the remission rate and improve social functioning of the patients.
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Objective To analyze the family burden of the caregivers of the psychosis patients in community, and the psychosocial factors which influence the family burden.Methods Conducted some questionnaires to survey the requirement and attitude on mental health knowledge,social support,family burden and coping style of the caregivers of the psychosis patients from the twelve communities which served as the stations for the psychosis of the twelve prefectures organized uniformly by Guangdong provincial disabled federation.Results 360 questionnaire was provided,and 308 replied to our questionnaire effectively.The mean score of each single item of the family burden questionnaire was beyond the moderate.The factor score of the economy burden was the highest among the factots of the economy burden(2.33±0.52),the daily activity of the family(2.17±0.53),the recreation activity of the family(2.00±0.58),the family relationship(2.10±0.54),the body health of the family members (2.03±0.65),and the mental health of the family members(2.09±0.68).The bad emotion and experience with the patients aggravated some factors of the family burden(P<0.05～0.01).According to correlation analysis and regression analysis,there were significant relation and impact between family burden with the requirement and attitude on mental health knowledge,subject support,coping style,age,economy,culture and so on(P<0.05～0.01). Conclusion Negative assumption to mental health will aggravate the family burden,transfering the positive message and changing passive coping style will help to reduce the family burden.
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@#ObjectiveTo investigate the negative emoion and the relative factors in the caregivers of the schizophrenia patients in community. Methods212 caregivers from 12 communities psychotic service stations in 12 prefectures in Guangdong were investigated with the Zung Self-rate of Depression, the experience and attitude of the psychosis, the requirement and attitude on mental health knowledge, the social support scale, the family burden scale and the simply coping style questionaire. ResultsThere were 112 caregivers with no depression (52.8%), 57 with mild depression (26.9%), 30 with middle depression (14.2%), 13 with severe depression (6.1%). More than 50% caregivers worry about unsafty, getting into trouble, worse reputation, genetics, felt scare, strained relationship with the patients. There were significant differences in the hopelessness, the strained relaionship, treatment in other cities, superstition, hospitalization longer between the depression and no depression group, as well as in the economy burden, the interference in the family living, the amusement of family, the family relaionship, the body health and the mental health of the other family members, but no significant in the factors of the requirement and attitude on mental healh knowledge. The caregivers with depression reported less social support than the caregivers with no depression, but there was no difference between these groups in utilization of support. ConclusionThe caregivers of the schizophrenia patients experience negative emotion in community, who need mental and material assistance and the education of the knowledge about diseases.
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@#ObjectiveTo investigate the negative emoion and the relative factors in the caregivers of the schizophrenia patients in community. Methods212 caregivers from 12 communities psychotic service stations in 12 prefectures in Guangdong were investigated with the Zung Self-rate of Depression, the experience and attitude of the psychosis, the requirement and attitude on mental health knowledge, the social support scale, the family burden scale and the simply coping style questionaire. ResultsThere were 112 caregivers with no depression (52.8%), 57 with mild depression (26.9%), 30 with middle depression (14.2%), 13 with severe depression (6.1%). More than 50% caregivers worry about unsafty, getting into trouble, worse reputation, genetics, felt scare, strained relationship with the patients. There were significant differences in the hopelessness, the strained relaionship, treatment in other cities, superstition, hospitalization longer between the depression and no depression group, as well as in the economy burden, the interference in the family living, the amusement of family, the family relaionship, the body health and the mental health of the other family members, but no significant in the factors of the requirement and attitude on mental healh knowledge. The caregivers with depression reported less social support than the caregivers with no depression, but there was no difference between these groups in utilization of support. ConclusionThe caregivers of the schizophrenia patients experience negative emotion in community, who need mental and material assistance and the education of the knowledge about diseases.
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Objective To find out about the current situation of mental health institutions in Guangdong. Methods An investigation via self-made questionnaires was made on the current situation of 62 mental health institutions in the province and a comparison was made of 22 mental hospitals between now and four years ago. Results Throughout the province, there were 9901 psychiatric beds, 1236 psychiatric doctors and 1909 psychiatric nurses, averaging respectively 1.16 beds, 0.15 doctors and 0.22 nurses per 10 thousand people. The bed utilization ratio was mostly 82.00% and only 12.00% of the mental health institutions adopted open management. A comparison of the 22 mental hospitals between now and 4 years ago showed that the numbers of hospital beds, doctors, doctors with associate senior professional tides and above, ECG machines, computers, hospital total income per year, and monthly charges for hospitalization had increased while the area of workplaces, the bed utilization ratio, the average number of daily outpatient visits, the average number of daily outpatient psychological consultations, and equipment other than ECG machines and computers remained unchanged and government funding had decreased. Couclusion The major problems with the mental health institutions in the province are shortage and lack of balance in the allocation of mental health resources, backwardness in the modes of management, difficulty in internal development, and reduction of government input.