Determination and difference analysis of bile acid active constituents of artificial bezoar in Babao jingfeng powder from different manufacturers / 中国药房

OBJECTIVE To establish the method for determination of bile acid active constituents （cholic acid， hyodeoxycholic acid and sodium taurocholate） in Babao jingfeng powder， and to compare the differences of 3 constituents in Babao jingfeng powder from different manufacturers. METHODS UPLC-MS method was adopted to determine the contents of cholic acid， hyodeoxycholic acid and sodium taurocholate in 9 batches of Babao jingfeng powder from 3 manufacturers. The separation was performed on a Phenomenex Luna® C18 column with mobile phase consisted of acetonitrile-water （gradient elution） at a flow rate of 0.5 mL/min. The column temperature was 40 ℃ and the sample size was 2 μL. MS system was operated in a negative ion single quadrupole mode， and the m/z of cholic acid， hyodeoxycholic acid and sodium taurocholate were 407.2， 392.2 and 514.2， respectively. With the contents of three components as the index， cluster analysis and principle component analysis were performed on 9 batches of samples. RESULTS The linear ranges of cholic acid， hyodeoxycholic acid and sodium taurocholate were 5.48- 548.40， 5.38-538.40， 4.74-474.05 ng/mL， respectively （r≥ 0.999 3）. RSDs of precision， repeatability and stability tests（24 h） were all lower than or equal to 3.7% （n＝6）， and the average recoveries were 103.3%， 103.3% and 101.6% with RSDs of 3.3%， 3.4%， 4.2% （n＝6）， respectively. The contentsof cholic acid ranged 0.702-1.711 mg/g， those of deoxycholic acid ranged 0.599-2.049 mg/g， and those of sodium taurocholate ranged 0.664-1.752 mg/g in 9 batches of samples. The average content of 3 components in samples from manufacturer A was high， and the difference between batches was the smallest； the average content of 3 components from manufacturer C was the lowest， and the difference between batches was large. Cluster analysis could basically distinguish samples from different manufacturers； cluster analysis was conducted by using the comprehensive score of principal components as an indicator， the results of which were basically consistent with those of cluster analysis for content. CONCLUSIONS The method is established successfully for the content determination of the 3 bile acid active constituents of artificial bezoar in Babao jingfeng powder. The contents of 3 components in Babao jingfeng powder from 3 manufacturers are significantly different.

On the application of teaching ward-round workshop in the teaching ability training for clinical teachers / 中华医学教育探索杂志

Objective:To explore the application effect of the teaching ward-round workshop on the teaching ability training for clinical teachers.Methods:From July to October 2019, 83 clinical teachers from The Affiliated Huai'an No.1 People's Hospital of Nanjing Medical University included in the study were divided into 8 groups for the training of teaching ward-round workshop. After the training, the evaluation results of clinical teaching ward-round, the satisfaction of clinical teaching ward-round, and the satisfaction of the workshop teaching model were compared. Chi-square test and t test were performed by SPSS 22.0. Results:The trainees were highly satisfied with the training mode of the teaching ward-round workshop. After the training, the clinical teaching ward-round assessment scores [(96.83±1.77) points] were higher than the average scores of the same period from April to June in 2019 [(91.25±2.86) points], with statistical significance ( P<0.05). In terms of satisfaction with clinical teaching ward rounds, the scores of 7 dimensions including preparation before ward rounds, highlighting the key and difficulties, and standard physical examination after the training were all higher than those before the training, with significant differences ( P<0.05). Conclusion:The training model of the teaching ward-round workshop helps to enhance the training effect, promote the teaching ability of clinical teachers, and improve the clinical teaching ward-round assessment results and satisfaction, which provides new ideas and references for the training of clinical medical professionals.

The level and significance of CD4 + CD25 + Foxp3 + Treg in peripheral blood of patients with type 2 diabetic peripheral neuropathy / 中国医师杂志

Objective:To investigate the level and significance of CD4 + CD25 + Foxp3 + Treg in peripheral blood of patients with type 2 diabetes mellitus (T2DM) peripheral neuropathy. Methods:160 patients with T2DM (T2DM group) treated in Yancheng First People's Hospital from January 2018 to March 2019 were selected, including 54 patients with peripheral neuropathy and 106 patients without peripheral neuropathy. At the same time, 160 healthy people were selected as the control group to detect the levels of CD4 + CD25 + Foxp3 + Treg and 25-(OH)D 3 in peripheral blood. Pearson correlation analysis was used to analyze the correlation between CD4 + CD25 + Foxp3 + Treg in peripheral blood and other indexes. The receiver operating characteristic (ROC) value curve was used to analyze the predictive value of CD4 + CD25 + Foxp3 + Treg in peripheral blood of type 2 diabetic peripheral neuropathy. Results:The ratio of CD4 + CD25 + Foxp3 + Treg in T2DM group was (7.82±1.03)%, which was significantly lower than that in control group [(15.53±3.82)%, P<0.05]; The duration of T2DM patients with peripheral neuropathy was (7.71±1.18)years, which was significantly longer than that without peripheral neuropathy ( P<0.05), while the proportions of 25-(OH)D 3 and CD4 + CD25 + Foxp3 + Treg were (49.88±12.27)mmol/L and (5.88±1.20)% respectively, which were significantly lower than that without peripheral neuropathy ( P<0.05); Patients with peripheral neuropathy in group T2DM had significantly higher Michigan Diabetic Neuropathy Scores (MDNS) than that in patients without peripheral neuropathy [(14.82±2.01) vs (4.41±0.43), P<0.05]. The CD4 + CD25 + Foxp3 + Treg was positively correlated with 25-(OH)D 3 ( r=0.367, P<0.05), and negatively correlated with MDNS ( r=-0.398, P<0.05); the CD4 + CD25 + Foxp3 + Treg predicted that the area under the ROC curve of T2DM patients with peripheral neuropathy was 0.822, the cut-off value was 6.50%, and the sensitivity and specificity were 80.00% and 72.00% respectively. Conclusions:The level of CD4 + CD25 + Foxp3 + Treg in peripheral blood of T2DM patients decreased, which may play a role in the occurrence and development of peripheral neuropathy.

The application of multi-level comprehensive model in the evaluation of medical practical teaching effect / 中华医学教育探索杂志

Objective:To evaluate the effectiveness of medical practical training with a multi-level comprehensive model.Methods:We randomly selected 100 medical undergraduates who received practical training in The Affiliated Huai'an No.1 People's Hospital of Nanjing Medical University from 2017 to 2019, 20 medical education experts, and 30 teachers for a questionnaire survey using self-designed questionnaire with 3 first-level items, 8 second-level items, and 31 third-level items. Data processing and analysis was made by multi-level comprehensive model.Results:The comprehensive evaluation data (0.176 4, 0.512 3, 0.252 5, 0.058 8) obtained by the multi-level comprehensive model showed that the proportions of medical undergraduates achieving excellent, good, moderate, and poor effects of medical practical training were 17.64%, 51.23%, 25.25%, and 5.88% respectively. According to the principle of maximum membership, the final comprehensive evaluation result of the effectiveness of medical practical training was "good".Conclusion:This research has demonstrated the scientificity and feasibility of using the proposed multi-level comprehensive model to evaluate the effectiveness of medical practical teaching. In the comprehensive evaluation, the quantitative processing of qualitative indices can generate the matching score of each index in the multi-level index system. The evaluation results are intuitive and easy to analyze, thus providing the basis for the targeted improvement of medical practical teaching effect.

Application of fuzzy comprehensive model for evaluating the mental quality of medical students / 中华医学教育探索杂志

Objective To explore the application of fuzzy mathematics theory in the evaluation of medical students' comprehensive mental quality. Methods A total of 80 medical undergraduates studying in the Affiliated Huai'an No.1 People’s Hospital of Nanjing Medical University from October to December 2017 were randomly selected to conduct a questionnaire survey on medical students' mental quality. The questionnaires were designed by the study group, containing 3 first-level items (learning pressure, life stress and interpersonal stress), and 19 secondary items, with the recovery rate as 95%. Fuzzy comprehensive evaluation method was used for data processing and analysis. Results By comparing the data obtained from the comprehensive evaluation of the secondary factors with those of the pre-set evaluation set, the study concluded that 25.00% of the medical students need to adjust the future pressure, 41.70% the family health status pressure and 26.79% the appearance pressure according to the principle of maximum mem-bership degree. The comprehensive evaluation of the first four factors (0.249 7, 0.268 9, 0.270 2, and 0.211 2) showed that the comprehensive mental quality of medical students was "good". The quantitative analysis results showed that 27.02% of the medical students had good comprehensive mental quality, 24.97% need the mental quality adjustments, 26.89% had the average mental quality, and 21.12% had outstanding mental quality. Fuzzy comprehensive evaluation indicated that it is necessary to adjust the learning pressure and life stress of medical students, while the interpersonal stress had little effect on the mental quality of medical students. Conclusion The fuzzy comprehensive evaluation adopts the quantitative method to deal with the qualitative indicators uniformly, being scientific and reasonable. The corresponding data of each indicator can be easily identified with the help of the indicator system built up in the evaluation, which provides evidence for distinguishing and improving the corresponding decision-making for improving the medical students' mental quality. This evaluation method has strong applicability and provides new methods and ideas for objectively evaluating the comprehensive mental quality of medical students.

Association analysis of the nutritional status and related factors in patients with Parkinson's disease / 中华神经科杂志

Objective To investigate the association between the nutritional status and related factors in patients with Parkinson's disease (PD).Methods Seventy-two patients with PD (PD group) and 71 age-and sex-matched healthy controls (control group) were enrolled in this study from September 2014 to November 2017 at the First Affiliated Hospital of Sun Yat-sen University.Their serum nutritional indices,including serum albumin,prealbumin,transferrin,free fatty acid and retinol conjugated protein,were collected.The PD participants were interviewed and assessed using motor and non-motor scales,including Hoehn and Yahr stage,Movement Disorder Society-Unified Parkinson's Disease Rating Scale (MDS-UPDRS),Non-Motor Symptoms Questionnaire for Parkinson's Disease (NMSS),Mini-Mental State Examination (MMSE),Unified Dyskinesia Rating Scale (UDysRS) and 39-item Parkinson's Disease Questionnaire (PDQ-39).Their medication dosage was indicated by daily levodopa equivalent doses (LEDD).Body mass index (BMI) was used to determine their nutritional status,with abnormal nutritional status defined as BMI lower than 20 kg/m2.Results Levels of serum albumin (41.60 (40.28,43.98) g/L vs 44.00 (42.30,46.20) g/L,Z=4.500,P＜0.01),transferrin ((2.32±0.34) g/L vs (2.51±0.34) g/L,t=-3.305,P=0.001),and free fatty acid (418.00 (289.75,637.25) μmol/L vs 547.00 (386.00,699.00) μmol/L,Z=2.079,P=0.038) of the PD group were significantly lower than those of the control group.There was a significant negative correlation between serum albumin and MDS-UPDRS-Ⅱ score (r=-0.254,P=0.031),MDS-UPDRS-Ⅳ score (r=-0.256,P=0.030),years of dyskinesia (r=-0.240,P=0.043),years of motor fluctuation (r=-0.304,P=0.009) and LEDDs (r=-0.321,P=0.006).Disease duration was negatively correlated with serum albumin (r=-0.285,P=0.015) and transferrin (r=-0.275,P=0.019),and age (r=-0.252,P=0.032) was negatively correlated with prealbumin.The forward binary Logistic regression model indicated that abnormal nutritional status was closely associated with rigidity (OR=1.171,95％CI 1.013-1.354,P=0.032),akinesia (OR=1.070,95％CI 1.000-1.144,P=0.048),UDysRS score (OR=1.051,95％CI 1.004-1.099,P=0.032),MDS-UPDRS-Ⅳ score (OR=1.177,95％CI 1.018-1.360,P=0.027) and MMSE score (OR=0.821,95％CI 0.678-0.994,P=0.043),but not correlated with tremor and axial symptoms.Compared with PD patients with abnormal nutritional status,PD patients with normal nutritional status had higher MMSE scores (28.00 (27.00,29.00) vs 28.00 (25.00,28.00),Z=-2.060,P=0.039),lower rigidity (9.60±3.83 vs 12.00±4.29,t=-2.264,P=0.027),akinesia (19.98 ± 8.00 vs 24.42:±:8.06,t=-2.071,P=0.042) and MDS-UPDRS-Ⅳ scores (8.00 (5.00,11.00) vs 10.00 (9.00,13.00),Z=2.642,P=0.008).Conclusions PD patients tend to have a lower serum nutritional indices.PD patients with lower levels of serum nutritional indices are characterized by more severe motor complication,longer disease duration,older age and higher LEDD.PD patients with abnormal nutritional status have worse cognition and more severe motor symptoms (rigidity,akinesia and motor complication).

Clinical Study of Androgen Receptor (CAG) Gene Polymorphism and Androgen in Male with Salt Sensitive Hypertension / 现代检验医学杂志

Objective To investigate the relationship between androgen receptor CAG-gene polymorphism and androgen in male with salt sensitive hypertension.Methods Through the oral saline loading test and furosemide volume method male hypertension group were divided into salt-sensitive (SS group) and salt-insensitive (SR group).The samples from 161 males were selected in the study,including salt sensitive hypertension patients (SS group,61/161),salt-insensitive hypertension patients (SR group,40/161) and age-matched healthy samples (control group,60/161).All samples were sequenced with an analysis method (CAG) n repeated polymorphism,and determinated of total testosterone (TT) and free testosterone (FT) level in serum by electrochemiluminescence immunoassay.Results The number of CAG repeats was 14～34,average 22.4± 2.7.The CAG repeats of SS,SR and control group were 23.5±3.75,22.3±3.17 and 21.8±2.95,respectively.There were significant differences among the three groups (t=2.627～ 3.257,all P＜0.05).The level of TT and FT in SS and SR group were decreased compared with that of control group.At the same time,the level of SS group was lower,and there were significant differences among the three groups (t=2.524～ 3.826,all P＜0.05).Conclusion The androgen receptor gene repeat length and androgen levels are associated with male hypertension,especially salt-sensitive hypertension.Long (CAG) n repeat polymorphism maybe a genetic factor in the pathogenesis of hypertension.Plasma androgen levels may be used as a predictor of male salt sensitive hypertension.

Application of case education based on the ADDIE model in nurse education / 中华医学教育探索杂志

Objective To explore the effect of case teaching method based on ADDIE model in the teaching of surgical nursing. Methods Two classes of the four-year nursing specialty college students (39 students in each class, 78 students in total) in the third grade were selected as samples. According to the principle of randomization, one class was set as the observation group, and the ADDIE model based on case teaching method was adopted. According to the five stages of ADDIE model, namely, analysis, design, development, implementation, and evaluation, the whole process was performed to achieve teaching goals and timely combination of clinical cases, so that the theoretical knowledge of teaching materials and clinical reality were highly connected. The other class was set as the control group. At the end of the semester, the teaching results were evaluated based on two groups of students' test scores and questionnaire findings. SPSS13.0 software was used for statistical analysis. t-test was used to test the significance of the test results,and chi square test was used to test the significance of the survey data. The results of the two teaching methods were compared with the control group. Results The scores of the two groups were significantly higher than those of the control group [(87.0±7.1) vs (78.0±8.6), P=0.000; (93.0±2.4) vs (85.0±3.8), P=0.000]. Significantly more students in the observation group (P<0.05) were satisfied with the teaching methods used to improve the enthusiasm and initiative of learning, improve their interest in learning, broaden their knowledge, improve the effect and efficiency of learning, inspire students to think, associate, and innovate, activate classroom atmosphere, improve the ability of students to analyze and solve problems, apply theories in practice, and accurately grasp the basic concepts and theoretical knowledge. Conclusion The case teaching method based on ADDIE model can effectively improve the teaching quality of nursing courses and improve students' ability to analyze and solve problems. It is well received by students, and it can enhance teachers' teaching skills as well.

Expression of Human Epidermal Growth Factor Receptor 2 and Correlation with Clinical Pathological Features in Breast Cancer / 现代检验医学杂志

Objective To evaluate of value of HER2 as a prognostic marker,and to analysis associations with common his-topathological parameters in BC cases.Methods In this study,formalin-fixed,paraffin-embedded samples of tumors from 160 breast cancer patients who underwent curative surgery proce-dures between 2011 and 2014 were tested by immunohisto-chemistry (IHC)as aprimary estimate of HER2 status,followed by fluorescence in situ hybridization (FISH).Concordance rate between IHC and FISH was evaluated.Theχ2 test was used to evaluate the correlation between HER2 gene amplifica-tion status and different clinical pathological features including:(estrogen receptor)ER and (progesterone receptor)PR ex-pression,age,menopausal status and tumor size.Results There was a significant inverse association between expression of hormone receptors (ER and PR)and HER2 amplification (all P0.05).HER2-negative le-sions were of higher grade and more likely to be ER-negative,PR-negative,p5 3-positive,lymph node metastasis,and also Ki-67≥20% as compared to the HER2-positive group and HER2 overe xpression was associated with the levels of ER and PR. Conclusion There is correlation of many clinical factors with HER2 expression.

Predictive Value of HER2/neu Amplification and Lymphovascular Invasion for Axillary Lymph Node Metastasis in Early Breast Cancer Patients / 现代检验医学杂志

Objective To study the predictive value of HER2/neu amplification and lymphovascular invasion for axillary lymph node metastasis in T1 breast cancer patients(mass<2 cm).Methods Reviewed the medical record of 206 T1 breast cancer patients who were the presence or absence of lymph node metastasis with IHC and FISH,analyzed the association be-tween ALNM and various clinicopathological predictive factors such as age,tumor size (T1a,T1b,T1c),multiplicity,the his-tologic grade,the nuclear grade,the presence of lymphovascular invasion (LVI),the estrogen and progesterone receptor sta-tus,an HER2/neu expression,the Ki-67 labeling index and the bcl-2 expression,and discussed the correlation of the various factors with axillary lymph node metastasis of T1 breast cancer.Results One hundred and thirty-nine were the node nega-tive group (T1N0)and the remaining 67 cases were allotted to the node positive group (T1N1-3),age (χ2 = 6.484,P =0.011),LVI (χ2 =72.813,P <0.001),histologic grade (χ2 =74.813,P =0.019),HER2/neu (χ2 =74.813,P <0.005),Ki-67 (χ2 =6.255,P =0.012)and bcl-2 (χ2 =4.977,P =0.026)were the statistically significant predictive factors related to node metastasis.The factors such as tumor size (χ2 =1.544,P =0.254),surgical method (χ2 =2.414,P =2.414),and ucle-ar grading HG (χ2 =2.017,P =0.159),estrogen receptors ER (χ2 =0.140,P =0.709),progesterone receptor PgR (χ2 =2.199,P =2.199),have no significant statistical correlation with early breast cancer lymph node metastasis.Conclusion HER2/neu overexpression and LVI were related to the increased incidence of ALNM in T1 breast cancer patients,LVI was the most predictive factor of ALNM.

Clinical evaluation of ultrasound-guided percutaneous microwave ablation of splenic tumors / 南方医科大学学报

<p><b>OBJECTIVE</b>To investigate the feasibility, safety and efficacy of ultrasound-guided percutaneous microwave ablation (MWA) of splenic tumors.</p><p><b>METHODS</b>Seven patients with 8 pathologically confirmed splenic tumors (including 2 metastases from the ovary and 4 from the lung, gastric adenocarcinoma, hepatocellular carcinoma, or rectal carcinoma; 1 hemangioma and 1 inflammatory pseudotumor) with sizes ranging from 1.3 to 6.2 cm (mean 3.1 ± 1.9 cm) were treated with MWA. A cooled shaft needle antenna was percutaneously inserted into the tumor under ultrasound guidance. A thermocouple was placed about 0.5 cm away from the tumor to monitor the temperature in real time during the ablation. The microwave emitting power was set at 50-60 W. The treatment efficacy was assessed by contrast-enhanced imaging at 1, 3 and 6 months following the procedure, and every 6 months thereafter.</p><p><b>RESULTS</b>All the tumors were completely ablated in a single session and no complications occurred. No local tumor progression was observed during a median follow up time of 13 months (4 to 92 months). The ablation zone, well defined on contrast-enhanced imaging, was gradually reduced with time. A new metastatic lesion was detected in the spleen at 11 months after the ablation in a ovarian carcinoma patient and was successfully treated by a second MWA. The post-ablation survival of the patients with splenic metastasis was 13 months (range 4 to 92 months). No complications other than fever and abdominal pain were observed in these patients.</p><p><b>CONCLUSION</b>Ultrasound-guided percutaneous MWA is a safe and effective minimally-invasive technique for treatment of splenic tumors in selected patients.</p>

Application of [11C] CFT dopamine transporter PET imaging in the diagnosis and severity assessment of Parkinson disease / 中国神经精神疾病杂志

Objective To investigate the clinical value of [11C]CFT PET in the diagnosis and severity assessment of Parkinson disease (PD). Methods Thirty-eight patients with PD at various Hoehn & Yahr (H&Y) stages were included and underwent a [11C]CFT PET scan. The correlation between [11C]CFT uptake and unified Parkinson disease rating scale part III (UPDRS III) of PD patients was evaluated by calculating Pearson’s regression coefficient. Statistical parametric mapping (SPM) analysis was performed to compare the difference of dopamine transporter (DAT) distribution between ear-ly and advanced PD patients. Results There was a significant reduction of [11C]CFT uptake in the bilateral striatum of PD patients. There was a significant negative correlation between clinical scores of UPDRS III, rigidity, bradykinesia, pos-ture, gait and [11C]CFT uptake in the striatum. The SPM analysis revealed a significant and asymmetric decrease of [11C] CFT uptake in the striatum, predominantly on the putamen and caudate nucleus contralateral to the onset limb, in the posterior area of ipsilateral putamen in early PD (H&Y 1-2) patients compared with the normal controls. There was a sig-nificant symmetric decrease of [11C]CFT uptake in both putamen and caudate nucleus in advanced PD (H&Y 3-5) pa- tients, compared with normal controls. Compared with early PD patients, the reduction of DAT was more severe in bilater-al caudate nucleus and the ipsilateral putamen in the advanced PD patients. Conclusions [11C]CFT PET is a sensitive biomarker in the diagnosis and assessment of disease severity of PD patients.

Effects of Rho-kinase inhibitor and Qiliqiangxin capsules on serum cytokines in patients with chronic heart failure / 中国生化药物杂志

Objective To observe the short term effects of Rho-kinase inhibitor and Qiliqiangxin capsule on serum tumor necrosis factor-α(TNF-α)and interleukin-6(IL-6)levels in patients with chronic heart failure,and explore the mechanism.Methods 120 chronic heart failure patients received conventional treatment for 4 weeks were divided into blank control group(Group A,n=30),Rho-kinase inhibitor treated group(Group B,n=30), Qiliqiangxin capsules-treated group (Group C,n =30 ),and the other 30 cases were treated with Rho-kinase inhibitor combined with Qiliqiangxin capsules(GroupD,n=30).TNF-α,IL-6 and BNP were measured and cardiac function was evaluated before and after treatment.The difference between 4 groups was analyzed. Results After treatment,the levels of TNF-α,IL-6,BNP in the observation group were lower than that in the control group.The difference was statistically significant(P<0.05 ).The levels of TNF-α,IL-6,BNP in the D group were lower than that in the B and C group.The difference was statistically significant(P<0.05 ).Conclusion Rho-kinase inhibitor combined with Qiliqiangxin capsule can improve cardiac function and reduce levels of serum cytokines associated with chronic heart failure,which is conducive to the treatment of chronic heart failure.

Transabdominal preperitoneal laparoscopic hernia repair with crossencircling arms of mesh / 国际外科学杂志

Objective To explore the feasibility and application skills of transabdominal preperitoneal prosthesis (TAPP) with cross-encircling arms of mesh.Methods From Septemer 2009 to February 2012,46 cases were given TAPP with cross-encircling arms of mesh.The clinical data and surgery videos were retrospectively analyzed.Results All of the 46 cases with 53 inguinal hernias were successful in TAPP.The mean operative time of unilateral hernia was (57.74 ± 11.89) min,the mean operative time of 7 cases with biliateral hernia was (83.86 ±20.42) min and the longest time was 125 min.There were 6 cases with the contralateral hidden hernia,2 cases with hematoma,1 case with paresthesias of skin,no realpse.Conclusion The mesh with cross-encircling arms can be exactly fixed by spermatic cord,ductus deferens or round ligament of uterus,without stitching and stappling.

The expression and correlation of inducible nitric oxide synthase, Bax and Bcl-2 in nasal polyps / 临床耳鼻咽喉头颈外科杂志

OBJECTIVE@#To detect the expressions of inducible nitric oxide synthase (iNOS), apoptosis-related gene Bax, Bcl-2 in nasal polyps,and discuss the their relationship.@*METHOD@#The apoptosis of 30 cases of nasal polyps was detected by TUNEL assay. The expressions of iNOS and Bax, Bcl-2 was detected by immunohistochemical SABC method. The expressions of iNOS and Bax, Bcl-2 was measured by western blot.@*RESULT@#1) The weakly positive stained apoptotic cells were detected at the surface epithelial cells and glandular epithelial cells of nasal polyps by TUNEL assay. 2) Immunohistochemical method revealed that positive stainings of iNOS, Bax, Bcl-2 located in the cytoplasm of epithelial cells, glandular epithelial cells, endothelial cells and infiltrating inflammatory cells in nasal polyps. The expression of Bax was weak, while the expressions of iNOS and Bcl-2 were strong. 3) iNOS, Bcl-2 and Bax was detected by western blot. The expressions of these proteins were significantly different (P<0.01). The expression of iNOS and Bcl-2 had a positive correlation (r=0.851, P<0.01), while the expression of iNOS and Bax had a negative correlation (r=-0.714, P<0.01).@*CONCLUSION@#The pro-apoptotic and anti-apoptotic proteins are co-existed in the nasal polyps, iNOS may play an important role in the pathogens of nasal polyps through inhibition of apoptosis.

Nursing of elderly patients with osteoporotic intertrochanteric fracture of femur undergoing artificial femoral head replacement / 中国实用护理杂志

Objective To summarize the nursing methods and effect of artificial femoral head replacement in treatment of osteoporotic interttochanteric fracture in elderly patients. Methods 55 patients with esteoporotic intertrochanteric fracture were selected in our hospital from February 2007 to February 2011.All patients were cared by targeted preoperative and postoperative nursing,helping them conducting functional training in time,giving discharge counseling and follow-up.The hip functional recovery of patients was evaluated by using the Harris evaluation standard,and the excellent rate of surgery was also evaluated. Results After the targeted care,55 patients went through the perioperative period safely,the average length of stay was ( 14.0 ± 3.1 )days,a total of 5 cases (9.09％)patiants suffered varying degrees of complications which were improved after symptomatic treatment.Patients were followed up for 3 to 36 months,only 2 patients died of cerebral vascular accident,all patients gained good recovery of hip function.Harris score was (84.45 ± 9.38),the excellent rate of surgery reached 78.18％. Conclusions Atificial femoral head replacement proves significant effect in treatment of osteoporotic intertrochanteric fractures in elderly patients,but with the accompanying surgical compliuations,special care and timely functional exercise methods should be paid attention to.

The analysis of training effect about pediatric advanced life support courses in sichuan region / 中国小儿急救医学

Objective To compare the skills level before and after pediatric advanced life support course and analyze the effect of the training. Methods The pediatric advanced life support was used as the textbook. The skills were got through attending theory classes, watching demonstrations and taking part in the simulator training. The questionnaires were filled strictly and the data was analysed. Results The test scores were increased after the training (P＜0. 01). There were only 8.7% of the trainees had used the rescue equipments and 61.3% had never seen the rescue equipments before training. More than 80% of the trainees were satisfied with the training about the utility and novelty. Conclusion pediatric advanced life support course can successfully deliver a large number of healthcare providers with international unique pediatric emergency treatment skills ,and raise the participants abilities of rescuing critical children.

Development and validation of a liquid chromatography-isotope dilution tandem mass spectrometry for determination of olanzapine in human plasma and its application to bioavailability study / 药学学报

A simple, reliable and sensitive liquid chromatography-isotope dilution mass spectrometry (LC-ID/MS) was developed and validated for quantification of olanzapine in human plasma. Plasma samples (50 microL) were extracted with tert-butyl methyl ether and isotope-labeled internal standard (olanzapine-D3) was used. The chromatographic separation was performed on XBridge Shield RP 18 (100 mm x 2.1 mm, 3.5 microm, Waters). An isocratic program was used at a flow rate of 0.4 m x min(-1) with mobile phase consisting of acetonitrile and ammonium buffer (pH 8). The protonated ions of analytes were detected in positive ionization by multiple reactions monitoring (MRM) mode. The plasma method, with a lower limit of quantification (LLOQ) of 0.1 ng x mL(-1), demonstrated good linearity over a range of 0.1 - 30 ng x mL(-1) of olanzapine. Specificity, linearity, accuracy, precision, recovery, matrix effect and stability were evaluated during method validation. The validated method was successfully applied to analyzing human plasma samples in bioavailability study.

Pathogen identification of Pinellia ternata tuber disease and selection of fungicide / 中国中药杂志

The rotten tuber of Pinellia ternata was found as an important disease during the growing season in Tianshui production area. The isolated pathogens were tested following Koch's postulates and identified as Fusarium oxysporum. The suitable growth conditions for the F. oxysporum were 15-30 degrees C, pH 6-8, the optimal condition was 21.9 degrees C and pH 7.2. Some fungicides were demonstrated to be effective to inhibit the pathogen growth. 70% thiophanate-methyl and 58% metalaxyl MZ were most effective to inhibit the pathogen. The EC50 were 0.002 7, 0.066 2 g x L(-1), respectively.

The effect of insulin glargine plus metformin on inflammatory factors in the treatment of patients with newly diagnosed type 2 diabetes / 中国综合临床

Objective To observe the effect of insulin glargine plus mefformin on inflammatory factors(IF) in the treatment of patients with newly diagnosed type 2 diabetes(T2DM).Methods 110 patients with newly diagnosed T2DM were given insulin glargine(beginning dose:10 U/d) and mefformin(0.5 g,tid) for 12 weeks;while 100 cases selected for the same period from the normal healthy population were taken as control group.Baseline fasting blood glucose(FPG),2 h postprandial blood glucose(2 hPG),glycosylated hemoglobin (HbA_1c),C-reactive protein(CRP),TNF-α and IL-6 were observed.Results Before treatment,FPG,2 hPG,HbA_1c and IF in T2DM group were obviously higher than those in control group(P＜0.05),but there was no difference in other clinical data (P＞0.05).After 12 weeks treatment,in T2DM group there was a significant improvement in blood glucose targets [FPG from (14.8±3.9) mmol/L to (6.6±2.1) mmoL/L;2 hPG from (17.6±3.3) mmol/L to (8.3±1.2)mmol/L;HbA1c from (9.6±2.7)% to (6.5±0.8)%,t=7.40,8.37,3.98,P＜0.05],and the level of IF also decreased significantly [CRP from (8.8±2.5) mg/L to (5.5±1.4) mg/L;TNFα from (2.9±0.6) ng/L to (1.6±0.2) ng/L;IL-6 from(170.3±22.2) pg/L to (105.9±14.6) pg/L,t=4.61,3.52,5.68,P＜0.05].Conclusions Insulin glargine and mefformin combined therapy can improve glucose metabolism in patients with newly diagnosed T2DM,and decrease the levels of IF.